Epidemiological and clinical characteristics of COVID-19 patients in Nantong, China

Introduction: COVID-19 is a newly emerging life-threatening respiratory disease caused by a newly identified coronavirus SARS-CoV-2. Methodology: We included 28 COVID-19 patients admitted to Nantong Third Hospital from January 23 to February 26, 2020. SARS-CoV-2 infection was confirmed using real-time RT-PCR. The demographic, epidemiological, clinical, laboratory parameters were obtained from each patient. Results: The vast majority (71.4%) of confirmed COVID-19 patients were brought in from outside of the city, and all others had contact history with these confirmed cases. The median age of patients was 50 years old and half had underlying diseases. The most common symptoms at the onset of illness were fever (96.4%), cough (67.9%), and chilly (28.6%), and 75.0% patients had two or more symptoms. Increased erythrocyte sedimentation rate, serum ferritin and C-reactive protein levels, and reduced absolute counts of total lymphocytes and T lymphocyte subsets were observed among the patients. The vast majority (85.7%) of patients showed bilateral or unilateral pneumonia, and three symptomatic patients and one asymptomatic case did not show abnormalities in their CT image. Among the 28 admitted patients, 24 were discharged as of February 26, 2020, with an average hospital stay of 14.96 (±4.27) days, which was not significantly associated with the interval between the onset of symptoms and admission. Conclusions: In the absence of specific antiviral drugs or a vaccine, quarantine or isolation is the most effective intervention strategy for preventing the spread of the virus. Adequate supportive medical care is crucial for good prognosis of COVID-19 patients.

Download Full-text

Az anti-Jo-1-pozitív antiszintetáz szindróma jellegzetességei gondozott betegeink alapján

Orvosi Hetilap ◽

10.1556/650.2016.30400 ◽

2016 ◽

Vol 157 (15) ◽

pp. 575-583 ◽

Cited By ~ 1

Author(s):

Katalin Szabó ◽

Melinda Nagy-Vincze ◽

Levente Bodoki ◽

Katalin Hodosi ◽

Katalin Dankó ◽

...

Keyword(s):

Medical Records ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

Clinical Phenotype ◽

Demographic Data ◽

Clinical Results ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Worse Prognosis

Introduction: In idiopathic inflammatory myopathies, the presence of anti-Jo-1 antibody defines a distinct clinical phenotype (myositis, arthritis, interstitial lung disease, Raynaud’s phenomenon fever, mechanic’s hands), called antisynthetase syndrome. Aim: To determine the demographic data as well as clinical, laboratory and terapeutical features of anti-Jo1 positive patients, followed by the department of the authors. Method: The medical records of 49 consecutive anti-Jo1 patients were reviewed. Results: Demographic and clinical results were very similar to those published by other centers. Significant correlation was found between the anti-Jo-1 titer and the creatine kinase and C-reactive protein levels. Distinct laboratory results measured at the time of diagnosis of the disease (C-reactive protein, antigen A associated with Sjogren’s syndrome, positive rheumatoid factor), and the presence of certain clinical symptoms (fever, vasculitic skin) may indicate a worse prognosis within the antisyntetase positive patient group. Conclusion: In the cases above more agressive immunosuppressive therapy may be required. Orv. Hetil., 2016, 157(15), 575–583.

Download Full-text

Improved Recovery and Survival with Trimethoprim or Cotrimoxazole in Patients with Severe COVID-19: A Retrospective Analysis

10.47363/jvrr/2020(1)118 ◽

2020 ◽

pp. 1-6

Author(s):

Veronica A.Varney ◽

◽

Thomas John ◽

Thomas Samuel ◽

◽

...

Keyword(s):

Ventilatory Support ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Protein Levels ◽

Reactive Protein ◽

Life Threatening Illness ◽

Formyl Peptide ◽

Life Threatening ◽

Immunological Effects ◽

Oxygen Requirements

Background: COVID-19 may become a life-threatening illness as a result of acute respiratory distress syndrome with the mainstay of management supportive, although dexamethasone and serum from recovered patients look helpful in reducing mortality in oxygen dependant patients. Methods: We retrospectively analysed data from 22 patients with severe COVID-19 treated with trimethoprim (TMP) or cotrimoxazole (CTX) added to standard therapy antibiotics (ST) and compared this with anonymized data from 22 patients with COVID-19 of similar severity receiving ST alone. Results: Patients receiving additional TMP or CTX showed clinical improvement within 48 hours with reduced fever (p= 0.001), C-reactive protein levels (p=0.002) and oxygen requirements (SpO2/FiO2, p<0.001). Mortality was reduced (to 5% versus 32% for ST, p=0.022) and the need for ventilatory support (3 versus 16 patients on ST, p<0.001) and hospital length of stay (mean: 9 days versus 22 days on ST p<0.001). Discussion: This benefit may be due to combined antimicrobial and immunological effects of TMP and CTX. Both drugs block stimulation of the formyl peptide receptors (FPR’s) on the surface of circulating neutrophils and monocytes. When stimulated, FPR’s cause homing of neutrophils to the lung and trigger the release of Reactive Oxygen Series driving cytokine production and therefore a possible cytokine storm. Stressed neutrophils can extrude their nuclear content as ‘external nets’ (NETosis) to trap infectious agents, these nets can block the pulmonary alveolar bed giving severe hypoxia and death as seen in post mortems from COVID-19 patients. Blocking of neutrophil FPR’s by these drugs may be the mechanism by which they protect the lung in COVID-19.

Download Full-text

Amitriptyline overdose in emergency department of university hospital

Human & Experimental Toxicology ◽

10.1177/0960327113520019 ◽

2014 ◽

Vol 33 (9) ◽

pp. 980-990 ◽

Cited By ~ 9

Author(s):

S Paksu ◽

L Duran ◽

M Altuntas ◽

H Zengin ◽

O Salis ◽

...

Keyword(s):

Pediatric Patients ◽

Clinical Laboratory ◽

Good Prognosis ◽

High Serum ◽

University Hospital ◽

Age Group ◽

Pediatric Age ◽

Pediatric Age Group ◽

Life Threatening ◽

Amitriptyline Poisoning

Objective: The purpose of this study was to evaluate the patients with acute amitriptyline poisoning and investigate predictive factors for the development of life-threatening complications. Methods: Demographics, clinical, laboratory, and electrocardiographic (ECG) findings of 250 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied. Results: Median age of patients was 14.6 years, of which, 70% of patients were female and 66% were in pediatric age group. The most common pathological clinical finding and laboratory abnormality were alteration of consciousness and hyponatremia. The rate of convulsive seizure, arrhythmia, and respiratory depression were 17 (6.8%), 16 (6.4%), and 11 (4.4%), respectively. These complications were more seen in pediatric patients than adults (15.8% and 1.2%). The incidence of hyponatremia was more in pediatric patients and severe poisoning groups (38.8 and 53.4%, respectively). The levels of amitriptyline and nortriptyline were significantly higher in the group with complications than the group without complications ( p < 0.05). All adult patients were discharged with good prognosis. In pediatric age group, one patient was discharged with severe neurological sequelae and one patient died. QRS duration >100 ms, long corrected QT duration interval, and low Glasgow Coma Score (GCS) at admission were identified as independent risk factors for the development of life-threatening complications (odds ratio: 69.4, 1.9, and 1383, respectively; p < 0.05). Conclusion: Amitriptyline poisoning may be associated with life-threatening complications, especially in pediatric age group and in patients with hyponatremia. Low GCS, presence of hyponatremia, high serum drug levels, and pathological ECG findings on admission may be helpful in predicting the development of complications and poor prognosis.

Download Full-text

Prognostic value of pro-adrenomedullin and copeptin in acute infective endocarditis

BMC Infectious Diseases ◽

10.1186/s12879-020-05655-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rosa Zampino ◽

Domenico Iossa ◽

Maria Paola Ursi ◽

Lorenzo Bertolino ◽

Roberto Andini ◽

...

Keyword(s):

Infective Endocarditis ◽

Clinical Laboratory ◽

Low Cost ◽

Reactive Protein ◽

Disease Characteristics ◽

Life Threatening ◽

Cardiac Disorders ◽

Embolic Risk ◽

Worse Prognosis

Abstract Background Infective endocarditis (IE) is a life-threatening disease whose prognosis is often difficult to predict based on clinical data. Biomarkers have been shown to favorably affect disease management in a number of cardiac disorders. Aims of this retrospective study were to assess the prognostic role of procalcitonin (PCT), pro-adrenomedullin (pro-ADM) and copeptin in IE and their relation with disease characteristics and the traditional biomarker C-reactive protein (CRP). Methods We studied 196 patients with definite IE. Clinical, laboratory and echocardiography parameters were analyzed, with a focus on co-morbidities. PCT, pro-ADM and copeptin were measured on stored plasma samples obtained on admission during the acute phase of the disease. Results Pro-ADM and copeptin were significantly higher in older patients and associated with prior chronic kidney disease. Pro-ADM was an independent predictor of hospital mortality (OR 3.29 [95%C.I. 1.04–11.5]; p = 0.042) whilst copeptin independently predicted 1-year mortality (OR 2.55 [95%C.I. 1.18–5.54]; p = 0.017). A high PCT value was strictly tied with S. aureus etiology (p = 0.001). CRP was the only biomarker associated with embolic events (p = 0.003). Conclusions Different biomarkers correlate with distinct IE outcomes. Pro-ADM and copeptin may signal a worse prognosis of IE on admission to the hospital and could be used to identify patients who need more aggressive treatment. CRP remains a low-cost marker of embolic risk. A high PCT value should suggest S. aureus etiology.

Download Full-text

Clinical and Radiographic Characteristics, Management and Short-term Outcomes of Patients with COVID-19 in Wenzhou, China

10.21203/rs.3.rs-17032/v1 ◽

2020 ◽

Author(s):

Liang Hong ◽

Enling Ye ◽

Gangqiang Sun ◽

Xiaoyang Wang ◽

Shengguo Zhang ◽

...

Keyword(s):

Laboratory Tests ◽

Viral Disease ◽

Good Prognosis ◽

Medical Data ◽

Shortness Of Breath ◽

C Reactive Protein ◽

Short Term ◽

Protein Levels ◽

Reactive Protein ◽

Ct Examination

Abstract Background: Coronavirus disease 2019 (COVID-19) is an emerging viral disease. Here, we reported the clinical features, management, and short-term outcomes of COVID-19 patients in Wenzhou, an area outside Wuhan.Methods: Patients admitted to the Infectious Diseases Department of Ruian People's Hospital in Wenzhou, from January 21 to February 7, 2020, were recruited. Medical data on epidemiological history, demographics, clinical characteristics, laboratory tests, computerized tomography (CT) examination, treatment, and short-term outcomes were retrospectively reviewed. Blood biochemistry and routine tests were examined using standard methods and automatic machines. CT examination was performed again for several times during the hospitalization as necessary.Results: A total of 67 confirmed COVID-19 cases were diagnosed; 64 (95.4%) were common cases and three (4.5%) severe cases. The most common symptoms at admission were fever (86.6%), cough (77.6%), productive cough (52.2%), chest distress (17.9%), and sore throat (11.9%), followed by diarrhea (7.4%), headache (7.4%), shortness of breath (6.0%), dizziness (4.5%), muscular soreness (4.5%), and running nose (4.5%). Thirty patients (47.8%) had increased C-reactive protein levels. The CT radiographs at admission showed abnormal findings in 54 (80.6%) patients. The patients were treated mainly by oxygen therapy and antiviral drugs. By February 17, 2020, none of the 67 patients died and no infection occurred among medical staff in the department. Fifty-four (80.6%) patients were completely recovered and all others were improving.Conclusion: Cases in Wenzhou are mild, with good prognosis. Timely and appropriate screening, diagnosis, and treatment are the key to achieve the good outcomes.

Download Full-text

Positive correlation between neovascularization degree of carotid atherosclerosis determined by contrast-enhanced ultrasound and level of serum C-reactive protein

VASA ◽

10.1024/0301-1526/a000429 ◽

2015 ◽

Vol 44 (3) ◽

pp. 0187-0194 ◽

Cited By ~ 6

Author(s):

Xiaoni Chang ◽

Jun Feng ◽

Litao Ruan ◽

Jing Shang ◽

Yanqiu Yang ◽

...

Keyword(s):

Contrast Enhancement ◽

Rank Correlation ◽

Artery Stenosis ◽

Contrast Enhanced Ultrasound ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Contrast Enhanced ◽

Grade 3 ◽

Axis View

Background: Neovascularization is one of the most important risk factors for unstable plaque. This study was designed to correlate plaque thickness, artery stenosis and levels of serum C-reactive protein with the degree of intraplaque enhancement determined by contrast-enhanced ultrasound. Patients and methods: Contrast-enhanced ultrasound was performed on 72 carotid atherosclerotic plaques in 48 patients. Contrast enhancement within the plaque was categorized as grade 1, 2 or 3. Maximum plaque thickness was measured in short-axis view. Carotid artery stenosis was categorized as mild, moderate or severe. Results: Plaque contrast enhancement was not associated with the degree of artery stenosis or with plaque thickness. Serum C-reactive protein levels were positively correlated with the number of new vessels in the plaque. C-reactive protein levels increased in the three groups(Grade 1: 3.72±1.79mg/L; Grade 2: 7.88±4.24 mg/L; Grade 3: 11.02±3.52 mg/L), with significant differences among them (F=10.14, P<0.01), and significant differences between each two groups (P<0.05). Spearmans rank correlation analysis showed that serum C-reactive protein levels were positively correlated with the degree of carotid plaque enhancement (Rs =0.69, P<0.01). Conclusions: The combination of C-reactive protein levels and intraplaque neovascularization detected by contrast-enhanced ultrasound may allow more accurate evaluation of plaque stability.

Download Full-text