scholarly journals Association of Underlying Diseases and Clinical Characteristics with Mortality in Patients with 2019 Novel Coronavirus in Iran

2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Mohammadhossein Zamanian ◽  
Zohre Foroozanfar ◽  
Zhila Izadi ◽  
Samira Jafari ◽  
Hossein Derakhshankhah ◽  
...  
Keyword(s):  
Heart Disease ◽  
Clinical Characteristics ◽  
Underlying Disease ◽  
Test Results ◽  
Rt Pcr ◽  
Factors Associated ◽  
History Of ◽  
Novel Coronavirus ◽  
Underlying Diseases ◽  
Pcr Test

Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kermanshah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mortality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137; 55.9%), cough (n = 93; 38.0%), and fever (n = 78; 31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09; 95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07; 95% CI: 1.46 to 17.58), hypertension (OR = 5.82; 95% CI: 1.13 to 30.04), smoking (OR = 11.44; 95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31; 95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23; 95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383; 95% CI: 0.17 to 0.88) and fever (OR = 0.278; 95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.

scholarly journals Clinical Characteristics of 538 Novel Coronavirus Disease Patients with Chronic Underlying Diseases in Wuhan, China: A retrospective Study

2020 ◽  
Author(s):  
Wanwan Yi ◽  
Xiaqing Yu ◽  
Hengwei Fan ◽  
Hengmei Zhu ◽  
Zhongwei Lv ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Nucleic Acid ◽  
Clinical Characteristics ◽  
Underlying Disease ◽  
Disease Group ◽  
Negative Results ◽  
Examination Result ◽  
Significant Difference ◽  
Novel Coronavirus ◽  
Underlying Diseases

Abstract Background Novel severe acute respiratory syndrome coronavirus 2 causes the novel coronavirus disease (COVID-19) in humans, which has spread rapidly worldwide. Most critical cases of COVID-19 are accompanied by complicated chronic underlying diseases. This retrospective study aims to analyze the clinical characteristics of COVID-19 patients with chronic underlying diseases.Methods A total of 1,183 COVID-19 patients were divided into the chronic underlying disease (CUD, n = 538) group and the non-underlying disease (non-CUD, n = 645) group. The clinical characteristics and outcomes were collected and compared between the two groups.Results There were significant differences in age, weight, and SPO2 on admission between the CUD and non-CUP groups. The ratio of severe cases in the CUD group was higher than that in the non-CUD group (χ2 = 35.58, p-value < 0.001). The white blood cell count, neutrophil count, C-reactive protein, urea nitrogen, creatinine, myoglobin, and cardiac troponin in the CUD group were significantly higher than those in the non-CUD group, while the lymphocyte count and albumin in the underlying disease group were significantly lower than those in the non-underlying disease group. No significant difference was found in the total number of tests, the number of positive or negative results in nucleic acid tests between the two groups. The negative rate for both IgG- and IgM-antibody tests in the CUD group was higher than that in the non-CUD group (χ2 = 5.57, p-value = 0.018). No statistical difference in mortality between the CUD (n = 18) and non-CUD groups (n = 13). All surviving patients were cured and discharged. A total of 33 patients had a positive re-examination result for nucleic acid test one week after discharge, including 14 patients with underlying diseases and 19 patients without underlying diseases. Conclusion: COVID-19 patients with underlying diseases had poorer clinical conditions and had a longer hospital stay, but after active treatment, the mortality had not increased significantly.

scholarly journals Changes in RT-PCR test results and symptoms during the menstrual cycle of a female individual infected with SARS-CoV-2: a case report

2020 ◽  
Author(s):  
Hua Zheng ◽  
Juan Tan ◽  
Ke Ma ◽  
Weihua Meng
Keyword(s):  
Menstrual Cycle ◽  
Hospital Discharge ◽  
Disease Susceptibility ◽  
Menstrual Period ◽  
Test Results ◽  
Rt Pcr ◽  
Case Presentation ◽  
Management Protocol ◽  
History Of ◽  
Pcr Test

Abstract Background: The implications of the menstrual cycle for disease susceptibility, development, and severity of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are largely unknown.Case presentation: We report a 37-year-old woman infected with SARS-CoV-2 who showed a 16-day incubation period. She developed a fever on the first day of her menstrual period, and again on the first day of her next menstrual period after hospital discharge. RT-PCR test results were positive during the first menstrual period before admission, turned negative during hospitalization, and then positive again during the second menstrual period after hospital discharge.Conclusions: This case indicates sex hormones may play an important role in SARS-CoV-2 infection. For women with history of exposure to SARS-CoV-2, the management protocol should include assessment of the menstrual status.

scholarly journals Persistence of SARS-COV-2 in body fluids: a bystander or whistle blower

2020 ◽  
Author(s):  
Ishani Bora ◽  
Sanjib Gogoi ◽  
Vaishnavi Venkatasubramanian ◽  
Roshan Mathew ◽  
Ritin Mohindra
Keyword(s):  
Clinical Improvement ◽  
Body Fluids ◽  
The Novel ◽  
Test Results ◽  
Rt Pcr ◽  
Clinical Recovery ◽  
Novel Virus ◽  
Novel Coronavirus ◽  
Government Authority ◽  
Pcr Test

The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pandemic by WHO. Apart from transmission and shedding of the virus through respiratory secretions in the form of droplets (mainly), several studies have shown the presence of the virus in various samples such as stool, urine and occasionally in blood, semen, tears and breastmilk. Whereas government authority guidelines consider a person as cured from COVID-19 when along with clinical improvement no more virus can be detected primarily on respiratory samples along with clinical improvement; the persistence of the virus in these body fluids even after clinical recovery and negative RT-PCR test results on respiratory samples, has raised many questions about the elusive nature of this novel virus along with the possibility of other routes of transmission of this virus in the community. Although studies performed till now across the globe on persistence of SARSCOV-2 in various body fluids are sparse, in this review we would like to present and analyse the results of those studies performed globally on the aforesaid topic to get a better insight of this side of the COVID-19 story.

scholarly journals Karantina Sonrası COVID-19 Tanısıyla Takip Edilen Hastaların Değerlendirilmesi

2020 ◽  
Vol 25 (4) ◽  
pp. 499-505
Author(s):  
Onur Ural ◽  
Şua Sümer ◽  
Nazlım Aktuğ Demir ◽  
Emine Yalçınkaya ◽  
Elif Uçan ◽  
...  
Keyword(s):  
Underlying Disease ◽  
Clinical Findings ◽  
Lung Involvement ◽  
Shortness Of Breath ◽  
Rt Pcr ◽  
The World ◽  
Underlying Diseases ◽  
Time Of Admission ◽  
Pcr Test ◽  
D Dimer

Introduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 ± 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARSCoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.

scholarly journals Clinical characteristics and viral load dynamics of COVID-19 in a mildly or moderately symptomatic outpatient sample

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258970
Author(s):  
Amanda Caplan ◽  
Kelly W. Bates ◽  
Carla Brioni ◽  
Aileen Santos ◽  
Linda M. Sabatini ◽  
...  
Keyword(s):  
Viral Load ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Symptom Duration ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Antibody Tests ◽  
Pcr Test

Background Studies of outpatients with mild or moderate COVID-19 are uncommon. We studied: 1) association of symptoms with reverse transcriptase polymerase chain reaction (RT-PCR) test results; and 2) association of initial RT-PCR cycle threshold (Ct) in relation to duration of RT-PCR positivity in outpatients with mild or moderate COVID-19. Methods This was a cohort study of outpatients with confirmed COVID-19 and at least one symptom. Participants had repeat nasopharyngeal swabs and symptom checklists every 3–5 days until two consecutive RT-PCR tests were negative. RT-PCR tests were used to assess viral load. Antibody tests for COVID-19 were performed at 2 weeks, 4 weeks, and 8 weeks after symptom onset. Results Twenty-five patients (nine females) were enrolled, ranging in age from 19–58 (median age 28 years). All patients reported at least one symptom, with a median of six symptoms per patient. Symptoms persisted for 6–67 days (median duration 18 days). In all 25 patients, blood samples collected a median of 13 days after symptom onset were positive for SARS-CoV-2 antibodies in 15 (60%). After a median of 28 days following symptom onset, 23/23 patients with available samples tested positive for antibodies. The longest duration of positive RT-PCR test was 49 days from first positive PCR test (Mean = 27.4, SD = 12.5, Median = 24). Initial Ct was significantly associated with longer duration (β = -1.3, SE = 0.3, p<0.01 per 1 cycle higher) of RT-PCR positivity. Conclusions In mildly or moderately ill COVID-19 outpatients, RT-PCT tests remained positive for as long as 49 days and test positivity and symptom duration correlated with initial viral load.

scholarly journals LO63: Evaluation of epinephrine secondary effects in a Canadian emergency department anaphylaxis adult cohort

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S30-S30
Author(s):  
S. Gabrielli ◽  
M. Ben-Shoshan ◽  
A. Lachance ◽  
M. Rhéaume ◽  
L. Londei-Leduc ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Clinical Characteristics ◽  
Sinus Tachycardia ◽  
Secondary Effects ◽  
Inappropriate Sinus Tachycardia ◽  
Factors Associated ◽  
History Of ◽  
Reaction Severity

Introduction: There are few large-scale studies assessing the true risk of epinephrine use during anaphylaxis in adults. We aimed to assess the demographics, clinical characteristics, and secondary effects of epinephrine treatment and to determine factors associated with major and minor secondary effects associated with epinephrine use among adults with anaphylaxis. Methods: From May 2012 to February 2018, adults presenting to the Hôpital du Sacré-Coeur de Montréal (HSCM) emergency department (ED) with anaphylaxis were recruited prospectively as part of the Cross-Canada Anaphylaxis Registry (C-CARE). Missed cases were identified through a previously validated algorithm. Data were collected on demographics, clinical characteristics, and management of anaphylaxis using a structured chart review. Multivariate logistic regression models were compared to estimate factors associated with side effects of epinephrine administration. Results: Over a 6-year period, 402 adult patients presented to the ED at HSCM with anaphylaxis. The median age was 38 years (Interquartile Range [IQR]: 27, 52) and 40.4% were males. The main trigger for anaphylaxis was food (53.0%). A total of 286 patients (71.1%) received epinephrine treatment, of which 23.9% were treated in the pre-hospital setting, 47.0% received treatment in the ED, and 5.0% received epinephrine in both settings. Among patients treated with epinephrine, major secondary effects were rare (1.4% of patients), including new changes to electrocardiogram, arrhythmia, and neurological symptoms. Minor secondary effects due to epinephrine were reported in 50.0% of patients, mainly inappropriate sinus tachycardia (defined as a rate over 100 beats/minute in 30.1%). Major cardiovascular secondary effects were associated with regular use of beta-blockers (aOR 1.10 [95%CI, 1.02, 1.18]), regular use of ACE-inhibitors (aOR 1.16 [95%CI, 1.07, 1.27]), and receiving more than two doses of epinephrine (aOR 1.09 [95%CI, 1.00, 1.18]). The model was adjusted for age, history of ischemic heart disease, trigger of anaphylaxis, presence of asthma, sex, and reaction severity. Inappropriate sinus tachycardia was more likely in females (aOR 1.18 [95%CI, 1.04, 1.33]) and palpitations, tremors, and psychomotor agitation were more likely in females (aOR 1.09 [95%CI, 1.00, 1.19]) and among those receiving more than two doses of epinephrine (aOR 1.49 [95%CI, 1.14, 1.96]). The models were adjusted for age, regular use of medications, history of ischemic heart disease, triggers of anaphylaxis, presence of asthma, reaction severity, and IV administration of epinephrine. Conclusion: The low rate of occurrence of major secondary effects of epinephrine in the treatment of anaphylaxis in our study demonstrates the overall safety of epinephrine use.

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek
Keyword(s):  
Polymerase Chain Reaction ◽  
Death Anxiety ◽  
Short Form ◽  
Anxiety Score ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Test Result ◽  
Pcr Test

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

Accuracy of Computed Tomography for Detection of COVID-19 among Suspected Patients

2021 ◽  
Vol 15 (9) ◽  
pp. 2474-2476
Author(s):  
Maham Munir Awan ◽  
Afshan Noreen ◽  
Farah Kalsoom ◽  
Muhammad Tahir ◽  
Umaima Majeed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Gold Standard ◽  
Radiology Department ◽  
True Positive ◽  
Test Results ◽  
Rt Pcr ◽  
Radiological Society ◽  
Medical University ◽  
Pcr Test

Objective: To determine the accuracy of CT chest in diagnosis of COVID-19 taking RT-PCR-testing as gold standard. Materials and Methods: A total of 150 patients of suspicion of COVID-19 who were referred for CT Chest in Radiology Department of Nishtar Medical University Multan from June-2020 to May-2021 were included. In all patients, two RT-PCR test results were obtained with 7 days of admission in hospital. Presence of any of these positive was labelled as COVID-19 infection. CT chest was performed in all patients within 2 days of admission in hospital using 128 slices CT scan machine. The diagnosis of COVID-19 infection was made according to the recommendations by Radiological Society of North America (RSNA) protocol. Results: Mean age was 51.3±14.7 years. 78 (52%) patients were male and 72 (48%) patients were female. RTPCR test was positive in 89 (59.3%) patients. While the CT chest findings were suggestive of COVID-19 infection in 130 (86.7%) patients. The sensitivity of CT chest was 95.5%, specificity 26.2%, PPV wad 65.4% and NPV was 80.0%. Conclusion: CT chest has a very good sensitivity for detection of COVID-19, it can be used as a rapid diagnostic tool especially in areas of pandemic. However, the specificity of CT chest is low, that can limit its use in low COVID-19 affected areas. Keywords: COVID-19, Computed tomography, False Positive, True Positive, Positive Predictive Value, Negative Predictive Value.

DIAGNOSTIC ROLE OF CHEST CT USING CO-RADS CATEGORIZATION IN SARS-COV-2 INFECTION WITH EMPHASIS ON IMPACT OF CT IN PATIENTS WITH DELAYED OR NEGATIVE INITIAL RTPCR TEST

2021 ◽  
pp. 51-52
Author(s):  
Tharani Putta ◽  
Kaushik Deconda
Keyword(s):  
Diagnostic Performance ◽  
Virus Disease ◽  
Vital Role ◽  
Chest Ct ◽  
Lung Involvement ◽  
Test Results ◽  
Rt Pcr ◽  
Diagnostic Role ◽  
Pcr Test

BACKGROUND AND OBJECTIVE: Role of chest CT in diagnosis of corona virus disease 2019 (COVID-19) has been controversial. The purpose of this study is to evaluate the diagnostic performance of chest CT when utilizing COVID-19 Reporting and Data System (CO-RADS). METHODOLOGY: Retrospective study including consecutive patients with positive SARS-CoV-2 RT-PCR test (initial or repeat test) and chest CT done in our institute between June and September 2020. Spectrum of CT ndings, CO-RADS score and 25 point CT severity score (CTSS) were recorded. RESULTS: A total of 300 consecutive patients with SARS-CoV-2 infection were included in the analysis. Out of the 168 patients who underwent CT prior to positive RT-PCR result, 125 (74.4%) had CO-RADS 3, 4 or 5 score on chest CT. 32 study patients (10.6%) had initial negative RT-PCR of which 24 (75%) had CO-RADS 4 or 5 score. Of the total patients with CO-RADS 3 to 5 score (227), 20 (8.8%) had severe lung involvement (CTSS 18-25), 83 (36.6%) had moderate lung involvement (CTSS 8-17) and 124 (54.6%) had mild lung involvement (CTSS 1-7). The mean CTSS was 7.9 with mean lobar score being higher in lower lobes (RLL=1.82, LLL=1.78) compared to the upper and middle lobes (RUL=1.61, RML=1.19, LUL=1.53). CONCLUSION:CT using CO-RADS scoring system has good diagnostic performance. In addition to assessing disease severity, it plays a vital role in triage of patients with suspected COVID-19 especially when there is limited availability of SARS-CoV-2 RT-PCR tests, delay in RT-PCR test results or in negative RT-PCR cases when there is high index of clinical suspicion.

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