Epidemiology, Clinical and Laboratory Manifestations, and Outcomes of Brucellosis Among 104 Patients in Referral Hospitals of Tehran, Iran

Background: Brucellosis is the most common zoonotic disease in Iran, imposing a significant financial burden on the healthcare system. The diversity of non-specific clinical manifestations of this disease can lead to misdiagnosis or delayed diagnosis. Therefore, it is important to pay attention to other aspects of this disease. Objectives: This study aimed to determine the epidemiology, clinical and laboratory manifestations, and outcomes of brucellosis. Methods: In this cross-sectional study, brucellosis patients, admitted to three hospitals, affiliated to Shahid Beheshti University of Medical Sciences (Tehran, Iran) from April 2015 to September 2020, were examined. The patients' medical records were reviewed for epidemiological, clinical, and laboratory findings. The outcomes of the disease were evaluated by phone calls. Results: Of the 104 patients included in this study, 53.8% were male, and 46.2% were female. The mean age of the patients was 43.07 ± 18.521 years. Unpasteurized dairy consumption and contact with livestock were reported in 60.6 and 27.9% of the patients, respectively. Also, 23.1% of the patients had high-risk occupations. The most common symptoms included fever (80.8%), chills (58.7%), backache (55.8%), and sweating (51%). The most common complication was osteoarticular involvement (21.2%), followed by neurobrucellosis (6.7%). Elevated alkaline phosphatase (89.7%), anemia (67.3%), increased C-reactive protein (57.7%), and increased erythrocyte sedimentation rate (48.1%) were common laboratory findings. The rates of improvement, treatment failure, and relapse were 86.9, 9.1, and 4%, respectively. There was no significant relationship between the rate of improvement and the antibiotic regimen. However, the most common cause of treatment failure was the patient’s poor compliance with treatment. Conclusions: The diversity of non-specific clinical manifestations of brucellosis is a diagnostic challenge. Therefore, physicians must request laboratory tests to evaluate brucellosis after taking a precise epidemiological and clinical history of suspected cases.

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The Frequency and Causes of Subepidermal Gaps or Blisters and the Compliance Rate Between Clinical Diagnosis and Pathology Reports from 2015 to 2019

Journal of Skin and Stem Cell ◽

10.5812/jssc.118423 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Abbas Darjani ◽

Hojat Eftekhari ◽

Seyedeh Rojin Amini Rad ◽

Narges Alizadeh ◽

Rana Rafiee ◽

...

Keyword(s):

Clinical Diagnosis ◽

Skin Diseases ◽

Histopathological Examination ◽

Compliance Rate ◽

Clinical Manifestations ◽

Final Diagnosis ◽

Direct Immunofluorescence ◽

Diagnostic Challenge ◽

Cross Sectional ◽

Pathology Reports

Background: Skin diseases are the fourth most common cause of human illness, and blisters with different clinical manifestations make a diagnostic challenge. Objectives: This study aimed to evaluate the frequency and causes of subepidermal gaps or blisters, as well as the compliance rate between the initial and final clinical diagnoses based on pathology reports. Methods: In this cross-sectional study, pathology reports of subepidermal blisters or gaps were evaluated in the patients referred to the Razi Laboratory of Rasht from 2015 to 2019. The samples were examined by a pathologist after hematoxylin and eosin staining. The reports included demographic information, clinical differential diagnoses, final diagnosis, direct immunofluorescence findings, and salt split results. Finally, the compliance rate of clinical diagnosis with pathology reports was determined. Results: A total of 183 pathology reports were evaluated, 170 of which contained the final diagnosis. Females were more frequently affected by the disease, and pemphigoid bolus and lichen planus were the most prevalent final diagnoses. The compliance rate between the initial and final diagnoses was 94%. About 37.2% of the reports lacked direct immunofluorescence (DIF) and salt split, and only 42.6% of the samples had undergone DIF examination, while 20.2% had both DIF and salt split. There was no significant association between the compliance rate of the final diagnosis with age, sex, and undergoing diagnostic tests. Conclusions: A high incidence of subepidermal gaps or blisters was seen in middle-aged individuals and females. The compliance rate of the initial clinical diagnosis with the final diagnosis based on pathological reports was high. Our findings emphasize the importance of histopathological examination and the complementary role of direct immunofluorescence and salt split in diagnosis.

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Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

Current Issues in Pharmacy and Medical Sciences ◽

10.2478/cipms-2021-0027 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Saleh Habibi ◽

Arefeh Babazadeh ◽

Soheil Ebrahimpour ◽

Parisa Sabbagh ◽

Mehran Shokri

Keyword(s):

Older Adults ◽

Age Groups ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Vital Signs ◽

The Elderly ◽

Community Acquired Pneumonia ◽

Northern Iran ◽

Laboratory Findings ◽

Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

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Cardiovascular manifestations in COVID-19 patients: A systematic review and meta-analysis

Journal of Cardiovascular and Thoracic Research ◽

10.34172/jcvtr.2021.30 ◽

2021 ◽

Vol 13 (3) ◽

pp. 181-189

Author(s):

Seyyedmohammadsadeq Mirmoeeni ◽

Amirhossein Azari Jafari ◽

Seyedeh Zohreh Hashemi ◽

Elham Angouraj Taghavi ◽

Alireza Azani ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Systolic Pressure ◽

Clinical Manifestations ◽

Laboratory Findings ◽

Cross Sectional ◽

Cardiovascular Comorbidities ◽

Study Characteristics ◽

Novel Coronavirus ◽

Cardiac Manifestations

Since December 2019, the COVID-19 pandemic has affected the global population, and one of the major causes of mortality in infected patients is cardiovascular diseases (CVDs).For this systematic review and meta-analysis, we systematically searched Google Scholar, Scopus, PubMed, Web of Science, and Cochrane databases for all articles published by April 2, 2020. Observational studies (cohort and cross-sectional designs) were included in this meta-analysis if they reported at least one of the related cardiovascular symptoms or laboratory findings in COVID-19 patients. Furthermore, we did not use any language, age, diagnostic COVID-19 criteria, and hospitalization criteria restrictions. The following keywords alone or in combination with OR and AND operators were used for searching the literature: "Wuhan coronavirus", "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "2019 novel coronavirus" "cardiovascular disease", "CVD", "hypertension", "systolic pressure", "dyspnea", "hemoptysis", and "arrhythmia". Study characteristics, exposure history, laboratory findings, clinical manifestations, and comorbidities were extracted from the retrieved articles. Sixteen studies were selected which involved 4754 patients, including 2103 female and 2639 male patients. Among clinical cardiac manifestations, chest pain and arrhythmia were found to have the highest incidence proportion. In addition, elevated lactate dehydrogenase (LDH) and D-dimer levels were the most common cardiovascular laboratory findings. Finally, hypertension, chronic heart failure, and coronary heart disease were the most frequently reported comorbidities. The findings suggest that COVID-19 can cause various cardiovascular symptoms and laboratory findings. It is also worth noting that cardiovascular comorbidities like hypertension have a notable prevalence among COVID-19 patients.

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Diffuse Leptomeningeal Glioneuronal Tumor in an Adult: A Diagnostic Challenge

Indian Journal of Neurosurgery ◽

10.1055/s-0041-1730130 ◽

2022 ◽

Author(s):

Mukesh Kumar Bhaskar ◽

Mukta Meel ◽

Kusum Mathur ◽

Arpita Jindal ◽

Mohit Khandelwal

Keyword(s):

Imaging Finding ◽

Magnetic Resonance Imaging Finding ◽

Delayed Diagnosis ◽

Glioneuronal Tumor ◽

Diagnostic Challenge ◽

Histologic Diagnosis ◽

Laboratory Findings ◽

Leptomeningeal Enhancement ◽

Diffuse Leptomeningeal Glioneuronal Tumor ◽

Brain And Spinal Cord

AbstractHere we report a rare case of diffuse leptomeningeal glioneuronal tumor (DLGNT) in a 35-year-old man, who was misdiagnosed twice as having tuberculosis meningitis and later racemose neurocysticercosis. His delayed diagnosis of DLGNT might be due to prevalence of tuberculosis in our country, similarity in magnetic resonance imaging finding of prominent leptomeningeal enhancement in different cisterns of brain, and extreme rarity of DLGNT in the adults. So, it should be differentiated clinically and radiographically from granulomatous or infectious conditions. Hence, a timely histologic diagnosis through a leptomeningeal biopsy of the brain and spinal cord in case of unusual leptomeningeal enhancement with uncertain laboratory findings is essential because cytological examination of the cerebrospinal fluid in DLGNT is known to be negative.

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Propylthiouracil-induced lupus-like or vasculitis syndrome

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2012.601 ◽

2012 ◽

Vol 7 ◽

Author(s):

Cuneyt Tetikkurt ◽

Mehmet Yuruyen ◽

Seza Tetikkurt ◽

Nihal Bayar ◽

Imran Ozdemir

Keyword(s):

Pleural Effusion ◽

Clinical Manifestations ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Diagnostic Challenge ◽

Drug Induced ◽

Exertional Dyspnea ◽

Laboratory Findings ◽

Left Pleural Effusion ◽

Antihistone Antibody

A 27 year old female with Graves’ disease presented with fever, exertional dyspnea and polyarthralgia. Erythema nodosum had occured three months earlier. The patient declared irregular use of propylthiouracil (PTU) for the last 8 months. Neutropenia and microscopic hematuria developed in the second week of admission. Chest X-ray showed inhomogenous pulmonary opacities, left pleural effusion and cardiomegaly. Computed tomography (CT) revealed multiple subpleural nodules, left pleural effusion, pericardial effusion, enlarged mediastinal and axillary lymph nodes. Bronchoalveolar lavage (BAL) cytology demonstrated hemosiderin laden macrophages. Histopathologic examination of the transbronchial biopsy specimen revealed a nonspecific inflammation. Serum was positive for ANA, P-ANCA, MPO-ANCA, PR3-ANCA and negative for anti-ds-DNA, C-ANCA, C3, C4 and antihistone antibody. All symptoms resolved in two months after PTU withdrawal and starting steroid treatment. The same clinical manifestations recurred when the patient used PTU erronously one month after discharge. This is a case of PTU induced-autoimmune disease in whom the accurate distinction between drug-induced-lupus (DIL) and vasculitis was not possible due to the significant overlap of clinical and laboratory findings causing a significant diagnostic challenge for the chest physician.

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A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

Iranian Jornal of Toxicology ◽

10.32598/ijt.10.4.332.1 ◽

2016 ◽

Vol 10 (3) ◽

pp. 47-50

Author(s):

Nasim Zamani ◽

◽

Leila Modir-Fallah Rad ◽

Kambiz Soltaninejad ◽

Shahin Shadnia ◽

...

Keyword(s):

Hospital Admission ◽

Demographic Data ◽

Clinical Manifestations ◽

Public Health Problem ◽

Cross Sectional Study ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Laboratory Findings ◽

Cross Sectional ◽

Tertiary Referral Center

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

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Renal imaging in children with chronic kidney disease

Paediatrica Indonesiana ◽

10.14238/pi53.4.2013.193-9 ◽

2013 ◽

Vol 53 (4) ◽

pp. 193

Author(s):

Wiwit Rahmawati ◽

Heru Muryawan ◽

Farah Prabowo

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Ultrasound Imaging ◽

Renal Cortex ◽

Clinical Manifestations ◽

Renal Ultrasound ◽

Laboratory Findings ◽

Cross Sectional ◽

Renal Imaging ◽

Echogenic Kidneys

Background Chronic kidney failure is a cause of death inchildren. Diagnosing chronic kidney disease is often made byclinical manifestations, laboratory findings and ultrasonographyor other imaging tests. Early detection of chronic kidney diseaseis needed for education and management of the disease.Objective To describe renal imaging findings and mortality inchildren with chronic kidney disease .Methods This was a cross-sectional study on children with kidneydiseases who were inpatients at Dr. Kariadi Hospital from January2008 to June 2011. Data were taken from medical records. Chronickidney disease was confirmed by clinical manifestations, laboratoryfindings, and radiologic imaging. Renal ultrasound findings weredetermined by the radiologist responsible at that time. Resultswere presented as ft:equency distributions.Results Of 37 chronic kidney disease cases, 27 were males and 10were females. Subjects' most common complaints were dyspnea (7out of 3 7) and edema (30 out of 3 7) . Renal ultrasound imaging ofsubjects with chronic kidney disease yielded the following findings:reduced cortico-medullary differentiation (30 out of 3 7), bilateralechogenic kidneys (21 out of 3 7), reduced renal cortex thickness(4 out of 37) and small-sized kidneys (4 out of 37) . Eight of the37 children died. These 8 subjects had the following radiologicimaging findin gs: both kidneys appeared small in size (4 out ofS),reduced 'renal cortex' thickness (4 out of 8), echogenic kidneys(6 out of 8), and reduced cortico-medullary differentiation (8out of8).Conclusion Renal ultrasound imaging of pediatric subjects withchronic kidney disease revealed findings of reduced corticomedullarydifferentiation, bilateral echogenic kidneys, reducedrenal cortex thickness, and small kidneys bilaterally.

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AB0514 CALF PAIN, KEY POINT IN THE DIAGNOSIS OF POLYARTERITIS NODOSA

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6578 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1554.2-1554

Author(s):

J. S. Peinado Acevedo ◽

M. Calle ◽

A. Medina ◽

D. Jaramillo Arroyave ◽

A. Vanegas ◽

...

Keyword(s):

Polyarteritis Nodosa ◽

Systemic Vasculitis ◽

Clinical Manifestations ◽

Hbv Infection ◽

Renal Infarction ◽

Laboratory Findings ◽

Cross Sectional ◽

Muscle Involvement ◽

Severity Scores ◽

Calf Pain

Background:polyarteritis nodosa (PAN) is a primary systemic vasculitis that is becoming a rare disease in part by the decrease in hepatitis B virus (HBV) infection due to widespread vaccination. It is characterized by a full vast constellation of nonspecific clinical manifestations, which sometimes delays and makes it difficult to diagnose. Still, muscle involvement is a feature that could guide the clinician.Objectives:to describe the main clinical and laboratory characteristics of patients with PAN and to confirm the frequency of muscle involvement.Methods:retrospective cross-sectional descriptive study of 23 adult patients diagnosed with PAN between January 2011 and December 2018 in two high complexity hospitals in Medellin-Colombia.Results:twenty-three patients met ACR 1990 classification criteria for PAN, 52% were men with a median age of 51 (IR 36-60), 78.3% were newly diagnosed, and only two patients (8.7%) had HBV infection. General symptoms (found in 95% of the patients), cutaneous (82%), and articular (56%) were the most frequent manifestations. Among systemic symptoms, myalgia, especially calf pain, was the most common characteristic (78.3%), followed by weight loss (73.9%), fatigue (69.3%), and fever (59.3%). Laboratory findings and severity scores are shown in the table. Angiography was performed in 27.3% of patients, finding splanchnic (renal, hepatic and splenic) microaneurysms (17.4%), stenosis (13%), and renal infarction (4.3%). Fourteen patients (61%) had at least one positive biopsy documenting medium-sized artery vasculitis, mainly skin, muscle, nerve, or both; 9 (39%) had normal or inconclusive biopsy findings. All patients received high daily doses of prednisolone (50 ± 16 mg); 52.2% required cyclophosphamide, 30.4% azathioprine, 17.4% methotrexate, 8.7% rituximab, 4.3% dapsone and 4.3% plasmapheresis; acetylsalicylic acid was given to half of the patients and only one required antiviral therapy for HBV. With treatment, 87% improved; 22.7% had an infection, and 8.7% of patients died.Conclusion:myalgia was the main characteristics of our PAN patients, especially in calves, and its presence in patients with other general, skin or articular symptoms should raise the suspect of this vasculitis.References:[1]Karadag O, Jayne DJ. Polyarteritis nodosa revisited: a review of historical approaches, subphenotypes and a research agenda. Clin Exp Rheumatol. 2018;36 Suppl 111(2):135–142.[2]Pagnoux C, Seror R, Henegar C, et al. Clinical features and outcomes in 348 patients with polyarteritis nodosa: a systematic retrospective study of patients diagnosed between 1963 and 2005 and entered into the French Vasculitis Study Group Database. Arthritis Rheum. 2010;62(2):616–626.TableCharacteristicPAN patients (n=23)CRP (mean and SD in mg/dl)6.3 ± 8.51ESR (mean and SD in mm/h)84 ± 38CPK (median and IR in U/L) normal value < 18076 (66)FFS (mean)1BVAS (median and IR)17 (7)PAN: polyarteritis nodosa; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; CPK: creatine phosphokinase; FFS: five factor score; BVAS: Birmingham Vasculitis Activity Score; SD: standard desviation; IR (interquartile range)Disclosure of Interests:None declared

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Spinal Radiographic Changes in Ankylosing Spondylitis: Association with Clinical Characteristics and Functional Outcome

The Journal of Rheumatology ◽

10.3899/jrheum.080831 ◽

2009 ◽

Vol 36 (6) ◽

pp. 1249-1255 ◽

Cited By ~ 33

Author(s):

ANNELIES BOONEN ◽

BERT vander CRUYSSEN ◽

KURT de VLAM ◽

SERGE STEINFELD ◽

CLIO RIBBENS ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Disease Duration ◽

Activity Index ◽

Clinical Manifestations ◽

Disease Activity Index ◽

Hla B27 ◽

Peripheral Arthritis ◽

Laboratory Findings ◽

Cross Sectional ◽

Radiographic Changes

Objective.To determine which patients with ankylosing spondylitis (AS) have radiographic spinal damage and to investigate the relation between radiographic spinal changes and limitations in physical function.Methods.A cross-sectional nationwide study in Belgium of patients with AS under the care of a rheumatologist. The treating physician completed a questionnaire including clinical disease manifestations and laboratory findings (HLA-B27 and C-reactive protein), and classified spinal radiographs into 3 categories: (1) no AS-related spinal abnormalities; (2) syndesmophytes; and (3) spinal ankylosis. Patients completed the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). Ordinal regressions were performed to quantify the relationship between clinical manifestations and spinal radiographic changes. Generalized linear models were computed to quantify relationships among clinical manifestations, radiographic spinal changes, and functioning (BASFI).Results.A total of 619 patients fulfilled modified New York criteria for definite AS and had evaluable radiographic data; 68% were male and disease duration was 17.5 (SD 12.2) years. Male sex, younger age at symptom onset, and hip involvement were associated with radiographic changes; but HLA-B27, peripheral arthritis, and extraarticular disease status (uveitis, psoriasis, and inflammatory bowel disease) were not. Older age, BASDAI, hip involvement, and spinal change contributed to BASFI; but sex, disease duration, peripheral arthritis, and extraarticular manifestations did not.Conclusion.Radiographic spinal changes in patients with AS are seen more often in men and those with hip involvement. BASFI status indicates the influence of radiographic changes and hip involvement, but does not reflect the presence of peripheral arthritis and does not differ between men and women.

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The cross-sectional study of hospitalized coronavirus disease 2019 patients in Xiangyang, Hubei province

10.1101/2020.02.19.20025023 ◽

2020 ◽

Cited By ~ 8

Author(s):

Jin-Wei Ai ◽

Jun-Wen Chen ◽

Yong Wang ◽

Xiao-Yun Liu ◽

Wu-Feng Fan ◽

...

Keyword(s):

Real Time ◽

Demographic Data ◽

Clinical Manifestations ◽

Subsequent Development ◽

Severe Case ◽

Multiple Organ ◽

Ct Scans ◽

Rt Pcr ◽

Laboratory Findings ◽

Cross Sectional

SummaryObjectiveTo describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 (COVID-19) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment.MethodsWe included 102 confirmed COVID-19 cases hospitalized in Xiangyang No.1 people’s hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed.FindingsAll cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever (86[84.3%] of 102 patients), cough (58[57%]), fatigue (28[27%]), shortness of breath (24[23%]), diarrhea (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure, three had multiple organ failure and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results.InterpretationMost COVID-19 patients in Xiangyang were secondary cases without sex difference, and the rate of severe case and death was low. Middle-to-old-age individuals were more susceptible to the virus infection and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively.

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