Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients With COVID-19

Background: Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim: We aimed to investigate the characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods: A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results: Approximately 91.23% (655/718) of COVID-19 patients were younger than 60 years old. Approximately 64.76% (465/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia, and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included age, the number of comorbidities and hyperlipidaemia for disease severity, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities and age played a predictive role in disease progression and outcomes.Conclusion: Not only high number and specific comorbidities but also age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on not only the number and specific comorbidities but also age in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563.

The clinical type and etiological agents of superficial dermatophytosis: A cross sectional study

Dermatophytosis are fungal infections caused by three genera of fungi that have the unique ability to invade and multiply within keratinized tissue (hair, skin, and nails). Although dermatomycoses are globally distributed, the endemic and most prevalent species of dermatophytosis differ strikingly from one geographic locality to another. Changing trend has been noticed in last few years with dermatophytic infections presenting as chronic, treatment unresponsive and recurrent. Also various microscopic and fungal culture studies have shown shift in identification of causative fungal species in recent years. Numerous studies have been done on the occurrence of dermatophytes in various parts of our country illustrating the range and changing pattern of fungal infection as well as causative fungal species. Total number of 150 patients attending outpatient department of our hospital who were clinically diagnosed as having superficial dermatophytosis were enrolled into the study. Patients were carefully screened as per inclusion and exclusion criteria and then enrolled in the study. Samples were taken from all the patients and examined for KOH direct microscopy and sent for fungal culture on Sabouraud’s Dextrose Agar as well as on Dermtophyte Test Medium. Results were then analyzed using standard statistical methods. Out of total 150 patients, 101 were males and 49 were females. Most common age group was 21-30 years (37.3%). 58 patients (38.7%) showed positivity to KOH microscopy as well as fungal culture. Additionally 25 more samples demonstrated positivity to KOH microscopy (total 83 patients) but negativity to culture, while 9 patient samples were positive to culture but negative to direct microscopy. Predominant fungal species isolated on culture was Trichophyton mentagrophytes (50.7%) while next common species isolated was T. tonsurans (29.9%). No significant association was found between dermatophyte isolate on culture and clinical type. Trichophyton mentagrophytes and Trichophyton tonsurans were the most common species isolated among subjects with Tinea faciei, Tinea cruris and Tinea corporis. The study showed a male preponderance and T. corporis was the commonest clinical type found. Majority of patients were in the 3rd decade and came within a duration of 1 month to 6 months of getting an infection. In patients diagnosed with tinea corporis, tinea cruris, tinea pedis and tinea manuum, T. mentagrophytes was the most predominant species isolated.

Pulmonary Mucormycosis as the Leading Clinical Type of Mucormycosis in Western China

The aim was to better understand the clinical characteristics of patients with mucormycosis in western China. We retrospectively investigated the clinical, laboratory, radiological and treatment profiles of mucormycosis patients during a 10-year period (2010–2019). As a result, 59 proven mucormycosis were enrolled in this study. It was found that 52.5% of patients had worse clinical outcomes. Pulmonary mucormycosis (PM) was the most common clinical manifestation. The most frequent risk factor was diabetes mellitus (38, 64.4%) for mucormycosis patients. Cough (43, 93.5%), fever (24, 52.2%) and hemoptysis/bloody phlegm (21, 45.7%) were the most common manifestations of PM. There were no differences in clinical manifestations, risk factors and laboratory tests between different clinical outcome groups (P>0.05). Lymph node enlargement (30, 65.2%), patchy shadows (28, 60.9%), cavitation (25, 53.3%) and bilateral lobe involvement (39, 84.8%) were the most common on chest CT. Nodule was more common in good outcome group (P <0.05). A total of 48 cases (81.4%) were confirmed by histopathological examination, 22 cases (37.3%) were confirmed by direct microscopy. PM patients were treated with amphotericin B/amphotericin B liposome or posaconazale had better clinical outcomes (P <0.05). In conclusion, PM was the most common clinical type of mucormycosis in China. Diabetes mellitus was the most common risk factor. PM has diverse imaging manifestations and was prone to bilateral lobes involvement. Early diagnosis and effective anti-mucor treatment contribute to successful treatment.

Generalized Dentin Dysplasia in a Four-Year-old dog

Dentin dysplasia is an autosomal-dominant genetic abnormality that occurs in humans and results in diffuse radiographic dental abnormalities and variable tooth discoloration due to an underlying defect in secondary dentinogenesis. This case report presents distinctive radiographic and histopathologic dental abnormalities in a dog that are consistent with generalized dentin dysplasia. These findings are similar to but not completely analogous to any specific clinical type of dentin dysplasia in humans. Grossly, the majority of the teeth in this case were discolored and most were determined to be vital. Dentin dysplasia should be included in the list of differential diagnoses of discolored teeth and notably this form of discoloration does not necessarily indicate loss of vitality.

Serum Level of Interleukin 17 in Alopecia Areata Patients and Its Relation with the Severity of the Disease: a Case Control Study

Background Alopecia Areata (AA) is one of the most common autoimmune diseases that’s characterized by hair loss on the scalp and/or body. It is an organ-specific autoimmune disease characterized by T-cell infiltrates and cytokine production. T-helper 17 (Th17) cells are crucially involved in the pathogenesis of autoimmune diseases. Objectives Our aim was to compare the serum level of interleukin-17 (IL-17) between alopecia areata patients and healthy controls to demonstrate its proposed role in the pathogenesis of alopecia areata and to correlate it with the severity of the disease. Subjects and methods The serum concentration of IL-17 was measured in 26 patients with AA and 26 healthy controls. The clinical type of AA was determined, and the severity of scalp hair loss was assessed in accordance with the Alopecia Areata Investigational Assessment Guideline criteria. Results The serum concentration of IL-17 was significantly higher in patients with AA as compared with healthy. The IL-17 concentration among cases ranged from 133.38 – 325.99 pg/ml with a median of 195.38, while among controls, the IL-17 concentration ranged from 13.59 – 225.73 pg/ml with a median of 48.42. No statistically significant difference was found in IL-17 levels regarding age, sex, clinical type, duration of disease or severity. Conclusion The significantly higher levels of serum IL-17 in patients with AA suggest a possible role of IL-17 as a proinflammatory cytokine in the pathogenesis of AA. This could point to the potential benefit of IL-17 inhibitors in recalcitrant cases of alopecia areata.

Dermatophytosis in a Suburban Hospital-A Study on Distribution and Clinical Types According to Age and Sex

Aim and Objectives: Dermatophytosis is a fungal infection of the outermost layer of skin and its appendages such as hair, nails and scalp. The present study was undertaken with a view to find out the clinical pattern of dermatophytic infections in our hospital. Materials and Methods: A total of 100 patients were included in the study. History was taken, general and physical examination was done. Multiple sites were involved in some cases, but were categorised prioritising the most predominant site involved. Patient was diagnosed and classified based on clinical types, age and sex. Results and Conclusion: A total of 100 patients were enrolled in the study in which 56 males and 44 females were affected. The most commonly affected age group was 19 to 59 years (63%). The most common clinical type of infection was T. cruris affecting 41% of the study population.

High number and specific comorbidities independently of age are closely related to progression and poor prognosis in patients with COVID-19

Background— Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim—In this study, we aimed to investigate the distribution characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods— A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The distribution characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results—Approximately 88.62% (637/718) of the COVID-19 patients were twenty to fifty-nine years old. Approximately 65.73% (554/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman and partial correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included the number of comorbidities and hyperlipidaemia for disease severity, age, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities played a predictive role in disease progression and outcomes.Conclusions—High number and specific comorbidities independently of age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on the number and specific comorbidities in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563A statement about the manuscript in research square This manuscript has been presented as preprint in the research sqaure according to the following link: https://www.researchsquare.com/article/ rs-576949/v2.