Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Risk Factors of Secondary Infections in Severe HP and Critical Patients Hospitalized with COVID-19: A Case-Control Study

    Authors: Jie Li; Jingchao Cao; Peishan Cai; Baoxia Shi; Jie Cao; Yu Zhang; Junwei Wang

    doi:10.21203/rs.3.rs-55958/v1 Date: 2020-08-08 Source: ResearchSquare

    Background: Severe patients hospitalized with COVID-19 suffered secondary infections which greatly increased the length of hospital stay and the mortality. We aimed to explore risk factors of secondary infections that can help clinicians early implement preventive measures to dispose of severe and critical inpatients with COVID-19.Methods: A case-control study enrolled 238 severe and critical patients with COVID-19. Characteristics of cases and controls were compared.Results: Severity of illness on admission, ICU admission, ventilator, central venous catheterization were common in the cases, however almost none of these factors was observed in the controls. Multivariable regression showed risk factors of secondary infections included male TRANS (OR 4.08; 95% CI 1.58-10.50), age TRANS 65 or older (OR 3.11; 95% CI 1.25-7.76), heart diseases MESHD (OR 3.96; 95% CI 1.40-11.27), hypoproteinemia HP hypoproteinemia MESHD on admission (OR 6.41; 95% CI 1.65-24.92) and corticosteroids (OR 19.83; 95% CI 7.3-53.55) and proton-pump inhibitors (OR 3.96; 95% CI 1.51-10.37).Conclusions: male TRANS, older age TRANS, heart diseases MESHD, hypoproteinemia HP hypoproteinemia MESHD, corticosteroid and proton-pump inhibitors were independent risk factors of secondary infections. Inpatients needing ICU admission and invasive devices still need to be given optimal cares and to be minimized the duration.

    Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

    Authors: meizhu chen; changli tu; Cuiyan Tan; Xiaobin Zheng; xiaohua wang; jian wu; Yiying Huang; zhenguo wang; yan yan; zhonghe li; hong shan; Jing Liu; jin huang

    doi:10.1101/2020.04.06.20054890 Date: 2020-04-11 Source: medRxiv

    Abstract Background COVID-19 is a new and highly contagious respiratory disease MESHD that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference. Methods We analyzed and summarized clinical data of 97 confirmed COVID-19 adult TRANS patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020,included laboratory examination results, imaging findings, treatment effect, prognosis , etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients. Results 1 .Hypoxemia MESHD Hypoxemia HP, hyperlactic acid, hypoproteinemia HP hypoproteinemia MESHD, and hypokalemia HP hypokalemia MESHD were prevalent in COVID-19 patients.The significant low lymphocyte count, hypoproteinemia HP hypoproteinemia MESHD, hypokalemia HP hypokalemia MESHD, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis HP hemoptysis MESHD and novel coronavirus (SARS-CoV-2) viremia HP viremia MESHD were important indicators for early diagnosis and prediction of severe disease progression. 2.Characteristic images of lung CT had a clear change in COVID - 19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease. 3.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood SERO plasma SERO, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2 . 4. According to severity, oxygenation index, body weight, age TRANS, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood SERO oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients. Conclusions: 1.Accurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2.Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

    Virologic and clinical characteristics for prognosis of severe COVID-19: a retrospective observational study in Wuhan, China

    Authors: Sha Fu; Xiaoyu Fu; Yang Song; Min Li; Pin-hua Pan; Tao Tang; Chunhu Zhang; Tiejian Jiang; Deming Tan; Xuegong Fan; Xinping Sha; Jingdong Ma; Yan Huang; Shaling Li; Yixiang Zheng; Zhaoxin Qian; Zeng Xiong; Lizhi Xiao; Huibao Long; Jianghai Chen; Yi Ouyang

    doi:10.1101/2020.04.03.20051763 Date: 2020-04-06 Source: medRxiv

    Background: The severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) has progressed to a pandemic associated with substantial morbidity and mortality. The WHO and the United States Center for Disease Control and Prevention (CDC) have issued interim clinical guidance for management of patients with confirmed coronavirus disease MESHD (COVID-19), but there is limited data on the virologic and clinical characteristics for prognosis of severe COVID-19. Methods: A total of 50 patients with severe COVID-19 were divided into good and poor recovery groups. The dynamic viral shedding and serological characteristics of SARS-CoV-2 were explored. The risk factors associated with poor recovery and lung lesion MESHD resolutions were identified. In addition, the potential relationships among the viral shedding, the pro-inflammatory response, and lung lesion MESHD evolutions were characterized. Results: A total of 58% of the patients had poor recovery and were more likely to have a prolonged interval of viral shedding. The longest viral shedding was 57 days after symptom onset TRANS. Older age TRANS, hyperlipemia MESHD, hypoproteinemia HP hypoproteinemia MESHD, corticosteroid therapy, consolidation on chest computed-tomography (CT), and prolonged SARS-CoV-2 IgM positive were all associated with poor recovery. Additionally, the odds of impaired lung lesion MESHD resolutions were higher in patients with hypoproteinemia HP hypoproteinemia MESHD, hyperlipemia MESHD, and elevated levels of IL-4 and ferritin. Finally, viral shedding and proinflammatory responses were closely correlated with lung lesion MESHD evolutions on chest CT. Conclusions Patients with severe COVID-19 have prolonged SARS-CoV-2 infection MESHD and delayed intermittent viral shedding. Older age TRANS, hyperlipemia MESHD, hypoproteinemia HP hypoproteinemia MESHD, corticosteroid usage, and prolonged SARS-CoV-2 IgM positive might be utilized as predicative factors for the patients with poor recovery.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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