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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Differential diagnosis for suspected cases of coronavirus disease MESHD 2019: a retrospective study

    Authors: Qiong Chi; Xinjian Dai; Xiangao Jiang; Lefei Zhu; Junyan Du; Yuxi Chen; Jiyang Zheng; Jianping Huang

    doi:10.21203/rs.3.rs-27776/v2 Date: 2020-05-08 Source: ResearchSquare

    Background: Since December 2019, the coronavirus disease MESHD 2019 (COVID-19) has infected more than 12,310322,000 people and killed over 556,000 people worldwide. However, Differential diagnosis remains difficult for suspected cases of COVID-19 and need to be improved to reduce misdiagnosis.Methods: Sixty-eight cases of suspected COVID-19 treated in Wenzhou Central Hospital from January 21 to February 20, 2020 were divided into confirmed and COVID-19-negative groups based on the results of real-time reverse transcriptase polymerase chain reaction (RT-PCR) nucleic acid testing of the novel coronavirus in throat swab specimens to compare the clinical symptoms and laboratory and imaging results between the groups.Results: Among suspected patients, 17 were confirmed to COVID-19-positive group and 51 were distinguished to COVID-19-negative group. Patients with reduced white blood SERO cell (WBC) count were more common in the COVID-19-positive group than in the COVID-19-negative group (29.4% vs 3.9%, P = 0.003). Subsequently, correlation analysis indicated that there was a significant inverse correlation existed between WBC count and temperature in the COVID-19-positive patients (r=-0.587, P=0.003), instead of the COVID-19-negative group. But reduced lymphocyte count was no different between the two groups (47.1% vs 25.5%, P= 0.096). More common chest imaging characteristics of the confirmed COVID-19 cases by high-resolution computed tomography (HRCT) included ground-glass opacities (GGOs), multiple patchy shadows, and consolidation with bilateral involvement than COVID-19-negative group (82.4% vs 31.4%, P=0.0002; 41.2% vs 17.6% vs P=0.048; 76.5% vs 43.1%, P=0.017; respectively). The rate of clustered infection MESHD was higher in COVID-19-positive group than COVID-19-negative group (64.7% vs 7.8%, P=0.001). Through multiplex PCR nucleic acid testing, 2 cases of influenza A, 3 cases of influenza B, 2 cases of adenovirus, 2 cases of Chlamydia pneumonia MESHD pneumonia HP, and 7 cases of Mycoplasma pneumoniae MESHD pneumoniae HP were diagnosed in the COVID-19-negative group.Conclusions: WBC count inversely correlated with the severity of fever HP fever MESHD, GGOs, multiple patchy shadows, and consolidation in chest HRCT and clustered infection MESHD are common but not specific features in the confirmed COVID-19 group.Reduced WBC count inversely correlating with the severity of fever HP fever MESHD, GGOs, multiple patchy shadows, and consolidation in chest HRCT and clustered infection MESHD are features in the confirmed COVID-19 group but not unique. Multiplex PCR nucleic acid testing helped differential diagnosis for suspected COVID-19 casesexclude pathogenic diagnosis in COVID-19 patients.

    Epidemiological and clinical features of 291 cases with coronavirus disease MESHD 2019 in areas adjacent to Hubei, China: a double-center observational study

    Authors: Xu Chen; Fang Zheng; Yanhua Qing; Shuizi Ding; Danhui Yang; Cheng Lei; Zhilan Yin; Xianglin Zhou; Dixuan Jiang; Qi Zuo; Jun He; Jianlei Lv; Ping Chen; Yan Chen; Hong Peng; Honghui Li; Yuanlin Xie; Jiyang Liu; Zhiguo Zhou; Hong Luo

    doi:10.1101/2020.03.03.20030353 Date: 2020-03-06 Source: medRxiv

    Abstract Background: The clinical outcomes of COVID-19 patients in Hubei and other areas are different. We aim to investigate the epidemiological and clinical characteristics of patient with COVID-19 in Hunan which is adjacent to Hubei. Methods: In this double-center, observational study, we recruited all consecutive patients with laboratory confirmed COVID-19 from January 23 to February 14, 2020 in two designated hospitals in Hunan province, China. Epidemiological and clinical data from patients' electronic medical records were collected and compared between mild, moderate and severe/critical group in detail. Clinical outcomes were followed up to February 20, 2020. Findings: 291 patients with COVID-19 were categorized into mild group (10.0%), moderate group (72.8%) and severe/critical group (17.2%). The median age TRANS of all patients was 46 years (49.8% were male TRANS). 86.6% patients had an indirect exposure history. The proportion of patients that had been to Wuhan in severe/critical group (48.0% vs 17.2%, p=0.006) and moderate group (43.4% vs 17.2%, p=0.007) were higher than mild group. Fever HP Fever MESHD (68.7%), cough HP (60.5%), and fatigue HP fatigue MESHD (31.6%) were common symptoms especially for severe and critical patients. Typical lung imaging finding were bilateral and unilateral ground glass opacity MESHD or consolidation. Leukopenia HP Leukopenia MESHD, lymphopenia HP lymphopenia MESHD and eosinopenia occurred in 36.1%, 22.7% and 50.2% patients respectively. Increased fibrinogen was detected in 45 of 58 (77.6%) patients with available results. 29 of 44 (65.9%) or 22 of 40 (55.0%) patients were positive in Mycoplasma pneumonia MESHD pneumonia HP or Chlamydia pneumonia MESHD pneumonia HP antibody test SERO respectively. Compared with mild or moderate group, severe/critical group had a relative higher level of neutrophil, Neutrophil-to-Lymphocyte Ratio, h-CRP, ESR, CK, CK-MB, LDH, D-dimer, and a lower level of lymphocyte, eosinophils, platelet, HDL and sodium (all p<0.01). Most patients received antiviral therapy and Chinese Medicine therapy. As of February 20, 2020, 159 (54.6%) patients were discharged and 2 (0.7%) patients died during hospitalization. The median length of hospital stay in discharged patients was 12 days (IQR: 10-15). Interpretation: The epidemiological and clinical characteristics of COVID-19 patients in Hunan is different from patients in Wuhan. The proportion of patients that had been to Wuhan in severe/critical group and moderate group were higher than mild group. Laboratory and imaging examination can assist in the diagnosis and classification of COVID-19 patients.

    Caution on Kidney Dysfunctions of 2019-nCoV Patients

    Authors: - Anti-2019-nCoV Volunteers; Zhen Li; Ming Wu; Jiwei Yao; Jie Guo; Xiang Liao; Siji Song; Jiali Li; Guangjie Duan; Yuanxiu Zhou; Xiaojun Wu; Zhansong Zhou; Taojiao Wang; Ming Hu; Xianxiang Chen; Yu Fu; Chong Lei; Hailong Dong; Chuou Xu; Yahua Hu; Min Han; Yi Zhou; Hongbo Jia; Xiaowei Chen; Junan Yan

    doi:10.1101/2020.02.08.20021212 Date: 2020-02-12 Source: medRxiv

    Summary Background: To date, large amounts of epidemiological and case study data have been available for the Coronavirus Disease MESHD 2019 (COVID-19), which suggested that the mortality was related to not just respiratory complications. Here, we specifically analyzed kidney functions in COVID-19 patients and their relations to mortality. Methods: In this multi-centered, retrospective, observational study, we included 193 adult TRANS patients with laboratory-confirmed COVID-19 from 2 hospitals in Wuhan, 1 hospital in Huangshi (Hubei province, 83 km from Wuhan) and 1 hospital in Chongqing (754 km from Wuhan). Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected, including data regarding to kidney functions. Data were compared among three groups: non-severe COVID-19 patients (128), severe COVID-19 patients (65) and a control group of other pneumonia HP pneumonia MESHD (28). For the data from computed tomographic (CT) scans, we also included a control group of healthy subjects (110 cases, without abnormalities in the lung MESHD and without kidney diseases MESHD). The primary outcome was a common presence of kidney dysfunctions MESHD in COVID-19 patients and the occurrence of acute kidney injury HP acute kidney injury MESHD ( AKI MESHD) in a fraction of COVID-19 patients. Secondary outcomes included a survival analysis of COVID-19 patients in conditions of AKI MESHD or comorbid chronic illnesses. Findings: We included 193 COVID-19 patients (128 non-severe, 65 severe (including 32 non-survivors), between January 6th and February 21th,2020; the final date of follow-up was March 4th, 2020) and 28 patients of other pneumonia HP pneumonia MESHD (15 of viral pneumonia MESHD pneumonia HP, 13 of mycoplasma pneumonia MESHD pneumonia HP) before the COVID-19 outbreak. On hospital admission, a remarkable fraction of patients had signs of kidney dysfunctions MESHD, including 59% with proteinuria HP proteinuria MESHD, 44% with hematuria HP hematuria MESHD, 14% with increased levels of blood SERO urea nitrogen, and 10% with increased levels of serum SERO creatinine, although mild but worse than that in cases with other pneumonia HP pneumonia MESHD. While these kidney dysfunctions MESHD might not be readily diagnosed as AKI MESHD at admission, over the progress during hospitalization they could be gradually worsened and diagnosed as AKI MESHD. A univariate Cox regression analysis showed that proteinuria HP proteinuria MESHD, hematuria HP hematuria MESHD, and elevated levels of blood SERO urea nitrogen, serum SERO creatinine, uric acid as well as D-dimer were significantly associated with the death of COVID-19 patients respectively. Importantly, the Cox regression analysis also suggested that COVID-19 patients that developed AKI MESHD had a ~5.3-times mortality risk of those without AKI MESHD, much higher than that of comorbid chronic illnesses (~1.5 times risk of those without comorbid chronic illnesses). Interpretation: To prevent fatality in such conditions, we suggested a high degree of caution in monitoring the kidney functions of severe COVID-19 patients regardless of the past disease history. In addition, upon day-by-day monitoring, clinicians should consider any potential interventions to protect kidney functions at the early stage of the disease and renal replacement therapies in severely ill patients, particularly for those with strong inflammatory reactions or a cytokine storm. Funding: None.

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MeSH Disease
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Transmission
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