Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Clinical features and disease severity in an Iranian population of COVID-19 patients

    Authors: Shima Nabavi; Zahra Javidarabshahi; Abolghasem Allahyari; Mohammad Ramezani; Mohsen Seddigh-Shamsi; Sahar Ravanshad; Mina AkbariRad; Farnoosh Ebrahimzadeh; Shohre Khatami; Maryam Emadzadeh; Neda Saeedian; Ahmadreza Zarifian; Maryam Miri; Fariba Rezaeetalab; Sepide Hejazi; Reza Basiri; Mahnaz Mozdourian

    doi:10.21203/rs.3.rs-51568/v1 Date: 2020-07-31 Source: ResearchSquare

    Objectives: Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age TRANS of 69.75±6.39 years, of whom 82 (41%) were female TRANS were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age TRANS, malignant comorbidities, dyspnea HP dyspnea MESHD, nausea/vomiting HP nausea/vomiting MESHD, confusion HP confusion MESHD, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum SERO C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock HP, coagulopathy MESHD, acidosis HP acidosis MESHD, sepsis HP sepsis MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea/vomiting HP nausea/vomiting MESHD, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea/vomiting HP nausea/vomiting MESHD, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum SERO CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease in COVID-19 patients.

    Resveratrol and Copper for treatment of severe COVID-19: an observational study (RESCU 002)

    Authors: Indraneel Mittra; Rosemarie de Souza; Rakesh Bhadade; Tushar Madke; P.D. Shankpal; Mohan Joshi; Burhanuddin Qayyumi; Atanu Bhattacharya; Vikram Gota; Sudeep Gupta; Pankaj Chaturvedi; Rajendra Badwe

    doi:10.1101/2020.07.21.20151423 Date: 2020-07-29 Source: medRxiv

    Background To be universally applicable in treatment of severe COVID-19, novel therapies, especially those with little toxicity MESHD and low cost, are urgently needed. We report here the use of one such therapeutic combination involving two commonly used nutraceuticals, namely resveratrol and copper in patients with this disease. This study was prompted by pre-clinical reports that sepsis HP-related cytokine storm and fatality in mice can be prevented by oral administration of small quantities of resveratrol and copper. Since cytokine storm and sepsis HP sepsis MESHD are major causes of death MESHD in severe COVID-19, we retrospectively analyzed outcomes of patients with this condition who had received resveratrol and copper. Methods & Findings Our analysis comprised of 230 patients with severe COVID-19 requiring inhaled oxygen who were admitted in a single tertiary care hospital in Mumbai between April 1 and May 13 2020. Thirty of these patients received, in addition to standard care, resveratrol and copper at doses of 5.6 mg and 560 ng, respectively, orally, once every 6 hours, until discharge or death MESHD. These doses were based on our pre-clinical studies, and were nearly 50 times and 2000 times less, respectively, than those recommended as health supplements. A multivariable-adjusted analysis was used to model the outcome of death MESHD in these patients and evaluate factors associated with this event. A binary logistic regression analysis was used, with age TRANS, sex, presence of comorbidities and receipt of resveratrol-copper as covariates. Data were updated as of May 30 2020. The number of deaths in resveratrol-copper and standard care only groups were 7/30 (23.3%, 95% CI 8.1%-38.4%) and 89/200 (44.5%, 95% CI 37.6%-51.3%), respectively. In multivariable analysis, age TRANS >50 years [odds ratio (OR) 2.558, 95% CI 1.454-4.302, P=0.0011] and female TRANS sex (OR 1.939, 95% CI 1.079-3.482, P=0.0267) were significantly associated, while presence of co-morbidities was not significantly associated (OR 0.713, 95% CI 0.405-1.256, P=0.2421) with death MESHD. There was a trend towards reduction in death MESHD in patients receiving resveratrol-copper (OR 0.413, 95% CI 0.164-1.039, P= 0.0604). Conclusions We provide preliminary results of a novel approach to the treatment of severe COVID-19 using a combination of small amounts of commonly used nutraceuticals, which is non-toxic and inexpensive, and therefore could be widely accessible globally. The nearly two-fold reduction in mortality with resveratrol-copper observed in our study needs to be confirmed in a randomized controlled trial.

    The incidence, risk factors and prognosis of acute kidney injury HP acute kidney injury MESHD in severe and critically ill MESHD patients with COVID-19 in mainland China: a retrospective study

    Authors: Ling Sang; Sibei Chen; Xia Zheng; Weijie Guan; Zhihui Zhang; Wenhua Liang; Ming Zhong; Li Jiang; Chun Pan; Wei Zhang; Jiaan Xia; Nanshan Chen; Wenjuan Wu; Hongkai Wu; Yonghao Xu; Xuesong Liu; Xiaoqing Liu; Jianxing He; Shiyue Li; Dingyu Zhang; Nanshan Zhong; Yimin Li

    doi:10.21203/rs.3.rs-50431/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: Since the clinical correlates, prognosis and determinants of AKI in patients with Covid-19 remain largely unclear, we perform a retrospective study to evaluate the incidence, risk factors and prognosis of AKI in severe and critically ill MESHD patients with Covid-19.Methods: We reviewed medical records of all adult TRANS patients (>18 years) with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University. The clinical data, including patient demographics, clinical symptoms and signs, laboratory findings, treatment [including respiratory supports, use of medications and continuous renal replacement therapy (CRRT)] and clinical outcomes, were extracted from the electronic records, and we access the incidence of AKI and the use of CRRT, risk factors for AKI, the outcomes of renal diseases MESHD, and the impact of AKI on the clinical outcomes.Results: Among 210 subjects, 131 were males TRANS (62.4%). The median age TRANS was 64 years (IQR: 56-71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) patients were classified as stage 1, 2 and 3, respectively. 54 cases (58.7%) received CRRT. Age TRANS, sepsis HP sepsis MESHD, Nephrotoxic drug MESHD, IMV and elevated baseline Scr were associated with AKI occurrence. The renal recover during hospitalization among 16 AKI patients (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure MESHD and higher P/F ratio. Of 210 patients, 93 patients deceased within 28 days of ICU admission. AKI stage 3, critical disease MESHD, greater age TRANS and minimum P/F <150mmHg independently associated with it.Conclusions: Among patients with Covid-19, the incidence of AKI was high. age TRANS , sepsis HP sepsis MESHD, nephrotoxic drug MESHD, IMV and baseline Scr were strongly associated with the development of AKI. Time from admission to AKI diagnosis, right heart failure MESHD and P/F ratio were independently associated with the potential of renal recovery. Finally, AKI KIDGO stage 3 independently predicted the risk of death within 28 days of ICU admission.

    COVID-19, What Could Sepsis HP Sepsis MESHD, Severe Acute Pancreatitis HP Pancreatitis MESHD, Gender TRANS Differences and Aging Teach Us?

    Authors: Claudio Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202007.0414/v1 Date: 2020-07-19 Source: Preprints.org

    Severe COVID-19 disease is characterised by an exaggerated inflammatory response, called cytokine storm, accompanied by a condition of immune depression MESHD. Even sepsis HP sepsis MESHD is characterised by an exaggerated inflammatory response, called SIRS (Systemic Inflammatory Response Syndrome), accompanied by a condition of immune depression MESHD called CARS (compensatory anti-inflammatory response syndrome). Clinical studies reveal that most sepsis HP sepsis MESHD patients who did not die during the hyper inflammatory response ( SIRS MESHD) subsequently succumbed to the condition of immune depression MESHD (CARS). Severe acute pancreatitis HP pancreatitis MESHD begins with local inflammation MESHD that induces systemic inflammatory response syndrome ( SIRS MESHD), accompanied and followed by a compensatory anti-inflammatory response (CARS). In COVID-19 disease, the male TRANS response to SARS CoV-2 virus is typically characterised by a robust inflammatory response. Instead, a cell-mediated immune response is dominant in women. This means that the male TRANS sex tends to have a more robust hyper inflammatory response than the female TRANS one. Furthermore, in women the condition of immune depression MESHD is less represented, therefore they are more protected. Sepsis HP Sepsis MESHD, severe acute pancreatitis HP pancreatitis MESHD and COVID-19 disease evolve between two fundamental aspects: hyper inflammation and immunodepression MESHD. The experience gained over years of studies of sepsis HP sepsis MESHD and severe acute pancreatitis HP pancreatitis MESHD suggests that therapies should be differentiated according to the evolutionary stage of the disease. The goal is to save the lives of most patients with COVID-19 disease. The identification of critical points, suitable for designing the windows of therapeutic opportunity, may allow the use of therapeutic interventions, in the COVID-19 disease, which are effective (there are no approved drugs yet), safe (without significant side effects), targeted (based on the evolutionary phase of the disease) personalized, (based on sex, co-morbidities, age TRANS, etc.) and timely (based on signs, symptoms, laboratory parameters and instrumental investigations).

    COVID-19 and Cancer: A Comparative Case Series

    Authors: seied Asadollah Mousavi; Tahereh Rostami; Azadeh kiumarsi; soroush Rad; mohammadreza Rostami; Fatemeh Motamedi; Alireza Gandomi-Mohammadabadi; Amirhossein Mirhosseini

    doi:10.21203/rs.3.rs-41710/v1 Date: 2020-07-13 Source: ResearchSquare

    BackgroundCancer patients, with an incidence of more than 18 million new cases per year, may constitute a significant portion of the COVID-19 infected population. In the pandemic situation,  these patients are considered highly vulnerable to infectious complications due to their immunocompromised state.Material & MethodsIn this retrospective case series, the documents of solid cancer MESHD patients infected by SARS-CoV-2, hospitalized in Shariati hospital (a tertiary care referral center designated for COVID-19 patients, affiliated by Tehran University of Medical Sciences) between 20 February and 20 April 2020, were evaluated. The diagnosis of COVID-19 was based on a positive real-time fluorescence reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 nucleic acids from nasal and/or pharyngeal specimens and/or features of chest CT scan highly suggestive for SARS-CoV-2.ResultsAmong 33 patients with solid cancer MESHD, 11 patients had a positive RT-PCR for SARS-CoV-2 and 22 patients had highly suggestive chest CT scan findings in favor of SARS-CoV-2 but negative RT-PCR . The mean age TRANS of the patients was 63.9 years, and 54.5% of the patients were males TRANS. Age and sex of the patients did not correlate with mortality. There was no difference in COVID-19 symptoms, lymphocytopenia MESHD, thrombocytopenia HP thrombocytopenia MESHD between survived and un-survived cancer MESHD patients. However, LDH level was significantly higher (7170±2077 vs. 932.3±324.7, P-value=0.016) and also serum SERO albumin was significantly lower in un-survived group (3.6±0.5 vs. 2.9±0.6 p-value=0.03). Among 16 patients with stage IV cancer MESHD, thirteen patients died, which was significantly higher compared to stage I-III cancer MESHD patients (81.3% vs. 18.8% P-value= <0.001).  In terms of developing complications, sepsis HP sepsis MESHD, invasive ventilation and mortality was significantly higher in patients who received cytotoxic chemotherapy within the last 14 days. There was no significant difference between the two groups of positive and negative SARS-CoV-2 RT-PCR regarding their sex, age TRANS, cancer type MESHD, mean Hemoglobin concentration, Platelet count, lymphocyte count, serum SERO albumin level, ESR and CRP titer or other laboratory findings and also in terms of clinical symptoms and coexisting.ConclusionIn this study, we showed that the mortality rate among cancer MESHD patients affected by COVID-19 was higher than general population and this rate has a significant correlation with factors such as the stage of the disease, the type of cancer MESHD, the activity of cancer MESHD and finally receiving cytotoxic chemotherapy within 14 days before diagnosis of COVID-19. We also showed that the outcome of cancer MESHD patients with positive RT-PCR for COVID-19 similar to those with negative RT-PCR with highly suggestive chest CT scan findings.

    Tocilizumab and Thromboembolism HP Thromboembolism MESHD in COVID-19: A Retrospective Hospital-based Cohort Analysis

    Authors: Kok Hoe Chan; Bhavik Patel; Bishnu Podel; Maria E Szabela; Hamid S Shaaban; Gunwant Guron; Jihad Slim

    doi:10.21203/rs.3.rs-39943/v1 Date: 2020-07-02 Source: ResearchSquare

    Background:Tocilizumab, an IL-6 receptor antagonist has been used in patients with Coronavirus Disease MESHD 2019 (COVID-19) as an anti-cytokine agent. IL-6 also plays a complex role in hemostasis and thrombosis MESHD. We observed a transient elevation of D-dimer in our patients who received Tocilizumab, which triggered the current study.Methods:A retrospective hospital-based cohort analysis of patients with confirmed COVID-19 who received Tocilizumab during the study period of 03/15/2020 to 05/20/2020. We retrieved demographic, clinical and laboratory data, we excluded patients who were receiving therapeutic anticoagulation therapy prior to Tocilizumab administration.  Descriptive analysis was performed, the cause of death MESHD and trends of D-dimer and inflammatory markers were studied. Results: Out of the 436 confirmed COVID 19 patients admitted during the study period, 24 met the inclusion criteria. Their median age TRANS was 47.5 years old. They were 18 males TRANS and 6 females TRANS; 15 patients survived, and 9 expired. Of the group that survived, 12 received therapeutic anticoagulation. Of the 7 patients who did not receive therapeutic anticoagulation, 4 expired, 1 from sepsis HP sepsis MESHD and 3 probably from thromboembolic complications MESHD, compared to 5 deaths in the 17 patients who received therapeutic anticoagulation with 4 dying from sepsis HP sepsis MESHD, and one possibly from thromboembolic complications MESHD.Conclusions:The interplay between IL-6, IL-6 receptor antagonist and venous thromboembolism MESHD thromboembolism HP are complex. We observed a transient elevation of D-dimer in COVID-19 patients who received Tocilizumab, and a trend toward increased death secondary to thromboembolism HP thromboembolism MESHD. This observation is novel and highlights the potential thrombophilic side effects of Tocilizumab.

    Association between NSAIDs use and adverse clinical outcomes among adults TRANS hospitalised with COVID-19 in South Korea: A nationwide study

    Authors: Han Eol Jeong; Hyesung Lee; Hyun Joon Shin; Young June Choe; Kristian B Filion; Ju-Young Shin

    doi:10.1101/2020.06.01.20119768 Date: 2020-06-02 Source: medRxiv

    BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may exacerbate COVID-19 and worsen associated outcomes by upregulating the enzyme that SARS-CoV-2 binds to enter cells. However, to our knowledge, no study has examined the association between NSAID use and the risk of COVID-19-related outcomes among hospitalised patients. METHODS: We conducted a population-based cohort study using South Korea nationwide healthcare database, which contains data of all subjects who received a test for COVID-19 (n=69,793) as of April 8, 2020. We identified a cohort of adults TRANS hospitalised with COVID-19, where cohort entry was the date of hospitalisation. NSAIDs users were those prescribed NSAIDs in the 7 days before and including the date of cohort entry and non-users were those not prescribed NSAIDs during this period. Our primary outcome was a composite of in-hospital death, intensive care unit admission, mechanical ventilation use, and sepsis HP sepsis MESHD; our secondary outcome was cardiovascular or renal complications MESHD. We conducted logistic regression analysis to estimate odds ratio (OR) with 95% confidence intervals (CI) using inverse probability of treatment weighting to minimize potential confounding. FINDINGS: Of 1,824 adults TRANS hospitalised with COVID-19 (mean age TRANS 49.0 years, standard deviation 19.0 years; female TRANS 59%), 354 were NSAIDs users and 1,470 were non-users. Compared with non-use, NSAIDs use was associated with increased risks of the primary composite outcome (OR 1.65, 95% CI 1.21-2.24) and of cardiovascular or renal complications MESHD (OR 1.87, 95% CI 1.25-2.80). Our main findings remained consistent when we extended the exposure ascertainment window to include the first three days of hospitalisation (OR 1.87, 95% CI 1.06-3.29). INTERPRETATION: Use of NSAIDs, compared with non-use, is associated with worse outcomes among hospitalised COVID-19 patients. While awaiting the results of confirmatory studies, we suggest NSAIDs be used with caution among patients with COVID-19 as the harms associated with their use may outweigh their benefits in this population.

    Analysis of the Clinical Characteristics of 77 COVID-19 Deaths

    Authors: Kaige Wang; Zhixin Qiu; Dan Liu; Jianfei Luo; Jiasheng Liu; Tao Fan; Chunrong Liu; Panwen Tian; Ye Wang; Zhong Ni; Shumin Zhang; Weimin Li

    doi:10.21203/rs.3.rs-23960/v1 Date: 2020-04-20 Source: ResearchSquare

    Purpose: For the emerging pandemic Coronavirus Disease MESHD 2019 (COVID-19), no clear description on its deaths’ clinical characteristics and causes of death MESHD is available. Hence, this study analyzed clinical characteristics of 77 COVID-19 deaths, providing data support to further understand this disease.Method: A retrospective analysis of 77 COVID-19 deaths in East Branch, Renmin Hospital of Wuhan University from February 1 to March 7, 2020 was performed in clinical characteristics, laboratory results, causes of death MESHD, and subgroup comparison. Results: Totally 72.7% of the deaths ( male TRANS- female TRANS ratio: 51:26, average age TRANS at death: 71, mean survival time: 17.4 days) had hypertension HP hypertension MESHD, heart disease MESHD, diabetes MESHD, chronic lung disease HP chronic lung disease MESHD, and other comorbidities. Acute respiratory distress HP respiratory distress MESHD syndrome ( ARDS MESHD) and sepsis HP sepsis MESHD were the main causes of death MESHD. Increases in C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer and lactic acid (LAC), and decreases in lymphocyte, cluster of differentiation (CD) 4+ and CD8+ cells were common in laboratory results. Subgroup analysis showed: 1) Most female TRANS deaths had cough HP cough MESHD and diabetes MESHD. 2) The male TRANS proportion in young and middle- aged TRANS deaths was higher; while elderly TRANS deaths were more prone to myocardial injury MESHD and elevated CRP. 3) There was no statistical difference between short-term and non-short-term survival subgroups. 4) CRP and LDH increased and CD4+ and CD8+ cells decreased significantly in patients with hypertension HP hypertension MESHD.Conclusions: The majority of COVID-19 deaths are males TRANS, especially the elderly TRANS with underlying diseases. The main causes of death include ARDS MESHD and sepsis HP sepsis MESHD. Most female TRANS deaths have cough HP cough MESHD and diabetes MESHD. Myocardial injury MESHD is common in elderly TRANS deaths. Patients with hypertension HP hypertension MESHD are prone to increased inflammatory index, tissue hypoxia MESHD and cellular immune injury.Authors Kaige Wang and Zhixin Qiu contributed equally to this work.

    Risk factors associated with fatal outcomes of novel coronavirus infection pneumonia MESHD pneumonia HP (COVID-19): A systematic review and meta-analysis

    Authors: Can Chen; Danying Yan; Yuqing Zhou; Guo Tian; Jie Wu; Xiaoxiao Liu; Chenyang Huang; Xiaofang Fu; Cheng Ding; Lei Lan; Chencheng Wang; Wei Wu; Robert Hecht; Changtai Zhu; Lanjuan Li; Shigui Yang

    doi:10.21203/rs.3.rs-23204/v1 Date: 2020-04-15 Source: ResearchSquare

    Background: The COVID-19 infection MESHD has caused 111652 deaths worldwide as of 13 April 2020. Risk factors for fatal outcomes of COVID-19 have varied across studies due to limited samples and have lacked effective qualitative and quantitative measurements. We performed a meta-analysis to evaluate risk factors for fatal outcomes of COVID-19.Methods: Data on demographic, clinic, laboratory findings and complications were extracted. Quantitative and qualitative synthesis was conducted for weighted-mean-difference (WMD) and odds-ratio (OR).Results: A total of 30 studies involving 5741 survivors and 1670 deaths were included. The death MESHD cases were significantly older than survivors (WMD=15.36, 95% CI: 12.90-17.82), male TRANS and smoking history showed higher risk to develop fatal outcome (OR=3.37, 95% CI: 2.27-5.01; OR=1.37, 95% CI: 1.02-1.83, respectively). The clinical symptoms including dyspnea HP dyspnea MESHD (OR=4.63, 95% CI: 2.85-7.54), hemoptysis HP (OR=3.11, 95% CI: 1.26-7.56), malaise (OR=2.44, 95% CI: 1.49-3.97). comorbidities with coronary heart disease MESHD (OR=4.36, 95% CI: 1.91-9.97), COPD MESHD (OR=3.70, 95% CI: 2.03-6.73) and cardiovascular disease MESHD (OR=3.45, 95% CI: 2.54-4.70). Compared to survivors, many laboratory indexes increased in deaths group, including serum SERO ferritin (WMD=741.47, 95% CI: 566.77-916.16), lactate dehydrogenase (WMD=226.86, 95% CI: 177.08-276.64) and myoglobin (WMD=102.58, 95% CI: 65.12-140.04), and the decreased indexes included PaO2/FiO2 (WMD=-71.61, 95% CI: -134.11 to -9.11), platelets (WMD=-41.09, 95% CI: -47.33 to -34.85) and PaO2 (WMD=-26.09, 95% CI: -38.9 to -13.29). Main complications contributed to the fatal outcome included sepsis HP sepsis MESHD (OR=184.61, 95% CI: 33.43-1019.42), shock HP shock MESHD (OR=133.76, 95% CI: 36.86-485.34) and respiratory failure HP respiratory failure MESHD (OR=47.37, 95% CI: 20.65-108.66). Conclusion: The main risk factors associated with fatal outcome of COVID-19 involved male TRANS, older age TRANS, smoking history, chronic medical conditions including coronary heart disease MESHD, COPD MESHD and cardiovascular disease MESHD, clinical symptoms including dyspnea HP dyspnea MESHD, hemoptysis HP hemoptysis MESHD and malaise, the increased laboratory indexes including serum SERO ferritin, lactate dehydrogenase and myoglobin, the decreased indexes including PaO2/FiO2, platelets and PaO2, main complications including sepsis HP sepsis MESHD, shock HP shock MESHD and respiratory failure HP respiratory failure MESHD. These factors could be considered in triaging patients and allocating medical resources when such medical resources are scarce, devising improved protocols for patient diagnosis and management, and developing new drugs and other therapies to treat COVID-19 patients.

    Clinical characteristics of 101 non-surviving hospitalized patients with COVID-19: A single center, retrospective study

    Authors: Qiao Shi; Kailiang Zhao; Jia Yu; Fang Jiang; Jiarui Feng; Kaiping Zhao; Xiaoyi Zhang; Xiaoyan Chen; Peng Hu; Yupu Hong; Man Li; Fang Liu; Chen Chen; Weixing Wang

    doi:10.1101/2020.03.04.20031039 Date: 2020-03-06 Source: medRxiv

    Abstract Background The outbreak of COVID-19 has aroused global concerns. We aimed to describe the clinical characteristics of COVID-19 nonsurvivors and analyze possible causes for the rapid disease progress to death. Methods Patients with confirmed COVID-19 died in Renmin Hospital of Wuhan University before February 15, 2020, were identified. We obtained epidemiological, demographic, and clinical data from electronic medical records. Results Among 101 nonsurvivors, the median age TRANS was 71.0 years (IQR, 59.0-80.0), 59.4% were male TRANS, 79.2% had one or more comorbidities including hypertension HP (58.4%), cardiovascular disease (22.8%), diabetes (20.8%) etc. The most common symptoms were fever HP (76.2%), cough HP (58.4%) and dyspnea HP (54.5%). Respiratory failure HP (99.0%), acute cardiac injury (52.5%), sepsis HP (40.6%) and acute kidney injury HP (23.8%) were most common complications. Compared with patients died after 3 days of admission, patients died within 3 days of admission had significantly higher white blood SERO cell count (10.8 vs 6.7*109/L, P=0.001) and neutrophil count (8.9 vs 5.5*109/L, P=0.001), longer prothrombin time (13.2 vs 12.5 s, P=0.040), higher D-dimer concentration (7.64 vs 2.82, P=0.040), higher lactate level (2.9 vs 2.2 mmol/L, P=0.042), lower oxygen saturation (85.0% vs 91.0%, P=0.008), and were more likely to suffer sepsis HP (52.1% vs 30.2%, P=0.025). Conclusions Older patients with underlying comorbidities suffering COVID-19 were at high risk of death. Respiratory failure HP, acute cardiac injury and acute kidney HP injury played crucial roles in the death of COVID-19 patients. Early development of sepsis HP was associated with the rapid disease progress to death.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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