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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Epidemiological and clinical features of 2019-nCoV acute respiratory disease MESHD cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study

    Authors: Di Qi; Xiaofeng Yan; Xumao Tang; Junnan Peng; Qian Yu; Longhua Feng; Guodan Yuan; An Zhang; Yaokai Chen; Jing Yuan; Xia Huang; Xianxiang Zhang; Peng Hu; Yuyan Song; Chunfang Qian; Qiangzhong Sun; Daoxin Wang; Jin Tong; Jianglin Xiang

    doi:10.1101/2020.03.01.20029397 Date: 2020-03-03 Source: medRxiv

    BackgroundIn January 19, 2020, first case of 2019 novel coronavirus (2019-nCoV) pneumonia MESHD pneumonia HP (COVID-19) was confirmed in Chongqing municipality, China. MethodsIn this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited. Epidemiological, demographic, clinical, radiological characteristics, laboratory examinations, and treatment regimens were collected on admission. Clinical outcomes were followed up until Feb 16, 2020. Results267 laboratory-confirmed COVID-19 patients admitted to 3 designated-hospitals in Chongqing provincial municipality from January 19 to February 16, 2020 were enrolled and categorized on admission. 217 (81.27%) and 50 (18.73%) patients were categorized into non-severe and severe subgroups, respectively. The median age TRANS of patients was 48.0 years (IQR, 35.0-65.0), with 129 (48.3%) of the patients were more than 50 years of age TRANS. 149 (55.8%) patients were men. Severe patients were significantly older (median age TRANS, 71.5 years [IQR, 65.8-77.0] vs 43.0 years [IQR, 32.5-57.0]) and more likely to be male TRANS (110 [50.7%] vs 39 [78.0%]) and have coexisting disorders (15 [30.0%] vs 26 [12.0%]). 41 (15.4%) patients had a recent travel TRANS to Hubei province, and 139 (52.1%) patients had a history of contact with patients from Hubei. On admission, the most common symptoms of COVID-19 were fever MESHD fever HP 225(84.3%), fatigue MESHD fatigue HP (208 [77.9%]), dry cough MESHD cough HP (189 [70.8%]), myalgia MESHD myalgia HP or arthralgia MESHD arthralgia HP (136 [50.9%]). Severe patients were more likely to present dyspnea MESHD dyspnea HP (17 [34.0%] vs 26 [12.0%]) and confusion MESHD confusion HP (10 [20.0%] vs 15 [6.9%]). Rales (32 [12.0%]) and wheezes (20 [7.5%]) are not common noted for COVID-19 patients, especially for the non-severe (11 [5.1%], 10 [4.6%]). 118 (44.2%). Most severe patients demonstrated more laboratory abnormalities. 231 (86.5%), 61 (22.8%) patients had lymphopenia MESHD lymphopenia HP, leukopenia MESHD leukopenia HP and thrombocytopenia MESHD thrombocytopenia HP, respectively. CD4+ T cell counts decrease HP was observed in 77.1 % of cases, especially in the severe patients (45, 100%). 53.1% patients had decreased CD+3 T cell counts, count of CD8+T cells was lower than the normal range in part of patients (34.4%). More severe patients had lower level of CD4+ T cells and CD+3 T cells (45 [100.0%] vs 29[56.9%], 31 [68.9%] vs 20 [39.2%]). Most patients had normal level of IL-2, IL-4, TNF- and INF-{gamma}, while high level of IL-6 and IL-17A was common in COVID-19 patients (47 [70.1%], 35 [52.2%]). Level of IL-6, IL-17A and TNF- was remarkably elevated in severe patients (32 [84.2%] vs 15 [51.7%], 25 [65.8%] vs 10 [34.5%], 17 [44.7%] vs 5 [17.2%]). All patients received antiviral therapy (267, 100%). A portion of severe patients (38, 76.0%) received systemic corticosteroid therapy. Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure HP (5[10.0%], 35[70.0%], 12[24.0%]). Traditional Chinese medicine was adopted to most of severe patients (43,86.0%). Conclusion:Our study firstly demonstrated the regional disparity of COVID-19 in Chongqing municipality and further thoroughly compared the differences between severe and non-severe patients. The 28-day mortality of COVID-19 patients from 3 designed hospitals of Chongqing is 1.5%, lower than that of Hubei province and mainland China including Hubei province. However, the 28-mortality of severe patients was relatively high, with much higher when complications occurred. Notably, the 28-mortality of critically severe patients complicated with severe ARDS is considerably as high as 44.4%. Therefore, early diagnosis and intensive care of critically severe COVID-19 cases, especially those combined with ARDS, will be considerably essential to reduce mortality.

    Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood SERO of SARS-CoV-2 infected patients

    Authors: Jing Liu; Sumeng Li; Jia Liu; Boyun Liang; Xiaobei Wang; Hua Wang; Wei Li; Qiaoxia Tong; Jianhua Yi; Lei Zhao; Lijuan Xiong; Chunxia Guo; Jin Tian; Jinzhuo Luo; Jinghong Yao; Ran Pang; Hui Shen; Cheng Peng; Ting Liu; Qian Zhang; Jun Wu; Ling Xu; Sihong Lu; Baoju Wang; Zhihong Weng; Chunrong Han; Huabing Zhu; Ruxia Zhou; Helong Zhou; Xiliu Chen; Pian Ye; Bin Zhu; Shengsong He; Yongwen He; Shenghua Jie; Ping Wei; Jianao Zhang; Yinping Lu; Weixian Wang; Li Zhang; Ling Li; Fengqin Zhou; Jun Wang; Ulf Dittmer; Mengji Lu; Yu Hu; Dongliang Yang; Xin Zheng

    doi:10.1101/2020.02.16.20023671 Date: 2020-02-18 Source: medRxiv

    Background: The dynamic changes of lymphocyte subsets and cytokines profiles of patients with novel coronavirus disease MESHD (COVID-19) and their correlation with the disease MESHD severity remain unclear. Method: Peripheral blood SERO samples were longitudinally collected from 40 confirmed COVID-19 patients and examined for lymphocyte subsets by flow cytometry and cytokine profiles by specific immunoassays SERO. Findings: Of the 40 COVID-19 patients enrolled, 13 severe cases showed significant and sustained decreases in lymphocyte counts but increases in neutrophil counts than 27 mild cases. Further analysis demonstrated significant decreases in the counts of T cells HP, especially CD8 + T cells, as well as increases in IL-6, IL-10, IL-2 and IFN-{gamma} levels in the peripheral blood SERO in the severe cases compared to those in the mild cases. T cell counts and cytokine levels in severe COVID-19 patients who survived the disease MESHD gradually recovered at later time points to levels that were comparable to those of the mild cases. Moreover, the neutrophil-to-CD8+ T cell ratio (N8R) were identified as the most powerful prognostic factor affecting the prognosis for severe COVID-19. Conclusion: The degree of lymphopenia MESHD lymphopenia HP and a proinflammatory cytokine storm is higher in severe COVID-19 patients than in mild cases, and is associated with the disease MESHD severity. N8R may serve as a useful prognostic factor for early identification of severe COVID-19 cases.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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