ABSTRACT
Objective:To investigate the clinical features and prognosis of patients with corona virus disease 2019 (COVID-19).Methods:The clinical data and chest computed tomography (CT) results of 496 patients with COVID-19 admitted to Wuhan No.7 Hospital from January 22 to February 24, 2020 were retrospectively analyzed. The nucleic acid of 2019 novel coronavirus (2019-nCoV) was detected by real-time fluorescence reverse transcription polymerase chain reaction.Results:There were 246(49.6%) males and 250(50.4%) females. The patients ranged from 10 to 91 years old. All of the patients had a history of living in Wuhan City or close contact with diagnosed patients. The detection of nucleic acid of 2019-nCoV in 496 patients were all positive, and one patient was recuperation positive 14 days after cured and discharged. There were 13 mild cases, 101 ordinary cases, 337 severe cases and 45 critical cases. Twelve (2.4%) patients were asymptomatic, 417(84.1%) patients had fever, and 67(13.5%) had normal body temperature. Other major symptoms included dry cough (229 cases (46.2%)), fatigue (129 cases (26.0%)), short breath (77 cases (15.5%)), expectoration (86 cases (17.3%)), dyspnea (43 cases (8.7%)), chest pain (11 cases (2.2%)) and diarrhea (86 cases (17.3%)). Seventy-five cases (15.1%) showed decreased peripheral blood white blood cell counts and 305 cases (61.5%) showed decreased lymphocyte proportions. Serum alanine aminotransferase and aspartate aminotransferase elevations were presented in 91 cases (18.3%) and 176 cases (35.5%), respectively. Infiltrates on chest CT were seen in 483 cases (97.4%), with 68.7%(332/483) in both lungs, 20.3%(98/483) in right lung, 11.0%(53/483) in left lung. No infiltrates on chest CT were seen in 13(2.6%) patients. As of February 24, 2020, 120(24.2%) patients were cured and discharged, 102(20.6%) patients improved, 52(10.5%) patients died, and the remaining patients were still under treatment. Among the dead patients, 16 cases (30.8%) aged from 61 to 70 years old, 32 cases (61.5%) aged≥71 years old, and 38 cases (73.1%) had underlying diseases.Conclusions:The COVID-19 lesions mainly involve both lungs. The main clinical features are fever and dry cough. The CT imaging findings of the lungs are mostly frosted hyaline. Peripheral white blood cell and leukomonocyte counts are decreased or normal. Older individuals with underlying diseases have increased risk of death.
ABSTRACT
Objective To evaluate the clinical effect of artificial liver support system (ALSS)on serum high -sensitivity C -reactive pro-tein (hs -CRP)level and investigate the influence of the change in hs -CRP level on clinical prognosis among patients with hepatic failure. Methods Patients were recruited into three groups:group one included 60 patients who received ALSS due to hepatic failure;group two in-cluded 37 patients with hepatic failure without ALSS treatment;and group three included 37 patients with chronic hepatitis B.The serum levels of hs -CRP were measured in groups two and three,and in group one before and after ALSS treatment.Comparison of continuous data between groups was made by t test,and comparison of categorical data was made by chi -square test.Results The levels of hs -CRP in group one before treatment and in groups two and three were 12.89 ±9.39,12.22 ±9.73,and 2.83 ±6.79,respectively.No significant difference in hs -CRP level between group one and group two was observed (P >0.05).However,the hs -CRP level in group three was significantly different from those in group one and group two (P <0.001 ).The improvement rate in group one after ALSS treatment (78.3%)was significantly higher compared with that in group two (54.05%)(χ2 =6.315,P <0.05).ALSS treatment (t =5.179,P <0.05).ALSS treatment was selectively effective in a subgroup of patients and greatly decreased the hs -CRP level in these patients (t =5.344,P =0.000),resulting in a significant difference from the patients who were unresponsive to ALSS treatment (t =2.368,P =0.038).Conclusion Artificial liver support system can decrease the hs -CRP level in patients with hepatic failure.Serum level of hs -CRP can be used as a clinical indicator of disease progression and predict the clinical outcomes of ALSS in patients with hepatic failure.