ABSTRACT
Background: The Coronavirus disease 2019 (COVID-19) has caused a global pandemic since December 2019, while the date on the relationship between cardiac injury and mortality in patients with COVID-19 is limited.Methods: All consecutive lab-confirmed critically ill COVID-19 patients in intensive care unit of Wuhan Red Cross Hospital from December 30, 2019 to March 18, 2020, were enrolled. Data of patients were collected. The prevalence of cardiac injury and its association with in-hospital mortality was analyzed.Results: Among the 50 ICU patients, 36 patients (72.0%) were complicated with cardiac injury and 14 patients (28.0%) without cardiac injury. Patients with cardiac injury had higher white blood cell counts, values of d-dimer, levels of lactate concentration, APACHE II score and lower PaO2/FiO2 at the time of admission than those without cardiac injury. The in-hospital case fatality ratio was higher in the cardiac injury than non-cardiac injury group (75.0% vs 21.4%;p=0.002).Multivariable-adjusted logistic proportional hazard regression analysis showed that a significantly higher risk of death in patients with cardiac injury than those without cardiac injury (OR, 5.876; 95% CI, 1.039–33.228).Conclusions: Cardiac injury is a common compilation and associated with higher risk of in-hospital death in patients with severe COVID-19.
Subject(s)
COVID-19 , Heart Diseases , DeathABSTRACT
Background: COVID-19 has spread worldwide, which becomes a huge threat to human beings.Materials: Severe COVID-19 patients from Sichuan area admitted to department of critical care medicine in Chengdu Public Health Clinical Medical Center were retrospectively enrolled. The liver function during the ICU hospitalization were record and analyzed.Results: The severe COVID-19 patients mainly presented with respiratory symptoms such as fever, cough and dyspnea, and the incidence was higher in the elderly patients and males. ALT, AST, TB, and PT increased to varying degrees during the course of the disease, and ALB decreased. The incidence of liver dysfunction in patients taking Lopinavir/Ritonavi was significantly higher than patient who did not have it, but there was no statistical difference (p<0.05). Patients taking low-dose Lopinavir/Ritonavi had a smaller effect on liver function than patients receiving normal dosage.Conclusion: Severe COVID-19 patients have obvious liver damage early in the course of the disease and have a slower recovery. Pay attention to avoid using drugs that can aggravate liver damage while treating the primary disease. If there is no alternative drug, we can give some liver protection treatment appropriately.
Subject(s)
Dyspnea , Fever , Cough , Chemical and Drug Induced Liver Injury , COVID-19 , Liver DiseasesABSTRACT
Background: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread throughout China, but the clinical characteristics of Tibetan patients living in the Qinghai-Tibetan plateau are unknown. We aimed to investigate the epidemiological, clinical, laboratory and radiological characteristics of these patients. Methods: We included 67 Tibetan patients with confirmed SARS-CoV-2 infection. The patients were divided into two groups based on the presence of clinical symptoms at admission, with 31 and 36 patients in the symptomatic and asymptomatic groups, respectively. The epidemiological, clinical, laboratory and radiological characteristics were extracted and analysed. Results: No patient had a history of exposure to COVID-19 patients from Wuhan or had travelled to Wuhan. The mean age of Tibetan patients was 39.3 years and 59% of the patients were male. Seven patients presented with fever on admission and lymphocytopenia was present in 20 patients. 47 patients had abnormal chest CTs at admission instead of stating that 20 were unchanged. Lactate dehydrogenase levels were increased in 31 patients. Seven patients progressed to severe COVID-19; however, after treatment, their condition was stable. No patients died. Of the 36 asymptomatic patients, the mean age was younger than the symptomatic group (34.4 ± 17.3vs 44.9 ± 18.1 years, P = 0.02). Lymphocyte count and prealbumin levels were higher in the asymptomatic group than the group with clinical symptoms (1.6 ± 0.5 vs 1.3 ± 0.6 and 241.8 ± 68.2 vs 191.9 ± 60.3, respectively; P < 0.05). Conclusions: Imported cases of COVID-19 in Tibetan patients were generally mild in this high-altitude area. Absence of fever or radiologic abnormalities on initial presentation were common.
Subject(s)
COVID-19ABSTRACT
Purpose To describe the imaging characteristics in COVID-19 Patients from non-pandemic regions to improve understanding of the disease. Methods We reviewed chest CT scans of 30 COVID-19 patients from three hospitals in Sichuan province, China. Results Typical CT manifestations include the involvement of multiple lobes, mostly in the peripheral zone of the lungs, and subpleural distribution. GGO, crazy paving or mixed GGO and consolidation is the most common signs. Few patients can present small amount of pleural effusion. It is worth noting that none of the lung cavities, tree buds, and lymphadenopathy appeared. The follow-up imaging findings of some patients showed progress when the initial CT score reached 7. Conclusion The CT scan still play an important role in screening the COVID-19, most of the images present positive signs, mainly subpleural, multiple GGO. CT might can predict the severity or whether the patient will progress to severe illness. A small number of patients may be missed if they are based on CT findings alone, which should be closely combined with the patient's epidemiological history and nucleic acid test.
Subject(s)
COVID-19 , Pleural Effusion , Lymphatic DiseasesABSTRACT
Abstract Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has rapidly spread throughout China, but the clinical characteristics of Tibetan patients living in the Qinghai-Tibetan plateau are unknown. We aimed to investigate the epidemiological, clinical, laboratory and radiological characteristics of these patients. We included 67 Tibetan patients with confirmed SARS-CoV-2 infection. The patients were divided into two groups based on the presence of clinical symptoms at admission, with 31 and 36 patients in the symptomatic and asymptomatic groups, respectively. The epidemiological, clinical, laboratory and radiological characteristics were extracted and analysed. No patient had a history of exposure to COVID-19 patients from Wuhan or had travelled to Wuhan. The mean age of Tibetan patients was 39.3 years and 59% of the patients were male. Seven patients presented with fever on admission and lymphocytopenia was present in 20 patients. 47 patients had abnormal chest CTs at admission instead of stating that 20 were unchanged. Lactate dehydrogenase levels were increased in 31 patients. Seven patients progressed to severe COVID-19; however, after treatment, their condition was stable. No patients died. Of the 36 asymptomatic patients, the mean age was younger than the symptomatic group (34.4vs 44.9 years, P=0.02). Lymphocyte count and prealbumin levels were higher in the asymptomatic group than the group with clinical symptoms (1.6 vs 1.3 and 241.8 vs 191.9, respectively; P<0.05). Imported cases of COVID-19 in Tibetan patients were generally mild in this high-altitude area. Absence of fever or radiologic abnormalities on initial presentation were common