AbstractBackgroud: To describe the frequency and distribution characteristics of gastrointestinal symptoms of coronavirus disease 2019 (COVID-19) patients.Methods: As a cohort study, all confirmed COVID-19 patients with gastrointestinal symptoms at Xiangyang No.1 people’s hospital were included until February 21st, 2020. Course of disease no less than 21 days.Gastrointestinal symptoms relevant data were extracted and analyzed. The frequency histograms of the symptoms were plotted. Main symptom characteristics were summarized.Results: Of 50 included patients with gastrointestinal symptoms, 21 were male, 29were female. The mean age was 53 (SD 16) years. Course of disease ranged from 21 to 34 days with a median of 26 days. Among all patients, 16 were critically ill and five died, 12 discharged. Thirty-one clinical symptoms occurred 3168 times in total, 6 gastrointestinal symptoms occurred 439 (13.86%) times and 25 non-gastrointestinal symptoms occurred 2 729(86.14%) times. All symptoms and non-gastrointestinal symptoms distributed in 1 to 34 days, reached peak on 6th day of follow up, first seven days were the fastigium and decreasing in the rest days. Gastrointestinal symptoms mainly distributed in 1 to 34 days, reached a peak of 36 times per day on 6th of follow-up with a fastigium during 6 to 12 day, showed a trend of rise first and then fall. Nausea, vomit and abdominal discomfort occurred 133, 70 and 62 times, respectively.Conclusions: A symptom frequency to time distribution model could describe the disease process quantitatively, indicating the change law of gastrointestinal symptoms and the organ damages in gastrointestinal system, could help us to better understand and treat the new disease. Females showed higher incidence of gastrointestinal symptoms, whether there is a sex difference in susceptibility needs to be further confirmed.Trial regitration: retrospectively registeredAuthors Guoxin Huang and Shengduo Pei contributed equally to this work.
ABSTRACT Background Coronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis, and prevent the aggravation of COVID-19. Methods Patients’ general information, clinical type, all CK values and outcome were collected. CK value of all cases during disease course started from different initial time were analyzed. Results All cases underwent 504 tests of CK since symptom onset and the median value was 51.7 (35.0-91.5) U/L. The first median value on the day 8 from exposure onset was 78.1 (69.1-85.8) U/L then showed an upward trend from the day 8 to the day 12 (reaching a peak of 279.3 U/L), finally showed a fluctuation decline after the day 12. The CK median value in critical cases reached the peak (625.5 U/L) on the transforming date, and then decreased rapidly to the normal range. Before death, the CK median value in dead cases firstly increased until the day −14 with a peak as 470.0 U/L, then decreased with fluctuation until day −2, and finally increased again on the day 0. Conclusions CK reached its peak on the day when it became critical type, dynamic detection of CK can guide clinical judgment of prognosis. The increase of CK is a high risk factor of death. Severe cell damage 2 weeks before death might determines the outcome of the disease even if CK drops to the normal range afterward.
Abstract Background Coronavirus disease‐2019 (COVID‐19) has spread all over the world and brought extremely huge losses. At present, there is a lack of study to systematically analyze the features of hydroxybutyrate dehydrogenase (α‐HBDH) in COVID‐19 patients. Methods Electronic medical records including demographics, clinical manifestation, α‐HBDH results and outcomes of all included patients were extracted. Results α‐HBDH in COVID‐19 group was higher than that in excluded group ( p < 0.001), and there was no significant difference in α‐HBDH before and after the exclusion of 5 patients with comorbidity in heart or kidney ( p = 0.671). In COVID‐19 group, the α‐HBDH value in ≥61 years old group, severe group, and critical group, death group all increased at first and then decreased, while no obvious changes were observed in other groups. And there were significant differences of the α‐HBDH value among different age groups ( p < 0.001), clinical type groups ( p < 0.001), and outcome groups ( p < 0.001). The optimal scale regression model showed that α‐HBDH value ( p < 0.001) and age ( p < 0.001) were related to clinical type. Conclusions α‐HBDH was increased in COVID‐19 patients, obviously in ≥61 years old, death and critical group, indicating that patients in these three groups suffer from more serious heart and kidney and other tissues and organs damage, higher α‐HBDH value, and risk of death. The difference between death and survival group in early stage might provide a approach to judge the prognosis. The accuracy of the model to distinguish severe/critical type and other types was 85.84%, suggesting that α‐HBDH could judge the clinical type accurately.
Abstract Background Coronavirus disease-2019 (COVID-19) has spread all over the world and brought extremely huge losses. At present, there is no study to systematically analyse the features of hydroxybutyrate dehydrogenase (α-HBDH) in COVID-19 patients with different ages, clinical types and outcomes. Methods Electronic medical records including demographics, clinical manifestation, α-HBDH test results and outcomes of 131 hospitalized COVID-19 patients, with confirmed result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection, were extracted and analyzed. Results The α-HBDH value in ≥61 years old group, severe group and critical group, death group all increased at first and then decreased, while no obvious changes were observed in other groups. And there were significant differences of the α-HBDH value among different age groups (P<0.001), clinical type groups (P<0.001) and outcome groups (P<0.001). The optimal scale regression model showed that α-HBDH value (P<0.001) and age (P<0.001) were related to clinical type. Conclusions α-HBDH value increases in some COVID-19 patients, obviously in ≥61 years old, death and critical group, indicating that patients in these three groups suffer from more serious tissues and organs damage, higher α -HBDH value and risk of death. The obvious difference between death and survival group in early stage may provide a approach to judge the prognosis. The accuracy of the model to distinguish severe/critical type and other types is 85.84%, suggesting that α-HBDH could judge the clinical type of COVID-19 patients accurately. In brief, α-HBDH is an important indicator to judge the severity and prognosis of COVID-19.
Mesenchymal stem cells (MSCs) have been regarded as an attractive and promising tool for cell-based therapy in immune disorders and inflammatory diseases, as well as for regenerative medicine, owing to their potent immunomodulatory function, paracrine effects and capacity of multilineage differentiation. However, a lot of factors, such as inflammatory factors, can influence their immunomodulatory function and thus change their efficiency and clinical outcomes in clinical application. In this review we try to summarize the immunomodulatory function of MSCs, factors in microenvironment which might influence this function, as well as their potential application and challenges.
Summary Objective To describe the epidemiological and clinical characteristics of the Coronavirus Disease 2019 (COVID-19) hospitalized patients and to offer suggestions to the urgent needs of COVID-19 prevention, diagnosis and treatment. Methods We included 102 confirmed COVID-19 cases hospitalized in Xiangyang No.1 people’s hospital, Hubei, China until Feb 9th, 2020. Demographic data, laboratory findings and chest computed tomographic (CT) images were obtained and analyzed. Findings All cases were confirmed by real-time RT-PCR, including 52 males and 50 females with a mean age of 50.38 years (SD 16.86). Incubation time ranged from one to twenty days with a mean period of 8.09 days (SD 4.99). Fever (86[84.3%] of 102 patients), cough (58[57%]), fatigue (28[27%]), shortness of breath (24[23%]), diarrhea (15[15%]), expectoration (13[12%]), inappetence (11[10%]) were common clinical manifestations. We observed a decreased blood leukocyte count and lymphopenia in 21 (20.6%) and 56 (54.9%) patients, respectively. There were 66 (68%) of 97 patients with elevated C-reactive protein levels and 49 (57.6%) of 85 with increased erythrocytes sedimentation rate. Higher levels of procalcitonin and ferritin were observed in 19 (25.3%) of 75 and 12 (92.3%) of 13 patients, respectively. Eight patients were admitted to intensive care unit (ICU), six developed respiratory failure, three had multiple organ failure and three died. The cumulative positivity rate over three rounds of real-time RT-PCR was 96%. One-hundred patients were found with typical radiological abnormalities in two rounds of chest CT scans, indicating a 98% consistency with real-time RT-PCR results. Interpretation Most COVID-19 patients in Xiangyang were secondary cases without sex difference, and the rate of severe case and death was low. Middle-to-old-age individuals were more susceptible to the virus infection and the subsequent development of severe/fatal consequences. The average incubation period was longer among our patients. We recommend prolonging the quarantine period to three weeks. Three times real-time RT-PCR plus two times CT scans is a practical clinical diagnosis strategy at present and should be used to increase the accuracy of diagnosis, thereby controlling the source of infection more effectively.
ABSTRACT BACKGROUND Coronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis and prevent the aggravation of COVID-19. METHODS All laboratory confirmed COVID-19 patients hospitalized in Xiangyang No.1 People’s Hospital were included. Patients’ general information, clinical type, CRP value and outcome were collected. CRP values of all patients during disease course from different initial time were analyzed. RESULTS The 131 enrolled patients were 50.13±17.13 years old. All cases underwent 724 tests of CRP since symptom onset, 53.18% of the test results were abnormal and the median value was 9.52(2.63-34.10) mg/L. The first median value on the day 8 from exposure onset was 39.08(11.92-47.89) mg/L then fluctuated around it until the day 28. The CRP median increased from 15.93 mg/L to 41.44 mg/L and then decreased to 18.26 mg/L before transformation of severe type, and then increased to 62.25 mg/L on the transforming date. Conversely, the CRP median increased from 56.17 mg/L 102.75 mg/L before transformation of critical type but decreased to 68.68 mg/L on the transforming date. The changes of CRP median over time before death ranged from 77.77 mg/L to 133.52 mg/L. CONCLUSIONS CRP increased before symptom onset and substantially increased during the early-to-mid stage (especially early stage), which was different from other virus-infected diseases. The changes of CRP before the transformation of clinical type was inconsistent with the aggravating of illness. And the CRP maintained over 100.00 mg/L prompted poor prognosis.
Introduction The aim of the study was to examine the association between frailty and osteoarthritis. Material and methods We conducted a cross-sectional study in the National Health and Nutrition Examination Survey, while logistic regression was used to explore the association of the two. Mendelian randomization (MR) study was used to explore the causal relationship between the two. Results In the cross-sectional study, logistic regression analysis showed that odds ratio (OR) (95% CI) value was 1.07 (1.05, 1.08). In the MR study, the inverse-variance weighting (IVW) results showed OR (95% CI) value of 1.69 (1.01–2.83). Conclusions There is both a correlation and a causal relationship between frailty and osteoarthritis, and frailty may be a potentially better response than age to osteoarthritis.
Abstract Background The stage of CT images was rarely studied and the relationship between the severity of Coronavirus Disease 2019 (COVID-19) and CT images has not been studied based on systematic quantitative analysis currently. Purpose To investigate the staging duration and classification of CT images of patients with COVID-19 based on quantitative analysis. Materials and Methods This is an ambispective observational cohort study based on 125 patients with COVID-19 from Jan 23 to Feb 28, 2020. The stage of CT and pulmonary lesion size were quantitatively analyzed. The categorical regression analysis based on optimal scale (CATREG) was performed to evaluate the association of CT score, age, and gender with the clinical type. Results The CT images of 125 patients with COVID-19 (50.13 ± 16.91 years, 66 women) were analyzed in this study. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 ± 2.31, 10.07 ± 4.91, and 20.60 ± 7.64 days, respectively. The median CT score was 5.00 (2.00-8.50) during the first 30 days, which reached a peak on the 11 th day. Significant differences were found between the median CT scores of different clinical types (P<0.05). Besides, the age was correlated with the clinical type (P<0.001), the CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type with the output accuracy 69.60%. Conclusion The four-stage staging method based on quantitative analysis is consistent with the change rules of staging features and COVID-19. Quantitative study by scoring pulmonary lesion sizes accurately revealed the evolvement of pulmonary lesions and differences between different clinical types. Summary Quantitative study of the stage duration and classification of chest CT images can objectively reveal the relationship between Coronavirus Disease 2019 (COVID-19) and chest CT images. Key Results 1. A four-stage staging method was proposed. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 ± 2.31, 10.07 ± 4.91, and 20.60 ± 7.64 days, respectively. 2. The severer the disease, the higher the median CT scores and their peak value. 3. The CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type.
Abstract Background Coronavirus disease-2019 (COVID-19) has spread all over the world and brought extremely huge losses. There is no study to systematically analyse the features of hydroxybutyrate dehydrogenase (α-HBDH) in COVID-19 patients during the periods before and after illness progression, before death and course from exposure onset. Methods We collected all included patients’ general information, clinical type, α-HBDH value and outcome, and analyzed α-HBDH values within different initial time and different periods. Results In the first 30 days after symptom onset, the α-HBDH median value was 156.33 U/L. The first test of α-HBDH since exposure onset appeared on the 8th day, it increased from the 8th day to 18th day and decreased after the 18th day. α-HBDH median value showed a slight change until it started to increase 1 day before transforming to severe type, while it continued to increase during 4 days before and after transforming to critical type. The α-HBDH median value ranged from 191.11 U/L to 455.11U/L before death. Conclusions α-HBDH value increases in some COVID-19 patients, obviously in severe type, critical type and death patients, and mainly in 18 days after exposure onset and 10 days after symptom onset. α-HBDH increases 1 day before transforming to severe type, continues to increase in critical type and death patients, increases rapidly 5 days before death. The increase of α-HBDH suggests that COVID-19 patients have tissues and organs damage, mainly in heart. In brief, α-HBDH is an important indicator to judge the severity and prognosis of COVID-19.
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