A quantitative exploration of symptoms in COVID-19 patients: an observational cohort study
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Background: As the spreading of the COVID-19 around the global, we investigated the characteristics and changes of symptoms in COVID-19 patients.Methods: This was an ambispective observational cohort study, and 133 confirmed COVID-19 patients were included and all symptoms over the course were analyzed qualitatively.The symptoms, their changes over the course in the cohort and in the different clinical types, etc. were illustrated.Differences in different periods and severities were analyzed through Chi square test, association with severity was analyzed through LASSO binomial logistic regression analysis.Inter-correlation and classification of symptoms were completed.Major symptoms were screened and their changes were illustrated.Results: A total of 43 symptoms with frequencies as 6067 in this cohort.Differences of symptoms in different stages and clinical types were significant.Expectoration, shortness of breath, dyspnea, diarrhea, poor appetite were positively but vomiting, waist discomfort, pharyngeal discomfort, acid reflux were negatively correlated with the combined-severe and critical type; dyspnea was correlated with the critical type.The 17 major symptoms were identified.The average daily frequency of symptoms per case was decreased continuously before the transition into the severe type and increased immediately one day before the transition and then decreased.It was decreased continuously before the transition date of the critical type and increased from the transition into the critical type to the next day and decreased thereafter.Dyspnea (P<0.001),shortness of breath (P<0.01) and chest distress (P<0.05) were correlated with death and their corresponding coefficient was 0.393, 0.258, 0.214, respectively. Conclusion:The symptoms of COVID-19 patients mainly related to upper respiratory tract infection, cardiopulmonary function, and digestive system.The mild type and the early stage in other types mainly related to upper respiratory tract infection.The cardiopulmonary function and digestive system associated symptoms were found in all other types and stages.Dyspnea was correlated with critical type and dyspnea, shortness of breath, and chest distress were correlated with death.Respiratory dysfunction (or incompleteness) associated symptoms were the characteristic symptoms.The changes of symptoms did not synchronously with the changes of severity before the transition into the severe or critical type.Summary It is given an account of a case of recurrent vomiting in a girl of 8 years. She have had her symptoms from the age of 2 years with frequent attacks of vomiting lasting several days, Her symptoms resembled closely the findings in cases of acetonemic vomiting except that the degree of acetonemia was very low and came on after the vomiting had begun. During the attacks there was a complete retention in the stomach, but when the vomitings had ceased the roentgenological findings where normal. Electroence phalography showed an electrical cerbral dysrhythmia and the condition of the patient was explained as beeing a visceral epileptic equivalent. As the recurrent vomiting of the patient showed close relationship to acetonemic vomiting it is argued that one ought to make an electroencephalography in similar cases.
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A 22-year-old woman has had chronic nausea, emesis with green vomitus, and diarrhea for the past 10 months. The diarrhea is frequent (about 3 to 8 times daily) and does not resolve with starvation.
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The purposes of this study were to develop and implement an observational training program and to assess the effects of a video observational training program on video and live observational proficiency. Physical education majors took a pretest in both a video and a live environment to assess observational proficiency. The task was observing children batting and answering questions regarding the critical features of the movement. The students were then placed into either a treatment ( n = 12) or a control ( n = 11) group. There were no differences between groups on either assessment ( p > .05). The treatment group then participated in a video observational training program. After the training, all subjects took a posttest in each environment to assess observational proficiency. The training was found to be effective in improving video observational proficiency ( p < .05) but not live observational proficiency ( p > .05). These results provide support for the effectiveness of video observational training in developing video observational proficiency but not live observational proficiency.
Observational learning
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Studies can be observational or experimental. With an observational study, the investigator does not determine the assignment of subjects, and there might not be a control group. If there is a control group, assignment of the independent variable (exposure or intervention) is not under the control of the investigator. Observational studies can be rigorously conducted, but the lack of random assignment of the exposure/intervention introduces confounding and bias. Thus, the quality of evidence resulting from observational studies is lower than that of experimental randomized controlled trials (RCTs). An observational study might be performed if an RCT is unethical, impractical, or outside the control of the investigator. There are many types of prospective and retrospective observational study designs. However, an observational study design should be avoided if an experimental study is possible. Sophisticated statistical approaches can be used, but this does not elevate an observational study to the level of an RCT. Regardless of quality, an observational study cannot establish causality.
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Journal Article Potential impact of observational cohort studies in Japan on rheumatoid arthritis research and practice Get access Hisashi Yamanaka, Hisashi Yamanaka Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan Correspondence to: Hisashi Yamanaka, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan Tel. +81-3-5269-1725; Fax +81-3-5269-1726 e-mail: yamanaka@ior.twmu.ac.jp Search for other works by this author on: Oxford Academic Google Scholar Shigeto Tohma Shigeto Tohma Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan Search for other works by this author on: Oxford Academic Google Scholar Modern Rheumatology, Volume 16, Issue 2, 1 April 2006, Pages 75–76, https://doi.org/10.3109/s10165-006-0464-8 Published: 01 April 2006 Article history Received: 24 January 2006 Accepted: 20 February 2006 Published: 01 April 2006
Clinical Practice
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For better management of rheumatoid arthritis (RA) patients, we need information both from well-designed clinical trials, such as randomized controlled trials, and from observational cohorts. Observational cohort study has not been developed in Japanese RA patients; however, two cohorts, IORRA (formerly J-ARAMIS) from 2000 and NinJa by iR-net from 2002, have been established. These two cohorts are an important source not only for better management of Japanese RA patients but also for solutions to a variety of issues concerning RA clinical practice in general. In this minireview, necessities of observational cohort studies are discussed.
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Observational cohort studies in early RA are a key source of evidence, despite inconsistencies in methodological approaches. This narrative review assesses the spectrum of methodologies used in addressing centre-level effect and case-mix adjustment in early RA observational cohort studies.An electronic search was undertaken to identify observational prospective cohorts of >100 patients recruited from two or more centres, within 2 years of an RA or early inflammatory arthritis diagnosis. References and author publication lists of all studies from eligible cohorts were assessed for additional cohorts.Thirty-four unique cohorts were identified from 204 studies. Seven percent of studies considered centre in their analyses, most commonly as a fixed effect in regression modelling. Reporting of case-mix variables in analyses varied widely. The number of variables considered in case-mix adjustment was higher following publication of the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement in 2007.Centre effect is unreported or inadequately accounted for in the majority of RA observational cohorts, potentially leading to spurious inferences and obstructing comparisons between studies. Inadequate case-mix adjustment precludes meaningful comparisons between centres. Appropriate methodology to account for centre and case-mix adjustment should be considered at the outset of analyses.
Case mix index
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