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Xue ZY, Xiao ZL, Cheng M, Xiang T, Wu XL, Ai QL, Wu YL, Yang T. Subdural effusion associated with COVID-19 encephalopathy: A case report. World J Clin Cases 2024; 12:1799-1803. [PMID: 38660075 PMCID: PMC11036469 DOI: 10.12998/wjcc.v12.i10.1799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/07/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The precise mechanism by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts the central nervous system remains unclear, with manifestations spanning from mild symptoms (e.g., olfactory and gustatory deficits, hallucinations, and headache) to severe complications (e.g., stroke, seizures, encephalitis, and neurally demyelinating lesions). The occurrence of single-pass subdural effusion, as described below, is extremely rare. CASE SUMMARY A 56-year-old male patient presented with left-sided limb weakness and slurred speech as predominant clinical symptoms. Through comprehensive imaging and diagnostic assessments, he was diagnosed with cerebral infarction complicated by hemorrhagic transformation affecting the right frontal, temporal, and parietal regions. In addition, an intracranial infection with SARS-CoV-2 was identified during the rehabilitation process; consequently, an idiopathic subdural effusion developed. Remarkably, the subdural effusion underwent absorption within 6 d, with no recurrence observed during the 3-month follow-up. CONCLUSION Subdural effusion is a potentially rare intracranial complication associated with SARS-CoV-2 infection.
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Affiliation(s)
- Zhi-Yuan Xue
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Zhong-Lin Xiao
- Department of Rehabilitation Medicine, The General Hospital of the Western Theater Command of the People’s Liberation Army of China, Chengdu 610000, Sichuan Province, China
| | - Ming Cheng
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Tao Xiang
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Xiao-Li Wu
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Qiao-Ling Ai
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Yang-Ling Wu
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Tao Yang
- Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
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Tian X, Xu Y, Wang L, Dong C, Yan X, Fan J, Xie H, Zhang H, Wang J, Liu Y, Wang Y, Pan S, Wu A, Liu X, Yao C, Wang M. Efficacy and safety of azvudine in symptomatic adult COVID-19 participants who are at increased risk of progressing to critical illness: a study protocol for a multicentre randomized double-blind placebo-controlled phase III trial. Trials 2024; 25:77. [PMID: 38254211 PMCID: PMC10804629 DOI: 10.1186/s13063-024-07914-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 will coexist with humans for a long time, and it is therefore important to develop effective treatments for coronavirus disease 2019 (COVID-19). Recent studies have demonstrated that antiviral therapy is a key factor in preventing patients from progressing to severe disease, even death. Effective and affordable antiviral medications are essential for disease treatment and are urgently needed. Azvudine, a nucleoside analogue, is a potential low-cost candidate with few drug interactions. However, validation of high-quality clinical studies is still limited. METHODS This is a multicentre, randomized, double-blind, placebo-controlled phase III clinical trial involving 1096 adult patients with mild-to-moderate symptoms of COVID-19 who are at high risk for progression to severe COVID-19. Patients will be randomized to (1) receive azvudine tablets 5 mg daily for a maximum of 7 days or (2) receive placebo five tablets daily. All participants will be permitted to use a standard treatment strategy except antiviral therapy beyond the investigational medications. The primary outcome will be the ratio of COVID-19-related critical illness and all-cause mortality among the two groups within 28 days. DISCUSSION The purpose of this clinical trial is to determine whether azvudine can prevent patients at risk of severe disease from progressing to critical illness and death, and the results will identify whether azvudine is an effective and affordable antiviral treatment option for COVID-19. TRIAL REGISTRATION ClinicalTrials.gov NCT05689034. Registered on 18 January 2023.
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Affiliation(s)
- Xinlun Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yan Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Luo Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Chongya Dong
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Xiaoyan Yan
- Peking University Clinical Research Institute, Beijing, China
| | - Junping Fan
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Huaiya Xie
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Hong Zhang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Jinglan Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yongjian Liu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yaqi Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Siqi Pan
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Aohua Wu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xueqi Liu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Chen Yao
- Peking University Clinical Research Institute, Beijing, China
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Mengzhao Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
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Wang Y, Li F, Liu J, Liu J, Qin P, Zhang J, Zhang Y, Wu S. Analysis of Symptom Spectra and Associated Factors Among 536 Respondents During the COVID-19 Epidemic in China: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:3261-3272. [PMID: 37942282 PMCID: PMC10629551 DOI: 10.2147/jmdh.s426607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose This study aims to identify common COVID-19 symptoms and asymptomatic infection rates during the epidemic in China. We also introduce the concepts of "Time-point asymptomatic rate" and "Period asymptomatic rate". Object and Methods A questionnaire survey was conducted online from December 2022 to January 5, 2023, collecting demographic characteristics, laboratory results, clinical symptoms, lifestyle and vaccination history. Statistical methods were used to analyze symptom characteristics, associated factors, and patterns during an 8-day observation period. Numerical variables were described by median M (Q1-Q3) or mean and standard deviation (). Categorical variables are described by frequency (N), ratio (%) or rate (%). The influencing factors were studied by Wilcoxon or Kruskal-Willis H rank sum test or logistic regression analysis, and the trend of symptom incidence by Spearman rank correlation. P value being ≤0.05 was statistically significant. Results Out of 536 participants, 493 (91.98%) were infected, with 3 asymptomatic cases and 490 symptomatic cases within 8 days. The time-point asymptomatic rate increased from 0.61% on day 1 to 15.42% on day 8. Fever, cough, and fatigue were the main symptoms, with additional symptoms such as vomiting, diarrhea, and hyposmia reported. Symptom durations varied, with cough and expectoration lasting longer and vomiting and diarrhea lasting shorter. Several symptoms showed a downward trend over time. Conclusion Our online survey highlighted that most COVID-19 patients experienced symptoms, and the time-point asymptomatic rate showed a dynamic change among the infected population. Onset patterns and demographic factors influence symptom occurrence and duration. These findings have implications for clinical practitioners and decision-makers in public health measures and strategies.
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Affiliation(s)
- Ye Wang
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, People’s Republic of China
| | - Fenxiang Li
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, People’s Republic of China
| | - Jian Liu
- Department of General Surgery, Maternal and Child Health Hospital, Qingyuan, Guangdong, People’s Republic of China
| | - Jing Liu
- Intensive Care Unit 1, The First Affiliated Hospital, Jinan University, Guangdong, Guangzhou, People’s Republic of China
| | - Pei Qin
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China
| | - Jiayi Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Yingtao Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Shuning Wu
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China
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Nikolaevich KA, Vladimirovich KA, Mikhailovich UV, Vladimirovich BY. Acute thrombosis of the lower limb arteries on the background of the XBB.1.5 ("Kraken") subvariant of omicron SARS-COV-2 - medical or surgical treatment? Indian J Thorac Cardiovasc Surg 2023; 39:601-607. [PMID: 37885941 PMCID: PMC10597904 DOI: 10.1007/s12055-023-01551-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 10/28/2023] Open
Abstract
Aim Comparative analysis of the results of open thrombectomy and conservative therapy in patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of Omicron Severe acute respiratory syndrome-related coronavirus-2 (Sars-cov-2). Material and methods The present prospective, open, multicenter comparative study for the period 04/01/2022 to 12/01/2023 included 167 patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of the XBB.1.5 ("Kraken") subvariant of Omicron Sars-cov-2.Depending on the treatment strategy, two groups were formed: group 1 - open thrombectomy (n = 136) and drug treatment with an anticoagulant (unfractionated heparin in a therapeutic dosage) and an antiplatelet (acetylsalicylic acid 125 mg once a day); group 2 - only drug therapy (n = 31). This group consisted of patients who refused surgical revascularization and were on a prophylactic dose of unfractionated heparin (5000 U 3 times a day subcutaneously). On the development of acute arterial thrombosis, 80 U/kg (maximum 5000 U) of unfractionated heparin was injected intravenously in a bolus, followed by transfer to intravenous infusion using an infusion pump with an initial rate of 18 U/kg per hour under control of activated partial thromboplastin time. Analgesic and antiplatelet therapy was also prescribed (acetylsalicylic acid 125 mg once a day). Results No significant intergroup differences either in mortality rates (group 1: n = 58, 38.2%; group 2: n = 7, 22.6%; p = 0.09) or limb amputation (group 1: n = 63, 46.3%; group 2: n = 9, 29.0%; p = 0.07) were found. However, there was a trend towards a decrease in the incidence of these events in the drug treatment group. After open thrombectomy, rethrombosis developed in 50.7% (n = 69) cases; and thrombosis after rethrombectomy followed by amputation in 46.3% (n = 63). There were no hemorrhagic complications in both groups. Myocardial infarction and ischemic strokes were not recorded. Conclusion Anticoagulant therapy demonstrates several advantages over aggressive surgical management. However, probably due to the small size of the studied sample, significant differences were not obtained. Further study of this issue is required with the identification of the optimal reperfusion method in this complex cohort of patients.
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Affiliation(s)
- Kazantsev Anton Nikolaevich
- Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation
- Kostroma Oncological Dispensary, Kostroma, Russian Federation
| | - Korotkikh Alexander Vladimirovich
- Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation
| | | | - Belov Yuri Vladimirovich
- First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation
- Federal State Budgetary Scientific Institution “Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky”, Moscow, Russian Federation
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Zhang L, Guo X, Yu D, Wang G. From the perspective of narrative psychology, the research on psychological trauma management of disabled people under the background of novel coronavirus infection is explored. Asian J Surg 2023; 46:5409-5410. [PMID: 37537058 DOI: 10.1016/j.asjsur.2023.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Lihua Zhang
- Chifeng Anding Hospital, No. 18, Gonger Street, Hongshan District, Chifeng City, Inner Mongolia, 024000, China
| | - Xiuzhen Guo
- Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Huhehot North Street, Inner Mongolia, 010050, China
| | - Dongsheng Yu
- Inner Mongolia Mental Health Center, Huhehot Ulanqab West Road, Inner Mongolia, 010050, China.
| | - Guoyan Wang
- Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Huhehot North Street, Inner Mongolia, 010050, China.
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Xu Y, Wang N, Shen X, Liu X, Liu H, Liu Y. Persistent lymphocyte reduction and interleukin-6 levels are independently associated with death in patients with COVID-19. Clin Exp Med 2023; 23:3719-3728. [PMID: 37310657 PMCID: PMC10261836 DOI: 10.1007/s10238-023-01114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023]
Abstract
To investigate the value of the peripheral blood lymphocyte count (LYM) combined with interleukin-6 (IL-6) in predicting disease severity and prognosis in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. This was a prospective observational cohort study. A total of 109 patients with SARS-CoV-2 pneumonia who were admitted to Nanjing First Hospital from December 2022 to January 2023 were enrolled. The patients were divided into two groups based on disease severity: severe (46 patients) and critically ill (63 patients). The clinical data of all patients were collected. The clinical characteristics, sequential organ failure assessment (SOFA) score, peripheral blood lymphocyte count, IL-6 level and other laboratory test results were compared between the two groups. A receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of each index for SARS-CoV-2 pneumonia severity; patients were regrouped using the optimal cut-off value of the ROC curve, and the relationship between different LYM and IL-6 levels and the prognosis of patients was analysed. Kaplan‒Meier survival curve analysis was performed; in the different LYM and IL-6 groups, the patients were regrouped based on whether thymosin was used, and the effect of thymosin on patient prognosis was compared between the groups. Patients in the critically ill group were significantly older than patients in the severe group (age: 78 ± 8 vs. 71 ± 17, t = 2.982, P < 0.05), and the proportion of patients with hypertension, diabetes and cerebrovascular disease was significantly higher in the critically ill group than in the severe group (69.8% vs. 45.7%, 38.1% vs. 17.4%, 36.5% vs. 13.0%; χ2 values, 6.462, 5.495, 7.496, respectively, all P < 0.05). Compared with the severe group, the critically ill group had a higher SOFA score on admission (score: 5.4 ± 3.0 vs. 1.9 ± 1.5, t = 24.269, P < 0.05); IL-6 and procalcitonin (PCT) in the critically ill group were significantly higher than those in the severe group on the first day of admission [288.4 (191.4, 412.9) vs. 513.0 (288.2, 857.4), 0.4 (0.1, 3.2) vs. 0.1 (0.05, 0.2); Z values, 4.000, 4.456, both P < 0.05]. The lymphocyte count continued to decline, and the lymphocyte count on the 5th day (LYM-5d) was still low (0.6 ± 0.4 vs. 1.0 ± 0.4, t = 4.515, both P < 0.05), with statistically significant differences between the two groups. ROC curve analysis indicated that LYM-5d, IL-6 and LYM-5d + IL-6 all had value for predicting SARS-CoV-2 pneumonia severity; the areas under the curve (AUCs) were 0.766, 0.725, and 0.817, respectively, and the 95% confidence intervals (95% CI) were 0.676-0.856, 0.631-0.819, and 0.737-0.897, respectively. The optimal cut-off values for LYM-5d and IL-6 were 0.7 × 109/L and 416.4 pg/ml, respectively. LYM-5d + IL-6 had the greatest value in predicting disease severity, and LYM-5d had higher sensitivity and specificity in predicting SARS-CoV-2 pneumonia severity. Regrouping was performed based on the optimal cut-off values for LYM-5d and IL-6. Comparing the IL-6 ≥ 416.4 pg/ml and LYM-5d < 0.7 × 109/L group with the other group, i.e., patients in the non-low-LYM-5d and high-IL-6 group, patients in the low-LYM-5d and high-IL-6 group had a higher 28-day mortality rate (71.9% vs. 29.9%, χ2 value 16.352, P < 0.05) and a longer hospital stay, intensive care unit (ICU) stay and mechanical ventilation time (days: 13.7 ± 6.3 vs. 8.4 ± 4.3, 9.0 (7.0, 11.5) vs. 7.5 (4.0, 9.5), 8.0 (6.0, 10.0) vs. 6.0 (3.3, 8.5); t/Z values, 11.657, 2.113, 2.553, respectively, all P < 0.05), as well as a higher incidence of secondary bacterial infection during the disease course (75.0% vs. 41.6%, χ2 value 10.120, P < 0.05). Kaplan‒Meier survival analysis indicated that the median survival time of patients in the low LYM-5d and high-IL-6 group was significantly shorter than that of patients in the non-low LYM-5d and high-IL-6 group (14.5 ± 1.8 d vs. 22.2 ± 1.1 d, Z value 18.086, P < 0.05). There was no significant difference in the curative effect between the thymosin group and the nonthymosin group. LYM and IL-6 levels are closely related to SARS-CoV-2 pneumonia severity. The prognosis for patients with IL-6 ≥ 416.4 pg/ml at admission and a lymphocyte count < 0.7 × 10 9/L on the 5th day is poor.
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Affiliation(s)
- You Xu
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Nianci Wang
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Xiao Shen
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Xu Liu
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Han Liu
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China.
| | - Ying Liu
- Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, People's Republic of China.
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Gao X, Li D, Cheng X, Xin X, Corno AF, Boscarelli A, Du X. Clinical characteristics of pediatric inpatients infected with the SARS-CoV-2 Omicron variant-a retrospective observational cohort study. Transl Pediatr 2023; 12:1396-1402. [PMID: 37575900 PMCID: PMC10416127 DOI: 10.21037/tp-23-292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Background The children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at risk of progressing to severe disease. Clinical characteristics treatment measures and prognosis of these special age group of patients have not been completely understood which necessitate more researches. This study sought to analyze the clinical characteristics of children infected with the Omicron variant to provide evidences for the prevention, diagnosis and treatment of the Omicron variant infection in children. Methods The subjects of this study included children hospitalized for the Omicron variant at Tianjin Binhai Hospital in November 2022. The data were collected from the electronic medical record system, and the clinical characteristics of the children were analyzed. The primary endpoints included the clinical presentation, laboratory tests, virological characteristics, treatment regimen, and clinical prognosis of the patients. Results A total of 49 patients were enrolled, of whom 32 (65.3%) were male. The patients had a median age of 10 (interquartile range, 6-11) years, and 34.7% of the patients received 2 or more coronavirus disease 2019 (COVID-19) vaccines. The main clinical manifestations of the patients were fever (79.6%) and cough (24.5%), with a maximum temperature of 42 ℃ and a median temperature of 39 (interquartile range, 38.4-39) ℃. The proportions of neutrophils and C-reactive protein were elevated by 50.0% and 25.0%, respectively. The total percentages of white blood cells and thrombocytopenia were 12.5% and 6.3%, respectively. D-dimer was examined in 6 cases, and was elevated to 1.77 μg/mL in 1 case (16.7%), and normal in 5 cases. The liver function, kidney function, and coagulation of 9 (100%) patients were all normal. After the anti-virus, anti-inflammatory response, antipyretic, and traditional Chinese medicine treatments, all the children were cured and discharged from the hospital. There were no severe cases. Conclusions The main manifestations of children infected with the SARS-CoV-2 Omicron variant were fever and cough. Some children had a high fever, nasal congestion, runny nose, gastrointestinal symptoms, and rash. A proportion of 12.5% of patients have a white blood cell count less than 4×109/L, and 6.3% have thrombocytopenia. The prognosis of the child was favorable after treatment with antiviral, antipyretic, and traditional Chinese medicine.
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Affiliation(s)
- Xiang Gao
- Department of Orthopedics, Tianjin Fifth Central Hospital, Tianjin, China
| | - Debao Li
- Department of Pediatrics, Tanggu Maternity Hospital, Tianjin, China
| | - Xiuling Cheng
- Department of Nursing, Tianjin Fifth Central Hospital, Tianjin, China
| | - Xiaoxia Xin
- Department of Hematology, Tianjin Fifth Central Hospital, Tianjin, China
| | | | - Alessandro Boscarelli
- Department of Pediatric Surgery and Urology, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Xinping Du
- Department of Cardiology, Tianjin Fifth Central Hospital, Tianjin, China
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Kozlov KV, Zhdanov KV, Ratnikova AK, Ratnikov VA, Tishkov AV, Grinevich V, Kravchuk YA, Miklush PI, Nikiforova PO, Gordienko VV, Popov AF, Andryukov BG. Hepatobiliary system and intestinal injury in new coronavirus infection (COVID-19): A retrospective study. World J Clin Cases 2023; 11:2226-2236. [PMID: 37122523 PMCID: PMC10131012 DOI: 10.12998/wjcc.v11.i10.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/22/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND An important area of effective control of the coronavirus disease 19 (COVID-19) pandemic is the study of the pathogenic features of severe acute respiratory syndrome coronavirus 2 infection, including those based on assessing the state of the intestinal microbiota and permeability.
AIM To study the clinical features of the new COVID-19 in patients with mild and moderate severity at the stage of hospitalization, to determine the role of hepatobiliary injury, intestinal permeability disorders, and changes in the qualitative and quantitative composition of the microbiota in the development of systemic inflammation in patients with COVID-19.
METHODS The study was performed in 80 patients with COVID-19, with an average age of 45 years, 19 of whom had mild disease, and 61 had moderate disease severity. The scope of the examination included traditional clinical, laboratory, biochemical, instrumental, and radiation studies, as well as original methods for studying microbiota and intestinal permeability.
RESULTS The clinical course of COVID-19 was studied, and the clinical and biochemical features, manifestations of systemic inflammation, and intestinal microbiome changes in patients with mild and moderate severity were identified. Intestinal permeability characteristics against the background of COVID-19 were evaluated by measuring levels of proinflammatory cytokines, insulin, faecal calprotectin, and zonulin.
CONCLUSION This study highlights the role of intestinal permeability and microbiota as the main drivers of gastroenterological manifestations and increased COVID-19 severity.
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Affiliation(s)
- Konstantin V Kozlov
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Konstantin V Zhdanov
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Anna K Ratnikova
- Department of Admission, Federal State Budgetary Institution "North-West District Scientific and Clinical Center Named After LG. Sokolov Federal Medical and Biological Agency", Saint-Petersburg 194291, Russia
| | - Vyacheslav A Ratnikov
- Department of Roentgenology, Federal State Budgetary Institution "North-West District Scientific and Clinical Center Named After LG. Sokolov Federal Medical and Biological Agency", Saint-Petersburg 194291, Russia
| | - Artem V Tishkov
- Department of Physics, Mathematics and Informatics, FSBEI HE IP. Pavlov SPbSMU MOH Russia, Saint-Petersburg 197022, Russia
| | - Vladimir Grinevich
- 2nd Department of Therapy (Advanced Medical Education), Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Yuriy A Kravchuk
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Panteley I Miklush
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Polina O Nikiforova
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Vera V Gordienko
- Department of Infectious Disease, Military Medical Academy Named After SM. Kirov, Saint-Petersburg 194044, Russia
| | - Alexander F Popov
- School of Medicine, Far Eastern Federal University, Vladivostok 690922, Russia
| | - Boris G Andryukov
- School of Medicine, Far Eastern Federal University, Vladivostok 690922, Russia
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Kagawa K, Kuroda H, Kaneko D, Imura M, Imaizumi U, Kido K, Tsukimoto S, Kurata S, Kishimoto N, Sanuki T. Safety of COVID-19 vaccine delivery by dentists: An observational cohort study. J Dent Sci 2023; 18:613-617. [PMID: 36068849 PMCID: PMC9437767 DOI: 10.1016/j.jds.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background/purpose Although many coronavirus disease 2019 (COVID-19) vaccine injections have been administered worldwide, the safety of this practice remains unclear. This study aimed to compare the rates of complications associated with COVID-19 vaccines administered by dentists with those of vaccines administered by nurses. This study aimed to evaluate the safety of a vaccination program delivered by dentists. Materials and methods This observational cohort study included 537 recipients of the second dose of the Pfizer COVID-19 vaccine, delivered as an intramuscular injection to the upper arm deltoid muscle by dentists or nurses at the study site. Vaccine recipients were divided into two groups according to the vaccination administrator (dentist vs. nurse groups). The rates of complications associated with intramuscular injection technique (numbness in the hand or arm at the time of the injection, vasovagal reflex at the time of the injection, vaccine-related shoulder injury, and prolonged numbness) were examined. Results A total of 125 vaccine recipients were included (nurse group, n = 84; dentist group, n = 41). The overall incidence rate of complications was lower in the dentist group (2.4%; 1/41) than in the nurse group (8.3%; 7/84). However, this difference was not statistically significant (P = 0.3). Conclusion This study suggests that the safety of COVID-19 vaccine administration is comparable between dentists and nurses.
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Affiliation(s)
- Keita Kagawa
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
- Department of Anesthesiology, Tokyo University, Tokyo, Japan
| | - Hidetaka Kuroda
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Dai Kaneko
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Miki Imura
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Uno Imaizumi
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Kanta Kido
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Shota Tsukimoto
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
- Department of Anesthesiology, Kindai University, Sayama, Japan
| | - Shinji Kurata
- Department of Dental Anesthesiology, Nagasaki University, Nagasaki, Japan
| | - Naotaka Kishimoto
- Department of Dental Anesthesiology, Niigata University, Niigata, Japan
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
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10
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Li X, Dong M, Xu S, Zhao H, Wei S, Song Z, Liu M, Ren D, Ren F, Zhao Q, Liu R, Xia C, Chen G, Chen J. [Preliminary Recommendations on the Timing of Lung Surgery after
Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer]. Zhongguo Fei Ai Za Zhi 2023; 26:148-150. [PMID: 36710244 PMCID: PMC10033236 DOI: 10.3779/j.issn.1009-3419.2023.102.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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Affiliation(s)
- Xin Li
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ming Dong
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Song Xu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Honglin Zhao
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Sen Wei
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zuoqing Song
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Minghui Liu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Dian Ren
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Fan Ren
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Qingchun Zhao
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Renwang Liu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chunqiu Xia
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Gang Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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11
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Fotouhi-Ardakani R, Kababian M, Saghafipour A, Alirezaei M, Vatandoost H. Molecular Evaluation of the Novel Coronavirus Infection of Cockroaches and Flies Collected from Kamkar-Arabnia Hospital in Qom City, Central Iran: With Innovated Internal Control. J Arthropod Borne Dis 2021; 15:358-365. [PMID: 36644306 PMCID: PMC9810581 DOI: 10.18502/jad.v15i4.10500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/03/2021] [Indexed: 01/18/2023] Open
Abstract
Background Due to the confirmation of the presence of the novel coronavirus in the feces and municipal sewerage system, and the feeding of domestic insects from fecal matter, as well as the ability of these insects to mechanically transmit microbes from the sewerage system. This study was aimed at molecular evaluation of the novel coronavirus infection isolated on cockroaches and flies collected from Kamkar-Arabnia Hospital in Qom City, Iran. Methods Totally, 18 samples; (12 samples cockroaches and 6 flies) from the external surface of cockroaches and houseflies as well as their digestive system were prepared. After designed and synthetized exogenous heterologous internal control, the RNA was extracted to investigate the contamination of these samples with the novel coronavirus. To detect the virus, the E and RdRp genes were identified. Results Investigation of coronavirus E gene using the multiplex one-step qPCR technique on the collected samples showed an amplification plot in CT= 35.70 related to the internal surfaces of cockroaches collected from the treatment and sick room of the hospital. Also, the design of internal control to ensure the accuracy of the extraction process was successful. Conclusion According to the findings of the present study regarding detecting the presence of the coronavirus infection in the digestive system of domestic insects such as American cockroaches and considering their ability to mechanically transmit viruses, it is recommended to control the domestic insects that are in close contact with humans in crowded places such as hospitals and health centers during the Covid-19 pandemic.
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Affiliation(s)
- Reza Fotouhi-Ardakani
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Majid Kababian
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran,Corresponding author: Dr. Abedin Saghafipour, E-mail:
| | - Abedin Saghafipour
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Melika Alirezaei
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Hassan Vatandoost
- Department of Medical Entomology and Vector Control, School of Health, Tehran University of Medical Sciences, Tehran, Iran,Department of Environment Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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12
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Fang KY, Cao WC, Xie TA, Lv J, Chen JX, Cao XJ, Li ZW, Deng ST, Guo XG. Exploration and validation of related hub gene expression during SARS-CoV-2 infection of human bronchial organoids. Hum Genomics 2021; 15:18. [PMID: 33726831 PMCID: PMC7962432 DOI: 10.1186/s40246-021-00316-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background In the novel coronavirus pandemic, the high infection rate and high mortality have seriously affected people’s health and social order. To better explore the infection mechanism and treatment, the three-dimensional structure of human bronchus has been employed in a better in-depth study on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We downloaded a separate microarray from the Integrated Gene Expression System (GEO) on a human bronchial organoids sample to identify differentially expressed genes (DEGS) and analyzed it with R software. After processing with R software, Gene Ontology (GO) and Kyoto PBMCs of Genes and Genomes (KEGG) were analyzed, while a protein–protein interaction (PPI) network was constructed to show the interactions and influence relationships between these differential genes. Finally, the selected highly connected genes, which are called hub genes, were verified in CytoHubba plug-in. Results In this study, a total of 966 differentially expressed genes, including 490 upregulated genes and 476 downregulated genes were used. Analysis of GO and KEGG revealed that these differentially expressed genes were significantly enriched in pathways related to immune response and cytokines. We construct protein-protein interaction network and identify 10 hub genes, including IL6, MMP9, IL1B, CXCL8, ICAM1, FGF2, EGF, CXCL10, CCL2, CCL5, CXCL1, and FN1. Finally, with the help of GSE150728, we verified that CXCl1, CXCL8, CXCL10, CCL5, EGF differently expressed before and after SARS-CoV-2 infection in clinical patients. Conclusions In this study, we used mRNA expression data from GSE150819 to preliminarily confirm the feasibility of hBO as an in vitro model to further study the pathogenesis and potential treatment of COVID-19. Moreover, based on the mRNA differentiated expression of this model, we found that CXCL8, CXCL10, and EGF are hub genes in the process of SARS-COV-2 infection, and we emphasized their key roles in SARS-CoV-2 infection. And we also suggested that further study of these hub genes may be beneficial to treatment, prognostic prediction of COVID-19.
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Affiliation(s)
- Ke-Ying Fang
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Wen-Chao Cao
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Tian-Ao Xie
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jie Lv
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jia-Xin Chen
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xun-Jie Cao
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Zhong-Wei Li
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Shu-Ting Deng
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
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13
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Makvandi S, Mahdavian M, Kazemi-Nia G, Vahedian-Azimi A, Guest PC, Karimi L, Sahebkar A. The 2019 Novel Coronavirus Disease in Pregnancy: A Systematic Review. Adv Exp Med Biol 2021; 1321:299-307. [PMID: 33656735 DOI: 10.1007/978-3-030-59261-5_27] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In December 2019, a respiratory disease caused by a coronavirus called SARS-CoV-2 (COVID-19) began in Wuhan, China, and quickly became a pandemic. In such situations, pregnant women are suspected of being among the vulnerable groups. The aim of this study was to report clinical symptoms, laboratory findings, and obstetrical complications, maternal, fetal, and neonatal complications of COVID-19 infection in pregnant women. We searched the Cochrane library, MEDLINE/PubMed, and Web of Sciences from their inception to April 5, 2020. Any study involving pregnant women with COVID-19 which evaluated the effect of the disease on pregnancy outcomes and fetal and neonatal complications was included in the study. The outcomes were the symptoms and laboratory findings, obstetrical complications, mode of delivery, and maternal, fetal, and neonatal complications. The search resulted in 69 titles and abstracts, which were narrowed down to 12 studies involving 68 women. The three most common symptoms of patients were fever, cough, and fatigue. The most common laboratory findings were an increase in C-reactive protein (CRP) and lymphopenia. The most common obstetrical complication was preterm labor (33.3%). No maternal deaths were reported. The Cesarean section rate was 83.3% and the vertical transition rate was 2.23%. The findings showed that the clinical symptoms and laboratory measures of pregnant women affected by COVID-19 did not differ from the general population. In general, the prognosis of mothers who suffered from COVID-19 and their newborns was satisfactory. However, there is a need for further rigorous studies to confirm these findings as the pandemic progresses.
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14
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Li Q, Cheng Q, Zhao Z, Dai N, Zeng L, Zhu L, Guo W, Li C, Wang J, Li S, Shen N, Ge Q. Novel coronavirus infection and acute kidney injury in two renal transplant recipients: a case report. J Int Med Res 2020; 48:300060520964009. [PMID: 33100064 PMCID: PMC7588709 DOI: 10.1177/0300060520964009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/04/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The causative virus of coronavirus disease 2019 (COVID-19) may cause severe fatal pneumonia. The clinical presentation includes asymptomatic infection, severe pneumonia, and acute respiratory failure. Data pertaining to acute renal injury due to COVID-19 in patients who have undergone renal transplantation are scarce. We herein report two cases of COVID-19 along with acute kidney injury following kidney transplantation.Case presentation: Two patients with COVID-19 underwent renal transplantation and were subsequently diagnosed with acute kidney injury. The first patient presented with progressive respiratory symptoms and acute renal injury. He was treated with diuretics and suspension of immunosuppressive therapy; however, the patient died. The second patient presented with respiratory tract symptoms, hypoxemia, and progressive deterioration of renal function followed by improvement. Her mycophenolate mofetil was stopped after admission, and tacrolimus was discontinued 10 days later. Moxifloxacin and methylprednisolone were continued in combination with albumin and gamma globulin infusion. A diuretic was administered, and prednisone was gradually reduced along with tacrolimus. The patient exhibited a satisfactory clinical recovery. CONCLUSION Patients who develop COVID-19 after kidney transplantation are at risk of acute kidney injury, and their prednisone, immunosuppressant, and gamma globulin treatment must be adjusted according to their condition.
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Affiliation(s)
- Qiuyu Li
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Qin Cheng
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Zhiling Zhao
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Nini Dai
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, PR China
| | - Lan Zhu
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Wei Guo
- Department of Radiology, Peking University Third Hospital, Beijing, PR China
| | - Chao Li
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Junhong Wang
- Department of Emergency, Peking University Third Hospital, Beijing, PR China
| | - Shu Li
- Department of Emergency, Peking University Third Hospital, Beijing, PR China
| | - Ning Shen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
| | - Qinggang Ge
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, PR China
- Qinggang Ge, Department of Critical Care Medicine, Peking University Third Hospital, No. 49 Huayuanbeilu Road, Haidian District, Beijing 100191, P.R. China.
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15
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Zeng H, Deng S, Zhou Z, Qiu X, Jia X, Li Z, Wang J, Duan H, Tu L, Wang J. Diagnostic value of combined nucleic acid and antibody detection in suspected COVID-19 cases. Public Health 2020; 186:1-5. [PMID: 32731151 PMCID: PMC7351380 DOI: 10.1016/j.puhe.2020.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/30/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Nucleic acid testing is the gold standard method for the diagnosis of coronavirus disease 2019 (COVID-19); however, large numbers of false-negative results have been reported. In this study, nucleic acid detection and antibody detection (IgG and IgM) were combined to improve the testing accuracy of patients with suspected COVID-19. STUDY DESIGN The positive rate of nucleic acid detection and antibody detection (IgG and IgM) were compared in suspected COVID-19 patients. METHODS A total of 71 patients with suspected COVID-19 were selected to participate in this study, which included a retrospective analysis of clinical features, imaging examination, laboratory biochemical examination and nucleic acid detection and specific antibody (IgM and IgG) detection. RESULTS The majority of participants with suspected COVID-19 presented with fever (67.61%) and cough (54.93%), and the imaging results showed multiple small patches and ground-glass opacity in both lungs, with less common infiltration and consolidation opacity (23.94%). Routine blood tests were mostly normal (69.01%), although only a few patients had lymphopenia (4.23%) or leucopenia (12.68%). There was no statistical difference in the double-positive rate between nucleic acid detection (46.48%) and specific antibody (IgG and IgM) detection (42.25%) (P = 0.612), both of which were also poorly consistent with each other (kappa = 0.231). The positive rate of combined nucleic acid detection and antibody detection (63.38%) was significantly increased, compared with that of nucleic acid detection (46.48%) and that of specific antibody (IgG and IgM) detection (42.25%), and the differences were statistically significant (P = 0.043 and P = 0.012, respectively). CONCLUSIONS Nucleic acid detection and specific antibody (IgG and IgM) detection had similar positive rates, and their combination could improve the positive rate of COVID-19 detection, which is of great significance for diagnosis and epidemic control.
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Affiliation(s)
- H Zeng
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - S Deng
- Scientific Research Platform, The Second Clinical Medical College, Guangdong Medical University, Dongguan 523808, China
| | - Z Zhou
- Department of Radiology, Shenzhen People's Hospital, Shenzhen 518020, China
| | - X Qiu
- Special Clinic Department, Southern University of Science and Technology Hospital, Shenzhen 518052, China
| | - X Jia
- Department of Clinical Laboratory Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - Z Li
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - H Duan
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - L Tu
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China.
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Abstract
A zoonotic coronavirus, tentatively labeled as 2019-nCoV by the World Health Organization (WHO), has been identified as the causative agent of the viral pneumonia outbreak in Wuhan, China, at the end of 2019. Although 2019-nCoV can cause a severe respiratory illness like SARS and MERS, evidence from clinics suggested that 2019-nCoV is generally less pathogenic than SARS-CoV, and much less than MERS-CoV. The transmissibility of 2019-nCoV is still debated and needs to be further assessed. To avoid the 2019-nCoV outbreak turning into an epidemic or even a pandemic and to minimize the mortality rate, China activated emergency response procedures, but much remains to be learned about the features of the virus to refine the risk assessment and response. Here, the current knowledge in 2019-nCoV pathogenicity and transmissibility is summarized in comparison with several commonly known emerging viruses, and information urgently needed for a better control of the disease is highlighted.
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Affiliation(s)
- Jieliang Chen
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China.
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