scholarly journals Clinical characteristics of COVID-19 in young patients differ from middle-aged and elderly patients

2021 ◽  
Author(s):  
Keqiang Wan ◽  
Chang Su ◽  
Lingxi Kong ◽  
Juan Liao ◽  
Wenguang Tian ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Smoking Status ◽  
Severe Disease ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Pneumonia Severity Index ◽  
Education Level ◽  
The Other ◽  
Middle Aged ◽  
Youth Group

IntroductionCoronavirus disease-2019 (COVID-19) spreads worldwide. The study Aimed to understand the clinical characteristics of young COVID-19 patients.Material and methods90 patients with severe COVID-19 infection in western Chongqing were collected from 21 January to 14 March 2020. They were divided into 4 groups based on age: youth (<39 years), middle-aged (39-48 years), middle-elderly aged (49-60 years), and elderly (> 60 years). The clinical symptoms, laboratory findings, imaging findings, and treatment effects were compared among the groups.ResultsThere were 22, 27, 19, and 22 cases in the youth, middle-aged, middle-elderly, and elderly groups, respectively. There were no significant differences with respect to gender or smoking status among the four groups. The clinical indicators of severe disease in the youth group were significantly different from the other three groups, and included the lymphocyte count (P = 0.00), C-reactive protein level (P = 0.03), interleukin-6 level (P = 0.01), chest computed tomography (CT) findings (P = 0.00), number of mild cases (P = 0.02), the education level (P = 0.00), and the CD4 + T lymphocyte level (P = 0.02) at the time of admission, and the pneumonia severity index (PSI) at the time of discharge (P = 0.00). The complications (P = 0.00) among the youth group were also significantly different from the other groups.ConclusionsYoung patients have milder clinical manifestations, which may be related to higher education level, higher awareness and higher acceptance of the prevention and control of the COVID-19 epidemic, as well as their good immune function.

scholarly journals Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

2020 ◽  
Author(s):  
Wenzhi ZHANG ◽  
Hui LI ◽  
Jingzhen LIU ◽  
Jiawei XU ◽  
Jinjin HAO ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
The Other ◽  
Hematopoietic Stem ◽  
Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

scholarly journals Retrospective analysis of clinical characteristics of 405 patients with COVID-19

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094903 ◽  
Author(s):  
Ting Zhan ◽  
Meng Liu ◽  
Yalin Tang ◽  
Zheng Han ◽  
Xueting Cheng ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Circulatory System ◽  
Respiratory Illnesses ◽  
Reactive Protein ◽  
Circulatory System Diseases ◽  
History Of ◽  
Abnormal Lymphocyte

Objective This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. Results The patients’ median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. Conclusion SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.

scholarly journals Management and Clinical Characteristics in Children with SARS-CoV-2 Infection: Experience in a highly complex public hospital in the city of São Paulo

2020 ◽  
Author(s):  
Rafael Santos Rodrigues Vieira ◽  
Erisson Linhares de Aguiar ◽  
Nara Michelle de Araújo Evangelista ◽  
Sergio Antonio Bastos Sarrubbo ◽  
Helmar Abreu Rocha Verlangieri ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
Pediatric Hospital ◽  
Multiprofessional Team ◽  
The City

AbstractIn February 2020, the World Health Organization designated the disease COVID-19, which means Coronavirus disease 2019. The virus that causes COVID-19 is designated as severe acute respiratory syndrome by Coronavirus 2 (SARS-CoV-2). The virus tends to determine clinical manifestations more frequently in adults and, especially, in the elderly, with high mortality in the population with chronic diseases. Most studies confirm the trend towards less severe disease in pediatric patients, and few studies describe the behavior of the virus in children. In late February 2020, a public pediatric hospital in the city of São Paulo, in the face of the announced epidemic, through its multiprofessional team, prepared itself to the care of patients with SARS-CoV-2 infection, determing certain clinical protocols defining the flow of care and therapeutic procedures to patients. This study intends to present the clinical characteristics and evolution of the disease by SARS-CoV-2 in pediatric patients seen in a public pediatric hospital of high complexity, evaluating the effectiveness and acceptance of the measures adopted. As a result, a good evolution of the disease was observed in the affected children, even in those with comorbidities. There was a trend towards a greater number of days of hospitalization and the need for ICU in patients with comorbidities and progression with clinical worsening after initial improvement. The protocols adopted and the flow instituted allowed good adherence by the multidisciplinary team.

scholarly journals Baseline clinical characteristics and prognostic factors in hospitalized COVID-19 patients aged ≤ 65 years: A retrospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248829
Author(s):  
Marta Betti ◽  
Marinella Bertolotti ◽  
Daniela Ferrante ◽  
Annalisa Roveta ◽  
Carolina Pelazza ◽  
...  
Keyword(s):  
Platelet Count ◽  
Prognostic Factors ◽  
Observational Study ◽  
Logistic Model ◽  
Severe Disease ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Retrospective Observational Study ◽  
Multivariable Logistic Regression Analysis

Background Individual differences in susceptibility to SARS-CoV-2 infection, symptomatology and clinical manifestation of COVID-19 have thus far been observed but little is known about the prognostic factors of young patients. Methods A retrospective observational study was conducted on 171 patients aged ≤ 65 years hospitalized in Alessandria’s Hospital from 1st March to 30th April 2020 with laboratory confirmed COVID-19. Epidemiological data, symptoms at onset, clinical manifestations, Charlson Comorbidity Index, laboratory parameters, radiological findings and complications were considered. Patients were divided into two groups on the basis of COVID-19 severity. Multivariable logistic regression analysis was used to establish factors associated with the development of a moderate or severe disease. Findings A total of 171 patients (89 with mild/moderate disease, 82 with severe/critical disease), of which 61% males and a mean age (± SD) of 53.6 (± 9.7) were included. The multivariable logistic model identified age (50–65 vs 18–49; OR = 3.23 CI95% 1.42–7.37), platelet count (per 100 units of increase OR = 0.61 CI95% 0.42–0.89), c-reactive protein (CPR) (per unit of increase OR = 1.12 CI95% 1.06–1.20) as risk factors for severe or critical disease. The multivariable logistic model showed a good discriminating capacity with a C-index value of 0.76. Interpretation Patients aged ≥ 50 years with low platelet count and high CRP are more likely to develop severe or critical illness. These findings might contribute to improved clinical management.

scholarly journals Constipation, Diabetes, and Split-Dose Regimen Are Associated With Suboptimal Bowel Preparation in Young Patients

2021 ◽  
Author(s):  
Lexin Liu ◽  
Jingbin Wang ◽  
Yingzhe Lai ◽  
Li Liu ◽  
Guoxin Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Bowel Preparation ◽  
Dose Regimen ◽  
Clinical Characteristics ◽  
Young Patients ◽  
The Other ◽  
Split Dose ◽  
Factors Associated

Abstract Background An increase in the incidence of colorectal cancer in young patients has been observed. However, there is little research investigating the factors associated with suboptimal bowel preparation focusing on young patients compared to patients > 50 years. Aims We aimed to evaluate the factors associated with a suboptimal bowel preparation in young patients (age ≤ 50 years) using the Boston Bowel Preparation Scale (BBPS). Methods This retrospective study analyzed 1,980 patients who underwent complete colonoscopy from June 2017 to September 2020. Data regarding demographic and clinical characteristics and bowel preparation adequacy were collected. Furthermore, factors associated with suboptimal bowel preparation were analyzed. Results Among our participants, 17.8% demonstrated suboptimal bowel preparation. After adjusting for several factors, multivariate analysis showed that diabetes (OR:0.28; 95% CI, 0.14–0.56, P = .000), constipation (OR:0.20; 95% CI, 0.13–0.29, P = .000), and split-dose bowel preparation (OR:1.69; 95% CI, 1.28–2.23, P = .000) were independent predictors of suboptimal bowel preparation. Additionally, constipation was significantly associated with poor bowel preparation in all colonic segments; on the other hand, diabetes and split-dose bowel preparation were significant on right side of the colon. Conclusions Constipation, diabetes and split-dose bowel preparation were significantly associated with suboptimal bowel preparation in young patients.

scholarly journals COVID-19 IN YOUNG AND MIDDLE-AGED ADULTS. PREDICTORS OF POOR OUTCOME AND CLINICAL DIFFERENCES.

2021 ◽  
Author(s):  
eva tabernero ◽  
Luis Alberto Ruiz ◽  
Pedro Pablo España ◽  
Raul Mendez ◽  
Leyre Serrano ◽  
...  
Keyword(s):  
Heart Disease ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Low Oxygen ◽  
Middle Aged ◽  
Poor Outcome ◽  
Poor Outcomes ◽  
Middle Aged Adults

ABSTRACT Young and middle-aged adults are the largest group of patients infected with SARS-CoV-2 and some of them develop severe disease. Objective: To investigate clinical manifestations in adults aged 18-65 years hospitalized for COVID-19 and identify predictors of poor outcome. Secondary objectives: to explore potential differences compared to the disease in elderly patients and the suitability of the commonly used community-acquired pneumonia prognostic scales in younger populations. Methods: Multicenter prospective registry of consecutive patients hospitalized for COVID-19 pneumonia aged 18-65 years between March and May 2020. We considered a composite outcome of “poor outcome” including intensive care unit admission and/or use of noninvasive ventilation, continuous positive airway pressure or high flow nasal cannula oxygen therapies and/or death. Results: We identified 513 patients <65 years of age, from a cohort of 993 patients. 102 had poor outcomes (19.8%) and 3.9% died. 78% and 55% of patients with poor outcomes were classified as low risk based on CURB and PSI scores respectively. A multivariate Cox regression model identified six independent factors associated with poor outcome: heart disease, chest pain, anosmia, low oxygen saturation, high LDH and lymphocyte count <800/mL. Conclusions: COVID-19 in younger patients carries significant morbidity and differs in some respects from this disease the elderly. Baseline heart disease is a relevant risk factor, while anosmia and pleuritic pain are more common and protective. Hypoxemia, LDH and lymphocyte count are predictors of poor outcome. We consider that CURB and PSI scores are not suitable criteria for deciding admission in this population.

scholarly journals Socio-demographic and Clinical Characteristics of Patients with Ulcerative Colitis at a Tertiary Care Centre in Nepal

2019 ◽  
Vol 8 (2) ◽  
pp. 26-29
Author(s):  
Rahul Pathak ◽  
Tshering Wangdi Sherpa ◽  
Anurag Jha ◽  
Rabin Hamal ◽  
Sabin Thapallya
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Colonoscopic Examination

Introduction: The prevalence of ulcerative colitis (UC) has gradually increased in Asia over the last few decades. However, there is a paucity of data regarding UC in Nepal. This study analyzed the socio-demographic and clinical characteristics of patients hospitalized with UC. Methods: This is a hospital based, cross-sectional study. Data was collected among 100 individuals admitted to the hospital with UC from June 2016 to May 2018. A descriptive analysis of the demographic and clinical characteristics was done. Results: Of the 100 patients 51 were male (M:F ratio 1.04:1). Average age at diagnosis was 38}12.53 years. 55% of the patients were Brahmins, 16% Kshetris, 8% Newars, 1% Muslim while the remaining 20% belonged to other indigenous ethnic groups. 79% of the patients were newly diagnosed cases while remaining 21% were admitted for acute flares of the disease. Rectal bleeding (85%) was the most common symptom followed by diarrhea (70%), tenesmus (63%), urgency (61%), pain abdomen (44%), weight loss (14%), fever (7%) and constipation (4%). Clinically, 41% had mild, 46% had moderate and 12% had severe disease activity. Extra intestinal manifestations were seen only in 12% of the patients. On colonoscopic examination, 41% had proctitis, 46% had left sided colitis and 13% had extensive colitis. Conclusion: Our study showed some differences in the demographic variables as well as clinical manifestations in the patients when compared to data from the west and even other Asian countries like India and China. Larger population-based studies are needed to better understand the epidemiology and characteristics of the disease in Nepal.  

scholarly journals MODY in Siberia – molecular genetics and clinical characteristics

2017 ◽  
Vol 20 (1) ◽  
pp. 5-12
Author(s):  
Alla Konstantinovna Ovsyannikova ◽  
Oksana Dmitrievna Rymar ◽  
Elena Vladimirovna Shakhtshneider ◽  
Elena Nikolaevna Voropaeva ◽  
Dinara Evgenevna Ivanoshchuk ◽  
...  
Keyword(s):  
Carbohydrate Metabolism ◽  
Molecular Genetics ◽  
Clinical Characteristics ◽  
Early Stage ◽  
Molecular Genetic ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Oral Hypoglycaemic Agents ◽  
Monogenic Forms Of Diabetes

The diagnosis of maturity onset diabetes of the young (MODY) has high clinical significance in young patients (no absolute need for exogenous insulin; normoglycaemia in most patients achieved by dieting or taking oral hypoglycaemic agents) and their relatives (high probability of first-degree relatives being carriers of mutations, which requires a thorough collection of family history and determination of the parameters of carbohydrate metabolism). Aim. This study aimed was to determine the clinical characteristics of different subtypes of MODY in a Siberian region. Materials and Methods. We performed an examination, biochemical and hormonal blood tests, ultrasound and molecular genetic testing of 20 patients with a clinical diagnosis of MODY. Results. Four subtypes of MODY were verified: MODY2 in 11 patients, MODY3 in two, MODY8 in one and MODY12 in two. Eleven patients (69%) exhibited no clinical manifestations of carbohydrate metabolism disorders, and one patient showed weight loss during early stage of the disease. Comorbidities included dyslipidemia, thyroid gland disorders and arterial hypertension. One patient (6%) exhibited diabetic nephropathy; two (13%), diabetic retinopathy and three (19%), peripheral neuropathy of lower legs. All patients achieved the target carbohydrate metabolism; the level of C-peptide was within the reference range. Conclusion. Four different subtypes of MODY (2, 3, 8, 12) were diagnosed in the present study, which differed in their clinical characteristics, presence of complications and treatment strategies. Our knowledge of monogenic forms of diabetes is expanding with the development in molecular genetics, but several aspects related to them require further study.

scholarly journals 510. Elevated IL-1β level as a predictor of inflammation and death in COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S320-S321
Author(s):  
Talia H Swartz ◽  
Sacha Gnjatic ◽  
Judith A Aberg ◽  
Miriam Merad ◽  
Keith Sigel
Keyword(s):  
New York ◽  
Nlrp3 Inflammasome ◽  
Clinical Characteristics ◽  
Smoking Status ◽  
Severe Disease ◽  
Serum Levels ◽  
Adverse Outcomes ◽  
Tnf Alpha ◽  
Inflammasome Activation ◽  
Hospital System

Abstract Background SARS-Cov-2 (severe acute respiratory disease coronavirus 2) causes Coronavirus Disease 2019 (COVID19) and is associated with respiratory failure and death in severe disease. This is associated with high levels of cytokines such as IL-6, IL-8 and TNF-alpha which are predictors of severe outcomes. SARS-CoV-2 leads to activation of the NLRP3 inflammasome which results in secretion of the cytokine IL-1ß. While high levels of IL-1ß are not observed in most patients with severe COVID-19, there is a subset of patients with high IL-1ß levels. Here we sought to characterize these patients and determine whether high IL-1ß levels are associated with adverse outcomes and death in COVID-19. Methods We identified 90 patients with high IL-1ß levels (greater or equal to 2 pg/ml) and laboratory confirmed COVID-19 hospitalized in our hospital system in New York March 12 and May 8, 2020. We collected baseline clinical characteristics, laboratory values, COVID-19 treatment, and outcomes from this group and the group with IL-1ß levels below 2 pg/ml. Baseline clinical characteristics and outcomes were compared. Results Comparing patients by IL-1ß level had similar demographics (age, sex, race/ethnicity, smoking status and comorbid disease prevalence). The group had comparable levels of adverse markers of disease severity but the patients with high IL-1ß had increased inflammatory biomarkers including IL-8 (629 vs. 68 pg/ml, p&lt; 0.0001), TNF-alpha (30 vs. 51 pg/ml, p&lt; 0.0001), IL-6 (173 vs. 5075 pg/ml, p&lt; 0.0001), CRP (141 vs. 178, p=0.0007), d-dimer (2.6 vs. 4 p=0.0002), and increased rates of death (30% vs. 20%, p=0.008). Conclusion Demographic and comorbid conditions are not effective at predicting high IL-1ß serum levels in COVID-19 patients, however those individuals with high levels are at risk for adverse outcomes of severe disease and death. Further investigation is required to probe the mechanism of NLRP3 inflammasome activation and IL-1ß signaling and the role of this cytokine in mediated inflammation and death in COVID-19. Disclosures Judith A. Aberg, MD, Theratechnology (Consultant)

scholarly journals PECULIARITIES AND CHARACTERISTICS OF INDICATORS OF THYROID CANCER AMONG RESIDENTS OF TOMSK AND TOMSK REGION

2014 ◽  
Vol 13 (2) ◽  
pp. 74-81
Author(s):  
I. N. Vorozhtsova ◽  
V. N. Latypova ◽  
T. V. Saprina ◽  
I. S. Beryozkina ◽  
A. P. Zima ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Characteristics ◽  
Young Patients ◽  
The Other ◽  
Papillary Cancer ◽  
The World ◽  
Tomsk Region ◽  
Different Populations ◽  
Stage 1 ◽  
Thyroid Cancer Incidence

The analysis of thyroid cancer incidence and its structure among different populations of Tomsk region is presented. We studied the report documents, the database of the Tomsk regional oncologic dispensary for the period 2008 to 2012. The clinical characteristics of patients with thyroid cancer were summarizes according to sex, age and place of residence. The papillary cancer was the most often diagnosed. It was found that in young patients, thyroid cancer was diagnosed more often in the stage 1 and 2. On the other hand, in elderly patients (above 60 years), thyroid cancer diagnosed at stage 3 and 4. In the Tomsk region, as elsewhere in the world, thyroid cancer is detected more often in women.

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