Analyzing the Early CT findings and Clinical Features of 12 Patients with 2019 Novel Coronavirus Disease (COVID-19) in China

2020 ◽  
Vol 22 (4) ◽  
Author(s):  
Xianwu Xia ◽  
Liang Sheng ◽  
Tiejun Yang ◽  
Guobing Zhang ◽  
Li Ding ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ct Findings ◽  
Novel Coronavirus

scholarly journals 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S296-S297
Author(s):  
Trini A Mathew ◽  
Jonathan Hopkins ◽  
Diane Kamerer ◽  
Shagufta N Ali ◽  
Daniel Ortiz ◽  
...  
Keyword(s):  
Clinical Features ◽  
Diagnostic Testing ◽  
Beaumont Hospital ◽  
High Capacity ◽  
Turnaround Time ◽  
Molecular Diagnostic ◽  
The Novel ◽  
Repeat Testing ◽  
Asymptomatic Patients ◽  
Novel Coronavirus

Abstract Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Figure 1 BH RO testing Epicurve Figure 2: Screening tool for repeat COVID19 testing and precautions Conclusion Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. Disclosures All Authors: No reported disclosures

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals COVID-19 in pregnancy: a systematic review of chest CT findings and associated clinical features in 427 patients

2021 ◽  
Vol 75 ◽  
pp. 75-82
Author(s):  
Rachel R. Oshay ◽  
Michael Y.C. Chen ◽  
Brandon K.K. Fields ◽  
Natalie L. Demirjian ◽  
Ryan S. Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Features ◽  
Chest Ct ◽  
Ct Findings ◽  
In Pregnancy

scholarly journals Retrospective analysis of the clinical features of outpatients with novel coronavirus in areas outside Wuhan, China

2020 ◽  
Author(s):  
Yong-Tao Li ◽  
Mei-Lian Peng ◽  
Jia-dan Fu ◽  
Li Liu ◽  
Yong-zheng Guo ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Clinical Performance ◽  
The Novel ◽  
C Reactive Protein ◽  
Early Screening ◽  
Reactive Protein ◽  
Ct Findings ◽  
Epidemic Area ◽  
Novel Coronavirus ◽  
Lung Ct

Abstract Objective: The novel coronavirus pneumonia (COVID-19) has spread rapidly across the globe with the movement of people. How to diagnose COVID-19 quickly and accurately is a concern for all. We retrospectively assessed the clinical characteristics of patients with COVID-19 detected by outpatient screening in areas outside Wuhan, China, to guide early screening outside the epidemic area, to isolate and treat COVID-19-positive patients, and to control the spread of this virus in the region.Results: Among the 213 patients treated in the fever clinic of our hospital, 41 tested positive for novel coronavirus (2019-nCoV) and 172 were negative. Among the positive patients, 13 (31.7%) of the patients had been to Wuhan, while 28 (68.3%) had not been to Wuhan. There were 4 cases of clustering occurrence. The main symptoms exhibited by COVID-19-positive patients were fever (87.8%), cough (68.3%), and expectoration (34.1%). The C-reactive protein (CRP) levels were increased in 35 (85.3%) positive patients; the hydroxybutyrate dehydrogenase in the myocardial zymogram was increased in 22 positive patients (53.6%) and 38 negative patients (22.1%); computed tomography (CT) findings revealed lung lesions in all 41 positive patients (100%).Conclusion: We classified the patient population and analyzed the data to understand the early clinical performance of COVID-19. Our research illustrate that screening for COVID-19 outside Wuhan should focus on early symptoms such as fever and cough, in combination with lung CT findings, epidemiological history, and sputum pathogen detection to determine whether patients need further isolation.

scholarly journals CLINICAL FEATURES OF NOVEL CORONAVIRUS 2019-INFECTED CASES WITH PRE-EXISTING CARDIOVASCULAR DISEASE, DISAGGREGATED BY GENDER

2021 ◽  
Vol 54 (2) ◽  
pp. 180-185
Author(s):  
Elham Mohammadyari ◽  
Mohammad Reza Kaffashian ◽  
Iraj Ahmadi ◽  
Azra Kenarkoohi ◽  
Askar Soufinia ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Laboratory ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Men And Women ◽  
Blood Pressures ◽  
Males And Females ◽  
The Mean ◽  
Novel Coronavirus ◽  
Common Laboratory

Objectives: This study was conducted to evaluate the clinical features of 68 coronavirus 2019-infected cardiac cases on gender basis. Methodology: Clinical, laboratory and electrocardiographic data of 68 COVID-19 patients with pre-existing cardiovascular diseases, analyzed and compared by gender-wise. Results: Dry cough (78% of male, 80% females) and fever (62% of male, 75% females) were the most common symptoms. Out of these 97% of them needed O2 supplementation. O2 saturation in patients with O2 therapy was 85%; 31% of men and 11% of women experienced intubation. The most common laboratory abnormalities, were neutrophilia, leukocytosis, lymphopenia, thrombocytopenia, decreased hemoglobin level, increased creatinine and urea, in men and women. Troponin level was different between male and female. Pneumonia was found in 86-87% patients. Approximately, Males and female, respectively53.10 and 52.8%, shown sinus tachycardia (ST arrythmia). PVC arrythmia was found in 2.9% of total patients. BBB arrythmia was found in 31.20% of males vs. 11.10% of females. The mean systole/diastole blood pressures respectively were 130±4/79.7 ±2 in males and 134±4/81±3 in females. Heart axis changes was identified in 43.8% and 27.8% of males and females respectively. Conclusion: Severity of symptoms and outcomes of COVID-19 in cardiac patients showed some differences between men and women which could be associated with differences in immune responses, respiratory tract properties, renin angiotensin system, sex hormones and lifestyle.  However, more studies to categorize gender differences are required.

scholarly journals Initial chest CT findings in COVID-19: correlation with clinical features

2020 ◽  
Vol 21 (8) ◽  
pp. 668-672
Author(s):  
Zhu-jing Shen ◽  
Nan Lu ◽  
Lu-lu Gao ◽  
Jian Lv ◽  
Hua-fu Luo ◽  
...  
Keyword(s):  
Clinical Features ◽  
Chest Ct ◽  
Ct Findings

scholarly journals A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

2020 ◽  
Vol 71 (15) ◽  
pp. 756-761 ◽  
Author(s):  
Dahai Zhao ◽  
Feifei Yao ◽  
Lijie Wang ◽  
Ling Zheng ◽  
Yongjun Gao ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Rt Pcr ◽  
Bilateral Involvement ◽  
Radiological Features ◽  
History Of ◽  
Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

scholarly journals Confirmed or unconfirmed cases of 2019 novel coronavirus pneumonia in Italian patients: a retrospective analysis of clinical features

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Giulia De Angelis ◽  
Brunella Posteraro ◽  
Federico Biscetti ◽  
Gianluca Ianiro ◽  
Lorenzo Zileri Dal Verme ◽  
...  
Keyword(s):  
Clinical Features ◽  
Multivariable Analysis ◽  
Etiologic Agent ◽  
Nasopharyngeal Swab ◽  
Imaging Features ◽  
Rt Pcr ◽  
Rna Detection ◽  
Incubation Periods ◽  
Novel Coronavirus ◽  
To Receive

Abstract Background Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia. Methods On March 31, 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples. Results Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for 2 days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11–1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72–0.90; P < 0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P < 0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis. Conclusions Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.

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