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LitCovid_Glycan-Motif-Structure
{"project":"LitCovid_Glycan-Motif-Structure","denotations":[{"id":"T87365","span":{"begin":20248,"end":20255},"obj":"https://glytoucan.org/Structures/Glycans/G15021LG"}],"text":"Table 3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-FMA-UBERON
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-UBERON
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-MONDO
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-CLO
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-GO-BP
{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T25","span":{"begin":2553,"end":2561},"obj":"http://purl.obolibrary.org/obo/GO_0007612"},{"id":"T26","span":{"begin":3275,"end":3283},"obj":"http://purl.obolibrary.org/obo/GO_0007612"},{"id":"T27","span":{"begin":13508,"end":13519},"obj":"http://purl.obolibrary.org/obo/GO_0007565"},{"id":"T28","span":{"begin":17063,"end":17068},"obj":"http://purl.obolibrary.org/obo/GO_0004111"},{"id":"T29","span":{"begin":21819,"end":21836},"obj":"http://purl.obolibrary.org/obo/GO_0019079"},{"id":"T30","span":{"begin":21819,"end":21836},"obj":"http://purl.obolibrary.org/obo/GO_0019058"},{"id":"T31","span":{"begin":21924,"end":21935},"obj":"http://purl.obolibrary.org/obo/GO_0016791"},{"id":"T32","span":{"begin":22091,"end":22096},"obj":"http://purl.obolibrary.org/obo/GO_0004111"},{"id":"T33","span":{"begin":22701,"end":22714},"obj":"http://purl.obolibrary.org/obo/GO_0003968"},{"id":"T34","span":{"begin":22701,"end":22714},"obj":"http://purl.obolibrary.org/obo/GO_0003899"}],"text":"Table 3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-sentences
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PD-HP
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency."}
LitCovid-PubTator
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3 Studies for diagnosis, prognosis and therapy of COVID‐19 patients\nStudy/region Study type/medical team Patient/median age/sex Diagnostic test Sample Inclusion criteria/residency Test results Most common symptoms/chronic disease Incubation period (day) Case fatality rate Diagnosis/prognosis/therapy\nWu et al. (2020), China Retrospective study/Chinese Center for Disease Control and Prevention 72,314; subjects: confirmed cases 44,672 (62%), suspected cases 16,186 (22%), diagnosed cases 10,567 (15%), asymptomatic cases 889 (1%)/age N = 44,672: 80: 3% (1,408), 30–79: 87% (38,680), 20–29: 8% (3,619), 10–19: 1% (549), \u003c10: 1% (416) PCR Throat swab samples Confirmed cases based on positive PCR, suspected cases based on symptoms and exposures only, clinically cases based on symptoms, exposures, and CT, asymptomatic cases diagnosis by positive PCR Spectrum of disease: (N = 44,415); mild: 81% (36,160), severe: 14% (6,168), critical: 5% (2,087) Cardiovascular disease: 10.5%, diabetes: 7.3%, chronic respiratory disease: 6.3%, hypertension: 6.0%, cancer: 5.6% About a week 2.3% (1,023 of 44,672 confirmed cases), 14.8% aged \u003e80 years (208 of 1,408), 8.0% aged 70–79 years (312 of 3,918) 49.0% in critical cases (1,023 of 2,087) Next step: to help “buy time” for more diagnostic and therapeutic research before COVID‐19 becomes too widespread\nTian et al. (2020), China Retrospective study/Beijing Emergency Medical Service 262/47.5/48.5% male Real‐time RT‐PCR Respiratory specimens COVID‐19 infected patients/residents of Beijing: 92 (73.3%), patients had been to Wuhan: 50 (26.0%), close contact with confirmed cases: 116 (60.4%), no contact history: 21 (10.9%) Spectrum of disease: sever: 46 (17.6%); common: 216; (82.4%); mild: 192 (73.3%); nonpneumonia: 11 (4.2%); asymptomatic:13 (5.0%) Fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%), headache (6.5%)/pulmonary infection, chronic cardiovascular disease and heart failure: 1, pulmonary infection and multiple chronic diseases: 1 Incubation: 6.7 days, illness onset to visit hospital: 4.5 days 3 (0.9%) Results: As of February 10, 45 (17.2%) patients have discharged\nFor COVID‐19 control: first step is prevent transmission at early stage, next steps is early isolation and quarantine of suspected subjects\nWang et al. (2020), China Retrospective cohort/Xi'an Jiaotong University First Affiliated Hospital, Nanchang University First Hospital and Xi'an No.8 Hospital of Xi'an Medical College 99 CT, artificial intelligence, inception migration‐learning model – Pathogen‐confirmed COVID‐19 patients Spectrum of disease: typical viral pneumonia or negative group: 55, confirmed nucleic acid testing or positive group: 44. CT (453 CT images): negative: 258, positive: 195 Viral pneumonia symptoms – – Screening:\nThe internal validation; accuracy: 82·9%, specificity: 80·5%, sensitivity: 84%\nThe external testing; accuracy: 73·1%, specificity: 67%, sensitivity: 74%\nAlgorithm prediction: a rate of 2 s per case on the graphic processing unit\nInterpretation: the early diagnosis through fast, accurate, safe and noninvasive methods is crucial for control of virus\nYan et al. (2020), China Retrospective study/Tongji Hospital 375, 58.83, 58.7% males CT, machine learning model (a supervised XGBoost classifier) – Validated or suspected COVID‐19 patient/Wuhan residents (37.9%), familial cluster (6.4%), health workers (1.9%) Spectrum of disease: critical patients: 46.1%, severe cases: RR ≥ 30bpm or SPO2 ≤93% on rest Fever: 49.9%, cough: 13.9%, fatigue 3.7%, dyspnea 2.1%, shock: 2 174\n16 + 1 Interpretation: the three indices‐based prognostic prediction model might predict themortality risk, recognition of critical cases, help to early identification, on time intervention, reducing mortality rate\nShi et al. (2020), China Retrospective/hospitals in Wuhan 81, 49–5, 42 (52%) men and 39 (48%) women Next‐generation sequencing or RT‐PCR, serial chest CT Throat swab specimens Confirmed COVID‐19 pneumonia patients/direct exposure to Huanan seafood market: 31 (38%), health‐care workers: 15 (19%), familial clusters: 7 (9%), any obvious history of exposure: 28 (35%) Spectrum of disease: mean number of involved lung segments: 10.5 (SD 6.4): group 1: subclinical patients (CT before symptom onset): 2.8 (3.3), group 2: ≤1 week after symptom onset/11.1 (5.4), group 3: \u003e1–2 weeks/13.0 (5.7), group 4: \u003e2–3 weeks/12.1 (5.9).\nCT:\nALL:\nbilateral abnormality: 64 [79%], peripheral 44 [54%], Ill‐defined 66 [81%], GGO: 53 [65%], mainly involving the right lower lobes: 225 [27%] of 849.\nGroup 1 (n=15): unilateral: 9 [60%]/multifocal 8 [53%]/GGO: 14 [93%]; Group 2 (n = 21): bilateral 19 [90%]/diffuse 11 [52%]/GGO predominance 17 [81%]; Group 3 (n = 30): GGO 17 [57%], consolidation/mixed patterns: 12 [40%]; Group 4 (n=15): consolidation/mixed patterns: 8 [53%].\nBlood:\nGroup1: Lower CRP and AST Fever: 59 [73%], dry cough: 48 [59%] nonspecific symptoms:\ndizziness:\n2 [2%], diarrhea:\n3 [4%], vomiting:\n4 [5%], headache:\n5 [6%], generalised weakness:\n7 [9%]/chronic pulmonary disease (tuberculosis): 1, T2D: 1, hypertension/cardiovascular/erebrovascular disease: 1 Symptom onset and discharge of 23–2 days 3 (4%) By February 8, 2020, 62 (77%) patients discharged\nInterpretation: COVID‐19 pneumonia include CT abnormalities that rapidly progress from focal unilateral to diffuse bilateral GGO coexisted with consolidations within 1–3 weeks (even in asymptomatic patients).\nEarly diagnosis through combined CT with clinical and laboratory findings\nBai et al. (2020), China Case study/The Fifth People's Hospital of Anyang 6, Patient 1: 20‐year‐old woman, patients 2–6: four women 42–57 years old CT, RT‐PCR Nasopharyngeal swabs Patient 1: met with Patients 2 and 3, and accompanied five relatives (Patients 2–6), Patients 2–6: no visited Wuhan or been in contact with any other people traveled to Wuhan Spectrum of disease: severe pneumonia: 2, moderate: others. A familial cluster of five patients with respiratory symptoms, 1 asymptomatic family member.\nBlood:\nall symptomatic patients: increased CRP, reduced lymphocyte.\nCT: multifocal GGO: in all symptomatic patients, subsegmental consolidation/fibrosis: 1.\nPatient 1: normal CT, CRP and lymphocyte count, RT‐PCR: negative, positive, negative.\nPatients 2–6:\nCOVID‐19 confirmed.\nPCR: positive for patients 2–6 within 1 day Fever: patients 2–6 19 days for patient 1 – Transmission: COVID‐19 transmission could transmit by an asymptomatic carrier S\nAi et al. (2020), China Cohort/Tangji hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei 1,014/51 ± 15/46% man Laboratory test, chest CT (7 day interval), RT‐PCR (Taq man one step): multiple assays (3 day interval) Throat swab Suspected of nCoV/China Positive CT: 88% (888/1,014), positive RT‐PCR: 59% (601/1,014).\nSensitivity of CT based on positive RT‐PCR: 97% (95%CI, 95–98%, 580/601).\nNegative RT‐PCR/positive CT: 75% (308/413).\nInitial positive CT consistent with COVID‐19 before the initial positive RT‐PCR: 60–93%.\nImprovement in follow‐up CT before the RT‐PCR turning negative: 42% (24/57), CT: GGO: 46% [409/888], consolidations: 50% [447/888], bilateral findings: 90% [801/888] Fever, dry cough Initial + to − PCR: 5.1 ± 1.5 days,\nInitial − to + PCR: 6.9 ± 2.3 days – Diagnosis: chest CT, as a highly sensitive method, could be considered as a primary tool for infection diagnosis in epidemic areas\nChen et al. (2020), China General Hospital of Central Theater Command, PLA 48/age; critically ill: 79.6 ± 12, sever: 63.9 ± 15, mild: 45.8 ± 14/31 males (77.1%) and 17 females (22.9%) Real‐time RT‐PCR, CT, GLMs analysis Serum, throat‐swab specimens Laboratory confirmed cases Spectrum of disease: mild: 21 (43.7%), severe 10 (20.8%), critically ill 17 (35.4%).\nBlood: low/lower lymphocytes: severe and critically ill, higher neutrophils: critically ill, higher PCT: critically ill.\nParameters stand for the organ dysfunction; TnT, AST, ALT, CRE, and BUN: higher in critically ill patients.\nPCR:\npositive RNAaemia: (a) serum: 5 (10.4%) of critically ill, (b) throat‐swab: 48 positive.\nIL‐6: value ≥100: 35.3% in critically ill, 10‐folds higher IL‐6 (cytokine storm): critically ill, RNAaemia positive: IL‐6 ≥100 (R = 0.902) Mild: fever, respiratory symptoms\nSevere: shortness of breath, RR ≥ 30 times/min, oxygen saturation (resting state) ≤93%, PaO2/FiO2 ≤300 mmHg\nCritically ill: respiratory failure, shock, multiple organ failure/diabetes: 12 [25%], hypertension: 23 [49.7%], heart disease: 8 [16.7%], mixed fungal infection: 27.1%, bacterial infection: (2.1%) – 3 Diagnosis; RNAaemia positive test confirmed critically ill patients\nPrognosis: strong association between RNAaemia with cytokine storm can be applied to predict the poor prognosis\nTherapeutic approach: in critically patients, IL‐6 should be considered as a therapeutic target\nFan et al. (2020), China Retrospective cohort study/three tertiary hospitals of Wenzhou 149/45.11 ± 13.35/81 (54.4%) males Laboratory test, PCR, CT Blood RT‐PCR confirmed patients: Hubei travel/residence history: N=85,\ncontact with people of Hubei: N=49, no traceable exposure history: N=15 Blood:\ndecreased oxygen saturation: 14(9.4%), leukopenia: 33 (24.2%), lymphopenia: 53 (35.6%), low platelets: 20 (13.4%), elevated CRP: 82 (55.0%), ALT/AST/CK and D‐dimer: less common.\nCT: most involved lung segments: 6 and, GGO: 287 segments, mixed opacity: 637 segments, consolidation: 170 segments, lesions: more in the peripheral lung with a patchy form, normal CT on admission: N=17, negative CT: N=12, no significant difference between patients with or without exposure history Fever:\n114/149, 76.5%,\nCough: 87/149, 58.4%,\nExpectoration:\n4 8/149, 32.2%, mild infection/cerebrovascular or digestive diseases:\n52 (34.9%) Negative CT: 10 days, 6.8 (5.0) days 0 (0.0%) Diagnosis: a normal CT cannot exclude the diagnosis of COVID‐19\nFan et al. (2020), China Retrospective, case series/Chongqing University Three Gorges Hospital 51/45/32 (62.7%) men Laboratory test, CT Blood Confirmed COVID‐19: patients had been to Wuhan:\n43 (84.3%), contact history of COVID‐19 patients: 4 (7.7%), no clear contact history:4 (7.7%) Spectrum of disease:\nnonsevere patients: n = 44, severe patients: 7 (13.7%)\nBlood: lymphopenia: 26 (51.0%), elevated CRP: 32 (62.7%).\nCT:\nGGO: 41 [80.4%], local consolidation of pneumonia:\n17 [33.3%], pleural thickening: 20 (39.2%), small amount of pleural effusion:\n7 (13.7%), streak shadow of lung: 8 (15.7%), multiple solid nodular shadow: 4 (7.8%), air bronchogram: 2 (3.9%), single lobe lesions: 2 (3.9%), multiple lobe lesions: 49 (96.1%) Fever:\n43 [84.3%], cough:\n38 [74.5%], dry cough with expectoration:\n16 (31.4%), fatigue: 22 [43.1%], asthenia: 22 (43.1%), dyspnea: 11/DM: 4 [57.1%] 2–5 days 1 Therapy:\nTCM decoction: 28 [54.9%], aerosol inhalation of recombinant human\nInterferon a‐1b: 51 (100%), Lopinavir/Ritonavir: 51 [100%], Bacillus licheniformis capsules: 44 [86.3%], glucocorticoid treatment: 10 (19.6%)\nOlder patients with server COVID‐19 (N = 7)\nAntibiotic treatment: 7 [100%], nutritional diet: 6 [85.7%), human albumin infusion: 4 (57.1%), immunoglobulin treatment: 4 (57.1%), mechanical ventilation: 6 [85.7%]\nResults and interpretation: discharged 50 patients after 12 days, without the common clinical symptoms, with the significant increased lymphocyte (p = .008) and significant decreased CRP significantly (p \u003c .001)\nFan et al. (2020), China Retrospective/Shanghai Public Health Clinical Center 148/50.5/49.3% females and 50.7% males Laboratory test, RT‐PCR and CT scanning Sera Confirmed SARS‐CoV‐2‐infected patients/a history of related epidemiology Blood:\nelevated LDH, AST, ALT, GGT, TB, ALP:\n35.1%, 21.6%, 18.2%, 17.6%, 6.1%, 4.1% in all patients; lower CD4+ and CD8+ T cells: (62.67%)/(56.1%) patients with abnormal liver function received more treatment compared with normal liver function (25%) (p = .009) Fever: (70.1%), cough: (45.3%), expectoration at admission:\n(26.7%),\nAbnormal liver functions at admission: 75 patients (50.7%) with moderate‐high degree fever (44%) in males,/chronic hepatitis B or C: N = 8 5 days (3–7) 1 Therapy:\nAntibiotics (Levofloxacin, Meropenem, Moxifloxacin, Cephalosporin), interferon, antiviral drugs (Arbidol, Lopinavir/ritonavir, Dnrunavir)\nResults and interpretation:\nall patients discharged from the hospital.\nLopinavir/Ritonavir treatment can significantly alleviate the SARS‐CoV‐2‐induced liver function damage\nChen et al. (2020) China Retrospective/Zhongnan Hospital of Wuhan University, Wuhan 9/26–34/female Clinical records, laboratory results, CT scans Amniotic fluid, cord blood, and neonatal throat swab, breastmilk samples Pregnant women with laboratory‐confirmed COVID‐19 pneumonia and caesarean section in their third trimester/a history of epidemiological exposure to COVID‐19 Blood:\nlymphopenia: N = 5, elevated CRP: N = 6, increased ALT and AST: N = 3, normal WBC count: N = 7, lower WBC: N = 1.\nNine mothers: none developed severe COVID‐19 pneumonia or dying as of Feb4.\nSix mothers:\namniotic fluid, cord blood, neonatal throat swab, and breastmilk: negative for COVID‐19.\nNine livebirths:\nwith 1‐min Apgar score of 8–9 and a 5‐min Apgar score of 9–10, No neonatal asphyxia.\nCT:\nmultiple patchy ground‐glass shadows: N=8 Fever: N = 7, cough N = 4, myalgia N = 3, sore throat: N = 2, malaise: N = 2, fetal distress:\nN = 2/gestational hypertension:\nN = 1, pre‐eclampsia: N = 1, influenza virus infection: N = 1 Short None Therapy: oxygen support (nasal cannula) and empirical antibiotic treatment: N = 9, antiviral therapy: N = 6\nInterpretation: no evidence for intrauterine infection caused by vertical transmission in late pregnancy\nLim et al. (2020), Korea Public health center, Myongji Hospital 1/54/male PCR, CT Throat swab, sputum A Korean man living in Wuhan China/Virus transmission;\nfrom index patient Patient A to Patients B, C, D@@ Spectrum of disease: mild respiratory symptoms.\nCT:\nsmall consolidation in right upper lobe, GGO in both lower lobes Chills, muscle pain 5–7 days – Therapy:\nLopinavir/Ritonavir\nResults and interpretation:\nsignificant decrease in β‐coronavirus viral loads due to the natural course of the healing process rather than administration of Lopinavir/Ritonavir, or both\nWu et al. (2020), China Retrospective/three Grade IIIA hospitals of Jiangsu 80/46.1/41 female (51.25%) Laboratory testing, real time RT‐PCR, CT Throat swab and/or nose swab, blood Confirmed COVID‐19 patients/with a history of epidemic in Wuhan and without contact with the seafood market Spectrum of disease:\nmild: 28 (35.00%), moderate: 49 (61.25%), severe: 3 (3.75%), critically ill: none\nLaboratory:\nlower WBC: 36 (45.00%), lymphocytopenia: 26 (32.50%), lower platelets: 11 (13.75%), high CRP: 62 (77.50%), high ESR: 59 (73.75%), elevated PCT: 1 (1.25%).\nLiver function:\nincreased ALT/AST: 3 (3.75%), lower albumin: 2 (2.50%).\nAbnormal myocardial enzyme spectrum and increase of CK: 18 (22.50%).\nIncreased LDH: 17 (21.25%).\nRenal function damage: 2 (2.50%).\nSerious renal function damage: 1.\nHyperglycemia: 19 (23.17%).\nIncreased D‐dimer: 3 (3.75%).\n9 kinds of respiratory pathogens and influenza A/B nucleic acids: all patients.\nCT: abnormal: 55 (68.75%), bilateral pneumonia: 36 (45.00%), unilateral pneumonia: 19 (23.75%), normal: 25 (31.25%).\nOrgan damage: acute respiratory injury: 10 (12.50%), renal injury: 2 (2.50%) Fever:\n63 (78.75%), cough: 51 (63.75%), shortness of breath: 30 (37.50%), muscle ache: 18 (22.50%), headache: 13 (16.25%) liver dysfunction: 3 (3.75%)/cardiovascular/cerebrovascular, endocrine, digestive, respiratory, malignancies and nervous system diseases: 38 (47.50%) 8.0 Not now Therapy:\nall patients:\nsingle antibiotic mainly Moxifloxacin and Ribavirin antiviral therapy, 12 (14.63%) patients:\nmethylprednisolone sodium succinate or methylprednisolone, 35 (43.75%) patients:\nnoninvasive ventilator, 1 patient: hemodialysis, 3 patients: TCM\nInterpretation: 21 cases discharged from the hospital: With no obvious gender susceptivity, lower proportion of liver dysfunction, abnormal CT and higher frequency nucleic acid detection\nLi et al. (2020), China Retrospective study/hospital in Wenzhou 175/46/92 women, 83/men Real‐time PCR, CT Respiratory tract samples or blood samples Confirmed COVID‐19/a history of exposure to the epidemic area: 57 (33%) patients Spectrum of disease:\nCOVID‐19:\nmild: mild clinical manifestations, no pneumonia; moderate: respiratory symptoms, mild pneumonia, severe (37): pneumonia, ARDS with RR \u003e30 times/min, oxygen saturation \u003c93%; critical (3): pneumonia, shock, respiratory failure, and failures in other organs, nearly all patients: GGO\nK+:\nsevere hypokalemia: 39 (higher body temperature, higher heart rate and RR, higher prevalence of dyspnea or tachypnea (p \u003c .05)), hypokalemia 69, normokalemia patients 67.\nCorrelations: severity of hypokalemia with body temperature, CK, CK‐MB, LDH, and CRP (p \u003c .01), 93% of severe/critically ill patients showed hypokalemia Cough, fever, pneumonia/hypertension: 28, diabetes: 12, other conditions:31 6 – Therapy:\n1 severe hypokalemia patients;\n3 g/day K+, 34 (SD = 4) g potassium during hospital stay\nGood response of patients to K+ supplements when they inclined to recovery\nInterpretation: hypokalemia is prevailing in COVID‐19 patients\nLan et al. (2020), China Case study/Zhongnan Hospital of Wuhan University, Wuhan 4, 30–36 years, 2 male RT‐PCR, thin‐section CT Throat swabs Medical personnel quarantined at home with COVID‐19 Spectrum of disease: mild to moderate\nResults: (at admission); PCR positive: for all CT positive: for all GGO, or mixed GGO/consolidation\n(after therapy); 2 consecutive negative RT‐PCR: all (after discharge); repeated RT‐PCR 5–13 days later: all positive Fever:3, cough: 3, both: 3 Symptom onset to recovery: 12–32 days – Therapy: antiviral treatment (75 mg of oseltamivir every 12 hr)\nResolved clinical symptoms and CT abnormalities: 3\nDelicate patches of GGO: 1\nInterpretation: possibility of at least a proportion of recovered patients act as virus carriers\nLi et al. (2020), China Retrospective study/Sino‐French New Town area Tongji Hospital 47, 62, 28 (59.6%) men Real‐time RT‐PCR Throat‐swab specimens, sputum or endotracheal aspirates Patients with severe COVID‐19 Spectrum of disease: severe: 41 critical: 5(17.9%) men and 1 (5.3%) women\nCommon: oxygen saturation \u003c93% after routine\nNasal oxygen supply: 3 men/1 woman\nBlood: PCT: higher in men, N‐terminal‐pro brain natriuretic peptide: Higher in 16(57.1%) men/5 (26.3%) women,\nPositive influenza A antibody: 5 men (17.9%) Fever: 34 [72.3%], cough: 36 [76.6%], myalgia: 5 [10.6%], fatigue: 7 [14.9%]/comorbidities: 30 (63.8%):\nCOPD, hypertension/CVD lower in men – 3.6% in men and 0 in women Therapy:\nantibiotics applied more in the men than the women\nResults and interpretation: 4 (21.1%) women/1 man (3.6%) discharged.\nPossibility of sex differences in severe COVID‐19 patients, Men with more complicated clinical condition and worse outcomes\nHan et al. (2020) Case study/People's Hospital in Wuwei A 47‐year‐old man/smoking for 20 years/no alcohol abuse RT‐PCR, CT Nasopharyngeal swab specimens Confirmed SARS‐CoV‐2/returned to Wuwei city on January 18 from Wuhan city by car Blood:\ndecreased lymphocytes, increased CRP, slightly elevated fibrinogen, neutrophil, LDH, and fibrinogen\nPCR: positive for expression of RdRPN, N and E genes\nCT: multiple patchy high‐density shadows scattered mainly in the border regions of lungs, solid changes, GGO changes, slightly thickened pleura Fever, cough productive of white phlegm, bosom frowsty, stuffy/runny noses, vertigo, fatigue, chest tightness, nausea, expiratory dyspnea, poor diet, lethargy/hypertension grade 2 and T2D – – Therapy:\ncombination therapy including:\nLopinavir/Ritonavir (800/200 mg daily), methylprednisolone (40 mg daily), recombinant human interferon α‐2b (10 million IU daily), ambroxol hydrochloride (60 mg daily) moxifloxacin hydrochloride (0.4 g daily), high flow humidification oxygen inhalation therapy, treatment of blood glucose, blood pressure, and rehydration therapy\nResults interpretation: the persistent negative results of SARS‐CoV‐2 on days 6 and 7, normal TLC, lung lesions partially absorbed, The patient discharged. Laboratory tests like TLC are necessary, CT combined with RT‐PCR is helpful, Lopinavir/Ritonavir are effective after failure of methylprednisolone/interferon alfa‐2b\nLiu et al. (2020), China Retrospective cohort and case study/Zhongnan Hospital of Wuhan University Dawu County People's Hospital 124 patients, 22 patients:\n12 therapy (mean age 53), 10 control (mean age 58) CT, PCR Serum 124 confirmed COVID‐19 cases, 12 HCOV infected patients Blood: (Study 1) decreased platelet: 25 (20.2%), prolonged PT: 77 (62.1%), increased FIB: 27 (21.8%), and increased D‐dimer: 26 (21.0%)\nSpectrum of disease: (study 2) severe cases: 6 mild cases: 4 critically ill: 2\nCT: (study 2) Bilateral pneumonia: all Study 1: hypercoagulability\nStudy 2: cough: all shortness of breath: most of them, nausea and vomiting: 60.0%/DM, cardiovascular and cerebrovascular diseases: 4 patients from the DIP, 5 patients control group – 1 Therapy: Dipyridamole (150 mg in three separate doses for 7 consecutive days), antiviral (ribavirin, 0.5 g, Q12hr), corticoid (methylprednisolone sodium succinate, 40 mg, qd), oxygen therapy, nutritional support\nResults and interpretation: significant increase in platelet/lymphocyte, significant decrease in D‐dimer levels\nDischarged patients: 50% of severe cases and all 4 mild cases.\nDipyridamole adjunctive therapy could significantly reduce viral replication, inhibits hypercoagulability and improves immune recovery\nAbbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; BUN, blood urea nitrogen; CK, creatine kinase; CK‐MB, creatine kinase myocardial band; COPD, chronic obstructive pulmonary disease; CRE, serum creatinine; CRP, C‐reactive protein; CT, computed tomography; CVD, cardiovascular disease; DM, diabetes mellitus; DM, diabetes mellitus; ESR, erythrocyte sedimentation rate; FIB, fibrinogen; FiO2, fraction of inspired oxygen; GGO, ground‐glass opacity; GGT, γ‐glutamyltransferase; GLM, Generalized Linear Model; LDH, lactate dehydrogenase; nCoV, novel coronavirus; PaO2, partial pressure of oxygen; PCT, procalcitonin; PT, prothrombin time; RNAaemia, SARS‐CoV‐2 nucleic acid; RR, respiratory rate; RT‐PCR, reverse transcriptase polymerase chain reaction; SpO2, oxygen saturation; T2D, type 2 diabetes; TB, total bilirubin; TCM, traditional Chinese medicine; TCM, traditional Chinese medicine; TLC, total lymphocyte count; TnT, troponin T; WBC, white blood cell.\nJohn Wiley \u0026 Sons, Ltd. 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