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Chun-Quan Ou

Other affiliations: Guangzhou Medical University
Bio: Chun-Quan Ou is an academic researcher from Southern Medical University. The author has contributed to research in topics: Population & Medicine. The author has an hindex of 30, co-authored 85 publications receiving 22652 citations. Previous affiliations of Chun-Quan Ou include Guangzhou Medical University.


Papers
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Journal ArticleDOI
TL;DR: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness, and patients often presented without fever, and many did not have abnormal radiologic findings.
Abstract: Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of...

22,622 citations

Journal ArticleDOI
TL;DR: It is found that among laboratory confirmed cases of COVID-19, patients with any comorbidity yielded poorer clinical outcomes than those without and a greater number ofComorbidities also correlated with poorer clinical outcome.
Abstract: Background The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide. Objective To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status. Methods We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11th, 2019 and January 31st, 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities. Results The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424–5.048], diabetes (HR 1.59, 95%CI 1.03–2.45), hypertension (HR 1.58, 95%CI 1.07–2.32) and malignancy (HR 3.50, 95%CI 1.60–7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16–2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61–4.17) among patients with two or more comorbidities. Conclusion Among laboratory-confirmed cases of Covid-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.

2,587 citations

Posted ContentDOI
09 Feb 2020-medRxiv
TL;DR: The 2019-nCoV epidemic spreads rapidly by human-to-human transmission and the disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.
Abstract: Background Since December 2019, acute respiratory disease (ARD) due to 2019 novel coronavirus (2019-nCoV) emerged in Wuhan city and rapidly spread throughout China. We sought to delineate the clinical characteristics of these cases. Methods We extracted the data on 1,099 patients with laboratory-confirmed 2019-nCoV ARD from 552 hospitals in 31 provinces/provincial municipalities through January 29th, 2020. Results The median age was 47.0 years, and 41.90% were females. Only 1.18% of patients had a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contacted with people from Wuhan. Fever (87.9%) and cough (67.7%) were the most common symptoms. Diarrhea is uncommon. The median incubation period was 3.0 days (range, 0 to 24.0 days). On admission, ground-glass opacity was the typical radiological finding on chest computed tomography (50.00%). Significantly more severe cases were diagnosed by symptoms plus reverse-transcriptase polymerase-chain-reaction without abnormal radiological findings than non-severe cases (23.87% vs. 5.20%, P Conclusions The 2019-nCoV epidemic spreads rapidly by human-to-human transmission. Normal radiologic findings are present among some patients with 2019-nCoV infection. The disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.

1,358 citations

Posted ContentDOI
27 Feb 2020-medRxiv
TL;DR: Comorbidities are present in around one fourth of patients with COVID-19 in China, and predispose to poorer clinical outcomes, and have significantly escalated risks of reaching to the composite endpoint compared with those who had a single comorbidity.
Abstract: Objective To evaluate the spectrum of comorbidities and its impact on the clinical outcome in patients with coronavirus disease 2019 (COVID-19). Design Retrospective case studies Setting 575 hospitals in 31 province/autonomous regions/provincial municipalities across China Participants 1,590 laboratory-confirmed hospitalized patients. Data were collected from November 21st, 2019 to January 31st, 2020. Main outcomes and measures Epidemiological and clinical variables (in particular, comorbidities) were extracted from medical charts. The disease severity was categorized based on the American Thoracic Society guidelines for community-acquired pneumonia. The primary endpoint was the composite endpoints, which consisted of the admission to intensive care unit (ICU), or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared among patients with COVID-19 according to the presence and number of comorbidities. Results Of the 1,590 cases, the mean age was 48.9 years. 686 patients (42.7%) were females. 647 (40.7%) patients were managed inside Hubei province, and 1,334 (83.9%) patients had a contact history of Wuhan city. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. 269 (16.9%), 59 (3.7%), 30 (1.9%), 130 (8.2%), 28 (1.8%), 24 (1.5%), 21 (1.3%), 18 (1.1%) and 3 (0.2%) patients reported having hypertension, cardiovascular diseases, cerebrovascular diseases, diabetes, hepatitis B infections, chronic obstructive pulmonary disease, chronic kidney diseases, malignancy and immunodeficiency, respectively. 130 (8.2%) patients reported having two or more comorbidities. Patients with two or more comorbidities had significantly escalated risks of reaching to the composite endpoint compared with those who had a single comorbidity, and even more so as compared with those without (all P Conclusion Comorbidities are present in around one fourth of patients with COVID-19 in China, and predispose to poorer clinical outcomes. Highlights What is already known on this topic -Since November 2019, the rapid outbreak of coronavirus disease 2019 (COVID-19) has recently become a public health emergency of international concern. There have been 79,331 laboratory-confirmed cases and 2,595 deaths globally as of February 25th, 2020 -Previous studies have demonstrated the association between comorbidities and other severe acute respiratory diseases including SARS and MERS. -No study with a nationwide representative cohort has demonstrated the spectrum of comorbidities and the impact of comorbidities on the clinical outcomes in patients with COVID-19. What this study adds -In this nationwide study with 1,590 patients with COVID-19, comorbidities were identified in 399 patients. Comorbidities of COVID-19 mainly included hypertension, cardiovascular diseases, cerebrovascular diseases, diabetes, hepatitis B infections, chronic obstructive pulmonary disease, chronic kidney diseases, malignancy and immunodeficiency. -The presence of as well as the number of comorbidities predicted the poor clinical outcomes (admission to intensive care unit, invasive ventilation, or death) of COVID-19. -Comorbidities should be taken into account when estimating the clinical outcomes of patients with COVID-19 on hospital admission.

682 citations

Journal ArticleDOI
01 May 2015-Allergy
TL;DR: A national investigation in China was performed to determine the prevalence and associated factors of chronic sinusitis and its consequences.
Abstract: Chronic rhinosinusitis (CRS) is characterized by inflammation of the mucosa of the nose and paranasal sinuses with a duration of at least 12 consecutive weeks and is a common otorhinolaryngologic disease that is frequently encountered in everyday practice (1). Although CRS is not a life-threatening disease, not all patients are cured or achieve control of their symptoms, even with maximal medical management or surgical intervention. The symptoms in CRS patients with (CRSwNP) and without nasal polyps (CRSsNP) are considerably overlapping, while patients with CRSwNP have higher symptom scores and more nasal symptoms (2). Patients with CRSwNP are particularly recalcitrant to usual therapies, and this type of CRS is increasingly prevalent (3). The persistent symptoms can result in facial pain/headache, impairments in general health, vitality and social functioning, stress disorders and other problems that affect patients’ lives and work (4–7). The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) group proposed clear guidelines for a symptom-based definition of rhinosinusitis that has been validated and accepted in epidemiological studies (1,8,9). The European postal survey of 57 128 adults in 12 countries reported that the overall prevalence of EP3OS-defined CRS was 10.9% and ranged from 6.9% to 27.1% in 19 centres (10). A recent survey reported a prevalence of EP3OS-defined CRS of 5.51% in Sao Paulo, Brazil (11). Some authors have used the data from the National Population Health Survey to estimate the prevalence of CRS and found prevalences of 6.95% in Korea (12) and 5.7% among female and 3.4% among male Canadians (13). The 2012 National Health Interview Survey of 34 525 adults found that 12% of adults have been told by a doctor or other health professional that they have sinusitis, and these self-reported doctor-diagnosed prevalences of sinusitis were 15% and 9% among males and females, respectively. The vital health statistic data revealed that CRS is more prevalent than other common chronic respiratory diseases, such as chronic obstructive pulmonary disease (3%) and asthma (8%) (14). Based on this high prevalence, some studies in the USA have claimed that CRS poses an enormous health and economic burden to individuals, the community and society (15). When accounting for the entire population into account, the health burden of CRS is speculated to be huge in Asia; nevertheless, little is known about the actual situation. A survey of 4554 Danes reported a CRS prevalence of 7.8% compared to the overall prevalence of 10.9% in 19 European centres (10,16). The National Health Interview Survey of US adults revealed a decreasing trend in CRS from 16% in 1997 to 14% in 2006 and 12% in 2012 (14,17,18). The literature suggests that the prevalence and patterns of CRS might vary by region and population and change over time due to environmental changes and the development of health care. The previous epidemiological data regarding CRS are mainly from western studies, and little is known regarding the potential socio-economic disparities. In Asia, large-scale epidemiological studies are required to update information about the prevalence of CRS, and such studies would provide information for the assessment of the disease burden and the development and promotion of public health policies associated with CRS. We conducted a cross-sectional investigation in seven major Chinese cities. This study aimed to provide a better understanding of the epidemiological characteristics of CRS, including its prevalence and associations with socio-economic factors and tobacco smoke.

287 citations


Cited by
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Journal ArticleDOI
TL;DR: It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality.
Abstract: In 2004, the first American Heart Association scientific statement on “Air Pollution and Cardiovascular Disease” concluded that exposure to particulate matter (PM) air pollution contributes to card...

5,227 citations

Journal ArticleDOI
TL;DR: During the epidemic period of COVID-19, clinicians should suspect severe acute respiratory syndrome coronavirus 2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
Abstract: Importance The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, is serious and has the potential to become an epidemic worldwide. Several studies have described typical clinical manifestations including fever, cough, diarrhea, and fatigue. However, to our knowledge, it has not been reported that patients with COVID-19 had any neurologic manifestations. Objective To study the neurologic manifestations of patients with COVID-19. Design, Setting, and Participants This is a retrospective, observational case series. Data were collected from January 16, 2020, to February 19, 2020, at 3 designated special care centers for COVID-19 (Main District, West Branch, and Tumor Center) of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China. The study included 214 consecutive hospitalized patients with laboratory-confirmed diagnosis of severe acute respiratory syndrome coronavirus 2 infection. Main Outcomes and Measures Clinical data were extracted from electronic medical records, and data of all neurologic symptoms were checked by 2 trained neurologists. Neurologic manifestations fell into 3 categories: central nervous system manifestations (dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia, and seizure), peripheral nervous system manifestations (taste impairment, smell impairment, vision impairment, and nerve pain), and skeletal muscular injury manifestations. Results Of 214 patients (mean [SD] age, 52.7 [15.5] years; 87 men [40.7%]) with COVID-19, 126 patients (58.9%) had nonsevere infection and 88 patients (41.1%) had severe infection according to their respiratory status. Overall, 78 patients (36.4%) had neurologic manifestations. Compared with patients with nonsevere infection, patients with severe infection were older, had more underlying disorders, especially hypertension, and showed fewer typical symptoms of COVID-19, such as fever and cough. Patients with more severe infection had neurologic manifestations, such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]), and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]). Conclusions and Relevance Patients with COVID-19 commonly have neurologic manifestations. During the epidemic period of COVID-19, when seeing patients with neurologic manifestations, clinicians should suspect severe acute respiratory syndrome coronavirus 2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.

5,153 citations

Journal ArticleDOI
TL;DR: Chest CT has a high sensitivity for diagnosis of CO VID-19 and may be considered as a primary tool for the current COVID-19 detection in epidemic areas, as well as for patients with multiple RT-PCR assays.
Abstract: Chest CT had higher sensitivity for diagnosis of COVID-19 as compared with initial reverse-transcription polymerase chain reaction from swab samples in the epidemic area of China.

4,717 citations

Journal ArticleDOI
28 Apr 2020-JAMA
TL;DR: Patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) in the Lombardy region of Italy were characterized, including data on clinical management, respiratory failure, and patient mortality.
Abstract: Importance In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited. Objective To characterize patients with coronavirus disease 2019 (COVID-19) requiring treatment in an intensive care unit (ICU) in the Lombardy region of Italy. Design, Setting, and Participants Retrospective case series of 1591 consecutive patients with laboratory-confirmed COVID-19 referred for ICU admission to the coordinator center (Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy) of the COVID-19 Lombardy ICU Network and treated at one of the ICUs of the 72 hospitals in this network between February 20 and March 18, 2020. Date of final follow-up was March 25, 2020. Exposures SARS-CoV-2 infection confirmed by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swabs. Main Outcomes and Measures Demographic and clinical data were collected, including data on clinical management, respiratory failure, and patient mortality. Data were recorded by the coordinator center on an electronic worksheet during telephone calls by the staff of the COVID-19 Lombardy ICU Network. Results Of the 1591 patients included in the study, the median (IQR) age was 63 (56-70) years and 1304 (82%) were male. Of the 1043 patients with available data, 709 (68%) had at least 1 comorbidity and 509 (49%) had hypertension. Among 1300 patients with available respiratory support data, 1287 (99% [95% CI, 98%-99%]) needed respiratory support, including 1150 (88% [95% CI, 87%-90%]) who received mechanical ventilation and 137 (11% [95% CI, 9%-12%]) who received noninvasive ventilation. The median positive end-expiratory pressure (PEEP) was 14 (IQR, 12-16) cm H2O, and Fio2was greater than 50% in 89% of patients. The median Pao2/Fio2was 160 (IQR, 114-220). The median PEEP level was not different between younger patients (n = 503 aged ≤63 years) and older patients (n = 514 aged ≥64 years) (14 [IQR, 12-15] vs 14 [IQR, 12-16] cm H2O, respectively; median difference, 0 [95% CI, 0-0];P = .94). Median Fio2was lower in younger patients: 60% (IQR, 50%-80%) vs 70% (IQR, 50%-80%) (median difference, −10% [95% CI, −14% to 6%];P = .006), and median Pao2/Fio2was higher in younger patients: 163.5 (IQR, 120-230) vs 156 (IQR, 110-205) (median difference, 7 [95% CI, −8 to 22];P = .02). Patients with hypertension (n = 509) were older than those without hypertension (n = 526) (median [IQR] age, 66 years [60-72] vs 62 years [54-68];P Conclusions and Relevance In this case series of critically ill patients with laboratory-confirmed COVID-19 admitted to ICUs in Lombardy, Italy, the majority were older men, a large proportion required mechanical ventilation and high levels of PEEP, and ICU mortality was 26%.

4,331 citations

Journal ArticleDOI
TL;DR: Among patients with pneumonia caused by SARS-CoV-2 (novel coronavirus pneumonia or Wuhan pneumonia), fever was the most common symptom, followed by cough, and bilateral lung involvement with ground-glass opacity was themost common finding from computed tomography images of the chest.

4,318 citations