Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study.
Tao Chen,Di Wu,Huilong Chen,Weiming Yan,Danlei Yang,Guang Chen,Ke Ma,Dong Xu,Haijing Yu,Hongwu Wang,Tao Wang,Wei Guo,Jia Chen,Chen Ding,Xiaoping Zhang,Jiaquan Huang,Meifang Han,Shusheng Li,Xiaoping Luo,Jianping Zhao,Qin Ning +20 more
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TLDR
Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk, including patients with cardiovascular comorbidity.Abstract:
Objective To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. Design Retrospective case series. Setting Tongji Hospital in Wuhan, China. Participants Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. Main outcome measures Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. Results The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. Conclusion Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.read more
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Impact of comorbidities on patients with COVID-19: A large retrospective study in Zhejiang, China.
Chanyuan Ye,Shanyan Zhang,Xiaoli Zhang,Huan Cai,Jueqing Gu,Jiangshan Lian,Yingfeng Lu,Hongyu Jia,Jianhua Hu,Ciliang Jin,Guodong Yu,Yimin Zhang,Jifang Sheng,Yida Yang +13 more
TL;DR: COVID‐19 patients with comorbidities had worse clinical outcomes as compared with those without any COMorbidity, and the higher the number of comors, the greater was the risk of serious adverse outcomes.
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Endothelial Dysfunction in the Brain: Setting the Stage for Stroke and Other Cerebrovascular Complications of COVID-19.
TL;DR: In this article, the authors explored the unique characteristics of the cerebral endothelium may be the underlying reason for the increased rates of cerebrovascular pathology associated with the coronavirus disease 2019 pandemic.
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Does SARS-CoV-2 Trigger Stress-InducedAutoimmunity by Molecular Mimicry? A Hypothesis.
Francesco Cappello,Antonella Marino Gammazza,Francesco Dieli,Everly Conway de Macario,Alberto J.L. Macario +4 more
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Trajectories of vital signs in patients with COVID-19.
Marco A. F. Pimentel,Oliver C. Redfern,Robert Hatch,J Duncan Young,Lionel Tarassenko,Peter J. Watkinson +5 more
TL;DR: Patients with COVID-19 who deteriorate in hospital experience rapidly-worsening respiratory failure, with low SpO2 and high FiO2, but only minor abnormalities in other vital signs, which has potential implications for the ability of early warning scores to identify deteriorating patients.
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Immunoinflammatory, Thrombohaemostatic, and Cardiovascular Mechanisms in COVID-19.
Selin Gencer,Michael Lacy,Dorothee Atzler,Emiel P. C. van der Vorst,Yvonne Döring,Yvonne Döring,Christian Weber +6 more
TL;DR: The mechanisms that may explain how viral entry and activation of endothelial cells by severe acute respiratory syndrome coronavirus 2 can give rise to a series of events including systemic inflammation, thrombosis, and microvascular dysfunction are surveyed.
References
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Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.
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TL;DR: The epidemiological and clinical characteristics of novel coronavirus (2019-nCoV)-infected pneumonia in Wuhan, China, and hospital-associated transmission as the presumed mechanism of infection for affected health professionals and hospitalized patients are described.
Journal ArticleDOI
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
Nanshan Chen,Min Zhou,Xuan Dong,Jie-Ming Qu,Fengyun Gong,Yang Han,Yang Qiu,Jingli Wang,Ying Liu,Yuan Wei,Jia'an Xia,Ting Yu,Xinxin Zhang,Li Zhang +13 more
TL;DR: Characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia, and further investigation is needed to explore the applicability of the Mu LBSTA scores in predicting the risk of mortality in 2019-nCoV infection.
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