Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery.
Yumiao Zhao1, Yao-min Shang, Wen-bin Song, Qingquan Li, Hua Xie, Qin-Fu Xu1, Jia Junli1, Li-ming Li1, Hong-li Mao1, Xiuman Zhou1, Hong Luo, Yan-feng Gao1, Ai-Guo Xu1 •
TL;DR: Radiological and physiological abnormalities were still found in a considerable proportion of COVID-19 survivors without critical cases 3 months after discharge, and higher level of D-dimer levels on admission could effectively predict impaired DLCO after 3 months discharge.
About: This article is published in EClinicalMedicine.The article was published on 2020-07-15 and is currently open access. It has received 604 citations till now. The article focuses on the topics: Pulmonary function testing & DLCO.
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Fei Zhou1, Ting Yu, Ronghui Du, Guohui Fan2, Ying Liu, Zhibo Liu1, Jie Xiang3, Yeming Wang4, Bin Song, Xiaoying Gu1, Xiaoying Gu2, Lulu Guan, Yuan Wei, Li Hui1, Xudong Wu, Jiuyang Xu5, Shengjin Tu, Yi Zhang1, Hua Chen, Bin Cao •
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
4,408 citations
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Chaolin Huang1, Lixue Huang1, Lixue Huang2, Yeming Wang1, Xia Li1, Lili Ren1, Xiaoying Gu3, Xiaoying Gu1, Liang Kang1, Lili Guo1, Min Liu3, Xing Zhou1, Jianfeng Luo1, Zhenghui Huang1, Shengjin Tu1, Yue Zhao, Li Chen, Decui Xu, Yanping Li, Caihong Li, Lu Peng, Yong Mei Li1, Wuxiang Xie4, Dan Cui5, Dan Cui1, Lianhan Shang6, Lianhan Shang1, Guohui Fan1, Guohui Fan3, Jiuyang Xu7, Geng Wang1, Geng Wang8, Ying Wang1, Jingchuan Zhong1, Chen Wang7, Chen Wang1, Jianwei Wang1, Dingyu Zhang1, Bin Cao •
TL;DR: In this article, the authors describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity.
2,933 citations
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Ani Nalbandian1, Kartik Sehgal2, Kartik Sehgal3, Aakriti Gupta4, Aakriti Gupta1, Mahesh V. Madhavan1, Claire McGroder1, Jacob S. Stevens1, Joshua R. Cook1, Anna S. Nordvig1, Daniel Shalev1, Tejasav S. Sehrawat5, Neha Ahluwalia6, Behnood Bikdeli, Donald Dietz1, Caroline Der-Nigoghossian7, Nadia Liyanage-Don1, Gregg F. Rosner1, Elana J. Bernstein1, Sumit Mohan1, Akinpelumi A Beckley1, David S. Seres1, Toni K. Choueiri2, Toni K. Choueiri3, Nir Uriel1, John C. Ausiello1, Domenico Accili1, Daniel E. Freedberg1, Matthew R. Baldwin1, Allan Schwartz1, Daniel Brodie1, Christine Kim Garcia1, Mitchell S.V. Elkind1, Jean M. Connors3, Jean M. Connors2, John P. Bilezikian1, Donald W. Landry1, Elaine Wan1 •
TL;DR: A comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae is provided in this paper, where the authors discuss relevant considerations for the multidisciplinary care of COPD survivors and propose a framework for the identification of those at high risk for COPD and their coordinated management through dedicated COPD clinics.
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
2,307 citations
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TL;DR: In this article, a systematic review and meta-analysis aimed to identify studies assessing the long-term effects of COVID-19, which can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery.
Abstract: COVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.
969 citations
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TL;DR: In this article, a review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure, including fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of posttraumatic stress disorder, muscle pain, concentration problems, and headache.
Abstract: Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.
679 citations
References
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Wei-jie Guan1, Zhengyi Ni1, Yu Hu1, Wenhua Liang1, Chun-Quan Ou1, Jianxing He1, Lei Liu1, Hong Shan1, Chunliang Lei1, David S.C. Hui1, Bin Du1, Lanjuan Li1, Guang Zeng1, Kowk-Yung Yuen1, Ruchong Chen1, Chun-Li Tang1, Tao Wang1, Ping-Yan Chen1, Jie Xiang1, Shiyue Li1, Jinlin Wang1, Zi-jing Liang1, Yi-xiang Peng1, Li Wei1, Yong Liu1, Ya-hua Hu1, Peng Peng1, Jian-ming Wang1, Ji-yang Liu1, Zhong Chen1, Gang Li1, Zhi-jian Zheng1, Shao-qin Qiu1, Jie Luo1, Chang-jiang Ye1, Shao-yong Zhu1, Nanshan Zhong1 •
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
"Follow-up study of the pulmonary fu..." refers background in this paper
...4% of COVID-19 patients according to the virus mutation [25,26]....
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...Several studies have reported that D-dimer on admission was the independent predictor of in-hospital death for patients with COVID-19 [25,41,42]....
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Fei Zhou1, Ting Yu, Ronghui Du, Guohui Fan2, Ying Liu, Zhibo Liu1, Jie Xiang3, Yeming Wang4, Bin Song, Xiaoying Gu1, Xiaoying Gu2, Lulu Guan, Yuan Wei, Li Hui1, Xudong Wu, Jiuyang Xu5, Shengjin Tu, Yi Zhang1, Hua Chen, Bin Cao •
TL;DR: Wang et al. as discussed by the authors used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death, including older age, high SOFA score and d-dimer greater than 1 μg/mL.
20,189 citations
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Dawei Wang1, Bo Hu1, Chang Hu1, Fangfang Zhu1, Xing Liu1, Jing Zhang1, Binbin Wang1, Hui Xiang1, Zhenshun Cheng1, Yong Xiong1, Yan Zhao1, Yirong Li1, Xinghuan Wang1, Zhiyong Peng1 •
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.
Abstract: Importance In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures Documented NCIP. Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0). Conclusions and Relevance In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.
16,635 citations
"Follow-up study of the pulmonary fu..." refers background in this paper
...4% of COVID-19 patients according to the virus mutation [25,26]....
[...]
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Qun Li1, Xuhua Guan1, Peng Wu2, Xiaoye Wang1, Lei Zhou1, Yeqing Tong1, Ruiqi Ren1, Kathy Leung2, Eric H. Y. Lau2, Jessica Y. Wong2, Xuesen Xing1, Nijuan Xiang1, Yang Wu1, Chao Li1, Chen Qi1, Dan Li1, Tian Liu1, Jing Zhao1, Man Liu1, Wenxiao Tu1, Chuding Chen1, Lianmei Jin1, Rui Yang1, Qi Wang1, Suhua Zhou1, Rui Wang1, Hui Liu1, Yingbo Luo1, Yuan Liu1, Ge Shao1, Huan Li1, Zhongfa Tao1, Yang Yang3, Yang Yang4, Zhiqiang Deng5, Boxi Liu5, Zhitao Ma5, Yanping Zhang1, Guoqing Shi1, Tommy Tsan-Yuk Lam2, Joseph T. Wu2, George F. Gao6, George F. Gao1, Benjamin J. Cowling2, Bo Yang5, Gabriel M. Leung2, Zijian Feng1 •
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Abstract: Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the...
13,101 citations
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Roujian Lu1, Xiang Zhao1, Juan Li2, Peihua Niu1, Bo Yang3, Honglong Wu, Wenling Wang1, Hao Song4, Baoying Huang1, Na Zhu1, Yuhai Bi4, Xuejun Ma1, Faxian Zhan3, Liang Wang4, Tao Hu2, Hong Zhou2, Zhenhong Hu, Weimin Zhou1, Li Zhao1, Jing Chen5, Yao Meng1, Ji Wang1, Yang Lin, Jianying Yuan, Zhihao Xie, Jinmin Ma, William J. Liu1, Dayan Wang1, Wenbo Xu1, Edward C. Holmes6, George F. Gao1, George F. Gao4, Guizhen Wu1, Weijun Chen, Weifeng Shi2, Wenjie Tan4, Wenjie Tan1 •
TL;DR: The phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans.
9,474 citations
"Follow-up study of the pulmonary fu..." refers background in this paper
...Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]....
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