The Characteristics of 50 Hospitalized COVID-19 Patients With and Without ARDS.
Michael Dreher,Alexander Kersten,Johannes Bickenbach,Paul Balfanz,Bojan Hartmann,Christian Cornelissen,Ayham Daher,Robert Stöhr,Michael Kleines,Sebastian Lemmen,J.C. Brokmann,Tobias Müller,Dirk Müller-Wieland,Gernot Marx,Nikolaus Marx +14 more
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TLDR
This initial description of a cohort of COVID-19 patients with and without ARDS in Germany reveals that those with ARDS more commonly have preexisting respiratory diseases and obesity, as well as persistently elevated inflammatory markers.Abstract:
BACKGROUND: The type of pneumonia (coronavirus disease 2019, COVID-19) that is caused by the new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) is now spreading across the world in a pandemic. Many patients with COVID-19 were admitted to the University Hospital Aachen during an outbreak that first struck the Heinsberg district in February 2020. METHODS: A comparative presentation of the clinical features of the first 50 COVID-19 patients with and without acute respiratory distress syndrome (ARDS) who were hospitalized in the University Hospital Aachen. RESULTS: 24 intubated patients were treated in the intensive care unit for ARDS of varying degrees of severity, while 26 patients who were breathing spontaneously without ARDS, but nevertheless needed supplemental oxygen, were treated in a separate isolation ward. The median age of the patients was 65 (IQR 58-76). The median latency from symptom onset to hospitalization was four days (IQR 1-8). Patients with ARDS had preexisting respiratory diseases more commonly than patients without ARDS (58% [95% confidence interval: 39; 76] versus 42% [26; 61]) and were more commonly overweight or obese (83% [64; 93] versus 42% [26; 61]). The two groups did not differ in viral burden but displayed significant differences in laboratory findings: ARDS patients had persistently elevated values for leukocytes, interleukin-6, lactate dehydrogenase, creatine kinase, and D-dimers over the period of observation. Patients without ARDS had persistently elevated inflammatory parameters and fever for at least one week, with an accompanying need for supplemental oxygen. Three of the patients with ARDS died of multiorgan failure, while four in the non-ARDS group died of respiratory insufficiency. CONCLUSION: This initial description of a cohort of COVID-19 patients with and without ARDS in Germany reveals that those with ARDS more commonly have preexisting respiratory diseases and obesity, as well as persistently elevated inflammatory markers. COVID-19 patients without ARDS may likewise require prolonged hospitalization because of persistently elevated inflammatory values with a simultaneous need for supplemental oxygen.read more
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Journal ArticleDOI
Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study.
Dominic Wichmann,Jan-Peter Sperhake,Marc Lütgehetmann,Stefan Steurer,Carolin Edler,Axel Heinemann,Fabian Heinrich,Herbert Mushumba,Inga Kniep,Ann Sophie Schröder,Christoph Burdelski,Geraldine de Heer,Axel Nierhaus,Daniel Frings,Susanne Pfefferle,Heinrich Becker,Hanns Bredereke-Wiedling,Andreas de Weerth,Hans-Richard Paschen,Sara Sheikhzadeh-Eggers,Axel Stang,Stefan Schmiedel,Carsten Bokemeyer,Marylyn M. Addo,Martin Aepfelbacher,Klaus Püschel,Stefan Kluge +26 more
TL;DR: In this paper, the causes of COVID-19-related deaths were investigated in a single academic medical center in the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of CoV-19 patients.
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Viral dynamics in mild and severe cases of COVID-19.
Yang Liu,Li Meng Yan,Lagen Wan,Tian Xin Xiang,Aiping Le,Jia Ming Liu,Malik Peiris,Leo L.M. Poon,Wei Zhang +8 more
TL;DR: Overall, the data indicate that, similar to SARS in 2002–03, Viral dynamics in mild and severe cases of COVID-19 are similar to that of SARS.
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Autopsy Findings and Venous Thromboembolism in Patients With COVID-19.
TL;DR: The high incidence of thromboembolic events suggests an important role of COVID-19–induced coagulopathy, as well as possible therapeutic interventions to reduce it, in patients dying with a polymerase chain reaction–confirmed diagnosis of CO VID-19.
Journal ArticleDOI
Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19.
Tobias Herold,Vindi Jurinovic,Chiara Arnreich,Brian J. Lipworth,Johannes C. Hellmuth,Michael von Bergwelt-Baildon,Matthias Klein,Tobias Weinberger +7 more
TL;DR: Maximal interleukin-6 levels before intubation showed the strongest association with the need of mechanical ventilation followed by maximal CRP, suggesting the possibility of using IL-6 or CRP levels to guide escalation of treatment in patients with COVID-19 related hyperinflammatory syndrome.
References
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Journal ArticleDOI
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
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.
Journal ArticleDOI
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.
Dawei Wang,Bo Hu,Chang Hu,Fangfang Zhu,Xing Liu,Jing Zhang,Binbin Wang,Hui Xiang,Zhenshun Cheng,Yong Xiong,Yan Zhao,Yirong Li,Xinghuan Wang,Zhiyong Peng +13 more
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
Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention
Zunyou Wu,Jennifer M. McGoogan +1 more
TL;DR: Hospitalised COVID-19 patients are frequently elderly subjects with co-morbidities receiving polypharmacy, all of which are known risk factors for d
Journal ArticleDOI
Acute respiratory distress syndrome: the Berlin Definition.
Ards Definition Task Force,V. Marco Ranieri,Gordon D. Rubenfeld,B. Taylor Thompson,Niall D. Ferguson,Ellen Caldwell,Eddy Fan,Luigi Camporota,Luigi Camporota,Arthur S. Slutsky +9 more
TL;DR: The updated and revised Berlin Definition for ARDS addresses a number of the limitations of the AECC definition and may serve as a model to create more accurate, evidence-based, critical illness syndrome definitions and to better inform clinical care, research, and health services planning.
Journal ArticleDOI
Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China
Chaomin Wu,Xiaoyan Chen,Yanping Cai,Jia’an Xia,Xing Zhou,Sha Xu,Han-Ping Huang,Li Zhang,Xia Zhou,Chunling Du,Yuye Zhang,Juan Song,Sijiao Wang,Yencheng Chao,Zeyong Yang,Jie Xu,Xin Zhou,Dechang Chen,Weining Xiong,Lei Xu,Feng Zhou,Jinjun Jiang,Chunxue Bai,Zheng Junhua,Yuanlin Song +24 more
TL;DR: Although high fever was associated with the development of ARDS, it was also associated with better outcomes among patients with ARDS and treatment with methylprednisolone may be beneficial for patients who develop ARDS.
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