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Characteristics and Early Prognosis of COVID-19 Infection in Fracture Patients.


  • 影响因子:3.57
  • DOI:10.2106/JBJS.20.00390
  • 作者列表:"Mi B","Chen L","Xiong Y","Xue H","Zhou W","Liu G
  • 发表时间:2020-05-06

BACKGROUND:Studies of the novel coronavirus-induced disease COVID-19 in Wuhan, China, have elucidated the epidemiological and clinical characteristics of this disease in the general population. The present investigation summarizes the clinical characteristics and early prognosis of COVID-19 infection in a cohort of patients with fractures. METHODS:Data on 10 patients with a fracture and COVID-19 were collected from 8 different hospitals located in the Hubei province from January 1, 2020, to February 27, 2020. Analyses of early prognosis were based on clinical outcomes and trends in laboratory results during treatment. RESULTS:All 10 patients presented with limited activity related to the fracture. The most common signs were fever, cough, and fatigue at the time of presentation (7 patients each). Other, less common signs included sore throat (4 patients), dyspnea (5 patients), chest pain (1 patient), nasal congestion (1 patient), headache (1 patient), dizziness (3 patients), abdominal pain (1 patient), and vomiting (1 patient). Lymphopenia (<1.0 × 10 cells/L) was identified in 6 of 10 patients, 9 of 9 patients had a high serum level of D-dimer, and 9 of 9 patients had a high level of C-reactive protein. Three patients underwent surgery, whereas the others were managed nonoperatively because of their compromised status. Four patients died on day 8 (3 patients) or day 14 (1 patient) after admission. The clinical outcomes for the surviving patients are not yet determined. CONCLUSIONS:The clinical characteristics and early prognosis of COVID-19 in patients with fracture tended to be more severe than those reported for adult patients with COVID-19 without fracture. This finding may be related to the duration between the development of symptoms and presentation. Surgical treatment should be carried out cautiously or nonoperative care should be chosen for patients with fracture in COVID-19-affected areas, especially older individuals with intertrochanteric fractures. LEVEL OF EVIDENCE:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.


背景: 对武汉市新型冠状病毒引起的疾病新型冠状病毒肺炎的研究,阐明了该病在普通人群中的流行病学和临床特征。本文总结了新型冠状病毒肺炎感染的临床特点及早期预后。 方法: 收集 2020 年 1 月 1 日至 20 年 2 月 27 日期间湖北省 8 家医院收治的 10 例骨折并新型冠状病毒肺炎患者的临床资料。早期预后分析基于治疗期间的临床结果和实验室结果趋势。 结果: 10 例患者均表现为骨折相关活动受限。就诊时最常见的体征为发热、咳嗽和乏力 (各 7 例)。其他较少见的体征包括咽喉痛 (4 例) 、呼吸困难 (5 例) 、胸痛 (1 例) 、鼻塞 (1 例) 、头痛 (1 例) 、头晕 3 例,腹痛 1 例,呕吐 1 例。10 例患者中有 6 例出现淋巴细胞减少 (<1.0 × 10 个细胞/L),9 例患者中有 9 例血清D-二聚体水平较高,9 例患者中 9 例C反应蛋白水平较高。3 例患者接受了手术,而其他患者因状态受损而非手术治疗。4 例患者在入院后第 8 天 (3 例) 或第 14 天 (1 例) 死亡。存活患者的临床结局尚未确定。 结论: 骨折患者新型冠状病毒肺炎的临床特征和早期预后往往比没有骨折的成人新型冠状病毒肺炎患者报道的更严重。这一发现可能与症状发展和表现之间的持续时间有关。对于COVID-19-affected骨折患者,尤其是老年股骨转子间骨折患者,应谨慎进行手术治疗或选择非手术治疗。 证据水平: 预后IV级。有关证据级别的完整描述,请参见作者说明。



作者列表:["Lim J","Jeon S","Shin HY","Kim MJ","Seong YM","Lee WJ","Choe KW","Kang YM","Lee B","Park SJ"]

METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

作者列表:["Zhang W","Du RH","Li B","Zheng XS","Yang XL","Hu B","Wang YY","Xiao GF","Yan B","Shi ZL","Zhou P"]

METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.