- 作者列表："Li H","Xiang X","Ren H","Xu L","Zhao L","Chen X","Long H","Wang Q","Wu Q
BACKGROUND:To explore the significance of SAA in evaluating the severity and prognosis of COVID-19. METHODS:A total of 132 patients with confirmed COVID-19 who were admitted to a designated COVID-19 hospital in Wuhan, China from January 18, 2020 to February 26, 2020 were collected. The dynamic changes of blood SAA, CRP, PCT, WBC, Lymphocyte (L), PLT, CT imaging, and disease progression were studied. All patients completed at least twice laboratory data collection and clinical condition assessment at three time points indicated for this study; The length of hospital stay was longer than 14 days prior to February 26, 2020. RESULTS:COVID-19 patients had significantly increased SAA and CRP levels, while L count decreased, and PCT, WBC, and PLT were in the normal range. As disease progressed from mild to critically severe, SAA and CRP gradually increased, while L decreased, and PLT, WBC, and PCT had no significant changes; ROC curve analysis suggests that SAA/L, CRP, SAA, and L count are valuable in evaluating the severity of COVID-19 and distinguishing critically ill patients from mild ones; Patients with SAA consistently trending down during the course of disease have better prognosis, compared with the patients with SAA continuously rising; The initial SAA level is positively correlated with the dynamic changes of the serial CT scans. Patient with higher initial SAA level are more likely to have poor CT imaging. CONCLUSIONS:SAA and L are sensitive indicators in evaluating the severity and prognosis of COVID-19. Monitoring dynamic changes of SAA, combined with CT imaging could be valuable in diagnosis and treatment of COVID-19.
背景: 探讨SAA在评估新型冠状病毒肺炎严重程度及预后中的意义。 方法: 收集 2020 年 1 月 18 日至 20 20 年 2 月 26 日在中国武汉市某新型冠状病毒肺炎定点医院住院的确诊新型冠状病毒肺炎患者共 132 例。观察两组患者血SAA、CRP、PCT、WBC、淋巴细胞 (L) 、PLT、CT影像学动态变化及病情进展情况。所有患者在本研究指定的三个时间点完成至少两次实验室数据收集和临床状况评估; 住院时间长于 2020 年 2 月 26 日前的 14 天。 结果: 新型冠状病毒肺炎患者SAA、CRP水平明显升高，L计数降低，PCT、WBC、PLT均在正常范围。随着病情由轻度向危重进展，SAA、CRP逐渐升高，而L降低，PLT、WBC、PCT无明显变化; ROC曲线分析提示SAA/L、CRP，SAA，L计数对评估新型冠状病毒肺炎的严重程度、鉴别危重病人和轻症患者有重要价值; SAA在病程中持续下降的患者预后较好。与SAA患者相比，SAA初始水平持续升高; SAA初始水平与系列CT扫描的动态变化呈正相关。初始SAA水平较高的患者更有可能CT成像较差。 结论: SAA和L是评价新型冠状病毒肺炎严重程度和预后的敏感指标。监测SAA的动态变化，结合CT影像学检查对新型冠状病毒肺炎的诊断和治疗有重要价值。
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.
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.
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.