Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients.
中国武汉冠状病毒病-19 感染的性别特异性临床特征和预后: 168 例重症患者的回顾性研究。
- 作者列表："Meng Y","Wu P","Lu W","Liu K","Ma K","Huang L","Cai J","Zhang H","Qin Y","Sun H","Ding W","Gui L","Wu P
:To confirm the relationship between sex and the progression of Coronavirus Disease-19 (COVID-19), and its potential mechanism, among severe patients. For this retrospective study, we included 168 consecutive severe patients with pathogen-confirmed COVID-19 who were hospitalized between January 16th and February 4th, 2020, at Tongji Hospital in Wuhan, China. Clinical characteristics, laboratory parameters, and outcomes were compared and analyzed between males and females. In the present study, we analyzed 168 severe patients with COVID-19, including 86 males and 82 females, and 48 patients (28.6%) were diagnosed as critically ill. Of 86 male patients, 12.8% (11/86) died and 75.6% (65/86) were discharged; of 82 female patients, 7.3% (6/82) died and 86.6% (71/82) were discharged. Eleven laboratory parameters showed significant differences between male and female patients, and six of them were higher during the whole clinical course in patients who died than in patients who were discharged. In adjusted logistic regression analysis, males with comorbidities presented a higher risk of being critically ill than males without comorbidities (OR = 3.824, 95% CI = 1.279-11.435). However, this association attenuated to null in female patients (OR = 2.992, 95% CI = 0.937-9.558). A similar sex-specific trend was observed in the relation between age and critically ill conditions. We highlighted sex-specific differences in clinical characteristics and prognosis. Male patients appeared to be more susceptible to age and comorbidities. Sex is an important biological variable that should be considered in the prevention and treatment of COVID-19.
目的: 在重症患者中证实性别与冠状病毒病-19 (新型冠状病毒肺炎) 进展的关系及其潜在机制。在这项回顾性研究中，我们纳入了中国武汉同济医院在 2020 年 1 月 16 日至 2 月 4 日期间住院的 168 例经病原体确诊的新型冠状病毒肺炎重症患者。比较分析男性和女性的临床特征、实验室参数和结局。在本研究中，我们分析了 168 例重症新型冠状病毒肺炎患者，其中男性 86 例，女性 82 例，48 例 (28.6%) 患者被诊断为危重症。86 例男性患者中，12.8% 例 (11/86) 死亡，75.6% 例 (65/86) 出院; 82 例女性患者中，7.3% 例 (6/82) 死亡，86.6% 例 (71/82) 出院。11 个实验室参数显示男女患者之间存在显著差异，其中 6 个在整个临床过程中死亡患者高于出院患者。在调整后的logistic回归分析中，有合并症的男性比无合并症的男性表现出更高的危重症风险 (OR = 3.824，95% CI = 1.279-11.435)。然而，这种相关性在女性患者中减弱至无效 (OR = 2.992，95% CI = 0.937-9.558)。在年龄和危重症之间的关系中观察到类似的性别特异性趋势。我们强调了临床特征和预后的性别特异性差异。男性患者似乎更容易受到年龄和合并症的影响。性别是新型冠状病毒肺炎防治中应考虑的重要生物学变量。
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.