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Article ; Online: Clinical Course and Risk Factors of Disease Deterioration in Critically Ill Patients with COVID-19.

Qin, Weidong / Bai, Wenwu / Liu, Keyin / Liu, Ya / Meng, Xiao / Zhang, Kai / Zhang, Mingxiang

2021 Volume 32, Issue 5-6, Page(s) 310–315

Abstract: ... survivors and nonsurvivors. Of all the 262 patients, 23 (8.8%) patients died and 239 (91.2%) were discharged ... The median age was 63.5 years and 46.9% of patients were male. The main complaints were fever (83.6%), cough ... 35.5%), diabetes mellitus (16.4%), and coronary artery disease (9.9%). Morbidity is higher in elderly ...

Abstract	The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in December 2019 and rapidly spread to other provinces in China as well as other countries. In this study, 262 patients diagnosed with moderate to severe SARS-CoV-2 pneumonia in Wuhan, China, were analyzed. Data were compared between survivors and nonsurvivors. Of all the 262 patients, 23 (8.8%) patients died and 239 (91.2%) were discharged. The median age was 63.5 years and 46.9% of patients were male. The main complaints were fever (83.6%), cough (63.4%), and fatigue (49.2%) in the surviving group, while there were more complaints of dyspnea (39.1%) and shortness of breath (56.5%) in the nonsurviving group. The main comorbidities were hypertension (35.5%), diabetes mellitus (16.4%), and coronary artery disease (9.9%). Morbidity is higher in elderly patients with more comorbidities. Patients were mainly treated with nasal cannula (93.9%), while the nonsurviving group received more invasive mechanical ventilation (39.1%). Arbidol (80.9%), ribavirin (36.6%), oseltamivir (38.9%), interferon (16.4%), and ganciclovir (14.5%) were used for the antiviral treatment. In the nonsurviving group, the number of white blood cells (WBC) was significantly increased and lymphocytes were decreased, and lymphopenia was more common. The levels of aspartate transaminase (AST), brain natriuretic peptide (BNP), creatine kinase isoenzyme MB (CK-MB), lactate dehydrogenase (LDH), and C-reactive protein (CRP) were also significantly increased in the nonsurviving group. The adjusted hazard ratios (HRs) for association of known variables for all-cause mortality due to the coronavirus disease 2019 were 2.467 (95% confidence interval [CI], 1.007-6.044;
MeSH term(s)	Aged ; Antiviral Agents/administration & dosage ; Biomarkers/blood ; COVID-19/blood ; COVID-19/mortality ; COVID-19/physiopathology ; COVID-19/therapy ; China/epidemiology ; Critical Illness ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; SARS-CoV-2/metabolism ; Survival Rate
Chemical Substances	Antiviral Agents ; Biomarkers
Language	English
Publishing date	2021-02-22
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1028152-6
ISSN	1557-7422 ; 1043-0342
ISSN (online)	1557-7422
ISSN	1043-0342
DOI	10.1089/hum.2020.255
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Article: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study.

Cummings, Matthew J / Baldwin, Matthew R / Abrams, Darryl / Jacobson, Samuel D / Meyer, Benjamin J / Balough, Elizabeth M / Aaron, Justin G / Claassen, Jan / Rabbani, LeRoy E / Hastie, Jonathan / Hochman, Beth R / Salazar-Schicchi, John / Yip, Natalie H / Brodie, Daniel / O'Donnell, Max R

medRxiv : the preprint server for health sciences

2020

Abstract: ... biomarker, and treatment data on critically ill adults with laboratory-confirmed-COVID-19 admitted to two ... in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill ... Background: Nearly 30,000 patients with coronavirus disease-2019 (COVID-19) have been hospitalized ...

Abstract	Background: Nearly 30,000 patients with coronavirus disease-2019 (COVID-19) have been hospitalized in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. Methods: We prospectively collected clinical, biomarker, and treatment data on critically ill adults with laboratory-confirmed-COVID-19 admitted to two hospitals in northern Manhattan between March 2nd and April 1st, 2020. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal-replacement-therapy, and time to clinical deterioration following hospital admission. The relationship between clinical risk factors, biomarkers, and in-hospital mortality was modeled using Cox-proportional-hazards regression. Each patient had at least 14 days of observation. Results: Of 1,150 adults hospitalized with COVID-19 during the study period, 257 (22%) were critically ill. The median age was 62 years (interquartile range [IQR] 51-72); 170 (66%) were male. Two-hundred twelve (82%) had at least one chronic illness, the most common of which were hypertension (63%; 162/257) and diabetes mellitus (36%; 92/257). One-hundred-thirty-eight patients (54%) were obese, and 13 (5%) were healthcare workers. As of April 14th, 2020, in-hospital mortality was 33% (86/257); 47% (122/257) of patients remained hospitalized. Two-hundred-one (79%) patients received invasive mechanical ventilation (median 13 days [IQR 9-17]), and 54% (138/257) and 29% (75/257) required vasopressors and renal-replacement-therapy, respectively. The median time to clinical deterioration following hospital admission was 3 days (IQR 1-6). Older age, hypertension, chronic lung disease, and higher concentrations of interleukin-6 and d-dimer at admission were independently associated with in-hospital mortality. Conclusions: Critical illness among patients hospitalized with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extra-pulmonary organ dysfunction, and substantial in-hospital mortality.
Keywords	covid19
Language	English
Publishing date	2020-04-20
Publishing country	United States
Document type	Preprint
DOI	10.1101/2020.04.15.20067157
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Article ; Online: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study.

Lancet (London, England)

2020 Volume 395, Issue 10239, Page(s) 1763–1770

Abstract: ... as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients ... deterioration following admission. The relation between clinical risk factors, biomarkers, and ... Interpretation: Critical illness among patients hospitalised with COVID-19 in New York City is common and ...

Abstract	Background: Over 40 000 patients with COVID-19 have been hospitalised in New York City (NY, USA) as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. Methods: This prospective observational cohort study took place at two NewYork-Presbyterian hospitals affiliated with Columbia University Irving Medical Center in northern Manhattan. We prospectively identified adult patients (aged ≥18 years) admitted to both hospitals from March 2 to April 1, 2020, who were diagnosed with laboratory-confirmed COVID-19 and were critically ill with acute hypoxaemic respiratory failure, and collected clinical, biomarker, and treatment data. The primary outcome was the rate of in-hospital death. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal replacement therapy, and time to in-hospital clinical deterioration following admission. The relation between clinical risk factors, biomarkers, and in-hospital mortality was modelled using Cox proportional hazards regression. Follow-up time was right-censored on April 28, 2020 so that each patient had at least 28 days of observation. Findings: Between March 2 and April 1, 2020, 1150 adults were admitted to both hospitals with laboratory-confirmed COVID-19, of which 257 (22%) were critically ill. The median age of patients was 62 years (IQR 51-72), 171 (67%) were men. 212 (82%) patients had at least one chronic illness, the most common of which were hypertension (162 [63%]) and diabetes (92 [36%]). 119 (46%) patients had obesity. As of April 28, 2020, 101 (39%) patients had died and 94 (37%) remained hospitalised. 203 (79%) patients received invasive mechanical ventilation for a median of 18 days (IQR 9-28), 170 (66%) of 257 patients received vasopressors and 79 (31%) received renal replacement therapy. The median time to in-hospital deterioration was 3 days (IQR 1-6). In the multivariable Cox model, older age (adjusted hazard ratio [aHR] 1·31 [1·09-1·57] per 10-year increase), chronic cardiac disease (aHR 1·76 [1·08-2·86]), chronic pulmonary disease (aHR 2·94 [1·48-5·84]), higher concentrations of interleukin-6 (aHR 1·11 [95%CI 1·02-1·20] per decile increase), and higher concentrations of D-dimer (aHR 1·10 [1·01-1·19] per decile increase) were independently associated with in-hospital mortality. Interpretation: Critical illness among patients hospitalised with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extrapulmonary organ dysfunction, and substantial in-hospital mortality. Funding: National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health, and the Columbia University Irving Institute for Clinical and Translational Research.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Betacoronavirus ; Biomarkers/blood ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Critical Illness/epidemiology ; Female ; Fibrin Fibrinogen Degradation Products/analysis ; Hospital Mortality ; Hospitalization ; Humans ; Interleukin-6/blood ; Male ; Middle Aged ; New York City/epidemiology ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Proportional Hazards Models ; Prospective Studies ; Respiration, Artificial ; Respiratory Distress Syndrome/virology ; Risk Factors ; SARS-CoV-2 ; Young Adult
Chemical Substances	Biomarkers ; Fibrin Fibrinogen Degradation Products ; IL6 protein, human ; Interleukin-6 ; fibrin fragment D
Keywords	covid19
Language	English
Publishing date	2020-05-19
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, N.I.H., Extramural
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(20)31189-2
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Article ; Online: Clinical and laboratory markers of the new coronavirus disease SARS-CoV-2 COVID-19 in hospitalized patients

L.R. Shostakovych-Koretskaya / T.V. Kireyeva / O.P. Shevchenko-Makarenko / M.O. Turchin / V.I. Chumak / V.O. Chortok / O.M. Drobyshevska

Medičnì Perspektivi, Vol 26, Iss 4, Pp 48-

2021 Volume 55

Abstract: ... mechanical ventilation were studied. Clinical and laboratory associations in hospitalized patients with COVID-19 were ... The prognostic predictors of an unfavorable course of coronavirus disease (COVID-19) and ... in patients. The study showed that COVID-19 disease has a phase nature, when after the first phase ...

Abstract	The prognostic predictors of an unfavorable course of coronavirus disease (COVID-19) and its complications with manifestations of pneumonia and the need for oxygen support and connection to the invasive mechanical ventilation were studied. Clinical and laboratory associations in hospitalized patients with COVID-19 were evaluated, the possible predictors of connection to the invasive mechanical ventilator in 37 patients were identified. Patients were hospitalized on day 6.65±3.32 of the disease, blood oxygen saturation (SpO2) depended on the severity of the disease and response to therapy. Positive significant correlations between the level of growth stimulating factor (ST2) and D-Dimer, creatine phosphokinase MB fraction (CPK-MB) and D-dimmer, CPK-MB and ST2 were revealed, as well as of ferritin and D-Dimer with ST2. There were no significant associations with troponin. C-reactive protein (CRP) probably correlated with CPK-MB and ferritin. The International Normalized Ratio (INR) indicator had significant correlations with D-dimmer, ST2 and CPK-MB. Cox regression analysis showed that the survival curve has a stepwised nature and the highest risk of deterioration, which requires mechanical ventilation, was noted on the 6th day of illness (95.0% CI = 0.9-1.0, with an average SpO2 level =87.3%). ROC analysis showed the presence of a possible relationship between D-Dimer, ST2 protein, CPK-MB and the risk of developing a critical condition requiring mechanical ventilation in patients. The study showed that COVID-19 disease has a phase nature, when after the first phase of the disease, the pulmonary phase and hypercytokinemia progress in some patients with the development of hypoxia, a decrease in SpO2. Therefore, the identification of markers of disease progression is essential for predicting the course and possible prevention of the development of acute respiratory distress syndrome with the use of invasive mechanical ventilation.
Keywords	covid-19 ; sars-cov-2 ; 2019-ncov ; pneumonia ; antiviral therapy ; invasive mechanical ventilation ; coronavirus disease ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Dnipro State Medical University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China.

Wang, Dawei / Yin, Yimei / Hu, Chang / Liu, Xing / Zhang, Xingguo / Zhou, Shuliang / Jian, Mingzhi / Xu, Haibo / Prowle, John / Hu, Bo / Li, Yirong / Peng, Zhiyong

Critical care (London, England)

2020 Volume 24, Issue 1, Page(s) 188

Abstract: ... onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors ... We described the clinical courses and prognosis in COVID-19 patients.: Methods: Retrospective case series ... Results: A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 ...

Abstract	Background: In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods: Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan and Xishui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results: A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia, and radiological multi-lobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury, and adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough, and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia, and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome, refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia, and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions: A period of 7-13 days after illness onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.
MeSH term(s)	Acute Kidney Injury/virology ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; China ; Coronavirus Infections/diagnosis ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Cough/virology ; Female ; Fever/virology ; Heart/virology ; Humans ; Lymphopenia/virology ; Male ; Middle Aged ; Pandemics ; Patient Discharge ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Prognosis ; Respiratory Distress Syndrome/virology ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Sex Factors ; Thrombocytopenia/virology ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-020-02895-6
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Article: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

Lancet

Abstract: ... as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients ... COVID-19, of which 257 (22%) were critically ill. The median age of patients was 62 years (IQR 51-72 ... INTERPRETATION: Critical illness among patients hospitalised with COVID-19 in New York City is common and ...

Abstract	BACKGROUND: Over 40â000 patients with COVID-19 have been hospitalised in New York City (NY, USA) as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. METHODS: This prospective observational cohort study took place at two NewYork-Presbyterian hospitals affiliated with Columbia University Irving Medical Center in northern Manhattan. We prospectively identified adult patients (aged ≥18 years) admitted to both hospitals from March 2 to April 1, 2020, who were diagnosed with laboratory-confirmed COVID-19 and were critically ill with acute hypoxaemic respiratory failure, and collected clinical, biomarker, and treatment data. The primary outcome was the rate of in-hospital death. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal replacement therapy, and time to in-hospital clinical deterioration following admission. The relation between clinical risk factors, biomarkers, and in-hospital mortality was modelled using Cox proportional hazards regression. Follow-up time was right-censored on April 28, 2020 so that each patient had at least 28 days of observation. FINDINGS: Between March 2 and April 1, 2020, 1150 adults were admitted to both hospitals with laboratory-confirmed COVID-19, of which 257 (22%) were critically ill. The median age of patients was 62 years (IQR 51-72), 171 (67%) were men. 212 (82%) patients had at least one chronic illness, the most common of which were hypertension (162 [63%]) and diabetes (92 [36%]). 119 (46%) patients had obesity. As of April 28, 2020, 101 (39%) patients had died and 94 (37%) remained hospitalised. 203 (79%) patients received invasive mechanical ventilation for a median of 18 days (IQR 9-28), 170 (66%) of 257 patients received vasopressors and 79 (31%) received renal replacement therapy. The median time to in-hospital deterioration was 3 days (IQR 1-6). In the multivariable Cox model, older age (adjusted hazard ratio [aHR] 1·31 [1·09-1·57] per 10-year increase), chronic cardiac disease (aHR 1·76 [1·08-2·86]), chronic pulmonary disease (aHR 2·94 [1·48-5·84]), higher concentrations of interleukin-6 (aHR 1·11 [95%CI 1·02-1·20] per decile increase), and higher concentrations of D-dimer (aHR 1·10 [1·01-1·19] per decile increase) were independently associated with in-hospital mortality. INTERPRETATION: Critical illness among patients hospitalised with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extrapulmonary organ dysfunction, and substantial in-hospital mortality. FUNDING: National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health, and the Columbia University Irving Institute for Clinical and Translational Research.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #306236
Database	COVID19

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Article ; Online: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

medRxiv

Abstract: ... and treatment data on critically ill adults with laboratory-confirmed-COVID-19 admitted to two ... in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill ... Background: Nearly 30,000 patients with coronavirus disease-2019 (COVID-19) have been hospitalized ...

Abstract	Background: Nearly 30,000 patients with coronavirus disease-2019 (COVID-19) have been hospitalized in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. Methods: We prospectively collected clinical, biomarker, and treatment data on critically ill adults with laboratory-confirmed-COVID-19 admitted to two hospitals in northern Manhattan between March 2nd and April 1st, 2020. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal-replacement-therapy, and time to clinical deterioration following hospital admission. The relationship between clinical risk factors, biomarkers, and in-hospital mortality was modeled using Cox-proportional-hazards regression. Each patient had at least 14 days of observation. Results: Of 1,150 adults hospitalized with COVID-19 during the study period, 257 (22%) were critically ill. The median age was 62 years (interquartile range [IQR] 51-72); 170 (66%) were male. Two-hundred twelve (82%) had at least one chronic illness, the most common of which were hypertension (63%; 162/257) and diabetes mellitus (36%; 92/257). One-hundred-thirty-eight patients (54%) were obese, and 13 (5%) were healthcare workers. As of April 14th, 2020, in-hospital mortality was 33% (86/257); 47% (122/257) of patients remained hospitalized. Two-hundred-one (79%) patients received invasive mechanical ventilation (median 13 days [IQR 9-17]), and 54% (138/257) and 29% (75/257) required vasopressors and renal-replacement-therapy, respectively. The median time to clinical deterioration following hospital admission was 3 days (IQR 1-6). Older age, hypertension, chronic lung disease, and higher concentrations of interleukin-6 and d-dimer at admission were independently associated with in-hospital mortality. Conclusions: Critical illness among patients hospitalized with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extra-pulmonary organ dysfunction, and substantial in-hospital mortality.
Keywords	covid19
Language	English
Publishing date	2020-04-20
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.04.15.20067157
Database	COVID19

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Article ; Online: Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

Matthew J Cummings / Matthew R Baldwin / Darryl Abrams / Samuel D Jacobson / Benjamin J Meyer / Elizabeth M Balough / Justin G Aaron / Jan Claassen / LeRoy E Rabbani / Jonathan Hastie / Beth R Hochman / John Salazar-Schicchi / Natalie H Yip / Daniel Brodie / Max R O'Donnell

Abstract	Background: Nearly 30,000 patients with coronavirus disease-2019 (COVID-19) have been hospitalized in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill patients with COVID-19 in this setting are needed. Methods: We prospectively collected clinical, biomarker, and treatment data on critically ill adults with laboratory-confirmed-COVID-19 admitted to two hospitals in northern Manhattan between March 2nd and April 1st, 2020. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal-replacement-therapy, and time to clinical deterioration following hospital admission. The relationship between clinical risk factors, biomarkers, and in-hospital mortality was modeled using Cox-proportional-hazards regression. Each patient had at least 14 days of observation. Results: Of 1,150 adults hospitalized with COVID-19 during the study period, 257 (22%) were critically ill. The median age was 62 years (interquartile range [IQR] 51-72); 170 (66%) were male. Two-hundred twelve (82%) had at least one chronic illness, the most common of which were hypertension (63%; 162/257) and diabetes mellitus (36%; 92/257). One-hundred-thirty-eight patients (54%) were obese, and 13 (5%) were healthcare workers. As of April 14th, 2020, in-hospital mortality was 33% (86/257); 47% (122/257) of patients remained hospitalized. Two-hundred-one (79%) patients received invasive mechanical ventilation (median 13 days [IQR 9-17]), and 54% (138/257) and 29% (75/257) required vasopressors and renal-replacement-therapy, respectively. The median time to clinical deterioration following hospital admission was 3 days (IQR 1-6). Older age, hypertension, chronic lung disease, and higher concentrations of interleukin-6 and d-dimer at admission were independently associated with in-hospital mortality. Conclusions: Critical illness among patients hospitalized with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extra-pulmonary organ dysfunction, and substantial in-hospital mortality.
Keywords	covid19
Publisher	medrxiv
Document type	Article ; Online
DOI	10.1101/2020.04.15.20067157
Database	COVID19

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Article ; Online: Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China

Wang, Dawei / Yin, Yimei / Hu, Chang / Liu, Xing / Zhang, Xingguo / Zhou, Shuliang / Jian, Mingzhi / Xu, Haibo / Prowle, John / Hu, Bo / Li, Yirong / Peng, Zhiyong

Critical care, 24(1):188

2020

Abstract: ... onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors ... We described the clinical courses and prognosis in COVID-19 patients. METHODS: Retrospective case series ... A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented ...

Abstract	BACKGROUND: In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. METHODS: Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan and Xishui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. RESULTS: A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia, and radiological multi-lobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury, and adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough, and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia, and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome, refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia, and death. Older age and male sex were independent risk factors for poor outcome of the illness. CONCLUSIONS: A period of 7–13 days after illness onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.
Keywords	COVID-19 ; Pneumonia ; Infection ; covid19
Language	English
Publishing country	de
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China

Dawei Wang / Yimei Yin / Chang Hu / Xing Liu / Xingguo Zhang / Shuliang Zhou / Mingzhi Jian / Haibo Xu / John Prowle / Bo Hu / Yirong Li / Zhiyong Peng

Critical Care, Vol 24, Iss 1, Pp 1-

2020 Volume 9

Abstract: ... onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors ... We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series ... A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented ...

Abstract	Abstract Background In December 2019, coronavirus disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan and Xishui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic, and clinical data were collected. The clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia, and radiological multi-lobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury, and adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough, and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia, and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome, refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia, and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in the COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.
Keywords	Coronavirus ; Infection ; Pneumonia ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; covid19
Subject code	610
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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