@ERSpublications These data showed that age ⩾65 years, pre-existing concurrent cardiovascular or cerebrovascular diseases, CD3 + CD8 + T-cells ⩽75 cells·μL −1 and cardiac troponin I ⩾0.05 ng·mL −1 were four risk factors predicting high mortality of COVID-19 pneumonia patients https://bit.ly/2Rh6NqvABSTRACT The aim of this study was to identify factors associated with the death of patients with COVID-19 pneumonia caused by the novel coronavirus SARS-CoV-2.All clinical and laboratory parameters were collected prospectively from a cohort of patients with COVID-19 pneumonia who were hospitalised to Wuhan Pulmonary Hospital (Wuhan City, Hubei Province, China) between 25 December 2019 and 7 February 2020. Univariate and multivariate logistic regression was performed to investigate the relationship between each variable and the risk of death of COVID-19 pneumonia patients.In total, 179 patients with COVID-19 pneumonia (97 male and 82 female) were included in the present prospective study, of whom 21 died. Univariate and multivariate logistic regression analysis revealed that age ⩾65 years (OR 3.765, 95% CI 1.146-17.394; p=0.023), pre-existing concurrent cardiovascular or cerebrovascular diseases (OR 2.464, 95% CI 0.755-8.044; p=0.007), CD3 + CD8 + T-cells ⩽75 cells·μL −1 (OR 3.982, 95% CI 1.132-14.006; p<0.001) and cardiac troponin I ⩾0.05 ng·mL −1 (OR 4.077, 95% CI 1.166-14.253; p<0.001) were associated with an increase in risk of mortality from COVID-19 pneumonia. In a sex-, age-and comorbid illness-matched case-control study, CD3 + CD8 + T-cells ⩽75 cells·μL −1 and cardiac troponin I ⩾0.05 ng·mL −1 remained as predictors for high mortality from COVID-19 pneumonia.We identified four risk factors: age ⩾65 years, pre-existing concurrent cardiovascular or cerebrovascular diseases, CD3 + CD8 + T-cells ⩽75 cells·μL −1 and cardiac troponin I ⩾0.05 ng·mL −1 . The latter two factors, especially, were predictors for mortality of COVID-19 pneumonia patients.

BACKGROUND: Since the outbreak of coronavirus disease 2019 in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases such as influenza viruses.RESEARCH QUESTION: The aim of this study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with ARDS.STUDY DESIGN AND METHODS: This analysis was a retrospective case-control study. Two independent cohorts of patients with ARDS infected with either COVID-19 (n ¼ 73) or H1N1 (n ¼ 75) were compared. Their clinical manifestations, imaging characteristics, treatments, and prognosis were analyzed and compared. RESULTS:The median age of patients with COVID-19 was higher than that of patients with H1N1, and there was a higher proportion of male subjects among the H1N1 cohort (P < .05). Patients with COVID-19 exhibited higher proportions of nonproductive coughs, fatigue, and GI symptoms than those of patients with H1N1 (P < .05). Patients with H1N1 had higher Sequential Organ Failure Assessment (SOFA) scores than patients with COVID-19 (P < .05). The PaO 2 /FIO 2 of 198.5 mm Hg in the COVID-19 cohort was significantly higher than the PaO 2 /FIO 2 of 107.0 mm Hg in the H1N1 cohort (P < .001). Ground-glass opacities was more common in patients with COVID-19 than in patients with H1N1 (P < .001). There was a greater variety of antiviral therapies administered to COVID-19 patients than to H1N1 patients. The in-hospital mortality of patients with COVID-19 was 28.8%, whereas that of patients with H1N1 was 34.7% (P ¼ .483). SOFA score-adjusted mortality of H1N1 patients was significantly higher than that of COVID-19 patients, with a rate ratio of 2.009 (95% CI, 1.563-2.583; P < .001).INTERPRETATION: There were many differences in clinical presentations between patients with ARDS infected with either COVID-19 or H1N1. Compared with H1N1 patients, patients with COVID-19-induced ARDS had lower severity of illness scores at presentation and lower SOFA score-adjusted mortality.

Background: Current therapy does not eradicate ocular morbidity and visual disability following retinopathy of prematurity. Anti-vascular endothelial growth factor treatment provides a potentially new treatment. Methods: Infants with birth weight <1,500g meeting established criteria for ROP treatment were recruited in 87 neonatal and ophthalmology centres in 26 countries. We performed a randomised, multicentre, open-label, 3arm, parallel-group study evaluating efficacy and safety of intravitreal injection of ranibizumab 0•2mg or ranibizumab 0•1mg against laser therapy. The primary outcome was treatment success, defined as survival with no active retinopathy, unfavourable structural outcomes or the need for an additional treatment modality at or before 24 weeks. Findings: Treatment success occurred in 56/70 (80%) infants receiving ranibizumab 0•2mg compared with 57/76 (75%) receiving ranibizumab 0•1mg and 45/68 (66%) infants following laser therapy. The odds ratio of a successful outcome following ranibizumab 0•2mg compared with laser therapy was 2•19 (95% confidence interval 0•99-4•82; p=0•051). One infant had an unfavourable structural outcome following ranibizumab 0•2mg, compared to five following ranibizumab 0•1mg and seven after laser therapy. Ranibizumab 0•2mg was effective in both Zone I and Zone II disease. Ranibizumab 0•1mg offered no advantage over 0•2 mg. Death, serious and non-serious systemic and ocular adverse events were evenly distributed between the three groups. Interpretation: In the treatment of retinopathy of prematurity, ranibizumab 0•2mg was effective with fewer unfavourable ocular outcomes than laser therapy and with an acceptable short-term safety profile. Funding: Novartis Pharma; RAINBOW ClinicalTrials.gov number, NCT02375971.

Highlights Tocilizumab can significantly improve COVID-19’s pulmonary inflammation. Tocilizumab can significantly improve the clinical symptoms of COVID-19 patients. Tocilizumab combined with or without favipiravir can effectively reduce the mortality of COVID-19.

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HIV, HBV, and HCV are risk factors for the development of abnormal LFTs and mortality during anti-TB treatment. TB patients co-infected with HIV and hepatitis virus need close follow-up.