Covid-19 CasesTo rapidly communicate information on the global clinical effort against Covid-19, the Journal has initiated a series of case reports that offer important teaching points or novel findings. The case reports should be viewed as observations rather than as recommendations for evaluation or treatment. In the interest of timeliness, these reports are evaluated by in-house editors, with peer review reserved for key points as needed. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19We describe a patient with Covid-19 and clinically significant coagulopathy, antiphospholipid antibodies, and multiple infarcts. He was one of three patients with these findings in an intensive care unit designated for patients with Covid-19. This unit, which was managed by a multidisciplinary team from Peking Union Medical College Hospital in the Sino-French New City Branch of Tongji Hospital in Wuhan, China, was set up on an emergency basis to accept the most critically ill patients during the outbreak of Covid-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was confirmed in all the patients by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay or serologic testing.A 69-year-old man with a history of hypertension, diabetes, and stroke presented with fever, cough, dyspnea, diarrhea, and headache. Covid-19 was diagnosed in the patient on January 25, 2020, on the basis of RT-PCR testing that detected SARS-CoV-2. The initial treatment was supportive; however, the illness subsequently progressed to hypoxemic respiratory failure warranting the initiation of invasive mechanical ventilation.

Background: The inflammatory response plays a critical role in coronavirus disease 2019 , and inflammatory cytokine storm increases the severity of COVID-19. Objective: To investigate the ability of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) to predict mild and severe cases of COVID-19. Study design: This retrospective cohort study included 140 patients diagnosed with COVID-19 from January 18, 2020, to March 12, 2020. The study population was divided into two groups according to disease severity: a mild group (MG) (n = 107) and a severe group (SG) (n = 33). Data on demographic characteristics, baseline clinical characteristics, and the levels of IL-6, CRP, and PCT on admission were collected. Results: Among the 140 patients, the levels of IL-6, CRP, and PCT increased in 95 (67.9 %), 91 (65.0 %), and 8 (5.7 %) patients on admission, respectively. The proportion of patients with increased IL-6, CRP, and PCT levels was significantly higher in the SG than in the MG. Cox proportional hazard model showed that IL-6 and CRP could be used as independent factors to predict the severity of COVID-19. Furthermore, patients with IL-6 > 32.1 pg/mL or CRP > 41.8 mg/L were more likely to have severe complications. Conclusion:The serum levels of IL-6 and CRP can effectively assess disease severity and predict outcome in patients with COVID-19. BackgroundCoronavirus disease 2019 (COVID-19) is highly infectious and contagious. The first COVID-19 epidemic occurred in Wuhan, China, in December 2019 [1,2]. The epidemic was declared to be a public health emergency of international concern by the World Health Organization on January 30, 2020. The clinical manifestations change rapidly, and severe cases can lead to hypoxia, multiple organ dysfunction, and death. However, no reliable indicators are yet available to predict disease severity and progression. The objective of this study is to identify specific serological indicators that can be used for diagnosis and guidance of treatment decisions. ObjectiveTo investigate the ability of IL-6, CRP, and PCT to predict mild and severe cases of COVID-19. Study design Methods and definitionsThe General Hospital of Central Theater Command of People's Liberation Army was designated to treat COVID-19 patients. This single-center, retrospective observational study was approved by the institutional Research Ethics Committee (Process No. 2020-008-1). A total of 141 cases of COVID-19 were confirmed in this hospital between January 18, 2020, and March 12, 2020. All patients were confirmed positively by SARS-CoV-2 nucleic acid RT-PCR (Ct value≤38.0, BGI, Shenzhen, China) using specimens derived from oropharyngeal swabs or sputum, prior to or during the hospitalization. All patients were monitored via the electronic health information system, and clinical data were collected until March 12, 2020, the last follow-up date. Patients with severe disease were categorized based on the seventh edition of the Chinese National Health Commission [3] and should meet any of the following c...

Background The coronavirus disease (COVID-19) epidemic has not been completely controlled. Although great achievements have been made in COVID-19 research and many antiviral drugs have shown good therapeutic effects against COVID-19, a simple oral antiviral drug for COVID-19 has not yet been developed. We conducted a meta-analysis to investigate the improvement in mortality or hospitalization rates and adverse events among COVID-19 patients with three new oral antivirals (including molnupiravir, fluvoxamine and Paxlovid). Methods We searched scientific and medical databases, such as PubMed, Web of Science, Embase and Cochrane Library for relevant articles and screened the references of retrieved studies on COVID-19. Results A total of eight studies were included in this study. The drug group included 2440 COVID-19 patients, including 54 patients who died or were hospitalized. The control group included a total of 2348 COVID-19 patients, including 118 patients who died or were hospitalized. The overall odds ratio (OR) of mortality or hospitalization was 0.33 (95% confidence interval [CI], 0.22–0.49) for COVID-19 patients in the drug group and placebo group, indicating that oral antiviral drugs were effective for COVID-19 patients and reduced the mortality or hospitalization by approximately 67%. Conclusions This study showed that three novel oral antivirals (molnupiravir, fluvoxamine and Paxlovid) are effective in reducing the mortality and hospitalization rates in patients with COVID-19. In addition, the three oral drugs did not increase the occurrence of adverse events, thus exhibiting good overall safety. These three oral antiviral drugs are still being studied, and the available data suggest that they will bring new hope for COVID-19 recovery and have the potential to be a breakthrough and very promising treatment for COVID-19. KEY MESSAGES Many antiviral drugs have shown good therapeutic effects, and there is no simple oral antiviral drug for COVID-19 patients. Meta-analysis was conducted for three new oral antivirals to evaluate the improvement in mortality or hospitalization rates and adverse events among COVID-19 patients. We focussed on three new oral Coronavirus agents (molnupiravir, fluvoxamine and Paxlovid) and hope to provide guidance for the roll-out of oral antivirals.

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