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Background Studies on the epidemiology of sepsis in intensive care units (ICUs) of prefecture-level hospitals in China are rare. This study aimed to investigate the epidemiological characteristics and mortality risk factors of sepsis in ICUs of tertiary hospitals in Sichuan, China. Material/Methods In this prospective, multicenter, observational study, patients admitted to the ICU of 7 tertiary hospitals in Sichuan (China) between October 10, 2017 and January 9, 2018 were screened for sepsis using the Sepsis-3 criteria. Patients with sepsis were included. Results Of the 1604 patients screened for sepsis, 294 (18.3%) had sepsis, and 140 (47.6%) had septic shock. Of these, 169 (57.5%) died. Multivariable analysis showed that central nervous system dysfunction (odds ratio [OR]=2.59, 95% confidence interval [CI]: 1.15–5.84, P=0.022), lowest blood phosphorus level (OR=2.56, 95% CI: 1.21–5.44, P=0.014), highest lactate level (OR=1.20, 95% CI: 1.10–1.32, P<0.001), 24-h Acute Physiologic Assessment and Chronic Health Evaluation-II (APACHE-II) score (OR=1.08, 95% CI: 1.03–1.13, P=0.002), and lung infection (OR=2.57, 95% CI: 1.30–5.09, P=0.007) were independently associated with mortality in patients with sepsis. Conclusions The prevalence and mortality rates of sepsis are high in tertiary hospital ICUs in Sichuan, China. The APACHE-II score on day 1 after diagnosis, acute central nervous system dysfunction, lowest blood phosphorus, high serum lactate, and lung infection were independent risk factors of mortality in patients with sepsis.

Introduction: This study aims to provide further clarifications on some new clinical characteristics of COVID-19 recently discovered by our research group. Material and methods: In this single-centred, retrospective study, we collected all confirmed cases of COVID-19 diagnosed in Dazhou, Sichuan, China from January 23 to February 25, 2020. All the cases were either imported from Wuhan or transmitted in family clusters. We analysed general information on all patients. Meanwhile, the contents of lactic acid, Fib-C, and D-dimer in the serum of patients were detected. Results: The study included 37 patients diagnosed as having COVID-19, the average age of the patients was 45.76 ±13.1 years. The average positive time of nucleic acid in pharyngeal swabs was 20.65 ±6.7 days. A total of 4 (10.8%) patients were asymptomatic. On serological examination, 33 (89.1%) patients had increased lactic acid, 17 patients had increased fibrinogen C (Fib-C), and 5 patients had increased D-dimer. Of all patients, 29 were positive for COVID-19-specific antibodies. We also detected COVID-19 nucleic acid in faecal specimens from 4 patients. Klebsiella pneumoniae was found in the sputum of 1 patient. A total of 4 patients received psychological intervention. Lopinavir/ritonavir and Abidol may not be effective in treating COVID-19. Conclusions: In the serum of most COVID-19-infected patients, lactic acid was higher than normal, and COVID-19-specific antibody was positive. Fib-C and D-dimer in the serum of some infected patients increased. Lopinavir/ ritonavir and Abidol have little effect on shortening the positive time of viral nucleic acid in patients.

KEYWORDSCOVID-19; SARS-CoV-2; Multidisciplinary therapeutic approachThe novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic threatening global public health. In the current paper, we describe our successful treatment of three COVID-19 pneumonia patients cases including severe cases and cases with mortality risk factors. One 32-year-old male COVID-19 patient was diagnosed with severe COVID-19 pneumonia and moderate ARDS. The second COVID-19 pneumonia patient had a history of diabetes and chronic bronchitis. The third case of COVID-19 pneumonia was an 82-year old female patient. All three cases had severe COVID pneumonia and therefore were aggressively managed with a multidisciplinary and personalized therapeutic approach that included nutritional support, antiviral pharmacotherapy, active control of comorbidities, prevention of complication development and psychological intervention. Our experience highlights the importance of the use of a multidisciplinary therapeutic approach that tailors to the specific condition of the patient in achieving a favorable clinical outcome.

Objective In December 2019, Wuhan, China, experienced an outbreak of coronavirus disease 2019 (COVID-19). Some patients admitted to our hospital were treated with early prone positioning (PP). Here, we analyzed its clinical significance. Methods This was a retrospective observational study. We defined the early PP group as mild COVID-19 patients who were placed into a prone position within 24 h of admission; others served as the control group. We recorded basic data and outcomes of early PP and compared the results to those of controls. Results After 1 day of treatment, oxygenation was greater in the early PP group than in the control group (P/F: 421.6 ± 39.74 vs. 382.1 ± 38.84 mmHg [1 mmHg = 0.133 kPa], p < 0.01). And early PP group spent less total time in prone position (11.1 ± 4.17 vs. 16.9 ± 5.20 days, p < 0.01), and required shorter hospitalization duration (12.2 ± 4.49 vs. 23.2 ± 4.83 days, p < 0.001). Conclusions Early PP treatment can improve hypoxia and shorten the prone position time and hospitalization duration in mild COVID-19 patients. It is a potential clinically applicable intervention.