Clinical characteristics and drug therapies in patients with the common-type coronavirus disease 2019 in Hunan, China

Abstract

Background Clinical characteristics of patients with the coronavirus disease 2019 (COVID-19) may present differently within and outside the epicenter of Wuhan, China. More clinical investigations are needed. Objective The study was aimed to describe the clinical characteristics, laboratory parameters, and therapeutic methods of COVID-19 patients in Hunan, China. Setting The First Hospital of Changsha, First People's Hospital of Huaihua, and the Central Hospital of Loudi, Hunan province, China. Methods This was a retrospective multi-center case-series analysis. Patients with confirmed COVID-19 diagnosis hospitalized at the study centers from January 17 to February 10, 2020, were included. The following data were obtained from electronic medical records: demographics, medical history, exposure history, underlying comorbidities, symptoms, signs, laboratory findings, computer tomography scans, and treatment measures. Main outcome measure Epidemiological, clinical, laboratory, and radiological characteristics and treatments. Results A total of 54 patients were included (51 had the common-type COVID-19, three had the severe-type), the median age was 41, and 52% of them were men. The median time from the first symptoms to hospital admission was seven days. Among patients with the common-type COVID-19, the median length of stay was nine days, and 21 days among patients with severe COVID-19. The most common symptoms at the onset of illness were fever (74.5%), cough (56.9%), and fatigue (43.1%) among patients in the common-type group. Fourteen patients (37.8%) had a reduced WBC count, 23 (62.2%) had reduced eosinophil ratio, and 21 (56.76%) had decreased eosinophil count. The most common patterns on chest-computed tomography were ground-glass opacity (52.2%) and patchy bilateral shadowing (73.9%). Pharmacotherapy included recombinant human interferon α2b, lopinavir/ritonavir, novaferon, antibiotics, systematic corticosteroids and traditional Chinese medicine prescription. The outcome of treatment indicated that in patients with the common-type COVID-19, interferon-α2b, but not novaferon, had some benefits, antibiotics treatment was not needed, and corticosteroids should be used cautiously. Conclusion As of February 10, 2020, the symptoms of COVID-19 patients in Hunan province were relatively mild comparing to patients in Wuhan, the epicenter. We observed some treatment benefits with interferon-α2b and corticosteroid therapies but not with novaferon and antibiotic treatment in our study population.

Prognostic value of liver biochemical parameters for COVID-19 mortality

“…After review of the titles and abstracts, 63 studies were considered to meet the criteria for full-text scanning. After removal of reviews, duplicate articles with smaller sample size, and studies which did not report liver biochemical parameters, 23 studies met the inclusion criteria [18] , [19] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] . Additionally, two studies were enrolled after review of the reference lists of all included studies and major review and meta-analyses [44] , [45] .…”

“…All these studies were published in 2020 and could be divided into non-survivors group and survivors group. Among them, 23 studies were from China [18] , [19] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [45] , one from the United States [35] and one from Spain [44] . Among the 23 studies from China, 20 studies were written in English and three in Chinese [18] , [28] , [42] .…”

“…Fourteen studies provided the levels of ALT between survivors and non-survivors group [18] , [19] , [24] , [25] , [26] , [27] , [31] , [32] , [34] , [36] , [37] , [39] , [43] , [45] . With heterogeneity (I 2 = 55.7%, P = 0.006), random-effect model was used and showed that survivors had lower level of ALT than non-survivors (WMD = -5.20 U/L, 95% CI = [-8.00, -2.41], P < 0.001) ( Fig.…”

Efficacy and Outcomes of Lianhuaqingwen Capsule for Coronavirus Disease 2019: A Retrospective Propensity Score Matching Analysis

“…Pathological researches found SARS-CoV-2 could potently bind with angiotensin converting enzyme 2 (ACE2), a receptor abundantly expressed in a variety of human organ cells [22], which might account for multiple adverse effects in COVID-19 patients, such as lung, nervous system, kidney, liver, gastrointestinal system and heart [23][24][25][26]. There are no validated effective therapeutic approaches for COVID-19 patients, and the main treatment interventions are supportive therapy, including oxygen therapy, antiviral medications, antibiotics, corticosteroids and traditional Chinese medications [27]. The e cacy of antiviral medications that have been used for SARS and MERS is needed further explore in COVID-19 patients [28].…”

Typical chest CT features can determine the severity of Coronavirus Disease 2019 (COVID-19): a systematic review and meta-analysis of observational studies&nbsp;

“…Different features of CT imaging had been reported in the included studies. However, the frequently reported features were ground glass opacity (GGO), reported in 15 studies (1-6, 8, 10-18), consolidation, reported in 10 studies(1,3,5,6,10,11,(14)(15)(16)(17), linear opacity, reported in 4 studies(1,3,6,16), bronchial wall thickening, reported in 3 studies(5,6,14), and bilateral lung involvement, reported in 15 studies(2-6, 8, 11-14, 16-20) (Table 1). Risk of bias was generally low after considering the observational designs (Supplementary…”