Clinical Treatment Experience in Severe and Critical COVID-19

Abstract

Compared with other deadly diseases, the coronavirus disease 2019 (COVID-19) is highly infectious with a relatively low mortality rate. Although critical cases account for only 5% of cases, the mortality rate for the same is nearly 50%. Therefore, the key to the COVID-19 treatment is to effectively treat severe patients and reduce the transition from severe to critical cases. A retrospective study was carried out to evaluate outcomes of treatment in patients with severe and critical COVID-19 admitted to a COVID-19 special hospital in Wuhan, China. A total of 75 severe and critical COVID-19 patients were admitted and treated with immunomodulation as the main strategy combined with anti-inflammatory therapy and appropriate anticoagulation. Leukocyte levels in patients with 7-14 days of onset to diagnosis were significantly lower than in those with >14 days. Higher levels of globulin and D-dimer and lower lymphocyte levels were found in the older age group (>65 years) than in the middle-aged group (50-64 years). Patients with comorbidity had higher levels of inflammatory indicators. After treatment, 65 (86.67%) patients were cured, 7 (9.33%) had improved, and 3 (4.00%) had died. Median hospitalization duration was 23 days. Fatal cases showed continuously increased levels of globulin, dehydrogenase (LDH), hypersensitive C-reactive protein (hs-CRP), D-dimer, and cytokines during treatment. Time from onset to diagnosis, age, and comorbidity are important influencing factors on treatment effects. The occurrence of immunosuppression, “cytokine storm,” and thrombosis may be an important cause of death in severely infected cases. In conclusion, high cure rate and low mortality suggested that immunomodulation combined with anti-inflammatory therapy and appropriate anticoagulant therapy is a good strategy for treatment of patients with severe and critical COVID-19.

Plant-Based Diet and Supplements Reduced COVID-19 Severity and Mortality in Elderly Patients with Multiple Comorbidities (Part 2: Exploring the Underlying Mechanisms of Successful Intervention)

“…In severe cases of COVID-19, increased oxidative stress can lead to inflammation, damage to endothelial cells, and blood clots, which can damage multiple organs. Moreover, SARS-CoV-2 can cause oxidative stress, interfering with inflammatory pathways and potentially cause long-term tissue harm [51,52].…”

Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review

“…COVID-19 is highly infectious. 2 It has now developed into a global pandemic, affecting more than 214 countries and regions around the world. As of July 2021, the cumulative number of confirmed cases worldwide has exceeded 190 million, and the cumulative number of deaths has exceeded 4 million.…”

Histamine-2 Receptor Antagonists and Proton Pump Inhibitors Are Associated With Reduced Risk of SARS-CoV-2 Infection Without Comorbidities Including Diabetes, Hypertension, and Dyslipidemia: A Propensity Score-Matched Nationwide Cohort Study

“… 12 26 The period of 1 month seems reasonable since previous studies reported the time from symptom onset to diagnosis to be as long as 4 weeks. 54 55 …”