COVID-19 disease: novel clinical manifestations and therapeutic exploration

Liu, Chun; Huang, Qiang; Wang, PingXi; Wu, Huaping; Deng, ShuKai; Liú, Dan; Xiang, ChunFeng; Gao, Qiang; Zeng, Fanwei; Zheng, Xiangde

doi:10.5114/aoms.2020.98401

Cited by 6 publications

(8 citation statements)

References 30 publications

(30 reference statements)

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“…We found that factors associated with the development of new in-hospital neurologic events seem to be mostly related to disease severity, both in respiratory parameters (PaO 2 /FiO 2 ratio, ARDS severity, and chest CT findings) and inflammatory markers (C-reactive protein, D-dimer, and neutrophil index/lymphocyte). Interestingly, headache on admission remained a factor associated with this outcome in the multivariate analysis; however, the frequency of headache in our study was higher than in other studies [ 16 – 19 , 25 , 26 ].…”

Section: Discussioncontrasting

confidence: 95%

Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City

et al. 2021

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Background The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexico City. Methods We analyzed records from consecutive adult patients hospitalized from March 15 to June 30, 2020, with moderate to severe COVID-19 confirmed by reverse transcription real-time polymerase chain reaction (rtRT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurologic syndromes were actively searched by a standardized structured questionnaire and physical examination, confirmed by neuroimaging, neurophysiology of laboratory analyses, as applicable. Results We studied 1,072 cases (65% men, mean age 53.2±13 years), 71 patients had pre-existing neurologic diseases (diabetic neuropathy: 17, epilepsy: 15, history of ischemic stroke: eight, migraine: six, multiple sclerosis: one, Parkinson disease: one), and 163 (15.2%) developed a new neurologic complication. Headache (41.7%), myalgia (38.5%), dysgeusia (8%), and anosmia (7%) were the most common neurologic symptoms at hospital presentation. Delirium (13.1%), objective limb weakness (5.1%), and delayed recovery of mental status after sedation withdrawal (2.5%), were the most common new neurologic syndromes. Age, headache at presentation, preexisting neurologic disease, invasive mechanical ventilation, and neutrophil/lymphocyte ratio ≥9 were independent predictors of new in-hospital neurologic complications. Conclusions Even after excluding initial clinical features and pre-existing comorbidities, new neurologic complications in hospitalized patients with COVID-19 are frequent and can be predicted from clinical information at hospital admission.

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Section: Discussioncontrasting

confidence: 95%

Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City

et al. 2021

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“…Patients with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop COVID-19, which has caused more than 1 million deaths worldwide to date [7]. Risk factors associated with death may vary between countries with different ethnical backgrounds [8][9][10][11][12][13][14][15]. These risk factors have been poorly described in Latin America, which represents a barrier to establishing proper epidemiological and clinical decisions to reduce the toll caused by this worrisome pandemic.…”

Section: Introductionmentioning

confidence: 99%

Ethnicity and other COVID-19 death risk factors in Mexico

et al. 2020

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IntroductionPatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19.Material and methodsWe analysed the Mexican Ministry of Health’s official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase–polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model.ResultsAs of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07–10.59%). The median time (interquartile range, IQR) from symptoms onset to death was nine days (5–13 days), and from hospital admission to death 4 days (2–8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IVM, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV).ConclusionsIn Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

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“…Lopinavir/ritonavir and remdesivir are among the drugs with poor lung distributions, and thus are considered to be inadequate for the inhibition of SARS-CoV-2 [59,60].…”

Section: Mostafa Ghaneimentioning

confidence: 99%