Dynamic changes in clinical and CT characteristics of COVID-19 cases with different exposure histories: a retrospective study

Li, Ruili; Liu, Guang-Xue; Huang, Xiaojie; Chen, Jia; Xia, Zhenying; Song, Wenyan; Wang, Xing; Zhang, Dongliang

doi:10.1186/s12879-020-05306-x

Cited by 8 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Известно, что улучшение по КТ может несколько отставать от клиники и, возможно, у нас был недостаточный срок наблюдения для получения более существенной динамики [31,32]. Более того, единой точки зрения о времени полной нормализации КТ-картины легких при «ковидной» пневмонии не существует, но имеются предположения, что это происходит не ранее, чем через четыре недели после выписки из стационара [33]. Имелась не очень тесная, но статистически значимая корреляция между динамикой поражения легких по КТ и показателем выраженности воспаления отношения лимфоцитов / СРБ (r= -0,37, p=0,025).…”

Section: редакционные статьи §unclassified

Proactive anti-inflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study

et al. 2021

View full text Add to dashboard Cite

Actuality The course of the novel coronavirus disease (COVID-19) is unpredictable. It manifests in some cases as increasing inflammation to even the onset of a cytokine storm and irreversible progression of acute respiratory syndrome, which is associated with the risk of death in patients. Thus, proactive anti-inflammatory therapy remains an open serious question in patients with COVID-19 and pneumonia, who still have signs of inflammation on days 7–9 of the disease: elevated C-reactive protein (CRP)>60 mg/dL and at least two of the four clinical signs: fever >37.5°C; persistent cough; dyspnea (RR >20 brpm) and/or reduced oxygen blood saturation <94% when breathing atmospheric air. We designed the randomized trial: COLchicine versus Ruxolitinib and Secukinumab in Open-label Prospective Randomized Trial in Patients with COVID-19 (COLORIT). We present here data comparing patients who received colchicine with those who did not receive specific anti-inflammatory therapy. Results of the comparison of colchicine, ruxolitinib, and secukinumab will be presented later.Objective Compare efficacy and safety of colchicine compared to the management of patients with COVID-19 without specific anti-inflammatory therapy.Material and Methods Initially, 20 people were expected to be randomized in the control group. However, enrollment to the control group was discontinued subsequently after the inclusion of 5 patients due to the risk of severe deterioration in the absence of anti-inflammatory treatment. Therefore, 17 patients, who had not received anti-inflammatory therapy when treated in the MSU Medical Research and Educational Center before the study, were also included in the control group. The effects were assessed on day 12 after the inclusion or at discharge if it occurred earlier than on day 12. The primary endpoint was the changes in the SHOCS-COVID score, which includes the assessment of the patient’s clinical condition, CT score of the lung tissue damage, the severity of systemic inflammation (CRP changes), and the risk of thrombotic complications (D-dimer) [1].Results The median SHOCS score decreased from 8 to 2 (p = 0.017), i.e., from moderate to mild degree, in the colchicine group. The change in the SHOCS-COVID score was minimal and statistically insignificant in the control group. In patients with COVID-19 treated with colchicine, the CRP levels decreased rapidly and normalized (from 99.4 to 4.2 mg/dL, p<0.001). In the control group, the CRP levels decreased moderately and statistically insignificantly and achieved 22.8 mg/dL by the end of the follow-up period, which was still more than four times higher than normal. The most informative criterion for inflammation lymphocyte-to-C-reactive protein ratio (LCR) increased in the colchicine group by 393 versus 54 in the control group (p = 0.003). After treatment, it was 60.8 in the control group, which was less than 100 considered safe in terms of systemic inflammation progression. The difference from 427 in the colchicine group was highly significant (p = 0.003).The marked and rapid decrease in the inflammation factors was accompanied in the colchicine group by the reduced need for oxygen support from 14 (66.7%) to 2 (9.5%). In the control group, the number of patients without anti-inflammatory therapy requiring oxygen support remained unchanged at 50%. There was a trend to shorter hospital stays in the group of specific anti-inflammatory therapy up to 13 days compared to 17.5 days in the control group (p = 0.079). Moreover, two patients died in the control group, and there were no fatal cases in the colchicine group. In the colchicine group, one patient had deep vein thrombosis with D-dimer elevated to 5.99 µg/mL, which resolved before discharge.Conclusions Colchicine 1 mg for 1-3 days followed by 0.5 mg/day for 14 days is effective as a proactive anti-inflammatory therapy in hospitalized patients with COVID-19 and viral pneumonia. The management of such patients without proactive anti-inflammatory therapy is likely to be unreasonable and may worsen the course of COVID-19. However, the findings should be treated with caution, given the small size of the trial.

show abstract

Section: редакционные статьи §unclassified

Proactive anti-inflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The most COVID-19 cases (> 70%) show ground glass opacities with consolidation and interstitial and/or interlobular septal thickening in Thorax CT (13). COVID-19 predominant CT findings are bilateral, peripheral and basal predominant ground-glass opacity, consolidation, or both (14).…”

Section: Discussionmentioning

confidence: 99%

What Are The Factors That Affect Post COVID 1st Month's Continuing Symptoms?

Özyürek¹,

Özdemirel²,

Akkurt³

et al. 2021

Preprint

View full text Add to dashboard Cite

Aim: The aim of our research was to investigate retrospectively the relationship between the symptoms and general characteristics, initial laboratory values and treatments in patients who had COVID- 19 and who applied to the chest diseases outpatient clinic for control after 1 month. Methods: Three hundred fifteen patients who were diagnosed with COVID- 19 and applied to the chest diseases outpatient clinic between May 2020 and August 2020 for control in the 1st month were included in the study. Patient information was collected from the hospital information system and the e-pulse system. Results: Females accounted for 50.2 % of the our patients and their mean age was 47.98 ± 14.81 (19-88) years. 14.3% (n: 45) of the individuals were 65 years of age and older. 20.6% (n: 65) of our patients were smoking. 70.2% (n: 221) of our patients were treated at home. 133 patients had at least one comorbid disease. The patients most frequently reported cough, dyspnea, weakness, myalgia and diarrhea. The most common symptoms were cough, dyspnea, weakness and myalgia in the first month. It was determined that the symptoms had persisted in patients who had been hospitalized, had dual therapy, had comorbid diseases and had more common pathologies in their pulmonary imagings. Conclusion: Symptoms may persist for a long time in hospitalized patients, in patients with COVID-19-related pneumonia and concomitant chronic diseases and in patients with high d-dimer and high CRP at the time of admission. Patients are informed that their symptoms may last for a long time, unnecessary hospital admissons can be avoided.

show abstract

“…A study by Ruili LI from Beijing also correlated various laboratory parameters including AGR and compared with CT severity index and found significant correlation of change in AGR with CT severity [15]. This study tries to find out that which one is more accurate predictor marker of severity of COVID-19 infection and result showed that NLR as compared to AGR is better predictor marker in terms of sensitivity (92.86 vs.85.71), specificity (97.87 vs. 93.62), positive predictive value (96.3 vs. 88.9) and negative predictive value (95.83 vs. 91.67).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-Lymphocytic Ratio (Nlr) or Albumin-Globulin Ratio (Agr) Which One Is a Better Predictor Marker in Assessment of Severity of Covid-19 Infection

Barya

Narang

Jain

et al. 2021

IJMBS

View full text Add to dashboard Cite

The current study retrospectively enrolled, 75 confirmed COVID-19 patients who were hospitalized in a tertiary care hospital from December 2020 to February 2021. The diagnosis was confirmed by RT-PCR from nasopharyngeal swab. Demographic data and laboratory values were collected from medical records and patient file. The following variables were recorded for each COVID-19 patient: age, sex, chest CT severity scores of lung involvement at admission, history of Comorbidities like diabetes mellitus, hypertension were noted and laboratory findings like Absolute neutrophils count, Absolute lymphocytes count recorded from Complete blood count of patient and Serum albumin, globulin level recorded from Liver function test of patient. This study proves that N-L ratio is more accurate predictor of severity of SARS-COVID-19 infection than A-G ratio with more sensitivity, specificity, positive and negative predictive value and can be used as a severity marker in places where medical resources is limited. However, a larger study with more subjects requires for exact correlation. Keywords: NLR, AGR, Severity & COVID-19.

show abstract

Dynamic changes in clinical and CT characteristics of COVID-19 cases with different exposure histories: a retrospective study

Cited by 8 publications

References 34 publications

Proactive anti-inflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study

Proactive anti-inflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study

What Are The Factors That Affect Post COVID 1st Month's Continuing Symptoms?

Neutrophil-Lymphocytic Ratio (Nlr) or Albumin-Globulin Ratio (Agr) Which One Is a Better Predictor Marker in Assessment of Severity of Covid-19 Infection

Contact Info

Product

Resources

About