Viral dynamics in mild and severe cases of COVID-19

Liu, Yang; Li, Yan; Wan, Lei; Xiang, Tian Xin; Le, Aiping; Liu, Jia Ming; Peiris, Malik; Poon, Leo L M; Zhang, Wei

doi:10.1016/s1473-3099(20)30232-2

Cited by 1,610 publications

(1,698 citation statements)

References 5 publications

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“…Also of note, TMPRSS2 is highly expressed in the lung and kidneys, but is present in only low to moderate levels in the heart and blood vessels, suggesting other mechanisms of injury for the latter organ systems [56]. Lastly, the amount of viral load in SARS-CoV-2 infection correlates with disease severity, with higher viral loads on presentation correlating with worse disease outcomes [57]. This study highlights the potential importance of direct viral toxicity in the pathogenesis of COVID-19 infections.…”

Section: Viral Toxicity and Myocardial Injury In Covid-2mentioning

confidence: 99%

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

et al. 2020

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Purpose of Review Coronavirus disease of 2019 (COVID-19) is a cause of significant morbidity and mortality worldwide. While cardiac injury has been demonstrated in critically ill COVID-19 patients, the mechanism of injury remains unclear. Here, we review our current knowledge of the biology of SARS-CoV-2 and the potential mechanisms of myocardial injury due to viral toxicities and host immune responses. Recent Findings A number of studies have reported an epidemiological association between history of cardiac disease and worsened outcome during COVID infection. Development of new onset myocardial injury during COVID-19 also increases mortality. While limited data exist, potential mechanisms of cardiac injury include direct viral entry through the angiotensinconverting enzyme 2 (ACE2) receptor and toxicity in host cells, hypoxia-related myocyte injury, and immune-mediated cytokine release syndrome. Potential treatments for reducing viral infection and excessive immune responses are also discussed. Summary COVID patients with cardiac disease history or acquire new cardiac injury are at an increased risk for in-hospital morbidity and mortality. More studies are needed to address the mechanism of cardiotoxicity and the treatments that can minimize permanent damage to the cardiovascular system.

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Section: Viral Toxicity and Myocardial Injury In Covid-2mentioning

confidence: 99%

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

et al. 2020

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“…These data are important to compare with that of the literature which shows that the viral RNA load can remain high for about three weeks in most patients in the absence of specific treatment [19,23] with extreme cases lasting for more than a month. A study conducted in 76 Chinese COVID-19 inpatients showed that high viral RNA load is associated with the severity of the disease [24]. Furthermore, in a study conducted on a small group of 16 Chinese COVID-19 inpatients, viral RNA was positively detected in 50% of them, after resolution of symptoms for a median duration of 2.5 days and a maximum of eight days [25].…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study

Gautret

Lagier

Parola

et al. 2020

Travel Medicine and Infectious Disease

684

825

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Background:We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. Methods: We conducted an uncontrolled non-comparative observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). Results: All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. Conclusion:We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.

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“…COVID-19 is an emerging disease, these viruses cause direct and indirect transmission of respiratory diseases with a wide range of asymptomatic, cold symptoms from respiratory/fever symptoms, cough, shortness of breath to kidney failure and death, leading to more severe respiratory illness epidemic and pandemic in most countries of the world (9). The complete clinical manifestation is not clear yet and understanding of the transmission risk is incomplete (10), but the virus is believed transmitted mostly via contact, droplets, aspirates, feces, and aerosols transmission is highly possible.…”

Section: Introductionmentioning

confidence: 99%

Modeling and Forecasting Trend of COVID-19 Epidemic in Iran

Ahmadi

Fadaei

Shirani

et al. 2020

Preprint

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Background: COVID-19 is an emerging disease and precise data are not available in the world and Iran. this study aimed to determine the epidemic trend and prediction of COVID-19 in Iran. Methods: This study is a secondary data analysis and modeling. We used the daily reports of definitive COVID-19 patients (sampling of severe cases and hospitalization) released by Iran Ministry of Health and Medical Education. Epidemic projection models of Gompertz, Von Bertalanffy and least squared error (LSE) were used to predict the number of cases at April 3, 2020 until May 13, 2020. Results: R0 in Iran was estimated to be 4.7 that has now fallen to below 2. Given the three different scenarios, the prediction of the patients on April 3, 2020 by Von Bertalanffy, Gompertz and LSE were estimated at 48200, 52500 and 58000, respectively. The number of deceased COVID-19 patients was also estimated to be 3600 individuals using the Von growth model, 4200 ones by Gompertz's model and 4850 ones according to the LSE method. To predict and estimate the number of patients and deaths in the end of epidemic based on Von and Gompertz models, we will have 87000 cases, 4900 and 11000 deaths until 13 May and 1 June, respectively. Conclusion: The process of controlling the epidemic is tangible. If enforcement and public behavior interventions continue with current trends, the control and reduction of the COVID-19 epidemic in Iran will be flat from April 28, until July, 2020 and new cases are expected to decline from the following Iranian new year.

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Viral dynamics in mild and severe cases of COVID-19

Abstract: 4 Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; published online Feb 24.

Cited by 1,610 publications

References 5 publications

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response

Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study

Modeling and Forecasting Trend of COVID-19 Epidemic in Iran

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