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Clinical characteristics and outcomes of COVID-19 patients with chronic underlying diseases COVID-19合并慢性基础疾病患者的临床特点及转归
Q4 Medicine Pub Date : 2021-01-15 DOI: 10.14188/J.1671-8852.2020.0233
T. Suo, Yanni Wang, Kaochang Zhao, Guo-zhong Chen
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引用次数: 0
Research status of mesenchymal stem cell therapy for COVID-19 间充质干细胞治疗COVID-19的研究现状
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0367
M. Wang, D. Yang, H. Cai
The COVID-19 pandemic caused by SARS-CoV-2 is rapidly and continuously spreading globally, posing a great threat to human life and health. It is urgent to find a safe and effective treatment. Studies have found that mesenchymal stem cells (MSCs) have powerful immunoregulatory and anti-inflammatory functions. They can mitigate and repair lung injury caused by the excessive immune response to the virus and reduce the risk of cytokine storm syndrome (CSS) and acute respiratory distress syndrome (ARDS), by regulating the function of immune cells, reducing the secretion of inflammatory factors, upregulating the anti-inflammatory factors and secreting a variety of cell growth factors. In addition, MSCs are also characterized by abundant sources, easy access, low immunogenicity, no ethical controversy, the ability to target chemotaxis in damaged tissues, and virus resistance. Therefore, it is considered an effective way to treat COVID-19. In this article, we evaluated the safety and efficacy of MSCs in the treatment of COVID-19 and its possible mechanism. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
由SARS-CoV-2引起的新冠肺炎大流行正在全球范围内迅速持续蔓延,对人类生命健康构成巨大威胁。迫切需要找到一种安全有效的治疗方法。研究发现间充质干细胞(MSCs)具有强大的免疫调节和抗炎功能。它们可以通过调节免疫细胞功能,减少炎症因子的分泌,上调抗炎因子,分泌多种细胞生长因子,减轻和修复病毒过度免疫应答引起的肺损伤,降低细胞因子风暴综合征(CSS)和急性呼吸窘迫综合征(ARDS)的发生风险。此外,间充质干细胞还具有来源丰富、易于获取、免疫原性低、无伦理争议、在受损组织中具有靶向趋化性和病毒抗性等特点。因此,它被认为是治疗COVID-19的有效方法。在本文中,我们评估了MSCs治疗COVID-19的安全性和有效性及其可能的机制。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Summary of perioperative hemodynamic management of 19 lung transplant recipients 19例肺移植患者围手术期血流动力学处理总结
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2021.6006
X. Zuo, Z. Zhong, W. Gao, G. Li, Q. Zhou, L. Zhan
Objective: To summarize and discuss the experience of perioperative hemodynamic management of lung transplant recipients. Methods: A total of 19 lung transplant recipients from December 2016 to December 2020 were investigated in Renmin Hospital of Wuhan University, all of which were transferred to the intensive care unit for further monitoring and treatment, and their clinical data were retrospectively analyzed. Results: The 19 lung transplant recipients included 5 cases of chronic obstructive pulmonary disease (COPD), 5 cases of idiopathic pulmonary fibrosis (IPF), 4 cases of pneumoconiosis, 2 cases of bronchiectasis, 1 case of later lung fibrosis associated with COVID-19, 1 case of connective tissue disease-related pulmonary fibrosis, and 1 case of Kartagener syndrome. Twelve cases adopted double lung transplantation, while seven cases reveived unilateral lung transplantation (4 cases of left single lung transplantation and 3 cases of right single lung transplantation). There were 6 deaths during the perioperative period. One case died of multi-drug resistant bacteria infection, one case died of circulatory failure caused by active thoracic hemorrhage post-operation, the third case died of intraoperative cardiac arrest, and the other 3 cases were given up because of multiple organs failure. The remaining 13 cases were cured and discharged. Of the 19 recipients, 14 received vasopressors. The total and daily fluid output of the recipients in 3 postoperation days were greater than the input volume (P<0.05). Conclusion: Lung transplantation is an effective method for the treatment of end-stage lung disease. The hemodynamic management is a keypoint during perioperative period. It is import to maintain the blood volume as low as possible under the premise of systemic perfusion, limit the amount of fluid, choose albumin or plasma to increase the colloidal osmotic pressure, and strengthen the maintenance of right heart function. These abobe measures may improve the prognosis of lung transplant recipients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:总结和探讨肺移植受者围手术期血流动力学管理的经验。方法:对2016年12月至2020年12月在武汉大学人民医院接受肺移植手术的19例患者进行调查,并对其临床资料进行回顾性分析。结果:19例肺移植患者中,慢性阻塞性肺疾病(COPD) 5例,特发性肺纤维化(IPF) 5例,尘肺病4例,支气管扩张2例,晚期新冠肺炎相关肺纤维化1例,结缔组织病相关肺纤维化1例,Kartagener综合征1例。双肺移植12例,单侧肺移植7例(左单肺移植4例,右单肺移植3例)。围手术期死亡6例。1例死于多重耐药菌感染,1例死于术后胸腔活动性出血导致循环衰竭,3例死于术中心脏骤停,其余3例因多器官衰竭而放弃手术。其余13例治愈出院。在19名接受者中,14名接受血管加压药物治疗。术后3 d受术者总排液量和日排液量均大于输入量(P<0.05)。结论:肺移植是治疗终末期肺部疾病的有效方法。血流动力学管理是围手术期的关键。重要的是在全身灌注的前提下尽量保持低血容量,限制液体的量,选择白蛋白或血浆增加胶体渗透压,加强对右心功能的维持。以上措施可改善肺移植受者的预后。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Evaluation of prognostic indicators for COVID⁃19 patients with diabetes COVID⁃19糖尿病患者预后指标评价
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0497
R. Shang, H. Liu, J. Ni
Objective: To retrospectively explore the prognostic indicators of COVID‑19 patients with diabetes. Methods: The clinical data of COVID‑19 patients with diabetes admitted to Huoshenshan Hospital in Wuhan from February 2020 to April 2020 was collected. Patients were divided into survival group and death group according to their outcomes. The differences of various indexes between the two groups were compared and the prognostic factors were screened by multivariate logistic regression analysis. The receiver operation characteristic (ROC) curve was used to evaluate the prognostic value of these factors. Results: Of the 80 patients, 49 were males and 31 were females, with an average age of 65.2 years. There were 61 cases discharged after treatment and 19 cases died. Age, leukocyte count, lymphocyte count, platelet count, C‑reactive protein (CRP), D‑dimer, lactate dehydrogenase(LDH), urea nitrogen, serum albumin, and serum sodium were significantly different between the survival group and the death group ( P <0.05). Multivariate logistic regression analysis showed that CRP ( OR =1.030, 95% CI =1.011‑1.048, P =0.002) and LDH ( OR =1.015, 95% CI =1.006‑1.025, P =0.002) correlated significantly with the mortality risk of the patients. The ROC curve analysis showed that the area under curve ( AUC ) of CRP was 0.884, when the optimal cut‑off value in predicting death events was 40.335 mg/L, the sensitivity, specificity, and accuracy was 78.9%, 82.0%, and 81.3%, respectively. The AUC of lactate dehydrogenase was 0.930, when the optimal cut‑off value in predicting death events was 273.450 U/L, the sensitivity, specificity, and accuracy was 94.7%, 86.9%, and 88.8%, respectively. Conclusion: Both CRP and LDH at admission has obvious correlation with the prognosis of COVID‑19 patients with diabetes and could be used to predict their prognosis. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:回顾性探讨新冠肺炎合并糖尿病患者的预后指标。方法:收集2020年2月至2020年4月武汉市火神山医院收治的新冠肺炎合并糖尿病患者的临床资料。根据预后将患者分为生存组和死亡组。比较两组患者各项指标的差异,通过多因素logistic回归分析筛选影响预后的因素。采用受试者工作特征(ROC)曲线评价这些因素的预后价值。结果:80例患者中,男性49例,女性31例,平均年龄65.2岁。经治疗出院61例,死亡19例。年龄、白细胞计数、淋巴细胞计数、血小板计数、C反应蛋白(CRP)、D二聚体、乳酸脱氢酶(LDH)、尿素氮、血清白蛋白、血清钠在生存组与死亡组之间差异有统计学意义(P <0.05)。多因素logistic回归分析显示,CRP (OR =1.030, 95% CI =1.011 ~ 1.048, P =0.002)、LDH (OR =1.015, 95% CI =1.006 ~ 1.025, P =0.002)与患者死亡风险显著相关。ROC曲线分析显示,CRP曲线下面积(AUC)为0.884,预测死亡事件的最佳截断值为40.335 mg/L,敏感性为78.9%,特异性为82.0%,准确性为81.3%。乳酸脱氢酶的AUC为0.930,预测死亡事件的最佳截断值为273.450 U/L,敏感性、特异性和准确性分别为94.7%、86.9%和88.8%。结论:入院时CRP和LDH均与COVID - 19糖尿病患者预后有明显相关性,可用于预测其预后。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 1
Clinical characteristics of patients with COVID-19 combined with cardiovascular disease COVID-19合并心血管疾病患者临床特征分析
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0328
Yi Zhang, A. Zhang, H. Ming, Z. Qiu, Yifan Jia, S. Lei, Z. Xia
Objective: To retrospectively analyze the clinical characteristics of coronavirus disease 2019 (COVID-19) and the impact of cardiovascular disease (CVD) on the clinical manifestations of COVID-19. Methods: A total of 128 patients diagnosed with COVID-19 in Renmin Hospital of Wuhan University from February 1 to February 29, 2020 were divided into CVD group (n=62) and non-CVD group (n=66). The general data, admission symptoms and laboratory examination results including blood routine, immunity, heart, liver and kidney function were obtained and statistically analyzed by SPSS 22.0 statistical software. The differences of various indexes between CVD group and non-CVD group were compared. Results: There was no significant difference in gender between CVD group and non-CVD group(P>0.05).The average age of CVD group was higher than that of non-CVD group (P 0.05). The average levels of eukocyte count, neutrophil ratio, neutrophil count, monocyte count, and C-reactive protein in CVD group were higher than those in non-CVD group (all P 0.05). The average LDH, myohemoglobin, CK-MB, NT-proBNP, TBIL, and Urea in CVD group were higher than those in non-CVD group (all P 0.05). Conclusion: Compared with non-CVD patients with COVID-19, CVD patients with COVID-19 are older, have more obvious symptoms, with a higher risksin heart, liver, and kidney injury, but the mechanism is not clear yet. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:回顾性分析2019冠状病毒病(COVID-19)的临床特点及心血管疾病(CVD)对COVID-19临床表现的影响。方法:将2020年2月1日至2月29日武汉大学人民医院确诊的COVID-19患者128例分为心血管病组(n=62)和非心血管病组(n=66)。获取患者一般资料、入院症状及血常规、免疫、心、肝、肾功能等实验室检查结果,采用SPSS 22.0统计软件进行统计分析。比较CVD组与非CVD组各项指标的差异。结果:CVD组与非CVD组性别差异无统计学意义(P < 0.05)。CVD组患者平均年龄高于非CVD组(P < 0.05)。CVD组白细胞计数、中性粒细胞比率、中性粒细胞计数、单核细胞计数、c反应蛋白平均水平均高于非CVD组(均P < 0.05)。CVD组平均LDH、肌血红蛋白、CK-MB、NT-proBNP、TBIL、尿素高于非CVD组(均P < 0.05)。结论:与非CVD合并COVID-19患者相比,CVD合并COVID-19患者年龄更大,症状更明显,心、肝、肾损伤风险更高,但其机制尚不清楚。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Initial chest CT imaging features of COVID-19 and their relation to clinical types 新型冠状病毒肺炎胸部CT首发表现及其与临床分型的关系
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0351
N. Fan, W. Yang, Y. Liang, W. Fan
Objective: To investigate the initial chest CT imaging features and clinical types of patients with COVID-19. Methods: A total 165 patients with COVID-19 were retrospectively analyzed according to different age groups and different clinical classifications. Results: There were statistically significant differences in involvement sites, involvement range, lesion distribution and largest diameter of the lesions in COVID-19 patients among different age groups. Logistic regression analysis of age between normal type group and severe type group showed statistical significance (P<0.05). The maximum sensitivity and specificity were 64.20% and 69.00%. The corresponding age threshold was 50.5 years old. Conclusion: The main manifestations of initial chest CT in COVID-19 patients were ground-glass opacities, most often involving the posterior basal segment of the lower lung. Single site involvement was more common in 17-35 years patients. Most of the lesions were distributed around the subpleural and bronchovascular bundle in 36-90 years patients, involving both lungs and reaching more than two pulmonary lobes. For the COVID-19 patients with diabetes, hypertension, or older than 50.5 years, early diagnosis, isolation and treatment are necessary, and the changes of their conditions should be closely mornitored. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:探讨新型冠状病毒肺炎(COVID-19)患者的早期胸部CT影像特征及临床分型。方法:对165例新冠肺炎患者按不同年龄组、不同临床分型进行回顾性分析。结果:不同年龄组COVID-19患者的受累部位、受累范围、病变分布、病变最大直径等差异均有统计学意义。正常型组与重度型组年龄差异Logistic回归分析,差异有统计学意义(P<0.05)。灵敏度和特异度分别为64.20%和69.00%。相应的年龄阈值为50.5岁。结论:新冠肺炎患者初始胸部CT表现以磨玻璃影为主,多累及下肺后基段。单部位受累在17-35岁的患者中更为常见。36-90岁患者多分布于胸膜下及支气管维管束周围,累及双肺,累及两个以上肺叶。对合并糖尿病、高血压及年龄大于50.5岁的新冠肺炎患者,应早诊断、早隔离、早治疗,密切监测病情变化。©2021,武汉大学医学杂志编辑委员会。版权所有。
{"title":"Initial chest CT imaging features of COVID-19 and their relation to clinical types","authors":"N. Fan, W. Yang, Y. Liang, W. Fan","doi":"10.14188/j.1671-8852.2020.0351","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0351","url":null,"abstract":"Objective: To investigate the initial chest CT imaging features and clinical types of patients with COVID-19. Methods: A total 165 patients with COVID-19 were retrospectively analyzed according to different age groups and different clinical classifications. Results: There were statistically significant differences in involvement sites, involvement range, lesion distribution and largest diameter of the lesions in COVID-19 patients among different age groups. Logistic regression analysis of age between normal type group and severe type group showed statistical significance (P<0.05). The maximum sensitivity and specificity were 64.20% and 69.00%. The corresponding age threshold was 50.5 years old. Conclusion: The main manifestations of initial chest CT in COVID-19 patients were ground-glass opacities, most often involving the posterior basal segment of the lower lung. Single site involvement was more common in 17-35 years patients. Most of the lesions were distributed around the subpleural and bronchovascular bundle in 36-90 years patients, involving both lungs and reaching more than two pulmonary lobes. For the COVID-19 patients with diabetes, hypertension, or older than 50.5 years, early diagnosis, isolation and treatment are necessary, and the changes of their conditions should be closely mornitored. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"589-593"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical characteristics of discharged COVID‑19 patients with reappeared positive nucleic acid test 核酸检测再次呈阳性的出院COVID - 19患者临床特征分析
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0580
X. Hu, L. Ni, Y. Chen, L. Zhang, Z. Cheng
Objective: To investigate the incidence of reappearance of positive results of nucleic acid (NA) test in discharged COVID‑19 patients, and retrospectively evaluate and compare the clinical characteristics between reappeared NA‑positive group and NA‑negative group, so as to provide the decision‑making basis for the quarantine management, health monitoring, and epidemic prevention. Methods: A total of 188 cases of discharged COVID‑19 patients from 3 quarantine observation sites in Wuhan from February to March 2020 were divided into reappeared NA‑positive group and NA‑negative group, based on the NA test. Clinical characteristics including general information, symptoms, underlying diseases, severity of disease, steroid administration, duration of hospitalization, duration from the beginning of positive to negative and time of onset of reappearance of positive for NA test, were compared between the two groups. Results: Of the 188 cases, 30 cases (15.96%) reappeared positive for NA test, and onset of reappearance ranged from day 1 to day 16 since the last NA negative, with a median time of 5 days after onset. A total of 51 cases (32.28%) in NA‑negative group had underlying diseases, while 18 (60.0%) cases reappeared NA‑positive had underlying diseases, and the rate of underlying diseases showed significant difference between the two groups (P<0.01). However, there were no statistical differences in gender, age, and symptoms on admission, severity of disease, steroid administration, duration from the beginning of positive to negative for NA test between the two groups. Conclusion: Since COVID‑19 patients with underlying diseases showed higher incidence of reappearance of positive NA test, COVID‑19 patients after discharge need to strengthen for quarantine control, further continuous health monitoring, and re‑tests of SARS‑CoV‑2 nucleic acid. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:调查出院COVID - 19患者核酸检测阳性结果再次出现的发生率,回顾性评价和比较再次出现NA阳性组和NA阴性组的临床特点,为检疫管理、健康监测和防疫工作提供决策依据。方法:根据NA检测结果,将2020年2 - 3月武汉市3个隔离观察点188例出院的COVID - 19患者分为再出现NA阳性组和NA阴性组。比较两组患者的临床特征,包括一般资料、症状、基础疾病、疾病严重程度、类固醇给药、住院时间、NA试验开始呈阳性到阴性的持续时间和再次出现阳性的时间。结果:188例患者中,30例(15.96%)再次出现NA检测阳性,再起时间为上一次NA阴性后第1天至第16天,中位时间为发病后5天。NA阴性组有基础疾病51例(32.28%),NA阳性组有基础疾病18例(60.0%),两组间基础疾病发生率差异有统计学意义(P<0.01)。然而,两组患者在性别、年龄、入院时症状、疾病严重程度、类固醇给药、NA检测开始阳性到阴性持续时间等方面均无统计学差异。结论:有基础疾病的COVID - 19患者NA检测再次出现阳性的发生率较高,出院后需加强检疫控制,进一步持续健康监测,并重新进行SARS - CoV - 2核酸检测。©2021,武汉大学医学杂志编辑委员会。版权所有。
{"title":"Clinical characteristics of discharged COVID‑19 patients with reappeared positive nucleic acid test","authors":"X. Hu, L. Ni, Y. Chen, L. Zhang, Z. Cheng","doi":"10.14188/j.1671-8852.2020.0580","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0580","url":null,"abstract":"Objective: To investigate the incidence of reappearance of positive results of nucleic acid (NA) test in discharged COVID‑19 patients, and retrospectively evaluate and compare the clinical characteristics between reappeared NA‑positive group and NA‑negative group, so as to provide the decision‑making basis for the quarantine management, health monitoring, and epidemic prevention. Methods: A total of 188 cases of discharged COVID‑19 patients from 3 quarantine observation sites in Wuhan from February to March 2020 were divided into reappeared NA‑positive group and NA‑negative group, based on the NA test. Clinical characteristics including general information, symptoms, underlying diseases, severity of disease, steroid administration, duration of hospitalization, duration from the beginning of positive to negative and time of onset of reappearance of positive for NA test, were compared between the two groups. Results: Of the 188 cases, 30 cases (15.96%) reappeared positive for NA test, and onset of reappearance ranged from day 1 to day 16 since the last NA negative, with a median time of 5 days after onset. A total of 51 cases (32.28%) in NA‑negative group had underlying diseases, while 18 (60.0%) cases reappeared NA‑positive had underlying diseases, and the rate of underlying diseases showed significant difference between the two groups (P<0.01). However, there were no statistical differences in gender, age, and symptoms on admission, severity of disease, steroid administration, duration from the beginning of positive to negative for NA test between the two groups. Conclusion: Since COVID‑19 patients with underlying diseases showed higher incidence of reappearance of positive NA test, COVID‑19 patients after discharge need to strengthen for quarantine control, further continuous health monitoring, and re‑tests of SARS‑CoV‑2 nucleic acid. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"867-871"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Advance on clinical characteristics and injury mechanism of diabetic patients with coronavirus pneumonia 糖尿病合并冠状病毒肺炎临床特点及损伤机制研究进展
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0516
Z. Liu, W. Dong
Currently, there are seven types of coronaviruses that can infect humans. Among them, severe acute respiratory syndrome coronavirus (SARS‑CoV), middle east respiratory syndrome coronavirus (MERS‑CoV) and severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) are three types of coronavirus which have the greatest impact on human health in the past 20 years. Diabetic patients with hypoimmunity may have adverse outcomes and different injury mechanisms when infected with coronaviruses. This review is about the advance on clinical characteristics and injury mechanism of diabetic patients with SARS‑CoV, MERS‑CoV, or SARS‑CoV‑2. The purpose of writting this review is to arouse the attention of clinicians to diabetic patients with coronavirus infection and provide help for clinicians in the treatment of coronavirus disease 2019. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目前,有七种冠状病毒可以感染人类。其中,严重急性呼吸综合征冠状病毒(SARS - CoV)、中东呼吸综合征冠状病毒(MERS - CoV)和严重急性呼吸综合征冠状病毒- 2 (SARS - CoV - 2)是近20年来对人类健康影响最大的三种冠状病毒。糖尿病低免疫患者感染冠状病毒后可能出现不良结局和不同的损伤机制。本文就糖尿病患者感染SARS - CoV、MERS - CoV和SARS - CoV - 2的临床特点及损伤机制研究进展作一综述。旨在引起临床医生对糖尿病合并冠状病毒感染患者的重视,为临床医生治疗2019冠状病毒病提供帮助。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Clinical observation of heart damage caused by coronavirus disease 2019 2019冠状病毒病致心脏损伤临床观察
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0375
F. Li, Z. Zhu, S. Chen, X. Gao, C. Li
Objective: To investigate the heart damage of coronavirus disease 2019 (COVID-19) patients. Methods: A total of 785 cases of COVID-19 treated in the Affiliated Hospital of Jianghan University from December 25, 2019 to February 18, 2020 were retrospectively studied. Patients with myocardial injury were screened out and then were divided into survival and non-survival groups. The clinical manifestations, laboratory examinations, electrocardiograms, imaging examinations, and clinical outcomes of the two groups were observed, and the characteristics and prognosis of myocardial injury related to COVID-19 were analyzed. Results: (1) Of the 785 patients, 90 had elevated serum troponin and were identified as myocardial injury patients. (2) COVID-19 related myocardial injury correlated to age and history of underlying diseases. Most of them were elderly (mean age 71.64±16.42 years), accompanied by basic diseases such as hypertension, coronary heart disease, and diabetes.(3) The main clinical manifestations in COVID⁃19 with myocardial injury were palpitations (76.7%), chest tightness (60%), and chest pain (6.67%). There was no statistical difference between survival and non-survival groups ( P >0.05);Laboratory examinations showed that myocardial enzymes (CK, CK-MB, and LDH), myoglobin, hypersensitive troponin, and NT-ProBNP all increased in varying degrees, especially in non-survivors ( P <0.001). Hypersensitive troponin and NT-ProBNP were independent risk factors for death in COVID⁃19 patients with myocardial injury. (4) Of the 90 patients with myocardial injury, 84 showed abnormal electrocardiograms, including atrial/ventricular premature beats, ST-segment elevation, ST-segment shift, conduction block, and abnormal Q waves. There were significant difference in conduction block rate between survival and non⁃survival groups ( P <0.05). Conlusion: COVID⁃19 can cause myocardial damage. Troponin is an important indicator for myocardial damage. Troponin and NT-ProBNP are independent risk factors for predicting death of COVID⁃19. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:了解2019冠状病毒病(COVID-19)患者的心脏损害情况。方法:对2019年12月25日至2020年2月18日在江汉大学附属医院收治的785例新冠肺炎患者进行回顾性分析。筛选出心肌损伤患者,分为生存组和非生存组。观察两组患者的临床表现、实验室检查、心电图、影像学检查及临床转归,分析新型冠状病毒肺炎相关心肌损伤的特点及预后。结果:(1)785例患者中,90例血清肌钙蛋白升高,确定为心肌损伤患者。(2)新冠肺炎相关心肌损伤与年龄、基础疾病史相关。以老年人居多(平均年龄71.64±16.42岁),并伴有高血压、冠心病、糖尿病等基础疾病。(3)合并心肌损伤的COVID⁃19患者主要临床表现为心悸(76.7%)、胸闷(60%)、胸痛(6.67%)。生存组与非生存组比较,差异无统计学意义(P < 0.05);实验室检查显示,心肌酶(CK、CK- mb、LDH)、肌红蛋白、高敏肌钙蛋白、NT-ProBNP均有不同程度升高,其中非生存组尤为明显(P <0.001)。超敏肌钙蛋白和NT-ProBNP是导致COVID⁃19心肌损伤患者死亡的独立危险因素。(4) 90例心肌损伤患者中,84例心电图异常,包括房/室早搏、st段抬高、st段移位、传导阻滞、Q波异常。存活组与非存活组传导阻滞率差异有统计学意义(P <0.05)。结论:COVID⁃19可引起心肌损害。肌钙蛋白是心肌损伤的重要指标。肌钙蛋白和NT-ProBNP是预测COVID⁃19死亡的独立危险因素。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Application of chest CT scans in the diagnosis and treatment of COVID⁃19 胸部CT扫描在COVID⁃19诊断和治疗中的应用
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.14188/j.1671-8852.2020.0344
Kaochang Zhao, T. Suo, Yanni Wang, Y. Huang, B. Xing, Guo-zhong Chen, J. Zou
Objective: To investigate the role of chest CT scan in the diagnosis and evaluation of COVID⁃19 by analyzing the imaging features of patients with COVID⁃19 at different stages. Methods: The clinical data and radiologic findings were retrospectively collected in medical staff who were confirmed COVID⁃19 and admitted in our hospital from January 10 to March 20, 2020. We analyzed the characteristics of clinical manifestations, the frequency and interval of chest CT scans in the course of illness, imaging features in different stages of diseases, and the CT imaging outcomes during follow⁃up. Results: A total of 95 patients who met the criteria were included. The average time from symptom onset to aggravation and to alleviation were 8.3 days and 17.6 days, respectively. Patients received an average of 5 chest CT scans. The average intervals from onset to the first positive CT signs, the most serious CT signs, and the CT signs starting to disappear were 3.5 days, 7.8 days and 15.7 days, respectively. The mean CT follow⁃up time were 38.2 days. The lung lesions were completely absorbed on CT images in 38 patients, or presented with disappearing of the CT signs in the other patients. No patients had serious fibrosis residues. Conclusion: Chest CT has high sensitivity for early diagnosis of COVID⁃19. The moderate and some serious COVID⁃19 patients have good outcomes on CT images by recent follow⁃up. The changes of clinical symptoms are consistent with the changes of chest CT signs, and both are easy indicators for the outcomes of COVID⁃19 patients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:通过分析不同阶段COVID⁃19患者的影像学特征,探讨胸部CT扫描在诊断和评价COVID⁃19中的作用。方法:回顾性收集2020年1月10日至3月20日在我院收治的确诊为COVID⁃19的医务人员的临床资料和影像学表现。分析两组患者的临床表现特点、病程中胸部CT扫描的频次和间隔、疾病不同阶段的影像学特征以及随访期间的CT影像学结果。结果:共纳入95例符合标准的患者。从症状出现到加重和缓解的平均时间分别为8.3天和17.6天。患者平均接受5次胸部CT扫描。从发病到首次出现CT阳性征象、最严重征象和CT征象开始消失的平均间隔时间分别为3.5 d、7.8 d和15.7 d。平均CT随访时间为38.2 d。38例患者肺部病变在CT上完全吸收,其余患者表现为CT征象消失。没有患者有严重的纤维化残留。结论:胸部CT对COVID⁃19的早期诊断具有较高的敏感性。通过近期随访,中、重度COVID⁃19患者的CT图像效果良好。临床症状的变化与胸部CT征象的变化一致,都是判断COVID⁃19患者预后的简便指标。©2021,武汉大学医学杂志编辑委员会。版权所有。
{"title":"Application of chest CT scans in the diagnosis and treatment of COVID⁃19","authors":"Kaochang Zhao, T. Suo, Yanni Wang, Y. Huang, B. Xing, Guo-zhong Chen, J. Zou","doi":"10.14188/j.1671-8852.2020.0344","DOIUrl":"https://doi.org/10.14188/j.1671-8852.2020.0344","url":null,"abstract":"Objective: To investigate the role of chest CT scan in the diagnosis and evaluation of COVID⁃19 by analyzing the imaging features of patients with COVID⁃19 at different stages. Methods: The clinical data and radiologic findings were retrospectively collected in medical staff who were confirmed COVID⁃19 and admitted in our hospital from January 10 to March 20, 2020. We analyzed the characteristics of clinical manifestations, the frequency and interval of chest CT scans in the course of illness, imaging features in different stages of diseases, and the CT imaging outcomes during follow⁃up. Results: A total of 95 patients who met the criteria were included. The average time from symptom onset to aggravation and to alleviation were 8.3 days and 17.6 days, respectively. Patients received an average of 5 chest CT scans. The average intervals from onset to the first positive CT signs, the most serious CT signs, and the CT signs starting to disappear were 3.5 days, 7.8 days and 15.7 days, respectively. The mean CT follow⁃up time were 38.2 days. The lung lesions were completely absorbed on CT images in 38 patients, or presented with disappearing of the CT signs in the other patients. No patients had serious fibrosis residues. Conclusion: Chest CT has high sensitivity for early diagnosis of COVID⁃19. The moderate and some serious COVID⁃19 patients have good outcomes on CT images by recent follow⁃up. The changes of clinical symptoms are consistent with the changes of chest CT signs, and both are easy indicators for the outcomes of COVID⁃19 patients. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.","PeriodicalId":35402,"journal":{"name":"Medical Journal of Wuhan University","volume":"42 1","pages":"704-708"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66657185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
武汉大学学报(医学版)
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