Clinical Characteristics of Coronavirus Disease 2019 in China

Abstract

Hypercytokinemia is a critically fatal factor in COVID-19. However, underlying pathogenic mechanisms are unknown. Here we show that brinogen and leukotriene-A4 hydrolase (LTA4H), two of the most potent in ammatory contributors, are elevated by 67.7 and astonishing 227.7% in the plasma of patients infected by SARS-CoV-2 and admitted to intensive care unit in comparison with healthy control, respectively. Conversely, transferrin identi ed as a brinogen immobilizer in our recent work and Spink6 are down-regulated by 40.3 and 25.9%, respectively. Furthermore, we identify Spink6 as the rst endogenous inhibitor of LTA4H, a pro-in ammatory enzyme catalyzing nal and rating limited step in biosynthesis of leukotriene-B4 that is an extremely in ammatory mediator and a target to design superior anti-in ammatory drugs. Additionally, virus Spike protein is found to evoke LTA4H and brinogen expression in vivo. Collectively, these ndings identify the imbalance between in ammatory drivers and antagonists, which likely contributes to hypercytokinemia in COVID-19. Spink6 may have superior antiin ammatory function because it speci cally targets epoxide hydrolase of LTA4H to inhibit leukotriene-B4 biosynthesis without effecting LTA4H's aminopeptidase activity.

Coronavirus 2019-nCoV: A brief perspective from the front line

“…24 The most common symptoms are fever (87.9%), fatigue (69.6%), dry cough (67.7%) and myalgia (34.8%), and these are accompanied with rhinobyon, rhinorrhoea, pharyngalgia and diarrhea in few patients 24 ( Table 1 ) of these patients were characterized by dyspnea and hypoxemia, which can rapidly progress to acute respiratory distress syndrome (ARDS), septic shock, metabolic acidosis, coagulation dysfunction, and even multiple organ dysfunction syndrome (MODS) in one week. 18,24 Some laboratory tests could provide some hints of the early forms of the disease, such as lymphopenia (82.1%), thrombocytopenia (36.2%) and leukopenia (33.7%). Most patients demonstrated elevated levels of C-reactive protein (CRP).…”

“…In addition, severe cases could have increasing levels of alanine aminotransferase, aspartate aminotransferase, creatine kinase and creatine. 18,24 All suspected patients are recommended to be examined by chest computerized tomography (CT). Most of the confirmed patients suffered from pneumonia (76.4%), and were characterized with groundglass opacity (50.0%) and bilateral patchy shadowing (46.0%) in the chest CT, and even subsegmental consolidation in severe patients.…”

“…Most of the confirmed patients suffered from pneumonia (76.4%), and were characterized with groundglass opacity (50.0%) and bilateral patchy shadowing (46.0%) in the chest CT, and even subsegmental consolidation in severe patients. 24,26 To date, most of these patients had a good prognosis. However, the mortality rate was higher in elder patients with chronic diseases (diabetes, hypertension and angiocardiopathy, etc.)…”

Novel coronavirus infection and pregnancy

“…In addition, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), two notable strains of the coronavirus family, are both known to be responsible for severe complications during pregnancy, including the need for endotracheal intubation, admission to an intensive care unit (ICU), renal failure and death 7,8 . In general, both studies reported that the clinical characteristics of the pregnant women with COVID-19 pneumonia were similar to those of non-pregnant adult patients who developed COVID-19 pneumonia [2][3][4] . Chen et al 9 reported the clinical characteristics of nine pregnant women with laboratory-confirmed COVID-19 in the third trimester, which comprised mainly fever and cough.…”

Clinical progression of patients with COVID-19 in Shanghai, China

“…14 19 in China, which confirmed the epidemic spreads rapidly by human-to-human transmission and that the disease severity predict poor clinical outcomes. 15 However, the clinical course of the COVID-19 is still not clear. Herein, we collected data from 249 laboratory confirmed cases, aiming to present the clinical progress of the COVID-19.…”