Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

Rodríguez-Morales, Alfonso J.; Cardona-Ospina, Jaime A.; Gutiérrez‐Ocampo, Estefanía; Villamizar‐Peña, Rhuvi; Holguin-Rivera, Yeimer; Escalera-Antezana, Juan Pablo; Alvarado-Arnez, Lucia Elena; Bonilla-Aldana, D. Katterine; Franco‐Paredes, Carlos; Henao-Martínez, Andrés F; Paniz‐Mondolfi, Alberto; Lagos-Grisales, Guillermo J.; Ramírez-Vallejo, Eduardo; Suárez, José Antonio; Zambrano, Lysien I.; Villamil-Gómez, Wilmer E.; Rabaan, Ali A.; Harapan, Harapan; Dhama, Kuldeep; Nishiura, Hiroshi; Kataoka, Hiromitsu; Ahmad, Tauseef; Sah, Ranjit

doi:10.20944/preprints202002.0378.v1

Cited by 39 publications

(45 citation statements)

References 39 publications

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“…Airways epithelium is the initial site of SARS-CoV-2 infection, from where the virus spreads throughout the body. Therefore, early in the disease course, COVID-19 is remarkably distinguished from other respiratory diseases due to the lymphopenia found in nearly half of the patients at admission (Rodriguez-Morales et al, 2020;Tan et al, 2020). Several possible explanations support this finding, with the four most promising ideas being related to the invasion of different tissues and immune activation.…”

Section: Ras Imbalance and Covid-19 Pathophysiologymentioning

confidence: 83%

Insights on SARS-CoV-2 Molecular Interactions With the Renin-Angiotensin System

Costa

Perez

Palmeira

et al. 2020

Front. Cell Dev. Biol.

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The emergence of SARS-CoV-2/human/Wuhan/X1/2019, a virus belonging to the species Severe acute respiratory syndrome-related coronavirus, and the recognition of Coronavirus Disease 2019 (COVID-19) as a pandemic have highly increased the scientific research regarding the pathogenesis of COVID-19. The Renin Angiotensin System (RAS) seems to be involved in COVID-19 natural course, since studies suggest the membrane-bound Angiotensin-converting enzyme 2 (ACE2) works as SARS-CoV-2 cellular receptor. Besides the efforts of the scientific community to understand the virus' molecular interactions with human cells, few studies summarize what has been so far discovered about SARS-CoV-2 signaling mechanisms and its interactions with RAS molecules. This review aims to discuss possible SARS-CoV-2 intracellular signaling pathways, cell entry mechanism and the possible consequences of the interaction with RAS components, including Angiotensin II (Ang II), Angiotensin-(1-7) [Ang-(1-7)], Angiotensin-converting enzyme (ACE), ACE2, Angiotensin II receptor type-1 (AT1), and Mas Receptor. We also discuss ongoing clinical trials and treatment based on RAS cascade intervention. Data were obtained independently by the two authors who carried out a search in the PubMed, Embase, LILACS, Cochrane, Scopus, SciELO and the National Institute of Health databases using Medical Subject Heading terms as "SARS-CoV-2," "COVID-19," "Renin Angiotensin System," "ACE2," "Angiotensin II," "Angiotensin-(1-7)," and "AT1 receptor." Similarly to other members of Coronaviridae family, the molecular interactions between the pathogen and the membrane-bound ACE2 are based on the cleavage of the spike glycoprotein (S) in two subunits. Following the binding of the S1 receptor-binding domain (RBD) to ACE2, transmembrane protease/serine subfamily 2 (TMPRSS2) cleaves the S2 domain to facilitate membrane fusion. It is very likely that SARS-CoV-2 cell entry results in downregulation of membrane-bound ACE2, an enzyme that converts Ang II into Ang-(1-7). This mechanism can result in lung injury and vasoconstriction. In addition, Ang II activates pro-inflammatory cascades when binding to the AT1 Receptor. On the other

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Section: Ras Imbalance and Covid-19 Pathophysiologymentioning

confidence: 83%

Insights on SARS-CoV-2 Molecular Interactions With the Renin-Angiotensin System

Costa

Perez

Palmeira

et al. 2020

Front. Cell Dev. Biol.

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“…A total of 466 (46.6%) were male, and 534 (53.4%) were female. The median (interquartile ranges) interval from disease onset to admission of the three groups was 10 (7-14), 11 (8)(9)(10)(11)(12)(13)(14)(15) and 10 (6-13) days, respectively. The most common symptoms before admission of all the patients were fever (75.4%), followed by cough (59.7%), fatigue (33.5%) and dyspnea (25.5%).…”

Section: Comparison Of Basic Clinical Characteristics Among the Threementioning

confidence: 99%

Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

Zhao

Wang

Zhang

et al. 2020

Aging

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Background: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited. Results: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death. Conclusions: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality. Methods: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed. www.aging-us.com 10071 AGING acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still increasing. The numbers of infected patients and deaths both exceeded the respective figures associated with the outbreaks of severe acute respiratory syndrome (SARS) in 2003 [3] and Middle East respiratory syndrome (MERS) in 2015 [4]. Compared to the mortality of SARS (10%) and MERS (35%), COVID-19 has a lower fatality rate of 2.3% [5-7]. However, the rapidly increasing number of cases and increasing evidence of human-to-human transmission suggest that SARS-CoV-2 is more contagious than SARS-CoV and MERS-CoV [8, 9].

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“…Thus, it is urgent to evaluate the disease severity and investigate possible biomarkers so as to make fast and correct clinical decisions. One recent study has pointed out that the patients with COVID-19 usually have increased serum C-reactive protein (CRP) (58.3%), lactate dehydrogenase (LDH) (57.0%) and erythrocyte sedimentation rate (ESR) (41.8%) 14 . But more evidence regarding other infection markers in COVID-19 needs further study.…”

Section: Introductionmentioning

confidence: 99%

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

She

Wang

et al. 2020

Preprint

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Objectives It is of clinical significance to evaluate the disease severity and investigate possible biomarkers of 2019 Novel coronavirus disease (COVID-19). In this study, we aim to describe the clinical characteristics of infection makers in severe and very severe patients with COVID-19. Methods This is a single center, observational analysis. We enrolled 48 in-hospital severe patients with COVID-19 admitted to the West District of Union Hospital of Tongji Medical College and analyzed infection biomarkers in 20 patients who had been tested for ferritin, PCT, CRP, etc. Results The median age was 59yrd (inter quartile range [IQR]:46-61) among severe COVID-19 group and 57yrd (IQR:45-71.5) among very severe group. We noted significantly increased CRP (1.48mg/L [IQR: 16.69-2.74] vs. 57.98mg/L [IQR: 38.335-77.565], P<0.05), PCT(0.05ng/ml [IQR: 0.03-0.06] vs. 0.21ng/ml [IQR: 0.11-0.42], P<0.05) and ferritin (291.13ng/ml [IQR: 102.1-648.42] vs. 1006.16ng/ml [IQR: 408.265-1988.25]). For blood count, significant increase was noticed in neutrophil percentage (67.6% [IQR: 61.8-76.4] vs. 86.7% [IQR: 82-92.35], P<0.01) and neutrophil count (3.75*10^9/L [IQR: 3.42-4.93] vs. 8.11*10^9/L [IQR: 5.675-8.905], P<0.05); and decrease was seen in lymphocyte percentage (22.7% [IQR: 17.4-27.4] vs. 8% [IQR: 4.85-13], P<0.05), lymphocyte count (1.62*10^9/L [IQR: 0.7-1.73] vs. 0.68*10^9/L [IQR: 0.385-1.04], P<0.05), and platelet count (214*10^9/L [IQR: 184-247] vs. 147*10^9/L [IQR: 126-202.5], P<0.05). Conclusions The serum levels of CRP, PCT and ferritin are markedly increased in very severe compared with severe COVID-19. Increased CRP, PCT and ferritin level might correlate to secondary bacterial infection and associated with poor clinical prognosis.

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Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

Cited by 39 publications

References 39 publications

Insights on SARS-CoV-2 Molecular Interactions With the Renin-Angiotensin System

Insights on SARS-CoV-2 Molecular Interactions With the Renin-Angiotensin System

Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

Utility of Ferritin, Procalcitonin, and C-reactive Protein in Severe Patients with 2019 Novel Coronavirus Disease

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