Clinical phenotypes of SARS-CoV-2: implications for clinicians and researchers

Rello, Jordi; Storti, Enrico; Belliato, Mirko; Serrano, Ricardo

doi:10.1183/13993003.01028-2020

Cited by 149 publications

(153 citation statements)

References 13 publications

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“…Individual CT pattern for prognostic implication can be determined within 2 weeks after symptom onset due to the remarkable evolution of patterns before 2 weeks and subsequent stabilization or evolution without prognostic impacts. Three kinds of phenotypes by characterizing the hypoxemiarelated severity have been proposed to guide the respiratory treatment for COVID-19 (23)(24)(25). Among them, a twophenotype of type L (low) and H (high) and a five-phenotype were defined to delineate the disease severity, mainly for hypoxemia state by clinical and/or imaging findings (23,25).…”

Section: Discussionmentioning

confidence: 99%

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Jin

Tian

Wang

et al. 2020

Front. Public Health

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Background: As global healthcare system is overwhelmed by novel coronavirus disease (COVID-19), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 pneumonia. Methods: One hundred and sixty-five patients with COVID-19 (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern 0 (negative), Pattern 1 (bronchopneumonia pattern), Pattern 2 (organizing pneumonia pattern), Pattern 3 (progressive organizing pneumonia pattern), and Pattern 4 (diffuse alveolar damage pattern). Clinical findings were compared across different categories. Time-dependent progression of CT patterns and correlations with clinical outcomes, i.e." discharge or adverse outcome (admission to ICU, requiring mechanical ventilation, or death), with pulmonary sequelae (complete absorption or residuals) on CT after discharge were analyzed. Results: Of 94 patients with outcome, 81 (86.2%) were discharged, 3 (3.2%) were admitted to ICU, 4 (4.3%) required mechanical ventilation, 6 (6.4%) died. 31 (38.3%) had complete absorption at median day 37 after symptom onset. Significant differences between pattern-categories were found in age, disease severity, comorbidity and laboratory results (all P < 0.05). Remarkable evolution was observed in Pattern 0-2 and Pattern 3-4 within 3 and 2 weeks after symptom-onset, respectively; most of patterns remained thereafter. After controlling for age, CT pattern significantly correlated with adverse outcomes [Pattern 4 vs. Pattern 0-3 [reference]; hazard-ratio [95% CI], 18.90 [1.91-186.60], P = 0.012]. CT pattern [Pattern 3-4 vs. Pattern 0-2 [reference]; 0.26 [0.08-0.88], P = 0.030] and C-reactive protein [>10 vs. ≤10 mg/L [reference]; 0.31 [0.13-0.72], P = 0.006] were risk factors associated with pulmonary residuals. Jin et al. CT Pattern Categorization of COVID-19 Conclusion: CT pattern categorization allied with clinical characteristics within 2 weeks after symptom onset would facilitate early prognostic stratification in COVID-19 pneumonia.

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Section: Discussionmentioning

confidence: 99%

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Jin

Tian

Wang

et al. 2020

Front. Public Health

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“…In the current study no speci c clinical signs were signi cantly associated with any speci c SARS-CoV-2 types. Upper respiratory infection, fever, coughing, sore throat, and runny nose were the most common symptoms in COVID-19 patients, as has been frequently previously reported [25][26][27][28]. Clinical outcomes may associated with host factors such as age, lymphocytopenia, and cytokine responsiveness rather than SARS-CoV-2 genetic factors [29].…”

Section: Discussionmentioning

confidence: 63%

Molecular epidemiology of the first wave of severe acute respiratory syndrome coronavirus 2 infection in Thailand in 2020

Puenpa

Suwannakarn

Chansaenroj

et al. 2020

Preprint

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The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major global concern. Several SARS-CoV-2 gene mutations have been reported. In the current study associations between SARS-CoV-2 gene variation and exposure history during the first wave of the outbreak in Thailand between January and May 2020 were investigated. Forty samples were collected at different timepoints during the outbreak, and parts of the SARS-CoV-2 genome sequence were used to assess genomic variation patterns. The phylogenetics of the 40 samples were clustered into L, G1, G2, O and T types. T types were predominant in Bangkok during the first local outbreak centred at a boxing stadium and entertainment venues in March 2020. Imported cases were infected with various types, including L, G1, G2 and O. In southern Thailand introductions of different genotypes were identified at different times. No clinical parameters were significantly associated with differences in genotype. The results indicated local transmission (type T, Spike protein (A829T)) and imported cases (types L, G1, G2 and O) during the first wave in Thailand. Genetic and epidemiological data may contribute to national policy formulation, transmission tracking and the implementation of measures to control viral spread.

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“…It has been reported that in severe cases of COVID-19, hypoxaemia is induced by the pneumonic process and might have several adverse effects in patients (Rello et al, 2020). There are several lines of defence mechanisms in response to hypoxia, which is a consequence of hypoxaemia, including responses triggers from mitochondria and ER (Bartoszewska and Collawn, 2020).…”

Section: Opinionmentioning

confidence: 99%

Endoplasmic reticulum as a potential therapeutic target for covid-19 infection management?

Sureda

Alizadeh

Nabavi

et al. 2020

European Journal of Pharmacology

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

show abstract

Clinical phenotypes of SARS-CoV-2: implications for clinicians and researchers

Cited by 149 publications

References 13 publications

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Molecular epidemiology of the first wave of severe acute respiratory syndrome coronavirus 2 infection in Thailand in 2020

Endoplasmic reticulum as a potential therapeutic target for covid-19 infection management?

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