Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings

Abstract

J o u r n a l P r e -p r o o f 2 (Lanjuan Li); yidayang65@zju.edu.cn (Yida Yang) Highlight  COVID-19 has be a great threat to world health.  We aim to investigate clinical features of patients with abnormal imaging findings.  Those with abnormal images have more obvious clinical and laboratory features.  Combing clinical data with imaging score can predict severe/critical type. AbstractPurpose: To investigate the epidemiological, clinical characteristics of COVID-19 patients with abnormal imaging findings. Methods: Patients confirmed with SARS-CoV-2 infection of Zhejiang province fromJan 17 to Feb 8 underwent CT or x-ray were enrolled. Epidemiological, clinical data were analyzed between those with abnormal or normal imaging findings.Results: Excluding 72 patients with normal images, 230 of 573 patients affected more than two lobes. The median radiograph score was 2.0 and there's negative correlation between the score and oxygenation index (ρ=-0.657, P<0.001). Patients with abnormal images were older (46.65±13.82), with higher rate of coexisting condition(28.8%), lower rate of exposure history and longer time between onset and confirmation(5d) than non-pneumonia patients(all P<0.05). Higher rate of fever, cough, expectoration, and headache, lower lymphocytes, albumin, serum sodium levels and higher total bilirubin, creatine kinase, lactate dehydrogenase and C-reactive J o u r n a l P r e -p r o o f 3 protein levels and lower oxygenation index were observed in pneumonia patients (all P<0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels and higher serum creatinine and radiograph score at admission were predictive factors for severe/critical subtype. Conclusion:Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiograph score can effectively predict severe/critical type.

Smoking Is Associated With COVID-19 Progression: A Meta-analysis

“…A total of 907 studies were retrieved through the search, of which 19, 8-26 16 from China, 1 from Korea, and 2 from the United States, included data on smoking behavior and COVID-19 disease progression (Supplementary Table S1). Seventeen studies [9][10][11][12][14][15][16][17][18][19][20][21][22][23][24][25][26] were based on hospitalized patients and two 8,13 included both hospitalized patients and outpatients.…”

“…The exposure group for our analysis were those who had a history of smoking (current smokers or former smokers) and unexposed group was never smokers. Nine studies 10,12,14,18,20,21,23,25,26 assessed whether the patient was a "current smoker," five studies 8,9,13,16,24 assessed whether the patient was a current or former smoker (as separate categories), and five studies 11,15,17,19,22 assessed whether the patient had a "history of smoking" (current or former).…”

COVID‐19 is a Real Headache!

“…[32][33][34] Prevalent headache in severe cases (17%) versus 10% in milder cases, reported by a recent study from Wuhan, could suggest the inflammation and hypoxia correlated with the disease severity may take a part. 1,4 Recently, it was also reported that compared with non-ICU COVID-19 patients, ICU patients had higher plasma levels of IL-2, IL-7, IL-10, G-CSF, IP-10, MCP1, MIP1A, and TNF. 8 Moreover, it is known that pyrogenic fever involves inflammatory mediators in the hypothalamus containing cytokines, glutamate, PGE 2 , NO, and reactive oxygen species; besides the principal cells in this part, microglia, macrophages, astrocytes, blood brain barrier, and endothelial cells.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] A recent meta-analysis (n = 3598 patients) and a handful of reports disclosed that headache is among the COVID-19-related symptoms with a rate mostly around 11%-14%, in patients who had either died or recovered. [3][4][5] A higher rate reported was 34% from Zhejiang province, China in a small series of 62 patients with a milder course compared to Wuhan, but no further details about the characteristics of the headache or prior headache history were given. 6 In a series of 262 confirmed cases of the COVID-19 in Beijing, the most common symptoms at the onset of illness were cited as fever, cough, fatigue, and dyspnea followed closely by headache with a rate of 6.5%.…”

Bilirubin levels in patients with mild and severe Covid‐19: A pooled analysis

“…We read with interest the commentary by Sun detected, but 12 were excluded as duplicates and three because of lacking data; two further articles were retrieved from reviewing the reference lists, and therefore, six articles were enrolled for analysis. [2][3][4][5][6][7] Standardized mean differences (SMD) were used to build forest plots of continuous data and to evaluate differences in bilirubin levels. P < .05 was considered statistically significant, and 95% confidence intervals (CIs) were reported.…”