Clinical Characteristics Of COVID-19 Infection Research Articles

Fatigue and neuropsychiatric manifestations of post-acute sequelae of COVID-19 (PASC): examining the relationship with clinical and inflammatory markers

ABSTRACT Background and aims Fatigue and neuropsychiatric (NP) symptoms are frequently observed in patients with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). This study aims to explore the relationship between clinical characteristics, inflammatory markers, and severity of fatigue and NP manifestations in COVID-19 survivors following the acute phase. Methods This cross-sectional study included adult participants who experienced any post-COVID NP symptoms. Questionnaires for fatigue (CFQ-11), anxiety-depression (DASS-21), insomnia (PSQI), cognitive impairment (ACE-III), and delayed processing speed (TMT-B) were administered. Demographic data, clinical characteristics of COVID-19 infection, and laboratory tests for inflammatory markers (CRP, IL-6, albumin, hemoglobin, and NL-ratio) were collected. Results The most common symptoms reported by 82 participants were fatigue (85.4%), insomnia (84.2%), anxiety (62.2%), subjective brain fog (61%), and depression (50%). There was no observed association between the severity of any target symptoms and the inflammatory markers. In multivariable analysis, a strong positive correlation was found between the number of PASC symptoms and the severity of fatigue, depression, anxiety, and sleep problems (p < 0.01). Those who had been infected more than once experienced more fatigue (p = 0.03). Patients with respiratory tract diseases were more likely to experience depression (p = 0.01), and smoking was associated with more sleep disturbances (p = 0.02). Lack of exercise was associated with slower processing speed (p = 0.02). Conclusion The severity of fatigue and NP symptoms of PASC is not correlated with changes in the inflammatory markers. However, certain clinical factors can predict the severity, including the number of PASC symptoms, frequency of COVID-19 infections, respiratory tract diseases, smoking, and exercise.

Paradoxical increase in left atrial strains early after Covid-19 infection, a result of comprehensive recovery phase four-chamber strains study.

Cardiac consequences of Covid-19 infection have been mentioned in various studies as a serious risk factor for in-hospital mortality. However, the existence of residual cardiac dysfunction after the acute phase is seldom investigated especially in people without a history of specific medical disease.One hundred health care workers with positive reverse transcription-polymerase chain reaction test underwent comprehensive 2D and 3D echocardiography six to eight weeks after infection. Patients were classified into Mild, Moderate, and Severe groups based on their clinical characteristics of covid-19 infection, and all echocardiographic parameters were compared between the three groups. Left ventricular (LV) stroke volume index was reduced in all groups compared to normal ranges and was more prominent in the severe group (P-value < 0.05). 3D-derived LV global longitudinal strain (GLS) was significantly lower in the severe group in comparison to the mild group (- 19.3 ± 1 Vs. - 22.2 ± 2, P-value < 0.001) and correlated with highly sensitive CRP level at the acute phase. Left atrial (LA) strains, including LA peak strain, LA contraction strain, and LA reservoir strain, were considerably higher and LA volume index was significantly lower in the clinically severe covid patients. Analysis based on the extent of lung involvement showed significantly increased 3D-derived right ventricular volumes in patients who experienced severe pneumonia despite normalized strains. Conclusion: subclinical LV dysfunction as reduced stroke volume index and GLS exists in the early recovery phase of normal individuals with severe course of covid-19. LA function indicated by LA strains paradoxically increases in severe covid-19 infection in this phase.

Comparison of clinical characteristics of COVID-19 between children and adult

The aim of the study was to evaluate and compare the clinical characteristics of COVID-19 infection in children and adult. This observational cross-sectional study was conducted in multiple corona dedicated hospitals, situated in Dhaka, Bangladesh from April 2020 to January 2021. Data of COVID -19 positive hospitalized patients were collected in a pre-tested question- naire during hospital stay with proper protective measures. Clinical characteristics of the COVID-19 positive hospitalized children and adult patients were evaluated. Approval was taken from institutional review board of respective institutes. Statistical analyses of the results were obtained by using SPSS-25. In this study the male-to-female ratio was 1:1.6 and 2.8:1 in child and adult patients respectively. More than three quarter (75.4%) of subjects had family members affected before the illness in the child group and more than half (50.9%) cases in the adult group. History of contact or exposure with any symptomatic case was present in 61.4% cases in the adult group but only 14% in the child group. The mean duration of illness was less (9.1}8.6 days) in the child group than in the adult group (14.8}9.5 days). The difference was statistically significant (p&lt;0.05) between the two groups. The most common symptoms in the child group were fever (71.9%), cough (77.2%) and runny nose (52.6%) whereas in the adult group most common symptoms were fatigue, excessive tiredness, or lethargy (80.7%), cough (77.2%) and anosmia (70.3%). There were statistically significant (p&lt;0.05) differences in symp- toms between the two groups. Raised body temperature was (&gt;1010 F) was found in the majori- ty (86.0%) subjects' in the child group than in the adult group where it was 50.9%. The mean SPo2 without oxygen was 96.8}1.2% in the child group and 92.8}5.7% in the adult group. Ten (17.5%) subjects had a symptom-free total illness in the child group and 3(5.3%) in the adult group. The difference in temperature, SPo2 without oxygen, consciousness, and symptom-free total illness were statistically significant (p&lt;0.05) between the two groups. In adult group 94.7% patient required hospital admission according to guideline, but in child group only 40.3% actually needed hospitalization, rest of the children got admitted along with family member or due to other diseases. Fever, cough and runny nose were more frequent symptoms in children however, fever, fatigue, excessive tiredness, anorexia, nausea, vomiting, anosmia, diarrhoea and body ache were more common in adult patients. These differences were statistically signifi- cant. In comparison to COVID-19 infected adult cases, infected children had higher oxygen saturation (without additional oxygen) by pulse oximeter. BSMMU J 2022; 15(1): 35-42

1189. COVID 19 Infection in Children in Colombia, Experience from a Nationwide Network (CORONARED)

BackgroundWorldwide SARS-CoV-2 infections increase every day. Despite the infection is less severe in children, it can be severe and associated with complications. However, local data remain scarce. We sought to describe epidemiological and clinical characteristics of COVID-19 infection in this population across different age groups. MethodsObservational, multicenter study across 23 Colombian hospitals from 22 different territories. We included all patients from 0 months to 17 years with confirmed SARS-CoV-2 infection by either antigen or RT-PCR testing. ResultsFrom March 1, 2020, to October 31, 2021, we identified 1,186 patients: neonates (88), 1 to 3 months (130), 4 to 23 months (306), 2 to 4 years (169), 5 to 11 years (229) and 12 to 18 years (226) with confirmed COVID-19 infection. Of those,77(6.2%) were asymptomatic, 631(53.2%) hospitalized, 132(11.2%) required PICU. 58 cases met WHO definition of MIS-C. Patients less than 24 months of age were characterized by fever (74%) and more respiratory distress (30.1%) compared to other groups. Patients >5yo seemed to have a more severe presentation. They had more gastrointestinal (GI) symptoms (31% vs 37.8%), had more need for ICU care given presentation with shock increased with age ( >5yo 9.5%; 5-12yo 10.6%; 12-18yo 11.5%). Lab markers including thrombocytopenia and Lymphopenia were more common on this age group. Antibiotic treatment was common (%%) especially in neonates (40.9%), despite bacterial coinfection was rare (8.7%), length of hospitalization was longer in older than 2-year-old groups. 23(1.9%) patients died, similar across different age groups. Heat map by age group ConclusionCOVID-19 infection in Colombian children presented differently across different age groups. Children older than 5 years had a more severe clinical course and prolonged hospital stays. Clinical findings according to age groups could help clinicians in characterizing and identifying COVID 19 infections in Children.Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Juan P. Rojas -Hernandez, Candidate for doctorate in Public Health, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Eduardo López Medina, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

Clinical Characteristics of COVID-19 Infection in the Pediatric Age Group

Aim: To investigate the complaints and findings of COVID-19 infection in a paediatric age group. Material and Method: The study included 130 patients with COVID-19 infection confirmed with reverse-transcription polymerase chain reaction (RT-PCR) test positivity. The cases were evaluated in respect of demographic data, such as age and gender, and clinical findings, such as fever, weight, cough, shortness of breath, and history of infectious contact. Results: Evaluation was made of 130 COVID-19-positive paediatric patients, comprising 69 (53%) males and 61 (47%) females, of which 54% were asymptomatic and 5.4% had severe clinical findings requiring follow up in the Intensive Care Unit (ICU). Of the symptomatic patients, fever was determined in 30%, listlessness in 24%, cough in 10.8%, respiratory problems in 9.2%, diarrhea in 6.2%, abdominal pain in 6.2%, vomiting in 2.3%, joint pain in 2.3%, and convulsions developed in 1.5% who had no previous history of convulsions. Of the 7 patients who required intensive care, 2 had cerebral palsy, 1 had hydrocephaly+shunt, 1 had metabolic disease (propionic acidemia), 2 had a history of trauma (struck by a motor vehicle), and in 1 there was no comorbidity. Mortality developed in 6 of the 7 patients in ICU. Conclusion: In a significant proportion of children, COVID-19 has an asymptomatic course, which contributes greatly to the spread of the disease. While COVID-19 can cause morbidities such as convulsions in the paediatric population, it may also result in mortality in children with underlying serious diseases.

CLINICAL AND EPIDEMIOLOGICAL PECULIARITIES IF COVID-19 INFECTION IN INFANTS

The aim of the research - to analyze the epidemiological and clinical peculiarities ofcoronavirus disease COVID-19 in infants compared to the older age group.Materials and methods. 188 inpatient cards of children who were hospitalized in theinfectious diseases departments of Chernivtsi Regional Children's Clinical Hospitalwith COVID-19 infection were analyzed, in particular, 63 children under 1 year of age(1st group) and 125 children aged 1 year and older (2nd group, comparison group).A complex of anamnestic, epidemiological and clinical characteristics of COVID-19infection was determined in hospitalized children.Results. During the analysis of the data it was found that the epidemiologicalsignificance was related to family contacts, unidentified non-family sources of infectionwere observed in a quarter of infants (25,4%) and 39,2% of children of group II (p&lt;0,05). The most common clinical symptoms in the general cohort were fever, weaknessand lethargy, loss of appetite, and signs of catarrhal pharyngitis. Symptoms of upperrespiratory tract disease prevailed in infancy, in particular, most had nasal congestion(55,6% vs. 40,2%, p&gt;0,05), 30,2% infants had rhinorrhea (16,8% in the 2nd group,p&lt;0,05), while in the comparison group the symptoms from the lower respiratory tractdominated, in particular, cough was significant more often observed (59,2% vs. 26,9%in the 1st group, p&lt;0,05). Lesions of the lower respiratory tract with the development ofpneumonia were significant more common in 32,0% of children in 2nd group and only in8,0% of infants (p&lt;0,05).Conclusions. Epidemiologically, the start of COVID-19 pandemic in Chernivtsi regionwith restrictive quarantine measures was characterized by a predominance of familialinfection and a significant proportion of unexplained extracurricular sources of infectionin children. In most infants with coronavirus disease caused by the new SARS-CoV-2coronavirus, respiratory symptoms were dominated by signs of upper respiratory tractinvolvement.

Clinical characteristics of COVID-19 infection in polyhandicapped persons in France

AimLittle is known about the clinical profile of COVID-19 infection in polyhandicapped persons. This study aimed to describe the characteristics of this infection among individuals with polyhandicap. MethodThis was a retrospective observational study. Polyhandicap was defined by the combination of motor deficiency, profound mental retardation, and age at onset of cerebral lesion younger than 6 years. A positive COVID-19 status was considered for patients with a positive COVID-19 laboratory test result, or patients presenting with compatible symptoms and living in an institution or at home with other patients or relatives who had laboratory-confirmed COVID-19 infection. Data collection included sociodemographic data, clinical and paraclinical characteristics, as well as the management and treatment for COVID-19 infection. ResultsWe collected 98 cases, with a sex ratio of 0.98 and a mean age of 38.5 years (3 months to 73 years). COVID-19 infection was paucisymptomatic in 46% of patients, 20.6% of patients presented with dyspnea, while the most frequent extra-respiratory symptoms were digestive (26.5%) and neurological changes (24.5%); 18 patients required hospital admission, four adults died. The mean duration of infection was longer for adults than for children, and the proportion of taste and smell disorders was higher in older patients. ConclusionThese findings suggest that PLH persons often develop paucisymptomatic forms of COVID-19 infection, although they may also experience severe outcomes, including death. Clinicians should be aware that COVID-19 symptoms in PLH persons are often extra-respiratory signs, mostly digestive and neurologic, which may help in the earlier identification of COVID-19 infection in this particular population of patients.

Spinal Anesthesia for Patients With Coronavirus Disease 2019 and Possible Transmission Rates in Anesthetists: Retrospective, Single-centre, Observational Cohort Study

(Br J Anaesth. 2020;124:670–675) Since COVID-19 has been declared an international public health emergency, clinical characteristics of COVID-19 infection, including pregnant women undergoing cesarean section, have been reported. However, there have not been reports on the perioperative characteristics or anesthetic management of infected patients undergoing surgery. Clinicians may be at high risk of infection during surgeries. This single-center, retrospective, observational cohort study was intended to describe experiences of performing spinal anesthesia in infected patients, report on the perioperative characteristics of patients with COVID-19, and report outcomes in patients who received spinal anesthesia, as well as describing the possible transmission rates in anesthetists administering spinal anesthesia.

Correlation of SARS-CoV-2 Serology and Clinical Phenotype Amongst Hospitalised Children in a Tertiary Children's Hospital in India.

IntroductionChildren usually present with minimal or no symptoms of COVID-19 infection. Antibody responses to SARS-CoV-2 in children from low- and middle-income countries (LMIC) have not been well described. We describe the prevalence of anti-SARS-CoV-2 antibodies and clinical phenotype of seropositive children admitted to a tertiary children’s hospital in South India.MethodsTo determine the seropositivity and describe the clinical characteristics of COVID-19 infection amongst hospitalised children, we performed a prospective clinical data collection and blood sampling of children admitted to Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India over 4 months of the COVID-19 pandemic. In seropositive children, we compared antibody titres between children with and without PIMS-TS.ResultsOf 463 children, 91 (19.6%) were seropositive. The median (range) age of seropositive children was 5 years (1 month–17 years). Clinical presentation was consistent with Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) in 48% (44/91) of seropositive children. The median (range) antibody titre was 54.8 (11.1–170.9) AU/ml among all seropositive children. The median antibody titre among the children with PIMS-TS (60.3 AU/mL) was significantly (p = 0.01) higher when compared to the children without PIMS-TS (54.8 AU/mL).ConclusionWe describe the antibody responses to SARS-CoV-2 amongst hospitalised children in a LMIC tertiary children’s hospital. Almost half of the seropositive children had PIMS-TS. Antibody levels may be helpful in the diagnosis and disease stratification of PIMS-TS.LAY SUMMARYChildren usually present with minimal or no symptoms of COVID-19 infection. However, Multisystem Inflammatory Syndrome in Children (MIS-C) or Paediatric inflammatory multisystem syndrome associated or related with SARS-CoV-2 infection (PIMS-TS) has emerged as a distinctive paediatric illness related to SARS-CoV-2. Recently, antibody testing for SARS-CoV-2 is being used increasingly as a diagnostic test for PIMS-TS. However, data on the antibody responses to SARS-CoV-2 in children are sparse. We, therefore, attempted to identify the seropositivity and describe the clinical spectrum of COVID-19 infection amongst infants and children getting hospitalised in a children’s hospital in south India. Nearly one-fifth of the hospitalised children tested serology positive over 4 months. Antibody levels in children with PIMS-TS were significantly higher in comparison to the other two groups (acute COVID-19 infection and children without PIMS-TS). Results from our study suggest that all children are at risk of COVID-19 infection though they may present with mild illness or no symptoms. We also observed that antibody testing may have a possible role in diagnosis of PIMS-TS.

Frequency, Clinical Characteristics and Outcome of Adult Patients with Acute Lymphoblastic Leukemia (ALL) and COVID-19 in Spain: Results of a Survey from Pethema and Geth Groups

Introduction and objective. SARS-CoV-2 pandemic has deeply impacted in Spain. In cancer patients (pts) the lethality has been higher than in normal population, but, little is known on the impact in adults with ALL. Our objective was to analyze the frequency, clinical characteristics and outcome of adult ALL patients infected by SARS-CoV-2.Methods. Between March 1, 2020 and May 31, 2020 (the period of the peak of COVID-19 infection in Spain) two registries from the PETHEMA (Programa Español de Tratamientos en Hematologia) and GETH (Grupo Español de Trasplante Hematopoyético y Terapia Celular) groups were activated to recruit adult patients with ALL and COVID-19 infection confirmed by PCR. The PETHEMA registry was based on ASH proposal (www.ashresearchcollaborative.org/covid-19-registry) and the GETH registry was specifically performed for hematological diseases and COVID-19 infection. Both registries were merged for this study. Eighty-four Spanish centers were contacted and weekly reminds were sent until May 19, 2020. The demographic and clinical characteristics of ALL and COVID-19 infection, the comorbidities, the treatment and outcome were collected. The study was closed for follow in July 10, 2020.Results. Fifty-six of 84 centers answered the survey and 28 patients with ALL and COVID-19 infection were identified in 17 of them, especially on March (n=11) and April (n=15). Median age was 46 (range 20-78) yrs. and 19 were aged over 40 yrs. Fifteen pts were male, 1 was active smoker and 9 showed one or more comorbidities (chronic liver disease [n=2] diabetes [n=1], hypertension [n=5], cardiopathy [n=2], prior malignancy [n=1] and hypogammaglobulinemia [n=1]). ALL was of B-cell precursors in 18 pts (Ph+ in 6) and T in 10. Twenty-six pts were on treatment of LAL (induction [n=10], consolidation [n=3], maintenance [n=1], HSCT [n=5], rescue [n=6], and palliative [n=1]). Eight patients were previously submitted to allogeneic HSCT, CAR T [n=1] or immunotherapy with monoclonal antibodies (inotuzumab, n=4) and 21 were receiving immunosuppressive drugs (corticosteroids in 11, fludarabine in 4, among others). Eleven pts showed neutropenia <0.5x109/L and 18 lymphocytopenia <0.5x109/L. Median value of C reactive protein was 28.7 mg/L (0.9-311.7) and D-dimer 690 ng/mL (120-31,200). The main clinical characteristics of COVID-19 infection were: fever (n=18), cough (n=16), shortness of breath (n=9) and asthenia (n=11) and 5 pts were asymptomatic. The most frequency therapies were hydroxychloroquine/chloroquine (n=23), combined or not with lopinavir/ritonavir. Tocilizumab was given to 8 pts. Twelve pts required oxygen supply and 7 required ICU support (median stay 16 [1-47] days). COVID-19 was solved in 18 pts, although 5 pts showed PCR+ persistence (median 25 [16-91] days) after resolution of symptoms. The treatment of ALL was stopped/modified in 11 pts. Nine pts dead (COVID-19 [n=6], COVID-19 and ALL progression [n=2] and COVID-19 andPseudomonassepsis [n=1]). A trend for higher mortality was observed in patients with neutropenia <0.5x109/L and in those with lymphocytopenia <0.5x109/L.Conclusion. The frequency of adult patients with ALL and COVID-19 infection can be considered high, given the low incidence of adult ALL. COVID-19 infection was frequent in patients with advanced age and on ALL therapy. The frequency of severe COVID-19 infection and the mortality were high.Supported in part by 2017 SGR288 (GRC) Generalitat de Catalunya and “la Caixa” Foundation.DisclosuresRibera:Pfizer, Amgen, Ariad, Novartis:Consultancy, Speakers Bureau;Pfizer, Amgen:Research Funding.Barba:Amgen, Celgene, Novartis, Pfizer:Speakers Bureau;Amgen, Celgene, Gilead, Jazz Pharmaceuticals, Novartis, Pfizer, Shire:Consultancy.

COVID-19 Infection in Patients with Paroxysmal Nocturnal Hemoglobinuria in Italy

COVID-19 pandemic has raised several concerns regarding patients with hematologic and immune-mediated diseases. It can be assumed that Paroxysmal nocturnal hemoglobinuria (PNH), both classic hemolytic and associated with aplastic anemia, particularly on treatment with complement inhibitors, may be more susceptible and have higher morbidity and mortality rates from COVID-19 than the general population. Italy has been heavily affected from the COVID-19 outbreak with the peak of contagions at the end of March 2020. As of July, 23 2020 the cumulative incidence of COVID-19 in Italy was 0.4% (1 case every 246 residents) (ranging from 0.06% - 1/1621- in Calabria to 0.9% - 1/106 - in Lombardy). We conducted a survey on 126 patients with PNH (77 females/49 males, median age 48 years, range 19-86) among 7 reference Italian centers in order to evaluate the occurrence and clinical characteristics of COVID-19 infection from the outbreak until the time of writing. According to International PNH Interest Group (IPIG) classification, 95 patients suffered from classic hemolytic PNH, 24 had associated bone marrow failures (aplastic anemia or myelodysplastic syndrome), and 7 had subclinical PNH (clone size <10%). Sixty-nine cases were on complement fraction 5 (C5) inhibition (72 eculizumab and 19 ravulizumab). Comorbidities were present in 33 patients, including arterial hypertension (N=14), ischemic cardiomyopathy (N=3), atrial fibrillation (N=2), diabetes mellitus (N=2), breast cancer (N=3), colon cancer (N=1), prostate cancer (N=1), Crohn disease (N=1), and Hashimoto thyroiditis (N=1). During the observation period, only one patient (55 years female), from Milan, Lombardy, not on C5-inhibitor was diagnosed with COVID-19 infection (positive swab, ageusia, and mild fever for few days). No hemolytic flare occurred, nor hospital admission was required. She received azithromycin and low molecular heparin. Other 6 patients, all on C5-inhibitors, experienced fever (N=5) and cough (N=2), and/or dysgeusia (N=1), of whom 2 experienced breakthrough hemolysis (BTH), but swabs and CT scans (N=2) were negative. At variance, 6 patients (4 on eculizumab and 2 on ravulizumab) experienced BTH without COVID-19 symptoms. Interestingly, a young male patient on eculizumab, working as medical doctor in a COVID-19 ward, did not contract the infection. In conclusion, this survey suggests that PNH subjects, either on complement inhibition or not, are not at significantly higher risk of COVID-19 infection as compared with the general population. As a matter of fact, the basic protective measures against COVID-19 have always been advised to PNH patients particularly during treatment and were presumably carefully followed during the pandemic. On the other hand, immune activation and inflammation are thought to play an important role in the clinical severity of COVID-19 pneumonia. Complement inhibition, which is under investigation in COVID-19 disease, seems at least not disadvantageous in PNH.DisclosuresBarcellini:Agios: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Alexion: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: invited speaker , Research Funding; Novartis: Honoraria, Other: invited speaker , Research Funding; Bioverativ: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees. Bianchi:Agios Pharmaceuticals: Other: Scientific Advisor. Notaro:Biocryst: Membership on an entity's Board of Directors or advisory committees; Alexion Pharmaceuticals: Honoraria.

Older age and frailty are the chief predictors of mortality in COVID-19 patients admitted to an acute medical unit in a secondary care setting- a cohort study

BackgroundThere is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n = 215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020.ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p < 0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p < 0.001) and respiratory diseases (group 2: 38 vs group 1: 25%, p = 0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p = 0.03), frailty (OR 5.1; p < 0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p = 0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients.ConclusionOlder age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

Clinical Characteristic of Covid-19 Infection in Pediatric: A Systematic Review

SARS-CoV-2 is a new type of corona virus that has been identified as a cause of COVID-19 cases. Thisdisease is transmitted quickly, causes a global pandemic and can affect all ages, including children. Inchildren, cases are still rare and hard to be found. Because the prevalence of events in children tends to besmaller than in adults, information about the clinical characteristics of COVID-19 infection in children isstill lacking. The aim of this research is to find out the clinical characteristics of COVID-19 infections inchildren. Conducting a literature review of various scientific studies related to the clinical characteristicsof COVID-19 infection in children. The most common clinical symptoms found in pediatric patients withCOVID-19 infection are coughing, fever and gastrointestinal symptoms where these symptoms usuallytend to be mild to moderate and often the symptoms are not specific or asymptomatic. Laboratory resultsare generally normal but the CT-Scan results show suspicion towards pneumonia in the majority cases ofchildren.

A case series describing the epidemiology and clinical characteristics of COVID-19 infection in Jilin Province

ABSTRACT Since its outbreak in Wuhan, Hubei Province China, 2019-coronavirus infected disease (COVID-19) had been widely spread all over the world, the control of which calls for a better understanding of its epidemiology and clinical characteristics. We included 12 confirmed cases of COVID-19 in First Affiliated Hospital of Jilin University from 23 January 2020 to 11 February 2020, which were retrospectively analyzed for epidemiological, demographic, clinical, laboratory, and radiological features. All the patients were confirmed by nucleic acid detection, the average age of whom was 45.25 years (range, 23–79 years). Most patients had a history of Wuhan traveling or had contact with Wuhan travelers or infected cases. Obvious family cluster was observed. Clinical manifestations included fever (12/12), fatigue (10/12), cough (6/12), sore throat (4/12), headache (3/12), and diarrhea (2/12). Only three out of eight patients had pneumonia manifestation on radiography. Most patients had a normal white blood cell (WBC) count and normal or reduced lymphocyte (LY) count. Pneumonia changes were observed in all the four patients who underwent a chest CT scan. Only one elderly patient developed severe pneumonia, while all the rest were mild disease and had a self-limiting course.

Clinical Characteristics of COVID-19 Infection in Newborns and Pediatrics: A Systematic Review.

World Health Organization has declared COVID-19 a pandemic and a global health emergency. Thus, it is necessary to clearly characterize clinical manifestations and management of COVID-19 infection in children to provide accurate information for healthcare workers. Accordingly, the present study was designed to review articles published on clinical manifestations and characteristics of children and infants with COVID-19. In this systematic review, medical databases including Cochrane Library, Web of Science, Embase, Scopus, SID, Medline, WHO and LitCovid were searched using English and Persian keywords including COVID-19, Pediatrics, Newborn, Coronavirus 2019, 2019-nCoV, SARS-CoV-2. Finally, data of 14 related articles were included in the study. A total of 2228 children, newborns and infants were studied. Clinical manifestation in children may be mild (72%), moderate (22%) or severe (6%), and the most common symptoms include dry cough (91%) and fever (96%). According to the included articles, two children had died, one of which was a 14-year-old boy and his exposure history and underlying disease were unclear, and the other was a male newborn with gestational age of 35 weeks and 5 days, birth weight of 2200, Apgar score of 8, 8 (1 min and 5 min) and his first symptom was increased heart rate. No differences were found between male and female children regarding infection with COVID-19. Most pediatrics were infected with COVID-19 due to family cluster or history of close contact. Infected children have relatively milder clinical symptoms compared to infected adults. We should pay special attention to early diagnosis and early treatment in children infected with COVID-19.