Coronavirus Infected Pneumonia Research Articles

A clinical case of metastatic ophthalmia against the background of a severe course of new coronavirus infection

The article presents a clinical case of severe bilateral metastatic ophthalmia caused by a bacterial infection against the background of a new coronavirus infection. In a female patient with a new coronavirus infection and viral pneumonia against the background of a septic condition signs of a liver abscess were revealed and a clinic of bilateral endogenous endophthalmitis developed. Despite intensive antibacterial therapy, the clinic of panophthalmitis of the left eye developed, the left eye was eviscerated. The same pathogen Klebsiellae pneumonia was isolated in vitreous body culture of the removed eye, conjunctiva smear and pus exudate from liver abscess. Bilateral metastatic ophthalmia was caused by the presence of an infectious focus in the body (liver abscess) on the background of weakened immunity due to severe septic condition of the patient. In turn, coronary viral infection led to severe respiratory tract damage and development of secondary immunodeficiency. The low effectiveness of intensive antibiotic therapy is associated with this. The rare case of bilateral metastatic ophthalmia described by us is of interest for ophthalmologists in terms of the possibility of such a serious complication caused by the bacterium Klebsiellae pneumonia, combined with liver abscess. At as-association of this pathology with severe coronavirus infection complicates the course, therapy and prognosis of this disease.

Effects of nebulized hypertonic saline on inflammatory mediators in patients with severe COVID-19 pneumonia: A double-blinded randomized controlled trial.

An exaggerated immune response is considered the most important aspect of COVID-19 pathogenesis. Hypertonic saline (HS) has shown promise in combating inflammation in several respiratory diseases. We investigated the effects of nebulized HS on clinical symptoms and inflammatory status in patients with severe novel coronavirus infection (COVID-19) pneumonia. We randomly assigned 60 adults admitted to the intensive care unit (ICU) due to severe COVID-19 pneumonia to the experimental (received nebulized 5% saline) and control (received nebulized distilled water) groups. All interventions were applied 4 times daily for 5 days. The levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and other clinical factors from venous blood were evaluated before and after intervention application. Mortality rate, intubation rate, and durations of ICU and hospital stay were also compared between groups. The levels of TNF-α (MD: -21.35 [-32.29, -10.40], P = 0.000) and IL-6 (-9.94 [-18.86, -1.02], P = 0.003) were lower in the experimental group compared to the control group after applying the interventions. The levels of white blood cell count, PO2, and serum sodium were also statistically significant differences between groups. However, we did not observe significant differences in terms of hospitalization durations and mortality rates. Nebulization of HS in patients with severe COVID-19 pneumonia appears to be effective in reducing inflammation, but does not appear to affect intubation rates, mortality, hospitalization, or length of stay in ICU.

IMPACT OF DIABETES MELLITUS ON CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: A novel coronavirus infection (SARS-CoV-2) pneumonia (COVID-19) has been quickly spreading throughout China and the rest of the world since December 2019. Respiratory tract infections are frequently linked to diabetes mellitus (DM), a different risk factor. This study has reported the clinical presentation and therapeutic outcomes of COVID-19 with diabetes. Methods: From medical records and histories provided by 72 Covid-19-infected patients with diabetes admitted to the KMCH institute of health sciences and research, Coimbatore, data on demographics, clinical, laboratory, and radiological characteristics as well as treatment outcomes were collected using data collection forms. Real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-CoV RNA was used to screen patients with Covid-19. Results: 72 diabetes patients who tested positive for Covid-19 were admitted for this study. SPSS software version 26 was used to evaluate the data that had been collected. Clinical profiles and outcomes of patients with and without diabetes underwent descriptive analysis. Controlled diabetics had a mean plasma glucose of 112.22±11.41, while uncontrolled diabetics had a mean plasma glucose of 154.2±23.22. Fever was the most prevalent symptom in both managed and uncontrolled diabetes patients (94% and 100%), followed by sore throat (84% and 88%). In patients with uncontrolled diabetes compared to those with controlled diabetes, breathlessness is considerably higher (p<0.05). In the CORADS scoring, 11 of the 34 diabetics with uncontrolled blood sugar levels had CORADS 6 (32.35%), compared to just 2 of the 38 diabetics with regulated blood sugar levels (5.26%), which is considerably higher (p<0.01). In uncontrolled diabetics, the length of hospital stay is much longer (p<0.001). Compared to diabetics with controlled blood sugar, uncontrolled patients SPO2 dramatically dropped (p<0.001). Those with uncontrolled diabetes are more likely to be admitted to the ICU than patients with controlled diabetes (p<0.05). In uncontrolled diabetes compared to controlled patients, the severity was considerably higher (p<0.05). One person who had uncontrolled diabetes died, although no one who had controlled diabetes died. Conclusion: Covid 19, persons with uncontrolled diabetes appear to be more likely to sustain lung damage, necessitating admission to the ICU, an extended stay in the hospital, and oxygen assistance throughout the duration of the illness.

Smoking as one of the predictors of the severity of the condition of patients suffering from a new coronavirus infection

The relationship between smoking and the lung damage volume in patients with a confirmed new coronavirus infection diagnosis, hospitalized in a temporary infectious hospital for the treatment of patients suffering from a new coronavirus infection and community-acquired pneumonia was evaluated. This was in the Odintsovo Districts Patriot Park of the Moscow region. Smoking cigarettes, both active and passive, as well as exposure to tobacco smoke on the body, are important upper and lower respiratory tract infection risk factors due to local immune response suppression. Nevertheless, data from a number of international studies indicate a significantly lower number of hospitalized smoking patients compared to non-smokers. These indicators were investigated as the percentage and degree of lung damage, smoking history, the number of cigarettes smoked per day, and the smoker's index. In the course of the study, the data on a smaller percentage of smokers admitted to inpatient treatment were confirmed in comparison with non-smokers and smokers in the general population. There was no statistically significant difference in the volume of lung damage between smoking and non-smoking patients according to the chest organs computed tomography. At the same time, there was an increase in the volume of lung tissue damage, depending on the smoking experience. This is apparently due to the irreversible changes formation in lung tissue against a long-term smoking background. The median age of smoking patients was 56 years with a variation from 46 to 68 years. The minimum and maximum ages were 29 and 82. The median lung lesion was 32% with a variation from 23% to 39%. The minimum and maximum lung damage is 10% and 40%, respectively. A moderate correlation was found between the smoking experience and the volume of lung damage. An increase in lung damage by 0.309% should be expected with an increase in smoking experience by one full year. There was also no statistically significant difference in the number of cigarettes smoked per day and the smokers index.

Modular Structure Construction Progress Scenario: A Case Study of an Emergency Hospital to Address the COVID-19 Pandemic

Recently, emergency structures have been in the spotlight because of the coronavirus disease (COVID-19) pandemic. This research examines the use of modular integrated construction (MiC) in developing an emergency hospital for individuals with novel coronavirus-infected pneumonia (NCIP). The whole process of building is based on the modular design and assembly idea. The primary structure was constructed using the modular steel buildings (MSBs) concept to suit emergency structures’ functional qualities and quick construction needs. An intelligent operation and maintenance management platform was built utilizing 5G, AI, IoT (IoT), cloud, big data, an d other technologies. A BIM model was created to evaluate and compare the construction plan, develop the combined section and connection node plan, and complete the detailed design of assembled steel structures. On-site modularization of fundamental structural components and accessories is utilized in a flowing operating mode, where the housing and supporting installation are closely coordinated. The research results show that information and data interaction is the key to speedy building design and construction, with digital simulation in one stage and on-site assembly in a crammed way. The study findings may be used to build comparable structures faster, utilizing modular building techniques.

Reducing barriers to accessing administrative data on SARS-CoV-2 vaccination for research.

<h3>Background</h3> The 2019-nCoV outbreak in Wuhan, China has attracted world-wide attention. As of February 11, 2020, a total of 44730 cases of novel coronavirus-infected pneumonia associated with COVID-19 were confirmed by the National Health Commission of China. <h3>Methods</h3> Three approaches, namely Poisson likelihood-based method (ML), exponential growth rate-based method (EGR) and stochastic Susceptible-Infected-Removed dynamic model-based method (SIR), were implemented to estimate the basic and controlled reproduction numbers. <h3>Results</h3> A total of 71 chains of transmission together with dates of symptoms onset and 67 dates of infections were identified among 5405 confirmed cases outside Hubei as reported by February 2, 2020. Based on this information, we find the serial interval having an average of 4.41 days with a standard deviation of 3.17 days and the infectious period having an average of 10.91 days with a standard deviation of 3.95 days. <h3>Conclusions</h3> The controlled reproduction number is declining. It is lower than one in most regions of China, but is still larger than one in Hubei Province. Sustained efforts are needed to further reduce the <i>R</i>_<i>c</i> to below one in order to end the current epidemic.

Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study.

Objectives:Our study was aimed to investigate the clinical characteristics of the patients with COVID-19 pneumonia and research new diagnostic methods for the disease.Methods:In this retrospective study, medical records of 46 novel coronavirus-infected pneumonia (NCIP) patients and 30 healthy individuals in the two multiple hospitals from January 2020 to March 2020 were studied. Clinical characteristics, chest computed tomographic (CT) scans, medicine treatment and laboratory information were collected and retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were evaluated.Results:The main symptoms of the patients with NCIP were fever (100%), cough (82.6%), anorexia (37%), expectoration (34.8%) and fatigue (21.7%), dyspnea (15.2%). Ground glass opacity (GGO) with patch shadow was the main observation of the CT imaging (43.4%), followed by GGO (21.7%), patch shadow (19.5%), GGO with consolidation (8.7%) and GGO with reticular pattern (2.1%). The median white blood cell (WBC) count, lymphocyte count, platelet, and lymphocyte-monocyte ratio (LMR) in NCIP group were all significantly lower than in control group (p<0.001, for all comparisons), while the median neutrophil-monocyte ratio (NLR) and platelets-monocyte ratio (PLR) were both significantly higher (p<0.001, for both comparisons). Median WBC count, lymphocyte count, and platelet count on discharge were significantly higher than on admission (p<0.05). Median PLR was significantly lower two weeks after discharge (p<0.001), while NLR remained the same. The area under the curve (AUC) value of WBC, lymphocyte and platelet counts, NLR, LMR and PLR were 0.766, 0.931, 0.655, 0.780, 0.847 and 0.845, respectively. Early stages of the disease were associated with quick changes in WBC, lymphocyte, and platelet levels. However, NLR did not recover even two weeks after the discharge.Conclusion:Changes in WBC, lymphocyte, and platelet counts, as well as NLR, LMR and PLR are strongly associated with COVID-19 pneumonia. Monitoring blood markers may assist in evaluating the progression of the disease

Criminal law regulation of criminal acts involving COVID-19 epidemic

On the eve of the 2020 Spring Festival, the new coronavirus pneumonia broke out, normal social order was affected, and crimes involving the epidemic increased. On February 6, 2020, the Supreme People’s Court, the Supreme People’s Procuratorate, the Ministry of Public Security, and the Ministry of Justice jointly issued “Opinions on Punishment of Crimes Obstructing the Prevention and Control of the Novel Coronavirus Infection Pneumonia Epidemic According to Law”, which clearly stipulates nine types of crimes that hinder the prevention and control of the epidemic. In order to clarify and solve some outstanding problems of inconsistent understanding of the application of laws in the practice of epidemic prevention and control, the Supreme People’s Procuratorate selected cases that accounted for a large portion of cases, reflected many problems, and urgently required practical practices; they then issued ten batches of “Typical Cases of Crimes Obstructing the Prevention and Control of the New Coronary Pneumonia Epidemic by Procuratorial Organs across the Country”. This article is mainly based on the “Prosecutors across the country handle typical cases of crimes obstructing the prevention and control of the new crown pneumonia epidemic in accordance with the law”, analyzing economic and property crimes, crimes that disrupt the order of social management, and crimes that endanger public safety.

Unusual presentation of coronavirus disease2019(COVID-19): two cases of acute abdomen

December 2019 SARS-CoV-2 is responsible for the novel coronavirus-infected pneumonia associated with acute respiratory distress syndrome, organ dysfunction and death. Since its discovery, a myriad of clinical presentations have surfaced and the past year has been a learning experience for all. We present two cases of acute abdomen presenting as a “surgical abdomen”; one had a negative laparotomy and negative PCR test, and the other who did not have surgery eventually tested positive on PCR testing. Both were incidentally diagnosed with COVID-19 pneumonia on a chest computed tomography scan and managed accordingly. It is unclear whether reported gastrointestinal manifestations are a direct causal effect of the virus in the gastrointestinal tract. Surgeons should be aware that COVID-19 can present as a “surgical abdomen” which may lead to negative laparotomies.

Clinical features of patients with COVID19, hospitalized in a multi-somatic hospital

The prevalence of COVID-19 infection and the mortality associated with the disease are steadily progressing [1, 2]. The difficulties in diagnosing and treating COVID-19 in the context of a constant increase in the number of cases cause an urgent need to study and describe this infection, which is important for the medical and scientific community around the world. We performed an observational study of patients with COVID 19 infection, which developed during hospital treatment of another acute or exacerbation of chronic somatic pathology. We analyzed the clinical symptoms, the severity of the course of the new coronavirus infection and viral pneumonia.

The clinical characters and prognosis of COVID-19 patients with multiple organ dysfunction.

To depict the clinical characters and prognosis of coronavirus disease 2019 patients who developed multiple organ dysfunction syndrome (MODS).A cohort consisted of 526 patients, which including 109 patients complicated MODS, was retrospectively analyzed to examine the clinical characteristics and risk factors of MODS.Among the 526 novel coronavirus-infected pneumonia patients, 109 patients developed multiple organ failure, the incidence rate was 20.7%. Among all 109 patients with MODS, 81.7% were over 60 years old, and 63.3% were male. The most common symptoms were fever (79.8%), dyspnea (73.4%), and fatigue (55.0%). Compared with patients non-MODS patients, there were 70 cases of MODS patients with one or more underlying diseases (64.2% vs 41.0%, P < .001). Respiratory failure (92.7%), circulatory failure (52.0%), and liver function injury (30.9%) were the most common symptoms within the spectrum of MODS. Invasive ventilator, noninvasive ventilator, and high-flow respiratory support treatment for patients in MODS patients were higher than those in the non-MODS group (P < .001). The antiviral therapy and 2 or more antibacterial drug treatments in MODS patients were higher than those in the non-MODS group (P < .001). The median hospital stay of all patients was 16 days (interquartile range [IQR], 9-26), of which 20 days (IQR, 11.5-30.5) in the MODS patients, which was approximately 4 days longer than that of non-MODS patients. In addition, our data suggested that lymphocyte counts <1.0 ∗ 109/L, Troponin T > 0.014 ng/mL and lower oxygenation index were risk factors for MODS. In the early stage of hospital admission, higher inflammatory indexes and lactic acid concentration were associated with increased risk of death.MODS often leads to poor prognosis in coronavirus disease 2019. Our data suggested the importance of early identification of MODS. We recommend close monitoring and timely supportive therapy for patients with high risks, stopping the disease progression before it was too late.

CARDIAC TAMPONADE WITH HEMORRHAGIC PERICARDIAL EFFUSION AS A RESULT OF NOVEL SARS-COV-2 INFECTION

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Cardiac tamponade is a serious and life-threatening condition in which fluid accumulates in the pericardial space resulting in impaired ventricular filling and cardiac compression, leading to hemodynamic compromise and ultimately cardiac arrest. Cardiac tamponade, due to a hemorrhagic pericardial effusion, can be caused by various etiologies. Here, we present a rare case in which a hemorrhagic pericardial effusion with tamponade physiology is the initial presentation of the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, also known as COVID-19. CASE PRESENTATION: A previously healthy 32-year-old male presented to the emergency room with chief complaints of chest pain and increasing shortness of breath, over a one week duration. Testing revealed SARS-CoV-2 positivity by PCR. Evaluation included a computed tomography angiogram excluding pulmonary embolism but revealing a large pericardial effusion. Echocardiogram confirmed this finding and showed ventricular filling changes consistent with tamponade physiology. Shortly after, the patient began exhibiting signs of hemodynamic instability. Emergent pericardiocentesis ensued with placement of a pericardial drain. A pericardial window was performed the following day. Initial fluid analysis was consistent with an inflammatory process. Cytology was negative for malignancy. He was treated with colchicine, and gradually obtained resolution of all of his symptoms. He was discharged home in stable condition. DISCUSSION: With a volatile virus exhibiting versatile pathogenicity, it is of paramount importance to understand its mechanisms of action in order to both, better predict its role in the formation of a pericardial effusion and prevent the development of cardiac tamponade (2). As was seen with SARS-CoV back in 2002, the novel coronavirus also depends on its S protein, specifically the S1 subunit, to adhere to and enter the host cell via endocytic entry. The host cell receptor, angiotensin- converting enzyme 2 (ACE 2), is widely expressed throughout the body, with sites noted in arterial and venous endothelial cells, renal podocytes, alveolar epithelial cells, and cardiac myocytes. This, in addition to, the pro-inflammatory storm mediated by downregulation of ACE 2 and subsequent reduced levels of Ang 1-7 leads to increased levels of apoptosis and myocyte injury (3). High levels of inflammatory cells congregated at these sites can infiltrate the pericardium leading to pericarditis and resultant pericardial effusion. CONCLUSIONS: We report one of the first cases of a hemorrhagic pericardial effusion with cardiac tamponade physiology as the initial manifestation of a COVID-19 infection in an otherwise healthy, young male. This adds to the growing literature of extrapulmonary manifestations of a COVID-19 infection, as we continue to treat more afflicted patients in this constantly evolving pandemic of the 21st century (1). REFERENCE #1: Dabbagh, M. F., Aurora, L., D'Souza, P., Weinmann, A. J., Bhargava, P., & Basir, M. B. (2020). Cardiac Tamponade Secondary to COVID-19. JACC. Case reports, 10.1016/j.jaccas.2020.04.009. Advance online publication. https://doi.org/10.1016/j.jaccas.2020.04.009 REFERENCE #2: Farina, Andrea, et al. "SARS-CoV-2 Detection in the Pericardial Fluid of a Patient with Cardiac Tamponade." European Journal of Internal Medicine, vol. 76, 22 Apr. 2020, pp. 100–101., doi:10.1016/j.ejim.2020.04.045. REFERENCE #3: Wang, Dawei, et al. "Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China." Jama, vol. 323, no. 11, 2020, p. 1061., doi:10.1001/jama.2020.1585. DISCLOSURES: No relevant relationships by Sabaa Ahmed, source=Web Response No relevant relationships by Nancy Guirguis, source=Web Response

Early Hospitalization Improves the Covid-19 Patients’ Prognosis

The COVID-19 outbreak in Wuhan has subsided but the world is still suffering from it. We present our experience gained during this outbreak from city and hospital perspectives which might inform others to make evidence-based decisions to tackle this devastating pandemic more effectively. We studied the counter-measures adopted by Wuhan Government and analyzed the city’s new coronavirus infected disease patient’s data obtained from the National Health Commission and one re-purposed hospital to accommodate COVID-19 patients of the counter-measures for the COVID-19 outbreak. There was a significant drop of new-patient after February 18th, 2020. Patients with disease-onset after February 4th had shorter onset to admission days than those with onset before February 4th; and also had less critical-illness and mortality rates. This was due to quicker hospitalization after February 4th. The scores of PCR results at diagnosis, the national early warning score and the time-to-death were not significantly different for critical-illness patients whose onset before vs. after February 4th. The critical and death rates can be decreased by early hospitalization and oxygen therapy for less severe novel coronavirus-infected pneumonia within 7 days after disease onset.

Liver manifestation associated with COVID-19 (Literature review)

The World Health Organization (WHO) named the 2019-nCoV virus on January 12, 2020 1 . Subsequently, in a short period of time, Novel Coronavirus Infected Pneumonia (NCIP) spread around the world, and on January 30, 2020, the WHO declared NCIP an international public health emergency 2 . On February 11, 2020, it was renamed Coronavirus Disease 2019 (COVID-19) 3 . Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which has been described as a form of the beta coronavirus cluster, is the cause of the pandemic and has 79.6% sequence identity with SARS-CoV 4 . COVID-19 is generally a self-limiting disease, but it can also be fatal: China's death rate is around 2.3 percent 5 , from 5.8 percent in Wuhan to 0.7 percent in the rest of China 6 . The proportion of serious or fatal infections that can be attributed to specific infected populations may vary by country and region. A certain percentage of deaths occurred in elderly patients or comorbid conditions (obesity, hypertension, diabetes, cardiovascular disease, chronic lung disease and cancer) 5-8 . These results were also found in critically ill patients referred to the intensive care unit, indicating that adequate liver oxygen supply is provided by compensatory mechanisms, including in cases of severe respiratory failure during COVID-19 disease 9-17 .

Role of CT Scan in Diagnosis of COVID-19 Infection- A Review

Since it was declared a worldwide pandemic, COVID-19 has ravaged almost all over the world and has overloaded several health-care systems. The pandemic also resulted in job losses as a result of lengthy shutdowns, which burdened the global economy. Even though significant clinical research progress has led to a better perceiving of the virus (SARS-CoV-2) nature and the disease (COVID-19) management, preventing the virus's spread has become a major concern as SARS-CoV-2 continues to wreak havoc around the world. Several countries suffered from the second or third wave of viral disease outbreaks, primarily caused by the mutation of SARS-CoV-2. Imaging is critical in the diagnosis and follow-up of patients with new coronavirus-infected pneumonia (NCIP). The primary imaging modality in clinically suspected cases is CT scan and it is useful for monitoring imaging changes following therapy. Therefore, CT is regarded as a useful diagnostic technique for clinically suspected cases of COVID-19. CT has the ability to detect patients who have a negative reverse transcription–polymerase chain reaction (RT-PCR) but are highly suspicious of NCIP in terms of clinical problems. In addition, the results of a CT scan may also reveal information concerning the severity of the condition. In this review article, the diagnosis of COVID-19 is discussed and CT characteristics are defined based on the newest research for the diagnosis and management of COVID-19.

Management of Bilateral Spontaneous Pneumothorax Related to COVID-19 Infection

Spontaneous pneumothorax is a rare but potentially fatal complication of coronavirus infection and COVID-19 pneumonia. Data is limited to guide clinicians in the setting of spontaneous pneumothorax when conservative management fails and operative intervention is required. We report the clinical course and operative strategy for a patient who presented with sequential bilateral spontaneous pneumothorax after being diagnosed with severe COVID-19 pneumonia. Conservative management with bilateral tube thoracostomies failed to resolve persistent alveolar-pleural fistulae, and ultimately the patient recovered after synchronous bilateral VATS blebectomies in the operating room. The timing and treatment of spontaneous pneumothorax requires follow-up education and surveillance for patients with this disease, as lack of prompt treatment outside the hospital could increase patient mortality. Spontaneous pneumothorax is a concern in patients who re-present with recurrent symptoms after COVID-19 diagnosis. When conservative treatment fails, surgery can safely be performed in COVID-19 patients with simultaneous bilateral pneumothorax with full functional recovery.

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

The Coronavirus Anxiety in the Elderly: The Role of Coping Styles with Stress and Meta-Worry

A Recent Update on Therapeutics to Treat Emerging n-COVID 19: A Review

: A coronavirus is a group of nonsegmented, single-stranded, enveloped viruses having positive RNA genomes. This virus was first described in 1931, and the first coronavirus was isolated (HCoV-229E) from humans in 1965. People be-come infected with four human coronavirus strains: 229E, NL63, OC43, and HKU1, which cause respiratory associated problems such as SARS and MERS. Lately, a new version of a strain called SARD-CoV-2 has been found. WHO called it novel coronavirus-infected pneumonia (NCIP) and later officially renamed as COVID-19 on 11th Feb 2020. The outbreak began in Wuhan, Hubei, China, in Dec 2019 and from now the outbreak becomes pandemic. Here, we have reviewed various categories of therapeutics, vaccines, and clinically investigated drugs to treat and prevent n-COVID-19. Till now, no specific FDA approved drugs or vaccines are available against n-COVID-19. Several options can be visualized to control or prevent emerging infections, including antivirals, immunomodulators, interferons, vaccines, monoclonal antibodies, and bio- molecules. Given the urgency of the outbreak, we have discussed some potential existing therapeutics for treating n-COVID-19.

Correlation Analysis between the Viral Load and the Progression of COVID-19.

Objectives This study is aimed at exploring the relationship of the viral load of coronavirus disease 2019 (COVID-19) with lymphocyte count, neutrophil count, and C-reactive protein (CRP) and investigating the dynamic change of patients' viral load during the conversion from mild COVID-19 to severe COVID-19, so as to clarify the correlation between the viral load and progression of COVID-19. Methods This paper included 38 COVID-19 patients admitted to the First Hospital of Jiaxing from January 28, 2020, to March 6, 2020, and they were clinically classified according to the Guidelines on the Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment. According to the instructions of the Nucleic Acid Detection Kit for the 2019 novel coronavirus (SARS-CoV-2), respiratory tract specimens (throat swabs) were collected from patients for nucleic acid testing. Patients' lymphocyte count and neutrophil count were determined by blood routine examination, and CRP was measured by biochemical test. Results The results of our study suggested that the cycle threshold (Ct) value of Nucleocapsid protein (N) gene examined by nucleic acid test was markedly positively correlated with lymphocyte count (p = 0.0445, R2 = 0.1203), but negatively correlated with neutrophil count (p = 0.0446, R2 = 0.1167) and CRP (p = 0.0393, R2 = 0.1261), which indicated that patients with a higher viral load tended to have lower lymphocyte count but higher neutrophil count and CRP. Additionally, we detected the dynamic change of Ct value in patients who developed into a severe case, finding that viral load of 3 patients increased before disease progression, whereas this phenomenon was not found in 2 patients with underlying diseases. Conclusion The results of this study demonstrated that viral load of SARS-CoV-2 is significantly negatively correlated with lymphocyte count, but markedly positively correlated with neutrophil count and CRP. The rise of viral load is very likely to be the key factor leading to the overloading of the body's immune response and resulting in the disease progression into severe disease.

Clinical and radiological imaging as prognostic predictors in COVID-19 patients

BackgroundSince the announcement of COVID-19 as a pandemic infection, several studies have been performed to discuss the clinical picture, laboratory finding, and imaging features of this disease. The aim of this study is to demarcate the imaging features of novel coronavirus infected pneumonia (NCIP) in different age groups and outline the relation between radiological aspect, including CT severity, and clinical aspect, including age, oxygen saturation, and fatal outcome. We implemented a prospective observational study enrolled 299 laboratory-confirmed COVID-19 patients (169 males and 130 females; age range = 2–91 years; mean age = 38.4 ± 17.2). All patients were submitted to chest CT with multi-planar reconstruction. The imaging features of NCIP in different age groups were described. The relations between CT severity and age, oxygen saturation, and fatal outcome were evaluated.ResultsThe most predominant CT features were bilateral (75.4%), posterior (66.3%), pleural-based (93.5%), lower lobe involvement (89.8%), and ground-glass opacity (94.7%). ROC curve analysis revealed that the optimal cutoff age that was highly exposed to moderate and severe stages of NCIP was 38 years old (AUC = 0.77, p < 0.001). NCIP was noted in 42.6% below 40-year-old age group compared to 84% above 40-year-old age group. The CT severity was significantly related to age and fatal outcome (p < 0.001). Anterior, centrilobular, hilar, apical, and middle lobe involvements had a significant relation to below 90% oxygen saturation. A significant negative correlation was found between CT severity and oxygen saturation (r = − 0.49, p < 0.001). Crazy-paving pattern, anterior aspect, hilar, centrilobular involvement, and moderate and severe stages had a statistically significant relation to higher mortality.ConclusionThe current study confirmed the value of CT as a prognostic predictor in NCIP through demonstration of the strong relation between CT severity and age, oxygen saturation, and the fatal outcome. In the era of COVID-19 pandemic, this study is considered to be an extension to other studies discussing chest CT features of COVID-19 in different age groups with demarcation of the relation of chest CT severity to different pattern and distribution of NCIP, age, oxygen saturation, and mortality rate.