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The characteristics and outcomes of 681 severe cases with COVID-19 in China

PURPOSE: To clarify the epidemiological, clinical, and therapeutic features of patients with severe COVID-19. METHODS: In this study, we enrolled 681 patients with confirmed cases of severe COVID-19. The epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected....

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Autores principales: Chen, Fang-fang, Zhong, Ming, Liu, Ya, Zhang, Yi, Zhang, Kai, Su, De-zhen, Meng, Xiao, Zhang, Yun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340593/
https://www.ncbi.nlm.nih.gov/pubmed/32736197
http://dx.doi.org/10.1016/j.jcrc.2020.07.003
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author Chen, Fang-fang
Zhong, Ming
Liu, Ya
Zhang, Yi
Zhang, Kai
Su, De-zhen
Meng, Xiao
Zhang, Yun
author_facet Chen, Fang-fang
Zhong, Ming
Liu, Ya
Zhang, Yi
Zhang, Kai
Su, De-zhen
Meng, Xiao
Zhang, Yun
author_sort Chen, Fang-fang
collection PubMed
description PURPOSE: To clarify the epidemiological, clinical, and therapeutic features of patients with severe COVID-19. METHODS: In this study, we enrolled 681 patients with confirmed cases of severe COVID-19. The epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected. RESULTS: The median age of the study participants was 65 years, 53.2% were male, and 104 (15.3%) died. Age, Neutrophil-To-Lymphocyte Ratio (NLR), acute myocardial injury, and levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), and CD3 T cells counts were independently associated with death, while arbidol and ribavirin were protective from death. The combination of NLR and acute myocardial injury on admission (AUC = 0.914) predicted mortality better than NLR, CRP, LDH, and acute myocardial injury. There were 312 (45.8%) patients with cardiovascular disease, of whom 23.4% died. β-blockers, ACEI/ARB, arbidol, and ribavirin might have a beneficial effect for severe COVID-19 patients with cardiovascular disease. CONCLUSION: The combination of NLR and acute myocardial injury on admission was highly predictive of mortality and survival. Clinicians should adopt more aggressive strategies for patients with a high NLR (>6.66) combined with myocardial injury. β-blockers and ACEI/ARB, as well as arbidol and ribavirin, were effective in COVID-19 patients with cardiovascular disease.
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spelling pubmed-73405932020-07-08 The characteristics and outcomes of 681 severe cases with COVID-19 in China Chen, Fang-fang Zhong, Ming Liu, Ya Zhang, Yi Zhang, Kai Su, De-zhen Meng, Xiao Zhang, Yun J Crit Care Article PURPOSE: To clarify the epidemiological, clinical, and therapeutic features of patients with severe COVID-19. METHODS: In this study, we enrolled 681 patients with confirmed cases of severe COVID-19. The epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected. RESULTS: The median age of the study participants was 65 years, 53.2% were male, and 104 (15.3%) died. Age, Neutrophil-To-Lymphocyte Ratio (NLR), acute myocardial injury, and levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), and CD3 T cells counts were independently associated with death, while arbidol and ribavirin were protective from death. The combination of NLR and acute myocardial injury on admission (AUC = 0.914) predicted mortality better than NLR, CRP, LDH, and acute myocardial injury. There were 312 (45.8%) patients with cardiovascular disease, of whom 23.4% died. β-blockers, ACEI/ARB, arbidol, and ribavirin might have a beneficial effect for severe COVID-19 patients with cardiovascular disease. CONCLUSION: The combination of NLR and acute myocardial injury on admission was highly predictive of mortality and survival. Clinicians should adopt more aggressive strategies for patients with a high NLR (>6.66) combined with myocardial injury. β-blockers and ACEI/ARB, as well as arbidol and ribavirin, were effective in COVID-19 patients with cardiovascular disease. Published by Elsevier Inc. 2020-12 2020-07-08 /pmc/articles/PMC7340593/ /pubmed/32736197 http://dx.doi.org/10.1016/j.jcrc.2020.07.003 Text en © 2020 Published by Elsevier Inc. Since January 2020 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.
spellingShingle Article
Chen, Fang-fang
Zhong, Ming
Liu, Ya
Zhang, Yi
Zhang, Kai
Su, De-zhen
Meng, Xiao
Zhang, Yun
The characteristics and outcomes of 681 severe cases with COVID-19 in China
title The characteristics and outcomes of 681 severe cases with COVID-19 in China
title_full The characteristics and outcomes of 681 severe cases with COVID-19 in China
title_fullStr The characteristics and outcomes of 681 severe cases with COVID-19 in China
title_full_unstemmed The characteristics and outcomes of 681 severe cases with COVID-19 in China
title_short The characteristics and outcomes of 681 severe cases with COVID-19 in China
title_sort characteristics and outcomes of 681 severe cases with covid-19 in china
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340593/
https://www.ncbi.nlm.nih.gov/pubmed/32736197
http://dx.doi.org/10.1016/j.jcrc.2020.07.003
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