Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area.
Clinical Characteristics and Outcome of Hospitalized COVID-19 Patients in a MERS-CoV Endemic Area.
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DOI：
10.2991/jegh.k.200806.002
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发表时间：
2020-09
影响因子：
7.3
通讯作者：
Memish ZA
中科院分区：
文献类型：
--
作者：
Barry M;AlMohaya A;AlHijji A;Akkielah L;AlRajhi A;Almajid F;Alsharidi A;Al-Shahrani FS;Alotaibi NH;Alanazi A;Ghonem L;Alhetheel A;Alsubaie S;Memish ZA
背景：自2020年3月2日至6月25日沙特阿拉伯王国出现首例COVID-19病例以来，该国报告了170,639例病例和1430例死亡。本报告的目的是描述在沙特阿拉伯最大的学术医院住院的99例COVID-19患者的特征和观察结果，并评估合并感染中东呼吸综合征冠状病毒（MERS-CoV）。方法：本单中心病例系列数据包括2020年3月22日至2020年5月31日，至2020年6月6日，沙特阿拉伯利雅得沙特国王大学医学城（KSUMC）所有确诊住院病例的流行病学、临床、放射学特征和实验室结果。我们对99名住院患者的资料进行了回顾性分析，并以百分比和单变量优势比给出了与严重程度相关的特征和因素。采用实时逆转录聚合酶链反应（RT-PCR）检测严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）， RT-PCR检测中东呼吸综合征冠状病毒。结果：本分析纳入的99例住院患者占在KSUMC检测的6633人中632例阳性SARS-CoV-2的16%（阳性率为9.4%）。所有99例检测患者的MERS-CoV PCR均为阴性。这99名住院患者中的大多数是男性（66%），平均年龄为44岁（范围19-87岁），四分之一（25.3%）是卫生保健工作者。有合并症的患者占52.5%，其中8.1%为无症状；最常见的是糖尿病（31.3%），其次是高血压（22.2%）。最常见的症状为发热（67.7%）、咳嗽（60.6%）、呼吸困难（43.4%）、上呼吸道症状（27.3%）、疲劳（26.3%）、腹泻（19.2%）和嗅觉丧失（9.1%）。99例患者的临床情况包括上呼吸道感染（47.5%）、胸片异常、淋巴细胞减少、高炎症标志物，五分之一（21%）的患者为中度肺炎，7%的患者为重度肺炎，22.2%的患者需要入院重症监护，12.1%的患者死亡。晚期出现严重疾病、胸部x线异常、淋巴细胞减少、高炎症标志物（c反应蛋白、铁蛋白和降钙素原）和终末器官损伤（高肌酐或高天冬氨酸转氨酶）是进入重症监护病房或死亡的预测因素。结论：我们在这组相对年轻的住院COVID-19患者早期队列中未观察到MERS-CoV合并感染，超过一半的患者有合并症，表现为发烧和/或咳嗽，胸部x线异常，淋巴细胞减少和高炎症标志物。鉴于中东呼吸综合征冠状病毒在该国的流行，对中东呼吸综合征冠状病毒和sars冠状病毒-2合并感染进行联合监测至关重要。
Background: The Kingdom of Saudi Arabia (KSA) reported 170,639 cases and 1430 deaths from COVID-19 since the first case emerged in the country on March 2 through June 25, 2020. The objective of this report is to describe the characteristics and outcome observed among 99 hospitalized COVID-19 patients in the largest academic hospital in KSA, and assess co-infection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Methods: This single-center case series data included select epidemiological, clinical, radiological features and laboratory findings of all confirmed hospitalized cases of COVID-19 in King Saud University Medical City (KSUMC), Riyadh, KSA, from March 22 until May 31, 2020, followed through June 6, 2020. We conducted retrospective analysis of listed data from 99 hospitalized patients and present characteristics and factors associated with severity in percentages and univariate odds ratios. Cases were confirmed using nasopharyngeal or throat swab by real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and MERS-CoV by RT-PCR. Results: The 99 hospitalized COVID-19 patients included in this analysis constitute 16% of 632 positive SARS-CoV-2 among 6633 persons who were tested at the KSUMC (positivity rate, 9.4%). MERS-CoV PCR was negative in all 99 patients tested. The majority of these 99 hospitalized patients were males (66%), had a mean age of 44 years (range, 19–87), and a quarter (25.3%) were health care workers. Patients with comorbid conditions accounted for 52.5% of patients including the 8.1% who were asymptomatic; diabetes mellitus being the most frequent (31.3%), followed by hypertension (22.2%). The most common presenting symptoms were fever (67.7%), cough (60.6%), dyspnea (43.4%), upper respiratory symptoms (27.3%), fatigue (26.3%), diarrhea (19.2%) and loss of smell (9.1%). The clinical conditions among these 99 patients included upper respiratory tract infection (47.5%), abnormal chest X-ray, lymphopenia, high inflammatory markers a fifth (21%) of patients had moderate pneumonia, while 7% had severe pneumonia with 22.2% requiring admission to the intensive care unit and 12.1% died. Late presentation with severe disease, an abnormal chest X-ray, lymphopenia, high inflammatory markers (C-reactive protein, ferritin, and procalcitonin), and end organ damage (high creatinine or high aspartate aminotransferase) were predictors for admission to critical care unit or died. Conclusion: We observed no MERS-CoV co-infection in this early cohort of hospitalized COVID-19 patients who were relatively young, more than half had comorbid conditions, presented with fever and/or cough, an abnormal chest X-ray, lymphopenia, and high inflammatory markers. Given MERS-CoV endemicity in the country, co-monitoring of MERS-CoV and SARS-CoV-2 coinfection is critical.
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影响因子：
39
作者：
Wu, Chaomin;Chen, Xiaoyan;Song, Yuanlin
通讯作者：
Song, Yuanlin
影响因子：
11.1
作者：
Lechien, Jerome R.;Chiesa-Estomba, Carlos M.;Saussez, Sven
通讯作者：
Saussez, Sven
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
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作者：
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通讯作者：
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影响因子：
105.7
作者：
Docherty, Annemarie B.;Harrison, Ewen M.;Semple, Malcolm G.
通讯作者：
Semple, Malcolm G.
影响因子：
11.8
作者：
Yao, Xueting;Ye, Fei;Liu, Dongyang
通讯作者：
Liu, Dongyang