scholarly journals Clinical Characteristics and Diagnostic Challenges of COVID−19: An Update From the Global Perspective

2021 ◽  
Vol 8 ◽  
Author(s):  
S. M. Hasan Israfil ◽  
Md. Moklesur Rahman Sarker ◽  
Parisa Tamannur Rashid ◽  
Ali Azam Talukder ◽  
Khandkar Ali Kawsar ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Case Fatality ◽  
Clinical Information ◽  
Ground Glass Opacity ◽  
Global Perspective ◽  
Global Features ◽  
Laboratory Findings

Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.

scholarly journals Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China: an integrated data analysis

2015 ◽  
Vol 144 (6) ◽  
pp. 1345-1354 ◽  
Author(s):  
C.-T. GUO ◽  
Q.-B. LU ◽  
S.-J. DING ◽  
C.-Y. HU ◽  
J.-G. HU ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Meta Analysis ◽  
Acute Infection ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Clinical Information ◽  
Laboratory Findings ◽  
Severe Fever ◽  
Elevated Lactate

SUMMARYSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was caused by a novel bunyavirus, SFTSV. The study aimed to disclose the epidemiological and clinical characteristics of SFTSV infection in China so far. An integrated clinical database comprising 1920 SFTS patients was constructed by combining first-hand clinical information collected from SFTS sentinel hospitals (n = 1159) and extracted data (n = 761) from published literature. The considered variables comprised clinical manifestations, routine laboratory tests of acute infection, hospitalization duration and disease outcome. SFTSV-IgG data from 19 119 healthy subjects were extracted from the published papers. The key clinical variables, case-fatality rate (CFR) and seroprevalence were estimated by meta-analysis. The most commonly seen clinical manifestations of SFTSV infection were fever, anorexia, myalgia, chill and lymphadenopathy. The major laboratory findings were elevated lactate dehydrogenase, aminotransferase, followed by thrombocytopenia, lymphocytopenia, elevated alanine transaminase and creatine kinase. A CFR of 12·2% was estimated, significantly higher than that obtained from national reporting data, but showing no geographical difference. In our paper, the mortality rate was about 1·9 parts per million. Older age and longer delay to hospitalization were significantly associated with fatal outcome. A pooled seroprevalence of 3·0% was obtained, which increased with age, while comparable for gender. This study represents a clinical characterization on the largest group of SFTS patients up to now. A higher than expected CFR was obtained. A wider spectrum of clinical index was suggested to be used to identify SFTSV infection, while the useful predictor for fatal outcome was found to be restricted.

scholarly journals Gejala Klinis dan Pemeriksaan Penunjang pada Neonatus Terinfeksi COVID-19

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jason Rampengan ◽  
Johnny Rompis ◽  
Valentine Umboh
Keyword(s):  
Cohort Study ◽  
Case Report ◽  
Literature Review ◽  
Observational Study ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Ground Glass Opacity ◽  
Google Scholar ◽  
Ground Glass ◽  
Laboratory Examinations

Abstract: COVID-19 is spreading at an extremely rapid rate and can affect all age groups, albeit, information about clinical symptoms and laboratory examinations of COVID-19 I in neonates is still quite limited. This study was aimed to determine the clinical symptoms, radiographic examinations especially CT-scans, and laboratory tests that could appear in neonates suffering from COVID-19. This was a literature review study using three databases, namely Pubmed, Clinical Key, and Google Scholar. The keywords used were Covid-19 / SARS-CoV-2 AND Neonatus AND sign and symptoms AND laboratory. The selection based on inclusion and exclusion criteria, obtained 15 case report studies, three retrospective studies, one observational study, and one cohort study. The review revealed that the most frequent clinical features that appeared were fever (54.8%), dyspnoea (35.4%), and cough (29%). Meanwhile, for CT-Scan radiographs, there were 14 of 31 neonates (45.2%) did not show any abnormalities or normal. The most frequent abnormal image was ground glass opacity (GGO) (29%). Among laboratory examinations, lymphopenia was the most common abnormality (32.2%). Moreover, leukocytosis, leukopenia, thrombocytopenia, increased PCT, AST, etc. could also occur. Of all the reviewed literatures, there were no death cases of neonates died due to COVID-19. In conclusion, fever, dyspnea, cough, and lymphopenia are the most common findings as well as GGO in the CT-Scan radiograph.Keywords: COVID-19, neonates Abstrak: COVID-19 menyebar dengan sangat pesat dan dapat menjangkiti semua kelompok usia namun informasi mengenai gejala klinis dan pemeriksaan laboratorium terhadap kelompok neonatus masih terbatas. Penelitian ini bertujuan untuk mengetahui gambaran klinis, pemeriksaan radiografi khususnya CT-Scan, dan pemeriksaan laboratorium yang bisa muncul pada neonatus dengan COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, Clinical Key, dan Google Scholar. Kata kunci yang digunakan yaitu Covid-19/ SARS-CoV-2 AND Neonatus AND sign and symptom AND laboratory. Hasil seleksi berdasarkan kriteria inklusi dan ekslusi mendapatkan 15 penelitian case report, tiga retrospective study, satu observational study, dan satu cohort study. Hasil kajian menunjukkan bahwa gambaran klinis yang paling sering muncul ialah demam (54,8%), sesak (35,4%), dan batuk (29%). Pemeriksaan radiografi CT-Scan, neonatus yang tidak menunjukkan kelainan (normal) terdapat pada 14 dari 31 neonatus diamati (45,2%), sedangkan kelainan yang sering muncul ialah ground glass opacity/GGO (29%). Pada pemeriksaan laboratorium, limfopenia merupakan kelainan tersering (32,2%), sedangkan leukositosis, leukopenia, trombositopenia, peningkatan PCT, AST, dll juga bisa terjadi. Dari semua literatur yang dikaji, tidak ditemukan kasus kematian neonatus akibat COVID-19. Simpulan penelitian ini ialah gambaran klinis yang paling sering muncul pada neonatus ialah demam, sesak, dan batuk, limfopenia, dan GGO pada CT-Scan.Kata kunci: COVID-19, neonatus

scholarly journals Correlations Between Epidemiological and Clinical Characteristics, Laboratory Tests and CT Scan Reports in the Diagnosis of COVID-19: A Diagnostic Accuracy Study

2021 ◽  
Author(s):  
Bobby Branson ◽  
Ramin Tavakoli ◽  
Mansoor Khaledi ◽  
Javad Fathi ◽  
Seyed Mohammad Shafiee ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Information ◽  
Pulmonary Involvement ◽  
Medical Sciences ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Quantitative Score ◽  
Accuracy Study ◽  
Hospital Comparison ◽  
The Relationship

Although the relationship between laboratory parameters, radiology, CT scan scan and clinical outcomes has not been well evaluated so far, COVID-19 is still a good challenge for this purpose. These tests can be used to diagnose, monitor, and treat COVID-19. The study was conducted from February 20 to August 31, 2020, following the referral of 340 patients with coronavirus symptoms at Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Clinical information of each patient is obtained based on patient information forms when visiting the hospital. Comparison of the relationship between lung involvement in CT scan and laboratory indicators, including biochemical and hematological factors is a suitable and reliable comparison to identify people with Covid 19. Based on the results of this study, it was found that ALT, AST, CRP, NEU, LDH, and Urea could be a suitable diagnostic method in positive RT-PCR for COVID-19. In this study, we tried to investigate the relationship between clinical and laboratory findings with CT-based quantitative score of pulmonary involvement in COVID-19 pneumonia and as a suitable and reliable method in continuing COVID-19 pandemic and diagnosis of COVID-19 infection.

scholarly journals Correct identification of incomplete Kawasaki disease

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110017
Author(s):  
Tianhua Li ◽  
Jie Feng ◽  
Na Li ◽  
Tingting Liu
Keyword(s):  
Kawasaki Disease ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Age Of Onset ◽  
Correct Diagnosis ◽  
Correct Identification ◽  
Incomplete Kawasaki Disease ◽  
Younger Age ◽  
Artery Disease ◽  
Timely Treatment

Incomplete Kawasaki disease (IKD) is characterized by a longer fever time, younger age of onset, and higher incidence of coronary artery disease compared with complete Kawasaki disease. Kawasaki disease is often difficult to diagnose early because of its incomplete clinical symptoms. This issue could delay treatment and harm the health of the child. This article reviews the clinical characteristics and pathogenesis of IKD to help clinicians understand the symptoms of IKD, make the correct diagnosis, and provide timely treatment.

scholarly journals Variety of radiological findings in a family with COVID-19: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Farideh Gharekhanloo ◽  
Iraj Sedighi ◽  
Salman Khazaei
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Pediatric Population ◽  
Case Series ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Imaging Features ◽  
Standard Regimen ◽  
Asymptomatic Children

Abstract Introduction In December 2019, a case series of pneumonia associated with seafood and wet animal market was reported as coronavirus disease 2019 (COVID-19) in Wuhan, Hubei, China. The COVID-19 less frequently affects the pediatric group, and asymptomatic children are commonly reported. This feature is important due to the potential transmissibility of COVID-19 through these cases. There is a variety of atypical clinical symptoms and imaging manifestations among children infected with COVID-19. Case presentation We report two sisters with COVID-19 pneumonia who had close contact with their 77-year-old grandmother. Their grandmother expired with a confirmed diagnosis of COVID-19. The older sister (15 years old) firstly presented with severe cough, fever, dyspnea, diarrhea, and lymphopenia. A chest computed tomography (CT) scan showed atypical lobar pneumonic infiltration only in the left lower lobe. The younger sister (6 years old) was affected the following day with milder symptoms (i.e., fever and cough). Her chest CT scan demonstrated typical mild generalized patchy ground-glass opacity with interlobular septal thickening scattered in both lungs. The CT presentation of their grandmother showed typical bilateral white lungs with crazy paving appearance. The standard regimen for both sisters was administrated, and the patients’ respiratory conditions improved after 5 days of treatment. Both cases were discharged with good general conditions. Conclusion Children are considered potentially important causes of COVID-19 transmission. The symptoms in children are milder, and clinicians should be aware of taking a definite history of infected family members. Atypical clinical symptoms and imaging features are more common in children than adults; therefore, it is necessary to identify the typical and atypical imaging patterns of COVID-19 pneumonia in the pediatric population.

scholarly journals Clinical Characteristics of Coronavirus Disease 2019 (COVID-19): An Updated Systematic Review

2020 ◽  
Author(s):  
Zhangfu Fang ◽  
Fang Yi ◽  
Kang Wu ◽  
Kefang Lai ◽  
Xizhuo Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Admission Rate ◽  
Final Analysis ◽  
Common Symptom ◽  
Laboratory Findings ◽  
Large Patient ◽  
Unbiased Manner ◽  
Novel Coronavirus

AbstractOBJECTIVEClinical characteristics of novel coronavirus disease (COVID-19) have been described in numerous studies but yielded varying results. We aimed to conduct a systematic review on scientific literatures and to synthesize critical data on clinical traits of COVID-19 from its initial outbreak to pandemic.METHODSSystematic searches were conducted to identify retrospective observational study that contained clinical characteristics on COVID-19 through multiple databases. Two reviewers independently evaluated eligible publications. Data on clinical characteristics of COVID-19 were extracted and analyzed.RESULTSSeventy-two retrospective studies demonstrating the clinical characteristics of COVID-19 were included. A total of 3470 COVID-19 patients were synthesized to the final analysis in an unbiased manner. The most common symptom was fever (2878 [83.0%]), and 63.4% of the patients presented fever as onset symptom. There were 2528 [88.2%] of 2866 cases had abnormal lung findings on chest CT scan. Laboratory findings showed that 1498 [62.8%] of 2387 cases had lymphopenia, and 1354 [64.8%] of 2091 cases had an increased level of C-reactive protein (CRP). A total of 185 [11.5%] patients were admitted to intensive care unit (ICU) while the overall case fatality rate (CFR) was 3.7%. Compared to patients admitted outside of Hubei, China, those from Hubei had a significant higher ICU admission rate (21.9% vs. 2.5%, p<0.001). Also, CFR attributed to COVID-19 was significantly higher in Hubei than that of non-Hubei admissions (10.4% vs. 0.6%, p<0.001).INTERPRETATIONThis large patient-based systematic review presents a more precise profiling of the COVID-19 from its outbreak to current pandemic. Dynamic evolvements of COVID-19 are needed to be characterized in future studies.

scholarly journals Clinical Characteristics Analysis of the “Re-positive” Discharged COVID-19 Pneumonia Patients in Wuhan, China

2020 ◽  
Author(s):  
Shengyang He ◽  
Wenwu Sun ◽  
Kefu Zhou ◽  
Mengyun Hu ◽  
Chun Liu ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Chest Ct ◽  
Apache Ii ◽  
Laboratory Results ◽  
Characteristics Analysis ◽  
Positive Rate ◽  
Chest Ct Scan ◽  
Demographic Features

Abstract Background: To analyze the clinical characteristics of the re-positive discharged COVID-19 patients and find markers to distinguish them.Methods：The demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, illness severities and chest CT scan results of 267 patients were collected during 1st January and 15th February 2020. COVID-19 was diagnosed by RT-PCR. The subsequent clinical symptoms and nucleic acid test results was obtained during the 14 days post-hospitalization quarantine.Results: 30 out of 267 COVID-19 patients were detected re-positive during the post-hospitalization quarantine. Re-positive patients couldn’t be distinguished by demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, chest CT scan results or subsequent clinical symptoms. However, the re-positive rate were found illness severity correlated, along with APACHE II and CURB-65.Conclusion: Common clinical characteristics arn’t able to distinguish re-positive patients. However, severe and critical cases with high APACHE II and CURB-65 scores are more likely to turn re-positive after discharge.Authors Shengyang He, Wenwu Sun, Kefu Zhou contributed equally to this work.

scholarly journals Neurocysticercosis in Children with Seizures: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Murli Manohar Gupta ◽  
Nagendra Chaudhary ◽  
Santosh Pathak ◽  
Nikhil Agrawal ◽  
Jaydev Yadav ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Focal Seizures ◽  
Magnetic Resonance Imaging Mri ◽  
Considerable Morbidity

Background. Neurocysticercosis (NCC), a common cause of seizures in children from low and middle income countries (LMICs), if not diagnosed and treated early enough may lead to considerable morbidity and mortality. There is a lack of data on the prevalence of NCC and its clinical characteristics among those with seizure in South-Western Nepal. Aims and Objectives. To study the prevalence and clinical characteristics of NCC in children with seizures. Material and Methods. All children admitted to Universal College of Medical Sciences, a tertiary hospital in South-Western Nepal with seizures during 2014–16, were tested for NCC. NCC was diagnosed by neuroimaging [computerized tomography (CT) scan or magnetic resonance imaging (MRI)]. We used logistic regression to test the association between NCC with participants’ characteristics and clinical symptoms. Results. Among 4962 in-patient children, 168 (104 boys and 64 girls) had seizures (138 with generalized tonic clonic seizures (GTCS) and 30 with focal seizures). 43% of children with seizures had CT scan confirmed NCC. The prevalence of NCC in the oldest children (13–16 years) was significantly greater (57.1% versus 15.6%) compared to the youngest (0–4 years) one (p<0.001). Among 72 children with NCC, the proportions of children with vesicular, calcified, and colloidal stages were 76% (n=35), 18% (n=13), and 6% (n=2), respectively. Children with focal seizures had 13% more NCC compared to those with GTCS but the result was statistically not significant. The adjusted odds of having NCC among 5–8 years, 9–12 years, and 13–16 years children were 6.6 (1.78–24.60), 11.06 (2.74–44.60), and 14.47 (3.13–66.96), respectively, compared to 0–4-year-old children. Reoccurrence of seizures within the first 3 months of taking antiepileptic drug in those with NCC was approximately 3 times higher compared to those without NCC (11% versus 4%, p=0.084). Conclusions. This study shows that NCC contributes significantly to higher prevalence of seizures in children in South-Western region of Nepal.

scholarly journals Epidemiological and clinical based study on four passages of COVID-19 patients: intervention at asymptomatic period contributes to early recovery

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaohong Zhang ◽  
Hailian Wang ◽  
Youwei Wang ◽  
Yu Lei ◽  
Kaiju Xu ◽  
...  
Keyword(s):  
Early Intervention ◽  
Clinical Characteristics ◽  
Oxygen Therapy ◽  
Antiviral Treatment ◽  
Virus Transmission ◽  
Case Fatality ◽  
Ground Glass Opacity ◽  
Typical Feature ◽  
Early Recovery ◽  
Protein Levels

Abstract Background With the worldwide spread of the 2019 novel coronavirus, scarce knowledge is available on the clinical features of more than two passages of patients. Further, in China, early intervention policy has been enacted since February. Whether early intervention contributes to swift recovery is still unknown. Hence, in this study, we focused on the patients from an isolated area, investigated the epidemiological and clinical characteristics of four serial passages of the virus. Methods From January 25 to February 29, 2020, all patient data on the SARS-CoV-2 passages in this isolated area were traced, and the patients were grouped according to the passaging of SARS-CoV-2. Clinical characteristics of patients, including laboratory, radiology, treatment and outcomes, were collected and analyzed. Results A total of 78 patients with four passages of virus transmission were included in this study. One patient transmitted SARS-CoV-2 to 8 patients (passage 2, P2), who next infected 23 patients (passage 3, P3), and then 46 patients (passage 4, P4). P2 received antiviral treatment when they had symptom, whereas P4 received antiviral treatment during their asymptomatic period. The incubation periods for P2, P3 and P4 patients were 7 days (IQR:2–12), 8 days (IQR:4–13) and 10 days (IQR:7–15), respectively. P2 patients showed lymphocytopenia (0.79 × 109/L), decreased lymphocyte percentages (12.15%), increased white blood cell count (6.51 × 109/L), increased total bilirubin levels (25% of P2 patients), increased C-reactive protein levels (100% of P2 patients) and abnormal liver function. By chest CT scans, all P2 patients (100%), 15 of P3 patients (65.22%) and 16 of P4 patients (34.78%) showed abnormality with typical feature of ground glass opacity. All of P2 patients (100%) received oxygen therapy, and in contrast, 19 of P4 patients (41.3%) received oxygen therapy. Further, significant decreased nucleic acid positive periods was found in P4 group (16 days, IQR: 10–23), compared with that of P2 group (22 days, IQR: 16–27). Moreover, the severity ratios were sharply decreased from 50% (P2 patients) to 4.35% (P4 patients), and the case fatality rate is zero. Conclusions Judged from four passages of patients, early intervention contributes to the early recovery of COVID-19 patients.

scholarly journals Clinical Presentation and Outcomes of Pregnant Women With Coronavirus Disease 2019: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Reem Matar ◽  
Layan Alrahmani ◽  
Nasser Monzer ◽  
Labib G Debiane ◽  
Elie Berbari ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Adult Population ◽  
Radiological Finding ◽  
Perinatal Outcomes ◽  
Ground Glass Opacity ◽  
Laboratory Findings

Abstract Background Descriptions of coronavirus disease 2019 (COVID-19) have focused on the nonpregnant adult population. This study aims to describe the clinical characteristics and perinatal outcomes of COVID-19 in pregnancy. Methods We searched databases from December 2019 to 30 April 2020. Eligible studies reported clinical characteristics, radiological findings, and/or laboratory testing of pregnant women during infection. Data were pooled across studies using a random-effects model. Results Twenty-four studies (136 women) were included. The most common symptoms were fever (62.9%) and cough (36.8%). Laboratory findings included elevated C-reactive protein (57%) and lymphocytopenia (50%). Ground-glass opacity was the most common radiological finding (81.7%). Preterm birth rate was 37.7% and cesarean delivery rate was 76%. There was 1 maternal death. There were 2 fetal COVID-19 cases. Conclusions The clinical picture in pregnant women with COVID-19 did not differ from the nonpregnant population; however, the rate of preterm birth and cesarean delivery are considerably higher than international averages.

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