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COVID-19 with Different Severities: A Multicenter Study of Clinical Features.
Am J Respir Crit Care Med. 2020 06 01; 201(11):1380-1388.AJ

Abstract

Rationale:

The coronavirus disease (COVID-19) pandemic is now a global health concern.

Objectives:

We compared the clinical characteristics, laboratory examinations, computed tomography images, and treatments of patients with COVID-19 from three different cities in China.

Methods:

A total of 476 patients were recruited from January 1, 2020, to February 15, 2020, at three hospitals in Wuhan, Shanghai, and Anhui. The patients were divided into four groups according to age and into three groups (moderate, severe, and critical) according to the fifth edition of the Guidelines on the Diagnosis and Treatment of COVID-19 issued by the National Health Commission of China.

Measurements and Main Results:

The incidence of comorbidities was higher in the severe (46.3%) and critical (67.1%) groups than in the moderate group (37.8%). More patients were taking angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers in the moderate group than in the severe and critical groups. More patients had multiple lung lobe involvement and pleural effusion in the critical group than in the moderate group. More patients received antiviral agents within the first 4 days in the moderate group than in the severe group, and more patients received antibiotics and corticosteroids in the critical and severe groups. Patients >75 years old had a significantly lower survival rate than younger patients.

Conclusions:

Multiple organ dysfunction and impaired immune function were the typical characteristics of patients with severe or critical illness. There was a significant difference in the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers among patients with different severities of disease. Involvement of multiple lung lobes and pleural effusion were associated with the severity of COVID-19. Advanced age (≥75 yr) was a risk factor for mortality.

Authors+Show Affiliations

Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Infectious Disease.Department of Infectious Disease, Wuhan Jinyintan Hospital, Wuhan, China.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Critical Medicine, and.Clinical Research Center, Ruijin Hospital.Department of Respiratory and Critical Care Medicine, The Ninth People's Hospital.Department of Respiratory Diseases, Tongling People's Hospital, Anhui, China.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Traditional Chinese Medicine, and.Respiratory and Tuberculosis Department, Shanghai Public Health Clinical Center, Shanghai, China.Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, and.Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; and.Department of Respiratory and Critical Care Medicine, Ruijin North Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Chest Department, Poudre d'Or Chest Hospital, Riviere du Rempart, Mauritius.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.Department of Infectious Disease.Department of Respiratory and Critical Care Medicine. Institute of Respiratory Diseases.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32275452

Citation

Feng, Yun, et al. "COVID-19 With Different Severities: a Multicenter Study of Clinical Features." American Journal of Respiratory and Critical Care Medicine, vol. 201, no. 11, 2020, pp. 1380-1388.
Feng Y, Ling Y, Bai T, et al. COVID-19 with Different Severities: A Multicenter Study of Clinical Features. Am J Respir Crit Care Med. 2020;201(11):1380-1388.
Feng, Y., Ling, Y., Bai, T., Xie, Y., Huang, J., Li, J., Xiong, W., Yang, D., Chen, R., Lu, F., Lu, Y., Liu, X., Chen, Y., Li, X., Li, Y., Summah, H. D., Lin, H., Yan, J., Zhou, M., ... Qu, J. (2020). COVID-19 with Different Severities: A Multicenter Study of Clinical Features. American Journal of Respiratory and Critical Care Medicine, 201(11), 1380-1388. https://doi.org/10.1164/rccm.202002-0445OC
Feng Y, et al. COVID-19 With Different Severities: a Multicenter Study of Clinical Features. Am J Respir Crit Care Med. 2020 06 1;201(11):1380-1388. PubMed PMID: 32275452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 with Different Severities: A Multicenter Study of Clinical Features. AU - Feng,Yun, AU - Ling,Yun, AU - Bai,Tao, AU - Xie,Yusang, AU - Huang,Jie, AU - Li,Jian, AU - Xiong,Weining, AU - Yang,Dexiang, AU - Chen,Rong, AU - Lu,Fangying, AU - Lu,Yunfei, AU - Liu,Xuhui, AU - Chen,Yuqing, AU - Li,Xin, AU - Li,Yong, AU - Summah,Hanssa Dwarka, AU - Lin,Huihuang, AU - Yan,Jiayang, AU - Zhou,Min, AU - Lu,Hongzhou, AU - Qu,Jieming, PY - 2020/4/11/pubmed PY - 2020/6/6/medline PY - 2020/4/11/entrez KW - ACEI/ARB KW - COVID-19 KW - multiple lung lobe involvement KW - pleural effusion KW - severity SP - 1380 EP - 1388 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 201 IS - 11 N2 - Rationale: The coronavirus disease (COVID-19) pandemic is now a global health concern.Objectives: We compared the clinical characteristics, laboratory examinations, computed tomography images, and treatments of patients with COVID-19 from three different cities in China.Methods: A total of 476 patients were recruited from January 1, 2020, to February 15, 2020, at three hospitals in Wuhan, Shanghai, and Anhui. The patients were divided into four groups according to age and into three groups (moderate, severe, and critical) according to the fifth edition of the Guidelines on the Diagnosis and Treatment of COVID-19 issued by the National Health Commission of China.Measurements and Main Results: The incidence of comorbidities was higher in the severe (46.3%) and critical (67.1%) groups than in the moderate group (37.8%). More patients were taking angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers in the moderate group than in the severe and critical groups. More patients had multiple lung lobe involvement and pleural effusion in the critical group than in the moderate group. More patients received antiviral agents within the first 4 days in the moderate group than in the severe group, and more patients received antibiotics and corticosteroids in the critical and severe groups. Patients >75 years old had a significantly lower survival rate than younger patients.Conclusions: Multiple organ dysfunction and impaired immune function were the typical characteristics of patients with severe or critical illness. There was a significant difference in the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers among patients with different severities of disease. Involvement of multiple lung lobes and pleural effusion were associated with the severity of COVID-19. Advanced age (≥75 yr) was a risk factor for mortality. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/32275452/full_citation L2 - https://www.atsjournals.org/doi/10.1164/rccm.202002-0445OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -