10 results on '"Qingquan Lv"'
Search Results
2. Severity of COVID-19 in Cancer patients versus patients without Cancer: A Propensity Score Matching Analysis
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Qingquan Lv, Luyuan Li, Kai Wang, Bing Sun, Yumei Liu, Chao Liu, Tian Hu, Qinyong Hu, and Jonathan C. Trent
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medicine.medical_specialty ,Leukopenia ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Cancer ,medicine.disease ,Procalcitonin ,chemistry.chemical_compound ,Oncology ,chemistry ,Lactate dehydrogenase ,Internal medicine ,Cohort ,Propensity score matching ,medicine ,medicine.symptom ,business ,Blood urea nitrogen - Abstract
Purpose: Data are extremely limited with regards to the impact of COVID-19 on cancer patients. Our study explored the distinct clinical features of COVID-19 patients with cancer. Experimental Design: 189 COVID-19 patients, including 16 cancer patients and 173 patients without cancer, were recruited. Propensity score 1:4 matching (PSM) was performed between cancer patients and patients without cancer based on age, gender and comorbidities. Survival was calculated by the Kaplan-Meier method and the difference was compared by the log-rank test. Results: PSM analysis yielded 16 cancer patients and 64 propensity score-matched patients without cancer. Compared to patients without cancer, cancer patients tended to have leukopenia and elevated high-sensitivity C-reactive protein (hs-CRP) and procalcitonin. For those with critical COVID-19, cancer patients had an inferior survival than those without cancer. Also, cancer patients with severe/critical COVID-19 tended to be male and present with low SPO2 and albumin, and high hs-CRP, lactate dehydrogenase and blood urea nitrogen on admission compared to those with mild COVID-19. In terms of risk factors, recent cancer diagnosis (within 1 year of onset of COVID-19) and anti-tumor treatment within 3 months of COVID-19 diagnosis were associated with inferior survival. Conclusions: We found COVID-19 patients with cancer have distinct clinical features as compared to patients without cancer. Importantly, cancer patients with critical COVID-19 were found to have poorer outcomes compared to those without cancer. In the cancer cohort, patients with severe/critical COVID-19 presented with a distinct clinical profile from those with mild COVID-19; short cancer history and recent anti-cancer treatment were associated with inferior survival.
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- 2020
3. Systemic corticosteroids and mortality in severe and critical COVID-19 patients in Wuhan, China
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Sui Peng, Yanbing Li, Jianfeng Wu, Ying Huang, Xin Liu, Jianqiang Huang, Krishnarajah Nirantharakumar, Cuiping Wang, Qiongya Wang, Qian Zhou, Shuling Chen, Guochao Zhu, Yang Yu, Kar Keung Cheng, Han Xiao, Yihao Liu, Zelong Liu, Xiang Si, Haipeng Xiao, Daya Yang, Hui Yi, Qingquan Lv, and Xiangdong Guan
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Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Pneumonia, Viral ,Biochemistry ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Endocrinology ,Adrenal Cortex Hormones ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Medical prescription ,Pandemics ,severe and critical ,Aged ,Retrospective Studies ,Clinical Research Article ,business.industry ,Proportional hazards model ,SARS-CoV-2 ,Biochemistry (medical) ,COVID-19 ,030208 emergency & critical care medicine ,Middle Aged ,Prognosis ,mortality ,Clinical trial ,Hospitalization ,Survival Rate ,Propensity score matching ,Corticosteroid ,Corticosteroid use ,Observational study ,Female ,Systemic corticosteroids ,business ,Coronavirus Infections ,AcademicSubjects/MED00250 - Abstract
Background Systemic corticosteroids are now recommended in many treatment guidelines, although supporting evidence is limited to 1 randomized controlled clinical trial (RECOVERY). Objective To identify whether corticosteroids were beneficial to COVID-19 patients. Methods A total of 1514 severe and 249 critical hospitalized COVID-19 patients from 2 medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting [IPTW] and propensity score matching [PSM]) were used to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases. Results Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to the non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in either severe cases (HR = 1.77; 95% CI, 1.08-2.89; P = 0.023), or critical cases (HR = 2.07; 95% CI, 1.08–3.98; P = 0.028). Findings were similar in time-varying Cox analysis. For patients with severe COVID-19 at admission, corticosteroid use was not associated with improved or harmful outcome in either PSM or IPTW analysis. For critical COVID-19 patients at admission, results were consistent with multivariable Cox model analysis. Conclusion Corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality for severe or critical cases in Wuhan. Absence of the beneficial effect in our study in contrast to that observed in the RECOVERY clinical trial may be due to biases in observational data, in particular prescription by indication bias, differences in clinical characteristics of patients, choice of corticosteroid used, timing of initiation of treatment, and duration of treatment.
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- 2020
4. The utility of MEWS for predicting the mortality in the elderly adults with COVID-19: a retrospective cohort study with comparison to other predictive clinical scores
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Chaoxing Xiao, Qingquan Lv, Binyan Jiang, Xiaofei Zhang, Lei Chen, Chunhua Yang, Xinyang Yu, Lichun Wang, and Enhe Liu
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medicine.medical_specialty ,Emergency and Critical Care ,Pneumonia severity index ,Population ,lcsh:Medicine ,Modified early warning score ,Logistic regression ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Virology ,medicine ,030212 general & internal medicine ,education ,Respiratory Medicine ,Outcome ,education.field_of_study ,Receiver operating characteristic ,APACHE II ,business.industry ,General Neuroscience ,lcsh:R ,COVID-19 ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Early warning score ,Mews ,Infectious Diseases ,Geriatrics ,Older adults ,General Agricultural and Biological Sciences ,business - Abstract
Background Older adults have been reported to be a population with high-risk of death in the COVID-19 outbreak. Rapid detection of high-risk patients is crucial to reduce mortality in this population. The aim of this study was to evaluate the prognositc accuracy of the Modified Early Warning Score (MEWS) for in-hospital mortality in older adults with COVID-19. Methods A retrospective cohort study was conducted in Wuhan Hankou Hospital in China from 1 January 2020 to 29 February 2020. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive value of MEWS, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Function Assessment (SOFA), quick Sequential Organ Function Assessment (qSOFA), Pneumonia Severity Index (PSI), Combination of Confusion, Urea, Respiratory Rate, Blood Pressure, and Age ≥65 (CURB-65), and the Systemic Inflammatory Response Syndrome Criteria (SIRS) for in-hospital mortality. Logistic regression models were performed to detect the high-risk older adults with COVID-19. Results Among the 235 patients included in this study, 37 (15.74%) died and 131 (55.74%) were male, with an average age of 70.61 years (SD 8.02). ROC analysis suggested that the capacity of MEWS in predicting in-hospital mortality was as good as the APACHE II, SOFA, PSI and qSOFA (Difference in AUROC: MEWS vs. APACHE II, −0.025 (95% CI [−0.075 to 0.026]); MEWS vs. SOFA, −0.013 (95% CI [−0.049 to 0.024]); MEWS vs. PSI, −0.015 (95% CI [−0.065 to 0.035]); MEWS vs. qSOFA, 0.024 (95% CI [−0.029 to 0.076]), all P > 0.05), but was significantly higher than SIRS and CURB-65 (Difference in AUROC: MEWS vs. SIRS, 0.218 (95% CI [0.156–0.279]); MEWS vs. CURB-65, 0.064 (95% CI [0.002–0.125]), all P < 0.05). Logistic regression models implied that the male patients (≥75 years) had higher risk of death than the other older adults (estimated coefficients: 1.16, P = 0.044). Our analysis further suggests that the cut-off points of the MEWS score for the male patients (≥75 years) subpopulation and the other elderly patients should be 2.5 and 3.5, respectively. Conclusions MEWS is an efficient tool for rapid assessment of elderly COVID-19 patients. MEWS has promising performance in predicting in-hospital mortality and identifying the high-risk group in elderly patients with COVID-19.
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- 2020
5. Progression, recovery and fatality in patients with SARS-CoV-2 related pneumonia in Wuhan, China: a single-centered, retrospective, observational study
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Xiping Wu, Tian Hu, Qingquan Lv, Zheng Ba, Yumei Liu, Kai Wang, Yuhai Hu, Xiaohua Lin, Lan Yu, Hexuan Fei, Hua Wang, and Yirong Lu
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medicine.medical_specialty ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Comorbidity ,Hypoxemia ,Pneumonia ,Internal medicine ,Case fatality rate ,medicine ,In patient ,medicine.symptom ,business - Abstract
Objectives To determine the case fatality rates and death risk factors. Design Retrospective case series. Setting A COVID-19 ward of a secondary Hospital in Wuhan, China. Participants Consecutively hospitalized COVID-19 patients between Jan 3, 2020 and Feb 27, 2020. Outcomes were followed up to discharge or death. Results Of 121 patients included, 66 (54.6%) were males. The median age was 59 (IQR: 46 to 67) years, and hypertension (33 patients; 27.3%) the leading comorbidity. Lymphopenia (83 of 115 patients; 72.2%) frequently occurred and then normalized on day 4 (IQR: 3 to 6) after admission in the survivors, with lung lesion absorbed gradually on day 8 (IQR: 6 to10) after onset (33 of 57 patients; 57.9%). The real-time polymerase chain reaction (RT-PCR) assays for SARS-CoV-2 were positive in 78 (78/108; 72.2%) patients, and a false-negative RT-PCR occurred in 15 (13.9%) patients. Hypoxemia occurred in 94 (94/117; 80.3%) patients, and supplemental oxygen was given in 88 (72.7%) patients, and mon-invasive or invasive ventilation in 20 (16.5%) cases. Corticosteroid use might link to death. The case fatality rates were 4.4% (one of 23 patients), 29.3% (12/41), 22.8% (13/57) or 45% (9/20) for patients with moderate, severe, critical illness or on ventilator. The length of hospital stay was 14 (IQR: 10 to 20) days, and selfcare ability worsened in 21 patients (21/66; 31.8%) cases. Patients over 60 years were most likely to have poorer outcomes, and increasing in age by one-year increased risk for death by 18% (CI: 1.04-1.32). Conclusions In management of patients with SARS-CoV-2 pneumonia, especially the elderly with hypertension, close monitoring and appropriate supportive treatment should be taken earlier and aggressively to prevent from developing severe or critical illness. Corticosteroid use might link to death. Repeated RT-PCR tests or novel detection methods for SARS-CoV-2 should be adopted to improve diagnostic efficiency. Strengths and limitations of this study ➢Eight case series reported mortality of 6.2% to 61.5% in COVID-19 patients in Wuhan, China. However, outcomes were inadequately followed and the risk factors for death unrevealed. ➢The case fatality rates were 4.4%, 29.3%, 22.8% or 45% for patients with moderate, severe, critical illness or on ventilator. ➢Age was the independent factor for death, and an increase by one-year increased risk for death by 18% (odds ratio: 1.18; 95% CI: 1.04-1.32; P ➢Case fatality rates calculated might be affected by small patient subset size and non-prospective data collection.
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- 2020
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6. Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: A retrospective cohort study
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Hui Yi, Yihao Liu, Krishnarajah Nirantharakumar, Ying Huang, Xin Liu, Cuiping Wang, Qiongya Wang, Jianqiang Huang, Daya Yang, Qian Zhou, Yanbing Li, Zelong Liu, Jianfeng Wu, Haipeng Xiao, Xiang Si, Han Xiao, Shuling Chen, Sui Peng, Xiangdong Guan, Qingquan Lv, Guochao Zhu, Yang Yu, and Kar Keung Cheng
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education.field_of_study ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Proportional hazards model ,Population ,Retrospective cohort study ,Internal medicine ,Baseline characteristics ,Propensity score matching ,Medicine ,Corticosteroid use ,business ,education - Abstract
Background: Systemic corticosteroids are recommended by some treatment guidelines and used in severe and critical COVID-19 patients, though evidence supporting such use is limited. Methods: From December 26, 2019 to March 15, 2020, 1514 severe and 249 critical hospitalized COVID-19 patients were collected from two medical centers in Wuhan, China. We performed multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (both inverse-probability-of-treatment-weighting (IPTW) and propensity score matching (PSM)) to estimate the association of corticosteroid use with the risk of in-hospital mortality among severe and critical cases. Results: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to no corticosteroid use group, systemic corticosteroid use showed no benefit in reducing in-hospital mortality in both severe cases (HR=1.77, 95% CI: 1.08-2.89, p=0.023), and critical cases (HR=2.07, 95% CI: 1.08-3.98, p=0.028). In the time-varying Cox analysis that with time varying exposure, systemic corticosteroid use still showed no benefit in either population (for severe patients, HR=2.83, 95% CI: 1.72-4.64, p< 0.001; for critical patients, HR=3.02, 95% CI: 1.59-5.73, p=0.001). Baseline characteristics were matched after IPTW and PSM analysis. For severe COVID-19 patients at admission, corticosteroid use was not associated with improved outcome in either the IPTW analysis. For critical COVID-19 patients at admission, results were consistent with former analysis that corticosteroid use did not reduce in-hospital mortality. Conclusions: Corticosteroid use showed no benefit in reducing in-hospital mortality for severe or critical cases. The routine use of systemic corticosteroids among severe and critical COVID-19 patients was not recommended.
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- 2020
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7. Elevation of blood glucose level predicts worse outcomes in hospitalized patients with COVID-19: a retrospective cohort study
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Yanbing Li, Ying Huang, Sui Peng, Xin Liu, Jianqiang Huang, Haipeng Xiao, Guochao Zhu, Yang Yu, Qian Zhou, Hui Yi, Yihao Liu, Xiangdong Guan, Cuiping Wang, Qiongya Wang, Han Xiao, Daya Yang, Xiang Si, Jianfeng Wu, Qingquan Lv, and Joseph J.Y. Sung
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Research design ,Blood Glucose ,Male ,Hospitalized patients ,Endocrinology, Diabetes and Metabolism ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Risk Factors ,Hospital Mortality ,infections ,Middle Aged ,Prognosis ,Hospitalization ,Treatment Outcome ,Disease Progression ,Female ,Coronavirus Infections ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Critical Illness ,Pneumonia, Viral ,030209 endocrinology & metabolism ,Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,Betacoronavirus ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,In patient ,Risk factor ,Epidemiology/Health Services Research ,Pandemics ,Aged ,Retrospective Studies ,Inpatients ,Proportional hazards model ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Length of Stay ,clinical study ,medicine.disease ,RC648-665 ,Hyperglycemia ,business ,Follow-Up Studies - Abstract
IntroductionWith intense deficiency of medical resources during COVID-19 pandemic, risk stratification is of strategic importance. Blood glucose level is an important risk factor for the prognosis of infection and critically ill patients. We aimed to investigate the prognostic value of blood glucose level in patients with COVID-19.Research design and methodsWe collected clinical and survival information of 2041 consecutive hospitalized patients with COVID-19 from two medical centers in Wuhan. Patients without available blood glucose level were excluded. We performed multivariable Cox regression to calculate HRs of blood glucose-associated indexes for the risk of progression to critical cases/mortality among non-critical cases, as well as in-hospital mortality in critical cases. Sensitivity analysis were conducted in patient without diabetes.ResultsElevation of admission blood glucose level was an independent risk factor for progression to critical cases/death among non-critical cases (HR=1.30, 95% CI 1.03 to 1.63, p=0.026). Elevation of initial blood glucose level of critical diagnosis was an independent risk factor for in-hospital mortality in critical cases (HR=1.84, 95% CI 1.14 to 2.98, p=0.013). Higher median glucose level during hospital stay or after critical diagnosis (≥6.1 mmol/L) was independently associated with increased risks of progression to critical cases/death among non-critical cases, as well as in-hospital mortality in critical cases. Above results were consistent in the sensitivity analysis in patients without diabetes.ConclusionsElevation of blood glucose level predicted worse outcomes in hospitalized patients with COVID-19. Our findings may provide a simple and practical way to risk stratify COVID-19 inpatients for hierarchical management, particularly where medical resources are in severe shortage during the pandemic.
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- 2020
8. ACP risk grade: a simple mortality index for patients with confirmed or suspected severe acute respiratory syndrome coronavirus 2 disease (COVID-19) during the early stage of outbreak in Wuhan, China
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Hongping Hu, Xueru Yin, Zhihong Liu, Zhifang Cai, Yuhai Hu, Jinlin Hou, Hui Li, Jie Peng, Jian Sun, Ying Han, Shufang Hu, Zixiao Zhou, Rong Fan, Qiongya Wang, Yabing Guo, Shibo Feng, Qiongfang Liu, Qingquan Lv, Jiatao Lu, Wenyong Gao, Haijun Li, and Xuefeng Yi
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medicine.medical_specialty ,business.industry ,Outbreak ,Disease ,medicine.disease_cause ,medicine.disease ,Pneumonia ,Interquartile range ,Internal medicine ,Radiological weapon ,medicine ,Stage (cooking) ,business ,Coronavirus ,Cohort study - Abstract
BackgroundSince the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) outbreaks in Wuhan, China, healthcare systems capacities in highly endemic areas have been overwhelmed. Approaches to efficient management are urgently needed and key to a quicker control of the outbreaks and casualties. We aimed to characterize the clinical features of hospitalized patients with confirmed or suspected COVID-19, and develop a mortality risk index for COVID-19 patients.MethodsIn this retrospective one-centre cohort study, we included all the confirmed or suspected COVID-19 patients hospitalized in a COVID-19-designated hospital from January 21 to February 5, 2020. Demographic, clinical, laboratory, radiological and clinical outcome data were collected from the hospital information system, nursing records and laboratory reports.ResultsOf 577 patients with at least one post-admission evaluation, the median age was 55 years (interquartile range [IQR], 39 - 66); 254 (44.0%) were men; 22.8% (100/438) were severe pneumonia on admission, and 37.7% (75/199) patients were SARS-CoV-2 positive. The clinical, laboratory and radiological data were comparable between positive and negative SARS-CoV-2 patients. During a median follow-up of 8.4 days (IQR, 5.8 - 12.0), 39 patients died with a 12-day cumulative mortality of 8.7% (95% CI, 5.9% to 11.5%). A simple mortality risk index (called ACP index), composed of Age and C-reactive Protein, was developed. By applying the ACP index, patients were categorized into three grades. The 12-day cumulative mortality in grade three (age ≥ 60 years and CRP ≥ 34 mg/L) was 33.2% (95% CI, 19.8% to 44.3%), which was significantly higher than those of grade two (age ≥ 60 years and CRP < 34 mg/L; age < 60 years and CRP ≥ 34 mg/L; 5.6% [95% CI, 0 to 11.3%]) and grade one (age < 60 years and CRP < 34 mg/L, 0%) (P ConclusionThe ACP index can predict COVID-19 related short-term mortality, which may be a useful and convenient tool for quickly establishing a COVID-19 hierarchical management system that can greatly reduce the medical burden and therefore mortality in highly endemic areas.
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- 2020
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9. ACP Risk Grade: A Simple Mortality Index for Patients with Confirmed or Suspected Severe Acute Respiratory Syndrome Coronavirus 2 Disease (COVID-19) During the Early Stage of Outbreak in Wuhan, China
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Zhihong Liu, Jie Peng, Qiongfang Liu, Jiatao Lu, Qiongya Wang, Shufang Hu, Qingquan Lv, Wenyong Gao, Haijun Li, Hongping Hu, Jinlin Hou, Hui Li, Zhifang Cai, Xueru Yin, Yuhai Hu, Shibo Feng, Yabing Guo, Xuefeng Yi, Jian Sun, Zixiao Zhou, Ying Han, and Rong Fan
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medicine.medical_specialty ,business.industry ,Outbreak ,Disease ,medicine.disease ,Pneumonia ,Interquartile range ,Radiological weapon ,Internal medicine ,Good clinical practice ,medicine ,Stage (cooking) ,business ,Cohort study - Abstract
Background: Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) outbreaks in Wuhan, China, healthcare systems capacities in highly endemic areas have been overwhelmed. Approaches to efficient management are urgently needed and key to a quicker control of the outbreaks and casualties. We aimed to characterize the clinical features of hospitalized patients with confirmed or suspected COVID-19, and develop a mortality risk index for COVID-19 patients. Methods: In this retrospective one-centre cohort study, we included all the confirmed or suspected COVID-19 patients hospitalized in a COVID-19-designated hospital from January 21 to February 5, 2020. Demographic, clinical, laboratory, radiological and clinical outcome data were collected from the hospital information system, nursing records and laboratory reports. Findings: Of 577 patients with at least one post-admission evaluation, the median age was 55 years (interquartile range [IQR], 39 - 66); 254 (44·0%) were men; 22·8% (100/438) were severe pneumonia on admission, and 37·7% (75/199) patients were SARS-CoV-2 positive. The clinical, laboratory and radiological data were comparable between positive and negative SARS-CoV-2 patients. During a median follow-up of 8·4 days (IQR, 5·8 - 12·0), 39 patients died with a 12-day cumulative mortality of 8·7% (95% CI, 5·9% to 11·5%). A simple mortality risk index (called ACP index), composed of Age and C-reactive Protein, was developed. By applying the ACP index, patients were categorized into three grades. The 12-day cumulative mortality in grade three (age ≥ 60 years and CRP ≥ 34 mg/L) was 33·2% (95% CI, 19·8% to 44·3%), which was significantly higher than those of grade two (age ≥ 60 years and CRP < 34 mg/L; age < 60 years and CRP ≥ 34 mg/L; 5·6% [95% CI, 0 to 11·3%]) and grade one (age < 60 years and CRP < 34 mg/L, 0%) (P
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- 2020
10. Effect and safety of Chinese herbal medicine granules in patients with severe coronavirus disease 2019 in Wuhan, China: a retrospective, single-center study with propensity score matching
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Fang Yan, Ailan Chen, Zehuai Wen, Wang Yuanyuan, Wenwei Ouyang, Chicheng Fu, Jianwen Guo, Jun Chen, Danwen Zheng, Zou Xu, Ding Banghan, Fang Li, Yuntao Liu, Li Zhou, Tianzhu Liu, Yi Wang, Qu Fang, Cecilia Stålsby Lundborg, Bo Liu, Zhongde Zhang, and Qingquan Lv
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Male ,CHM: Chinese herbal medicine ,medicine.medical_treatment ,RRR: relative risk reduction ,Pharmaceutical Science ,Single Center ,0302 clinical medicine ,Drug Discovery ,0303 health sciences ,IQR: interquartile range ,Mortality rate ,Middle Aged ,CT: computerized tomography ,ECMO: extracorporeal membrane oxygenation ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Chinese herbal medicine ,NNT: number needed to treat ,China ,medicine.medical_specialty ,Fever ,Coronavirus disease 2019 (COVID-19) ,RR: respiratory rate ,Article ,03 medical and health sciences ,Internal medicine ,Fibrinolysis ,ARR: absolute risk reduction ,medicine ,Humans ,In patient ,Propensity Score ,Aged ,Retrospective Studies ,030304 developmental biology ,PSM: propensity score matching ,Pharmacology ,NTproBNP: N-terminal prohormone of brain natriuretic peptide ,COVID-19: coronavirus disease 2019 ,TCM: traditional Chinese medicine ,business.industry ,SARS: severe acute respiratory syndrome ,COVID-19 ,Retrospective cohort study ,COVID-19 Drug Treatment ,WHO: World Health Organization ,Complementary and alternative medicine ,Propensity score matching ,Usual care ,business ,Drugs, Chinese Herbal ,propensity score matching Abbreviations AEs: Adverse events - Abstract
Background Chinese herbal medicine (CHM) has been used for severe illness caused by coronavirus disease 2019 (COVID-19), but its treatment effects and safety are unclear. Purpose This study reviews the effect and safety of CHM granules in the treatment of patients with severe COVID-19. Methods We conducteda single-center, retrospective study on patients with severe COVID-19 in a designated hospital in Wuhan from January 15, 2020 to March 30, 2020. The propensity score matching (PSM) was used to assess the effect and safety of the treatment using CHM granules. The ratio of patients who received treatment with CHM granules combined with usual care and those who received usual care alone was 1:1. The primary outcome was the time to clinical improvement within 28 days, defined as the time taken for the patients’ health to show improvement by decline of two categories (from the baseline) on a modified six-category ordinal scale, or to be dischargedfrom the hospital before Day 28. Results Using PSM, 43 patients (45% male) aged 65.6 (57–70) yearsfrom each group were exactly matched. No significant difference was observed in clinical improvement of patients treated with CHM granules compared with those who received usual (p = 0.851). However, the use of CHM granules reduced the 28-day mortality (p = 0.049) and shortened the duration of fever (4 days vs. 7 days, p = 0.002). The differences in the duration of cough and dyspnea and the difference in lung lesion ratio on computerized tomography scans were not significant.Commonly,patients in the CHM group had an increased D -dimer level (p = 0.036). Conclusion Forpatients with severe COVID-19, CHM granules, combined with usual care, showed no improvement beyond usual care alone. However, the use of CHM granules reduced the 28-day mortality rate and the time to fever alleviation. Nevertheless, CHM granules may be associated with high risk of fibrinolysis.
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- 2021
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