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      Relationships among lymphocyte subsets, cytokines, and the pulmonary inflammation index in coronavirus (COVID‐19) infected patients

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          Summary

          We explored the relationships between lymphocyte subsets, cytokines, pulmonary inflammation index (PII) and disease evolution in patients with (corona virus disease 2019) COVID‐19. A total of 123 patients with COVID‐19 were divided into mild and severe groups. Lymphocyte subsets and cytokines were detected on the first day of hospital admission and lung computed tomography results were quantified by PII. Difference analysis and correlation analysis were performed on the two groups. A total of 102 mild and 21 severe patients were included in the analysis. There were significant differences in cluster of differentiation 4 (CD4 + T), cluster of differentiation 8 (CD8 + T), interleukin 6 (IL‐6), interleukin 10 (IL‐10) and PII between the two groups. There were significant positive correlations between CD4 + T and CD8 + T, IL‐6 and IL‐10 in the mild group ( r 2 = 0·694, r 2 = 0·633, respectively; P < 0·01). After ‘five‐in‐one’ treatment, all patients were discharged with the exception of the four who died. Higher survival rates occurred in the mild group and in those with IL‐6 within normal values. CD4 + T, CD8 + T, IL‐6, IL‐10 and PII can be used as indicators of disease evolution, and the PII can be used as an independent indicator for disease progression of COVID‐19.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Chaolin Huang, Yeming Wang, Xingwang Li … (2020)
          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

            Dawei Wang, Bo Hu, Fangfang Zhu … (2020)
            In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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              Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

              Nanshan Chen, Min Zhou, Xuan Dong … (2022)
              Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
              Article 0 comments Cited 9349 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Jinglong Lv:
                ORCID: https://orcid.org/0000-0001-5777-7468
                13608388377@163.com
                Journal
                Journal ID (nlm-ta): Br J Haematol
                Journal ID (iso-abbrev): Br. J. Haematol
                Journal ID (doi): 10.1111/(ISSN)1365-2141
                Journal ID (publisher-id): BJH
                Title: British Journal of Haematology
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0007-1048
                ISSN (Electronic): 1365-2141
                Publication date (Electronic): 20 April 2020
                Publication date (Print): May 2020
                Volume: 189
                Issue: 3 ( doiID: 10.1111/bjh.v189.3 )
                Pages: 428-437
                Affiliations
                [ 1 ] Chongqing University Three Gorges Hospital Chongqing China
                [ 2 ] Pharmaceutical Department of Chongqing Three Gorges Central Hospital Chongqing China
                [ 3 ] Quality Control Department of Chongqing Three Gorges Central Hospital Chongqing China
                [ 4 ] Neurosurgery of Chongqing Three Gorges Central Hospital Chongqing China
                [ 5 ] Department of Hematology Chongqing Three Gorges Central Hospital Chongqing China
                [ 6 ] Department of Endocrinology Chongqing Three Gorges Central Hospital Chongqing China
                [ 7 ] Research and Foreign Affairs Department of Chongqing Three Gorges Central Hospital Chongqing China
                [ 8 ] Department of Hematology the First Affiliated Hospital of Chongqing Medical University Chongqing China
                [ 9 ] Department of Cardiology Chongqing Three Gorges Center Hospital Chongqing China
                [ 10 ] School of Mathematics and Statistics Chongqing University Chongqing China
                [ 11 ] College of Basic Medicine Qingdao University Qingdao Shandong China
                [ 12 ] Qingdao Raisecare Biotechnology Co., Ltd Qingdao Shandong China
                [ 13 ] Department of Infectious Diseases Chongqing Three Gorges Center Hospital Chongqing China
                [ 14 ] Department of Radiology Chongqing Three Gorges Central Hospital Chongqing China
                Author notes
                [*] [* ] Correspondence: Jinglong Lv, Department of Hematology, Chongqing Three Gorges Central Hospital, No. 165, Xincheng Road, Wanzhou District, Chongqing 404100, China.

                E‐mail: 13608388377@ 123456163.com

                [†]

                Suxin Wan, Qingjie Yi and Shibing Fan contributed equally to this article.

                Author information
                https://orcid.org/0000-0001-5777-7468
                Article
                Publisher ID: BJH16659
                DOI: 10.1111/bjh.16659
                PMC ID: 7262036
                PubMed ID: 32297671
                SO-VID: 0e9f3303-82a9-492c-a713-5c8c27595341
                Copyright © © 2020 British Society for Haematology and John Wiley & Sons Ltd
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date received : 24 February 2020
                Date accepted : 22 March 2020
                Page count
                Figures: 3, Tables: 7, Pages: 10, Words: 6467
                Funding
                Funded by: Fundamental Research Funds for the Central Universities
                Award ID: 2020CDJGRH‐YJ03
                Categories
                Subject: Research Paper
                Subject: Covid‐19
                Custom metadata
                source-schema-version-number 2.0
                cover-date May 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.3 mode:remove_FC converted:01.06.2020

                ScienceOpen disciplines: Hematology
                Keywords: coronavirus infected disease,lymphocyte subsets,cytokines,pulmonary inflammatory index,disease classification
                Data availability:
                ScienceOpen disciplines: Hematology
                Keywords: coronavirus infected disease, lymphocyte subsets, cytokines, pulmonary inflammatory index, disease classification

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