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BackgroundCoronavirus disease-2019 (COVID-19) has spread all over the world and brought extremely huge losses. At present, there is no study to systematically analyse the features of hydroxybutyrate dehydrogenase (-HBDH) in COVID-19 patients with different ages, clinical types and outcomes. MethodsElectronic medical records including demographics, clinical manifestation, -HBDH test results and outcomes of 131 hospitalized COVID-19 patients, with confirmed result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection, were extracted and analyzed. ResultsThe -HBDH value in [≥]61 years old group, severe group and critical group, death group all increased at first and then decreased, while no obvious changes were observed in other groups. And there were significant differences of the -HBDH value among different age groups (P<0.001), clinical type groups (P<0.001) and outcome groups (P<0.001). The optimal scale regression model showed that -HBDH value (P<0.001) and age (P<0.001) were related to clinical type. Conclusions-HBDH value increases in some COVID-19 patients, obviously in [≥]61 years old, death and critical group, indicating that patients in these three groups suffer from more serious tissues and organs damage, higher -HBDH value and risk of death. The obvious difference between death and survival group in early stage may provide a approach to judge the prognosis. The accuracy of the model to distinguish severe/critical type and other types is 85.84%, suggesting that -HBDH could judge the clinical type of COVID-19 patients accurately. In brief, -HBDH is an important indicator to judge the severity and prognosis of COVID-19.
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BackgroundCoronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis, and prevent the aggravation of COVID-19. MethodsPatients general information, clinical type, all CK values and outcome were collected. CK value of all cases during disease course started from different initial time were analyzed. ResultsAll cases underwent 504 tests of CK since symptom onset and the median value was 51.7 (35.0-91.5) U/L. The first median value on the day 8 from exposure onset was 78.1 (69.1-85.8) U/L then showed an upward trend from the day 8 to the day 12 (reaching a peak of 279.3 U/L), finally showed a fluctuation decline after the day 12. The CK median value in critical cases reached the peak (625.5 U/L) on the transforming date, and then decreased rapidly to the normal range. Before death, the CK median value in dead cases firstly increased until the day -14 with a peak as 470.0 U/L, then decreased with fluctuation until day -2, and finally increased again on the day 0. ConclusionsCK reached its peak on the day when it became critical type, dynamic detection of CK can guide clinical judgment of prognosis. The increase of CK is a high risk factor of death. Severe cell damage 2 weeks before death might determines the outcome of the disease even if CK drops to the normal range afterward.
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BackgroundCoronavirus disease-2019 (COVID-19) has spread all over the world and brought extremely huge losses. There is no study to systematically analyse the features of hydroxybutyrate dehydrogenase (-HBDH) in COVID-19 patients during the periods before and after illness progression, before death and course from exposure onset. MethodsWe collected all included patients general information, clinical type, -HBDH value and outcome, and analyzed -HBDH values within different initial time and different periods. ResultsIn the first 30 days after symptom onset, the -HBDH median value was 156.33 U/L. The first test of -HBDH since exposure onset appeared on the 8th day, it increased from the 8th day to 18th day and decreased after the 18th day. -HBDH median value showed a slight change until it started to increase 1 day before transforming to severe type, while it continued to increase during 4 days before and after transforming to critical type. The -HBDH median value ranged from 191.11 U/L to 455.11U/L before death. Conclusions-HBDH value increases in some COVID-19 patients, obviously in severe type, critical type and death patients, and mainly in 18 days after exposure onset and 10 days after symptom onset. -HBDH increases 1 day before transforming to severe type, continues to increase in critical type and death patients, increases rapidly 5 days before death. The increase of -HBDH suggests that COVID-19 patients have tissues and organs damage, mainly in heart. In brief, -HBDH is an important indicator to judge the severity and prognosis of COVID-19.
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ObjectivesTo study the features of creatine-kinase (CK) in COVID-19 patients with different ages, clinical types and outcomes and quantify the relationship between CK value and clinical type. MethodsAll laboratory confirmed COVID-19 patients hospitalized in Xiangyang No.1 Peoples Hospital were included. Patients general information, clinical type, all CK values and outcome were collected. ResultsThe peak median value of CK in cases aged [≥] 71 years old (appeared at T2) was higher than that in cases aged [≤] 70 years old. There was statistical difference between the two groups (P=0.001). Similarly, the peak in critical cases (appeared at T2) was higher than moderate and severe types, and significant difference were existed among moderate, severe, and critical types (P=0.000). Moreover, the peak value in death group (appeared at T2) was higher than those in survival group. Significant difference was also found between them (P=0.000). According to the optimal scale regression model, the CK value (P=0.000) and age (P=0.000) were associated with the clinical type. ConclusionsDifference of the CK in different ages, clinical types, and outcomes were significant. The results of the optimal scale regression model are helpful to judge the clinical type of COVID-19 patients.
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BackgroundTo characterize C-reactive protein (CRP) changes features from patients with coronavirus disease 2019 (COVID-19) and to quantify the correlation between CRP value and clinical classification. MethodsThis was a bidirectional observational cohort study. All laboratory confirmed COVID-19 patients hospitalized in Xiangyang No.1 Peoples Hospital were included. Patients general information, clinical type, CRP value and outcome were collected. Patients were grouped according to the age, clinical type and outcome, and their CRP were compared. The CRP value, age gender, and clinical type were used to build a categorical regression model to investigate the association between CRP and clinical type. ResultsThe 131 patients aged 50.13{+/-}17.13 years old. There were 4 mild, 88 moderate, 21 severe and 18 critical cases. Statistical significance of CRP median exists between different clinical types and ages. There were 10 deaths and 121 cases have been discharged. The CRP in death group dramatically increased continuously until died, while increased firstly and decreased later in the survivor and survivor in critical type. The categorical regression model also showed that CRP and age had significant coefficient. During the first 15 days from symptom onset, the maximum of CRP ranged between 0.47-53.37 mg/L were related to mild combined with moderate type, ranged 53.84-107.08 mg/L were related to severe type, and 107.42-150.00 mg/L were related to the critical type. ConclusionsCRP showed different distribution feature and existed differences in various ages, clinical types and outcomes of COVID-19 patients. The features corresponded with disease progression.
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BACKGROUNDCoronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis and prevent the aggravation of COVID-19. METHODSAll laboratory confirmed COVID-19 patients hospitalized in Xiangyang No.1 Peoples Hospital were included. Patients general information, clinical type, CRP value and outcome were collected. CRP values of all patients during disease course from different initial time were analyzed. RESULTSThe 131 enrolled patients were 50.13{+/-}17.13 years old. All cases underwent 724 tests of CRP since symptom onset, 53.18% of the test results were abnormal and the median value was 9.52(2.63-34.10) mg/L. The first median value on the day 8 from exposure onset was 39.08(11.92-47.89) mg/L then fluctuated around it until the day 28. The CRP median increased from 15.93 mg/L to 41.44 mg/L and then decreased to 18.26 mg/L before transformation of severe type, and then increased to 62.25 mg/L on the transforming date. Conversely, the CRP median increased from 56.17 mg/L 102.75 mg/L before transformation of critical type but decreased to 68.68 mg/L on the transforming date. The changes of CRP median over time before death ranged from 77.77 mg/L to 133.52 mg/L. CONCLUSIONSCRP increased before symptom onset and substantially increased during the early-to-mid stage (especially early stage), which was different from other virus-infected diseases. The changes of CRP before the transformation of clinical type was inconsistent with the aggravating of illness. And the CRP maintained over 100.00 mg/L prompted poor prognosis.
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BackgroundThe stage of CT images was rarely studied and the relationship between the severity of Coronavirus Disease 2019 (COVID-19) and CT images has not been studied based on systematic quantitative analysis currently. PurposeTo investigate the staging duration and classification of CT images of patients with COVID-19 based on quantitative analysis. Materials and MethodsThis is an ambispective observational cohort study based on 125 patients with COVID-19 from Jan 23 to Feb 28, 2020. The stage of CT and pulmonary lesion size were quantitatively analyzed. The categorical regression analysis based on optimal scale (CATREG) was performed to evaluate the association of CT score, age, and gender with the clinical type. ResultsThe CT images of 125 patients with COVID-19 (50.13 {+/-} 16.91 years, 66 women) were analyzed in this study. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 {+/-} 2.31, 10.07 {+/-} 4.91, and 20.60 {+/-} 7.64 days, respectively. The median CT score was 5.00 (2.00-8.50) during the first 30 days, which reached a peak on the 11th day. Significant differences were found between the median CT scores of different clinical types (P<0.05). Besides, the age was correlated with the clinical type (P<0.001), the CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type with the output accuracy 69.60%. ConclusionThe four-stage staging method based on quantitative analysis is consistent with the change rules of staging features and COVID-19. Quantitative study by scoring pulmonary lesion sizes accurately revealed the evolvement of pulmonary lesions and differences between different clinical types. SummaryQuantitative study of the stage duration and classification of chest CT images can objectively reveal the relationship between Coronavirus Disease 2019 (COVID-19) and chest CT images. Key Results1. A four-stage staging method was proposed. Except for pre-early stage, the duration of early, progression-consolidation, and dissipation stage of CT images was 3.40 {+/-} 2.31, 10.07 {+/-} 4.91, and 20.60 {+/-} 7.64 days, respectively. 2. The severer the disease, the higher the median CT scores and their peak value. 3. The CT scores of 0.00-11.50, 11.50-16.00, and 16.00-20.00 were separately correlated with the moderate, severe, and critical type.
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BackgroundAs the spreading of the COVID-19 around the global, we investigated the characteristics and changes of symptoms in COVID-19 patients. MethodsThis was an ambispective observational cohort study, and 133 confirmed COVID-19 patients were included and all symptoms over the course were analyzed qualitatively. The symptoms, their changes over the course in the cohort and in the different clinical types, etc. were illustrated. Differences in different periods and severities were analyzed through Chi square test, association with severity was analyzed through LASSO binomial logistic regression analysis. Inter-correlation and classification of symptoms were completed. Major symptoms were screened and their changes were illustrated. ResultsA total of 43 symptoms with frequencies as 6067 in this cohort. Differences of symptoms in different stages and clinical types were significant. Expectoration, shortness of breath, dyspnea, diarrhea, poor appetite were positively but vomiting, waist discomfort, pharyngeal discomfort, acid reflux were negatively correlated with the combined-severe and critical type; dyspnea was correlated with the critical type. The 17 major symptoms were identified. The average daily frequency of symptoms per case was decreased continuously before the transition into the severe type and increased immediately one day before the transition and then decreased. It was decreased continuously before the transition date of the critical type and increased from the transition into the critical type to the next day and decreased thereafter. Dyspnea (P<0.001), shortness of breath (P<0.01) and chest distress (P<0.05) were correlated with death and their corresponding coefficient was 0.393, 0.258, 0.214, respectively. ConclusionThe symptoms of COVID-19 patients mainly related to upper respiratory tract infection, cardiopulmonary function, and digestive system. The mild type and the early stage in other types mainly related to upper respiratory tract infection. The cardiopulmonary function and digestive system associated symptoms were found in all other types and stages. Dyspnea was correlated with critical type and dyspnea, shortness of breath, and chest distress were correlated with death. Respiratory dysfunction (or incompleteness) associated symptoms were the characteristic symptoms. The changes of symptoms did not synchronously with the changes of severity before the transition into the severe or critical type.
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BACKGROUND:Adipose-derived stem cels under osteogenic induction can be combined with biodegradable silk fibroin/hydroxyapatite scaffold, which is expected to develop a new biocompatible and osteogenic bone fusion material. OBJECTIVE:To study the effect of silk fibroin/hydroxyapatite composite on the viability and osteogenic properties of adipose-derived stem cels after osteogenic induction. METHODS:Adipose-derived stem cels were obtained from rat’s fat tissue, then adherently cultured, proliferated and passaged in vitro. Passage 3 cels were cultured in conditioned medium for osteogenic induction, and then seeded onto silk fibroin/hydroxyapatite scaffold as experimental group. Adipose-derived stem cels cultured on the cover glasses at the same condition acted as control group. The celular morphology, proliferation and differentiation were assessed respectively by means of phase contrast microscope, MTT assay and alkaline phosphatase activity measurement. RESULTS AND CONCLUSION:After osteogenic induction, adipose-derived stem cels could adhere to the scaffold material and proliferate on the surface of silk fibroin/hydroxyapatite scaffold normaly. No significant difference was found in cel proliferation and alkaline phosphatase activity between the experimental and control groups (P > 0.05), suggesting the celular activity and function were not affected by the material. These findings indicate that silk fibroin/hydroxyapatite composite material has good cytocompatibility. Subject headings: Silk; Hydroxyapatites; Stem Cels; Adipose Tissue; Biocompatible Materials; Tissue Engineering.