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Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China

Frontiers of Medicine 2023年第6期17卷 1030-1046页

作者： Dong Wei yusang xie Xuefei Liu Rong Chen Min Zhou Xinxin Zhang Jieming Qu IDepartment of Infectious Diseases Research Laboratory of Clinical VirologyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Pulmonary and Critical Care Medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Respiratory Diseases Shanghai Jiao Tong University School of MedicineShanghai 200025China Shanghai Key Laboratory of Emergency Prevention Diagnosis and Treatment of Respiratory InfectiousDiseasesShanghai 200025China

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages,which was defined by the World Health Organization as coronavirus disease 2019(COVID-19).The pandemic is considered a significant threat to global public health till now.In this review,we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2,including its prototype and variants.The overall clinical features of variants of concern(VOC),heterogeneity in the clinical manifestations,radiology and pathology of COVID-19 patients are also discussed,along with advances in therapeutic agents.

关键词： coronavirus disease 2019 SARS-CoV-2 epidemiology clinical features

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Liver dysfunction on admission worsens clinical manifestations and outcomes of coronavirus disease 2019

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2023年第3期1卷 181-187页

作者： Fangying Lu Rong Chen Kandi Xu Jie Huang Dexiang Yang Tao Bai yusang xie Yun Ling Kui Liu Wei Du Jiayang Yan Huihuang Lin Jian Li Yun Feng Min Zhou Yi Guo Department of Respiratory and Critical Care Medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Respiratory Diseases Shanghai Jiao Tong University School of MedicineShanghai 200025China Department of Critical Medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Respiratory Diseases Tongling People’s HospitalTonglingAnhui 244099China Department of Infectious Disease Wuhan Jinyintan HospitalWuhanHubei 430048China Department of Infectious Disease Shanghai Public Health Clinical CenterShanghai 200025China Department of Respiratory and Critical Care Medicine Tongji HospitalTongji Medical College of Huazhong University of Science and TechnologyWuhanHubei 430030China Clinical Research Center Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Background:Liver dysfunction was common in coronavirus disease 2019(COVID-19),but its association with clinical features and poor prognosis has not been fully delineated.Our study aimed to determine the role of liver dysfunction in COVID-19 and understand the predictors for worse outcomes in patients with liver injury.Methods:We conducted this multicenter,retrospective study in five designated hospitals for COVID-19 manage-ment.Laboratory-confirmed COVID-19 patients were enrolled and classified into the normal live function group and liver dysfunction group according to liver enzymes,bilirubin,and albumin on admission,respectively.Data of baseline,clinical manifestations,and outcomes were collected and compared in the paired groups.Results:Of the 649 included COVID-19 patients,200(30.8%),69(10.6%),and 267(41.1%)patients had elevated liver enzymes,increased bilirubin,and low-level albumin,respectively.Fever,cough,and dyspnea were the most common symptoms and showed an increased proportion in the liver dysfunction group.Compared with patients in the normal liver function group,patients with liver dysfunction manifested decreased lymphocytes,higher level of leukocytes,neutrophils,inflammatory indicators,and cytokines,as well as more severe impairment in kidney function and myocardium.They were more likely to show bilateral involvement and more pulmonary lobes involved according to chest images.With increased proportion of patients who developed severe/critical conditions and needed mechanical ventilation and systemic glucocorticoid therapy,patients with liver dysfunc-tion on admission showed significantly higher in-hospital mortality.Moreover,cardiac troponin I≥1.5 ng/mL was identified as an independent mortality predictor in the elevated liver enzymes group.Conclusion:Patients with liver dysfunction on admission had worse clinical manifestation,and resulted in higher rate of severe/critical type,receiving mechanical ventilation and in-hospital mortality.

关键词： COVID-19 Liver dysfunction Clinical manifestation Outcomes Mortality

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