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First described in December 2019 in Wuhan (China), COVID-19 disease rapidly spread worldwide, constituting the biggest pandemic in the last 100 years. Even if SARS-CoV-2, the agent responsible for COVID-19, is mainly associated with pulmonary injury, evidence is growing that this virus can affect many organs, including the heart and vascular endothelial cells, and cause haemostasis, CNS, and kidney and gastrointestinal tract abnormalities that can impact in the disease course and prognosis. In fact, COVID-19 may affect almost all the organs. Hence, SARS-CoV-2 is essentially a systemic infection that can present a large number of clinical manifestations, and it is variable in distribution and severity, which means it is potentially life-threatening. The goal of this comprehensive review paper in the series is to give an overview of non-pulmonary involvement in COVID-19, with a special focus on underlying pathophysiological mechanisms and clinical presentation. [ABSTRACT FROM AUTHOR]

Coronavirus infection disease-19 (COVID-19) is a worldwide catastrophic emergency that first appeared in late 2019, in Wuhan, China. COVID-19 is a multitropism disease that first affects lung tissue. However, extrapulmonary manifestations have been suspected from the first COVID-19 cases. The ocular signs and symptoms were from the early changes that occur during the course of the disease. Changes in the anterior eye segment have a relatively higher incidence than the posterior eye segment. Of which, conjunctivitis, COVID-19 pharyngioceratoconjuctivitis, iridocyclitis, corneal punctate epitheliopathy, and pathomorphological changes in the physio-anatomy of the anterior eye segment. The potential pathogenesis includes direct penetration of the virus into the eye (conjunctiva, lumbus, and cornea) or due to a systemic pathway through viremia, as well as due to autoimmune antibodies against the ocular structure (immune privilege). The presence of ocular manifestations of the external anterior fibrous layer suggests a mild course of the disease. [ABSTRACT FROM AUTHOR]

COVID-19 emerged in Wuhan, China, but was caused by the original coronavirus, severe acute respiratory syndrome associated coronavirus-2 (SARS-CoV2). In early 2020, there was a widespread breakout of cases well over world, resulting in an epidemic that rapidly escalated to become a pandemic. This abruptly shook the global healthcare system. The emergence of the alpha, beta, and delta SARS-CoV-2 were associated with new waves of infections, sometimes across the entire world but until this month i.e., between Nov-Dec, 2021, Delta variant reigned supreme until the emergence of a newer variant i.e., Omicron (B.1.1.529) of SARS-CoV-2. Delta had 13 mutations. Of these, nine are in the spike protein, the protrusion on the surface of the virus that helps it latch onto human cells. Specifically, two are in a molecular hook, called the "receptor-binding domain". Omicron, a creation caused by monstrous mutations. At least 32 mutations are in the spike protein and 10 in the receptor-binding domain. was designated a COVID-19 variant of concern (VoC) by the World Health Organization (WHO) on 26th November 2021. Structurally, the omicron variant has shown too mutated at antibody binding sites which would leverage them for escaping the possible immune response by the body. We don't yet know much about the other alterations and how they might affect the virus's behavior. Omicron COVID-19 strain after identifying individuals with symptoms that were not the same as those seen in the Delta form. People with night sweats have also been reported. The new omicron variant has more mutations than the prevailing rampant delta virus. This makes the newer variant more transmissible, better able to evade itself from various vaccines readily available in the current scenario. These overall increases in the percentage changes in a single day cases of COVID-19 reported cases can be attributed to the beginning of third wave or can be speculated as newer surge of omicron variant cases. Yet another new variant has been detected in France with 46 mutations and 37 deletions in its genetic code, many affecting the spike protein. 'B.1.640.2' is the current nomenclature for this variation. [ABSTRACT FROM AUTHOR]

Corona virus disease was first reported in December 2019 in Wuhan, China and is spreading across the world in an alarming fashion. To contain the spread, it is very important to identify the subtle/not readily apparent symptoms of COVID-19 at the earliest. The aim of the study is to determine the incidence duration progress of sino-nasal symptoms in COV 2 positive patients using SNAQ scoring. Patients who tested positive for SARS-COV 2 by RT-PCR and admitted in our hospital under category A (n = 382) were included in the study. A detailed history was collected from all the patients and sino-nasal assessment questionnaire (SNAQ) was provided to the patient with complaints of sinonasal symptoms and they were asked to fill the forms on day 3, 7 and 14. To identify the characteristics of sinonasal symptoms in COVID-19 patients with a history of smoking, smoking history was also collected in detail and patients were classified based on Brinkman's index into mild, moderate and severe smokers. In this study, the incidence of sinonasal symptoms was 24%. Average SNAQ scoring on day 3 was 30.09 and on day 7 was 12.9 and day 14 is 3.8. There was a decline in score on day 7 compared to day 3 indicating symptoms decrease by day7. Average SNAQ scoring in non-smokers and mild and moderate smokers was 20.18, 34.11, 57.5 respectively. The SNAQ scoring in smokers was more than that of non-smokers and was also persistent for a longer duration compared to non-smokers. Sino-nasal symptoms catch our eye because it is an important route for transmission. Viral shedding from sinonasal tract may be an important source for transmission. History and degree of smoking should also be considered while dividing COVID-19 patients into categories. [ABSTRACT FROM AUTHOR]

Objective: In December 2019, severe acute respiratory syndrome coronavirus-2, which emerged in Wuhan, China, spread rapidly and created a pandemic. Coronavirus disease-2019 (COVID-19) can affect different organ systems, including the skin. Recently, COVID-19 cases with skin lesions of different clinicopathological features have been published. This study aimed to present the histopathological features of 19 COVID-19 cases with cutaneous findings and discuss them in light of the literature. Methods: Skin biopsy specimens of 19 patients with skin rashes associated with COVID-19 were evaluated histopathologically and clinically. Results: Clinical manifestations of rashes developed in eight female, seven male, and four pediatric patients with COVID-19. Urticaria/urticarial vasculitis (n=7), maculopapular eruption (n=7), panniculitis (n=2), purpuric eruptions (n=2), and livedoid-like lesions were noted. Histopathologically, besides the inflammatory findings, the most striking feature was that the vessels were more or less affected in almost all cases. Conclusions: Cutaneous lesions associated with COVID-19 are increasingly being reported. We believe that every data presented about this disease, which has many unknowns, will shed light on future research. Every case can lead us a new way. [ABSTRACT FROM AUTHOR]

In December 2019, in Wuhan, China, the first cases of infection with SARS-CoV 2 responsible for COVID-19 disease were identified. SARS-CoV 2 was declared a pandemic on March 11, 2020, and since then has attracted the medical world's attention. The threat to humans' health that this emerging pandemic could leave raises awareness on the importance of understanding the mechanisms that underlie the developing conditions. The epidemiology, clinical picture, and pathogenesis of COVID-19 show that this virus presents new strategies to overcome the past defensive medicine. While all the current data has focused on the pulmonary and cardiovascular manifestations, little has been written about the neurological implications of the disease. This review updates new clinical aspects that SARS-CoV 2 expresses in humans by focusing primarily on neurological manifestations. The damage to the nervous system became more apparent - anosmia, ageusia, polyneuritis, meningitis, meningoencephalitis, stroke, acute necrotizing encephalopathy. Oxygen therapy is vital for those in critical health situations. Finally, prevention is the most important element in breaking the epidemiological chain. [ABSTRACT FROM AUTHOR]

COVID-19 was caused by the original coronavirus, severe acute respiratory syndrome associated coronavirus-2 (SARS CoV2), which originated in Wuhan, China. COVID-19 had a large breakout of cases in early 2020, resulting in an epidemic that turned into a pandemic. This quickly enveloped the global healthcare system. The principal testing method for COVID-19 detection, according to the WHO, is reverse transcription polymerase chain reaction (RT-PCR). Isolation of patients, quarantine, masking, social distancing, sanitizer use, and complete lockdown were all vital health-care procedures for everyone. With the 'new normal' and vaccination programmes, the number of cases and recovered patients began to rise months later. The easing of restrictions during the plateau phase resulted in a rebound of instances, which hit the people with more ferocity and vengeance towards the start of April 2021. Coronaviruses have evolved to cause respiratory, enteric, hepatic, and neurologic diseases, resulting in a wide range of diseases and symptoms such as fever, cough, myalgia or fatigue, shortness of breath, muscle ache, headache, sore throat, rhinorrhea, hemoptysis, chest pain, nausea, vomiting, diarrhoea, anosmia, and ageusia. Coronavirus infections can be mild, moderate, or severe in intensity. COVID-19 pulmonary dysfunction includes lung edoema, ground-glass opacities, surfactant depletion, and alveolar collapse. Patients who presented with gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, or diarrhoea had a higher risk of negative outcomes. COVID-19's influence on cognitive function is one of COVID-19's long-term effects. More clinical situations need to be reviewed by healthcare professionals so that an appropriate management protocol may be developed to reduce morbidity and death in future coming third/fourth wave cases. [ABSTRACT FROM AUTHOR]

A novel coronavirus disease (COVID-19), caused by a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was discovered in Wuhan, China, in December 2019, and the world has suffered from a pandemic. As of 22nd March 2020, at least 185 countries worldwide had been affected by COVID-19. SARS-CoV-2, leading to COVID-19 pneumonia, infects cells through ACE-2 receptors. The disease has different clinical signs and symptoms, including chills, high fever, dyspnea, and cough. Other symptoms including haemoptysis, myalgia, diarrhoea, expectoration, and fatigue may also occur. The rapid rise in confirmation cases is severe in preventing and controlling COVID-19. In this review, the article will explore and evaluate the insights into how COVID influences patients with other comorbid conditions such as cardiovascular disease, diabetes, Parkinson's, and how conditions Urolithiasis, anosmia, and anuria may develop after infection. The virus mutates and the variants are now prevalent in the present scenario where the world stands in eradicating the pandemic by looking into the development of vaccines by several countries and how the vaccination can temporarily help prevent COVID spread. [ABSTRACT FROM AUTHOR]

When a new coronavirus appeared in the late 2019, identified as the cause of several cases of pneumonia in Wuhan, Paracetamol was initially reported to be the preferable antipyretic medication, choice which was detrimental to the use of other drugs. People have resorted to buying large stocks of Paracetamol and some have used it in large doses, regardless of the consequences. However, the Paracetamol (Acetaminophen) overdose remains the leading cause of death or transplantation due to acute liver failure in many parts of the world. This review aims at presenting the pharmacokinetics, the clinical signs, and the risk factors for systemic toxicity associated with Paracetamol overdose, as well as the current therapeutic approach. Paracetamol is primarily metabolized in the liver, by glucuronidation and sulfation. In case of a Paracetamol overdose, a large amount of NAPQI is conjugated with glutathione, and this process is due to a major depletion of glutathione, thus leading to hepatic necrosis, renal failure, and encephalopathy. The evaluation of serum acetaminophen levels by analytical methods is extremely useful both for the diagnosis and the therapy monitoring. [ABSTRACT FROM AUTHOR]

Identifying order of symptom onset of infectious diseases might aid in differentiating symptomatic infections earlier in a population thereby enabling non-pharmaceutical interventions and reducing disease spread. Previously, we developed a mathematical model predicting the order of symptoms based on data from the initial outbreak of SARS-CoV-2 in China using symptom occurrence at diagnosis and found that the order of COVID-19 symptoms differed from that of other infectious diseases including influenza. Whether this order of COVID-19 symptoms holds in the USA under changing conditions is unclear. Here, we use modeling to predict the order of symptoms using data from both the initial outbreaks in China and in the USA. Whereas patients in China were more likely to have fever before cough and then nausea/vomiting before diarrhea, patients in the USA were more likely to have cough before fever and then diarrhea before nausea/vomiting. Given that the D614G SARS-CoV-2 variant that rapidly spread from Europe to predominate in the USA during the first wave of the outbreak was not present in the initial China outbreak, we hypothesized that this mutation might affect symptom order. Supporting this notion, we found that as SARS-CoV-2 in Japan shifted from the original Wuhan reference strain to the D614G variant, symptom order shifted to the USA pattern. Google Trends analyses supported these findings, while weather, age, and comorbidities did not affect our model's predictions of symptom order. These findings indicate that symptom order can change with mutation in viral disease and raise the possibility that D614G variant is more transmissible because infected people are more likely to cough in public before being incapacitated with fever. Author summary: We developed a mathematical model to predict symptom order of symptomatic COVID-19 cases from patient characteristics data in the USA and China. Surprisingly, our model predicted that cough occurs first in the USA, while fever occurs first in China. We hypothesized the difference is due to the SARS-CoV-2 D614G variant, which was predominate in the USA during data collection, whereas the original Wuhan reference strain was predominate in China. To test this, we used patient data from the outbreak in Japan, which was initially dominated by the Wuhan reference strain but eventually dominated by the D614G variant. The predicted symptom order changed with the viral variant, but not region, weather, patient age, or comorbidity. These results support the notion that cough occurs earlier in the D614G variant than the Wuhan reference strain. The D614G variant's greater transmissibility might be explained by infected individuals coughing and spreading the virus before they are incapacitated by fever. Additionally, we hope other researchers will further investigate symptom order of infectious diseases to understand how viral variants and comorbidities affect disease progression. Such work is especially important now as contagious and deadly variants of SARS-CoV-2 are under investigation and rapidly spreading worldwide. [ABSTRACT FROM AUTHOR]

In December 2019, a novel coronavirus had emerged in Wuhan city, China that led to an outbreak resulting in a global pandemic, taking thousands of lives. The infectious virus was later classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Individuals infected by this novel virus initially exhibit nonspecific symptoms such as dry cough, fever, dizziness and many more bodily complications. From the "public health emergency of international concern" declaration by the World Health Organisation (WHO), several countries have taken steps in controlling the transmission and many researchers share their knowledge on the SARS-COV-2 characteristics and viral life cycle, that may aid in pharmaceutical and biopharmaceutical companies to develop SARS-CoV-2 vaccine and antiviral drugs that interfere with the viral life cycle. In this literature review the origin, classification, aetiology, life cycle, clinical manifestations, laboratory diagnosis and treatment are all reviewed. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic that has affected the lives of billions of individuals. Coronavirus disease 2019 (COVID-19) emerged in December 2019 likely as a result of zoonotic transmission from wild animals linked to a large wet market in Wuhan, China. Hypertention as a risk factor in COVID-19 patients explore through various studies reviewed and through these observations find the link between hypertension and COVID-19. Severity of COVID-19 illness is skewed towards the elderly population who have a higher prevalence of hypertension. However, there are number of factors that could potentially confound a possible relationship between hypertension and severe COVID-19. The first is age: both severe COVID-19 and hypertension are common in the elderly. A biomarker is defined as a "characteristic that can be objectively measured and evaluated as an indicator of normal biological and pathological processes, or pharmacological responses to a therapeutic intervention". Biomarkers in COVID 19 can be useful. Patients with hypertension, especially older individuals and those with other known risk factors, are at increased risk of developing severe symptoms during COVID-19 infection. Antihypertensive therapy with ACE inhibitors or ARBs in patients with COVID-19 should be carefully continued, with careful monitoring to detect hypotension and kidney injury. For non-hospitalized patients with COVID-19, ongoing management of comorbid conditions is essential to minimize risk. This includes lifestyle factors such as diet and sleep, along with maintaining regular medications like antihypertensive drugs. Arrhythmias and sudden cardiac arrest are common manifestations of COVID-19. Heart palpitations have been reported to be the main presenting symptom of COVID-19 in patients without a fever or cough. Overall, multidisciplinary management of COVID-19 based on a rapidly growing body of evidence will help ensure the best possible outcomes for patients, including those with risk factors such as hypertension. [ABSTRACT FROM AUTHOR]

The epidemiological outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), alias COVID-19, began in Wuhan, Hubei, China, in late December and eventually turned into a pandemic that has led to over 3.71 million deaths and over 173 million infected cases worldwide. In addition to respiratory manifestations, COVID-19 patients with neurological and myocardial dysfunctions exhibit a higher risk of in-hospital mortality. The immune function tends to be affected by cardiovascular risk factors and is thus indirectly related to the prognosis of COVID-19 patients. Many neurological symptoms and manifestations have been reported in COVID-19 patients; however, detailed descriptions on the prevalence and characteristic features of these symptoms are restricted due to insufficient data. It is thus advisable for clinicians to be vigilant for both cardiovascular and neurological manifestations to detect them at an early stage to avoid inappropriate management of COVID-19 and to address the manifestations adequately. Patients with severe COVID-19 are notably more susceptible to developing cardiovascular and neurological complications than non-severe COVID-19 patients. This review focuses on the consequential outcomes of COVID-19 on cardiovascular and neuronal functions, including other influencing factors. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 that causes Coronavirus disease 2019 (COVID-19) was first known in Wuhan, China, in December 2019. The aim of this study was to evaluate the level of common hepatic, renal, and cardiac diagnostic markers in hospitals in patients with severe COVID 19. In this study, 259 patients with symptoms of severe COVID-19 and a positive RT-PCR assay of nasopharyngeal samples were enrolled. Inclusion criteria are positive for COVID-19 patients at the diagnosis of an infectious disease physician. Diagnostic markers of liver, kidney, and heart were evaluated by age and gender. In this study, 48.3% of patients severe with COVID-19 were male, and 51.7% were female. The mean of markers such as LDH, Direct Bilirubin, SGOT, SGPT, D-dimer was higher than normal, which was observed in men more than women. The mean of CK-MB also was higher than normal, which was observed in women more than men. The highest mean of markers was seen in the older ages. The mean of BUN was observed in the age range of 55-64 years and above 65 years above normal. But the mean of CPK, creatinine, potassium and alkaline phosphatase were normal. The results of the present study showed an increase in the level of some of the most important diagnostic markers of hepatic, renal, and cardiac in patients with COVID 19. This increase was greater in some markers, including SGOT, SGPT, Direct bilirubin, LDH, D-dimer, in men than in women, and more in older patients. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, the first cases of which were reported in Wuhan, China in December 2019. The disease often presents with major respiratory symptoms. In addition, gastrointestinal (GI) symptoms are observed. They may be the first or even the only symptoms of the disease. The aim of this study is to demonstrate the presentation of GI symptoms and their relationship to other symptoms, the clinical course and prognosis of patients with COVID-19. Methods: Included in this study were patients over 18 years of age who had been hospitalised for treatment in clinics and intensive care units due to COVID-19 between March and June 2020. The symptoms reported by the patients at the time of admission and the data collected as a result of the clinical follow-up were evaluated. Results: Out of the 1,045 patients with COVID-19, 140 patients (13.4%) had GI symptoms. The complaints of these 140 patients were nausea (53.6%), vomiting (32.1%), abdominal pain (11.4%), diarrhea (45.7%), anorexia (43.6%) and loss of taste (5.6%). In 3.2% of the patients, only GI symptoms were present, without any respiratory symptoms. Conclusion: Gastrointestinal symptoms were present at the time of admission in 13.4% of the patients with COVID-19. The most common GI symptom in the patients was nausea. Length of stay in hospital and mortality rate were higher in patients with only GI symptoms. Therefore, GI symptoms should be considered in patients with suspected COVID-19. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome-coronavirus-2 (SARSCoV- 2) virus, was identified as the cause of a pandemic of respiratory illness in Wuhan, China one year ago. The Coronavirus disease 2019 (COVID-19), may cause mild disease with nonspecific signs and symptoms such as fever, cough, myalgia, and fatigue, or severe pneumonia with respiratory failure and sepsis. However, endocrinological manifestations are yet to be established, in patients with COVID-19. The effect of COVID-19 on thyroid function is unknown at this time. Evidence support that patients with COVID-19 who are followed up in intensive care units may develop thyroid dysfunction as a non-thyroidal illness syndrome. Until now, twenty-two cases with subacute thyroiditis and five cases with Graves’ Diseases potentially associated with SARSCoV- 2 infection have been reported in literature. Physicians should be aware of possible relationships between thyroid dysfunction and COVID-19. This study aimed to review thyroid dysfunction in patients with COVID-19, and to overview thyroid diseases that are probably related to COVID-19. [ABSTRACT FROM AUTHOR]

December 2019 will never be forgotten in the history of medicine when an outbreak of pneumonia of unknown etiology in Wuhan, China sooner or later prompted the World Health Organization to issue a public health warning emergency. This is not the first nor will it be the last time that a member of β‐coronaviruses (CoVs) is waging a full‐scale war against human health. Notwithstanding the fact that pneumonia is the primary symptom of the novel coronavirus (2019nCoV; designated as SARS‐CoV‐2), the emergence of severe disease mainly due to the injury of nonpulmonary organs at the shadow of coagulopathy leaves no choice, in some cases, rather than a dreadful death. Multiple casual factors such as inflammation, endothelial dysfunction, platelet and complement activation, renin‐angiotensin‐aldosterone system derangement, and hypoxemia play a major role in the pathogenesis of coagulopathy in coronavirus disease 2019 (COVID‐19) patients. Due to the undeniable role of coagulation dysfunction in the initiation of several complications, assessment of coagulation parameters and the platelet count would be beneficial in early diagnosis and also timely prediction of disease severity. Although low‐molecular‐weight heparin is considered as the first‐line of treatment in COVID‐19‐associated coagulopathy, several possible therapeutic options have also been proposed for better management of the disease. In conclusion, this review would help us to gain insight into the pathogenesis, clinical manifestation, and laboratory findings associated with COVID‐19 coagulopathy and would summarize management strategies to alleviate coagulopathy‐related complications. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is widely acknowledged as a severe traumatic event, and depression, anxiety, and psychological distress are common in diagnosed patients. However, the correlations of biological indicators with emotion are rarely reported. The primary objective of this study was to explore the dysfunction of immune-inflammatory characteristics in patients with depression-anxiety symptoms. We investigated the mental status of inpatients with COVID-19 in Wuhan and compared the differences in cytokines and lymphocytes between patients with and without depression-anxiety symptoms at admission. After two weeks of treatment, we evaluated the mental conditions and measured the cytokines and lymphocytes of the patients with depression and anxiety symptoms and explored the changes and their associations. Approximately half of the patients with COVID-19 had depression and anxiety symptoms, and the symptoms were related to the ratio of CD4+/CD8+ and the level of CD4+ T lymphocytes. When compared with patients without depression-anxiety symptoms, CD4+ T lymphocytes level was significantly higher in COVID-19 patients with depression-anxiety symptoms. This study provided novel evidence regarding the association between depression and anxiety symptoms and immune characteristics, especially CD4+ T lymphocyte levels, in COVID-19 patients. We emphasized the importance of paying attention to the dynamic immune process of patients diagnosed with COVID-19 with depression/anxiety. [ABSTRACT FROM AUTHOR]

Objective: SARS-CoV-2, emerged in December 2019 in the city of Wuhan in the People's Republic of China affects children as well as all age groups. The aim of the study was to evaluate the clinical features and outcomes of pediatric cases with COVID-19 in the first month of the epidemic in Turkey. Method: This single center cross-sectional study was conducted in University of Health Sciences Dr Behçet Uz Child Diseases and Pediatric Surgery Training and Research Hospital during the period of March 11 - April 20, 2020. Demographic, epidemiological and clinical data were collected from medical records. All patients were confirmed by real time reverse transcription-polymerase chain reaction. Chidren were classified as asymptomatic, mild, moderate, severe, and critically ill patients. Results: In this study, we reported the clinical characteristics of a case series involving 30 chilren with COVID-19 aged from 23 days to 16 years. Twenty-nine (96.7%) patients had confirmed contact with family members for COVİD-19. The majority of patients were asymptomatic (50%) or had mild symptoms (26.7%). Fever (46.6%) and cough (33.3%) were the most common symptoms. Conclusion: Our study indicated that COVID 19 in children exhibited less severe symptoms and had better outcomes. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is an acute infection of the respiratory tract that emerged in December 2019 in Wuhan, China. It was quickly established that both the symptoms and the disease severity may vary from one case to another and several strains of SARS-CoV-2 have been identified. To gain a better understanding of the wide variety of SARS-CoV-2 strains and their associated symptoms, thousands of SARS-CoV-2 genomes have been sequenced in dozens of countries. In this article, we introduce COVIDomic, a multi-omics online platform designed to facilitate the analysis and interpretation of the large amount of health data collected from patients with COVID-19. The COVIDomic platform provides a comprehensive set of bioinformatic tools for the multi-modal metatranscriptomic data analysis of COVID-19 patients to determine the origin of the coronavirus strain and the expected severity of the disease. An integrative analytical workflow, which includes microbial pathogens community analysis, COVID-19 genetic epidemiology and patient stratification, allows to analyze the presence of the most common microbial organisms, their antibiotic resistance, the severity of the infection and the set of the most probable geographical locations from which the studied strain could have originated. The online platform integrates a user friendly interface which allows easy visualization of the results. We envision this tool will not only have immediate implications for management of the ongoing COVID-19 pandemic, but will also improve our readiness to respond to other infectious outbreaks. Author summary: This article introduces COVIDomic, a new integrative multi-omics online platform designed to facilitate the analysis of the large amount of health data collected from COVID-19 patients. The COVIDomic platform includes a user-friendly interface and provides a set of bioinformatics tools for the analysis of multi-modal metatranscriptomic data to determine the origin of the coronavirus strain and the expected severity of the disease. An analytical workflow includes microbial pathogens community analysis, COVID-19 genetic epidemiology and patient stratification. These features allow studying the presence of common microbial organisms, their antibiotic resistance and the severity of the infection, as well as obtaining insights on the geographical locations from which the strain could have originated. Such openly distributed multi-modal platform will greatly accelerate the ongoing COVID-19 research and improve our readiness to respond to other infectious outbreaks. [ABSTRACT FROM AUTHOR]

The coronavirus disease of 2019 (COVID-19), which began in Wuhan, China, at the end of 2019, is spreading around the world and causing many deaths, mainly from pneumonia. Currently, there are no specific drugs to treat COVID-19, and existing antiviral drugs are being used as an alternative. One of these is favipiravir, a new type of influenza drug. However, its efficacy, dosage, and duration of administration are still under study. In this case study, we administered favipiravir to patients with COVID-19 and determined the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the COVID-19 pathogen, using semi-quantitative real-time reverse transcription PCR in sputum samples. We report on two patients in whom the viral load increased again after completion of 10 days of favipiravir treatment and a transient relapse of symptoms was observed. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China, and since then, it has emerged as a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested impairment of olfactory and gustatory sensations associated with corona virus disease (COVID-19). Angiotensin-converting enzyme-2 is an important aspect for the manifestations seen in this deadly viral disease. The associated olfactory and gustatory dysfunction can also lead to partial and/or complete loss of the ability to smell and taste in the early stages of disease onset. Evidence has also suggested that the presence of SARS-CoV-2 nucleic acid in human saliva makes it the carrier of the infectious viral disease and aids in its diagnosis. The present review focuses on the listed clinical manifestations in the form of olfactory and gustatory impairment in SARS-CoV-2 virus disease. [ABSTRACT FROM AUTHOR]

Background. COVID-19 is a disease caused by a new strain of coronavirus (SARS-COVID-19). The WHO first learned about this new virus on December 31, 2019, following a report on a group of cases of "viral pneumonia" in Wuhan, People's Republic of China, and declared a pandemic in March 2020. The disease was an almost complete unknown at the outset, but knowledge of its pathophysiology, clinical picture, and treatment options grew and developed rapidly. Objective. Dizziness is a very common symptom that patients report in routine clinical practice and one of the significant clinical manifestations of COVID-19. This short report investigated a possible connection between COVID-19 and benign paroxysmal positional vertigo (BPPV). Methods. We present two cases of benign paroxysmal positional vertigo (BPPV), which developed within two weeks of SARS-COVID-19 infection, manifesting with mild disease severity in early November 2020. Results. In both cases, the disease manifested by severe, short-lived attacks of vertigo, objective-circular type, with accompanying nausea and vomiting. The symptoms occurred when lying in bed and turning to the right and assuming an upright position. The diagnosis of posterior semicircular canal BPPV (PC-BPPV) was made based on a subjectively and objectively positive right-sided Dix–Hallpike test. Conclusions. The pathophysiology of post-COVID BPPV is probably similar to that of other viral infections, with some of its specificities such as inducing hypercoagulation and microthrombus formation, which can cause significant circulatory disorders possibly affecting its pathogenesis. [ABSTRACT FROM AUTHOR]

The coronavirus disease-19 (COVID-19), first appearing in Wuhan, China, and later declared as a pandemic, has caused serious morbidity and mortality worldwide. Severe cases usually present with acute respiratory distress syndrome (ARDS), pneumonia, acute kidney injury (AKI), liver damage, or septic shock. However, with recent advances in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) research, the virus´s effect on cardiac tissues has become evident. Reportedly, an increased number of COVID-19 patients manifested serious cardiac complications such as heart failure, increased troponin, and N-terminal pro-B-type natriuretic peptide levels (NT-proBNP), cardiomyopathies, and myocarditis. These cardiac complications initially present as chest tightness, chest pain, and heart palpitations. Diagnostic investigations such as telemetry, electrocardiogram (ECG), cardiac biomarkers (troponin, NT-proBNP), and inflammatory markers (D-dimer, fibrinogen, PT, PTT), must be performed according to the patient´s condition. The best available options for treatment are the provision of supportive care, anti-viral therapy, hemodynamic monitoring, IL-6 blockers, statins, thrombolytic, and anti-hypertensive drugs. Cardiovascular disease (CVD) healthcare workers should be well-informed about the evolving research regarding COVID-19 and approach as a multi-disciplinary team to devise effective strategies for challenging situations to reduce cardiac complications. [ABSTRACT FROM AUTHOR]

In December 2019, a novel coronavirus outbreak with multiple system involvement started initially in Wuhan City, Hubei Province of China. Coronavirus disease 2019 (COVID-19) infection is a systemic disorder typically presenting with fever, fatigue, and upper and lower respiratory symptoms, although neurological manifestations are increasingly reported, but pathological mechanisms have yet to be established. The symptoms of infection with COVID-19 are dependent on the patient's age and underlying medical illness, and on the condition of the immune system. Neurotropic and neuroinvasive capabilities of coronaviruses have been described in humans. We herein report a patient infected with COVID-19 who developed pneumonia associated with acute progressive myelopathy. Neurological examination revealed progressive flaccid areflexic paralysis of lower limbs over 3 days with retention of urine and sensory level at 10th spinal thoracic segment (T10). The patient had a positive nasopharyngeal swab for COVID-19 at the onset of the neurological symptoms. This case of acute progressive myelopathy adds further evidence of the complications of severe COVID-19 infection, and we are dealing with a virus of unpredictable behavior. Since this virus neurotropism is not clear yet, further investigations should be conducted on the mechanism of possible neurological infection in patients with COVID-19. [ABSTRACT FROM AUTHOR]

Objective: To discern the symptomatic features of coronavirus disease 2019 (COVID‐19) and to evaluate the severity and prognosis of the disease. Methods: In this retrospective cohort study, 932 hospitalized patients with COVID‐19 in Wuhan were enrolled, including 52 severe and 880 non‐severe cases. All patients were followed up for 3 months after discharge. The symptomatic features and follow‐up data of the patients in both groups were analyzed and compared. Results: Of the 932 patients, fever (60.0%), cough (50.8%) and fatigue (36.4%) were the most common symptoms. In total, 32.7% of the severe cases presented with gastrointestinal symptoms at disease onset, including anorexia, nausea, vomiting or diarrhea, which was significantly higher than that of the non‐severe group (P = 0.0015). The incidence of olfactory disturbance and dysgeusia was only 3.1% and 6.2%, respectively. After adjusting for age and sex, multivariate regression analysis showed that fever lasting for over 5 days (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.00‐3.62, P = 0.0498), anorexia at onset (OR 2.61, 95% CI 1.26‐5.40, P = 0.0096), and modified Medical Research Council level above grade 2 when dyspnea occurred (OR 14.19, 95% CI 7.01‐28.71, P < 0.0001) were symptomatic risk factors for severe COVID‐19. During the follow‐up, cough (6.2%), dyspnea (7.2%), fatigue (1.8%), olfactory disturbance and dysgeusia (1.5%) were the significant remaining symptoms. Conclusions: COVID‐19 causes clusters of symptoms with multiple systems involved. Certain symptomatic characteristics have predictive value for severe COVID‐19. Short‐term follow‐up data reveal that most patients have a good prognosis. [ABSTRACT FROM AUTHOR]

COVID-19 is a disease caused by the new coronavirus (SARS-CoV-2), identified in Wuhan, China, in December 2019, and declared a pandemic by the World Health Organization in March 2020. Clinical manifestations occur mainly in respiratory system, however some studies have reported extra-pulmonary changes, such as oral and maxillofacial implications. This study aims to verify the possible oral and maxillofacial implications of COVID-19. Therefore, an integrative literature review was carried out. Systematic searches were carried out in SciELO, PubMed, Web of Science, Scopus and Google Scholar from June 6 to 8, 2020. Inclusion criteria were studies that evaluated oral and / or maxillofacial manifestations of COVID-19 and portrayed clinical cases of patients with the disease. Exclusion criteria were studies that were unavailable for reading in full, literature reviews and letters to the editor. Twelve studies were selected, in which the main manifestations were changes in taste and smell, dry mouth, ulcers in the oral mucosa and increase in cervical and submandibular lymph nodes, which may present together with other respiratory symptoms or in isolation. Because of this, the identification of some of these changes can contribute to the early diagnosis of the disease, however more studies are needed to improve the scientific evidence on the subject, to clarify whether part of these changes are manifestations of the disease or a consequence of the immune status of the patient. patient who favors the development of opportunistic infections and neglect of oral hygiene. [ABSTRACT FROM AUTHOR]

An outbreak of coronavirus disease (COVID-19) occurred for the first time in Wuhan, China which spread as a pandemic to various countries of the world, resulting in high morbidity and mortality. Death toll in India on 8th February 2021 was 1,55,080. India had implemented steps such as lockdown and advised social distancing, washing of hands, and wearing masks to reduce the burden of Covid-19. This review discusses the epidemiological features, the population at risk and control strategies of novel coronavirus disease in India. The data was collected from various sources on individual details of Covid-19 cases, population density and affluence percentage from the literature studied. The data was used to analyse the susceptibility of the population to this disease. It was found that Indian males, age group 20 to 40 (based on morbidity) and above 60 (based on mortality) were at high risk. The authors compiled epidemiology, management and control strategies of covid-19 in India. Therefore, because of various early implementations, India has managed the disease well earlier, but in the current scenario (30 Nov 2020) morbidity and mortality have been at peak. Immunization of frontline workers started on 16th January 2021. Initially, 7,017,411 doses of Covishield and Covaxin vaccines have been given by 10th February 2021. Thus, the existing strategies like proper diagnosis, treatment, and successful implementation of vaccine inoculation will reduce covid-19 burden and may lead to normalcy. [ABSTRACT FROM AUTHOR]

Background and Aim: Patients with 2019 novel coronavirus disease (COVID‐19) could present with gastrointestinal symptoms without fever or respiratory manifestations, which could be overlooked by health‐care providers. We aimed to evaluate the clinical characteristics of COVID‐19 in patients presenting with initial gastrointestinal symptoms. Methods: We evaluated all confirmed cases of COVID‐19 in Zhongnan Hospital of Wuhan University between January 10 and February 29, 2020. We divided these patients into two groups: patients with initial gastrointestinal symptoms (group A, n = 183) and patients with respiratory syndrome and/or fever (group B, n = 1228). The clinical characteristics, radiological features, and laboratory data were assessed. Results: The clinical procedures of both groups underwent 1–2 weeks rising period and were downward trend at 3 weeks; less than 5% of patients progressed to critical illness. In both groups, mean leukocyte count (P = 0.354) and lymphocyte count (P = 0.386) were below normal, and C‐reactive protein level was elevated (P = 0.412). There was mild liver function injury (aspartate aminotransferase, 65.8 ± 12.7 vs 67.4 ± 9.3 U/L, P = 0.246; alanine aminotransferase, 66.4 ± 13.2 vs 69.6 ± 12.7 U/L, P = 0.352), and normal renal function was intact (blood urea nitrogen 6.4 ± 2.5 vs 5.6 ± 2.8 mmol/L P = 0.358; creatinine 85.7 ± 37.2, 91.2 ± 32.6 μmol/L, P = 0.297). After a series of treatment, 176 and 1169 were stable and alive in groups A and B, respectively. The survival rate did not differ significantly between the groups (P = 0.313). Conclusion: COVID‐19 patients presented with initial gastrointestinal symptoms had similar clinical characteristics and outcomes, when compared with patients with fever and respiratory symptoms. [ABSTRACT FROM AUTHOR]

The etiology of chronic eosinophilic pneumonia (CEP) is not precisely known, although its characteristic features include eosinophilia, involving alveoli or blood; subacute or chronic respiratory and general symptoms; while chest radiological imaging shows peripheral pulmonary infiltrates. Many cases of pneumonia associated with the new coronavirus (2019-nCoV) were detected in Wuhan, China starting in December 2019. HRCT is a highly sensitive and convenient screening tool for 2019-nCoV. The radiological appearance of the new coronavirus pneumonia is not very different from that of the common viral pneumonia, but it has some unique features. It usually manifests with patchy or punctuate opacities resembling ground glass (85.7%), and patchy consolidation (19.0%), and the lesions are mainly located in the subpleural area. Here we present a case of CEP who presented with shortness of breath, cough, fever, and a clinical and radiological picture similar to COVID-19. [ABSTRACT FROM AUTHOR]

In December 2019, a novel coronavirus was isolated from the respiratory epithelium of patients with unexplained pneumonia in Wuhan, China. This pathogen, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a pathogenic condition that has been termed coronavirus disease 2019 (COVID-19) and has reached pandemic proportions. As of 17 September 2020, more than 30 million confirmed SARS-CoV-2 infections have been reported in 204 different countries, claiming more than 1 million lives worldwide. Accumulating evidence suggests that SARS-CoV-2 infection can lead to a variety of clinical conditions, ranging from asymptomatic to life-threatening cases. In the early stages of the disease, most patients experience mild clinical symptoms, including a high fever and dry cough. However, 20% of patients rapidly progress to severe illness characterized by atypical interstitial bilateral pneumonia, acute respiratory distress syndrome and multiorgan dysfunction. Almost 10% of these critically ill patients subsequently die. Insights into the pathogenic mechanisms underlying SARS-CoV-2 infection and COVID-19 progression are emerging and highlight the critical role of the immunological hyper-response - characterized by widespread endothelial damage, complement-induced blood clotting and systemic microangiopathy - in disease exacerbation. These insights may aid the identification of new or existing therapeutic interventions to limit the progression of early disease and treat severe cases. [ABSTRACT FROM AUTHOR]

Since SARS-CoV-2 virus emerging in winter 2019 in Wuhan, Hubei, China, COVID-19 has spread among different countries. The novel corona virus has affected more than 15,000,000 people all around the world. Becoming pandemic, COVID-19 is a major concern for both people and health systems. Novel corona virus affects multiple organs such as lungs and kidneys which can lead to acute respiratory distress syndrome and acute kidney injury (AKI) ending to death. Furthermore, patients with COVID-19 may present different atypical symptoms making the diagnoses more complicated. The current patient presented to the emergency department with a 7-day history of hemoptysis and hematuria which are among the less common symptoms among patients infected with SARS-CoV-2 virus. In addition to delayed diagnosis, atypical symptoms and signs make management and treatment more difficult. Awareness of new, atypical symptoms and the effective treatment is associated with better outcome and prognosis. [ABSTRACT FROM AUTHOR]

In December 2019, an emergence of pneumonia was detected in patients infected with a novel coronavirus (CoV) in Wuhan (Hubei, China). The International Committee on Taxonomy of Viruses named the virus severe acute respiratory syndrome‑CoV‑2 and the disease CoV disease‑19 (COVID‑19). Patients with COVID‑19 present with symptoms associated with respiratory system dysfunction and hematological changes, including lymphopenia, thrombocytopenia and coagulation disorders. However, to the best of our knowledge, the pathogenesis of COVID‑19 remains unclear. Therefore, understanding the mechanisms underlying the hematological changes that manifest during COVID‑19 may aid in the development of treatments and may improve patient prognosis. [ABSTRACT FROM AUTHOR]

Numerous unexplained pneumonia cases were reported to the World Health Organization (WHO) by Wuhan, China, in December 2020. Severe acute respiratory syndrome coronavirus−2 (SARS‐CoV‐2), a zoonotic pathogen, came into sight, spreading coronavirus disease 2019 (COVID‐19) all over the globe. Association of cutaneous signs and symptoms with COVID‐19 is being studied worldwide, principally, to determine if these dermatoses can help in early recognition of SARS‐CoV‐2 infection. These dermatological manifestations can range from erythematous rash, urticaria to livedo reticularis, and acrocyanosis in patients of all age groups. Correspondingly, dermatologists treating COVID‐19 patients, suffering from inflammatory dermatoses, with biologics or immunomodulators should exert caution and use specific protocols to adjust the doses of these medications. Prevention of person‐to‐person transmission of COVID‐19 is being promoted universally, with the use of personal protective equipment (PPE), hand washes, and hand sanitizers around the clock. However, an array of cutaneous adverse effects such as contact dermatitis, irritant contact dermatitis, friction blisters, contact urticaria, acne, and infections are associated with the use of PPE. Extra‐pulmonary manifestations of COVID‐19 are still emerging in the community, and physicians and researchers are working together globally to strengthen the clinical management of these patients. Cases of COVID‐19 continue to rise across the world, and an unprecedented approach has been taken to develop effective vaccines and therapeutic strategies against existing and forthcoming mutagenic strains of SARS‐CoV‐2. [ABSTRACT FROM AUTHOR]

Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which originated from Wuhan, China, has spread to the other countries in a short period of time. We report a 47-year-old male who was admitted to our hospital due to suffering from progressive vertigo and ataxia for 7 days prior to the admission. Neurological examination revealed cerebellar dysfunction, and brain magnetic resonance imaging (MRI) depicted edema of the cerebellar hemisphere associated with leptomeningeal enhancement. Cerebrospinal fluid (CSF) analysis showed mild lymphocytic pleocytosis, elevated protein, and lactate dehydrogenase. SARS-CoV-2 RNA was detected in the oropharyngeal/nasopharyngeal and CSF specimens. As a result, treatment with lopinavir/ritonavir was initiated, and patient symptoms and signs improved significantly during the course of hospitalization. To the best of our knowledge, this is the first case of acute cerebellitis associated with COVID-19 disease which is reported in the literature so far. [ABSTRACT FROM AUTHOR]

Background: In December 2019, the novel coronavirus (SARS-CoV-2) infection was first reported in Wuhan city, central China, which has spread rapidly. The common clinical features of patients with SARS-CoV-2 infection included fever, fatigue, and damage to the respiratory or digestive system. However, it is still unclear whether SARS-CoV-2 infection could cause damage to the central nervous system (CNS) inducing psychiatric symptoms.Case Report: Herein, we present the first case of SARS-CoV-2 infection with manic-like symptoms and describe the diagnosis, clinical course, and treatment of the case, focusing on the identifications of SARS-CoV-2 in the specimen of cerebrospinal fluid (CSF). The patient developed manic-like symptoms when his vital signs recovered on illness day 17. After manic-like attack, the detection of SARS-CoV-2 specific IgG antibody in CSF was positive, while the reverse transcriptase-polymerase chain reaction (RT-PCR) on CSF for the SARS-CoV-2 was negative. The patient received Olanzapine for treatment and his mood problems concurrently improved as indicated by scores of Young Manic Rating Scale (YMRS).Limitation: This is a single case report only, and the RT-PCR test for SARS-CoV-2 in CSF was not performed simultaneously when SARS-CoV-2 was positive in samples of sputum and stool.Conclusion: This first case of COVID-19 patient with manic-like symptoms highlights the importance of evaluation of mental health status and may contribute to our understanding of potential risk of CNS impairments by SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

An outburst of novel coronavirus (COVID-19) that began in Wuhan, China, has blowout speedily, with cases nowadays established in numerous nations. Although COVID-19 is utmost well-known for creating substantial respiratory signs, it can also result in numerous extrapulmonary appearances. These situations include thrombotic difficulties, myocardial dysfunction and arrhythmia, acute coronary illness, acute kidney and gastrointestinal indications, hepatocellular damage, high blood sugar and ketosis, neurologic illnesses, ocular symptoms, and dermatologic complications. In our research, we documented the first cases of COVID-2019 infection in the gastrointestinal tract (GIT) in Thi-Qar city, south of Iraq. We categorized the patient's initial mild symptoms of the disease course with expansion to extrapulmonary symptoms in about a week after the illness. We described the diagnosis and laboratory tests of the cases. From 130 COVID-19 positive cases, there was 110 cases has both pulmonary and digestive signs, while, only 20 has display digestive signs alone. Our positive cases have shown increased level of ferritin, D-dimmer and IgM serum level. In conclusion, our data urge the importance of close collaboration between clinicians, laboratory scientist and government authorities, as well as the urgent need for rapid spreading of clinical statistics linked to the care of Iraqi patients with this evolving novel viral infection. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) is caused by SARS-CoV-2 virus, which can result in serious respiratory illnesses such as pneumonia leading to respiratory failure. It was first reported in Wuhan, Hubei, China, in December 2019 and rapidly spread globally, becoming a pandemic in March 2020. Among comorbidities observed in SARS-CoV-2 positive patients, hypertension (68.3%) and type 2-diabetes (30.1%) are the most frequent conditions. Although symptoms are highly heterogeneous (ranging from absence of symptoms to severe acute respiratory failure), patients with metabolic-associated diseases often experience worse COVID-19 outcomes. This review investigates the association between metabolic disorders and COVID-19 severity, exploring the molecular mechanisms potentially underlying this relationship and those that are responsible for more severe COVID-19 outcomes. In addition, the role of the main biological processes that may connect metabolic alterations to SARS-CoV-2 infection such as hyperglycemia, immune system deregulation, ACE-2 receptor modulation, and inflammatory response is described. The impact of metabolic disorders on the prognosis of COVID-19 has major implications in public health especially for countries affected by a high incidence of metabolic diseases. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is an emerging viral disease. Here, we report the clinical features, management, and short-term outcomes of COVID-19 patients in Wenzhou, China, an area outside Wuhan.Methods: Patients admitted to the Infectious Diseases Department of Ruian People's Hospital in Wenzhou, from January 21 to February 7, 2020, were recruited. Medical data on epidemiological history, demographics, clinical characteristics, laboratory tests, chest computerized tomography (CT) examination, treatment, and short-term outcomes were retrospectively reviewed. Blood biochemistry and routine tests were examined using standard methods and automatic machines. CT examination was performed several times during hospitalization as necessary.Results: A total of 67 confirmed COVID-19 cases were diagnosed; 64 (95.4%) were common cases and three (4.5%) were severe cases. The most common symptoms at admission were fever (86.6%), cough (77.6%), productive cough (52.2%), chest distress (17.9%), and sore throat (11.9%), followed by diarrhea (7.4%), headache (7.4%), shortness of breath (6.0%), dizziness (4.5%), muscular soreness (4.5%), and running nose (4.5%). Thirty patients (47.8%) had increased C-reactive protein levels. The CT radiographs at admission showed abnormal findings in 54 (80.6%) patients. The patients were treated mainly by oxygen therapy and antiviral drugs. By March 3, 2020, all 67 patients completely recovered and had negative nucleic acid tests. The patients were discharged from the hospital and transferred to a medical observation isolation center for further observation.Conclusion: Cases of COVID-19 in Wenzhou are milder and have a better prognosis, compared to those in Wuhan. Timely and appropriate screening, diagnosis, and treatment are the key to achieve good outcomes. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused a pandemic coronavirus disease-19 (COVID-19) that began in Wuhan city, China, in December 2019. Till 14th April, 19,39,801 people have been affected by this virus, of whom 1,20,897 died. Though respiratory symptoms are the typical manifestation of this disease, gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, loss of taste sensation, diarrhea, abdominal pain, and discomfort have been reported. The pooled prevalence of GI symptom is 17.6% (95% confidence interval, 12.3%–24.5%), as indicated in a meta-analysis. A few studies suggested that the presence of GI symptoms is associated with poorer prognosis. The virus is excreted in feces during the acute disease, and even after, the nasopharyngeal swab has become negative for viral ribonucleic acid. Fecal viral excretion may have clinical significance because of possible feco-oral transmission of the infection. Nearly, 10.5%–53% of patients with COVID-19, particularly those with severe disease, have been shown to have an elevation of hepatic enzymes though biochemical and clinical jaundice are uncommon. Knowledge about this disease in general and GI involvement, in particular, is currently evolving. [ABSTRACT FROM AUTHOR]

COVID‐19 is highly contagious pathogenic viral infection initiated from Wuhan seafood wholesale market of China on December 2019 and spread rapidly around the whole world due to onward transmission. This recent outbreak of novel coronavirus (CoV) was believed to be originated from bats and causing respiratory infections such as common cold, dry cough, fever, headache, dyspnea, pneumonia, and finally Severe Acute Respiratory Syndrome (SARS) in humans. For this widespread zoonotic virus, human‐to‐human transmission has resulted in nearly 83 lakh cases in 213 countries and territories with 4,50,686 deaths as on 19 June 2020. This review presents a report on the origin, transmission, symptoms, diagnosis, possible vaccines, animal models, and immunotherapy for this novel virus and will provide ample references for the researchers toward the ongoing development of therapeutic agents and vaccines and also preventing the spread of this disease. [ABSTRACT FROM AUTHOR]

Coronaviruses are positive-sense single-strand RNA viruses that infect amphibians, birds, and mammals. Coronavirus Disease 2019 (COVID-19) has become a major health problem caused by one of the coronaviruses called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has spread fast throughout the globe since its first identification in Wuhan, China, in December 2019. Although COVID-19 is principally defined by its respiratory symptoms, it is now clear that the virus can also affect the digestive system causing gastrointestinal (GI) symptoms like diarrhea, loss of appetite, nausea/vomiting, and abdominal pain as a major complaint. GI symptoms could be the initial signs of preceding respiratory signs, carrying a potential for slowed investigation and raised disease transmission opportunities. Various studies recognized the COVID-19 RNA in stool specimens of infected patients, and its viral receptor angiotensin-converting enzyme-2 (ACE-2) is highly expressed in GI epithelial cells. Many cases were reported negative using nasopharyngeal/oropharyngeal swabs and finally, SARS‐CoV‐2 RNA was detected in their anal/rectal swabs and stool specimens. These suggest that COVID-19 can actively infect and replicate in the GI tract. In this review, we elaborate on the close relationship between SARS-CoV-2 and the digestive system, focusing on the current status in the field of COVID-19 in gastroenterology, liver injury, endoscopy, inflammatory bowel disease, imaging, and the potential underlying mechanisms with illustrating the current epidemiological status regarding this pandemic. [ABSTRACT FROM AUTHOR]

Introduction: The first cases of coronavirus disease 2019 (COVID-19) were noted in December 2019 in Wuhan province, China. The World Health Organisation (WHO) announced the pandemic status on March 11, 2020. The manifestations of the disease are as follows: fever, cough, fatigue, anosmia and ageusia, dyspnoea, chest pain, muscle soreness, chills, sore throat, rhinitis, headache, gastrointestinal (GI) symptoms, and dermal lesions. Aim: To evaluate the relationship between dermal lesions and GI symptoms in a group of COVID-19 patients. Material and methods: A group of 441 COVID-19 patients admitted to the Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw between March 15th and June 15th, 2020. Results: Of 441 patients with confirmed SARS-CoV-2 infection, 255 (58.5%) experienced gastrointestinal (GI) symptoms: lack of appetite was reported in 124 (48.6%) cases, diarrhoea was noted in 109 (42.7%), abdominal pain in 95 (37.3%), vomiting in 37 (14.5%), and nausea in 32 (12.5%) cases. Eight (1.81%) patients had dermal lesions: erythematous macular lesions (2 patients - 25%), erythematous infiltrated lesions (2; 25%), erythematous infiltrated and exfoliative lesions (3; 37.5%), erythematous papular lesions (3; 37.5%), and erythematous oedematous lesions (2; 25%). All of those patients reported gastrointestinal symptoms during the hospitalisation. Conclusions: The following study analyses possible causes of dermal lesions and their coexistence with GI symptoms. Several possible theories were taken into account, including the microbiota alterations and issue of drug-related complications. [ABSTRACT FROM AUTHOR]

• A high rate of asymptomatic SARS-CoV-2 carriers was found in healthcare workers. • Asymptomatic individuals had lower antibody levels in the acute phase. • Asymptomatic IgG titration reduced during the early convalescent phase. To investigate the proportion and characteristics of asymptomatic infection among healthcare workers (HCWs). This study retrospectively investigated 1407 HCWs who were screened for COVID-19 by chest computed tomography (CT) scans and nasopharyngeal swabs for SARS-CoV-2 nucleic acid. Demographics, CT features, nasopharyngeal swabs, baseline symptoms, and laboratory data were collected. Of 1407 HCWs, 235 had symptoms and 1172 were asymptomatic close contacts, of which, 107 were symptomatic cases and 84 were close contacts who had abnormal CT findings. Of 152 symptomatic individuals and 908 close contacts tested for SARS-CoV-2 nucleic acid, 122 symptomatic cases and 38 close contacts had positive reverse-transcriptase real-time polymerase chain (RT-PCR) test results. The rate of confirmed asymptomatic infections was 4.2% (38/908). Both symptomatic and asymptomatic infected cases had high titrations of specific IgG or had ≥four-fold increase in IgG during convalescence compared with the acute phase. Combining the RT-PCR tests and serological findings, the rate of asymptomatic infections was 9.7% (88/908). In terms of the duration of viral shedding, there was no significant difference between symptomatic mild/moderate participants and asymptomatic infections. The findings demonstrated that a high rate of asymptomatic SARS-CoV-2 carriers existed among healthcare worker close contacts during the outbreak of COVID-19. [ABSTRACT FROM AUTHOR]

Background. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR2-COV-2) and was first identified in Wuhan, China, in December of 2019, but quickly spread to the rest of the world, causing a pandemic. While some studies have found no link between smoking status and severe COVID-19, others demonstrated a significant one. The present study aimed to determine the relationship between smoking and clinical COVID-19 severity via a systematic meta-analysis approach. Methods. We searched the Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting smoking status and comparing nonsevere and severe patients were included. Nonsevere cases were described as mild, common type, nonintensive care unit (ICU) treatment, survivors, and severe cases as critical, need for ICU, refractory, and nonsurvivors. Results. A total of 16 articles detailing 11322 COVID-19 patients were included. Our meta-analysis revealed a relationship between a history of smoking and severe COVID-19 cases (OR = 2.17 ; 95% CI: 1.37–3.46; P <.001). Additionally, we found an association between the current smoking status and severe COVID-19 (OR = 1.51 ; 95% CI: 1.12–2.05; P <.008). In 10.7% (978/9067) of nonsmokers, COVID-19 was severe, while in active smokers, severe COVID-19 occurred in 21.2% (65/305) of cases. Conclusion. Active smoking and a history of smoking are clearly associated with severe COVID-19. The SARS-COV-2 epidemic should serve as an impetus for patients and those at risk to maintain good health practices and discontinue smoking. The trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) CRD42020180173. [ABSTRACT FROM AUTHOR]

Coronavirus 2019 disease (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It emerged in Wuhan, China, in December 2019 and has caused a widespread global pandemic. The symptoms of COVID-19 can vary from mild upper respiratory symptoms to severe pneumonia with hypoxemic respiratory failure. Multiple studies and reports have reported a hypercoagulable state associated with this disease, and various recommendations have emerged to guide the use of anticoagulants for prophylaxis. We are reporting a case of symptomatic acute splenic thrombosis causing splenic infarction in a patient suffering from a severe case of COVID-19 and despite the use of an intermediate dose of low-molecular-weight heparin (LMWH). The patient was treated with full-dose anticoagulation and was eventually discharged home on a direct oral anticoagulant. [ABSTRACT FROM AUTHOR]

In December 2019, China reported several cases of a new coronavirus disease (COVID-19). The COVID-19 outbreak, which was initially limited to Wuhan, China, has rapidly spread worldwide. Infection of the disease occurs through exposure to the virus through inhalation of respiratory droplets or if a person touches a mucosal surface after touching an object with the virus on it. The common symptoms of COVID-19 are fever, dry cough, dyspnea (difficult or labored breathing), fatigue, chest pain, and myalgia (muscle pain), etc. Real-time polymerase chain reaction is used to detect the virus in sputum, throat, nasal swabs, and secretion of lower respiratory samples. Early diagnosis, isolation, and supportive care are necessary for the treatment of the patients. The present review aims to provide recent information on COVID-19 related to its epidemiology, clinical symptoms, and management. This article also summarizes the current understanding of severe acute respiratory syndrome coronavirus-2 and its history of origin. [ABSTRACT FROM AUTHOR]

Since December 2019, an increasing number of cases associated with the 2019 novel coronavirus (2019-nCoV) have emerged in Wuhan, China, which has resulted in a rapid outbreak in China and worldwide. The present study aimed to describe the clinical, laboratory and radiological characteristics of 2019-nCoV pneumonia (NCP) in Zhejiang province, outside of Wuhan. A total of 74 patients with 2019-nCoV were continuously enrolled between January 22 and March 2, 2020 at Zhejiang Hospital. Diagnosis was confirmed at Zhejiang Hospital by reverse transcription-PCR (RT-PCR), which was approved by the Chinese government. Subsequently, the clinical features between positive- and negative-NCP patients in Zhejiang were compared. Among the 74 hospitalized patients with suspected 2019-NCP, six patients (one male and five female patients) were confirmed to be infected with 2019-nCoV by RT-PCR. The average age of the confirmed patients was 40±13 years. There were three family clusters among the confirmed cases, one patient from each of these families had travel history or contact with patients from Wuhan within 2 weeks. Compared with non-NCP patients, the most common symptoms at onset for patients with NCP were fever (5/6; 83.3%) and cough (5/6; 83.3%), followed by dyspnea/pharyngalgia (2/6; 33.3%), whereas myalgia (1/6; 16.7%) and fatigue (1/6; 16.7%) were less common. All 74 patients with suspected NCP exhibited abnormal computerized tomography (CT) images. In total, 2/6 (33.3%) patients with confirmed NCP presented with bilateral pneumonia, and 21/68 (30.9%) non-NCP patients exhibited bilateral pneumonia, with bilateral distribution of patchy shadows or ground glass opacity. The present study revealed that epidemiological history was critical to the diagnosis of 2019-nCoV in low epidemic regions outside Hubei province. It was also identified that chest CT could not replace nucleic acid testing due to similar radiological manifestations. [ABSTRACT FROM AUTHOR]

The coronavirus family has significant human and animal pathogens. At the end of December 2019, a novel coronavirus was recognized as the reason for a group of pneumonia cases of unidentified etiology in Wuhan, a city in the Hubei Province of China. The novel coronavirus has rapidly become widespread, resulting in an epidemic throughout China, followed by a pandemia, an increasing number of cases in various countries throughout the world. Coronavirus disease 2019 (COVID-19) is spread through large droplets produced during coughing and sneezing by symptomatic patients, as well as asymptomatic individuals before starting of their symptoms. The incubation period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is assumed to be 14 days succeeding exposure, mostly around four to five days. Individuals of all ages may acquire SARS-CoV-2 infection, although middle age and older individuals are the majority. The usual clinical characteristics involve fever, dry cough, fatigue, sore throat, rhinorrhea, conjunctivitis headache, myalgia, dyspnea, nausea, vomiting and diarrhea. Hence, there are no unique clinical features that yet dependably differentiate COVID-19 disease from other upper/lower airway viral infections. In a subgroup of cases, by the end of the first week, COVID-19 disease may develop to pneumonia, pulmonary failure and death. The aim is here to discuss the COVID-19 disease beginning from virology, epidemiology and continuing with clinical manifestations, diagnosis, its complications and to finish with available therapeutic options and conclusion. [ABSTRACT FROM AUTHOR]