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Background: Limited studies have explored the association between clinical symptoms and titers of SARS‐CoV‐2 antibodies. Study Design and Methods: In this cross‐sectional study, whole‐blood donors who had experienced a confirmed or suspected COVID‐19 infection completed questionnaires at the time of blood donation. Plasma SARS‐CoV‐2 immunoglobulin G (IgG) titers were measured using an enzyme‐linked immunosorbent assay. Logistic regression models were used to calculate odds ratios (ORs) for high‐titer COVID‐19 convalescent plasma (CCP) for each variable. Results: Among the total 386 donors, 120 (31%) donors with IgG titers ≥1:160 were classified as high‐titer donors. The multivariable ORs (95% confidence intervals [CIs]) for high titers were 2.33 (1.45–3.75), 2.11 (1.29–3.43), 1.10 (1.01–1.21), 1.19 (1.00–1.43), and 1.97 (1.05–3.71) for sore throat, cough, symptom count, fever duration, and low fever (compared with non‐fever), respectively. No significant association was observed between other symptoms and medical visits and the odds of high‐titer CCP. The association between high‐titer CCP and fever duration was restricted to confirmed COVID‐19‐infected donors, while associations with sore throat and cough remained significant in suspected infected donors. In addition, medical visit was positively associated with high‐titer CCP in suspected donors, but not in confirmed donors. In bootstrapped logistic regression models, the associations remained significant and reproducible for medical visit in suspected donors and for sore throat and cough in both suspected donors and total donors. Discussion: Experiencing a sore throat and cough were associated with high‐titer CCP in overall donors. We also identified sore throat, cough, and medical visits as potential predictors of high‐titer CCP for suspected donors during the pandemic. [ABSTRACT FROM AUTHOR]

Objectives: At the end of 2022, the COVID-19 outbreak erupted in China, and BA.5.2 or BF.7 subtypes of Omicron novel variations were implicated in more than 90% of the cases. We created a real-world questionnaire survey to better understand how this new variant pandemic was affecting rheumatic patients in China. Methods: During the COVID-19 outbreak in China, the subjects of this study were rheumatic patients and non-rheumatic individuals (control group), who were matched for sex and age. Professional physicians carefully questioned the participants before administering a questionnaire as part of the study. This study focused on the general baseline characteristics, clinical symptoms and treatment after COVID-19 infection, and the target populations' awareness of COVID-19. Results: The study included 1130 participants, of whom 572 were assigned to the rheumatic group and 558 to the control group. The percentage of vaccinated controls was significantly higher than that of rheumatic patients (90.1% vs. 62.8%, p < 0.001), while the rate of COVID-19 infection was not significantly different between the two groups (82.3% vs. 86.6%, p = 0.051). Patients with rheumatic disease experienced substantially more days of fever following infection (2.87 ± 3.42 vs. 2.18 ± 1.65, p = 0.002) compared to individuals in the control group. The rheumatic patients had a greater prevalence of cough (67.1% vs. 54.0%, p < 0.001), somnipathy (13.8% vs. 6.0%, p < 0.001), and conjunctivitis/ophthalmodynia (5.3% vs. 2.1%, p = 0.008), while dry throat/throat pain/weakness (49.9% vs. 59.4%, p = 0.003), myalgia/osteodynia (33.3% vs. 41.8%, p = 0.003), and dyspnea (14.0% vs. 25.3%, p < 0.001) were more likely to occur in non-rheumatic group after infection. Human immunoglobulin (2.1% vs. 0.2%, p = 0.006), glucocorticoids (19.5% vs. 1.6%, p < 0.001), oxygen support (6.8% vs. 2.1%, p < 0.001), and traditional Chinese medicine (21.9% vs. 16.6%, p = 0.037) were all more frequently used by rheumatic patients with COVID-19 infection. People in the control group were more confused about whether to use masks in following social activities after contracting COVID-19 (14.7% vs. 7.6%, p = 0.001). In the control group, more individuals than patients with rheumatic disease (25.1% vs. 13.4%, p < 0.001) expressed an interest to receive the vaccine again. After being exposed to COVID-19, the majority of rheumatic patients (66.9%) reported no discernible change, only 29.1% reported a worsening of their symptoms, and the remaining 4% indicated an improvement. Conclusions: After the COVID-19 outbreak in China, the proportion of patients with rheumatic diseases infected with the virus was similar to that of normal individuals. But the clinical symptoms, follow-up treatment requirements, and awareness of the COVID-19 among rheumatic patients were distinct from those among non-rheumatic patients, necessitating the use of individualized diagnosis and treatment plans as well as health advice by medical professionals in clinical work. Key Points • Despite there were different comorbidities and vaccination rates, the rate of COVID-19 infection in patients with rheumatic disease was similar to that of normal individuals. • After COVID-19 infection, rheumatic patients and normal controls had different clinical symptoms and drug usage. • After being exposed to COVID-19, the majority of rheumatic patients felt no significant change in the primary disease, while the normal controls was more likely to accept a new vaccine injection and confused about whether to use masks in following social activities. [ABSTRACT FROM AUTHOR]

Patients infected with the Omicron variant of SARS-CoV-2 mainly develop mild COVID-19, manifesting as upper respiratory symptoms, fatigue, and fever. Shufeng Jiedu capsule (SFJDC), a traditional Chinese medicine indicated for treatment of upper respiratory infections in China, was tested for its efficacy and safety in treatment of an Omicron infection at a mobile cabin hospital in response to an outbreak of COVID-19 in Shanghai, China in April 2022. In this open-label, randomized controlled trial, patients in the control group received best supportive care, while those in the test group received additional SFJDC therapy for 7 days. SFJDC markedly alleviated patients' symptoms including a sore throat, coughing, fatigue, and a fever after 7 days of treatment. The virus negative time was significantly shorter in the SFJDC treatment group, but there were no obvious differences in the virus negative rate between the two groups at the end of the 7-day follow-up. These results suggest that patients with the Omicron infection may benefit from SFJDC treatment. Double-blind, randomized controlled trials are warranted to comprehensively evaluate the efficacy and safety of SFJDC in a large cohort study in the future. [ABSTRACT FROM AUTHOR]

Background and objectives: At present, the focus of the fighting against COVID-19 in China is shifting to strictly prevent the entrance of cases from abroad and disease transmission. Therefore, it is extremely urgent to better understand the clinical features of imported cases from overseas countries, which is conductive to formulate the corresponding countermeasures. This study aimed to describe the clinical features of COVID-19 cases imported from Russia through the Suifenhe port, in order to identify baseline and clinical data associated with disease progression and present corresponding countermeasures. Methods: All COVID-19 cases imported from Russia through the Suifenhe port were included in this retrospective study. According to the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (seventh edition)", imported COVID-19 cases were divided into asymptomatic infection, mild, moderate, severe, and critical groups. Baseline and clinical data, including age, gender, comorbidities, disease severity, symptoms at onset, body temperature, white blood cell (WBC) count, lymphocyte (LYMPH) count, lymphocyte percentage (LYM%), C-reactive protein (CRP), oxygenation index (OI), and the use therapeutic modalities were obtained on admission, and then compared between groups. Results: A total of 375 COVID-19 cases imported from Russia through Suifenhe port were included, of whom the asymptomatic infection, mild, moderate, severe, and critical groups accounted for 4.0%, 13.9%, 75.5%, 5.3%, and 1.3%, respectively. The majority of the imported COVID-19 cases were men (61.9%) with a median age of 38.72 years who had no comorbidity (87.7%). Nearly one-third of them (33.1%) were asymptomatic at onset, and common initial symptoms included fever (36.5%), cough (36.0%), pharyngeal discomfort (12.3%), expectoration (8.0%), and chest tightness (5.3%). In total, 180 (48%) and 4 (1.1%) enrolled imported cases received nasal tube oxygen inhalation therapy and high-flow oxygen absorption, respectively; the remaining patients did not undergo oxygen therapy. The values of age, body temperature, WBC, LYMPH, LYM%, CRP, and OI were 38.72 ± 10.50, 35.10 ± 7.92, 5.59 ± 1.97, 1.67 ± 0.68, 31.05 ± 10.22, 8.00 ± 14.75, and 389.03 ± 74.07, respectively. Gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy showed significant differences between groups (P = 0.036, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, = 0.045, < 0.001, respectively). Conclusions: Compared with domestic confirmed patients, COVID-19 patients who arrived at China from Russia through the Suifenhe port had significantly different clinical features, and the differences in gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy between groups were statistically significant. Therefore, detailed and comprehensive countermeasures were developed to manage and prevent another outbreak based on these clinical features. [ABSTRACT FROM AUTHOR]

In the last month of 2019, a new virus emerged in China, spreading rapidly and affecting the whole world. This virus, which is called corona, is the most contagious type of virus that humanity has ever encountered. The virus has caused a huge crisis worldwide as it leads to severe infections and eventually death in humans. On March 11, 2020, it was announced by the World Health Organization that a COVID-19 outbreak has occurred. Computer-aided digital technologies, which eliminate many problems and provide convenience in people's lives, did not leave humanity alone in this regard and rushed to provide a solution for this unfortunate event. One of the important aspects in which computer-aided digital technologies can be effective is the diagnosis of the disease. Reverse transcription-polymerase chain reaction (RT-PCR), which is a standard and precise technique for diagnosing the disease, is an expensive and time-consuming method. Moreover, its availability is not the same all over the world. For this reason, it can be very attractive and important to distinguish the COVID-19 disease from a cold or flu through a cough sound analysis via smartphones which have entered into the lives of many people in recent years. In this study, we proposed a machine learning-based system to distinguish patients with COVID-19 from non-COVID-19 patients by analyzing only a single cough sound. Two different data sets were used, one accessible for the public and the other available on request. After combining the data sets, the features were obtained from the cough sounds using the mel-frequency cepstral coefficients (MFCCs) method, and then, they were classified with seven different machine learning classifiers. To determine the optimum values of hyperparameters for MFCCs and classifiers, the leave-one-out cross-validation (LOO-CV) strategy was implemented. Based on the results, the k-nearest neighbors classifier based on the Euclidean distance (kNN Euclidean) with the accuracy rate, sensitivity of COVID-19, sensitivity of non-COVID-19, F-measure, and area under the ROC curve (AUC) of 0.9833, 1.0000, 0.9720, 0.9799, and 0.9860, respectively, is more successful than other classifiers. Finally, the best and most effective features were determined for each classifier using the sequential forward selection (SFS) method. According to the results, the proposed system is excellent compared with similar studies in the literature and can be easily used in smartphones and facilitate the diagnosis of COVID-19 patients. In addition, since the used data set includes reflex and unconscious coughs, the results showed that conscious or unconscious coughing has no effect on the diagnosis of COVID-19 patients based on the cough sound. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic since its outbreak in Wuhan, China. It is an urgent task to prevent and treat COVID-19 effectively early. In China's experience combating the COVID-19 pandemic, Chinese herbal medicine (CHM) has played an indispensable role. A large number of epidemiological investigations have shown that mild to moderate COVID-19 accounts for the largest proportion of cases. It is of great importance to treat such COVID-19 cases, which can help control epidemic progression. Many trials have shown that CHM combined with conventional therapy in the treatment of mild to moderate COVID-19 was superior to conventional therapy alone. This review was designed to evaluate the add-on effect of CHM in the treatment of mild to moderate COVID-19. Methods: Eight electronic databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the Clinical Trials.gov website, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database and China Biology Medicine (CBM) were searched from December 2019 to March 2021 without language restrictions. Two reviewers searched and selected studies, and extracted data according to inclusion and exclusion criteria independently. Cochrane Risk of Bias (ROB) tool was used to assess the methodological quality of the included RCTs. Review Manager 5.3.0 software was used for statistical analysis. Results: Twelve eligible RCTs including 1393 participants were included in this meta-analysis. Our meta-analyses found that lung CT parameters [RR = 1.26, 95% CI (1.15, 1.38), P<0.00001] and the clinical cure rate [RR = 1.26, 95%CI (1.16, 1.38), P<0.00001] of CHM combined with conventional therapy in the treatment of mild to moderate COVID-19 were better than those of conventional therapy. The rate of conversion to severe cases [RR = 0.48, 95%CI (0.32, 0.73), P = 0.0005], TCM symptom score of fever [MD = -0.62, 95%CI (-0.79, -0.45), P<0.00001], cough cases [RR = 1.43, 95%CI (1.16, 1.75), P = 0.0006], TCM symptom score of cough[MD = -1.07, 95%CI (-1.29, -0.85), P<0.00001], TCM symptom score of fatigue[MD = -0.66, 95%CI (-1.05, -0.28), P = 0.0007], and CRP[MD = -5.46, 95%CI (-8.19, -2.72), P<0.0001] of combination therapy was significantly lower than that of conventional therapy. The WBC count was significantly higher than that of conventional therapy[MD = 0.38, 95%CI (0.31, 0.44), P<0.00001]. Our meta-analysis results were robust through sensitivity analysis. Conclusion: Chinese herbal medicine combined with conventional therapy may be effective and safe in the treatment of mild to moderate COVID-19. More high-quality RCTs are needed in the future. [ABSTRACT FROM AUTHOR]

Background: In December 2019, pneumonia associated with COVID-19 has spread from Wuhan to other areas in China. In the present study, we aimed to further clarify the clinical features and outcomes of acute kidney injury (AKI) in patients infected with COVID-19 in Xiangyang, Hubei, China. Methods: All confirmed cases of COVID-19 with AKI in Xiangyang Central Hospital from January 22 to May 31, 2020, were included in this retrospective study. Data of epidemiological, clinical, laboratory, radiological tests, treatment, complication, and outcomes were collected and analyzed. Patients were divided into intensive care unit (ICU) group and isolation ward (non-ICU) group. Results: Of the total patients, 33.3% in the non-ICU group and 85.7% in the ICU group had chronic diseases. In addition, 85.7% of patients in the ICU group died. The most common symptoms were fever, cough, and fatigue. The lymphocyte count in the ICU group was significantly reduced compared with the non-ICU group. The chest computed tomography (CT) images appeared showed multiple mottles and ground-glass opacity. Strip shadow could be found in chest CT images of some recovered patients. All patients received antiviral treatment. Most patients in the ICU group were given methylprednisolone, immunoglobulin, antibiotics, and mechanical ventilation and 35.7% of patients in the ICU group received continuous renal replacement therapy. Conclusions: Elderly with chronic comorbidities were more susceptible to COVID-19, showing a higher mortality rate due to multiple organ damage, and 35.7% of patients with AKI in ICU received renal replacement therapy. Moreover, part of the cured patients might need additional time to recover for poor lung function. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is not just a disease of the respiratory system. The virus can affect the gastrointestinal (GI) tract as well. Recognizing the various manifestations in every organ system is important because these manifestations can contribute to community-based transmission. Methods:We outline the evidence of the pathophysiology of COVID-19 in the GI tract, the effects of the virus on the gut and liver, the presence of the virus in stool samples, and the potential for fecal-oral transmission of COVID-19. Most of the literature sources used in this paper are case studies from China following the surge of COVID-19 infection. Results: In patients with COVID-19, GI symptoms such as anorexia, nausea, vomiting, diarrhea, and abdominal pain have presented in conjunction with respiratory symptoms such as fever, shortness of breath, and cough. Evidence also shows acute hepatocellular injury, indicated by elevated liver enzymes such as alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase. Fecal-oral transmission of COVID-19 is suspected because of the presence of COVID-19 RNA in stool samples of COVID-19-positive patients. Conclusion: Even without the presence of respiratory symptoms, several GI symptoms are associated with COVID-19 infection, as well as possible fecal-oral transmission. Therefore, COVID-19 infection should be considered for patients presenting with primarily GI symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Clinical characterisation studies have been essential in helping inform research, diagnosis and clinical management efforts, particularly early in a pandemic. This systematic review summarises the early literature on clinical characteristics of patients admitted to hospital, and evaluates the quality of evidence produced during the initial stages of the pandemic. Methods: MEDLINE, EMBASE and Global Health databases were searched for studies published from January 1st 2020 to April 28th 2020. Studies which reported on at least 100 hospitalised patients with Covid-19 of any age were included. Data on clinical characteristics were independently extracted by two review authors. Study design specific critical appraisal tools were used to evaluate included studies: the Newcastle Ottawa scale for cohort and cross sectional studies, Joanna Briggs Institute checklist for case series and the Cochrane collaboration tool for assessing risk of bias in randomised trials. Results: The search yielded 78 studies presenting data on 77,443 people. Most studies (82%) were conducted in China. No studies included patients from low- and middle-income countries. The overall quality of included studies was low to moderate, and the majority of studies did not include a control group. Fever and cough were the most commonly reported symptoms early in the pandemic. Laboratory and imaging findings were diverse with lymphocytopenia and ground glass opacities the most common findings respectively. Clinical data in children and vulnerable populations were limited. Conclusions: The early Covid-19 literature had moderate to high risk of bias and presented several methodological issues. Early clinical characterisation studies should aim to include different at-risk populations, including patients in non-hospital settings. Pandemic preparedness requires collection tools to ensure observational studies are methodologically robust and will help produce high-quality data early on in the pandemic to guide clinical practice and public health policy. Review registration: Available at https://osf.io/mpafn [ABSTRACT FROM AUTHOR]

The newly identified coronavirus SARS‐CoV‐2 that spread from China is causing the pandemic COVID‐19 with a fatality rate from 5‐15%. It causes fever, cough, myalgia, fatigue up to dyspnoea, responsible for hospitalization and artificial oxygenation. SARS‐CoV‐2 infects human cells using ACE2, the transmembrane protease serine 2 (TMPRSS2) and the SARS‐CoV‐2 main protease (Mpro). Once bound to ACE2 and the other two proteases in concert they allow the virus replication and spread throughout the body. Our attention has been focused on the role of ACE2 as its binding to by the virus increases bradykinin and its metabolites, which facilitate inflammation in the lung (causing cough and fever), coagulation and the complement system. These three systems are involved in angioedema, cardiovascular dysfunction and sepsis, pathologies which occur in COVID‐19 patients. Thus, we propose that blocking the kallikrein–kinin system with lanadelumab, approved for hereditary angioedema, will prevent facilitation of these 3 systems. Linked Articles: This article is part of a themed issue on The Pharmacology of COVID‐19. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.21/issuetoc [ABSTRACT FROM AUTHOR]

A large COVID-19 outbreak occurred on the cruise ship Diamond Princess in February 2020. Little information has been reported about the clinical characteristics of the patients. This single-center, retrospective, observational study was conducted in Yokohama, Japan. We included symptomatic patients who were infected on the ship and admitted to our hospital between 5 and 19 February 2020. All the cases were confirmed with SARS-CoV-2 infection by polymerase chain reaction (PCR). We confirmed 17 cases. The average age was 69 years; 10 patients were Asian and 7 were Caucasian. Eleven patients had one or more chronic diseases. The major symptoms were cough and fever. Chest computed tomography (CT) scans found bilateral ground-glass opacities predominantly in the peripheral area, which were similar to reports from cases in China. C-reactive protein (CRP) levels were higher in severe and critical cases than in mild to moderate cases. The moderate to severe cases reached symptomatic resolution; one of the three critical cases resulted in death due to multiple organ failure. SARS-CoV-2 was detected by PCR at an average of 7 days after symptomatic resolution. Cough and fever, increased blood CRP levels, and CT findings of bilateral ground-glass opacities predominantly in the peripheral lung were characteristic of the COVID-19 cases in this study. These findings were compatible with those of previous reports. [ABSTRACT FROM AUTHOR]

Covid 19 is an acute respiratory disease caused by a novel type of Coronavirus (SARS-CoV-2) that was first detected in Wuhan, Hubei Province of China. Its most common symptoms are fever, cough, and weakness; and in the early stages, there may not be findings on chest computed tomography. In pulmonary involvement, peripheral ground-glass areas, a cobblestone appearance, consolidated areas, and interlobular septal thickening, which are usually prominent in the lower lobes may be seen in thorax computed tomography. Consolidation, solid nodules, halo sign, inverted halo sign, vascular enlargement, subpleural line, air bronchograms, and bronchiectasis are other less common findings. In our case, we aimed to present our 69 years old female patient with bilateral nodular densities on thoracic CT and transthoracic fine-needle aspiration biopsy result was reported as lesions compatible with interstitial fibrosis due to Covid-19 inflammation. [ABSTRACT FROM AUTHOR]

The pandemic of coronavirus disease-19 started in Wuhan City of China in December 2019 and quickly spread all over the world, infecting almost two million people. The clinical presentation of the disease is mild/moderate in 80% of cases; however, it leads to a critical clinical presentation by 20%, which is severe or very severe disease requires intensive care. The mortality is high, especially in cases with advanced age, comorbidities, and pneumonia-related acute respiratory distress syndrome and respiratory failure, while children are often with subclinical manifestations. The most common clinical findings are fever, cough, fatigue, and shortness of breath. The incubation period ranges from 2 to 14 days. The most common laboratory findings are lymphocytopenia and thrombocytopenia. Elevated D-dimer, ferritin, troponin I, lactate dehydrogenase and interleukin-6, and hypoxia (O2 saturation =90%) were identified as "poor prognostic factors" associated with severe disease and mortality. The monitoring of such parameters was reported to be beneficial for determining patients with risk and potentially high mortality. [ABSTRACT FROM AUTHOR]

ABSTRACT: Coronaviruses are enveloped, positive-sense, single-stranded RNA viruses which belong to family Coronaviridae. These viruses are responsible for mild to severe respiratory ailments such as common cold to SARS, MERS and COVID-19. Pandemic COVID-19 is an ongoing issue of 2020. It starts from Wuhan city of China that later extended to the whole world (203 countries). However, according to another report of World Health Organization (WHO) the virus may start from some other part of the world rather than Wuhan city of China. The major structural components of COVID-19 are spike, envelope and nucleocapsid proteins. It enters the cell via cellular receptors angiotensin-converting enzyme 2 (ACE-2). Its symptoms are high fever, dry cough, fatigue, dyspnea, tiredness, headache, body-aches, pneumonia, and difficult breathing. Its man to man transmission is extraordinarily high and has ability to infect all age groups however, morbidity cases are noticed higher in elderly group of people. It can be transferred by the carriers via cough, sneeze or when they touched the surfaces or any object. It is concluded that there are more chances for the spread of disease in casual and workplaces. To control pandemic COVID-19 there is need to spread awareness about its structure, way of transmission and prevention. The present review discusses structure, mechanism of action, incubation period, most affected age groups, symptoms, transmission, and precautions to stop its progress. [ABSTRACT FROM AUTHOR]