The natural course of COVID‐19 patients without clinical intervention
The natural course of coronavirus disease 2019 (COVID‐19) patients without clinical intervention has not yet been documented. One hundred and fifty‐eight patients from two hospitals were enrolled to identify the indicators of severe COVID‐19 and observe the natural course of COVID‐19 patients withou...
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| Veröffentlicht in: | Journal of medical virology 2021-09, Vol.93 (9), p.5527-5537 |
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| creator | Wu, Daxian Rao, Qunfang Zhang, Wenfeng |
| description | The natural course of coronavirus disease 2019 (COVID‐19) patients without clinical intervention has not yet been documented. One hundred and fifty‐eight patients from two hospitals were enrolled to identify the indicators of severe COVID‐19 and observe the natural course of COVID‐19 patients without clinical intervention. The total computed tomography (CT) score, a quantitative score based on assessment of the number, quadrant, and area of the lesions in CT, tended to perform better than assessment based only on the number or area of the lesions (p = 0.0004 and p = 0.0887, respectively). Multivariate logistic regression showed that the total CT score, chest tightness, lymphocyte, and lactate dehydrogenase (LDH) were independent factors for severe COVID‐19. For patients admitted in 2 weeks from onset to hospitalization, the frequency of severe COVID‐19 was gradually increased with the delayed hospitalization. The symptoms of fatigue, dry cough, sputum production, chest tightness, and polypnea were gradually more frequent. The levels of C‐reactive protein, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, γ‐glutamyl transpeptidase, LDH, and d‐dimer were also gradually increased, as well as the scores based on CT. Conversely, the lymphocyte count and the albumin level were gradually decreased with the delayed hospitalization. Detail turning points of the above alterations were observed after 10–14 days from onset to hospitalization. Total CT score was a simple and feasible score for identifying severe COVID‐19. COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10–14 days but gradually improved thereafter.
Highlights
Present study developed a simple and feasible score based on CT to identify severe COVID‐19.
Present study was the first to investigate the natural course of COVID‐19 patients without clinical intervention.
COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10‐14 days but gradually improved thereafter. |
| doi_str_mv | 10.1002/jmv.27087 |
| format | Article |
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Highlights
Present study developed a simple and feasible score based on CT to identify severe COVID‐19.
Present study was the first to investigate the natural course of COVID‐19 patients without clinical intervention.
COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10‐14 days but gradually improved thereafter.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.27087</identifier><identifier>PMID: 33990975</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Alanine ; Alanine transaminase ; Albumins ; Aspartate aminotransferase ; Bilirubin ; Cell number ; Chest ; clinical intervention ; Computed tomography ; Coronaviruses ; Cough ; COVID-19 ; delayed hospitalization ; Dimers ; Hospitalization ; Intervention ; L-Lactate dehydrogenase ; Lactate dehydrogenase ; Lactic acid ; Lesions ; Lymphocytes ; natural course ; Patients ; Polypnea ; Signs and symptoms ; Sputum ; Tightness ; Viral diseases ; Virology ; γ-Glutamyltransferase</subject><ispartof>Journal of medical virology, 2021-09, Vol.93 (9), p.5527-5537</ispartof><rights>2021 Wiley Periodicals LLC</rights><rights>This article is protected by copyright. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4717-db74090741a61065551a07a54a3ea08e33c291bc40b3312af64a0f02d62161dd3</citedby><cites>FETCH-LOGICAL-c4717-db74090741a61065551a07a54a3ea08e33c291bc40b3312af64a0f02d62161dd3</cites><orcidid>0000-0003-0337-4991 ; 0000-0001-8485-2857 ; 0000-0003-1868-4642</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.27087$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.27087$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33990975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Daxian</creatorcontrib><creatorcontrib>Rao, Qunfang</creatorcontrib><creatorcontrib>Zhang, Wenfeng</creatorcontrib><title>The natural course of COVID‐19 patients without clinical intervention</title><title>Journal of medical virology</title><addtitle>J Med Virol</addtitle><description>The natural course of coronavirus disease 2019 (COVID‐19) patients without clinical intervention has not yet been documented. One hundred and fifty‐eight patients from two hospitals were enrolled to identify the indicators of severe COVID‐19 and observe the natural course of COVID‐19 patients without clinical intervention. The total computed tomography (CT) score, a quantitative score based on assessment of the number, quadrant, and area of the lesions in CT, tended to perform better than assessment based only on the number or area of the lesions (p = 0.0004 and p = 0.0887, respectively). Multivariate logistic regression showed that the total CT score, chest tightness, lymphocyte, and lactate dehydrogenase (LDH) were independent factors for severe COVID‐19. For patients admitted in 2 weeks from onset to hospitalization, the frequency of severe COVID‐19 was gradually increased with the delayed hospitalization. The symptoms of fatigue, dry cough, sputum production, chest tightness, and polypnea were gradually more frequent. The levels of C‐reactive protein, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, γ‐glutamyl transpeptidase, LDH, and d‐dimer were also gradually increased, as well as the scores based on CT. Conversely, the lymphocyte count and the albumin level were gradually decreased with the delayed hospitalization. Detail turning points of the above alterations were observed after 10–14 days from onset to hospitalization. Total CT score was a simple and feasible score for identifying severe COVID‐19. COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10–14 days but gradually improved thereafter.
Highlights
Present study developed a simple and feasible score based on CT to identify severe COVID‐19.
Present study was the first to investigate the natural course of COVID‐19 patients without clinical intervention.
COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10‐14 days but gradually improved thereafter.</description><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Albumins</subject><subject>Aspartate aminotransferase</subject><subject>Bilirubin</subject><subject>Cell number</subject><subject>Chest</subject><subject>clinical intervention</subject><subject>Computed tomography</subject><subject>Coronaviruses</subject><subject>Cough</subject><subject>COVID-19</subject><subject>delayed hospitalization</subject><subject>Dimers</subject><subject>Hospitalization</subject><subject>Intervention</subject><subject>L-Lactate dehydrogenase</subject><subject>Lactate dehydrogenase</subject><subject>Lactic acid</subject><subject>Lesions</subject><subject>Lymphocytes</subject><subject>natural course</subject><subject>Patients</subject><subject>Polypnea</subject><subject>Signs and symptoms</subject><subject>Sputum</subject><subject>Tightness</subject><subject>Viral diseases</subject><subject>Virology</subject><subject>γ-Glutamyltransferase</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1O3DAURi1EBcPQRV8ARWJTFoF7Hf_Em0poWmAqKjbA1vI4TsejTDzEySB2fYQ-Y58Ew1AElbq6i3t0_F1_hHxCOEYAerJYro-phFJukRGCErkCidtkBMhELgTyXbIX4wIASkXpDtktCqVAST4i59dzl7WmHzrTZDYMXXRZqLPJ1e30659fv1FlK9N71_Yxu_f9PAx9Zhvfeptw3_auW6edD-0--VCbJrqPL3NMbs6-XU8u8sur8-nk9DK3TKLMq5lkkNIxNAJBcM7RgDScmcIZKF1RWKpwZhnMigKpqQUzUAOtBEWBVVWMyZeNdzXMlq6y6fWUXK86vzTdgw7G6_eb1s_1z7DWJWW0ZDwJPr8IunA3uNjrpY_WNY1pXRiippyWKIVikNDDf9BF-qA2nZcoThFLJZ6oow1luxBj5-rXMAj6qR6d6tHP9ST24G36V_JvHwk42QD3vnEP_zfp7z9uN8pHom-Zdg</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Wu, Daxian</creator><creator>Rao, Qunfang</creator><creator>Zhang, Wenfeng</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0337-4991</orcidid><orcidid>https://orcid.org/0000-0001-8485-2857</orcidid><orcidid>https://orcid.org/0000-0003-1868-4642</orcidid></search><sort><creationdate>202109</creationdate><title>The natural course of COVID‐19 patients without clinical intervention</title><author>Wu, Daxian ; Rao, Qunfang ; Zhang, Wenfeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4717-db74090741a61065551a07a54a3ea08e33c291bc40b3312af64a0f02d62161dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Albumins</topic><topic>Aspartate aminotransferase</topic><topic>Bilirubin</topic><topic>Cell number</topic><topic>Chest</topic><topic>clinical intervention</topic><topic>Computed tomography</topic><topic>Coronaviruses</topic><topic>Cough</topic><topic>COVID-19</topic><topic>delayed hospitalization</topic><topic>Dimers</topic><topic>Hospitalization</topic><topic>Intervention</topic><topic>L-Lactate dehydrogenase</topic><topic>Lactate dehydrogenase</topic><topic>Lactic acid</topic><topic>Lesions</topic><topic>Lymphocytes</topic><topic>natural course</topic><topic>Patients</topic><topic>Polypnea</topic><topic>Signs and symptoms</topic><topic>Sputum</topic><topic>Tightness</topic><topic>Viral diseases</topic><topic>Virology</topic><topic>γ-Glutamyltransferase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Daxian</creatorcontrib><creatorcontrib>Rao, Qunfang</creatorcontrib><creatorcontrib>Zhang, Wenfeng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Daxian</au><au>Rao, Qunfang</au><au>Zhang, Wenfeng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The natural course of COVID‐19 patients without clinical intervention</atitle><jtitle>Journal of medical virology</jtitle><addtitle>J Med Virol</addtitle><date>2021-09</date><risdate>2021</risdate><volume>93</volume><issue>9</issue><spage>5527</spage><epage>5537</epage><pages>5527-5537</pages><issn>0146-6615</issn><eissn>1096-9071</eissn><abstract>The natural course of coronavirus disease 2019 (COVID‐19) patients without clinical intervention has not yet been documented. One hundred and fifty‐eight patients from two hospitals were enrolled to identify the indicators of severe COVID‐19 and observe the natural course of COVID‐19 patients without clinical intervention. The total computed tomography (CT) score, a quantitative score based on assessment of the number, quadrant, and area of the lesions in CT, tended to perform better than assessment based only on the number or area of the lesions (p = 0.0004 and p = 0.0887, respectively). Multivariate logistic regression showed that the total CT score, chest tightness, lymphocyte, and lactate dehydrogenase (LDH) were independent factors for severe COVID‐19. For patients admitted in 2 weeks from onset to hospitalization, the frequency of severe COVID‐19 was gradually increased with the delayed hospitalization. The symptoms of fatigue, dry cough, sputum production, chest tightness, and polypnea were gradually more frequent. The levels of C‐reactive protein, alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, γ‐glutamyl transpeptidase, LDH, and d‐dimer were also gradually increased, as well as the scores based on CT. Conversely, the lymphocyte count and the albumin level were gradually decreased with the delayed hospitalization. Detail turning points of the above alterations were observed after 10–14 days from onset to hospitalization. Total CT score was a simple and feasible score for identifying severe COVID‐19. COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10–14 days but gradually improved thereafter.
Highlights
Present study developed a simple and feasible score based on CT to identify severe COVID‐19.
Present study was the first to investigate the natural course of COVID‐19 patients without clinical intervention.
COVID‐19 patients without clinical intervention deteriorated gradually during the initial 10‐14 days but gradually improved thereafter.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33990975</pmid><doi>10.1002/jmv.27087</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-0337-4991</orcidid><orcidid>https://orcid.org/0000-0001-8485-2857</orcidid><orcidid>https://orcid.org/0000-0003-1868-4642</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of medical virology, 2021-09, Vol.93 (9), p.5527-5537 |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Alanine Alanine transaminase Albumins Aspartate aminotransferase Bilirubin Cell number Chest clinical intervention Computed tomography Coronaviruses Cough COVID-19 delayed hospitalization Dimers Hospitalization Intervention L-Lactate dehydrogenase Lactate dehydrogenase Lactic acid Lesions Lymphocytes natural course Patients Polypnea Signs and symptoms Sputum Tightness Viral diseases Virology γ-Glutamyltransferase |
| title | The natural course of COVID‐19 patients without clinical intervention |
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