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Immunological Evaluation on Potential Treatment Window for Hospitalized COVID-19 Patients
Journal of Inflammation Research ( IF 4.5 ) Pub Date : 2020-11-24 , DOI: 10.2147/jir.s280331
Jing Yuan 1 , Shanglong Kou 2 , Yanhua Liang 1 , JianFeng Lan 1 , Xiaohe Li 1 , Lijiao Zeng 1 , Rongrong Zou 1 , Yingxia Liu 1 , Lei Liu 1 , Yanchao Pan 1
Affiliation  

Purpose: Novel coronavirus disease has become such an escalating epidemic that the exponential growth of infected patients has overloaded the health-care systems in many countries. Determination of early assessments for patients with a risk of clinical deterioration would benefit the management of COVID-19 outbreaks.
Patients and Methods: A total of 214 confirmed COVID-19 patients were enrolled from January 11th to February 11th 2020. Medical records including laboratory parameters, clinical outcomes and other characteristics of the admitted patients were analyzed retrospectively.
Results: The critical patients experienced a significantly prolonged onset–admission interval and presented with lymphopenia (r=− 0.547, p=0.015) and lower albumin level (p< 0.001) 6 days after symptom onset. Early admission of critical patients significantly reduced the duration of hormone therapy. Starting from 9 days of hospital stay, the reduced lymphocyte counts exhibited linear growth. Furthermore, on days 9 and 12, significant correlations were demonstrated between immunological manifestations and duration of hormone therapy in critical patients, and length of hospital stay in severe patients. In addition, the virus negative conversion rate was more significantly correlated with increased lymphocytes in critical patients.
Conclusion: Early intervention, within 6 days of symptom onset, benefited patients’ recovery from critical illness. The 9– 12 days of hospital care represented a valuable window during which to evaluate the therapeutic effects on physical recovery and virus clearance.

Keywords: COVID-19, critical illness, potential window, length of hospital stay


中文翻译:

住院 COVID-19 患者潜在治疗窗口的免疫学评估

目的:新型冠状病毒病已成为一种不断升级的流行病,感染患者的指数增长已使许多国家的医疗保健系统不堪重负。对有临床恶化风险的患者进行早期评估将有利于 COVID-19 暴发的管理。
患者和方法: 2020 年 1 月 11 日至 2 月 11 日共招募了 214 名确诊的 COVID-19 患者。回顾性分析了入院患者的医疗记录,包括实验室参数、临床结果和其他特征。
结果:危重患者的发病-入院间隔显着延长并出现淋巴细胞减少(r =- 0.547,p= 0.015) 和较低的白蛋白水平 ( p < 0.001) 症状出现后 6 天。危重患者的早期入院显着缩短了激素治疗的持续时间。从住院9天开始,减少的淋巴细胞计数呈线性增长。此外,在第 9 天和第 12 天,危重患者的免疫学表现与激素治疗持续时间以及重症患者的住院时间之间显示出显着相关性。此外,病毒转阴率与危重患者淋巴细胞增多更显着相关。
结论:在症状出现后 6 天内进行早期干预,有利于患者从危重病中康复。9-12 天的住院治疗代表了一个宝贵的窗口,在此期间可以评估对身体恢复和病毒清除的治疗效果。

关键词: COVID-19、危重病、潜在窗口期、住院时间
更新日期:2020-11-25
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