SARS-CoV-2 Infection in a Pediatric Department in Milan: A Logistic Rather Than a Clinical Emergency

The Pediatric Infectious Disease Journal

Chidini, Giovanna; Villa, Cristina; Calderini, Edoardo; Marchisio, Paola; De Luca, Daniele

Introduction

The number of subjects infected with SARS-Cov-2 is dramatically increasing in Lombardy, Northern Italy, since February 21, 2020, leading to an infection chain that represents the largest coronavirus disease 2019 (CoVID-19) outbreak in Europe to date. Nowadays, few SARS-Cov-2–positive children have been admitted to pediatric departments. In winter season, a huge number of children with acute respiratory failure needs to be hospitalized in pediatric ward/ pediatric intensive care units if ventilated. This setting could be very difficult to have clinical criteria aiming to isolate suspected SARS-CoVID-2 children to avoid spreading of infection among health care professionals, other patients and visitors. The aim of this report is to document our experience in facing pediatric CoVID-19 emergency in Milan.

Keywords

Clinical aspects, diagnosis, treatment

COVID-19: protect great apes during human pandemics

Nature 
579, 7800, 497 (2020)

Gillespie, T. R.; Leendertz, F. H.

Correspondence

SARS-CoV-2, the coronavirus responsible for the current COVID-19 pandemic, is also a threat to our closest living relatives, the great apes. As leading experts in the conservation and health of these animals, we urge governments, conservation practitioners, researchers, tourism professionals and funding agencies to reduce the risk of introducing the virus into these endangered apes.

Keywords

COVID-19, SARS-CoV-2, Treatment, human pandemics

Care For Laboratory Animals During COVID-19 Crisis

Nature

Volume 579, Issue 7800, Page 497

Pullium, J. K.

Introduction

All US research programmes funded by Public Health Solutions in New York City or accredited by the nonprofit organization AAALAC International are required to have a care plan in place for laboratory animals in the event of a disaster. The COVID-19 pandemic could constitute such a disaster if it creates severe shortages in staffing and in supply chains.

Keywords

Reservoir

COVID-19: ban 'orientalism' by critics of wildlife trade

Infectious Disease Reports
Volume 12, March 2020, Issue 1, 8543

Pagani-Nunez, E.

Correspondence

Western voices claim that China needs “to discredit engrained cultural beliefs” to make the country’s ban on wildlife trade workable.

Keywords

COVID-19, SARS-CoV-2, Wildlife

How blood from coronavirus survivors might save lives

Nature

Maxmen, A.

News

Hospitals in New York City are gearing up to use the blood of people who have recovered from COVID-19 as a possible antidote for the disease. Researchers hope that the century-old approach of infusing patients with the antibody-laden blood of those who have survived an infection will help the metropolis — now the US epicentre of the outbreak — to avoid the fate of Italy, where intensive-care units (ICUs) are so crowded that doctors have turned away patients who need ventilators to breathe.

Keywords

Normative guidance; Clinical aspects, diagnosis, treatment

Football cannot restart soon during the COVID-19 emergency! A critical perspective from the Italian experience and a call for action

British journal of sports medicine

Corsini, A.; Bisciotti, G. N.; Eirale, C.; Volpi, P.

Introduction

In early 2020, the world is facing a global emergency called COVID-19 (coronavirus disease 2019). On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection.

The seriousness of the situation is evidenced by the extreme uncertainty of the measures taken by the governments of the various countries to stem the pandemic spread.

From 8 March 2020, the Italian Government implemented extraordinary measures to decrease the pathogen spread, targeting social distancing between individuals. The law focused on closing the commercial business, limiting the sporting activities and decreasing the opportunity for social gatherings. The most important issue has been the sharp increase in the number of people infected which is causing a significant increase in acute respiratory failure cases (severe acute respiratory syndrome coronavirus 2 (SARS-COV-2)) and acute respiratory distress syndrome requiring hospital admission and intensive care treatment. Contrary from what was thought at the beginning, young people are also affected by the disease and can develop the severe respiratory conditions mentioned above.

Initially, despite the outbreak phenomenon, professional sports were not stopped, and on 11 March 2020, the first football player belonging to Italian Serie A tested positive …

Keywords

Epidemiology

Cancer Care Delivery Challenges Amidst Coronavirus Disease - 19 (COVID-19) Outbreak: Specific Precautions for Cancer Patients and Cancer Care Providers to Prevent Spread (Copy)

Asian Pacific journal of cancer prevention : APJCP
Volume 21, Issue 3, March 2020, pg 569-573

Shankar, A.; Saini, D.; Roy, S.; Mosavi Jarrahi, A.; Chakraborty, A.; Bharti, S. J.; Taghizadeh-Hesary, F.

Abstract

Coronavirus outbreak has affected thousands of people in at least 186 countries which has affected the cancer care delivery system apart from affecting the overall health system. Cancer patients are more susceptible to coronavirus infection than individuals without cancer as they are in an immunosuppressive state because of the malignancy and anticancer treatment. Oncologists should be more attentive to detect coronavirus infection early, as any type of advanced cancer is at much higher risk for unfavorable outcomes. Oncology communities must ensure that cancer patients should spend more time at home and less time out in the community. Oncologists and other health care professionals involved in cancer care have a critical opportunity to communicate to their patients to pass on right information regarding practice modifications in view of COVID-19 outbreaks. Countries must isolate, test, treat and trace to control the coronavirus pandemic. There is a paucity of information on novel coronavirus infection and its impact on cancer patients and cancer care providers. To date, there is no scientific guideline regarding management of cancer patients in a background of coronavirus outbreak.

.

Keywords

Cancer, coronavirus, COVID-19- ublhoypatients

Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms

Gut

Jin, X.; Lian, J. S.; Hu, J. H.; Gao, J.; Zheng, L.; Zhang, Y. M.; Hao, S. R.; Jia, H. Y.; Cai, H.; Zhang, X. L.; Yu, G. D.; Xu, K. J.; Wang, X. Y.; Gu, J. Q.; Zhang, S. Y.; Ye, C. Y.; Jin, C. L.; Lu, Y. F.; Yu, X.; Yu, X. P.; Huang, J. R.; Xu, K. L.; Ni, Q.; Yu, C. B.; Zhu, B.; Li, Y. T.; Liu, J.; Zhao, H.; Zhang, X.; Yu, L.; Guo, Y. Z.; Su, J. W.; Tao, J. J.; Lang, G. J.; Wu, X. X.; Wu, W. R.; Qv, T. T.; Xiang, D. R.; Yi, P.; Shi, D.; Chen, Y.; Ren, Y.; Qiu, Y. Q.; Li, L. J.; Sheng, J.; Yang, Y.

Abstract

OBJECTIVE: The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.

DESIGN: COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. RESULTS: Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5 degrees C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m(6)A methylation and changed binding capacity with ACE2.

CONCLUSION: We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.

Keywords

Clinical aspects, diagnosis, treatment

Risk-adapted Treatment Strategy For COVID-19 Patients

International Journal of Infectious Diseases

Zhang, Min-Xia; Yan, Hong-Fan; Wu, Jia-Yu; Zheng, Yu-Jun

Abstract

Background: There are no clear expert consensus or guidelines on how to treat 2019 coronavirus disease (COVID-19). The objective of this study is to investigate the short-term effect of risk-adapted treatment strategy on patients with COVID-19. Methods: We collected the medical records of 55 COVID-19 patients for analysis. We divided these patients into mild, moderate and severe groups, and risk-adapted treatment approaches were given according to the illness severity. Results: Twelve patients were in mild group and 22 were in moderate group (non-severe group, n = 34), and 21 patients were in severe group. At the end of the first two weeks after admission, clinical manifestations had completely despeared in 31(91.2%)patients in non-severe group, and 18(85.7%) patients in severe group (p = 0.85). Both groups had a satisfied chest CT imaging recovery, which includes 22(64.7%) patients in non-severe group and 12(57.1%) patients in severe group recovered at least 50% of the whole leisions in the first week, and 28(82.4%) and 16(76.2%) recovered at least 75% in the second week, respectively. There were no significant differences in SARS-CoV-2 nucleic acid negativity (p = 0.92). There were also no significant differences in the levels of SARS-CoV-2-IgM and IgG antibody production between the two groups (p = 0.13, 0.62). There were 45 cases were discharged from the hospital, and no patients died at the time of this clinical analysis. Conclusions: Risk-adapted treatment strategy was associated with significant clinical manifestations alleviation and clinical imaging recovery. In severe COVID-19 patients, early and short-term use of lowdose methylprednisolone was beneficial and did not delay SARS-CoV-2 nucleic acid clearance and influence IgG antibody production.

Keywords

COVID-19, novel coronavirus pneumonia, risk-adapted treatment strategy, antiviral treatment, low-dose corticosteroid

Routes for COVID-19 importation in Brazil

Journal of travel medicine

Candido, D. D. S.; Watts, A.; Abade, L.; Kraemer, M. U. G.; Pybus, O. G.; Croda, J.; Oliveira, W.; Khan, K.; Sabino, E. C.; Faria, N. R.

Abstract

The global outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been declared a pandemic by the WHO. As the number of imported SARS-CoV-2 cases is on the rise in Brazil, we use incidence and historical air travel data to estimate the most important routes of importation into the country.

Keywords

Coronavirus, brazil, disease outbreaks, severe acute respiratory syndrome, air travel, pandemics, sars-cov-2, covid-19

Immediate Health Surveillance Response to COVID-19 Epidemic

Epidemiologia e servicos de saude: revista do Sistema Unico de Saude do Brasil
Volume 29, 2020, Issue 1, e2020002

Croda, J. H. R.; Garcia, L. P.

Introduction

On December 31st 2019 the World Health Organization (WHO) was notified of the occurrence of a pneumonia outbreak in the city of Wuhan, Hubei Province, People’s Republic of China. The etiological agent was rapidly identified as a novel coronavirus: SARS-COV-2 The outbreak began in a seafood and live animals market and, as at the date of this publication, the animal reservoir is unknown.

The first Emergency Committee meeting about the novel coronavirus outbreak in China, convened by WHO in accordance with the International Health Regulations (IHR) (2005), was held on January 23rd 2020. Consensus was not reached by that meeting as to whether the event was a Public Health Emergency of International Concern (PHEIC). At its second meeting, held on January 30th, the number of cases and countries reporting confirmed cases were seen to have increased and this lead to the outbreak being declared a PHEIC…

Keywords

Epidemiology

Characteristic ECG Manifestations in Patients with COVID-19

Canadian Journal of Cardiology

He, Jia; Wu, Bo; Chen, Yaqin; Tang, Jianjun; Liu, Qiming; Zhou, Shenghua; Chen, Chen; Qin, Qingwu; Huang, Kang; Lv, Jianlei; Chen, Yan; Peng, Daoquan.

Abstract

Cardiac involvement has been reported in patients with COVID-19, which may be reflected by ECG changes. Two COVID-19 cases in our report exhibited different ECG manifestations as the disease caused deterioration. The first case presented temporary SIQIIITIII morphology followed by reversible nearly complete atrioventricular block, while the second demonstrated ST segment elevation accompanied by multifocal ventricular tachycardia. The underlying mechanisms of these electrocardiographic abnormalities in the severe stage of COVID-19 may be attributed to hypoxia and inflammatory damage incurred by the virus.

Keywords

Epidemiology

Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy

American journal of obstetrics and gynecology

Dashraath, P.; Jing Lin Jeslyn, W.; Mei Xian Karen, L.; Li Min, L.; Sarah, L.; Biswas, A.; Arjandas Choolani, M.; Mattar, C.; Lin, S. L.

Abstract

The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome 2 (SARS-CoV-2) virus, is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2 - 2.5, indicating that 2 - 3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with over 7,000 related deaths. The SARS-CoV-2 virus has been isolated from asymptomatic individuals, and affected patients continue to be infectious two weeks after cessation of symptoms. The substantial morbidity and socioeconomic impact have necessitated drastic measures across all continents, including nationwide lockdowns and border closures. Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. Physiological and mechanical changes in pregnancy increase susceptibility to infections in general, particularly when the cardiorespiratory system is affected, and encourage rapid progression to respiratory failure in the gravida. Furthermore, the pregnancy bias towards T-helper 2 (Th2) system dominance which protects the fetus, leaves the mother vulnerable to viral infections, which are more effectively contained by the Th1 system. These unique challenges mandate an integrated approach to pregnancies affected by SARS-CoV-2. Here we present a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission and maternal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery are addressed. Additionally, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment and telemedicine. Our aim is to share a framework which can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core.

Keywords

Normative guidance; Epidemiology

COVID-19, guests and crews of cruise: observation on Thai citizens

International maritime health
Volume 71, 2020, Issue 1, p 9

Yasri, S.; Wiwanitkit, V.

Introduction

COVID-19 is a new emerging infection starting from China [1]. This new disease was imported to many countries such as Thailand [2]. After the firs importation to Thailand as the first country, there are already more than 20 countries with imported disease. At first, the importation of disease is mainly by air travel. However, the new consideration is raised when there is an emerging problem of disease outbreak at international tourist cruise. The outbreak on Diamond Princess, which was detected in Japan, became an interesting situation.

Keywords

COVID-19, guest, crew, cruise

COVID-19, SARS And MERS: Are They Closely Related?

Clinical Microbiology and Infection

Petrosillo, Nicola; Viceconte, Giulio; Ergonul, Onder; Ippolito, Giuseppe; Petersen, Eskild 

Abstract

Background

The 2019 novel coronavirus (SARS-CoV-2) is a new human coronavirus which is spreading with epidemic features in China and other Asian countries with cases reported worldwide. This novel Coronavirus Disease (COVID-19) is associated with a respiratory illness that may cause severe pneumonia and acute respiratory distress syndrome (ARDS). Although related to the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS), COVID-19 shows some peculiar pathogenetic, epidemiological and clinical features which have not been completely understood to date.

Objectives

We provide a review of the differences in terms of pathogenesis, epidemiology and clinical features between COVID-19, SARS and MERS.

Sources

The most recent literature in English language regarding COVID-19 has been reviewed and extracted data have been compared with the current scientific evidence about SARS and MERS epidemics.

Content

COVID-19 seems not to be very different from SARS regarding its clinical features. However, it has a fatality rate of 2.3%, lower than SARS (9.5%) and much lower than MERS (34.4%). It cannot be excluded that because of the COVID-19 less severe clinical picture it can spread in the community more easily than MERS and SARS. The actual basic reproductive number (R0) of COVID-19 (2-2.5) is still controversial. It is probably slightly higher than the R0 of SARS (1.7-1.9) and higher than MERS (<1),. The gastrointestinal route of transmission of SARS-CoV-2, which has been also assumed for SARS-CoV and MERS-CoV, cannot be ruled out and needs to be further investigated.

Implications

There is still much more to know about COVID-19, especially as concerns mortality and capacity of spreading on a pandemic level. Nonetheless, all of the lessons we learned in the past from SARS and MERS epidemics are the best cultural weapons to face this new global threat.

Keywords

Coronavirus, COVID-19, Emerging infections, MERS, SARS

Coronavirus Disease 2019 as a challenge for maritime medicine

International maritime health

Vol 71, No 1 (2020)

Sikorska, K.

Introduction

On 11 March 2020 World Health Organization (WHO) ”made the assessment that Coronavirus Disease 2019 (COVID-19) can be characterised as a pandemic”. Six weeks earlier, on 30 January 2020, the outbreak caused by a novel coronavirus was declared a Public Health Emergency of International Concern.

Keywords

Epidemiology

Coronavirus (Covid-19) outbreak on the cruise ship Diamond Princess

International maritime health
Volume 71, Issue 1

Dahl, E.

Introduction

The whole world has recently been following the media frenzy covering the quarantine of Diamond Princess, the first cruise ship that had an outbreak of coronavirus illness (Covid-19) on board. It developed soon after the occurrence of China’s Covid-19 outbreak, which — according to the World Health Organization (WHO) — “poses a very grave threat for the rest of the world” and should be viewed as “Public Enemy Number 1” [1]. Lasting more than 14 days, the ship quarantine is unprecedented for the cruise industry, and some maritime health issues of concern may be worth addressing already shortly after the interned passengers and crew had finally disembarked the vessel.

Keywords

coronavirus, COVID-19, outbreak, passengers, crew, cruise ship medicine

Multi-omics Evaluation of Gastrointestinal and Other Clinical Characteristics of SARS-CoV-2 and COVID-19

Gastroenterology

Du, Mulong; Cai, Guoshuai; Chen, Feng; Christiani, David C.; Zhang, Zhengdong; Wang, Meilin.

Introduction

Since December 2019, coronavirus disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has produced a worldwide panic. Except for a principal human to human transmission method by droplet and contact, there is still limited knowledge about possible alternate transmission methods to guide clinical care. Recent clinical studies have observed digestive symptoms in COVID-19 patients, possibly because of the enrichment and infection of SARS-CoV-2 in the gastrointestinal tract, mediated by virus receptor of angiotensin converting enzyme II (ACE2), which suggests the potential for a fecaloral route of SARS-CoV-2 transmission 3, 4. However, there is still a large gap in the biological knowledge of COVID-19. In this study, via a bulk-to-cell strategy focusing on ACE2, we performed an integrated omics analysis at the genome, transcriptome and proteome levels in bulk tissues and single cells across species to decipher the potential routes for SARS-CoV-2 infection in depth.

Keywords

COVID-19, SARS-CoV-2, Treatment

Monitoring Transmissibility and Mortality of COVID-19 in Europe

International Journal of Infectious Diseases

Yuan, Jing; Li, Minghui; Lv, Gang; Lu, Z. Kevin

Abstract

Objectives: As a global pandemic is inevitable, real-time monitoring of transmission is vital for containing the spread of COVID-19. The main objective was to report real-time effective reproduction numbers (R(t)) case fatality rate (CFR).

Methods: Data were mainly obtained from WHO website, up to 9 March 2020. R(t) was estimated by exponential growth rate (EG) and time dependent (TD) methods. “R0” package in R was employed to estimate R(t) by fitting the existing epidemic curve. Both naïve CFR (nCFR) and adjust CFR (aCFR) were estimated.

Results: In EG method, R(t) was 3.27 [3.17-3.38] for Italy, 6.32 [5.72-6.99] for France, 6.07 [5.51- 6.69] for Germany, 5.08 [4.51-5.74] for Spain. With TD method, the R value for March 9 was 3.10 [2.21-4.11] for Italy, 6.56 [2.04-12.26] for France, 4.43 [1.83-7.92] for Germany, and 3.95 [0-10.19] for Spain.

Conclusions: This study provides important findings on an early outbreak of COVID-19 in Europe. Due to the recent rapid increase in new cases of COVID-19, real-time monitoring of the transmissibility and mortality in Spain and France is a priority.

Keywords

COVID-19, effective reproduction numbers, Control, Europe

Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis

European Journal of Neurology

Guan, Wei-Jie; Liang, Wen-Hua; Zhao, Yi; Liang, Heng-Rui; Chen, Zi-Sheng; Li, Yi-Min; Liu, Xiao-Qing; Chen, Ru-Chong; Tang, Chun-Li; Wang, Tao; Ou, Chun-Quan; Li, Li; Chen, Ping-Yan; Sang, Ling; Wang, Wei; Li, Jian-Fu; Li, Cai-Chen; Ou, Li-Min; Cheng, Bo; Xiong, Shan; Ni, Zheng-Yi; Xiang, Jie; Hu, Yu; Liu, Lei; Shan, Hong; Lei, Chun-Liang; Peng, Yi-Xiang; Wei, Li; Liu, Yong; Hu, Ya-Hua; Peng, Peng; Wang, Jian-Ming; Liu, Ji-Yang; Chen, Zhong; Li, Gang; Zheng, Zhi-Jian; Qiu, Shao-Qin; Luo, Jie; Ye, Chang-Jiang; Zhu, Shao-Yong; Cheng, Lin-Ling; Ye, Feng; Li, Shi-Yue; Zheng, Jin-Ping; Zhang, Nuo-Fu; Zhong, Nan-Shan; He, Jian-Xing.

Abstract

BACKGROUND: The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide. OBJECTIVE: To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status. METHODS: We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11(th), 2019 and January 31(st), 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities. RESULTS: The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424-5.048], diabetes (HR 1.59, 95%CI 1.03-2.45), hypertension (HR 1.58, 95%CI 1.07-2.32) and malignancy (HR 3.50, 95%CI 1.60-7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16-2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61-4.17) among patients with two or more comorbidities. CONCLUSION: Among laboratory-confirmed cases of Covid-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomes.

Keywords

Clinical aspects, diagnosis, treatment