ritonavir and Lymphopenia

Topics: Age Factors; Aged; Betacoronavirus; China; Coronavirus Infections; COVID-19; Critical Illness; Drug Therapy, Combination; Glucocorticoids; Hospital Mortality; Humans; Lorazepam; Lymphopenia; Middle Aged; Multiple Organ Failure; Pandemics; Pneumonia, Viral; Proportional Hazards Models; Risk Factors; Ritonavir; SARS-CoV-2

Although some information on the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and a few selected cases has been reported, data on the clinical characteristics and outcomes of patients hospitalized therewith in South Korea are lacking. We conducted a retrospective single-center study of 98 consecutive hospitalized patients with confirmed SARS-CoV-2 infection at Yeungnam University Medical Center in Daegu, South Korea. Sixty patients were women (61.2%), and the mean age was 55.4±17.1 years. Thirteen patients (13.3%) were treated in the intensive care unit (ICU). The mean interval from symptom onset to hospitalization was 7.7±4.5 days. Patients who received ICU care were significantly older and were more likely to have diabetes mellitus. The National Early Warning Score on the day of admission was significantly higher in patients requiring ICU care. Acute respiratory distress syndrome (13/13 patients; 100%), septic shock (9/13; 69.2%), acute cardiac injury (9/13; 69.2%), and acute kidney injury (8/13; 61.5%) were more common in patients who received ICU care. All patients received antibiotic therapy, and most (97/98 patients; 99.0%) received antiviral therapy (lopinavir/ritonavir). Hydroxychloroquine was used in 79 patients (80.6%), and glucocorticoid therapy was used in 18 patients (18.4%). In complete blood counts, lymphopenia was the most common finding (40/98 patients; 40.8%). Levels of all proinflammatory cytokines were significantly higher in ICU patients. As of March 29, 2020, the mortality rate was 5.1%. Here, we report the clinical characteristics and laboratory findings of SARS-CoV-2 patients in South Korea up to March 29, 2020.

Topics: Adult; Aged; Betacoronavirus; Coronavirus Infections; COVID-19; Cytokines; Drug Combinations; Female; Humans; Hydroxychloroquine; Intensive Care Units; Lopinavir; Lymphopenia; Male; Middle Aged; Pandemics; Pneumonia, Viral; Republic of Korea; Retrospective Studies; Ritonavir; SARS-CoV-2

Topics: Aged; Anemia; Anticoagulants; Anticonvulsants; Antiviral Agents; Betacoronavirus; Calcium Channel Blockers; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Enzyme Inhibitors; Humans; Hydroxychloroquine; Lopinavir; Lymphopenia; Male; Pandemics; Pneumonia, Viral; Posterior Leukoencephalopathy Syndrome; Ritonavir; SARS-CoV-2; Status Epilepticus; Verapamil

Since December 2019, Coronavirus Disease 2019 (COVID-19) has emerged as a global pandemic. We aimed to investigate the clinical characteristics and analyzed the risk factors for prolonged viral RNA shedding. We retrospectively collected data from 112 hospitalized COVID-19 patients in a single center in Wuhan, China. Factors associated with prolonged viral RNA shedding (≥28 days) were investigated. Forty-nine (43.8%) patients had prolonged viral RNA shedding. Patients with prolonged viral shedding were older and had a higher rate of hypertension. Proinflammatory cytokines, including interleukin-2R (IL-2R) and tumor necrosis factor-α (TNF-α), were significantly elevated in patients with prolonged viral shedding. Multivariate analysis revealed that hypertension, older age, lymphopenia and elevated serum IL-2R were independent risk factors for prolonged viral shedding. This comprehensive investigation revealed the distinct characteristics between patients with or without prolonged viral RNA shedding. Hypertension, older age, lymphopenia and high levels of proinflammatory cytokines may be correlated with prolonged viral shedding.

Topics: Adrenal Cortex Hormones; Adult; Aged; Aged, 80 and over; China; Comorbidity; COVID-19; COVID-19 Drug Treatment; Cytokine Release Syndrome; Diabetes Mellitus; Drug Combinations; Female; Hospitalization; Humans; Hydroxychloroquine; Hypertension; Interferons; Lopinavir; Lymphopenia; Male; Middle Aged; Receptors, Interleukin-2; Retrospective Studies; Risk Factors; Ritonavir; RNA, Viral; SARS-CoV-2; Severity of Illness Index; Tumor Necrosis Factor-alpha; Virus Shedding