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An Introduction to the Clinical and Diagnostic Features, and CoViD19 Complications

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Cardiovascular Complications of COVID-19
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Abstract

The clinical and diagnostic features of the CoViD19 are well described in several study reports worldwide. The disease may present in an asymptomatic form or as a severe disease and may result in a fatal outcome. The impact of the SARS CoV2 stress may elicit complex immunopathological body responses involving a range of the hematological and biochemical manifestations, clinical symptomatology, and radiological abnormalities of varying severities important to diagnose the CoViD19 and determine the severity. This chapter describes the key clinical and diagnostic features of CoViD19 as presented in the emerging literature, along with the associated evidence base, and provides an overview of the main complications associated with the disease. We highlight the blood abnormalities commonly associated with the infection that may help clinicians understand the novel coronavirus disease. We further present the radiological abnormalities associated with CoVid19 that may characterize and reflect different severities of the disease, as highlighted in the research studies, and that also form the evidence base of the novel coronavirus disease clinical and diagnostic features.

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References

  1. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China N Engl J Med. 2020. Published online Feb 28. https://doi.org/10.1056/NEJMoa2002032.

  2. Li Q, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New Engl J Med. 2020.

    Google Scholar 

  3. Wu Z, Mc Googan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA: Published; 2020.

    Book  Google Scholar 

  4. Kronbichler A, et al. Asymptomatic patients as a source of COVID-19 infections: a systematic review and meta-analysis. Int J Infect Dis. 2020;98:180–6.

    Google Scholar 

  5. He X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26(5):672–5.

    Google Scholar 

  6. Zumla A, Chan JF, Azhar EI, Hui DS, Yuen KY. Coronaviruses—drug discovery and therapeutic options. Nat Rev Drug Discov. 2016;15(5):327–47.

    Article  CAS  Google Scholar 

  7. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020.

    Google Scholar 

  8. Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C. Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection. JAMA. 2020;323(20):2089–90.

    Article  CAS  Google Scholar 

  9. Levy MM, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Crit Care Med. 2003;31:1250–6.

    Article  Google Scholar 

  10. Clinical characteristics of 113 deceased patients with coronavirus disease,. retrospective study. BMJ. 2019;2020:368. https://doi.org/10.1136/bmj.m1091 (Published 26 March 2020).

  11. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020. https://doi.org/10.1001/jama.2020.1585. [Epub ahead of print] PubMed PMID: 32031570; PubMed Central PMCID: PMC7042881.

  12. Zhang W, Du RH, Li B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9(1):386–9. https://doi.org/10.1080/22221751.2020.1729071. PubMed Google Scholar Crossref.

  13. Pan Y, Zhang D, Yang P, Poon LLM, Wang Q. Viral load of SARS-CoV-2 in clinical samples. Lancet Infect Dis. 2020;20(4):411–2. Published online February 24, 2020. https://doi.org/10.1016/S1473-3099(20)30113-4. PubMed Google Scholar.

  14. Gao QY, Chen YX, Fang JY. 2019 novel coronavirus infection and gastrointestinal tract. J Dig Dis. 2020;21:125–6. https://doi.org/10.1111/751-2980.12851.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Xiao F, Tang M, Zheng X, et al. Evidence for gastrointestinal infection of SARS-CoV-2. medRxiv 2020. https://doi.org/10.1053/j.gastro.2020.02.055.

  16. Wang W, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843–4.

    Google Scholar 

  17. Bwire GM, et al. Detection profile of SARS‐CoV‐2 using RT‐PCR in different types of clinical specimens: a systematic review and meta‐analysis. J Med Virol. 2020.

    Google Scholar 

  18. Yu F, et al. Quantitative detection and viral load analysis of SARS-CoV-2 in infected patients. Clin Infect Dis. 2020.

    Google Scholar 

  19. Diagnostic testing for SARS-CoV-2, Interim Guidance, 11 September 2020 World Health Organisation. https://www.who.int/publications/i/item/diagnostic-testing-for-sars-cov-2. Accessed on 17 November 2020.

  20. NIH CoViD19 treatment guidelines. Testing for SARS-CoV-2 Infection. Last Updated: November 3, 2020. https://www.covid19treatmentguidelines.nih.gov/overview/sars-cov-2-testing/. Accessed on December 11, 2020.

  21. Hanson KE, et al. Infectious diseases society of America guidelines on the diagnosis of COVID-19. Clin Infect Dis. 2020.

    Google Scholar 

  22. Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19 Published by IDSA, 5/6/2020. Accessed December 11, 2020.

    Google Scholar 

  23. https://www.idsociety.org/covid-19-real-time-learning-network/diagnostics/antibody-testing/. Accessed December 11, 2020.

  24. https://www.cdc.gov/coronavirus/2019-ncov/lab/serology-testing.html.

  25. https://www.fda.gov/medical-devices/letters-health-care-providers/important-information-use-serological-antibody-tests-covid-19-letter-health-care-providers.

  26. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;26(368):m1091. https://doi.org/10.1136/bmj.m1091. Erratum. In: BMJ. 2020 Mar 31;368:m1295. PubMed PMID: 32217556.

  27. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–7. https://doi.org/10.1111/jth.14768.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10.

    Article  CAS  Google Scholar 

  29. Seymour CW, Kennedy JN, Wang S, Chang CH, Elliott CF, Xu Z, Berry S, Clermont G, Cooper G, Gomez H, Huang DT, Kellum JA, Mi Q, Opal SM, Talisa V, van der Poll T, Visweswaran S, Vodovotz Y, Weiss JC, Yealy DM, Yende S, Angus DC. Derivation, validation, and potential treatment implications of novel clinical phenotypes for sepsis. JAMA. 2019;321(20):2003–17. [PMC free article: PMC6537818] [PubMed: 31104070].

    Google Scholar 

  30. Wang X, Xu W, Hu G, Xia S, Sun Z, Liu Z. SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion. Cell Mol Immunol. 2020;17(8):894.

    Article  CAS  Google Scholar 

  31. Moore BJB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020;368(490):473–4. And 113 BMJ study.

    Google Scholar 

  32. Ozsurekci Y, Aykac K, Er AG, Halacli B, Arasli M, Oygar PD, Gürlevik S, Cura Yayla BC, Karakaya J, Alp A, Topeli A. Predictive value of cytokine/chemokine responses for the disease severity and management in children and adult cases with COVID-19. J Med Virol. 2021;93(5):2828–37.

    Article  CAS  Google Scholar 

  33. Luo Y, Mao L, Yuan X, Xue Y, Lin Q, Tang G, Song H, Wang F, Sun Z. Prediction model based on the combination of cytokines and lymphocyte subsets for prognosis of SARS-CoV-2 infection. J Clin Immunol. 2020;40(7):960–9.

    Article  CAS  Google Scholar 

  34. Cabaro S, D'Esposito V, Di Matola T, Sale S, Cennamo M, Terracciano D, Parisi V, Portella G, Beguinot F, Atripaldi L, Sansone M. Cytokine signature and COVID-19 prediction models in the two waves of pandemics. 2021.

    Google Scholar 

  35. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020.

    Google Scholar 

  36. Liu J, Li S, Liu J, Liang B, Wang X, Wang H, Li W, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMed. 2020:102763.

    Google Scholar 

  37. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497–506.

    Google Scholar 

  38. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507–13.

    Google Scholar 

  39. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;S1473–3099(20):30086–3008.

    Google Scholar 

  40. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019-nCoV pneumonia. Radiology. 2020 Feb 6 [Epub ahead of print].

    Google Scholar 

  41. Chen C, Wang H, Liang Z, et al. Predicting illness severity and short-term outcomes of COVID-19: a retrospective cohort study in China. 2020;1(1):100007. https://doi.org/10.1016/j.xinn.2020.04.007.

  42. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients [published online ahead of print, 2020 Mar 14]. AJR Am J Roentgenol. 2020:1–7. https://doi.org/10.2214/AJR.20.23034.

  43. Qin L, et al. A predictive model and scoring system combining clinical and CT characteristics for the diagnosis of COVID-19. Eur Radiol. 2020;30(12):6797–807.

    Google Scholar 

  44. Francone M, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol. 2020;30(12):6808–17.

    Google Scholar 

  45. Wynants L, et al. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ. 2020;369.

    Google Scholar 

  46. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/in-vitro-diagnostics-euas-antigen-diagnostic-tests-sars-cov-2#Individual%20EUAs. Accessed on December 16, 2021.

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Correspondence to Umair Mallick .

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Mallick, U. (2022). An Introduction to the Clinical and Diagnostic Features, and CoViD19 Complications. In: Cardiovascular Complications of COVID-19. Springer, Cham. https://doi.org/10.1007/978-3-030-90065-6_3

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  • DOI: https://doi.org/10.1007/978-3-030-90065-6_3

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