Treatment Outcomes in COVID-19 Patients with Brucellosis:Case Series in Heilongjiang and Systematic Review of Literature

Objective Clinical characteristics and outcome in COVID-19 with brucellosis patients has not been well demonstrated,we tried to analyze clinical outcome in local and literature COVID-19 cases with brucellosis before and after recovery.Methods We retrospectively collected hospitalization data of comorbid patients and prospectively followed up after discharge in Heilongjiang Infectious Disease Hospital from January 15,2020 to April29,2022.Demographics,epidemiological,clinical symptoms,radiological and laboratory data,treatment medicines and outcomes,and follow up were analyzed,and findings of a systematic review were demonstrated.Results A total of four COVID-19 with brucellosis patients were included.One patient had active brucellosis before covid and 3 patients had nonactive brucellosis before brucellosis.The median age was54.5 years,and all were males(100.0%).Two cases(50.0%)were moderate,and one was mild and asymptomatic,respectively.Three cases(75.0%)had at least one comorbidity(brucellosis excluded).All4 patients were found in COVID-19 nucleic acid screening.Case C and D had only headache and fever on admission,respectively.Four cases were treated with Traditional Chinese medicine,western medicines for three cases,no adverse reaction occurred during hospitalization.All patients were cured and discharged.Moreover,one case(25.0%)had still active brucellosis without re-positive COVID-19,and other three cases(75.0%)have no symptoms of discomfort except one case fell fatigue and anxious during the follow-up period after recovery.Conducting the literature review,two similar cases have been reported in two case reports,and were both recovered,whereas,no data of follow up after recovery.Conclusion These cases indicate that COVID-19 patients with brucellosis had favorable outcome before and after recovery.More clinical studies should be conducted to confirm our findings.

Factors Defining the Development of Severe Illness in Patients with COVID-19:A Retrospective Study

Objective Early triage of patients with coronavirus disease 2019(COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.Methods We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24,2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator(LASSO)and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.Results A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio(OR, 1.27;95% CI, 1.15–1.39), albumin(OR,0.76;95% CI, 0.70–0.83), and chest computed tomography abnormalities(OR, 2.01;95% CI, 1.41–2.86)and the AUC of the validation cohort was 0.822(95% CI, 0.7667–0.8776).Conclusion This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.