On March 11, 2020, the WHO declared that coronavirus disease 2019 (COVID-19) can be characterized as a pandemic based on the alarming levels of spread and severity and on the alarming levels of inaction. COVID-19 has received worldwide attention as emergency, endangering international public health and economic development. There is a growing body of literatures regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as COVID-19. This review will focus on the latest advance of epidemiology, pathogenesis, and clinical characteristics about COVID-19. Meanwhile, tuberculosis (TB) remains the leading representative respiratory tract communicable disease threatening public health. There are limited data on the risk of severe disease or outcomes in patients with concurrence of TB and COVID-19. Nevertheless, co-infection of some virus would aggravate TB, such as measles. And tuberculosis and influenza co-infection compared with tuberculosis single infection was associated with increased risk of death in individuals. This review will also introduce the characteristics about the concurrence of TB and emerging infectious diseases to provide a hint to manage current epidemic.
Objective To analyze the clinical features, therapeutic management and risk factors for mortality of patients with severe novel A (H1N1) influenza in Shanghai, China.
Methods All patients were diagnosed by influenza A (H1N1) virus mRNA detection. Chest CT scan, routine blood, hepatic function, humoral and cellular immunity, sputum smears, and sputum cultures were performed. Logistic analysis was applied to identify risk factors for mortality.
Results Total of 68 patients were enrolled in this study, the primary clinical symptoms including cough (66, 97.1%), expectoration (41, 60.3%), and polypnea (41, 60.3%). Altogether, 37 (54.4%) and 11 (16.2%) patients were infected with bacterial and fungal, respectively. CT scan demonstrated that 67 (98.6%) patients had pneumonia. Oxygen therapy, oseltamivir, antibiotic and antifungal drugs were performed in 68 (100%), 66 (97.1%), 39 (57.4%), and 11 (16.2%) patients, respectively. Finally, 4 of 68 patients died. Logistic analysis demonstrated that there was a significant correlation between the percentage of neutrophils and mortality before therapy and direct bilirubin content and mortality after therapy, respectively.
Conclusions Patients with severe H1N1 influenza were susceptible to bacterial and/or fungal infection. The risk factors for mortality may be associated with pre-therapeutic neutrophil percentage and post-therapeutic direct bilirubin content.