CovidSeniorV1, Main, Exploration, bibRecord, 000256

Risks and features of secondary infections in severe and critical ill COVID-19 patients.

Identifieur interne : 000256 ( Main/Exploration ); précédent : 000255; suivant : 000257

Risks and features of secondary infections in severe and critical ill COVID-19 patients.

Source :

Emerging microbes & infections [ 2222-1751 ] ; 2020.

RBID : pubmed:32815458

Descripteurs français

English descriptors

Abstract

Objectives Severe or critical COVID-19 is associated with intensive care unit admission, increased secondary infection rate, and would lead to significant worsened prognosis. Risks and characteristics relating to secondary infections in severe COVID-19 have not been described. Methods Severe and critical COVID-19 patients from Shanghai were included. We collected lower respiratory, urine, catheters, and blood samples according to clinical necessity and culture and mNGS were performed. Clinical and laboratory data were archived. Results We found 57.89% (22/38) patients developed secondary infections. The patient receiving invasive mechanical ventilation or in critical state has a higher chance of secondary infections (P<0.0001). The most common infections were respiratory, blood-stream and urinary infections, and in respiratory infections, the most detected pathogens were gram-negative bacteria (26, 50.00%), following by gram-positive bacteria (14, 26.92%), virus (6, 11.54%), fungi (4, 7.69%), and others (2, 3.85%). Respiratory Infection rate post high flow, tracheal intubation, and tracheotomy were 12.90% (4/31), 30.43% (7/23), and 92.31% (12/13) respectively. Secondary infections would lead to lower discharge rate and higher mortality rate. Conclusion Our study originally illustrated secondary infection proportion in severe and critical COVID-19 patients. Culture accompanied with metagenomics sequencing increased pathogen diagnostic rate. Secondary infections risks increased after receiving invasive respiratory ventilations and intravascular devices, and would lead to a lower discharge rate and a higher mortality rate.

DOI: 10.1080/22221751.2020.1812437
PubMed: 32815458

Affiliations:

République populaire de Chine

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to stream Main, to step Corpus: 000575
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Le document en format XML

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<author><name sortKey="Zhang, Haocheng" sort="Zhang, Haocheng" uniqKey="Zhang H" first="Haocheng" last="Zhang">Haocheng Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Zhang, Yi" sort="Zhang, Yi" uniqKey="Zhang Y" first="Yi" last="Zhang">Yi Zhang</name>
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<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
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<author><name sortKey="Wu, Jing" sort="Wu, Jing" uniqKey="Wu J" first="Jing" last="Wu">Jing Wu</name>
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<country xml:lang="fr">République populaire de Chine</country>
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<author><name sortKey="Li, Yang" sort="Li, Yang" uniqKey="Li Y" first="Yang" last="Li">Yang Li</name>
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<author><name sortKey="Zhou, Xian" sort="Zhou, Xian" uniqKey="Zhou X" first="Xian" last="Zhou">Xian Zhou</name>
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<author><name sortKey="Li, Xin" sort="Li, Xin" uniqKey="Li X" first="Xin" last="Li">Xin Li</name>
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<author><name sortKey="Chen, Haili" sort="Chen, Haili" uniqKey="Chen H" first="Haili" last="Chen">Haili Chen</name>
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<author><name sortKey="Guo, Mingquan" sort="Guo, Mingquan" uniqKey="Guo M" first="Mingquan" last="Guo">Mingquan Guo</name>
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<author><name sortKey="Chen, Shu" sort="Chen, Shu" uniqKey="Chen S" first="Shu" last="Chen">Shu Chen</name>
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<author><name sortKey="Sun, Feng" sort="Sun, Feng" uniqKey="Sun F" first="Feng" last="Sun">Feng Sun</name>
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<author><name sortKey="Mao, Richeng" sort="Mao, Richeng" uniqKey="Mao R" first="Richeng" last="Mao">Richeng Mao</name>
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<country xml:lang="fr">République populaire de Chine</country>
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<author><name sortKey="Qiu, Chao" sort="Qiu, Chao" uniqKey="Qiu C" first="Chao" last="Qiu">Chao Qiu</name>
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<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Zhu, Zhaoqin" sort="Zhu, Zhaoqin" uniqKey="Zhu Z" first="Zhaoqin" last="Zhu">Zhaoqin Zhu</name>
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<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
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<author><name sortKey="Ai, Jingwen" sort="Ai, Jingwen" uniqKey="Ai J" first="Jingwen" last="Ai">Jingwen Ai</name>
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<country xml:lang="fr">République populaire de Chine</country>
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<author><name sortKey="Zhang, Wenhong" sort="Zhang, Wenhong" uniqKey="Zhang W" first="Wenhong" last="Zhang">Wenhong Zhang</name>
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<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Risks and features of secondary infections in severe and critical ill COVID-19 patients.</title>
<author><name sortKey="Zhang, Haocheng" sort="Zhang, Haocheng" uniqKey="Zhang H" first="Haocheng" last="Zhang">Haocheng Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Zhang, Yi" sort="Zhang, Yi" uniqKey="Zhang Y" first="Yi" last="Zhang">Yi Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Wu, Jing" sort="Wu, Jing" uniqKey="Wu J" first="Jing" last="Wu">Jing Wu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Li, Yang" sort="Li, Yang" uniqKey="Li Y" first="Yang" last="Li">Yang Li</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
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<author><name sortKey="Zhou, Xian" sort="Zhou, Xian" uniqKey="Zhou X" first="Xian" last="Zhou">Xian Zhou</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Li, Xin" sort="Li, Xin" uniqKey="Li X" first="Xin" last="Li">Xin Li</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
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<author><name sortKey="Chen, Haili" sort="Chen, Haili" uniqKey="Chen H" first="Haili" last="Chen">Haili Chen</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Guo, Mingquan" sort="Guo, Mingquan" uniqKey="Guo M" first="Mingquan" last="Guo">Mingquan Guo</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chen, Shu" sort="Chen, Shu" uniqKey="Chen S" first="Shu" last="Chen">Shu Chen</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sun, Feng" sort="Sun, Feng" uniqKey="Sun F" first="Feng" last="Sun">Feng Sun</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mao, Richeng" sort="Mao, Richeng" uniqKey="Mao R" first="Richeng" last="Mao">Richeng Mao</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Qiu, Chao" sort="Qiu, Chao" uniqKey="Qiu C" first="Chao" last="Qiu">Chao Qiu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zhu, Zhaoqin" sort="Zhu, Zhaoqin" uniqKey="Zhu Z" first="Zhaoqin" last="Zhu">Zhaoqin Zhu</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ai, Jingwen" sort="Ai, Jingwen" uniqKey="Ai J" first="Jingwen" last="Ai">Jingwen Ai</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Zhang, Wenhong" sort="Zhang, Wenhong" uniqKey="Zhang W" first="Wenhong" last="Zhang">Wenhong Zhang</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai</wicri:regionArea>
<wicri:noRegion>Shanghai</wicri:noRegion>
</affiliation>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Bacteremia (microbiology)</term>
<term>Bacteremia (mortality)</term>
<term>Bacteremia (pathology)</term>
<term>Bacteremia (virology)</term>
<term>Bacterial Infections (microbiology)</term>
<term>Bacterial Infections (mortality)</term>
<term>Bacterial Infections (pathology)</term>
<term>Bacterial Infections (virology)</term>
<term>Betacoronavirus (pathogenicity)</term>
<term>Coronavirus Infections (microbiology)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (pathology)</term>
<term>Coronavirus Infections (virology)</term>
<term>Critical Illness (MeSH)</term>
<term>Female (MeSH)</term>
<term>Fungemia (microbiology)</term>
<term>Fungemia (mortality)</term>
<term>Fungemia (pathology)</term>
<term>Fungemia (virology)</term>
<term>Fungi (pathogenicity)</term>
<term>Gram-Negative Bacteria (pathogenicity)</term>
<term>Gram-Positive Bacteria (pathogenicity)</term>
<term>Humans (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Lung (microbiology)</term>
<term>Lung (pathology)</term>
<term>Lung (virology)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Mycoses (microbiology)</term>
<term>Mycoses (mortality)</term>
<term>Mycoses (pathology)</term>
<term>Mycoses (virology)</term>
<term>Opportunistic Infections (microbiology)</term>
<term>Opportunistic Infections (mortality)</term>
<term>Opportunistic Infections (pathology)</term>
<term>Opportunistic Infections (virology)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (microbiology)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (pathology)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Respiration, Artificial (adverse effects)</term>
<term>Respiratory Tract Infections (microbiology)</term>
<term>Respiratory Tract Infections (mortality)</term>
<term>Respiratory Tract Infections (pathology)</term>
<term>Respiratory Tract Infections (virology)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Risk (MeSH)</term>
<term>Severity of Illness Index (MeSH)</term>
<term>Survival Analysis (MeSH)</term>
<term>Urinary Tract Infections (microbiology)</term>
<term>Urinary Tract Infections (mortality)</term>
<term>Urinary Tract Infections (pathology)</term>
<term>Urinary Tract Infections (virology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Analyse de survie (MeSH)</term>
<term>Bactéries à Gram négatif (pathogénicité)</term>
<term>Bactéries à Gram positif (pathogénicité)</term>
<term>Bactériémie (anatomopathologie)</term>
<term>Bactériémie (microbiologie)</term>
<term>Bactériémie (mortalité)</term>
<term>Bactériémie (virologie)</term>
<term>Betacoronavirus (pathogénicité)</term>
<term>Champignons (pathogénicité)</term>
<term>Femelle (MeSH)</term>
<term>Fongémie (anatomopathologie)</term>
<term>Fongémie (microbiologie)</term>
<term>Fongémie (mortalité)</term>
<term>Fongémie (virologie)</term>
<term>Humains (MeSH)</term>
<term>Indice de gravité de la maladie (MeSH)</term>
<term>Infections bactériennes (anatomopathologie)</term>
<term>Infections bactériennes (microbiologie)</term>
<term>Infections bactériennes (mortalité)</term>
<term>Infections bactériennes (virologie)</term>
<term>Infections de l'appareil respiratoire (anatomopathologie)</term>
<term>Infections de l'appareil respiratoire (microbiologie)</term>
<term>Infections de l'appareil respiratoire (mortalité)</term>
<term>Infections de l'appareil respiratoire (virologie)</term>
<term>Infections opportunistes (anatomopathologie)</term>
<term>Infections opportunistes (microbiologie)</term>
<term>Infections opportunistes (mortalité)</term>
<term>Infections opportunistes (virologie)</term>
<term>Infections urinaires (anatomopathologie)</term>
<term>Infections urinaires (microbiologie)</term>
<term>Infections urinaires (mortalité)</term>
<term>Infections urinaires (virologie)</term>
<term>Infections à coronavirus (anatomopathologie)</term>
<term>Infections à coronavirus (microbiologie)</term>
<term>Infections à coronavirus (mortalité)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Maladie grave (MeSH)</term>
<term>Mycoses (anatomopathologie)</term>
<term>Mycoses (microbiologie)</term>
<term>Mycoses (mortalité)</term>
<term>Mycoses (virologie)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (anatomopathologie)</term>
<term>Pneumopathie virale (microbiologie)</term>
<term>Pneumopathie virale (mortalité)</term>
<term>Pneumopathie virale (virologie)</term>
<term>Poumon (anatomopathologie)</term>
<term>Poumon (microbiologie)</term>
<term>Poumon (virologie)</term>
<term>Risque (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Unités de soins intensifs (MeSH)</term>
<term>Ventilation artificielle (effets indésirables)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Respiration, Artificial</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Bactériémie</term>
<term>Fongémie</term>
<term>Infections bactériennes</term>
<term>Infections de l'appareil respiratoire</term>
<term>Infections opportunistes</term>
<term>Infections urinaires</term>
<term>Infections à coronavirus</term>
<term>Mycoses</term>
<term>Pneumopathie virale</term>
<term>Poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Ventilation artificielle</term>
</keywords>
<keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Bactériémie</term>
<term>Fongémie</term>
<term>Infections bactériennes</term>
<term>Infections de l'appareil respiratoire</term>
<term>Infections opportunistes</term>
<term>Infections urinaires</term>
<term>Infections à coronavirus</term>
<term>Mycoses</term>
<term>Pneumopathie virale</term>
<term>Poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Bacteremia</term>
<term>Bacterial Infections</term>
<term>Coronavirus Infections</term>
<term>Fungemia</term>
<term>Lung</term>
<term>Mycoses</term>
<term>Opportunistic Infections</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Tract Infections</term>
<term>Urinary Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Bacteremia</term>
<term>Bacterial Infections</term>
<term>Coronavirus Infections</term>
<term>Fungemia</term>
<term>Mycoses</term>
<term>Opportunistic Infections</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Tract Infections</term>
<term>Urinary Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Bactériémie</term>
<term>Fongémie</term>
<term>Infections bactériennes</term>
<term>Infections de l'appareil respiratoire</term>
<term>Infections opportunistes</term>
<term>Infections urinaires</term>
<term>Infections à coronavirus</term>
<term>Mycoses</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Betacoronavirus</term>
<term>Fungi</term>
<term>Gram-Negative Bacteria</term>
<term>Gram-Positive Bacteria</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>Bactéries à Gram négatif</term>
<term>Bactéries à Gram positif</term>
<term>Betacoronavirus</term>
<term>Champignons</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Bacteremia</term>
<term>Bacterial Infections</term>
<term>Coronavirus Infections</term>
<term>Fungemia</term>
<term>Lung</term>
<term>Mycoses</term>
<term>Opportunistic Infections</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Tract Infections</term>
<term>Urinary Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Bactériémie</term>
<term>Fongémie</term>
<term>Infections bactériennes</term>
<term>Infections de l'appareil respiratoire</term>
<term>Infections opportunistes</term>
<term>Infections urinaires</term>
<term>Infections à coronavirus</term>
<term>Mycoses</term>
<term>Pneumopathie virale</term>
<term>Poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Bacteremia</term>
<term>Bacterial Infections</term>
<term>Coronavirus Infections</term>
<term>Fungemia</term>
<term>Lung</term>
<term>Mycoses</term>
<term>Opportunistic Infections</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Tract Infections</term>
<term>Urinary Tract Infections</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Critical Illness</term>
<term>Female</term>
<term>Humans</term>
<term>Intensive Care Units</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Retrospective Studies</term>
<term>Risk</term>
<term>Severity of Illness Index</term>
<term>Survival Analysis</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité de la maladie</term>
<term>Maladie grave</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Risque</term>
<term>Sujet âgé</term>
<term>Unités de soins intensifs</term>
<term>Études rétrospectives</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><i>Objectives</i>
 Severe or critical COVID-19 is associated with intensive care unit admission, increased secondary infection rate, and would lead to significant worsened prognosis. Risks and characteristics relating to secondary infections in severe COVID-19 have not been described. <i>Methods</i>
 Severe and critical COVID-19 patients from Shanghai were included. We collected lower respiratory, urine, catheters, and blood samples according to clinical necessity and culture and mNGS were performed. Clinical and laboratory data were archived. <i>Results</i>
 We found 57.89% (22/38) patients developed secondary infections. The patient receiving invasive mechanical ventilation or in critical state has a higher chance of secondary infections (<i>P</i>
<0.0001). The most common infections were respiratory, blood-stream and urinary infections, and in respiratory infections, the most detected pathogens were gram-negative bacteria (26, 50.00%), following by gram-positive bacteria (14, 26.92%), virus (6, 11.54%), fungi (4, 7.69%), and others (2, 3.85%). Respiratory Infection rate post high flow, tracheal intubation, and tracheotomy were 12.90% (4/31), 30.43% (7/23), and 92.31% (12/13) respectively. Secondary infections would lead to lower discharge rate and higher mortality rate. <i>Conclusion</i>
 Our study originally illustrated secondary infection proportion in severe and critical COVID-19 patients. Culture accompanied with metagenomics sequencing increased pathogen diagnostic rate. Secondary infections risks increased after receiving invasive respiratory ventilations and intravascular devices, and would lead to a lower discharge rate and a higher mortality rate.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32815458</PMID>
<DateCompleted><Year>2020</Year>
<Month>09</Month>
<Day>15</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>09</Month>
<Day>15</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2222-1751</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>9</Volume>
<Issue>1</Issue>
<PubDate><Year>2020</Year>
<Month>Dec</Month>
</PubDate>
</JournalIssue>
<Title>Emerging microbes & infections</Title>
<ISOAbbreviation>Emerg Microbes Infect</ISOAbbreviation>
</Journal>
<ArticleTitle>Risks and features of secondary infections in severe and critical ill COVID-19 patients.</ArticleTitle>
<Pagination><MedlinePgn>1958-1964</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1080/22221751.2020.1812437</ELocationID>
<Abstract><AbstractText><i>Objectives</i>
 Severe or critical COVID-19 is associated with intensive care unit admission, increased secondary infection rate, and would lead to significant worsened prognosis. Risks and characteristics relating to secondary infections in severe COVID-19 have not been described. <i>Methods</i>
 Severe and critical COVID-19 patients from Shanghai were included. We collected lower respiratory, urine, catheters, and blood samples according to clinical necessity and culture and mNGS were performed. Clinical and laboratory data were archived. <i>Results</i>
 We found 57.89% (22/38) patients developed secondary infections. The patient receiving invasive mechanical ventilation or in critical state has a higher chance of secondary infections (<i>P</i>
<0.0001). The most common infections were respiratory, blood-stream and urinary infections, and in respiratory infections, the most detected pathogens were gram-negative bacteria (26, 50.00%), following by gram-positive bacteria (14, 26.92%), virus (6, 11.54%), fungi (4, 7.69%), and others (2, 3.85%). Respiratory Infection rate post high flow, tracheal intubation, and tracheotomy were 12.90% (4/31), 30.43% (7/23), and 92.31% (12/13) respectively. Secondary infections would lead to lower discharge rate and higher mortality rate. <i>Conclusion</i>
 Our study originally illustrated secondary infection proportion in severe and critical COVID-19 patients. Culture accompanied with metagenomics sequencing increased pathogen diagnostic rate. Secondary infections risks increased after receiving invasive respiratory ventilations and intravascular devices, and would lead to a lower discharge rate and a higher mortality rate.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Haocheng</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Yi</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wu</LastName>
<ForeName>Jing</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Li</LastName>
<ForeName>Yang</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhou</LastName>
<ForeName>Xian</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Li</LastName>
<ForeName>Xin</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chen</LastName>
<ForeName>Haili</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Guo</LastName>
<ForeName>Mingquan</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chen</LastName>
<ForeName>Shu</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sun</LastName>
<ForeName>Feng</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mao</LastName>
<ForeName>Richeng</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Qiu</LastName>
<ForeName>Chao</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhu</LastName>
<ForeName>Zhaoqin</ForeName>
<Initials>Z</Initials>
<AffiliationInfo><Affiliation>Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ai</LastName>
<ForeName>Jingwen</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Wenhong</ForeName>
<Initials>W</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Disease, Huashan Hospital affiliated to Fudan University, Shanghai, People's Republic of China.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Emerg Microbes Infect</MedlineTA>
<NlmUniqueID>101594885</NlmUniqueID>
<ISSNLinking>2222-1751</ISSNLinking>
</MedlineJournalInfo>
<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
<SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016470" MajorTopicYN="N">Bacteremia</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001424" MajorTopicYN="N">Bacterial Infections</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
<QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016469" MajorTopicYN="N">Fungemia</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005658" MajorTopicYN="N">Fungi</DescriptorName>
<QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006090" MajorTopicYN="N">Gram-Negative Bacteria</DescriptorName>
<QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006094" MajorTopicYN="N">Gram-Positive Bacteria</DescriptorName>
<QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008168" MajorTopicYN="N">Lung</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009181" MajorTopicYN="N">Mycoses</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009894" MajorTopicYN="N">Opportunistic Infections</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012306" MajorTopicYN="N">Risk</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014552" MajorTopicYN="N">Urinary Tract Infections</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">SARS-CoV-2</Keyword>
<Keyword MajorTopicYN="N">intensive care</Keyword>
<Keyword MajorTopicYN="N">intravascular devices</Keyword>
<Keyword MajorTopicYN="N">respiratory ventilations</Keyword>
<Keyword MajorTopicYN="N">secondary infection</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>8</Month>
<Day>21</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>9</Month>
<Day>17</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
<Month>8</Month>
<Day>21</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">32815458</ArticleId>
<ArticleId IdType="doi">10.1080/22221751.2020.1812437</ArticleId>
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</pubmed>
<affiliations><list><country><li>République populaire de Chine</li>
</country>
</list>
<tree><country name="République populaire de Chine"><noRegion><name sortKey="Zhang, Haocheng" sort="Zhang, Haocheng" uniqKey="Zhang H" first="Haocheng" last="Zhang">Haocheng Zhang</name>
</noRegion>
<name sortKey="Ai, Jingwen" sort="Ai, Jingwen" uniqKey="Ai J" first="Jingwen" last="Ai">Jingwen Ai</name>
<name sortKey="Chen, Haili" sort="Chen, Haili" uniqKey="Chen H" first="Haili" last="Chen">Haili Chen</name>
<name sortKey="Chen, Shu" sort="Chen, Shu" uniqKey="Chen S" first="Shu" last="Chen">Shu Chen</name>
<name sortKey="Guo, Mingquan" sort="Guo, Mingquan" uniqKey="Guo M" first="Mingquan" last="Guo">Mingquan Guo</name>
<name sortKey="Li, Xin" sort="Li, Xin" uniqKey="Li X" first="Xin" last="Li">Xin Li</name>
<name sortKey="Li, Yang" sort="Li, Yang" uniqKey="Li Y" first="Yang" last="Li">Yang Li</name>
<name sortKey="Mao, Richeng" sort="Mao, Richeng" uniqKey="Mao R" first="Richeng" last="Mao">Richeng Mao</name>
<name sortKey="Qiu, Chao" sort="Qiu, Chao" uniqKey="Qiu C" first="Chao" last="Qiu">Chao Qiu</name>
<name sortKey="Sun, Feng" sort="Sun, Feng" uniqKey="Sun F" first="Feng" last="Sun">Feng Sun</name>
<name sortKey="Wu, Jing" sort="Wu, Jing" uniqKey="Wu J" first="Jing" last="Wu">Jing Wu</name>
<name sortKey="Zhang, Wenhong" sort="Zhang, Wenhong" uniqKey="Zhang W" first="Wenhong" last="Zhang">Wenhong Zhang</name>
<name sortKey="Zhang, Yi" sort="Zhang, Yi" uniqKey="Zhang Y" first="Yi" last="Zhang">Yi Zhang</name>
<name sortKey="Zhou, Xian" sort="Zhou, Xian" uniqKey="Zhou X" first="Xian" last="Zhou">Xian Zhou</name>
<name sortKey="Zhu, Zhaoqin" sort="Zhu, Zhaoqin" uniqKey="Zhu Z" first="Zhaoqin" last="Zhu">Zhaoqin Zhu</name>
</country>
</tree>
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	Serveur d'exploration sur la COVID chez les séniors
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Serveur d'exploration sur la COVID chez les séniors

Risks and features of secondary infections in severe and critical ill COVID-19 patients.

Risks and features of secondary infections in severe and critical ill COVID-19 patients.

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