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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Thi-Kim T, Nguyen-Quang T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Nguyen-Chi T, Nguyen-Van T, Tang-Thi-Thao T, Nguyen-Tuan A, Nguyen-Hoang Q, Hoang-Phi-Tuyet P, Vu-Van G, Nguyen-Lan H, Nguyen-Hong C, Dinh-Ngoc S, Truong-Viet D, Nguyen-Nhu V, Nguyen-Duy T. Predictive Factors of Mortality in Patients with Severe COVID-19 Treated in the Intensive Care Unit: A Single-Center Study in Vietnam. Pulm Ther 2023; 9:377-394. [PMID: 37415031 PMCID: PMC10447826 DOI: 10.1007/s41030-023-00231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION The fourth outbreak of COVID-19 with the delta variant in Vietnam was very fierce due to the limited availability of vaccines and the lack of healthcare resources. During that period, the high mortality of patients with severe and critical COVID-19 caused many concerns for the health system, especially the intensive care units. This study aimed to analyze the predictive factors of death and survival in patients with severe and critical COVID-19. METHODS We conducted a cross-sectional and descriptive study on 151 patients with severe and critical COVID-19 hospitalized in the Intensive Care Unit of Binh Duong General Hospital. RESULTS Common clinical symptoms of severe and critical COVID-19 included shortness of breath (97.4%), fatigue (89.4%), cough (76.8%), chest pain (47.7%), loss of smell (48.3%), loss of taste (39.1%), and headache (21.2%). The abnormal biochemical features were leukopenia (2.1%), anemia, thrombocytopenia (18%), hypoxia with low PaO2 (34.6%), hypocapnia with reduced PaCO2 (29.6%), and blood acidosis (18.4%). Common complications during hospitalization were septic shock (15.2%), cardiogenic shock (5.3%), and embolism (2.6%). The predictive factors of death were being female, age > 65 years, cardiovascular comorbidity, thrombocytopenia (< 137.109/l), and hypoxia at inclusion or after the first week or blood acidosis (pH < 7.28). The use of a high dose of corticosteroids reduced the mortality during the first 3 weeks of hospitalization but significantly increased risk of death after 3 and 4 weeks. CONCLUSIONS Common clinical symptoms, laboratory features, and death-related complications of critical and severe COVID-19 patients were found in Vietnamese patients during the fourth wave of the COVID-19 pandemic. The results of this study provide new insight into the predictive factors of mortality for patients with severe and critical COVID-19.
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Affiliation(s)
- Sy Duong-Quy
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
- Hershey Medical Center, Penn State Medical College, State College, PA, USA
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Duc Huynh-Truong-Anh
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Tien Nguyen-Quang
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thuy Tran-Ngoc-Anh
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Nam Nguyen-Van-Hoai
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Mai Do-Thi-Thu
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Thanh Nguyen-Chi
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | - Toi Nguyen-Van
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Tram Tang-Thi-Thao
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Anh Nguyen-Tuan
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | - Quan Nguyen-Hoang
- Biomedical Research Center, Lam Dong Medical College, Dalat City, Vietnam
| | | | - Giap Vu-Van
- Respiratory Center, Bach Mai Hospital, Hanoi City, Vietnam
| | - Hieu Nguyen-Lan
- Phu Chanh Covid-19 Hospital, Binh Duong General Hospital, Thu Dau Mot, Binh Duong Province, Vietnam
| | | | - Sy Dinh-Ngoc
- Respiratory Department, National Hospital of Lung Diseases, Hanoi City, Vietnam
| | - Dung Truong-Viet
- Department of Public Health, Thang Long University, Ha Noi City, Vietnam
| | - Vinh Nguyen-Nhu
- Department of Respiratory Functional Exploration. University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Thai Nguyen-Duy
- National Institute for Control of Vaccines and Biologicals, Ministry of Health, Hanoi City, Vietnam.
- Department of Biomedical Sciences, Vietnam University of Traditional Medicine, Ministry of Health, Hanoi City, Vietnam.
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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Quang T, Nguyen-Thi-Kim T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Nguyen-Van T, Tang-Thi-Thao T, Nguyen-Tuan A, Nguyen-Van T, Tran-Xuan Q, Vu-Tran-Thien Q, Trinh-Du T, Tran-Thai T, Nguyen-Duy T, Tran-Van H, Vo-Thi-Kim A. Guillain-Barré Syndrome due to COVID-19 Vero Cell Vaccination Associated with Concomitant COVID-19 Infection-induced ARDS and Treated Successfully by Therapeutic Plasma Exchange: A First Case Report from Vietnam. Pulm Ther 2023; 9:271-280. [PMID: 36991236 PMCID: PMC10057680 DOI: 10.1007/s41030-023-00219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain-Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination.
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Affiliation(s)
- Sy Duong-Quy
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam.
- Immuno-Allergology Division, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA.
- Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh, Vietnam.
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
| | - Duc Huynh-Truong-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tien Nguyen-Quang
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thuy Tran-Ngoc-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Nam Nguyen-Van-Hoai
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Mai Do-Thi-Thu
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tinh Nguyen-Van
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tram Tang-Thi-Thao
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Anh Nguyen-Tuan
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Toi Nguyen-Van
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Quan Vu-Tran-Thien
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - The Trinh-Du
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Tuan Tran-Thai
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Thai Nguyen-Duy
- National Institute for Control of Vaccines and Biologicals, Ministry of Health, Hanoi, Vietnam
| | - Huong Tran-Van
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam
- Department of Public Health, Thang Long University, Hanoi, Vietnam
| | - Anh Vo-Thi-Kim
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam.
- Department of Public Health, Thang Long University, Hanoi, Vietnam.
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Duong-Quy S, Huynh-Truong-Anh D, Tran-Xuan Q, Nguyen-Quang T, Nguyen-Thi-Kim T, Nguyen-Chi T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Tang-Thi-Thao T, Bui-Diem K, Hoang-Anh T, Nguyen-Ngoc-Phuong T, Nguyen-Nhu V. Bradycardia unresponded to atropin testing was successfully treated with therapeutic plasma exchange in a patient with severe COVID-19 complicated by Guillain-Barré syndrome: A case report. Front Cardiovasc Med 2023; 9:1035896. [PMID: 36741850 PMCID: PMC9892716 DOI: 10.3389/fcvm.2022.1035896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been an alarming situation worldwide for the past 2 years. The symptoms of coronavirus disease 2019 (COVID-19) are not only confined to the respiratory system but also affect a multitude of organ systems. Bradycardia associated with Guillain-Barré syndrome (GBS) is a rare autonomic and peripheral neurological complication of COVID-19. In this case report, we present the case of a 26-year-old man diagnosed with bradycardia associated with GBS after contracting COVID-19. Initially, this patient had the classical symptoms of COVID-19 and was hospitalized in the intensive care unit (ICU) for acute respiratory distress syndrome (ARDS). Then, he developed weakness in the lower extremities, diminished tendon reflexes, a loss of sensation without sphincter muscle disorders, and bradycardia. His bradycardia did not respond to atropine. The patient was treated concurrently with a high-flow nasal cannula, systemic corticosteroids, anticoagulation, and therapeutic plasma exchange (TPE) for COVID-19-induced ARDS, bradycardia, and GBS. His ARDS and bradycardia improved after the first cycle of TPE and medical treatment. After three cycles of TPE, the patient progressively recovered his muscle strength in the lower limbs and regained peripheral sensation. He was discharged from the hospital in stable condition after 4 weeks of hospitalization and was followed up after 6 months for cardiorespiratory and neurological complications. This case report elucidates the potential difficulties and challenges that physicians may encounter in diagnosing and treating COVID-19-induced bradycardia and GBS during the pandemic outbreak. However, the patient outcomes with the treatment combining the conventional treatment with therapeutic plasma exchange seem to be optimistic.
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Affiliation(s)
- Sy Duong-Quy
- Biomedical Research Center, Lam Dong Medical College, Da Lat, Vietnam,COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam,Division of Pulmonary, Allergy, and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, United States,Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam,*Correspondence: Sy Duong-Quy ✉
| | - Duc Huynh-Truong-Anh
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Tien Nguyen-Quang
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Thanh Nguyen-Thi-Kim
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Thanh Nguyen-Chi
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Thuy Tran-Ngoc-Anh
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Nam Nguyen-Van-Hoai
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | - Mai Do-Thi-Thu
- COVID-19 Unit of Phu Chanh, Binh Duong General Hospital, Thu° Dãu Môt, Binh Duong, Vietnam
| | | | - Khue Bui-Diem
- Department of Physiology and Pathophysiology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tien Hoang-Anh
- Department of Cardiology. Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | | | - Vinh Nguyen-Nhu
- Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam,Department of Respiratory Functional Exploration, University Medical Center, Ho Chi Minh City, Vietnam,Vinh Nguyen-Nhu ✉
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4
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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Thi-Kim T, Nguyen-Quang T, Nguyen-Chi T, Tran-Xuan Q, Nguyen-Nhu V, Ngo C, Craig T. Guillain-Barré Syndrome in Patient With SARS-CoV-2 PCR Positivity Treated Successfully With Therapeutic Exchange Plasma: A First Case Report From Vietnam. Front Neurol 2022; 13:868667. [PMID: 35693014 PMCID: PMC9175001 DOI: 10.3389/fneur.2022.868667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Since the first case of Guillain-Barré syndrome (GBS)-associated SARS-CoV-2 (COVID-19) infection reported in 2020, a series of cases have been published in some countries. In this case report, we present a young patient with GBS, whose clinical and laboratory data were appropriate for the diagnosis of GBS due to COVID-19 infection. Neurological examination revealed the muscular weakness of lower limbs with Medical Research Council (MRC) scale of 2/5 associated with diminished reflexes. Laboratory studies showed the positive nasal swab RT-PCR test for COVID-19, leukopenia, increased ferritin and LDH levels, normal electrolyte and liver and kidney function, and normal chest X-ray. The result of cerebrospinal fluid showed the albuminocytologic dissociation. The patient was treated with remdesivir, dexamethasone, anticoagulation, and therapeutic plasma exchange (TPE). Patient's muscle weakness was significantly improved after 1 week of admission. He was discharged at 23rd days of hospitalization and followed-up in the out-patients department.
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Affiliation(s)
- Sy Duong-Quy
- Department of Clinical Research, Biomedical Research Center, Lam Dong Medical College, Dalat, Vietnam
- Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
- Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, United States
- Department of Expert Consultation, Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
- *Correspondence: Sy Duong-Quy
| | - Duc Huynh-Truong-Anh
- Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Tien Nguyen-Quang
- Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Thanh Nguyen-Chi
- Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Vinh Nguyen-Nhu
- Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
- Department of Respiratory Functional Exploration. University Medical Center, Ho Chi Minh, Vietnam
| | - Carine Ngo
- Department of Pathology, Institute Gustave Roussy, Villejuif, France
| | - Timothy Craig
- Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, United States
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Duong-Quy S, Huynh-Truong-Anh D, Le-Thi-Hong N, Le-Van T, Le-Thi-Kim S, Nguyen-Quang T, Nguyen-Thi-Kim T, Nguyen-Phuong N, Nguyen-Chi T, Nguyen-Van T, Duong-Thi-Thanh V, Nguyen-Tien D, Ngo C, Craig T. Acute Respiratory Distress Syndrome Associated with Multisystem Inflammatory Syndrome in a Child with Covid-19 and Diabetic Ketoacidosis: A Case Report. Pulm Ther 2022; 8:333-342. [PMID: 35608797 PMCID: PMC9127484 DOI: 10.1007/s41030-022-00192-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/12/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (Covid-19), has uncontrollable effects on many organs. A great number of previously published scientific reports have revealed that patients with diabetes mellitus face a more severe form of Covid-19 with a higher death rate. Here we present the case of a 13-year-old unvaccinated boy who was admitted to an intensive care unit (ICU) with a history of fever, cough, dyspnea, throat pain, nausea, and confusion that progressed to lethargy after 24 h. On clinical examination, he was in a coma with Kussmaul’s breathing, and was anuric. His blood biochemical analysis demonstrated hyperglycemia, severe metabolic acidosis, kidney failure, electrolyte disturbances, and inflammation. Chest x-ray showed pneumonia and a pleural effusion. The results of the SARS-CoV-2 real-time polymerase chain reaction were positive. The patient was diagnosed with Covid-19-induced acute respiratory distress syndrome associated with multisystem inflammatory syndrome in children secondary to his acute respiratory failure, acute kidney injury, and new-onset type 1 diabetes mellitus with diabetic ketoacidosis. He was intubated for invasive mechanical ventilation and received a normal saline infusion and continuous insulin infusion (0.1 IU/kg/h) for the treatment of his diabetic ketoacidosis. He was also treated with methylprednisolone, aspirin, and heparin, and underwent continuous renal replacement therapy for acute renal failure for 9 days. The patient was discharged from ICU on day 16 and was followed up regularly as an outpatient with daily treatment, including subcutaneous insulin injection (30 IU/day) and a calcium channel blocker for hypertension (nifedipine 20 mg/day).
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Affiliation(s)
- Sy Duong-Quy
- Biomedical Research Center, Lam Dong Medical College, Da Lat, Vietnam. .,Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam. .,Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA.
| | | | - Nhung Le-Thi-Hong
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Tap Le-Van
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Sa Le-Thi-Kim
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Tien Nguyen-Quang
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | | | - Ngan Nguyen-Phuong
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Thanh Nguyen-Chi
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Tinh Nguyen-Van
- Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Van Duong-Thi-Thanh
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Dung Nguyen-Tien
- Department of Pediatric Intensive Care Unit, Bach Mai Hospital, Hanoi, Vietnam
| | - Carine Ngo
- Department of Pathology, Institute Gustave Roussy, Villejuif, France
| | - Timothy Craig
- Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA
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