ABSTRACT
The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.
Subject(s)
Humans , Aged , Middle Aged , COVID-19/prevention & control , SARS-CoV-2 , Pandemics/prevention & control , China/epidemiology , Disease Outbreaks/prevention & control , VaccinationABSTRACT
The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.
ABSTRACT
Objective To evaluate the diagnostic value of quantitative detection of cytomegalovirus (CMV) DNA from different sources [plasma, sputum and bronchoalveolar lavage fluid(BALF)] for CMV pneumonia after allogeneic hematopoietic stem cell transplantation. Methods Clinical data of 405 recipients undergoing allogeneic hematopoietic stem cell transplantation were retrospectively analyzed. Among them, 19 recipients diagnosed with CMV pneumonia were assigned into the CMV pneumonia group, and 229 recipients with CMV viremia alone, 11 recipients without CMV pneumonia who received fiberoptic bronchoscopy and 16 recipients diagnosed with bacterial or fungal pneumonia based on pathogenic evidence receiving sputum culture were assigned into the control A, B and C groups, respectively. The incidence of CMV pneumonia was summarized. The CMV DNA load of specimens from different sources (plasma, sputum and BALF) of recipients with CMV pneumonia was analyzed. The clinical prognosis of recipients with CMV pneumonia was evaluated. Results Among 405 recipients undergoing allogeneic hematopoietic stem cell transplantation, 19 cases developed CMV pneumonia, and the overall incidence of CMV pneumonia was 4.7%(19/405). The CMV DNA load in the plasma, sputum and BALF of recipients with CMV pneumonia was higher than those in the control A, B and C groups (all P < 0.05). In the 19 recipients, 12 cases were cured after antiviral treatment and 7 died from treatment failure(3 cases abandoned treatment). The fatality was 37%(7/19). Conclusions Quantitative detection of CMV DNA in the plasma, sputum and BALF may increase the diagnostic rate of CMV pneumonia, thereby improving clinical prognosis of recipients undergoing allogeneic hematopoietic stem cell transplantation.
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Objective To investigate the clinical value of heat shock protein 90α (HSP90α), glutathione S-transferase P1 (GSTP1), ubiquitin specific peptidase 8 (USP8) and chitinase 3-like 1 (CHI3L1) in bronchoalveolar lavage fluid (BALF) and serum for diagnosis and evaluation of the extent of peripheral lung cancer. Methods The levels of HSP90α, GSTP1, USP8 and CHI3L1 of in BALF and serum were measured and compared among 100 patients with peripheral lung cancer (PLC) and 50 patients with benign lung diseases (BLD) by ELISA. The results were compared and analyzed. Results The average content of HSP90α and CHI3L1 in BALF of PLC patients were higher than that in BLD patients (P0.05). The levels of HSP90α and CHI3L1 in BALF of the patients with small nodular lung cancer group (primary focus diameter ≤1cm) and BLD patients showed no significant difference (P>0.05). The levels of GSTP1 and USP8 in BALF and serum of PLC patients and that of BLD patients showed no significant difference (P>0.05). The levels of HSP90α, GSTP1, USP8 and CHI3L1 in BALF and serum showed no significant correlation with other factors, such as the patient's age, pathological classification (adenocarcinoma or squamous carcinoma) and stage of lung cancer (phase to ). The level of CHI3L1 in BALF was correlated to the diameter of the primary foci (P<0.05), while the levels of other lung cancer markers in BALF and serum showed no significant correlation with diameter of primary focus. Conclusion Detection of tumor markers such as HSP90α and CHI3L1 from patients' BALF has a diagnostic value for PLC, and is superior to the examinations of patients' serum specimens. The measurement of HSP90α in BALF shows better clinical value, and it may contribute to the diagnosis of peripheral pulmonary carcinoma.
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Objective To observe whether cigarette smoke alter the component of pulmonary surfactant pro-tein A and D. Methods In this study, we determined the contents of SP-A and SP-D in BAL fluids of healthy smok-ers and nonsmokers by enzyme linked immunosorbent assay(ELISA). Resluts The contents of SP-A and SP-D in BAL fluids were significantly decreased in smokers compared to those in nonsmokers[ (3.1±0.40) μg/ml vs (1.8± 0.4)μg/ml, (1.5±0.2) μg/ml vs (0.6±0.1)μg/m, all P <0.05]. Conclusion These results suggested that the decreased levels of SP-A and SP-D in smokers may impair the host defense functions of suffactant in the peripheral airways and might have a crucial role in the development of chronic obstructive lung disease.
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Objective To study changes in ACE, LDH and AKP in BALF and blood after rapid decompression in rabbits. Methods Thirty healthy New-Zealand rabbits were randomly divided into low decompression group and rapid decompression group. The respective activity of ACE, LDH and AKP in BALF and blood of rabbits was measured. Results Various degrees of increase in activity of ACE, LDH and AKP in BALF were observed after rapid decompression. Conclusion The simultaneous enhancement of activity of these enzymes suggest that there was injury to the lung consistent with the degree of injury after rapid decompression.