Bilateral acute depigmentation of the iris determined in two cases after COVID-19 infection

Bilateral acute depigmentation of the iris (BADI) is a rare disease characterized by iris atrophy. Although it can be self-limiting, it is sometimes progressive and can lead to glaucoma and severe vision loss. Two female patients were admitted to our clinic because of a change in iris color following coronavirus disease 2019 (COVID-19) infection. After the exclusion of other etiologies in the eye examination, BADI was diagnosed in both cases. Thus, it was shown that COVID-19 may also be involved in the etiology of BADI.

After action review of the COVID-19 pandemic response in North West province, South Africa

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) pandemic with major disruptions globally. Northwest Province Department of Health (NWDoH) in South Africa set up comprehensive epidemiological emergency response plans for preventing, finding, containing and stopping the spread of COVID-19 in accordance with the National Disaster Management Act. Objectives: This After-Action Report (AAR) describes the provincial response to the pandemic from September 2020 to October 2022. Method: The AAR was conducted using the World Health Organization AAR methodology. Focus groups discussed five items: coordination, leadership and governance; epidemiology, surveillance and laboratory; case management and continuity of essential services; risk communication and community engagement and COVID-19 vaccination. Results: The timely establishment and activation of provincial intergovernmental and intersectoral coordinating structures led to effective coordination, resource mobilisation, leadership, decision-making and intervention. The effective communication in the department and other stakeholders resulted in improved surveillance data quality, timelier response and increased ownership of data. Dissemination, training and implementation of case management protocols ensured standardised case management. The multi-channel information dissemination targeting different audiences empowered people with real-time knowledge on the infection and encouraged health-seeking behaviours. Conclusion: The AAR demonstrated the importance of coordinated epidemiological, laboratory and communication response that requires significant public health reserve capacity in peacetime for rapid expansion in an emergency. Contribution: This review contributes to the body of knowledge emerging from the COVID-19 pandemic and provides guidance on enhanced public health response to future emergencies.

Verification of detection method for multiple pathogens in plasma of convalescent patients with Coronavirus Disease 2019 / 中国生物制品学杂志

@#Objective To systematically verify the detection method for multiple pathogens in plasma of convalescent patients(CPs)with Coronavirus Disease 2019(COVID-19).Methods According to the actual situation of plasma samples and the requirements of kit,the molecular biological detection method for multiple pathogens in plasma of CPs with COVID-19 was systematically verified for specificity,reproducibility,intermediate precision and limit of detection(LOD),and confirmed for applicability by detecting 50 plasma samples of CPs with COVID-19.Results The results of interference test and cross test showed that the detection of positive samples and negative samples were not affected;The RSDs of melting temperature values(Tm)of the positive control four pathogens by the same or different test personnels at different time under the same test conditions were 0.07%,0.14%,0.07%,0.14% and 0.06%,0.23%,0.23%,0.20%,and those of internal control(IC)and amplification control(AC)1 and 2 were 0.07%,0.01%,0.07%,0.14% and 0.11%,0.10%,0.15%,0.22%,respectively.Meanwhile,the RSDs of reproducibility and intermediate precision were less than 15% and20% respectively,which met the requirements;The minimum LOD of 22 pathogens were determined;No pathogen was detected in 50 plasma samples of CPs with COVID-19.Conclusion The method for detecting pathogens in plasma of CPs with COVID-19 was specific,stable,reliable and reproducible,which was suitable for the detection of pathogens in plasma of CPs with COVID-19.

Food and nutrition security in the Philippines during the COVID-19 pandemic / Journal of Rural Medicine

Objective: The COVID-19 pandemic placed the Philippines’ food and nutrition issues front and center. In this paper, we discuss the response of its government in addressing food and nutrition security at the beginning of the COVID-19 pandemic and describe its implications on nutritional status. We also cite initiatives that address food accessibility and availability in the communities. Lastly, we explore the importance of nutrition security dimension in food security.Methods: We analyze food and nutrition security issues in the Philippines during the COVID-19 pandemic through online reports and news articles.Results: The distribution of food and financial assistance in the country was extensive, albeit insufficient, considering the prolonged lockdown restrictions. Constantly changing community quarantine guidelines have affected the movement of food supply, delivery of health services, and household economic security. Nutrition programs, such as vitamin A supplementation, feeding for children, and micronutrient supplementation for pregnant women, had lower coverage rates, and by the latter half of 2020, the country had reached its highest recorded hunger rate. Cases of both undernutrition and overnutrition are predicted to rise because of dietary imbalances and a variety of factors. Conversely, community members and some local government units took it upon themselves to improve the food situation in their areas. The provision of food packs containing fresh fruits and vegetables was lauded, as it exemplified a conscious effort to deal with nutrition security.Conclusion: Efforts to address food security have always focused on increasing accessibility, availability, and affordability, often neglecting the nutritional components of foods. Strategies that incorporate nutrition security into food security are much needed in the country, especially during emergencies like the COVID-19 pandemic.

Pathological Changes and Cause of Death Associated with the Global Novel Coronavirus Disease (COVID-19) / 法医学杂志

The coronavirus disease 2019 (COVID-19) has been a global epidemic for more than three years, causing more than 6.9 million deaths. COVID-19 has the clinical characteristics of strong infectivity and long incubation period, and can cause multi-system damage, mainly lung damage, clinical symptoms of acute respiratory distress syndrome (ARDS) and systemic multiple organ damage. The SARS-CoV-2 virus is still constantly mutating. At present, there is no global consensus on the pathological changes of COVID-19 associated deaths and even no consensus on the criteria for determining the cause of death. The investigation of the basic pathological changes and progression of the disease is helpful to guide the clinical treatment and the development of therapeutic drugs. This paper reviews the autopsy reports and related literature published worldwide from February 2020 to June 2023, with a clear number of autopsy cases and corresponding pathological changes of vital organs as the inclusion criteria. A total of 1 111 autopsy cases from 65 papers in 18 countries are included. Pathological manifestations and causes of death are classified and statistically analyzed, common pathological changes of COVID-19 are summarized, and analytical conclusions are drawn, suggesting that COVID-19 infection can cause life-threatening pathological changes in vital organs. On the basis of different health levels of infected groups, the direct cause of death is mainly severe lung damage and secondary systemic multiple organ failure.

Evolution of the newest diagnostic methods for COVID-19: a Chinese perspective / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Coronavirus disease 2019 (COVID-19) has continued to spread globally since late 2019, representing a formidable challenge to the world's healthcare systems, wreaking havoc, and spreading rapidly through human contact. With fever, fatigue, and a persistent dry cough being the hallmark symptoms, this disease threatened to destabilize the delicate balance of our global community. Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region, and an important factor in epidemic assessment and the development of control measures. It also plays a crucial role in ensuring that patients receive the appropriate medical treatment, leading to optimal patient care. Reverse transcription-polymerase chain reaction (RT-PCR) technology is currently the most mature method for detecting viral nucleic acids, but it has many drawbacks. Meanwhile, a variety of COVID-19 detection methods, including molecular biological diagnostic, immunodiagnostic, imaging, and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs. These methods can help clinicians diagnose and treat COVID-19 patients. This review describes the variety of such methods used in China, providing an important reference in the field of the clinical diagnosis of COVID-19.

TONG Xiaolin's Cold-Damp Epidemic Differentiation and Treatment Concepts and Diagnostic and Therapeutic Key Points / 中医杂志

Building on a clear understanding of the diagnosis and treatment patterns for cold-damp epidemics， and incorporating the insights of Academician TONG Xiaolin regarding the differentiation and treatment of such epidemics， this article have distilled the key diagnostic principles. These principles primarily entail observing color and pulse， initially distinguishing between yin and yang， with treatment focusing on dispelling cold and dampness. A comprehensive approach is adopted throughout treatment， with a combination of overall strategies and tailored treatments that evolve in line with the patient's condition. In critical and severe cases， particular attention is given to aspects such as sweating， pulse analysis， and consciousness， preventing the pathogen from penetrating deeply. Efforts are made to open and close organ networks， expelling external pathogens without fixating on resolving constipation. The dosage and efficacy of herbal remedies are adjusted based on individual circumstances and clinical symptoms. The objective is to eliminate pathogens comprehensively， while being vigilant against relapses， ultimately achieving a full recovery. This overview of the thought processes and clinical principles for diagnosing and treating cold-damp epidemics will guide precise clinical practices and provide a theoretical foundation for the involvement of traditional Chinese medicine in epidemic prevention and treatment.

Psychological Impact of Covid-19 Pandemic on Mental Health Practitioners in Selangor, Malaysia

@#Introduction: The Coronavirus disease pandemic of 2019 (COVID-19) has had psychological implications and altered the public’s well-being. In response to the pandemic, mental health practitioners play an essential role in mitigating the adverse psychological effects among the public. However, as the demand for mental health services increases, the responsibilities of mental health professionals are far stretched from what they can handle. Therefore, this research is aimed to explore the psychological impact of the pandemic on the mental health practitioners in Selangor and their coping strategies. Method: A total of 10 mental health practitioners who are clinical psychologists and counselors participated in the one-to-one interview. The collected data were analysed using thematic analysis. Result: The higher client loads, the transition to virtual therapy, burnout, and anxiety were found to have an impact on the mental health practitioners’ well-being. Despite the challenging psychological impact, the mental health practitioners expressed a high level of satisfaction with their jobs, which they attributed to the supportive organisational culture and their intrinsic drive for selecting this profession. The mental health practitioners have reported that perceived organisational support, social support, and self-care approaches are effective coping mechanisms. Mindfulness skills such as breathing techniques and meditation are often practiced by the participants to calm the mind and body from a long day of work. Conclusion: The implication of the study contributes to breaking the stigmatisation of help seeking behaviour among the helping professions, as well as urging the policy makers, governments, and foundations to play a part in providing accessible and quality mental healthcare to the society.

Perioperative mechanical ventilation strategy for COVID-19 patients: Recommendation / 中国胸心血管外科临床杂志

@#Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.

Early prediction of severe COVID-19 in patients with Sjögren's syndrome / 北京大学学报(医学版)

OBJECTIVE@#To investigate the predictive value of blood cell ratios and inflammatory markers for adverse prognosis in patients with primary Sjögren's syndrome (PSS) combined with coronavirus disease 2019 (COVID-19).@*METHODS@#We retrospectively collected clinical data from 80 patients with PSS and COVID-19 who visited the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University from December 2022 to February 2023. Inclusion criteria were (1) meeting the American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome; (2) confirmed diagnosis of COVID-19 by real-time reverse transcription polymerase chain reaction or antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); (3) availability of necessary clinical data; (4) age > 18 years. According to the clinical classification criteria of the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial the 10th Revised Edition)", the patients were divided into the mild and severe groups. Disease activity in primary Sjögren' s syndrome was assessed using the European League Against Rheumatism (EULAR) Sjögren' s syndrome disease activity index (ESSDAI). Platelet-lymphocyte ratio (PLR), C-reactive protein-lymphocyte ratio (CLR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and other laboratory data were compared between the two groups within 24-72 hours post-infection.@*RESULTS@#The mild group consisted of 66 cases with an average age of (51. 52±13. 16) years, and the severe group consisted of 14 cases with an average age of (52.64±10.20) years. Disease activity, CRP, platelets, PLR, and CLR were significantly higher in the severe group compared with the mild group (P < 0.05). Univariate analysis using age, disease activity, CRP, platelets, PLR, and CLR as independent variables indicated that disease activity, CRP, PLR, and CLR were correlated with the severity of COVID-19 (P < 0.05). Multivariate logistic regression analysis further confirmed that PLR (OR=1.016, P < 0.05) and CLR (OR=1.504, P < 0.05) were independent risk factors for the severity of COVID-19 in the critically ill patients. Receiver operator characteristic (ROC) curve analysis showed that the area under the curve (AUC) for PLR and CLR was 0.708 (95%CI: 0.588-0.828) and 0.725 (95%CI: 0.578-0.871), respectively. The sensitivity for PLR and CLR was 0.429 and 0.803, respectively, while the highest specificity was 0.714 and 0.758, respectively. The optimal cutoff values for PLR and CLR were 166.214 and 0.870, respectively.@*CONCLUSION@#PLR and CLR, particularly the latter, may serve as simple and effective indicators for predicting the prognosis of patients with PSS and COVID-19.

Visualized Analysis of Advances and Hot Spots of Lianhua Qingwen in Recent 10 Years / 中国实验方剂学杂志

ObjectiveTo analyze relevant literature on Lianhua Qingwen preparations and clarify the research advances and hot spots in this field， so as to provide references for clinical rational application and further research. MethodLiterature related to Lianhua Qingwen preparations in the recent 10 years was retrieved from six databases， including China National Knowledge Infrastructure（CNKI）， VIP， Wanfang Data， PubMed， and Web of Science， followed by management and analysis by NoteExpress and CiteSpace. ResultFinally， 344 and 76 Chinese and English research articles were included， and the number of publications increased in recent years. The research articles were published in 162 Chinese and 48 English journals. Shijiazhuang Yiling Pharmaceutical Co.， Ltd. and Guangzhou Medical University were institutions with the largest number of Chinese and English publications， respectively. LIU Minyan was the author who had published the most articles. Keywords with high frequency included clinical efficacy， Lianhua Qingwen， inflammatory factors， traditional Chinese medicine， and coronavirus disease-2019（COVID-19）. Nineteen clusters， including clinical efficacy， Chinese medicine， Lianhua Qingwen， COVID-19， and influenza A virus， and 47 emergent keywords， including herpes zoster， pneumonia， inflammatory factors， influenza， and gut microbiota， were generated. ConclusionCooperation and exchanges in this field are insufficient. Research focuses on the clinical efficacy of Lianhua Qingwen in the treatment of COVID-19 and other diseases， pharmacological action and mechanism of antiviral drugs， and micro-mechanism research focuses on related pathways and target proteins， as well as the combination of Chinese and western medicines.

Uptake and impact of COVID-19 vaccination among HIV key populations: a cohort study from Tamil Nadu, India / Journal of Rural Medicine

Objective: Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated.Materials and Methods: This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs.Results: Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants.Conclusion: The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.

The disparity of utilization rate among specific groups for a rapid spreading telehealth application called LEBER during the COVID-19 state of emergency in Japan / Journal of Rural Medicine

Objectives: The purpose of this research is to describe the social demographics and chief complaints of users of a free medical consultation application in Ibaraki Prefecture, where a free medical consultation application was released.Methods: The present study included users of a telehealth application in Ibaraki Prefecture between April 9 and May 17, 2020, during the state of emergency. User background characteristics were descriptively analyzed to clarify individual factors with the potential to act as barriers to equally using innovative solutions. Additionally, the age and consultation time distribution by sex were examined for those who used the application for COVID-19 and non-COVID-19 issues.Results: Most of the participants were in their thirties. Moreover, 72% were female, with most being in their thirties (86%) and the least being in their sixties (45%). The number of consultations was concentrated between 6 p.m. and 10 p.m., with the least between 1 a.m. and 5 a.m. The telehealth application users were mainly females in their thirties and forties.Conclusions: To prevent the widening of health disparities due to the rapid introduction of telehealth, further research is required to identify why the use of the application did not spread beyond the aforementioned user groups.

Clinical research progress on drugs against SARS-CoV-2 / 中国生物制品学杂志

@#The rapid spread of Coronavirus Disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has had a devastating impact on public health and the global economy. Tremendous efforts had been put on urgent development of prophylactic or therapeutic drugs against SARS-CoV-2,mainly smallmolecule antiviral drugs and monoclonal antibodies,to reduce the impact and burden of COVID-19. Currently,National Medical Products Administration(NMPA)of China or Food and Drug Administration(FDA)of the United States have approved three small-molecule drugs and three monoclonal antibodies for use. This paper reviews the clinical research progress and challenges of the main drugs against SARS-CoV-2 on the market at present.

Seroincidencia de anticuerpos IgG del SARS-CoV-2 y factores de riesgo en trabajadores sanitarios asintomáticos del hospital Departamental de Villavicencio

Objetivo: Estimar la seroincidencia acumulada de inmunoglobulinas (Ig) clase G (IgG) anti-SARS-CoV-2 en trabajadores de la salud asintomáticos y su asociación epidemiológica dentro de las áreas funcionales del Hospital Departamental de Villavicencio (HDV). Metodología: Se llevó a cabo un estudio observacional analítico longitudinal de una cohorte de trabajadores, donde cada 21 días, en tres oportunidades, se midieron IgG anti-SARS-CoV-2 en suero sanguíneo, a través de ELISA indirecto, en una muestra representativa aleatoria (n= 105) de trabajadores sanitarios del hospital (N= 756). Como instrumento de recolección de datos se utilizó una encuesta, donde cada trabajador sanitario declaró no haber sido diagnosticado con COVID-19, e igualmente registró la información sobre las variables independientes: sexo, edad, condición laboral, área funcional y comorbilidades. Resultados: La prevalencia inicial para SARS-CoV-2 entre los trabajadores sanitarios asintomáticos del HDV fue de 9,52 % (IC 95 % 5,25-16,65). La seroincidencia acumulada durante 42 días fue de 12,38 % (IC 95 % 7,38-20,04). El riesgo relativo (RR) se utilizó para establecer los factores de riesgo asociados a las variables independientes. El sexo masculino (RR ajustado = 3,34, IC 95 % 1,98-5,86), obesidad (RR ajustado = 10,98, IC 95 % 1,41-85,98) y sexo femenino (RR ajustado = 2,15, IC 95 % 1,12-4,31) en las áreas funcionales de Hospitalización, Medicina Crítica y Urgencias, respectivamente, son factores de riesgo en el HDV. Conclusión: Un total de 13 de 105 trabajadores sanitarios del hospital seroconvirtieron positivamente para SARS-CoV-2 y fueron asintomáticos durante 42 días de seguimiento epidemiológico. Además, existen factores de riesgo importantes en su exposición a este virus en el HDV.

Objective: To estimate the cumulative seroincidence of antisars-CoV-2 immunoglobulin (Ig) class G (IgG) in asymptomatic health care workers and its epidemiological association within the functional areas of the Villavicencio Departmental Hospital (HDV). Methodology: A longitudinal analytical observational study of a cohort of workers was conducted in which anti- SARS-CoV-2 IgG levels in blood serum were measured every 21 days on three occasions using an indirect ELISA in a random representative sample (n = 105) of hospital health workers (N = 756). The data collection tool was a survey in which each healthcare worker indicated that they had not been diagnosed with COVID-19 and provided information on the independent variables: sex, age, job status, functional area, and comorbidities. Results: The baseline prevalence for SARS-CoV-2 among asymptomatic HDV healthcare workers was 9.52% (CI 95% 5.25-16.65). Cumulative seroincidence over 42 days was 12.38% (CI 95% 7.38-20.04). Relative risk (RR) was used to establish the risk factors associated with the independent variables. Male sex (adjusted RR 3.34, CI 95% 1.98-5.86), obesity (adjusted RR 10.98, CI 95% 1.41- 85.98) and female sex (adjusted RR 2.15, CI 95% 1.12-4.31) in the functional areas of Hospitalization, Critical Medicine and Emergency, respectively, are risk factors in the HDV. Conclusion: During 42 days of epidemiological follow-up, 13 out of 105 hospital healthcare workers seroconverted positively for SARS-CoV-2 and remained asymptomatic. Additionally, significant risk factors are associated with their exposure to this virus in the HDV.

Objetivo: Estimar a incidência zero acumulada de imunoglobulinas (Ig) classe G (IgG) anti-SARS-CoV-2 em profissionais de saúde assintomáticos e sua associação epidemiológica dentro das áreas funcionais do Hospital Estadual de Villavicencio (HDV). Metodologia: Foi realizado um estudo observacional analítico longitudinal de uma coorte de profissionais, no qual a cada 21 dias, em três ocasiões mediram-se IgG anti-SARS-CoV-2 em soro sanguíneo, através de ELISA indireto, em uma amostra representativa aleatória (n = 105) de profissionais de saúde do hospital (N =756). Como instrumento de recolecção de dados foi usada uma pesquisa, onde cada profissional de saúde declarou não ter sido diagnosticado com COVID-19, e igualmente registrou a informação sobre as variáveis independentes: sexo, idade, condições de trabalho, área de atuação e comorbidades. Resultados: A prevalência inicial para SARS-CoV-2 entre os profissionais de saúde assintomáticos do HDV foi de 9,52% (IC 95% 5,25-16,65). A incidência zero acumulada durante 42 dias foi de 12,38% (IC 95% 7,38-20,04). O risco relativo (RR) foi utilizado para estabelecer os fatores de risco associados às variáveis independentes. O sexo masculino (RR ajustado 3,34, IC 95% 1,98-5,86), obesidade (RR ajustado 10,98, IC 95% 1,41-85,98) e sexo feminino (RR ajustado 2,15, IC 95% 1,12-4,31) nas áreas funcionais de Internação, Unidade de Terapia Intensiva e Urgências, respectivamente, são fatores de risco no HDV. Conclusão: Um total de 13 de 105 profissionais de saúde do hospital foram detectados positivamente para SARS-CoV-2 e foram assintomáticos durante 42 dias de seguimento epidemiológico. Além disso, existem importantes fatores de risco na sua exposição a este vírus no HDV.

Improvement of Physical Function in Three Cases of Severe COVID-19 / The Japanese Journal of Rehabilitation Medicine

Many acute and subacute complications of coronavirus disease 2019 (COVID-19) have been reported. However, the recovery process in severely ill patients is not clear. Here, we report three patients with favorable physical function after severe COVID-19. All three patients were older than 65 years and had comorbidities such as diabetes mellitus, hypertension, and smoking habits. During respiratory failure, they received mechanical ventilation support for more than 4 days. Two patients had undergone tracheostomy, and one had undergone extracorporeal membrane oxygenation (ECMO). At the time of transfer to our hospital, they had lower-limb muscle weakness, respiratory distress on exertion, exercise-induced hypoxemia (EIH), and complications from immobility, such as peroneal nerve palsy. During rehabilitation, we monitored peripheral blood oxygen saturation, adjusted the workload, and administered temporary orthotic therapy. The patients improved within 150 days after the onset of the disease, and they were discharged home and were able to walk as a practical means of transportation. Even after severe COVID-19, the patients achieved good physical function. Interventions for EIH and complications due to immobility were additionally necessary. In the future, we must examine the relationship between improvements in physical function and rehabilitation.

Thumb-tack needles based on "Biaoben acupoint compatibility" for sequela of COVID-19 during recovery period / 中国针灸

OBJECTIVE@#To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period.@*METHODS@#Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment.@*RESULTS@#Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05).@*CONCLUSION@#The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Contributions of the Medical Affairs Department to Healthcare Professionals and the Effects of the New Coronavirus Disease 2019 Pandemic on the Contributions / 医薬品情報学

Objective: The purpose of this study was to assess the opinions of healthcare professional regarding the contributions of the Medical Affairs department. Furthermore, we aimed to identify factors influencing and reasons for the contributions in the new coronavirus disease 2019 (COVID-19) pandemic situation.Design/Methods: A web-based survey was conducted among healthcare professionals (Key Opinion Leader/Key Thought Leader, KOL/KTL) who had multiple contacts with the Medical Affairs department, Japan.Results: The responses of 141 KOL/KTLs in Japan were collected; 77.3% of the respondents indicated that the contributions of the Medical Affairs department exceeded their expectations (achieved the expected level of contribution). The most common responses were “the identification of unmet medical needs” and “the dissemination of medical and scientific information, providing advanced medical and scientific information;” other responses included “promoting sales of the company's drugs.” The requests from KOL/KTLs regarding quality were “knowledge about biological and clinical statistics” and “proposal and quick response ability from the perspective of medical staff and patients,” but these responses were partially different between physicians and pharmacists. COVID-19 has resulted in substantial changes, for example, “face-to-face” interactions have significantly decreased from 91.5 to 50.4% and “Online” interactions have significantly increased from 20.6 to 70.9%. However, the effects of the declaration of emergency state could not be identified. The KOL/KTLs requested to make the meeting times more appropriate, conduct in-depth two-way discussions, provide latest information, and discuss about professional manners and behaviors.Conclusion: In summary, regardless of the changes in the types of activities caused by COVID-19, the Medical Affairs department has made substantial contributions to healthcare professionals, who highly appreciated them. Furthermore, depending on responses of individuals whose expectations could not be met, areas of improvements have been suggested.

Prevention， Treatment， and Recuperation of Infection with SARS-CoV-2 Variants by Traditional Chinese Medicine Based on Idea of Epidemic Prevention of Jiangnan Medical School / 中国实验方剂学杂志

Because of the frequent occurrence of epidemics in Jiangnan since ancient times， the local medical schools have accumulated rich experience in epidemic prevention， among which Yushan medical school， Wumen medical school， and Qiantang medical school are famous. The physicians have inherited the theory in Treatise on Cold Damage Diseases and developed the therapies for febrile diseases. Adhering to the idea of integrating cold and febrile diseases， the physicians in Jiangnan flexibly adapt ZHANG Zhongjing's theory by combining regional climate， patient physique and other factors to explain the pathogenesis， which is of great significance for the prevention and treatment of epidemics. Therefore， traditional Chinese medicine （TCM） has demonstrated good curative effect on coronavirus disease-2019 （COVID-19） in China. However， the SARS-CoV-2 variants （Delta and Omicron） characterized by strong infectivity， pathogenicity， and immune escape capacity keep emerging， which bring great challenges to the global prevention and control of this pandemic. To this end， we studied the ways of Jiangnan medical school for the prevention and treatment of epidemics， reviewed the evolution of TCM treatment protocols for COVID-19， and summarized China's experience in fighting against the emerging SARS-CoV-2 variants. Further， we explored the measures of TCM in treating SARS-CoV-2 variants from prevention， treatment， and rehabilitation according to the theory for epidemic prevention of Jiangnan medical school. This paper provides reference for the prevention and treatment of emerging SARS-CoV-2 variant and facilitates the development of TCM epidemiology.

Efficacy of Fuzheng Huayu Tablets for Treating Pulmonary Inflammation in COVID-19 Patients / 中国实验方剂学杂志

ObjectiveTo observe the efficacy and safety of Fuzheng Huayu tablets （FHT） for treating pulmonary inflammation in patients with coronavirus disease 2019 （COVID-19）. MethodA total of 70（4 cases were lost to follow-up, and 66 cases were finally completed） COVID-19 patients were recruited from February 1 to April 15 in 2020. They were assigned to a control group （35 patients） and a FHT group （31 patients）. The patients in the control group received routine treatment alone and those in the FHT group received FHT in addition to routine treatment. The primary outcome was the ratio of patients showing improvement in chest computed tomographic manifestations after 14 days. The secondary outcome measures included remission rate or progression rate of critical illness， clinical remission rate of respiratory symptoms， routine blood examination， C-reactive protein （CPR） level， procalcitonin （PCT） level， and blood oxygen saturation （SPO2）. The safety was assessed based on liver and kidney functions and adverse events. ResultAfter the 14-day treatment， the ratio of patients showing improvement in the FHT group （100%） was higher than that in the control group （77.1%） （χ2=8.063，P<0.01）. The ratio of disease stages after treatment showed no significant difference between two groups. In the FHT group， the symptoms including cough， dyspnea， and fatigue were alleviated after treatment （P<0.01）. In the control group， the symptoms including fever， cough， and dyspnea were alleviated （P<0.01）， while the fatigue was not relieved after treatment. No significant difference was observed in the clinical symptoms between the two groups after treatment. After treatment， the FHT group showed decreased white blood cell （WBC） count and neutrophil-to-lymphocyte ratio （NLR） （P<0.01）， elevated platelet （PLT） level （P<0.05）， lowered CRP level （P<0.05）， and no significant difference in lymphocyte （LYM）， hemoglobin （Hb）， SPO2 or PCT level. The control group showed decreased NLR （P<0.05） and WBC count （P<0.01）， elevated PCT level （P<0.05）， and no significant change in LYM， Hb， PLT， SPO2 or CRP level after treatment. Furthermore， the FHT group had higher PLT level than the control group （P<0.05） after treatment， and other indicators had no significant differences between the two groups. The liver and kidney functions had no significant difference between the two groups after treatment. ConclusionFHT can safely promote the absorption of acute pulmonary inflammation in COVID-19 patients.