Insights into new-onset autoimmune diseases after COVID-19 vaccination.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in more than 670 million infections and almost 7 million deaths globally. The emergence of numerous SARS-CoV-2 has heightened public concern regarding the future course of the epidemic. Currently, the SARS-CoV-2 Omicron variant has rapidly become globally dominant in the COVID-19 pandemic due to its high infectivity and immune evasion. Consequently, vaccination implementation is critically significant. However, growing evidence suggests that COVID-19 vaccination may cause new-onset autoimmune diseases, including autoimmune glomerulonephritis, autoimmune rheumatic diseases, and autoimmune hepatitis. Nevertheless, the causal relationship between COVID-19 vaccines and these autoimmune diseases remains to be demonstrated. In this review, we provide evidence that vaccination induces autoimmunity and summarize possible mechanisms of action, such as molecular mimicry, activation by bystanders, and adjuvants. Our objective is not to refute the importance of vaccines, but to raise awareness about the potential risks of COVID-19 vaccination. In fact, we believe that the benefits of vaccination far outweigh the possible risks and encourage people to get vaccinated.

Advantages of integrated Chinese and western medicine in prevention and treatment of viral diseases

Many viral diseases are highly contagious, and correlated with poor prognosis and great harm. Chinese medicine(CM) has played an important role in the prevention and treatment of viral diseases, including epidemic encephalitis B, epidemic hemorrhagic fever, viral hepatitis A, SARS, H1 N1 influenza and COVID-19, and performs better in improving symptoms, shorting the course of disease, delaying disease progression, increasing clinical cure rate and reducing mortality compared with symptomatic and supportive treatment alone. We retrospectively analyze the role of CM in the prevention and treatment of viral diseases, thus to provide reference for clinical practice.

The Involvement of Chronic Kidney Disease and Acute Kidney Injury in Disease Severity and Mortality in Patients with COVID-19: A Meta-Analysis.

BACKGROUND: A meta-analysis was performed to evaluate the association of chronic kidney disease (CKD) and acute kidney injury (AKI) with the clinical prognosis of patients with coronavirus disease 2019 (COVID-19). METHODS: The PubMed, EMBASE, Cochrane Library, medRxiv, Social Science Research Network, and Research Square databases (from December 1, 2019 to May 15, 2020) were searched to identify studies that reported the associations of CKD/AKI and disease severity/mortality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and meta-regression was performed. RESULTS: In total, 42 studies enrolling 8,932 participants were included in this meta-analysis. The quality of most included studies was moderate to high. Compared with patients without previously diagnosed CKD, those with CKD had a significantly increased risk of progressing to a severe condition (OR 2.31, 95% CI 1.64-3.24) or death (OR 5.11, 95% CI 3.36-7.77). Similarly, compared with patients without AKI, those with AKI had a significantly increased risk of progressing to a severe condition (OR 11.88, 95% CI 9.29-15.19) or death (OR 30.46, 95% CI 18.33-50.59). Compared with patients with previously diagnosed CKD, those with AKI were more likely to progress to a severe condition (pgroup < 0.001, I2 = 98.3%) and even to death (pgroup < 0.001, I2 = 96.5%). Age had a significant impact on the association between CKD and disease severity (p = 0.001) but had no impact on the associations between AKI and disease severity (p = 0.80), between CKD and mortality (p = 0.51), or between AKI and mortality (p = 0.86). Four important complications (cardiac injury, shock, acute respiratory distress syndrome, and liver injury) did not significantly affect the associations between CKD/AKI and disease severity/mortality, indicating that CKD/AKI may be independent clinical prognostic indicators for patients with COVID-19. CONCLUSIONS: In COVID-19 patients, CKD/AKI was associated with worse outcomes compared with those without CKD/AKI. AKI was associated with higher risks of severity and mortality than CKD.

Analysis of clinical characteristics of critically ill patients during prevention and control of new coronavirus pneumonia

OBJECTIVE: To analyze the clinical characteristics of critically ill patients during the prevention and control of new coronavirus pneumonia and to improve the diagnosis and treatment of critically ill patients with fever. METHODS: A retrospective case analysis method was used to collect clinical data of 80 patients admitted to the critically ill area of fever clinic in the first medical center of PLA general hospital from February to March,2020. Pharyngeal swab specimens were collected from all patients at 24 h intervals and tested for new coronavirus nucleic acid twice.At the same time, a combination of influenza A and B virus nucleic acid were determined, and lung computer tomography scan examination were performed. The differences in clinical data of patients with different blood leukocyte count groups were compared. RESULTS: All patients had negative results for new coronavirus nucleic acid tests, and 2 patients had a positive test for influnenza A virus nucleic acid. One patient was tested positive for hepatitis B virus nucleic acid. There were 60 patients(75.00%) with age over 65 years, 47 patients(58.75%) with more than two basic medical diseases, 70 patients(87.50%) with lung CT indicating lesions, 30 patients(37.50%) with acute kidney injury. Compared with patients with while blood cell count <1010~9/L, patients with WBC>=1010~9/L had higher incidence of diabetes mellitus WBC(P=0.024). There was no significant difference in retention time, body temperature, oxygenation index, and incidence of acute kidney injury between two groups of patients. CONCLUSION: The critically ill patients diagnosed in hospital had the characteristics of old age, many chronic diseases, widespread lung disease, and prone to acute kidney injury during screening. Nucleic acid detection is the most important differential diagnosis basis for the screening of new coronavirus infection.