Corona virus disease 2019-associated liver injury in cold regions

The corona virus disease 2019 (COVID-19) pandemic has created a global health and economic crisis. Our studies uncovered that in addition to respiratory symptoms, liver damage is also common in COVID-19 patients;however, the cause of liver damage has not been fully elucidated. In this article, we summarize the clinical manifestations and pathological features of COVID-19 reported in published relevant studies and delineate the etiology and pathogenesis of COVID-19-related liver injury. We speculate that cold stimulation may be associated with COVID-19-related liver injury, which should be considered in clinical decision-making and treatment of COVID-19 in cold regions. [ FROM AUTHOR]

A multi-centre service evaluation of the impact of the COVID-19 pandemic on presentation of newly diagnosed cancers and type 1 diabetes in children in the UK (preprint)

Background: The COVID-19 pandemic led to changes in patterns of presentation to Emergency Departments (ED). Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions. Methods: We collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres, and T1DM in four centres between 1st January - 31st July 2020 and the corresponding period in 2019. We assessed the impact of lockdown on total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity. Findings: For CCs and T1DM, the route to diagnosis and severity of illness at presentation were unchanged across all time periods. Diagnostic intervals for CCs during lockdown were comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI in Jan-Mar 2020 (median 2.7 weeks). Diagnostic intervals for T1DM during lockdown were similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in Jan-Mar 2020 (median 21 days). Interpretation: There is no evidence of diagnostic delay or increased illness severity for CC or T1DM, during the first phase of the pandemic across the participating centres. This provides reassuring data for children and families with these life-changing conditions.

The Prevalence of Mental Health Problems and Associated Risk Factors among Military Health Workers of COVID-19 Specialized Hospitals in Wuhan, China: A Cross-Sectional Survey (preprint)

Background China has been severely affected by COVID-19 (Coronavirus Disease 2019) since December 2019.In the combat against COVID-19, military health workers in China suffered from many pressures. This study aimed to investigate the current psychological status and risk factors of the military health workers.Methods Using a web-based cross-sectional survey, we collected data from 194 military health workers from three inpatient wards in two COVID-19 specialized hospitals. The survey questions consisted of demographic information, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-15 (PHQ-15). Hierarchical regression analysis was used to explore potential risk factors for mental health problem.Results The overall prevalence of depressive symptoms, generalized anxiety and somatic symptoms were37.6%, 32.5% and 50%, respectively. Severe depression, generalized anxiety and somatic symptoms was 5.2%, 3.6% and 15.5%. In 22.7% of cases, comorbidities existed between depression, generalized anxiety and somatization. Junior-grade professional title was associated with depression, older age was associated with generalized anxiety and somatization, and less sleep duration and poor sleep quality were associated with all three symptoms.Conclusion The prevalence of depression, generalized anxiety and somatic symptoms were high in military health workers of COVID-19 specialized hospitals during the COVID-19 outbreak. Junior-grade professional title, older age, less sleep duration, and poor sleep quality have significant effects on the mental health of military health workers. Continuous surveillance and monitoring of the psychological consequences of the COVID-19outbreak should become routine to promote the mental health of military health workers.

Clinical symptoms and psychological changes of patients with COVID-19 in Jiangxi Province (preprint)

Objective The purpose of this study was to determine the prevalence and differences in etiology, clinical manifestations, and psychological activity of coronavirus disease-19 (COVID-19) among patients. Results We recruited 90 subjects, 30 were healthy controls, 30 were patients with moderate infection, and 30 were patients with severe/critical infections. No significant differences were noted in the sex ratio, mean age, body mass index, or blood type; however, the history of exposure of the patients with COVID-19 compared with healthy controls was noteworthy. The erythrocyte sedimentation rate, as well as the levels of C-reactive protein and serum amyloid A (SAA) were all increased. In terms of mental health, there were significant differences in the worry scores between severely and moderately infected patients and healthy controls. There was a significant difference in depression scores between patients with moderate infection and healthy hypertension, and there was also a significant difference in dream worry scores. Analysis of the Mini-Mental State Examination scores showed that for patients with moderate infection, the depression score was moderately and positively correlated with the dream anxiety score. For patients with severe infection, the anxiety score was positively correlated with the dream anxiety score, and the depression score was moderately and positively correlated with the dream anxiety score. Conclusion Patients with severe infection showed increased pain and sputum in the pharyngeal area compared with patients with moderate infection. Patients with blood type A may be more susceptible to COVID-19, and lymphopenia may indicate worsening of COVID-19.

Changes in the clinical characteristics of severe Corona Virus Disease 2019 in Jiangxi Province (preprint)

Backgrounds: To determine the differences in clinical manifestations and biomarker levels of Corona Virus Disease 2019 (COVID-19) patients, including common patients and severe (serious and critical) patients.Methods: A total of 89 COVID-19 patients were diagnosed and treated at the First Affiliated Hospital of Nanchang University. We clinically classified the patients and collected data. Findings: There was a higher proportion of confirmed cases in patients with type A blood (44.8%). There were no obvious differences in number of lung lobes involved in the lesion between the patients with or without a positive nucleic acid test (p>0.05).There were obvious differences in contact history (p<0.001), duration of symptoms (p=0.004), and respiratory rate (p=0.029) between the patients with or without a positive nucleic acid test. According to the results of the nucleic acid diagnosis test, there were no obvious differences in the number of lung lobes involved in the lesion and all items of routine blood, liver, and kidney function tests between the patients with or without positive nucleic acid tests (all p>0.05). Between the common patients and severe patients, there were obvious differences in age (p=0.006), duration of symptoms (p=0.001), diastolic blood pressure (p=0.046), lymphocyte count (p＜0.0001), neutrophil count (p=0.019), albumin (p=0.002), lactate dehydrogenase (p=0.007), calcium (p＜0.0001), C-reactive protein (CRP) (p=0.004), erythrocyte sedimentation rate (p=0.021), international standard ratio (p=0.020), and CD3 (p=0.001), CD3+CD4 (p=0.006), and CD3+CD8 (p=0.001) levels. In patients infected with SARS-COV-2, the number of lung lobes involved in the lesion were positively correlated with lymphocytes (R=0.261, p=0.044); the body mass index (BMI) values were positively correlated with the number of lung lobes involved in the lesion (R=0.320, P=0.034); the age (R=0.391, p<0.001) and respiratory rate (R=0.352, p=0.001) were positively correlated with neutrophil count; and the age (R=0.349, p=0.001) and the number of lung lobes involved in the lesion (R=0.422, p=0.001) were positively correlated with CRP.Conclusion: Patients with blood type A may be more susceptible to SARS-COV-2. The decrease in lymphocytes may indicate the aggravation of COVID-19, whereas the number of lung lobes involved in the lesion may not be a valid criterion for COVID-19 diagnosis.