ABSTRACT
BACKGROUND: patients with pre-existence of cardiovascular disease (CVD) are vulnerable to coronavirus disease 2019 (COVID-19), and COVID-19 will cause long-term burden of CVD. However, the common pathogenic mechanisms are not fully elucidated. More detailed knowledge of linking biological molecules and the role of immune signature would allow more valuable and specific clinical management. METHODS: the gene expression profiles of CVD and COVID-19 were retrieved from the GEO database. Common differentially expressed genes (DEGs) were screened with the Limma R package and the WGCNA algorithm, and then functional enrichment analysis, protein-protein interaction network, hub genes, and small therapeutic molecules analyses were performed. The hub immune-related genes (HIRGs) were intersected, and their associations with immune cells, expressional correlation, evaluated performance, and potential signal pathways were further investigated. RESULTS: In total, 57 common DEGs were identified as a shared transcriptional signature between CVD and COVID-19, and 12 hub genes were screened using five topological algorithms. There are common altered immune responses in the response of these two diseases, and seven HIRGs, including C5AR1, MMP9, CYBB, FPR2, CSF1R, TLR2, and TLR4, were identified, with positive correlation to altered macrophages and neutrophils. Nine small molecular agents (SMAs) were detected as promising therapeutic drugs. These seven HIRGs mainly participated in the inflammatory immune response through activation of Il2 stat5 signaling and Tnfa signaling via nfκb pathways, and ROC curves confirmed their good discriminatory capacity in the two diseases. CONCLUSIONS: this study established the co-expression network and identified a new immune-related seven-gene signature as therapeutic targets, which may provide new insights into pathogenic mechanisms and novel clinical management strategies.
ABSTRACT
In order to summarize the experience and lessons in the response of COVID-19 and other public health emergencies in medical institutions in China, the weak in the public health system were identified. We analyzed the contribution of the public health system to the people's health, summarized the public health functions, current status in performing public health, the existing problems and the development trend of public health in medical institutions in China. China's public health system has contributed greatly to the health of the Chinese people since the founding of the People's Republic of China, however, old and new infectious diseases epidemics pose huge challenge to our public health system, In medical institutions in China, public health management is weak;the compensation mechanism of public health has not been established;surveillance is not sensitive;clinical treatment and prevention are not integrated;difficulties exist in nosocomial infection prevention and control, working enthusiasm for public health is not high at present. It is necessary to pay attention to public health in medical institutions, strengthen the construction of the public health system by increasing investment and address the problems in public health function from the respects of system and mechanism in medical institutions, promote the integration of clinical treatment and prevention, and improve the capability of medical institutions in performing public health, especially in primary medical institutions in rural areas.