Clinical significance of serum interleukin 6 in elderly patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant and its correlation with underlying diseases.

Objective To investigate the clinical significance of serum interleukin 6 (IL-6) in elderly patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant and its correlation with underlying diseases. Methods A total of 22 elderly patients (80 years old) infected with omicron variant, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. to Jun. 2022 and tested positive for SARS-CoV-2 RNA, were included. The level of serum IL-6 was measured by flow cytometry, and the level of serum C reactive protein (CRP) was measured by immunonephelometry. Patients were divided into pneumonia group (16 cases) and non-pneumonia group (6 cases) according to the imaging examination results, and were divided into severe group (severe and critical type, 5 cases) and non-severe group (mild and normal type, 17 cases) according to the condition. Binary logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia. Meanwhile, the relationships between underlying diseases and serum IL-6 level were explored. Results Among the 22 patients, 6 were mild, 11 were normal, 3 were severe, and 2 were critical. The baseline serum IL-6 level in the pneumonia group was significantly higher than that in the non-pneumonia group (20.16+/-12.36pg/mL vs 5.42+/-1.57 pg/mL, P=0.009), and there was no significant difference in baseline serum CRP level between the 2 groups (P0.05). There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the non-severe group (both P0.05). Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant (odds ratio OR=2.407, 95% confidence interval CI0.915-6.328;OR=1.030, 95% CI 0.952-1.114). ROC curve analysis showed that the area under curve values of serum IL-6 and CRP in predicting the progression to pneumonia were 0.969 (95% CI 0.900-1.000) and 0.656 (95% CI 0.380-0.932), respectively, with statistical significance (Z=2.154, P=0.030). There were no significant differences in the baseline serum IL-6 level or proportions of severe patients or pneumonia patients among patients with or without hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease or chronic obstructive pulmonary disease (all P0.05). The baseline serum IL-6 levels of the omicron variant infected elderly patients with 1, 2, and 3 or more underlying diseases were 12.50 (9.15, 21.75), 23.55 (9.63, 50.10), and 10.90 (5.20, 18.88) pg/mL, respectively, with no statistical significance (P0.05). Conclusion For omicron variant infected patients, serum IL-6 level is significantly increased in patients with pneumonia manifestations and is correlated with disease progression. Serum IL-6 level is of great guiding significance to judge disease progression and evaluate efficacy and prognosis of elderly coronavirus disease 2019 patients.Copyright © 2022, Second Military Medical University Press. All rights reserved.

[Clinical characteristics and short-term prognosis of 22 cases with SARS-CoV-2 infection associated acute encephalopathy].

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P>0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

Clinical significance of serum interleukin 6 in elderly patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant and its correlation with underlying diseases

Objective To investigate the clinical significance of serum interleukin 6 (IL-6) in elderly patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant and its correlation with underlying diseases. Methods A total of 22 elderly patients (>80 years old) infected with omicron variant, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. to Jun. 2022 and tested positive for SARS-CoV-2 RNA, were included. The level of serum IL-6 was measured by flow cytometry, and the level of serum C reactive protein (CRP) was measured by immunonephelometry. Patients were divided into pneumonia group (16 cases) and non-pneumonia group (6 cases) according to the imaging examination results, and were divided into severe group (severe and critical type, 5 cases) and non-severe group (mild and normal type, 17 cases) according to the condition. Binary logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia. Meanwhile, the relationships between underlying diseases and serum IL-6 level were explored. Results Among the 22 patients, 6 were mild, 11 were normal, 3 were severe, and 2 were critical. The baseline serum IL-6 level in the pneumonia group was significantly higher than that in the non-pneumonia group ([20.16+/-12.36]pg/mL vs [5.42+/-1.57] pg/mL, P=0.009), and there was no significant difference in baseline serum CRP level between the 2 groups (P>0.05). There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the non-severe group (both P>0.05). Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant (odds ratio [OR]=2.407, 95% confidence interval [CI]0.915-6.328;OR=1.030, 95% CI 0.952-1.114). ROC curve analysis showed that the area under curve values of serum IL-6 and CRP in predicting the progression to pneumonia were 0.969 (95% CI 0.900-1.000) and 0.656 (95% CI 0.380-0.932), respectively, with statistical significance (Z=2.154, P=0.030). There were no significant differences in the baseline serum IL-6 level or proportions of severe patients or pneumonia patients among patients with or without hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease or chronic obstructive pulmonary disease (all P>0.05). The baseline serum IL-6 levels of the omicron variant infected elderly patients with 1, 2, and 3 or more underlying diseases were 12.50 (9.15, 21.75), 23.55 (9.63, 50.10), and 10.90 (5.20, 18.88) pg/mL, respectively, with no statistical significance (P>0.05). Conclusion For omicron variant infected patients, serum IL-6 level is significantly increased in patients with pneumonia manifestations and is correlated with disease progression. Serum IL-6 level is of great guiding significance to judge disease progression and evaluate efficacy and prognosis of elderly coronavirus disease 2019 patients.Copyright © 2022, Second Military Medical University Press. All rights reserved.

What can we learn from the 2008 financial crisis for global power decarbonization after COVID-19?

Since the outbreak of the COVID-19 pandemic, power generation and the associated CO2 emissions in major countries have experienced a decline and rebound. Knowledge on how an economic crisis affects the emission dynamics of the power sector would help alleviate the emission rebound in the post-COVID-19 era. In this study, we investigate the mechanism by which the 2008 global financial crisis sways the dynamics of power decarbonization. The method couples the logarithmic mean Divisia index (LMDI) and environmentally extended input-output analysis. Results show that, from 2009 to 2011, global power generation increased rapidly at a rate higher than that of GDP, and the related CO2 emissions and the emission intensity of global electricity supply also rebounded;the rapid economic growth in fossil power-dominated countries (e.g., China, the United States, and India) was the main reason for the growth of electricity related CO2 emissions;and the fixed capital formation was identified as the major driver of the rebound in global electricity consumption. Lessons from the 2008 financial crisis can provide insights for achieving a low-carbon recovery after the COVID-19 crisis, and specific measures have been proposed, for example, setting electricity consumption standards for infrastructure construction projects to reduce electricity consumption induced by the fixed capital formation, and attaching energy efficiency labels and carbon footprint labels to metal products (e.g., iron and steel, aluminum, and fabricated metal products), large quantities of which are used for fixed capital formation. © 2023 The Authors

A living WHO guideline on drugs for covid-19

Clinical question What is the role of drug interventions in the treatment and prevention of covid-19? Recommendations The first version on this living guidance focuses on corticosteroids. It contains a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19, and a weak or conditional recommendation against systemic corticosteroids in patients with non-severe covid-19. Corticosteroids are inexpensive and are on the World Health Organisation list of essential medicines. How this guideline was created This guideline reflects an innovative collaboration between the WHO and the MAGIC Evidence Ecosystem Foundation, driven by an urgent need for global collaboration to provide trustworthy and living covid-19 guidance. A standing international panel of content experts, patients, clinicians, and methodologists, free from relevant conflicts of interest, produce recommendations for clinical practice. The panel follows standards, methods, processes, and platforms for trustworthy guideline development using the GRADE approach. We apply an individual patient perspective while considering contextual factors (that is, resources, feasibility, acceptability, equity) for countries and healthcare systems. The evidence A living systematic review and network meta-analysis, supported by a prospective meta-analysis, with data from eight randomised trials (7184 participants) found that systemic corticosteroids probably reduce 28 day mortality in patients with critical covid-19 (moderate certainty evidence;87 fewer deaths per 1000 patients (95% confidence interval 124 fewer to 41 fewer)), and also in those with severe disease (moderate certainty evidence;67 fewer deaths per 1000 patients (100 fewer to 27 fewer)). In contrast, systemic corticosteroids may increase the risk of death in patients without severe covid-19 (low certainty evidence;absolute effect estimate 39 more per 1000 patients, (12 fewer to 107 more)). Systemic corticosteroids probably reduce the need for invasive mechanical ventilation, and harms are likely to be minor (indirect evidence). Understanding the recommendations The panel made a strong recommendation for use of corticosteroids in severe and critical covid-19 because there is a lower risk of death among people treated with systemic corticosteroids (moderate certainty evidence), and they believe that all or almost all fully informed patients with severe and critical covid-19 would choose this treatment. In contrast, the panel concluded that patients with non-severe covid-19 would decline this treatment because they would be unlikely to benefit and may be harmed. Moreover, taking both a public health and a patient perspective, the panel warned that indiscriminate use of any therapy for covid-19 would potentially rapidly deplete global resources and deprive patients who may benefit from it most as potentially lifesaving therapy. Updates This is a living guideline. Work is under way to evaluate other interventions. New recommendations will be published as updates to this guideline. Readers note This is version 1 of the living guideline, published on 4 September (BMJ 2020;370:m3379) version 1. Updates will be labelled as version 2, 3 etc. When citing this article, please cite the version number. Submitted August 28 Accepted August 31Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.

Analysis of the current Covid-19 infection and vaccination status in patients with neurofibromatosis type 1

Background: To investigate the common symptoms after Covid-19 infection, characteristics of adverse events after vaccination, changes in clinical manifestations related to Neurofibromatosis type 1 (NF1), as well as the current vaccination status and factors related to vaccine hesitation among NF1 patients, in order to provide a basis for scientific protection and vaccine acceptance in NF1 individuals in the new phase of pandemic management. Method(s): From December 29, 2022, to January 10, 2023, we conducted a self-assessment questionnaire survey among diagnosed NF1 patients. General data were provided including sex, age, main clinical presentations, and current treatment. This study mainly focused on the infection and vaccination status of Covid-19 among these patients with NF1. The data were statistically analyzed using SPSS26.0 software. Result(s): Of the 250 questionnaires distributed, 226 were valid. Among the 164 patients (72.6%) with Covid-19 infection, the most common infection symptoms and incidence of patients were not significantly different from those in the normal population (P>0.05), but the incidence of symptoms such as nasal congestion, headache, myalgia, sore throat, abdominal pain, diarrhea, and eye discomfort was higher than that in the normal population (P<0.05), and no severe infection was observed;186 patients (82.3%) had completed the Covid-19 vaccination, and more than half of those who were not vaccinated had no plans for vaccination. Among the vaccinated patients, there was no significant difference in the incidence of adverse events, such as fever, pain, redness, and swelling at the injection site after vaccination, compared to the normal population (P>0.05), but the incidence of fatigue and headache was higher in NF1 patients (P<0.001). Most patients with NF1 believe that there is no significant progressive change in NF1-related clinical manifestations after Covid-19 infection and vaccination. Conclusion(s): Currently, some NF1 patients appear to be worried about the evolution of their disease after Covid-19 infection in the face of large fluctuations in the pandemic situation, and some patients hesitate to receive the vaccine due to their special disease condition. Thus, clinical trials should be conducted to develop a refined pandemic response and vaccination program for this special group.Copyright © 2023 China Medical Cosmetology Press Co. Ltd.

Exploring the Effect of Social Media and Spatial Characteristics During the COVID-19 Pandemic in China

The declaration of COVID-19 as a pandemic has largely amplified the spread of related information on social platforms, such as Twitter, Facebook and WeChat. In this work, we investigate how the disease and information co-evolve in the population. We focus on COVID-19 and its information during the period when the disease was widely spread in China, i.e., from January 25th to March 24th, 2020. The co-evolution between disease and information is explored via the spatial analysis of the two spreading processes. We visualize the geo-location of both disease and information at the province level and find that disease is more geo-localized compared to information. High correlation between disease and information data is observed, and also people care about the spread of disease only when it comes to their neighborhood. Regard to the content of the information, we obtain that positive messages are more negatively correlated with the disease compared to negative and neutral messages. Additionally, two machine learning algorithms, i.e., linear regression and random forest, are introduced to further predict the number of infected using characteristics, such as disease spatial related and information-related features. We obtain that both the disease spatial related characteristics of nearby cities and information-related characteristics can help to improve the prediction accuracy. The methodology proposed in this paper may shed light on new clues of emerging infections prediction. © 2013 IEEE.

Immune memory after SARS-CoV-2 infection.

The COVID-19 pandemic has become a serious global public health threat with more than 540 million infections and 6.32 million cases of death as of 25 June, 2022.Understanding whether COVID-19 patients can obtain persistent immune protection after recovery is crucial for vaccine development, disease control and epidemic forecast.The persistent immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is mainly derived from the immune memory.Thus, the generation and maintenance of immune memory specifically targeted to the virus were reviewed in this paper. Copyright © 2022 Society of Microbiology and Immunology. All rights reserved.

Exploring the effect of social media and spatial characteristics during the COVID-19 pandemic in China

The declaration of COVID-19 as a pandemic has largely amplified the spread of related information on social platforms, such as Twitter, Facebook and WeChat. In this work, we investigate how the disease and information co-evolve in the population. We focus on COVID-19 and its information during the period when the disease was widely spread in China, i.e., from January 25th to March 24th, 2020. The co-evolution between disease and information is explored via the spatial analysis of the two spreading processes. We visualize the geo-location of both disease and information at the province level and find that disease is more geo-localized compared to information. High correlation between disease and information data is observed, and also people care about the spread of disease only when it comes to their neighborhood. Regard to the content of the information, we obtain that positive messages are more negatively correlated with the disease compared to negative and neutral messages. Additionally, two machine learning algorithms, i.e., linear regression and random forest, are introduced to further predict the number of infected using characteristics, such as disease spatial related and information-related features. We obtain that both the disease spatial related characteristics of nearby cities and information-related characteristics can help to improve the prediction accuracy. The methodology proposed in this paper may shed light on new clues of emerging infections prediction. Author

Immune memory after SARS-CoV-2 infection

The COVID-19 pandemic has become a serious global public health threat with more than 540 million infections and 6.32 million cases of death as of 25 June, 2022.Understanding whether COVID-19 patients can obtain persistent immune protection after recovery is crucial for vaccine development, disease control and epidemic forecast.The persistent immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is mainly derived from the immune memory.Thus, the generation and maintenance of immune memory specifically targeted to the virus were reviewed in this paper. © 2022 Society of Microbiology and Immunology. All rights reserved.

A 1-year longitudinal study: Change in mental health outcomes of frontline emergency department healthcare workers in this COVID-19 pandemic

Background: There are ample cross-sectional data demonstrating association of COVID-19 pandemic with depression and anxiety in frontline healthcare workers (HCWs). However, there is a lack of longitudinal studies among frontline HCWs to quantify the change in depression and anxiety in this pandemic. Objectives: We aim to (1) quantify the change in depression and anxiety symptoms in our cohort of frontline emergency department (ED) HCWs over a 1-year period, and (2) identify factors associated with this change. Methods: This is a prospective longitudinal single-center study carried out over a 1-year period in June 2020 and June 2021. A paper-based survey questionnaire was administered to ED HCWs and participation was voluntary. Depression and anxiety were measured using Depression, Anxiety and Stress Scale-21 Items (DASS-21). No specific intervention was implemented by the study team over the year. The overall response rate was 93.5%. In all, 241 HCWs were matched based on last 4 digits of their phone number, gender, ethnicity, and occupation. Logistic regressions were performed to identify factors associated with depression and anxiety. Results: HCWs were mainly females (71.8%), nurses (71.4%), or Chinese (38.6%). There was a significant increase in median depression score among doctors (2020: 1 (0-3) vs 2021: 3 (0-5), p=0.018). HCWs ≥41 years (odds ratio (OR), 10.6;95% confidence interval (CI), 1.5-75.9)), living with elderly (OR, 4.3;1.3-14.4), and with greater Concerns in Workload (OR, 2.5;1.5-4.2) had higher risk of depression. HCWs with more years of work experience (OR, 0.9;0.8-1.0) and who perceived better workplace support (OR, 0.3;0.2-0.6) had lower risk of depression. There was significant reduction in median anxiety score among all HCWs (2020: 2 (0-4) vs 2021: 2 (0-4), p=0.045) and in prevalence of anxiety (2020: 30.7% vs 2021: 21.6%, p=0.023). HCWs living with elderly (OR, 5.9;1.8-19.2), with greater Concerns in COVID-19 Infection Risk (OR, 2.0;1.1-3.3), and with Workload (OR, 1.6;1.0-2.6) had higher risk of anxiety, while those living with young children (OR, 0.1;0.02-0.5) had lower risk of anxiety. Conclusion: Our longitudinal study showed that mental health outcomes in frontline ED HCWs continued to be poor after a year. Several factors have been identified, which will allow for targeted interventions to optimize and prevent deterioration of our frontline HCWs' well-being.

Post COVID-19 recovery for independent full-service restaurants using the salience theory: what will it take to get customers to return?

Purpose This study aims to compare customers' perceived importance of various post-COVID-19 recovery strategies (i.e. sanitary practices, discounts, menu modification and marketing strategies) adopted by independent full-service restaurants (casual dining versus upscale/fine dining) using the salience theory. It also assesses the associations between customers' perceptions and their restaurant spending patterns. Design/methodology/approach An online survey was administered to assess 657 US adult participants' restaurant spending behaviors at different stages of the COVID-19 pandemic using recall questions. Higher-spending versus lower-spending participants' perceived importance of restaurant recovery strategies were compared in the casual dining versus upscale/fine dining contexts. Findings Amid the COVID-19 pandemic, sanitary practices were the most important factor in participants' restaurant choices, and it was more important for independent casual dining restaurants than for upscale/fine dining restaurants. No significant difference was found in participants' perceived importance of sanitary practices across different geographic regions. Higher-spending diners (HSD) perceived almost every restaurant recovery strategy as important. Lower-spending diners (LSD) only considered sanitary practices as important. Practical implications This study identified important strategies that restaurant operators and public health officials can adopt to help full-service restaurants recover from pandemic losses. Originality/value This study differs from previous consumer choice studies;in that it compared HSD with LSD regarding their perceived importance of various restaurant recovery strategies. This study also provides new insights for understanding the salience theory of choice under the impact of COVID-19.

Analysis for the spread of COVID-19 in China based on the impulsive partial differential equation with diffusion

At the beginning of 2020, COVID-19 broke out in Wuhan and quickly swept the world. At present, the global epidemic prevention and control is still facing severe challenges. Scientific and effective measures of the epidemic is crucial to epidemic prevention and control. In this paper, a COVID-19 diffusion prediction model is established based on the impulsive partial differential equation and traditional infectious disease model, which can describe the spatial diffusion of viruses. This is also a lack of other models. The model divides the total population into seven groups: susceptible, quarantine, exposed, asymptomatic, infected, diagnosed and recovered, while considering the influence of time and space on the spread of the virus. In order to test the model, we take Jiangsu Province in China as an example, compare the calculated results with the actual data, and verify the effectiveness of the model through numerical calculation. © COPYRIGHT SPIE.

A comprehensive review of diagnosis and treatment in critically ill adults with COVID-19

The highly infectious coronavirus disease 2019 (COVID-19) that emerged in Wuhan, China, was caused by a novel strain of coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Subsequently, it was considered as one of the serious potential threats to global public health due to rapid spread worldwide. The purpose of this paper is to describe the characteristics of epidemiology, clinical manifestations, diagnosis, differential diagnosis, and treatment of traditional Chinese medicine and modern medicine in critically ill adults with COVID-19. We searched the related papers published up to April 20, 2020 on the PubMed and the China National Knowledge Infrastructure database. The findings will improve the potential recognition of COVID-19 among clinicians and the general public, and presumably contribute to the reduction of mortality.

Optimization strategies for online courses in Chinese universities during COVID-19 pandemic

During the COVID-19 pandemic, Chinese colleges and universities have online courses all over the country, but there is no definitive model for evaluating the effect of online course education. In addition, most domestic universities analyze the factors that affect online courses from a qualitative perspective, and there are fewer reasonable mathematical models. This paper uses the Logistic model to establish a multiple model between college students' online course learning conditions and various influencing factors, and uses a questionnaire survey to analyze the learning status of Chengdu University of Technology students who have taken online courses during the epidemic. Comparison of forecasts. It provides a reference for improving the online learning management system and improving students' online learning level in the future. © Published under licence by IOP Publishing Ltd.

Management strategies for diagnosis and treatment process of stroke patients during an outbreak of SARS-CoV-2

SARS-CoV-2 is highly infectious and poses a serious threat to human health. In addition to typical respiratory manifestations, some patients have neurological symptoms or other cerebrovascular disease risk factors, which may easily lead to stroke and endanger life. During the outbreak of Coronavirus disease 2019 (COVID-19), the relevant diagnosis and treatment process strategies were formulated for general outpatient department of neurology, emergency department of neurology/green channel of stroke, intervention operation of suspected/confirmed patients, and management of neurological ward, so as to provide guidance for rapid screening and treatment of stroke patients, and avoid the occurrence of nosocomial infection. © 2020, Editorial Board of Journal of Xi'an Jiaotong University (Medical Sciences). All right reserved.

Clinical characteristics of non-critically ill patients with novel coronavirus infection (COVID-19) in a Fangcang Hospital.

OBJECTIVES: To describe the clinical characteristics of patients in a Fangcang Hospital. METHODS: Non-critically ill individuals with positive SARS-CoV-2 RT-PCR tests admitted between 7 February and 12 February 2020 to Dongxihu Fangcang Hospital, which was promptly constructed because of the rapid, exponential increase in COVID-19 patients in Wuhan, China, were included; clinical course through to 22 February was recorded. RESULTS: A total of 1012 non-critically ill individuals with positive SARS-CoV-2 RT-PCR tests were included in the study. Thirty (of 1012, 3.0%) individuals were asymptomatic on admission. During hospitalization, 16 of 30 (53.3%) asymptomatic individuals developed different symptoms. Fourteen of 1012 patients (1.4%) remained asymptomatic from exposure to the end of follow up, with a median duration of 24 days (interquartile range 22-27). Fever (761 of 1012, 75.2%) and cough (531 of 1012, 52.4%) were the most common symptoms. Small patchy opacities (355 of 917, 38.7%) and ground-glass opacities (508 of 917, 55.4%) were common imaging manifestations in chest CT scans. One hundred patients (9.9%) were transferred to designated hospitals due to aggravation of illness. Diarrhoea emerged in 152 of 1012 patients (15.0%). Male, older age, diabetes, cardiovascular diseases, chills, dyspnoea, So2 value of ≤93%, white blood cell counts of >10 × 109/L and large consolidated opacities on CT images were all risk factors for aggravation of illness. CONCLUSIONS: Non-critically ill individuals had different clinical characteristics from critically ill individuals. Asymptomatic infections only accounted for a small proportion of COVID-19. Although with a low incidence, diarrhoea was observed in patients with COVID-19, indicating the possibility of faecal-oral transmission.