Impact of Coronavirus Disease 2019 on Snail`s Density of Schistosoma`s Host in Wuhan (preprint)

Background: The density of snails among schistosomiasis hosts has been kept at a low level and even disappeared in many places in Wuhan. However, from the beginning of the epidemic to the lifting of the seal in Wuhan, which the work of snail detection and extermination has been at a standstill. In order to analyze the potential harm of Coronavirus disease 2019 (COVID-19) on urban schistosomiasis transmission, we investigated the density of snails in the Jiangan and Hongshan districts of Wuhan, which evaluated the possibility of schistosomiasis outbreak in Wuhan city. Methods The density and infection status of snails were monitored by GPS satellite, which the risk value was calculated by adjusting Kaiser model. SigmaPlot was used to draw a three-dimensional risk matrix. Results (i)The living snail frame occurrence rate was 1.48% and the average living snail density was 0.054/0.11 m 2 in 2020. Compared with that in 2019, the area of existing snails Tianxingzhou increased greatly. The area of historical snails was 24187 m 2 has increased which the average density of living snails was 0.019/0.11 m 2 . No infectious snails were found in the survey area. (ii) Experts have high enthusiasm (E = 100%). The authority of experts on the indicators of possibility, harmfulness and uncontrollability is 0.842, 0.870 and 0.866 respectively, all greater than 0.7, indicating that expert evaluation is authoritative. After adjusting the Kaiser model, the top three risk values were the north bank of Tianxingzhou, Tianxingzhou as a whole, and Hongshan as a whole. The existing snail sites in the north bank of Tianxingzhou had the highest risk value and ranked the second Pak sha Chau. The highest risk value was found in the historical snail village of Yangsiji village. The risk events on the north bank of Tianxingzhou are located in the orange zone, which belongs to the high-risk area. The whole Hongshan District, the existing snail Tianxingzhou and the tail of Tianxingzhou are located in the yellow zone, belonging to the moderate risk area. Other risk events are located in the blue or green zones and are in the low risk or negligible sub-zone. (iii)The three dimensional risk matrix shows that the potential risk level of the existing snail spot and the possibility of risk occurrence of Tianxingzhou is high. The existing snail points on the Pak sha Chau, indicating the severity of the risk event; Historical snails, indicating the unpredictability of risk events once they occur. The emergency monitoring points show that once the risk event occurs, the level of uncontrollability rises instantly. The whole Hongshan district indicates the severity of the occurrence of the risk event. Conclusion Under the influence of Covid-19 epidemic, the risk of schistosomiasis infection was high and the historical snail snail appeared again in Wuhan. Therefore, the prevention and control work of schistosomiasis infection should be strengthened in Wuhan.

Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19: case report and literature review.

Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide. Numerous studies have shown its typical and atypical CT findings. We report one COVID-19 patient who presented with a transient pneumothorax, spontaneous pneumomediastinum (SP), as well as subcutaneous emphysema during hospitalization. Chest CT andclinical findings were discussed, and a literature review is presented. The probable cause of SP in COVID-19 was alveolar damage. Once pneumothorax and SP were present, the patient should be carefully monitored to prevent respiratory deterioration, especially when lung lesions are severe.

What is the Role of Chest CT Scan for Pediatric Patient Diagnosis of COVID-19? (preprint)

Objectives To retrospectively analyze the CT imaging features and patterns at baseline and as they evolve with time as the disease progresses or resolves in a cohort of pediatric patients affected with 2019 corona virus disease (COVID-19) pneumonia from three different cities in China.Methods We evaluated 29 pediatric patients with COVID-19 in the authors’ institution from Jan 1 to Feb 20, 2020. Cases were confirmed by laboratory test and were analyzed for epidemiological, demographic, clinical, radiological features and patterns.Results 29 initial scans and 23 follow-up scans were obtained from 29 patients. 15(52%) patients had been to Hubei Province and 26 (90%) of them had close contact with the COVID-19 positive patients in 14 days prior to the illness onset. The peak severity time was 5-8 days after symptom onset. A significant difference between the number of involved segments at different time points was indicated (p=0.019). Half (52%) of the laboratory confirmed patients had no CT positive findings. Nine (31%) of the laboratory confirmed patients had no symptoms. Six (21%) had no CT positive findings nor symptoms. All the patients of one center(n=6) whose fecal samples remained positive after the respiratory samples became negative.Conclusion The common positive CT findings included ground-glass opacities (50%), ground-glass opacities mixed with consolidation (36%), peribronchial thickening (21%), and consolidations (14%). We recommend for pediatric patients CT should not be used as a first-line test to diagnose COVID-19.

Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19 (preprint)

Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis. Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range; 0, none; 25, maximum) was determined. Results: We analyzed clinical data from 46 patients (26 males and 20 females; age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively). Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.

Features of liver injury in patients with coronavirus disease 2019 in Bozhou, China / 临床肝胆病杂志

ObjectiveTo investigate the condition of liver injury in different populations of patients with coronavirus disease 2019 (COVID-2019), and to further understand the pathogenic characteristics of COVID-2019. MethodsA total of 28 patients with COVID-2019 and liver injury who were admitted to the designated hospitals for COVID-2019 in Bozhou, China from February 1 to 12, 2020 were enrolled, and they were divided into male group（n=15） and female group（n=13） according to sex or young group（n=10） and middle-aged and elderly group（n=17） according to age. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) were measured on admission. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups, the Fisher exact test was used for comparison of categorical data between two groups. ResultsVarying degrees of liver injury were observed in the 28 patients. There were no significant differences in the levels of ALT, AST, GGT, ALP, and LDH between the male group and the female group and between the young group and the middle-aged and elderly group (all P＞0.05). There was no significant difference in abnormal rate of ALT, AST, GGT and LDH between male group and female group (all P＞0.05); There was no significant difference in abnormal rate of ALT, AST, GGT between the young group and the middle-aged and elderly group (all P＞0.05); there was a significant difference in abnormal rate of LDH between the young group and the middle-aged and elderly group(P＜0.05). ConclusionPatients with COVID-2019 may experience different degrees of liver injury with the development of the disease, middle-aged and elderly patients tend to develop liver injury.There was no significant correlation with gender and age in mild and general patients. Therefore, liver function should be monitored in patients with COVID-2019, and the treatment method should be selected carefully to prevent liver injury.