Obesity Is Associated with Attenuated Tissue Immunity in COVID-19.

RATIONALE: Obesity affects 40% of US adults, is associated with a pro-inflammatory state, and presents a significant risk factor for the development of severe COVID-19. To date, there is limited information on how obesity might affect immune cell responses in SARS-CoV-2 infection. OBJECTIVES: To determine the impact of obesity on respiratory tract immunity in COVID-19 across human lifespan. METHODS: We analysed single cell transcriptomes from bronchiolar lavage in three ventilated adult cohorts with (n=24) or without COVID-19 (n=9), from nasal immune cells in children with (n=14) or without COVID-19 (n=19), and from peripheral blood mononuclear cells in an independent adult COVID-19 cohort (n=42), comparing obese (Ob) and non-obese subjects (N-Ob). MEASUREMENTS AND MAIN RESULTS: Surprisingly, we found that adult Ob subjects had attenuated lung immune/inflammatory responses in SARS-CoV-2 infection, with decreased expression of interferon (IFN)α, IFNγ and tumour necrosis factor (TNF) alpha response gene signatures in almost all lung epithelial and immune cell subsets, and lower expression of IFNG and TNF in specific lung immune cells. Peripheral blood immune cells in an independent adult cohort showed a similar, but less marked, reduction in type I IFN and IFNγ response genes, as well as decreased serum IFNα in Ob patients with SARS-CoV-2. Nasal immune cells from Ob children with COVID-19 also showed reduced enrichment of IFNα and IFNγ response genes. CONCLUSIONS: These findings show blunted tissue immune responses in Ob COVID-19 patients, with implications for treatment stratification, supporting the specific application of inhaled recombinant type I IFNs in this vulnerable subset. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Analysis of home gymnastics during covid-19 / Análise da ginástica doméstica durante a covid-19 / Análisis de la gimnasia doméstica durante el covid-19

ABSTRACT Introduction Gymnastics has become a viral sport thanks to home isolation and low requirements for sports venues and equipment. However, evidence is still lacking that home gymnastics can maintain physical and psychological function stability, even if performed correctly. Objective Analyze the effects of home gymnastics during covid-19 restrictions. Methods This experiment adopts the intragroup control method, five times a week for four weeks. Before and after the experiment, relevant data such as baseline physical quality, body shape, body composition, and exercise indexes are collected. The data are compared and analyzed statistically. Results Home gymnastics can effectively improve the body composition of its practitioners, improve basal metabolism, improve their body shape, improve cardiopulmonary function, and make athletes maintain good exercise ability, good lifestyle habits, and a healthy mentality. Conclusion It is recommended that teachers and interested departments actively organize students at home to perform corresponding gymnastics and use sports to ward off bad lifestyle habits and anxiety, promoting good physical and psychological function during home isolation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução A ginástica tornou-se um esporte viral graças ao isolamento doméstico e devido a suas baixas exigências para locais e equipamentos esportivos. Porém ainda faltam evidências de que a ginástica em casa possa manter a estabilidade da função física e psicológica, ainda que executada corretamente. Objetivo Analisar os efeitos da ginástica doméstica durante as restrições da covid-19. Métodos Este experimento adota o método de controle intragrupo, cinco vezes por semana durante quatro semanas. Antes e depois do experimento, os dados relevantes como qualidade física basal, forma corporal, composição corporal e índices de exercício são coletados. Os dados são comparados e analisados estatisticamente. Resultados A ginástica em casa pode efetivamente melhorar a composição corporal dos seus praticantes, melhorar o metabolismo basal, melhorar sua forma corporal, melhorar a função cardiopulmonar, e fazer com que os esportistas mantenham boa capacidade de exercício, bons hábitos de vida e mentalidade saudável. Conclusão Recomenda-se aos professores e departamentos interessados a organizarem ativamente os estudantes em casa para realizar a ginástica correspondente e usar o esporte para afastar os maus hábitos de vida e a ansiedade, promovendo uma boa função física e psicológica durante o isolamento doméstico. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La gimnasia se ha convertido en un deporte viral gracias al aislamiento doméstico y a sus escasas necesidades de instalaciones y equipamiento deportivo. Sin embargo, todavía no hay pruebas de que la gimnasia doméstica pueda mantener la estabilidad de la función física y psicológica, incluso si se realiza correctamente. Objetivo Analizar los efectos de la gimnasia domiciliaria durante las restricciones de covid-19. Métodos Este experimento adopta el método de control intragrupo, cinco veces por semana durante cuatro semanas. Antes y después del experimento, se recogen datos relevantes como la calidad física de referencia, la forma corporal, la composición corporal y los índices de ejercicio. Los datos se comparan y se analizan estadísticamente. Resultados La gimnasia en casa puede mejorar eficazmente la composición corporal de sus practicantes, mejorar el metabolismo basal, mejorar su forma corporal, mejorar la función cardiopulmonar y hacer que los deportistas mantengan una buena capacidad de ejercicio, buenos hábitos de vida y una mentalidad saludable. Conclusión Se recomienda a los profesores y a los departamentos interesados que organicen activamente a los alumnos en casa para que realicen la gimnasia correspondiente y utilicen el deporte para alejar los malos hábitos de vida y la ansiedad, promoviendo un buen funcionamiento físico y psicológico durante el aislamiento en casa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Analysis of home gymnastics during covid-19 / Análise da ginástica doméstica durante a covid-19 / Análisis de la gimnasia doméstica durante el covid-19

ABSTRACT Introduction Gymnastics has become a viral sport thanks to home isolation and low requirements for sports venues and equipment. However, evidence is still lacking that home gymnastics can maintain physical and psychological function stability, even if performed correctly. Objective Analyze the effects of home gymnastics during covid-19 restrictions. Methods This experiment adopts the intragroup control method, five times a week for four weeks. Before and after the experiment, relevant data such as baseline physical quality, body shape, body composition, and exercise indexes are collected. The data are compared and analyzed statistically. Results Home gymnastics can effectively improve the body composition of its practitioners, improve basal metabolism, improve their body shape, improve cardiopulmonary function, and make athletes maintain good exercise ability, good lifestyle habits, and a healthy mentality. Conclusion It is recommended that teachers and interested departments actively organize students at home to perform corresponding gymnastics and use sports to ward off bad lifestyle habits and anxiety, promoting good physical and psychological function during home isolation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução A ginástica tornou-se um esporte viral graças ao isolamento doméstico e devido a suas baixas exigências para locais e equipamentos esportivos. Porém ainda faltam evidências de que a ginástica em casa possa manter a estabilidade da função física e psicológica, ainda que executada corretamente. Objetivo Analisar os efeitos da ginástica doméstica durante as restrições da covid-19. Métodos Este experimento adota o método de controle intragrupo, cinco vezes por semana durante quatro semanas. Antes e depois do experimento, os dados relevantes como qualidade física basal, forma corporal, composição corporal e índices de exercício são coletados. Os dados são comparados e analisados estatisticamente. Resultados A ginástica em casa pode efetivamente melhorar a composição corporal dos seus praticantes, melhorar o metabolismo basal, melhorar sua forma corporal, melhorar a função cardiopulmonar, e fazer com que os esportistas mantenham boa capacidade de exercício, bons hábitos de vida e mentalidade saudável. Conclusão Recomenda-se aos professores e departamentos interessados a organizarem ativamente os estudantes em casa para realizar a ginástica correspondente e usar o esporte para afastar os maus hábitos de vida e a ansiedade, promovendo uma boa função física e psicológica durante o isolamento doméstico. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La gimnasia se ha convertido en un deporte viral gracias al aislamiento doméstico y a sus escasas necesidades de instalaciones y equipamiento deportivo. Sin embargo, todavía no hay pruebas de que la gimnasia doméstica pueda mantener la estabilidad de la función física y psicológica, incluso si se realiza correctamente. Objetivo Analizar los efectos de la gimnasia domiciliaria durante las restricciones de covid-19. Métodos Este experimento adopta el método de control intragrupo, cinco veces por semana durante cuatro semanas. Antes y después del experimento, se recogen datos relevantes como la calidad física de referencia, la forma corporal, la composición corporal y los índices de ejercicio. Los datos se comparan y se analizan estadísticamente. Resultados La gimnasia en casa puede mejorar eficazmente la composición corporal de sus practicantes, mejorar el metabolismo basal, mejorar su forma corporal, mejorar la función cardiopulmonar y hacer que los deportistas mantengan una buena capacidad de ejercicio, buenos hábitos de vida y una mentalidad saludable. Conclusión Se recomienda a los profesores y a los departamentos interesados que organicen activamente a los alumnos en casa para que realicen la gimnasia correspondiente y utilicen el deporte para alejar los malos hábitos de vida y la ansiedad, promoviendo un buen funcionamiento físico y psicológico durante el aislamiento en casa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Probe-Free Identification of RNA Virus Variants with Point Mutations by Surface-Enhanced Raman Spectroscopy.

As observed in the COVID-19 pandemic, RNA viruses continue to rapidly evolve through mutations. In the absence of effective therapeutics, early detection of new severely pathogenic viruses and quarantine of infected people are critical for reducing the spread of the viral infections. However, conventional detection methods require a substantial amount of time to develop probes specific to new viruses, thereby impeding immediate response to the emergence of viral pathogens. In this study, we identified multiple types of viruses by obtaining the spectral fingerprint of their surface proteins with probe-free surface-enhanced Raman scattering (SERS). In addition, the SERS-based method can remarkably distinguish influenza virus variants with several surface protein point mutations from their parental strain. Principal component analysis (PCA) of the SERS spectra systematically captured the key Raman bands to distinguish the variants. Our results show that the combination of SERS and PCA can be a promising tool for rapid detection of newly emerging mutant viruses without a virus-specific probe.

Longitudinal Analysis of Biologic Correlates of COVID-19 Resolution: Case Report.

While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.

Longitudinal Analysis of Biologic Correlates of COVID-19 Resolution: Case Report

While the biomarkers of COVID-19 severity have been thoroughly investigated, the key biological dynamics associated with COVID-19 resolution are still insufficiently understood. We report a case of full resolution of severe COVID-19 due to convalescent plasma transfusion. Following transfusion, the patient showed fever remission, improved respiratory status, and rapidly decreased viral burden in respiratory fluids and SARS-CoV-2 RNAemia. Longitudinal unbiased proteomic analysis of plasma and single-cell transcriptomics of peripheral blood cells conducted prior to and at multiple times after convalescent plasma transfusion identified the key biological processes associated with the transition from severe disease to disease-free state. These included (i) temporally ordered upward and downward changes in plasma proteins reestablishing homeostasis and (ii) post-transfusion disappearance of a subset of monocytes characterized by hyperactivated Interferon responses and decreased TNF-α signaling. Monitoring specific dysfunctional myeloid cell subsets in peripheral blood may provide prognostic keys in COVID-19.

COVID-19: systemic pathology and its implications for therapy.

Responding to the coronavirus disease 2019 (COVID-19) pandemic has been an unexpected and unprecedented global challenge for humanity in this century. During this crisis, specialists from the laboratories and frontline clinical personnel have made great efforts to prevent and treat COVID-19 by revealing the molecular biological characteristics and epidemic characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, SARS-CoV-2 has severe consequences for public health, including human respiratory system, immune system, blood circulation system, nervous system, motor system, urinary system, reproductive system and digestive system. In the review, we summarize the physiological and pathological damage of SARS-CoV-2 to these systems and its molecular mechanisms followed by clinical manifestation. Concurrently, the prevention and treatment strategies of COVID-19 will be discussed in preclinical and clinical studies. With constantly unfolding and expanding scientific understanding about COVID-19, the updated information can help applied researchers understand the disease to build potential antiviral drugs or vaccines, and formulate creative therapeutic ideas for combating COVID-19 at speed.

Prevalence and Characteristics of Rheumatoid-Associated Autoantibodies in Patients with COVID-19.

OBJECTIVE: Patients with rheumatic immune diseases were more likely to develop severe or critical COVID-19. We aimed to determine whether rheumatoid factor antibodies were present in COVID patients and the level and type of rheumatoid factor antibodies produced in COVID-19 patients were related to the degree of the patient's condition. The study also aimed to determine the prevalence and characteristics of rheumatoid factor antibodies in patients with COVID-19. METHODS: Sera collected from 129 patients with COVID-19 were tested for rheumatoid factor antibodies by ELISA. Five patients were tracked for several months to monitor dynamic changes of these antibodies. RESULTS: Rheumatoid-associated autoantibodies were detected in 20.16% of patients (26/129) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition, IgM-RF was primarily present in critically ill patients, while IgA-RF was mainly present in mild patients. Five patients were able to track for several months to monitor dynamic changes of these antibodies. Rheumatoid factor antibodies peaks in the later phase of the disease and last for longer time. Anti-Jo-1 antibody was found in one of the five patients. CONCLUSION: This was the case series report that rheumatoid-associated autoantibodies are present in patients with COVID-19. The clinical significance of these antibodies was not fully understood and needed further characterization. These autoantibodies are related to the severity of the patient's disease and exist for a long time in the patient's body, while their impact on the patient's health is unknown.

Aberrant cytokine expression in COVID-19 patients: Associations between cytokines and disease severity.

Cytokines play pleiotropic, antagonistic, and collaborative in viral disease. The high morbidity and mortality of coronavirus disease 2019 (COVID-19) make it a significant threat to global public health. Elucidating its pathogenesis is essential to finding effective therapy. A retrospective study was conducted on 71 patients hospitalized with COVID-19. Data on cytokines, T lymphocytes, and other clinical and laboratory characteristics were collected from patients with variable disease severity. The effects of cytokines on the overall survival (OS) and event-free survival (EFS) of patients were analyzed. The critically severe and severe patients had higher infection indexes and significant multiple organ function abnormalities than the mild patients (P < 0.05). IL-6 and IL-10 were significantly higher in the critically severe patients than in the severe and mild patients (P < 0.05). IL-6 and IL-10 were closely associated with white blood cells, neutrophils, T lymphocyte subsets, D-D dimer, blood urea nitrogen, complement C1q, procalcitonin C-reactive protein. Moreover, the IL-6 and IL-10 levels were closely correlated to dyspnea and dizziness (P < 0.05). The patients with higher IL-10 levels had shorter OS than the group with lower levels (P < 0.05). The older patients with higher levels of single IL-6 or IL-10 tended to have shorter EFS (P < 0.05), while the patients who had more elevated IL-6 and IL-10 had shorter OS (P < 0.05). The Cox proportional hazard model revealed that IL-6 was the independent factor affecting EFS. IL-6 and IL-10 play crucial roles in COVID-19 prognosis.

Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign.

OBJECTIVES: The outbreak of the 2019 coronavirus disease (COVID-19) pandemic in Wuhan, China, has subsided after being hard hit by the disease and subsequent city lockdown. Information on the number of people involved in Wuhan is still inadequate. This study aimed to describe the screening results of 61 437 community members in Wuchang District, Wuhan. METHODS: In mid-May 2020, Wuhan launched a population-scale city-wide SARS-CoV-2 testing campaign, which aimed to perform nucleic acid and viral antibody testing for citizens in Wuhan. Here we show the screening results of cluster sampling of 61 437 residents in Wuchang District, Wuhan, China. RESULTS: A total of 1470 (2.39%, 95% CI 2.27-2.52) individuals were detected positive for at least one antiviral antibody. Among the positive individuals, 324 (0.53%, 95% CI 0.47-0.59) and 1200 (1.95%, 95% CI 1.85-2.07) were positive for immunoglobulin IgM and IgG, respectively, and 54 (0.08%, 95% CI 0.07-0.12) were positive for both antibodies. The positive rate of female carriers of antibodies was higher than those of male counterparts (male-to-female ratio of 0.75), especially in elderly citizens (ratio of 0.18 in 90+ age subgroup), indicating a sexual discrepancy in seroprevalence. In addition, viral nucleic acid detection using real-time PCR had showed 8 (0.013%, 95% CI 0.006-0.026) asymptomatic virus carriers. DISCUSSION: The seroprevalence of SARS-CoV-2 in Wuhan was low. Most Wuhan residents are still susceptible to this virus. Precautions, such as wearing mask, frequent hand hygiene and proper social distance, are necessary before an effective vaccine or antiviral treatments are available.

The aggressive surgical treatment and outcome of a colon cancer patient with COVID-19 in Wuhan, China.

BACKGROUND: Cancer patients are at increased risk of novel coronavirus disease 2019 (COVID-19). Currently, surgeries for cancer patients with COVID-19 are generally suggested to be properly delayed. CASE PRESENTATION: We presented a 69-year-old Chinese female colon cancer patient with COVID-19, the first case accepted the surgical treatment during the pandemic in China. The patient developed a fever on January 28, 2020. After treatments with Ceftriaxone and Abidol, her fever was not moderated yet. A repeat chest computed tomography (CT) scan showed significantly exacerbated infectious lesions with a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid. An abdomen CT scan indicated the tumor of ascending colon with local wrapped changes. She was diagnosed with 'Severe novel coronavirus pneumonia' and 'Incomplete bowel obstruction: Colon cancer?'. After actively anti-inflammatory and anti-viral therapies, a right colectomy with lymph node dissection was performed on March 11, followed by a pathological examination. The patient successfully recovered from COVID-19 pneumonia and incomplete bowel obstruction after surgery without any postoperative related complications and was discharged on the 9th day after operation. Significant degeneration, necrosis and slough of focal intestinal and colonic mucosal epithelial cells were observed under microscope. No surgeons, nurses or anesthetists in our team were infected with SARS-CoV-2. CONCLUSIONS: It is meaningful and imperative to share our experience of protecting health care personnels from SARS-CoV-2 infection and providing references for optimizing treatment of cancer patients, at least for the operative intervention with absolute necessity or surgical emergency, during the outbreak of COVID-19.

Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients.

An outbreak of new coronavirus SARS-CoV-2 was occurred in Wuhan, China and rapidly spread to other cities and nations. The standard diagnostic approach that widely adopted in the clinic is nucleic acid detection by real-time RT-PCR. However, the false-negative rate of the technique is unneglectable and serological methods are urgently warranted. Here, we presented the colloidal gold-based immunochromatographic (ICG) strip targeting viral IgM or IgG antibody and compared it with real-time RT-PCR. The sensitivity of ICG assay with IgM and IgG combinatorial detection in nucleic acid confirmed cases were 11.1%, 92.9% and 96.8% at the early stage (1-7 days after onset), intermediate stage (8-14 days after onset), and late stage (more than 15 days), respectively. The ICG detection capacity in nucleic acid-negative suspected cases was 43.6%. In addition, the concordance of whole blood samples and plasma showed Cohen's kappa value of 0.93, which represented the almost perfect agreement between two types of samples. In conclusion, serological ICG strip assay in detecting SARS-CoV-2 infection is both sensitive and consistent, which is considered as an excellent supplementary approach in clinical application.

Can routine laboratory tests discriminate SARS-CoV-2-infected pneumonia from other causes of community-acquired pneumonia?

BACKGROUND: The clinical presentation of SARS-CoV-2-infected pneumonia (COVID-19) resembles that of other etiologies of community-acquired pneumonia (CAP). We aimed to identify clinical laboratory features to distinguish COVID-19 from CAP. METHODS: We compared the hematological and biochemical features of 84 patients with COVID-19 at hospital admission and 221 patients with CAP. Parameters independently predictive of COVID-19 were calculated by multivariate logistic regression. The receiver operating characteristic (ROC) curves were generated and the area under the ROC curve (AUC) was measured to evaluate the discriminative ability. RESULTS: Most hematological and biochemical indexes of patients with COVID-19 were significantly different from patients with CAP. Nine laboratory parameters were identified to be predictive of a diagnosis of COVID-19. The AUCs demonstrated good discriminatory ability for red cell distribution width (RDW) with an AUC of 0.87 and hemoglobin with an AUC of 0.81. Red blood cell, albumin, eosinophil, hematocrit, alkaline phosphatase, and mean platelet volume had fair discriminatory ability. Combinations of any two parameters performed better than did the RDW alone. CONCLUSIONS: Routine laboratory examinations may be helpful for the diagnosis of COVID-19. Application of laboratory tests may help to optimize the use of isolation rooms for patients when they present with unexplained febrile respiratory illnesses.