Single-cell analysis of adult human heart across healthy and cardiovascular disease patients reveals the cellular landscape underlying SARS-CoV-2 invasion of myocardial tissue through ACE2.

BACKGROUND: The distribution of ACE2 and accessory proteases (ANAD17 and CTSL) in cardiovascular tissue and the host cell receptor binding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are crucial to understanding the virus's cell invasion, which may play a significant role in determining the viral tropism and its clinical manifestations. METHODS: We conducted a comprehensive analysis of the cell type-specific expression of ACE2, ADAM17, and CTSL in myocardial tissue from 10 patients using RNA sequencing. Our study included a meta-analysis of 2 heart single-cell RNA-sequencing studies with a total of 90,024 cells from 250 heart samples of 10 individuals. We used co-expression analysis to locate specific cell types that SARS-CoV-2 may invade. RESULTS: Our results revealed cell-type specific associations between male gender and the expression levels of ACE2, ADAM17, and CTSL, including pericytes and fibroblasts. AGT, CALM3, PCSK5, NRP1, and LMAN were identified as potential accessory proteases that might facilitate viral invasion. Enrichment analysis highlighted the extracellular matrix interaction pathway, adherent plaque pathway, vascular smooth muscle contraction inflammatory response, and oxidative stress as potential immune pathways involved in viral infection, providing potential molecular targets for therapeutic intervention. We also found specific high expression of IFITM3 and AGT in pericytes and differences in the IFN-II signaling pathway and PAR signaling pathway in fibroblasts from different cardiovascular comorbidities. CONCLUSIONS: Our data indicated possible high-risk groups for COVID-19 and provided emerging avenues for future investigations of its pathogenesis. TRIAL REGISTRATION: (Not applicable).

Status of mandatory treatment of mentally ill offenders without criminal responsibility in China: Information from 5,262 mandatory treatment judgments.

Background: To avoid public health risks, all governments ensure monitoring and treatment of mentally ill persons if they offend and assess their level of criminal responsibility. The Criminal Procedure Law of the People's Republic of China (2013) instituted special procedures. However, there are few articles in English which explain the implementation of mandatory treatment procedures in China. Methods: We collected 5,262 qualified documents from 2013 to 2021 from the China Judgments Documents Online. We analyzed social demographic characteristics, trial-related information as well as the mandatory treatment-related content, to investigate the mandatory treatment of China's mentally ill offenders without criminal responsibility, from 2013 to 2021. Simple descriptive statistics and chi-square tests were used to compare differences among several types of documents. Results: There was an overall change trend of the number of documents: increasing year by year from 2013 to 2019 after the implementation of the new law, but with sharp decrease in 2020 and 2021 during covid-19 pandemic. From 2013 to 2021, a total of 3,854 people had applications made for mandatory treatment, of whom 3,747 (97.2%) were given mandatory treatment, 107 (2.8%) had applications rejected. "Schizophrenia and other psychotic disorders" was the most common diagnosis in both groups and all offenders receiving mandatory treatment (3,747, 100.0%) were considered to have no criminal responsibility. A total of 1,294 patients had applications made for relief of mandatory treatment, of whom 827 (63.9%) were subsequently approved for relief, 467 (36.1%) were rejected. A total of 118 patients had applications for relief two or more times, and 56 (47.5%) were finally relieved. Conclusion: Our study presents the Chinese model of a criminal mandatory treatment system to the international community which has been in operation since the implementation of the new law. Legislatory changes and covid-19 pandemic can have effect on the number of mandatory treatment cases. Patients, their close relatives and mandatory treatment institutions have the right to apply for relief from mandatory treatment, but the final decision in China is taken by the court.

Expert consensus on prevention and control of infection in COVID-19 designated hospitals

OBJECTIVE: To further standardize and guide the infection prevention and control(IPC) in designated hospitals so as to effectively ensure the stability, order and safety of medical treatment, ensure the safety of health care workers and patients, and reduce cross infections caused by the transmission of COVID-19. METHODS: The experts who repeatedly participated in the national COVID-19 medical treatment and IPC were invited to compile the consensus based on latest national norms, characteristics of the omicron and situation of epidemic prevention and control. RESULTS: The consensus consisted of two major parts: comprehensive coverage and control of infections in designated hospitals, with 47 recommendations involved. CONCLUSION: The expert consensus will provide guidance for the upcoming prevention and control of infection in designated hospitals.

Dynamic chest computed tomography change analysis and prediction of length of stay for delta variant COVID-19 patients

OBJECTIVE: As hospital admission rate is high during the COVID-19 pandemic, hospital length of stay (LOS) is a key indicator of medical resource allocation. This study aimed to elucidate specific dynamic longitudinal computed tomography (CT) imaging changes for patients with COVID-19 over in-hospital and predict individual LOS of COVID-19 patients with Delta variant of SARS-CoV-2 using the machine learning method. MATERIALS AND METHODS: This retrospective study recruited 448 COVID-19 patients with a total of 1761 CT scans from July 14, 2021 to August 20, 2021 with an averaged hospital LOS of 22.5 ± 7.0 days. Imaging features were extracted from each CT scan, including CT morphological characteristics and artificial intelligence (AI) extracted features. Clinical features were obtained from each patient's initial admission. The infection distribution in lung fields and progression pattern tendency was analyzed. Then, to construct a model to predict patient LOS, each CT scan was considered as an independent sample to predict the LOS from the current CT scan time point to hospital discharge combining with the patients' corresponding clinical features. The 1761 follow-up CT data were randomly split into training set and testing set with a ratio of 7:3 at patient-level. A total of 85 most related clinical and imaging features selected by Least Absolute Shrinkage and Selection Operator were used to construct LOS prediction model. RESULTS: Infection-related features were obtained, such as the percentage of the infected region of lung, ground-glass opacity (GGO), consolidation and crazy-paving pattern, and air bronchograms. Their longitudinal changes show that the progression changes significantly in the earlier stages (0–3 days to 4–6 days), and then, changes tend to be statistically subtle, except for the intensity range between (−470 and −70) HU which exhibits a significant increase followed by a continuous significant decrease. Furthermore, the bilateral lower lobes, especially the right lower lobe, present more severe. Compared with other models, combining the clinical, imaging reading, and AI features to build the LOS prediction model achieved the highest R2 of 0.854 and 0.463, Pearson correlation coefficient of 0.939 and 0.696, and lowest mean absolute error of 2.405 and 4.426, and mean squared error of 9.176 and 34.728 on the training and testing set. CONCLUSION: The most obvious progression changes were significantly in the earlier stages (0–3 days to 4–6 days) and the bilateral lower lobes, especially the right lower lobe. GGO, consolidation, and crazy-paving pattern and air bronchograms are the most main CT findings according to the longitudinal changes of infection-related features with LOS (day). The LOS prediction model of combining clinical, imaging reading, and AI features achieved optimum performance.

The applicability and efficacy of Micro-Video Psychological Training Camp in groups with mild to moderate symptoms of depression and anxiety: A prospective and randomized controlled trial protocol.

Background: Mental health is a global issue requiring global attention. Depression and anxiety are two of the most common mental disorders (CMDs) and are characterized by high incidence and high comorbidity. In recent years, the prolonged COVID-19 pandemic and exacerbated social instability have posed significant challenges to the mental resilience and mental health outcomes of the global population. Now more than ever, with an increase in mental health needs, it has become even more crucial to find an effective solution to provide universal mental healthcare. Psychotherapy is of vital importance for those coping with symptoms of depression and anxiety and is used to enhance mental resilience. However, such therapy can be difficult to access in reality. In this context, the Micro-Video Psychological Training Camp (MVPTC) platform will be developed. Objectives: As an online self-help platform for psychological intervention, the MVPTC platform was developed for those who suffer from mild to moderate symptoms of depression and/or anxiety and is tasked with the goal of reducing depressive and anxious symptoms while improving mental resilience. Thus, this study will be carried out to verify its efficacy and applicability. Methods: In this parallel-group, randomized controlled trial, a total of 200 mild to moderately depressed and/or anxious adults seeking self-help will be randomly recruited and assigned to either the micro-video psychological intervention group or the wait list control group. Online measurements by self-assessment will be taken at baseline, post-intervention, 1-month, and 3-month follow-up. Results: The primary results will involve symptoms of depression and anxiety. The secondary results will involve mental resilience. An analysis will be conducted based on the intention-to-treat principle. Discussion: This trial will examine whether the MVPTC platform for the relief of symptoms and the enhancement of resilience in a population screened for depression and anxiety symptoms proves effective and applicable. Large-scale resilience enhancement may benefit public mental health in terms of preventive interventions, managing depressive and anxiety symptoms, and promoting mental health. With the MVPTC-based method being applied, a brief, efficient, and structured intervention model can potentially be established, having the potential to provide necessary and accessible mental support for an extensive target group. Clinical trial registration: http://www.chictr.org.cn/, identifier ChiCTR2100043725.

Retrospective study of the immunogenicity and safety of the CoronaVac SARS-CoV-2 vaccine in people with underlying medical conditions.

BACKGROUND: People living with chronic disease, particularly seniors (≥60 years old), made up of most severe symptom and death cases among SARS-CoV-2 infected patients. However, they are lagging behind in the national COVID-19 vaccination campaign in China due to the uncertainty of vaccine safety and effectiveness. Safety and immunogenicity data of COVID-19 vaccines in people with underlying medical conditions are needed to address the vaccine hesitation in this population. METHODS: We included participants (≥40 years old) who received two doses of CoronaVac inactivated vaccines (at a 3-5 week interval) and were healthy or had at least one of 6 common chronic diseases. The incidence of adverse events after vaccination was monitored. Vaccine immunogenicity was studied by determining neutralizing antibodies and SARS-CoV-2-specific T cell responses post vaccination. RESULTS: Here we show that chronic diseases are associated with a higher rate of mild fatigue following the first dose of CoronaVac. By day 14-28 post vaccination, the neutralizing antibody level shows no significant difference between disease groups and healthy controls, except for people with coronary artery disease (p = 0.0287) and chronic respiratory disease (p = 0.0416), who show moderate reductions. Such differences diminish by day 90 and 180. Most people show detectable SARS-CoV-2-specific T cell responses at day 90 and day 180 without significant differences between disease groups and healthy controls. CONCLUSIONS: Our results highlight the comparable safety, immunogenicity and cellular immunity memory of CoronaVac in seniors and people living with chronic diseases. This data should reduce vaccine hesitancy in this population.

People living with chronic diseases, particularly those over the age of 60, are more likely to have severe symptoms and die following SARS-CoV-2 infection. However, many have not been vaccinated during the national COVID-19 vaccination campaign in China due to concerns about vaccine safety and effectiveness. Here we show that the inactivated COVID-19 vaccine, CoronaVac, is as safe in older people with chronic diseases as it is for healthy people. Also, only slightly differences are seen in the immune response of people with diseases compared to healthy people. Overall, our results highlight that the CoronaVac vaccine is safe and effective in people living with chronic diseases.

Treatment of hospital wastewater by electron beam technology: Removal of COD, pathogenic bacteria and viruses.

The effective treatment of hospital sewage is crucial to human health and eco-environment, especially during the pandemic of COVID-19. In this study, a demonstration project of actual hospital sewage using electron beam technology was established as advanced treatment process during the outbreak of COVID-19 pandemic in Hubei, China in July 2020. The results indicated that electron beam radiation could effectively remove COD, pathogenic bacteria and viruses in hospital sewage. The continuous monitoring date showed that the effluent COD concentration after electron beam treatment was stably below 30 mg/L, and the concentration of fecal Escherichia coli was below 50 MPN/L, when the absorbed dose was 4 kGy. Electron beam radiation was also an effective method for inactivating viruses. Compared to the inactivation of fecal Escherichia coli, higher absorbed dose was required for the inactivation of virus. Absorbed dose had different effect on the removal of virus. When the absorbed dose ranged from 30 to 50 kGy, Hepatitis A virus (HAV) and Astrovirus (ASV) could be completely removed by electron beam treatment. For Rotavirus (RV) and Enterovirus (EV) virus, the removal efficiency firstly increased and then decreased. The maximum removal efficiency of RV and EV was 98.90% and 88.49%, respectively. For the Norovirus (NVLII) virus, the maximum removal efficiency was 81.58%. This study firstly reported the performance of electron beam in the removal of COD, fecal Escherichia coli and virus in the actual hospital sewage, which would provide useful information for the application of electron beam technology in the treatment of hospital sewage.

Association between smoking and COVID-19 severity: A multicentre retrospective observational study.

The relationship between smoking and coronavirus disease 2019 (COVID-19) severity remains unclear. This study aimed to investigate the effect of smoking status (current smoking and a smoking history) on the clinical severity of COVID-19. Data of all enrolled 588 patients, who were referred to 25 hospitals in Jiangsu province between January 10, 2020 and March 14, 2020, were retrospectively reviewed. Univariate and multivariate regression, random forest algorithms, and additive interaction were used to estimate the importance of selective predictor variables in the relationship between smoking and COVID-19 severity. In the univariate analysis, the proportion of patients with a current smoking status in the severe group was significantly higher than that in the non-severe group. In the multivariate analysis, current smoking remained a risk factor for severe COVID-19. Data from the interaction analysis showed a strong interaction between the number of comorbidities in patients with COVID-19 and smoking. However, no significant interaction was found between smoking and specific comorbidities, such as hypertension, diabetes, etc. In the random forest model, smoking history was ranked sixth in mean decrease accuracy. Active smoking may be significantly associated with an enhanced risk of COVID-19 progression towards severe disease. However, additional prospective studies are needed to clarify the complex relationship between smoking and COVID-19 severity.

Electrochemical Oxygen Generator With 99.9% Oxygen Purity and High Energy Efficiency

Under the growing crisis of the coronavirus disease 2019 pandemic, the global medical system is facing the predicament of an acute shortage of medical‐grade oxygen (O2, ≥ 99.5% purity). Herein, an oxygen generation device is manufactured that relies on electrochemical technology. The performance of the electrochemical oxygen generator (EOG) is remarkably improved to a practically applicable level, achieving long‐term (>200 h), stable, and quick production (>1.5 L min−1) of high purity O2 (99.9%) at high energy efficiency (496 L kW−1 h−1), via simultaneous optimization for intrinsic electrochemical reaction mechanisms, electrocatalysts, and external cell structure. The EOG also presents powerful competitiveness in user experience, which finds expression in high portability (4.7 kg), nearly instant O2 production (<1 s), and a quiet working condition (<39 dB). The EOG shows great potential to substitute commercial pressure swing adsorption O2 generation devices, which may significantly impact the traditional oxygen production industry. [ FROM AUTHOR] Copyright of Advanced Energy Materials is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Difference and Cluster Analysis on the Carbon Dioxide Emissions in China During COVID-19 Lockdown via a Complex Network Model

The continuous increase of carbon emissions is a serious challenge all over the world, and many countries are striving to solve this problem. Since 2020, a widespread lockdown in the country to prevent the spread of COVID-19 escalated, severely restricting the movement of people and unnecessary economic activities, which unexpectedly reduced carbon emissions. This paper aims to analyze the carbon emissions data of 30 provinces in the 2020 and provide references for reducing emissions with epidemic lockdown measures. Based on the method of time series visualization, we transform the time series data into complex networks to find out the hidden information in these data. We found that the lockdown would bring about a short-term decrease in carbon emissions, and most provinces have a short time point of impact, which is closely related to the level of economic development and industrial structure. The current results provide some insights into the evolution of carbon emissions under COVID-19 blockade measures and valuable insights into energy conservation and response to the energy crisis in the post-epidemic era.

Will Green Finance Contribute to a Green Recovery? Evidence From Green Financial Pilot Zone in China.

In the post-epidemic era, green finance plays a more significant role in supporting the "green recovery" of the economy, so it is necessary to evaluate the implementation effect of previous green financial policies. In 2017, the green finance reform and innovation pilot zone set up in five provinces and autonomous regions made an exploration in the development of green finance. From the perspective of micro-enterprises, can this policy play a beneficial policy effect in the long run? Based on the quasi-natural experiment of green finance pilot, using the data of A-share listed companies, this paper empirically tests the impact of pilot policies on the long-term value of green enterprises in pilot areas. It is found that, compared with non-pilot zones, the green finance pilot enables a significant increase in the Tobin Q-measured value of green enterprises in the pilot zones. Heterogeneity analysis shows that green finance pilot has a more significant impact on non-state-owned enterprises, enterprises in traditional industries, large enterprises, and enterprises in the eastern region of China. Green finance pilot zone can achieve better policy effects in areas with stronger environmental impact regulation and higher financial development levels. The mechanism test shows that the green finance pilot affects the long-term value of green enterprises through the capital market effect improving the stock trading activity of enterprises and through the real effect improving the operational efficiency and profitability of enterprises. From the perspective of micro-enterprises, this paper enriches the research on the development effect of green finance and provides theoretical support for the effect evaluation of green finance pilot policies.

Plasma gp96 is a Novel Predictive Biomarker for Severe COVID-19.

Early and effective identification of severe coronavirus disease 2019 (COVID-19) may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. This study analyzed plasma concentrations of heat shock protein gp96 in nonsevere (including mild and typical) and severe (including severe and critical) patients with COVID-19 to evaluate its potential as a predictive and prognostic biomarker for disease severity. Plasma gp96 levels that were positively correlated with interleukin-6 (IL-6) levels were significantly elevated in COVID-19 patients admitted to the hospital but not in non-COVID-19 patients with less severe respiratory impairment. Meanwhile, significantly higher gp96 levels were observed in severe than nonsevere patients. Moreover, the continuous decline of plasma gp96 levels predicted disease remission and recovery, whereas its persistently high levels indicated poor prognosis in COVID-19 patients during hospitalization. Finally, monocytes were identified as the major IL-6 producers under exogenous gp96 stimulation. Our results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19. IMPORTANCE Early and effective identification of severe COVID-19 may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. Some heat shock proteins (Hsps) are released during oxidative stress, cytotoxic injury, and viral infection and behave as danger-associated molecular patterns (DAMPs). This study analyzed plasma concentrations of Hsp gp96 in nonsevere and severe patients with COVID-19. Significantly higher plasma gp96 levels were observed in severe than those in nonsevere patients, and its persistently high levels indicated poor prognosis in COVID-19 patients. The results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19.

Quantum dots assembly enhanced and dual-antigen sandwich structured lateral flow immunoassay of SARS-CoV-2 antibody with simultaneously high sensitivity and specificity.

Exploring reliable and highly-sensitive SARS-CoV-2 antibody diagnosis by point-of-care (POC) manner, holds great public health significance for extensive COVID-19 screening and controlling. Unfortunately, the currently applied gold based lateral flow immunoassay (GLFIA) may expose both false-negative and false-positive interpretations owing to the sensitivity and specificity limitations, which may cause significant risk and waste of public resources for large population screening. To simultaneously overcome the drawbacks of GLFIA, a novel fluorescent LFIA based on signal amplification and dual-antigen sandwich structure was established with largely improved sensitivity and specificity. The compact three-dimensional incorporation of hydrophobic quantum dots within dendritic affinity templates and multilayer surface derivation guaranteed a high and robust fluorescence of single label, which lowered the false negative rate of GLFIA prominently. A dual-antigen sandwich structure using labeled/immobilized SARS-CoV-2 spike receptor binding domain antigen for capturing total human SARS-CoV-2 antibody was developed, instead of general indirect antibody capturing approach, to reduce the false positive rate of GLFIA. Over 300 cases of COVID-19 negative and 97 cases of COVID-19 positive samples, the current assay revealed a 100% sensitivity and 100% specificity confirmed by both polymerase chain reaction (PCR) and chemiluminescence immunoassay (CLIA), compared with the considerable misinterpretation cases by currently applied GLFIA. The quantitative results verified by receiver operating characteristic curve and other statistical analysis indicated a well-distinguished positive/negative sample groups. The proposed strategy is highly sensitive towards low concentrated SARS-CoV-2 antibody serums and highly specific towards serums from COVID-19 negative persons and patients infected by other viruses.

Residual chlorine disrupts the microbial communities and spreads antibiotic resistance in freshwater.

Chlorine disinfection is a key global public health strategy for the prevention and control of diseases, such as COVID-19. However, little is known about effects of low levels of residual chlorine on freshwater microbial communities and antibiotic resistomes. Here, we treated freshwater microcosms with continuous low concentrations of chlorine and quantified the effects on aquatic and zebrafish intestinal microbial communities and antibiotic resistomes, using shotgun metagenome and 16S rRNA gene sequencing. Although chlorine rapidly degraded, it altered the aquatic microbial community composition over time and disrupted interactions among microbes, leading to decreases in community complexity and stability. However, community diversity was unaffected. The majority of ecological functions, particularly metabolic capacities, recovered after treatment with chlorine for 14 d, due to microbial community redundancy. There were also increased levels of antibiotic-resistance gene dissemination by horizontal and vertical gene transfer under chlorine treatment. Although the zebrafish intestinal microbial community recovered from temporary dysbiosis, growth and behavior of zebrafish adults were negatively affected by chlorine. Overall, our findings demonstrate the negative effects of residual chlorine on freshwater ecosystems and highlight a possible long-term risk to public health.

Analysis of the attention to COVID-19 epidemic based on visibility graph network

Most of the existing researches on public health events focus on the number and duration of events in a year or month, which are carried out by regression equation. COVID-19 epidemic, which was discovered in Wuhan, Hubei Province, quickly spread to the whole country, and then appeared as a global public health event. During the epidemic period, Chinese netizens inquired about the dynamics of COVID-19 epidemic through Baidu search platform, and learned about relevant epidemic prevention information. These groups’ search behavior data not only reflect people’s attention to COVID-19 epidemic, but also contain the stage characteristics and evolution trend of COVID-19 epidemic. Therefore, the time, space and attribute laws of propagation of COVID-19 epidemic can be discovered by deeply mining more information in the time series data of search behavior. In this study, it is found that transforming time series data into visibility network through the principle of visibility algorithm can dig more hidden information in time series data, which may help us fully understand the attention to COVID-19 epidemic in Chinese provinces and cities, and evaluate the deficiencies of early warning and prevention of major epidemics. What’s more, it will improve the ability to cope with public health crisis and social decision-making level. [ABSTRACT FROM AUTHOR] Copyright of Modern Physics Letters B is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Clinical course of patients on maintenance hemodialysis and COVID-19: a retrospective longitudinal study.

Coronavirus Disease 2019 (COVID-19) emerges as a global pandemic and there is a lack of evidence about the clinical course and outcome of patients on maintenance hemodialysis (MHD). Here we conducted a retrospective longitudinal study aimed to analyze the clinical features and outcome of MHD patients hospitalized with COVID-19. Of 3126 inpatients with COVID-19 at 3 Branches of Wuhan Tongji Hospital from Jan 18th to Mar 9th, 2020, 19 patients were undergoing maintenance hemodialysis. Among the 19 MHD patients with COVID-19, 6 patients (31.6%) died, and 13 patients (68.4%) were able to be discharged. Baseline characteristics, clinical courses, laboratory findings, and dynamic trajectories of major laboratory markers were compared between survivors and nonsurvivors. According to our findings, MHD patients with COVID-19 who experienced non-surviving outcome had more elevated CRP, IL6 and procalcitonin as well as fibrinogen levels at various points compared to survivors. Thus the dysregulation of immune response as well as coagulation abnormalities might be highly involved in the pathological process of COVID-19, contributing to the poor prognosis in MHD patients.

Safety and Comfort of Wearing Medical Masks in Adult Surgical Patients After General Anesthesia During the COVID-19 Epidemic: A Retrospective, Observational Cohort Study.

OBJECTIVE: This study assessed oxygen saturation variation and comfort in adult surgical patients wearing masks in PACU during the COVID-19 epidemic. DESIGN: Retrospective observation was applied in this study. METHODS: One hundred thirty-seven patients wearing no medical masks (Group A, aged from 20 to 87) and 136 patients wearing medical masks (Group B, aged from 18 to 91) were selected in this retrospective study after extubation in PACU. After extubation their pulse oxygen saturation, noninvasive mean blood pressure and heart rate were recorded at two different time points (treated with 40% O2 oxygen therapy for 10 minutes and breathing room air for 10 minutes). The comfort, arterial blood gas data, complications and duration of patients were also reviewed in PACU. FINDINGS: There were no significant differences in the pulse oxygen saturation between the two groups after inhaling 40% O2 or air. Compared with Group A, patients in Group B have lower comfort (6 [4-7] vs 7 [6-8]; P < .001), with shortened duration after extubation in PACU (50 [45-55] vs 56 [48-60]; P < .001). No significant differences were found in heart rate, noninvasive mean blood pressure, arterial blood gas data and complications. And no hypoxemia and respiratory adverse events happened in two groups. CONCLUSIONS: Wearing medical masks does not reduce oxygen saturation in adult surgical patients during recovery from general anesthesia. The discomfort caused by masks is the concern in PACU.

Proteomics Analysis of Serum from COVID-19 Patients.

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic. To understand the changes in plasma proteomics upon SARS-CoV-2 infection, we analyzed the protein profiles of plasma samples from 10 COVID-19 patients and 10 healthy volunteers by using the DIA quantitative proteomics technology. We compared and identified differential proteins whose abundance changed upon SARS-CoV-2 infection. Bioinformatic analyses were then conducted for these identified differential proteins. The GO/KEEG database was used for functional annotation and enrichment analysis. The interaction relationship of differential proteins was evaluated with the STRING database, and Cytoscape software was used to conduct network analysis of the obtained data. A total of 323 proteins were detected in all samples. Difference between patients and healthy donors was found in 44 plasma proteins, among which 36 proteins were up-regulated and 8 proteins were down-regulated. GO functional annotation showed that these proteins mostly composed of cellular anatomical entities and proteins involved in biological regulation, cellular processes, transport, and other processes. KEEG functional annotation further showed that these proteins were mainly involved in complement system activation and infectious disease processes. Importantly, a KEEG pathway (natural killer cell-mediated cytotoxicity) was enriched, with three important activators of this pathway, ICAM1/2 and IgG, being up-regulated. Protein-protein interaction (PPI) statistics indicated that, among these 44 proteins, 6 were the most significantly up-regulated (DBH, SHGB, TF, ICAM2, THBS1, and C1RL) while 2 were the most significantly down-regulated (APCS and ORM1). Results from this study showed that a few proteins associated with immune activation were up-regulated in patient plasma. In addition, this study established a method for extraction and quantitative determination of plasma components in convalescent plasma from COVID-19 patients.

Mycobacterium vaccae Nebulization in the Treatment of COVID-19: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Severe acute respiratory syndrome coronavirus 2 infection is associated with strong infectiousness and has no effective therapy. We aimed to explore the efficacy and safety of Mycobacterium vaccae nebulization in the treatment of Coronavirus Disease 2019 (COVID-19). Methods: In this randomized, double-blind, placebo-controlled clinical trial, we included 31 adult patients with moderate COVID-19 who were admitted to the Fourth People's Hospital of Nanning (Nanning, China) between January 22, 2020 and February 17, 2020. Patients were randomly divided into two groups: group A (standard care group) and group B (M. vaccae in combination with standard care group). The primary outcome was the time interval from admission to viral RNA negative conversion (oropharyngeal swabs were used in this study). Secondary outcomes included chest computed tomography (CT), mortality, length of hospital stay, complications during treatment, and so on. Patients were followed up to 4 weeks after discharge (reexamination of viral RNA, chest CT, etc.). Results: Nucleic acid test negative conversion time in group B was shorter than that in group A (2.9 days [2.7-8.7] vs. 6.8 days [3.3-13.8]; p = 0.045). No death and no conversion to severe or critical cases were observed in both groups. Two weeks after discharge, neither "relapse" nor "return to positive" cases were found. Four weeks after discharge, it was found that there was no case of " relapse " or "return to positive" in group B, and 1 patient in group A showed "return to positive", but there was no clinical manifestation and imaging progression. No adverse reactions related to M. vaccae were found during observation period. Conclusion:M. vaccae treatment might shorten the time interval from admission to viral RNA negative conversion, which might be beneficial to the prevention and treatment of COVID-19. Clinical Trial Registration: ChiCTR2000030016.