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Background Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia in children. However, prior to this study, there was a lack of research on the genotypes and macrolide resistance monitoring of M. pneumoniae in Wuhan. The factors contributing to the severity of illness caused by M. pneumoniaeinfection are still under investigation. We aimed to evaluate the clinical manifestations, genotypes, macrolide resistance, respiratory microenvironment, and their relationship with the severity of illness in children with M. pneumoniaepneumonia in Wuhan. Results Among 1,259 clinical samples, 461 samples were positive for M. pneumoniae via qPCR. We successfully identified the P1 genotypes of 127 samples based on metagenomic and Sanger sequencing, with P1-type 1 (113/127, 88.98%) being the dominant genotype. In addition, we identified the MLST genotypes of 67 samples, with ST-3 being the most common (60/67, 89.6%), followed by ST-14 (5/67, 7.4%) and ST-7 (2/67, 3%). No significant difference in pathogenicity was observed among different genotypes. The macrolide resistance rate of M. pneumoniaeisolates was 96% (48/50) and all mutations were A2063G in domain V of 23S rRNA gene. There was no significant difference between the upper respiratory microbiome of patients with mild and severe symptoms. The pan-genome analysis revealed that the genome of M. pneumoniae is highly conserved, with the core genome comprising 79% of the total genome length. In addition, the initial serological test cannot accurately diagnose M. pneumoniae infection. qPCR is suitable for detecting M. pneumoniaeinfection, while IgM titers greater than 1:160 can be used as a predictor of severity. Conclusions This study is the first to characterize the epidemic and genomic features of M. pneumoniae in Wuhan after the COVID-19 outbreak in 2020, which provides a scientific data basis for monitoring and infection prevention and control of M. pneumoniae in the post-pandemic era.
Subject(s)
COVID-19 , Pneumonia , Pneumonia, MycoplasmaABSTRACT
The impacts of COVID-19 lockdowns on human life, air quality, and river water quality around the world have received significant attention. In comparison, assessments of the implications for freshwater ecosystems are relatively rare. This study explored the impact of COVID-19 lockdowns on aquatic ecosystems in the Yangtze River by comparing river water quality, phytoplankton, zooplankton, and fish data collected at the site in the middle reach of the Yangtze River in 2018 and 2020. The results show that during COVID-19 lockdowns, the reduction in industrial and domestic effluent discharge led to a reduction in organic pollution and industrial plant nutrient pollution in rivers. Among them, PO43--P, CODMn, and TP were significantly decreased (p < 0.05). During lockdowns, nutrient supplies such as TN and TP were reduced, which led to inhibition of algae growth and decreased phytoplankton abundance. Phytoplankton affects the abundance of zooplankton through a bottom-up effect, and a decrease in phytoplankton density leads to a decrease in zooplankton density. The decrease in plankton density led to lower primary productivity in rivers, reduced fish feed supplies, intensified competition among fish populations, with increases in population dominated by high trophic level carnivorous fish. In addition, the decrease in fishing intensity has contributed to an increase in the number of rivers-sea migratory fish;the fish community was earlier mainly dominated by small-sized species with a short life cycle, and the number of supplementary populations has now increased. As a consequence, the fish community structure shows a tendency toward high complexity and high fish diversity. Overall, these observations demonstrate that the rapid revival of the retrogressive Yangtze River ecosystem is possible through limitation of anthropic interferences.
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Background In fulfilling the COVID-19 containment, primary health care (PHC) facilities in China played an important role. We sought to investigate the exact tasks performed at the PHC facilities and the processes of COVID-19 prevention and control.Methods Semi-structured face-to-face interviews for primary care physicians (PCPs) and a simple survey for residents were conducted in the field survey. Based-on purposive stratified sampling, 32 PCPs were selected from 22 PHC facilities in Wuhan as a high-risk city, in Shanghai as medium-risk city and in Zunyi as low-risk city. In the field survey, semi-structured face-to-face interviews were conducted with PCPs to summarize the tasks of COVID-19 prevention and control at the PHC facilities. A simple survey was used to investigate the local residents’ awareness about COVID-19 prevention and control.Results In pre-outbreak period, the PHC facilities mainly engaged in storing medical supplies; in out-break period, they were responsible for screening, transferring, quarantine and treatment; in regular prevention and control period, attention was given to the employees and items of cold-chain & fresh food markets, etc. In Wuhan, PHC facilities focused on graded diagnoses and treatments of patients; in Shanghai, they were mainly engaged in at-home/centralized quarantine; in Zunyi, they focused on the screening of high-risk individuals. In urban areas, COVID-19 were more likely to be transmitted; in urban-rural areas, it was difficult to perform screening on the migrant populations; in rural areas, the risk was much lower. The community residents had satisfactory compliance with the preventive measures.Conclusion We identified differences in the prevention and control tasks performed at the PHC facilities in China. During the different phases of the pandemic, the tasks were adjusted depending on the gradually comprehensive understanding of COVID-19. Among the cities at different risk levels, screening, quarantine, transferring or treatment was chosen to be a priority accordingly. Located in different intra-city geographic locations at different risk levels, the PHC facilities conducted their own tasks accordingly. Additionally, compliance on the part of the local community residents could not be overemphasized in COVID-19 prevention and control.
Subject(s)
COVID-19ABSTRACT
Background: An increasing number of children with severe coronavirus disease 2019 (COVID-19) is being reported, yet the spectrum of disease severity and expression patterns of angiotensin- converting enzyme 2 (ACE2) in children at different developmental stages are largely unknow. Methods: We analysed clinical features in a cohort of 173 children with COVID-19 (0-15 yrs.-old) between January 22, 2020 and March 25, 2020. We systematically examined the expression and distribution of ACE2 in different developmental stages of children by using a combination of children’s lung biopsies, pluripotent stem cell-derived lung cells, RNA-sequencing profiles, and ex vivo SARS-CoV-2 pseudoviral infections. Findings: It revealed that infants (<1yrs.-old), with a weaker potency of immune response, are more vulnerable to develop pneumonia whereas older children (>1 yrs.-old) are more resistant to lung injury. The expression levels of ACE2 however do not vary by age in children’s lung. ACE2 is notably expressed not only in Alveolar Type II (AT II) cells, but also in SOX9 positive lung progenitor cells detected in both pluripotent stem cell derivatives and infants’ lungs. The ACE2+ SOX9+ cells are readily infected by SARS-CoV-2 pseudovirus and the numbers of the double positive cells are significantly decreased in older children. Interpretation: Infants (<1 yrs.-old) with COVID-19 infection are more vulnerable to lung injuries. ACE2 expression in multiple types of lung cells including SOX9 positive progenitor cells, in cooperation with an unestablished immune system, could be risk factors contributing to vulnerability of infants with COVID-19. There is a need to continue monitoring lung development in young children who have recovered from COVID-19 infection. Funding: National Natural Science Grant of China (No 31571407; 31970910); Hong Kong Health and Medical Research Fund (HMRF) (No:06172956), and Stem Cell and Regenerative Medicine Fund (Guangzhou Women and Children's Medical Centre, Grant No:5001-4001010)Declaration of Interests: The authors declare no competing interest.Ethics Approval Statement: This study was approved by the respective Institutional Review Board. Written informed consent was obtained from patients and/or guardians before data collected.
Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar , Lung Injury , Pneumonia , COVID-19ABSTRACT
Coronavirus Disease 2019 (COVID-19) spreads globally as a sever pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cell entry of SARS-CoV-2 mainly depends on binding of the viral spike (S) proteins to angiotensin converting enzyme 2 (ACE2) on host cells. Therefore, repurposing of known drugs to inhibit S protein-ACE2 interaction could be a quick way to develop effective therapy for COVID-19. Using a high-throughput screening system to investigate the interaction between spike receptor binding domain (S-RBD) and ACE2 extracellular domain, we screened 3581 FDA-approved drugs and natural small molecules and identified ceftazidime as a potent compound to inhibit S-RBD-ACE2 interaction by binding to S-RBD. In addition to significantly inhibit S-RBD binding to HPAEpiC cells, ceftazidime efficiently prevented SARS-CoV-2 pseudovirus to infect ACE2-expressing 293T cells. The inhibitory concentration (IC50) was 113.2 M, which is far below the blood concentration (over 300 M) of ceftazidime in patients when clinically treated with recommended dose. Notably, ceftazidime is a drug clinically used for the treatment of pneumonia with minimal side effects compared with other antiviral drugs. Thus, ceftazidime has both anti-bacterial and anti-SARS-CoV-2 effects, which should be the first-line antibiotics used for the clinical treatment of COVID-19.
Subject(s)
COVID-19ABSTRACT
The 2019 new coronavirus pneumonia (COVID-19) caused by the new coronavirus (SARS-Cov-2) infection has become a global pandemic, and currently there is a lack of specific antiviral drugs. Traditional Chinese medicine plays a critical role in the treatment of COVID-19. Scutellaria baicalensis is an important component of the Qingfei Paidu decoction recommended in the Chinese National Health Commission's Treatment Regimen and Wuhan Xiehe No.2 and No.3 prescriptions as well. Baicalein is the main ingredient in Scutellaria baicalensis, and has various pharmacological effects such as antiviral, antibacterial, antiallergic, and immunomodulatory activities, showing a broad prospect in new drug development. This article systemically reviewed the recent progress in the preclinical and clinical studies, potential drug interactions, and other aspects of baicalein, which will help further development and clinical application of the drug.
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Background ： A respiratory epidemic defined as coronavirus disease 2019 ( COVID-19 ) is becoming unstoppable and has been declared a pandemic. Patients with cancer are more likely to develop COVID-19. Based on our experience during the pandemic period, we propose some surgery strategies for gastric cancer patients under the COVID-19 situation. Methods ： We defined the ‘COVID-19’ period as occurring between 2020-01-20 and 2020-03-20. All the enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results ： The waiting times before admission increased by 4 days in CG(PCG:4.5 [IQR: 2, 7.8] vs. CG:8.0 [IQR: 2,20]; P = 0.006). More patients had performed chest CT scan besides abdominal CT before admission during COVID-19 period(PCG:22[32%]vs. CG:30[73%], p=0.001). After admission, during COVID period, the waiting time before surgery was longer(3[IQR: 2,5] vs. 7[IQR: 5,9]; P < 0.001),more laparoscopic surgery were performed(PCG: 51[75%] vs. CG: 38[92%],p=0.021), and hospital stay after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11] ; P < 0.001). The total cost of hospitalization increased during COVID period, (9.22[IQR:7.82,10.97] vs. 10.42[IQR:8.99,12.57]; p=0.006). Conclusion ： Since no data is available yet on the impact of COVID-19 on gastric cancer patients,our own experience with COVID-19 in gastric cancer surgery has hopefully provided an opportunity for colleagues to reflect on their own service and any contingency plans they have to tackle the crisis. Keywords: gastric cancer; coronavirus disease 2019; COVID-19; retrospective analysis; real-world data.