Evolution of viral pneumonia before and after COVID-19 pandemic---A retrospective study based on respiratory viral nucleic acid results from 5,928 patients (preprint)

Background: There are limited data on etiology of viral pneumonia under the impact of COVID-19 pandemic. We aimed to investigate the changes of viral pneumonia before and after COVID-19 pandemic among patients diagnosed with pneumonia. Methods: This is a single-center retrospective study. Patients hospitalized with pneumonia during January 1,2016 and Dec 31,2021 in West China Hospital were included and divided into pre- and post-COVID-19 groups according to the point of COVID-19 outbreak in China which was December 8,2019. Results of the 13 viral nucleic acid tests were compared between the two groups. Results: 5,928 patients were analyzed,3,945 in the pre-COVID-19 group while 1,983 in the post-COVID-19. Respiratory viral nucleic acid screening proportion was riseing after COVID-19 (14.8％ VS 22.8％).But the positive rate of post-COVID-19 total virus and Influenza virus had decreased 23.3% and 18.3%, respectively,p＜0.05. The top three viral pneumonia were InfAH1N1(2009),Human Rhinovirus,Human Adenovirus before COVID-19, while HRV, Human Parainfluenza virus, Human Respiratory Syncytial virus after COVID-19 pandemic. Notebly,InfAH1N1(2009) pneumonia decreased to 0％ after the pandemic. Conclusions: Proportion of viral pneumonia has significantly decreased under the impact of COVID-19 pneumonia and the incidence of InfAH1N1(2009) pneumonia is almost 0.

Comparison of Associations Between Glucocorticoids Treatment and Mortality in COVID-19 Patients and SARS Patients: A Systematic Review and Meta-Analysis (preprint)

BackgroundThe response to glucocorticoids treatment may be different between Covid-19 and SARS. MethodsIn this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, ClinicalTrials.gov, ICTRP from 2002 to October 7, 2020. We used fixed-effects and random-effects models to compute the risk ratio of death in the group receiving glucocorticoids treatment and the control group for COVID-19 and SARS, respectively.ResultsTen trials and 71 observational studies, with a total of 45935 patients, were identified. Glucocorticoids treatment, was associated with decreased all-cause mortality both in COVID-19 (risk ratio, 0.88; 95% confidence interval, 0.82 to 0.94; I2=26%) and SARS (0.48; 0.29 to 0.79; 10%), based on high quality evidence, as well as decreased all-cause mortality-including composite outcome of COVID-19 (0.89; 0.82 to 0.98; 0%). In subgroup analyses, all-cause mortality was significantly lower among COVID-19 patients being accompanied by severe ARDS but not mild ARDS, taking low-dose or pulse glucocorticoids, being critically severe but not only severe, being of critical severity and old but not young, being of critical severity and men but not women, non-early taking glucocorticoids and taking dexamethasone or methylprednisolone; but for SARS, lower mortality were observed among those who were taking medium-high dose glucocorticoids, being severe or critically severe, early taking glucocorticoids, and taking dexamethasone or prednisolone. ConclusionsGlucocorticoids treatment reduced mortality in COVID-19 and SARS patients of critical severity; however, different curative effects existed between the two diseases among subpopulations, mainly regarding sex- and age-specific effects, optimal doses and use timing of glucocorticoids.

Collaborative City Digital Twin For Covid-19 Pandemic: A Federated Learning Solution (preprint)

In this work, we propose a collaborative city digital twin based on FL, a novel paradigm that allowing multiple city DT to share the local strategy and status in a timely manner. In particular, an FL central server manages the local updates of multiple collaborators (city DT), provides a global model which is trained in multiple iterations at different city DT systems, until the model gains the correlations between various response plan and infection trend. That means, a collaborative city DT paradigm based on FL techniques can obtain knowledge and patterns from multiple DTs, and eventually establish a `global view' for city crisis management. Meanwhile, it also helps to improve each city digital twin selves by consolidating other DT's respective data without violating privacy rules. To validate the proposed solution, we take COVID-19 pandemic as a case study. The experimental results on the real dataset with various response plan validate our proposed solution and demonstrate the superior performance.

Challenges and countermeasures for diagnosis and treatment work in hepatobiliary surgery in the epidemic of novel coronavirus pneumonia / 临床肝胆病杂志

The epidemic of coronavirus disease 2019 (COVID-19) has become a severe and complicated situation. As of February 23, 2020, there have been more than 77,038 confirmed cases of new coronavirus infection nationwide. COVID-19 is highly infectious and has a long incubation period and a variety of clinical manifestations, which has a great impact on society and economy and also seriously affects the daily operation of hepatobiliary surgery. This article discusses and recommends the medical protection measures required for outpatient, ward, and operation of hepatobiliary surgery, in order to reduce the risk of nosocomial infection in hepatobiliary surgery during the COVID-19 epidemic.