COVID-19-Associated Disease Course Is Shortened in Moderate-to-Severe Atopic Dermatitis Patients Receiving Dupilumab Treatment: A Retrospective Cross-Sectional Study.

Previous studies suggest that allergic diseases may be a protective factor in SARS-CoV-2 infection. However, data regarding the impact of dupilumab, a widely used immunomodulatory medication, on COVID-19 in an allergic population are very limited. To investigate the incidence and severity of COVID-19 among moderate-to-severe atopic dermatitis (AD) patients treated with dupilumab, a retrospective cross-sectional survey was conducted among patients with moderate-to-severe AD who presented at the Department of Allergy of Tongji Hospital from 15 January 2023 to 31 January 2023. Healthy individuals matched for gender and age were also enrolled as a control. All subjects were asked about their demographic characteristics, past medical history, COVID-19 vaccination history, and medications, as well as the presence and duration of individual COVID-19-related symptoms. A total of 159 moderate-to-severe AD patients and 198 healthy individuals were enrolled in the study. Among the AD patients, 97 patients were treated with dupilumab, and 62 patients did not receive any biologicals or systemic treatments (topical treatment group). The proportions of people who were not infected with COVID in the dupilumab treatment group, topical treatment group and healthy control group were 10.31%, 9.68% and 19.19%, respectively (p = 0.057). There was no significant difference in COVID-19-related symptom scores among all groups (p = 0.059). The hospitalization rates were 3.58% in the topical treatment group and 1.25% in the healthy control group, and no patient was hospitalized in the dupilumab treatment group (p = 0.163). Compared with healthy control group and topical treatment group, the dupilumab treatment group had the shortest COVID-19-associated disease duration (dupilumab treatment group, 4.15 ± 2.85 d vs. topical treatment group, 5.43 ± 3.15 d vs. healthy control group, 6.09 ± 4.29 d; p = 0.001). Among the AD patients treated with dupilumab for different times, there was no appreciable difference (<0.5 year group, 5 ± 3.62 d vs. 0.5-1 year group, 4.84 ± 2.58 d vs. >1 year group, 2.8 ± 1.32 d; p = 0.183). Dupilumab treatment shortened the duration of COVID-19 in patients with moderate-to-severe AD. AD patients can continue their dupilumab treatment during the COVID-19 pandemic.

MobCovid: Confirmed Cases Dynamics Driven Time Series Prediction of Crowd in Urban Hotspot.

Monitoring the crowd in urban hot spot has been an important research topic in the field of urban management and has high social impact. It can allow more flexible allocation of public resources such as public transportation schedule adjustment and arrangement of police force. After 2020, because of the epidemic of COVID-19 virus, the public mobility pattern is deeply affected by the situation of epidemic as the physical close contact is the dominant way of infection. In this study, we propose a confirmed case-driven time-series prediction of crowd in urban hot spot named MobCovid. The model is a deviation of Informer, a popular time-serial prediction model proposed in 2021. The model takes both the number of nighttime staying people in downtown and confirmed cases of COVID-19 as input and predicts both the targets. In the current period of COVID, many areas and countries have relaxed the lockdown measures on public mobility. The outdoor travel of public is based on individual decision. Report of large amount of confirmed cases would restrict the public visitation of crowded downtown. But, still, government would publish some policies to try to intervene in the public mobility and control the spread of virus. For example, in Japan, there are no compulsory measures to force people to stay at home, but measures to persuade people to stay away from downtown area. Therefore, we also merge the encoding of policies on measures of mobility restriction made by government in the model to improve the precision. We use historical data of nighttime staying people in crowded downtown and confirmed cases of Tokyo and Osaka area as study case. Multiple times of comparison with other baselines including the original Informer model prove the effectiveness of our proposed method. We believe our work can make contribution to the current knowledge on forecasting the number of crowd in urban downtown during the Covid epidemic.

Incremental theory of personality attenuates the effect of environmental uncertainty on intertemporal choices

To examine the impact of environmental uncertainty on individuals' intertemporal choices and the moderating effect of implicit personality theory, two studies were conducted. Study 1 investigated the moderating role of implicit personality theory in the influence of environmental uncertainty on intertemporal choice using questionnaires. Study 2 examined whether priming incremental personality theory could change entity theorists' intertemporal preference in an uncertain environment. The results showed that implicit personality theory plays a moderating role in the influence of environmental uncertainty on intertemporal choice. For entity theorists, the delay discounting rate was positively correlated with environmental uncertainty. In contrast, for incremental theorists, the delay discounting rate was not significantly correlated with environmental uncertainty. After priming incremental personality theory, entity theorists' delay discounting decreased significantly. Thus, we conclude that incremental personality theory buffers the effect of environmental uncertainty on intertemporal choice.

Changes in mental health across the COVID-19 pandemic for local and international university students in Australia: a cohort study.

PURPOSE: Previous research has indicated that university students experienced substantial mental health issues during the global COVID-19 pandemic, but few studies have considered changes relative to pre-pandemic levels across population groups. Hence, the aim of this study was to compare changes in mental health and associated stressors across the pandemic for international and local university students studying in Australia. METHODS: In a cohort of 4407 university students, we assessed depression (Patient Health Questionnaire 2), anxiety (Generalized Anxiety Disorder-2), social support (Medical Outcomes Study-Social Support Survey), inability to afford food, fear of partner, and experiences of discrimination, both pre-pandemic (April-May 2019) and during the pandemic (September-October 2020). Change in prevalence between local and international students were estimated with logistic regression, adjusting for baseline factors. RESULTS: Compared to local students, international students experienced an increase in probable major depression (odds ratio (OR) 1.43, 95% Confidence Interval (CI) 1.23, 1.66), low social support (OR 2.63, 95% CI 2.23, 3.11), inability to afford food (OR 5.21, 95% CI 3.97, 6.83) race-based discrimination (OR 2.21, 95% CI 1.82, 2.68) and fear of partner (OR 3.46, 95% CI 2.26, 5.13). Interaction analyses indicated that these issues were more likely to be experienced by students living outside their country of origin, inclusive of international students based in Australia (depression p value interaction term 0.02). CONCLUSION: The pandemic had a substantial negative impact on international students, particularly those living outside of their country of origin during the pandemic. The inequalities exacerbated by the pandemic were present prior to the pandemic and are likely to continue post-pandemic without action. Interventions to build the supports for international students need to be urgently explored.

Effectiveness and Safety of Lianhua Qingwen Capsules for COVID-19: A Propensity-Score Matched Cohort Study.

As a traditional Chinese medicine, Lianhua Qingwen capsules have been widely used to treat Coronavirus Disease 2019 (COVID-19). This study was aimed to demonstrate the association between treatment with Lianhua Qingwen capsules and the clinical outcomes of hospitalized patients with COVID-19. This retrospective study was conducted at four hospitals in Central China. Data of hospitalized COVID-19 patients were collected between December 19, 2019 and April 26, 2020. Based on whether Lianhua Qingwen capsules were used, patients were classified into Lianhua Qingwen and non-Lianhua Qingwen (control) groups. To control for confounding factors, we used conditional logistic regression in a propensity-score matched (PSM) cohort (1 : 1 balanced), as well as logistic regression without matching as sensitivity analysis. A total of 4918 patients were included, 2760 of whom received Lianhua Qingwen capsules and 2158 of whom did not. In the PSM model, after adjusting for confounders, the in-hospital mortality was similar between the Lianhua Qingwen group and the control group (6.8% vs. 3.3%, adjusted OR, 0.66 [95% CI, 0.38-1.15], p = 0.138). The negative conversion rate of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection was higher in the Lianhua Qingwen group (88.3% vs. 96.1%, adjusted OR, 4.02 [95% CI, 2.58-6.25], p < 0.001). The incidence of acute liver injury was comparable between the two groups (14.0% vs. 11.5%, adjusted OR: 0.85 [95% CI, 0.71-1.02], p = 0.083), and the incidence of acute kidney injury was lower in the Lianhua Qingwen group (5.3% vs. 3.0%, adjusted OR: 0.71 [95% CI, 0.50-1.00], p = 0.048). Treatment with Lianhua Qingwen capsules was not significantly associated with in-hospital mortality in COVID-19 patients. In the Lianhua Qingwen group, the negative conversion rate of SARS-CoV-2 infection was higher and the incidence of acute kidney injury was lower than in the control group.

The mental health of international university students from China during the COVID-19 pandemic and the protective effect of social support: A longitudinal study.

BACKGROUND: During the COVID-19 pandemic Chinese international students were reported to experience racism, food security issues and social isolation. However, no study has investigated the prevalence of these issues and the potential for worsening mental health in this population group during the pandemic. Therefore, this study aimed to examine the effect of this pandemic on the mental health of Chinese international students living in Australia and China, and the protective effect of social support. METHODS: Data were extracted from a survey of Australian university students (April-June 2019) and follow-up during the pandemic (Sept-Oct 2020). The prevalence of anxiety, major depression and pandemic-related stressors was reported. Multivariable logistic regression was used to assess the association between country of residence, social support (baseline/follow-up), and follow-up self-reported mental health. RESULTS: With the pandemic, there was a substantial increase in the prevalence of anxiety (24.7 % vs 45.7 %) and major depression (22.1 % vs 43.8 %). Major depression was less likely to be reported by international students in China (34.8 %) than in Australia (46.3 %). Students with high social support during the pandemic were less likely to report major depression (Adjusted OR:0.15 [95 % CI 0.06,0.34]), although this effect was not observed longitudinally (Adjusted OR:1.03 [95 % CI 0.58,1.83]). LIMITATION: Post pandemic improvement in mental health cannot be assessed. CONCLUSION: The pandemic appeared to have had a strong negative effect on Chinese international university students' mental health. Those living in Australia were more likely to experience poorer mental health, highlighting the need for increased support to this group.

Efficacy and Safety of COVID-19 Vaccination in Older Adults: A Systematic Review and Meta-Analysis.

Objective: To analyze the differences in efficacy and safety of different types of novel coronavirus pneumonia (COVID-19) vaccines in different age groups (young adults and elderly). Methods: Randomized controlled trials (RCTs) on COVID-19 vaccine in PubMed, Embase, Web of Science, and Cochrane library were searched by computer, and eight eligible studies were analyzed. Meta-analysis was performed using Stata 16.0 and RevMan5.4 software. Results: The mean geometric titer (GMT) of the virus in the elderly was significantly higher than that in the placebo group (SMD = 0.91, 95% CI (0.68, 1.15), p < 0.01), presenting no obvious difference compared with the young adults (SMD = 0.19, 95% CI (0.38, 0.01), p = 0.06). Meanwhile, the effect of multiple vaccinations was better than that of single vaccination (SMD = 0.83, 95% CI (0.33, 1.34), p < 0.01). However, the number of adverse events (AEs) in the elderly was lower than that in the young adults (OR = 0.35, 95% CI (0.29, 0.42), p < 0.01). Conclusions: The immunization effect of COVID-19 vaccine in the elderly is obvious, especially after multiple vaccinations, and the incidence of AEs in the elderly is low, which proves that the vaccination of the elderly is safe and effective.

The relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic: Emotional labor and burnout as mediators.

BACKGROUND: In the context of the Corona Virus Disease 2019 (COVID-19) pandemic, research on personal-job fit and physical and mental health was inadequate. We aimed to explore the relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic and verify emotional labor and burnout as mediators. METHODS: A total of 2868 medical staff from two general hospitals, were included from July 3 to July 27, 2022, in Wuhan, China. SPSS was used for statistical description, and AMOS was used for structural equation modeling (SEM) to analyze the mediating effect of emotional labor and burnout. RESULTS: In the SEM, the total effect of personal-job fit on physical and mental health was significant (ß = 0.855, 95 % CI: 0.748-0.972). The mediating effect of surface acting between personal-job fit and physical and mental health was significant (ß = 0.078, 95 % CI: 0.053-0.110). The mediating effect of burnout was significant (ß = 0.220, 95 % CI: 0.175-0.274), but the mediating effect of deep acting was not significant (ß = 0.006, 95 % CI: -0.013-0.025). The chain mediating effect of surface acting or deep acting and burnout between personal-job fit and physical and mental health was significant (ß = 0.082, 95 % CI: 0.059-0.108; ß = 0.049, 95 % CI: 0.038-0.063). LIMITATIONS: Owing to the cross-sectional study, causal relationship, and direction of effects among variables could not be determined. CONCLUSIONS: Personal-job fit has significant direct and indirect effects on physical and mental health. Monitoring and intervening in personal-job fit, emotional labor, and burnout might be effective ways to promoting physical and mental health among medical staff during the COVID-19 pandemic.

Effects of COVID-19 on Residential Planning and Design: A Scientometric Analysis

Coronavirus disease has caused city blockades, making people spend longer in residential areas than ever before. Human well-being and health are directly affected by the suppression of the epidemic through residential planning and design. In this regard, scholars from all over the world have made significant efforts to explore the links between COVID-19 and residential planning and design, trying to adjust the states in time to cope with the effects of COVID-19 in the long run. This study is based on Bibliometrix to conduct a scientometric analysis of the literature on 'Effects of COVID-19 on residential planning and design (ECRPD)';published in Web of Science and Scopus from 2019 to October 2022. The aim of this study is to comprehensively present the scientific knowledge of ECRPD research through general characteristics' analysis, citation analysis, and horizontal conceptual structure analysis, and try to summarize how residential planning and design responds to COVID-19, so as to provide support and advice for urban planners, builders, and policy makers. According to the results, ECRPD research is growing significantly, and the scientific productivity of it has increased exponentially. The main effects and feedback are characterized by three aspects: residential environment, residential building space and planning space, and residential traffic and community management. Generally, ECRPD research has expanded beyond the disciplines of architecture and planning. Environmental and energy concerns have attracted the most attention, though practical research into residential building space is relatively limited. To fully deal with COVID-19's multiple negative facets, it is imperative to promote cross-disciplinary and multi-field collaboration, implement new technologies and methods for traditional disciplines, develop bioclimatic buildings to cope with environmental changes, and strengthen practical research in residential building and planning to ensure that a sustainable and resilient living environment is created in the post-pandemic era.

The evaluation of urban spatial quality and utility trade-offs for Post-COVID working preferences: a case study of Hong Kong.

The formation of urban districts and the appeal of densely populated areas reflect a spatial equilibrium in which workers migrate to locations with greater urban vitality but diminished environmental qualities. However, the pandemic and associated health concerns have accelerated remote and hybrid work modes, altered people's sense of place and appreciation of urban density, and transformed perceptions of desirable places to live and work. This study presents a systematic method for evaluating the trade-offs between perceived urban environmental qualities and urban amenities by analysing post-pandemic urban residence preferences. By evaluating neighbourhood Street View Imagery (SVI) and urban amenity data, such as park sizes, the study collects subjective opinions from surveys on two working conditions (work-from-office or from-home). On this basis, several Machine Learning (ML) models were trained to predict the preference scores for both work modes. In light of the complexity of work-from-home preferences, the results demonstrate that the method predicts work-from-office scores with greater precision. In the post-pandemic era, the research aims to shed light on the development of a valuable instrument for driving and evaluating urban design strategies based on the potential self-organisation of work-life patterns and social profiles in designated neighbourhoods.

Association between periodontitis and COVID-19 infection: a two-sample Mendelian randomization study.

Background and Objective: Epidemiological studies report associations between coronavirus disease 2019 (COVID-19) and periodontitis; however, causality has not been proven. The aim of this study is to assess the associations between COVID-19 susceptibility and periodontitis with two-sample Mendelian randomization (MR) analyses. Methods: A two-sample summary MR analysis was performed using data for outcome and exposure from the OpenGWAS database on people of European descent. Periodontal complex traits (PCTs) were chosen as a proxy for the periodontitis phenotype. The causal association between PCT3 (Aggregatibacter actinomycetemcomitans), PCT5 (Porphyromonas gingivalis), and gingival crevicular fluid (GCF) interleukin-1ß (IL-1ß) and COVID-19 were considered. Genome-wide association study (GWAS) data with the two largest sample sizes were selected as COVID-19 outcomes (datasets ebi-a-GCST010776 and ebi-a-GCST010777). Single-nucleotide polymorphisms (SNPs) associated with PCT3, PCT5, and GCF IL-1ß at statistical significance at genome-wide level (P < 5 × 10-8) were identified as genetic instruments. We used two-sample summary MR methods and tested the existence of a pleiotropic effect with MR-Egger. Results: Inverse-variance weighted (IVW) estimates showed that there was a positive association between COVID-19 risk and periodontitis (ebi-a-GCST010776: odds ratio [OR] = 1.02 (95% confidence interval (CI), 1.00-1.05), P = 0.0171; ebi-a-GCST010777: OR = 1.03 (95% CI, 1.00-1.05), P = 0.0397). The weighted median also showed directionally similar estimates. Exploration of the causal associations between other PCTs and COVID-19 identified a slight effect of local inflammatory response (GCF IL-1ß) on COVID-19 risk across the two datasets (ebi-a-GCST010776: IVW OR = 1.02 (95% CI, [1.01-1.03]), P < 0.001; ebi-a-GCST010777: IVW OR = 1.03 (95% CI, [1.02-1.04]), P < 0.001). The intercepts of MR-Egger yielded no proof for significant directional pleiotropy for either dataset (ebi-a-GCST010776: P = 0.7660; ebi-a-GCST010777: P = 0.6017). Conclusions: The findings suggests that periodontitis and the higher GCF IL-1ß levels is causally related to increase susceptibility of COVID-19. However, given the limitations of our study, the well-designed randomized controlled trials are needed to confirm its findings, which may represent a new non-pharmaceutical intervention for preventing COVID-19.

Ambroxol for the treatment of COVID-19 among hospitalized patients: A multicenter retrospective cohort study.

Ambroxol is a commonly used mucolytic agent principally used to treat respiratory diseases, which may have a role as adjunctive therapy for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but there is lack of evidence about its effectiveness on coronavirus disease-2019 (COVID-19) patients. To study the association between ambroxol use and clinical outcomes among hospitalized patients of COVID-19 infection. We conducted a multicenter retrospective cohort study involving 3,111 patients with confirmed SARS-CoV-2 infection from three hospitals in Wuhan from 19 December 2019 to 15 April 2020, and the primary outcome was in-hospital mortality. COVID-19 patients were classified into ambroxol and non-ambroxol groups based on the administration of ambroxol during hospitalization. Two analyses including propensity score matching (PSM) to obtain a 1:1 balanced cohort and logistic regression were used to control for confounding factors. The average age of 3,111 patients was 57.55 ± 14.93 years old, 127 of them died during hospitalization, and 924 of them used ambroxol. Treatment with ambroxol did not have a significant effect on in-hospital mortality of COVID-19 patients when compared with non-ambroxol in PSM model after adjusting for confounders (8.0% vs. 3.5%, adjusted OR, 1.03 [95% CI, 0.54-1.97], p = 0.936). Adverse events such as nausea/vomiting, headache, and rash were comparable between the two groups. Our results suggest that the use of ambroxol is not significantly associated with in-hospital mortality in COVID-19 patients, which provides evidence for evaluating the effects of ambroxol on COVID-19 patient outcomes and may be helpful for physicians considering medication alternatives for COVID-19 patients.

A comparative study of spike protein of SARS-CoV-2 and its variant Omicron (B.1.1.529) on some immune characteristics.

The emergence of Omicron variant raises great concerns because of its rapid transmissibility and its numerous mutations in spike protein (S-protein). S-protein can act as a pathogen-associated molecular pattern and complement activator as well as antigen. We compared some immune characteristics of trimer S-proteins for wild type (WT-S) and B.1.1.529 Omicron (Omicron-S) to investigate whether the mutations have affected its pathogenicity and antigenic shift. The results indicated that WT-S and Omicron-S directly activated nuclear factor-κB (NF-κB) and induced the release of pro-inflammatory cytokines in macrophages, but the actions of Omicron-S were weaker. These inflammatory reactions could be abrogated by a Toll-like receptor 4 antagonist TAK-242. Two S-proteins failed to induce the production of antiviral molecular interferon-ß. In contrast to pro-inflammatory effects, the ability of two S-proteins to activate complement was comparable. We also compared the binding ability of two S-proteins to a high-titer anti-WT-receptor-binding domain antibody. The data showed that WT-S strongly bound to this antibody, while Omicron-S was completely off-target. Collectively, the mutations of Omicron have a great impact on the pro-inflammatory ability and epitopes of S-protein, but little effect on its ability to activate complement. Addressing these issues can be helpful for more adequate understanding of the pathogenicity of Omicron and the vaccine breakthrough infection.

Development of optimized drug-like small molecule inhibitors of the SARS-CoV-2 3CL protease for treatment of COVID-19.

The SARS-CoV-2 3CL protease is a critical drug target for small molecule COVID-19 therapy, given its likely druggability and essentiality in the viral maturation and replication cycle. Based on the conservation of 3CL protease substrate binding pockets across coronaviruses and using screening, we identified four structurally distinct lead compounds that inhibit SARS-CoV-2 3CL protease. After evaluation of their binding specificity, cellular antiviral potency, metabolic stability, and water solubility, we prioritized the GC376 scaffold as being optimal for optimization. We identified multiple drug-like compounds with <10 nM potency for inhibiting SARS-CoV-2 3CL and the ability to block SARS-CoV-2 replication in human cells, obtained co-crystal structures of the 3CL protease in complex with these compounds, and determined that they have pan-coronavirus activity. We selected one compound, termed coronastat, as an optimized lead and characterized it in pharmacokinetic and safety studies in vivo. Coronastat represents a new candidate for a small molecule protease inhibitor for the treatment of SARS-CoV-2 infection for eliminating pandemics involving coronaviruses.

Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19.

The outbreak of coronavirus disease 2019 (COVID-19) has led to the emergence of global health care. In this study, we aimed to explore the association between drug treatments and the incidence of drug-induced liver injury (DILI) in hospitalized patients with COVID-19. A retrospective study was conducted on 5113 COVID-19 patients in Hubei province, among which 395 incurred liver injury. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models. The results showed that COVID-19 patients who received antibiotics (HR 1.97, 95% CI: 1.55-2.51, p < 0.001), antifungal agents (HR 3.10, 95% CI: 1.93-4.99, p < 0.001) and corticosteroids (HR 2.31, 95% CI: 1.80-2.96, p < 0.001) had a higher risk of DILI compared to non-users. Special attention was given to the use of parenteral nutrition (HR 1.82, 95% CI: 1.31-2.52, p < 0.001) and enteral nutrition (HR 2.71, 95% CI: 1.98-3.71, p < 0.001), which were the risk factors for liver injury. In conclusion, this study suggests that the development of DILI in hospitalized patients with COVID-19 needs to be closely monitored, and the above-mentioned drug treatments may contribute to the risk of DILI.

Epidemic versus economic performances of the COVID-19 lockdown: A big data driven analysis.

Lockdown measures have been a "panacea" for pandemic control but also a violent "poison" for economies. Lockdown policies strongly restrict human mobility but mobility reduce does harm to economics. Governments meet a thorny problem in balancing the pros and cons of lockdown policies, but lack comprehensive and quantified guides. Based on millions of financial transaction records, and billions of mobility data, we tracked spatio-temporal business networks and human daily mobility, then proposed a high-resolution two-sided framework to assess the epidemiological performance and economic damage of different lockdown policies. We found that the pandemic duration under the strictest lockdown is less about two months than that under the lightest lockdown, which makes the strictest lockdown characterize both epidemiologically and economically efficient. Moreover, based on the two-sided model, we explored the spatial lockdown strategy. We argue that cutting off intercity commuting is significant in both epidemiological and economical aspects, and finally helped governments figure out the Pareto optimal solution set of lockdown strategy.

Cardiac Biomarker Abnormalities Are Closely Related to Prognosis in Patients with COVID-19

武漢大学人民医院に入院した新型コロナウイルス感染症の重症患者148例(男性67例、女性81例、平均57.2±17.7歳)を対象に、心筋バイオマーカーと予後との関連性について検討した。患者148例のうち99例(66.9%)は高血圧症、糖尿病、貧血、腎障害、肝障害、慢性閉塞性肺疾患、心血管疾患、悪性腫瘍等の基礎疾患を有していた。患者を転帰に応じて、生存群96例(男性39.6%、平均51.4±16.1歳)と死亡群52例(男性55.8%、平均68.6±14.8歳)の2群に分類した。血中NT-proBNP(基準範囲は450pg/mL未満)は死亡群(1035.46pg/mL)が生存群(81.15pg/mL)より有意に高く、CK-MBも死亡群(2.62ng/mL)が生存群(0.67ng/mL)より有意に高かった(いずれもP<0.001)。心筋トロポニンcTnIは生存群で0.000であったが、死亡群は0.131ng/mLであった。血清ミオグロビンは死亡群(101.83μg/L)が生存群(26.86μg/L)より有意に高かった(P<0.001)。心血管合併症を呈した19例のうち14例が死亡した。

An analytical study of drug utilization, disease progression, and adverse events among 165 COVID-19 patients.

BACKGROUND: The coronavirus disease 2019 (COVID-19) epidemic has lasted for nearly 4 months by this study was conducted. We aimed to describe drug utilization, disease progression, and adverse drug events of COVID-19. METHODS: A retrospective, single-center case series study enrolled 165 consecutive hospitalized COVID-19 patients who were followed up until March 25, 2020, from a designated hospital in Wuhan. Patients were grouped by a baseline degree of severity: non-severe and severe. An analytical study of drug utilization, disease progression, and adverse events (AEs) of COVID-19 was conducted. RESULTS: Of the 165 COVID-19 cases, antivirals, antibacterials, glucocorticoids, and traditional Chinese medicine (TCM) were administered to 92.7%, 98.8%, 68.5%, and 55.2% of patients, respectively. The total kinds of drugs administered to the severe subgroup [26, interquartile range (IQR) 18-39] were 11 more than the non-severe subgroup (15, IQR 10-24), regardless of comorbidities. The 2 most common combinations of medications in the 165 cases were 'antiviral therapy + glucocorticoids + TCM' (81, 49.1%) and 'antiviral therapy + glucocorticoids' (23, 13.9%). Compared with non-severe cases, severe cases received more glucocorticoids (88.5% vs. 66.2%, P=0.02), but less TCM (50.0% vs. 63.3%, P=0.20), and suffered a higher percentage of death (34.6% vs. 7.2%, P=0.001). At the end of the follow-up, 130 (78.8%) patients had been discharged, and 24 (14.5%) died. There were 13 patients (7.9%) who had elevated liver enzymes, and 49 patients (29.7%) presented with worsening kidney function during the follow-up. CONCLUSIONS: Of the 165 COVID-19 patients, the fatality rate remained high (14.5%). Drug utilization for COVID-19 was diverse and generally complied with the existing guidelines. Combination regimens containing antiviral drugs might be beneficial to assist COVID-19 recovery. Additionally, liver and kidney AEs should not be ignored.

Anxiety and depression in allergic rhinitis patients during COVID-19 pandemic in Wuhan, China.

BACKGROUND: During COVID-19 pandemic, many allergic rhinitis (AR) patients stopped their treatment including pharmacotherapy and allergen immunotherapy. OBJECTIVE: This study aimed to investigate the anxiety and depression and general effect of COVID-19 pandemic on AR patients' psychological status in Wuhan, China. METHODS: In October 2019, 222 outpatients suffering from AR in our department and 133 healthy controls were enrolled. All participants were asked to finish the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) questionnaire. The demographic characteristics and the severity of AR symptoms were recorded. In April 2020, the AR patients and healthy controls were re-contacted to finish the questionnaires by telephone or online. The SAS and SDS scores in AR patients and healthy controls and the correlation with other variables were analyzed. RESULTS: For AR patients, the SAS and SDS scores were significantly higher than healthy controls. Meanwhile, the rates of anxiety and depression were 24.8% and 19.4% respectively. The education level and symptoms severity were correlated with SAS and SDS scores. Ninety-eight AR patients and 56 healthy controls finished the questionnaires after COVID-19 pandemic. The AR patients' SAS and SDS scores were lower than before COVID-19 pandemic and were correlated with AR symptom scores. The scores of healthy controls were not different with before COVID-19 pandemic. CONCLUSIONS: The occurrence of anxiety and depression is common in AR patients. Severity of symptoms and low education level are the risk factors causing anxiety and depression. COVID-19 pandemic has no significant negative impact on the AR patients' psychological status.

Clinical characteristics, therapeutic management, and prognostic factors of adult COVID-19 inpatients with hematological malignancies.

Patients with hematological malignancies with immunodeficiency are at high risk for SARS-CoV-2 infection. We retrospective summarized clinical characteristics of coronavirus disease 2019 (COVID-19) inpatients with hematological malignancies, shared treatment experiences, and analysis prognostic factors. Fourteen patients were enrolled. The median duration of viral shedding was 27.5 days in survivors. The median duration of time to death was 13 days in non-survivors. Non-survivors tend to present lower neutrophil count, more imaging finding of bilateral diffuse patch opacities, more undergoing intensive chemotherapy or immunosuppression. Laboratory and image findings were atypical and diverse. COVID-19 inpatients undergoing intensive chemotherapy or immunosuppression might have increased risk of death. The diagnostic value of specific antibody detection is limited. Therefore, adult COVID-19 inpatients with hematological malignancies present atypical, severe symptoms, decreased virus clearance ability, abnormal antibody response and poor outcome. During the epidemic, the pros and cons need to be carefully weighed while selecting the treatment methods.