Traditional Chinese medicine combined with Moxibustion in the treatment of "long-COVID": A protocol for systematic review and meta-analysis.

BACKGROUND: From the end of 2019 to now, COVID-19 is still prevalent, which poses a great threat to international public health. With the increasing number of people infected, the number of patients with COVID-19 sequelae is also increasing, but there is no specific drug for COVID-19 sequelae. In China, traditional Chinese medicine combined with acupuncture has been widely used in COVID-19 sequelae, but there is still a lack of evidence-based medicine evaluation. The purpose of this study was to evaluate the efficacy and safety of traditional Chinese medicine combined with moxibustion in the treatment of COVID-19 sequelae. METHODS: According to the retrieval strategy, the "long COVID" randomized controlled trial of traditional Chinese medicine combined with moxibustion will be search in eight databases composed of PubMed, Embase, Web of Science, China National knowledge Infrastructure Database, China Biomedical Database and China Science and Technology Journal Database, regardless of publication date or language. The study was screened according to the inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the study. Meta-analysis was carried out using RevMan5.3 and STATA12.0 software. Finally, the level of evidence of the results will be evaluated. RESULTS: This study will evaluate whether traditional Chinese medicine combined with moxibustion can effectively treat the symptoms of COVID-19 sequelae. CONCLUSION: This study will provide evidence whether there is benefit of traditional Chinese medicine combined with moxibustion in the treatment of COVID-19 sequelae. At the same time, our research results will provide a reference for clinical decision-making and guiding development in the future.

Insights into potential mechanisms of asthma patients with COVID-19: A study based on the gene expression profiling of bronchoalveolar lavage fluid.

BACKGROUND: The 2019 novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a major challenge threatening the global healthcare system. Respiratory virus infection is the most common cause of asthma attacks, and thus COVID-19 may contribute to an increase in asthma exacerbations. However, the mechanisms of COVID-19/asthma comorbidity remain unclear. METHODS: The "Limma" package or "DESeq2" package was used to screen differentially expressed genes (DEGs). Alveolar lavage fluid datasets of COVID-19 and asthma were obtained from the GEO and GSV database. A series of analyses of common host factors for COVID-19 and asthma were conducted, including PPI network construction, module analysis, enrichment analysis, inference of the upstream pathway activity of host factors, tissue-specific analysis and drug candidate prediction. Finally, the key host factors were verified in the GSE152418 and GSE164805 datasets. RESULTS: 192 overlapping host factors were obtained by analyzing the intersection of asthma and COVID-19. FN1, UBA52, EEF1A1, ITGB1, XPO1, NPM1, EGR1, EIF4E, SRSF1, CCR5, PXN, IRF8 and DDX5 as host factors were tightly connected in the PPI network. Module analysis identified five modules with different biological functions and pathways. According to the degree values ranking in the PPI network, EEF1A1, EGR1, UBA52, DDX5 and IRF8 were considered as the key cohost factors for COVID-19 and asthma. The H2O2, VEGF, IL-1 and Wnt signaling pathways had the strongest activities in the upstream pathways. Tissue-specific enrichment analysis revealed the different expression levels of the five critical host factors. LY294002, wortmannin, PD98059 and heparin might have great potential to evolve into therapeutic drugs for COVID-19 and asthma comorbidity. Finally, the validation dataset confirmed that the expression of five key host factors were statistically significant among COVID-19 groups with different severity and healthy control subjects. CONCLUSIONS: This study constructed a network of common host factors between asthma and COVID-19 and predicted several drugs with therapeutic potential. Therefore, this study is likely to provide a reference for the management and treatment for COVID-19/asthma comorbidity.

Impact of Adverse Childhood Experiences on Older Adult Poverty: Mediating Role of Depression.

Background: Adverse childhood experiences (ACEs) refer to traumatic events experienced by children in early life, including abuse, neglect, and family dysfunction, which are common worldwide. ACEs are harmful to mental health, and psychological problems can influence personal economic poverty in adulthood. We focused on family dysfunction and discussed the effect of different types of ACEs on poverty and the corresponding mediating effect of depression. Materials and Methods: A total of 9,910 individuals who were 60 years or older from the China Health and Retirement Longitudinal Study in 2014 and 2015 were analysed. The chi-square test was used to compare poverty incidence among subgroups of independent or control variables. Binary logistic regression analysis was used to test the effect of different types of ACEs on depression, and four logistic regression models were established to observe the association between ACEs on older adult poverty and the mediating effect of depression. The path diagram of the direct effect and indirect effect was drawn to test the mediating effect of depression. Results: Early death of father, the male guardian getting upset and witnessing violence of father to mother are the risk factors for older adult poverty, whereas female guardian getting upset, relationship with female guardians and parental quarrel are protective factors for older adult poverty. Furthermore, depression has a partial mediating effect on some factors including early death of father, male guardian getting upset, relationship with female guardian, parental quarrel, and witnessing violence of father to mother. Conclusions: Paternal ACE factors can directly make children more likely to fall into poverty as older adults and can indirectly influence older adult poverty through the partial mediating effect of depression. Assisting poor families, providing psychological counselling, formulating family visit plans, nurturing orphan children under state supervision, and other policies that focus on groups that have experienced paternal ACE events are essential to eliminating the risk factors that influence older adult poverty.

Association Between Dynamic Trends of Functional Disability and Poverty Among People Aged 45 and Over.

BACKGROUND: The disability problem has become prominent with the acceleration of the global aging process. Individual disability is associated with economic conditions and contributes to family poverty. As disability will change over a long period of time and may even show distinct dynamic trends, we aimed to focus on activities of daily living (ADL) and classify functional disability trends. Moreover, we aimed to highlight and analyze the association between functional disability trends and economic conditions and explore the influencing factors. MATERIALS AND METHODS: A total of 11,222 individuals who were 45 years old or older were included in four surveys conducted by the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, and 2018. Samples were analyzed after excluding those with missing key variables. The latent class growth model was used to classify the ADL trends. Two binary logistic regressions were established to observe the association between the ADL trends and follow-up economic conditions or catastrophic health expenditure trends. RESULTS: ADL trends of older adults were classified into improving (25.4%), stabilizing (57.0%), and weakening ADL (17.6%). ADL trend was associated with follow-up poverty (p = 0.002) and catastrophic health expenditure trends (p < 0.001). Compared with the improving ADL trend, the stabilizing ADL may have a negative influence on individuals' economic conditions (OR = 1.175, 95%CI = 1.060-1.303). However, a stabilizing ADL trend was less likely to bring about catastrophic health expenditures (OR = 0.746, 95%CI = 0.678-0.820) compared with an improving ADL trend. CONCLUSION: The improvement of functional disability would make the medical expense burden heavier but would still be beneficial for the prevention of poverty. A significant association was found between socioeconomic factors and poverty. Preventing the older adults from developing disability and illness, improving the compensation level of medical insurance, and optimizing the long-term care insurance and the primary healthcare system can potentially contribute to the prevention of poverty. Meanwhile, focusing on people who are poor at early stages, women, middle-aged, low-educated, and in rural areas is important.

Evolution of COVID-19 in patients with autoimmune rheumatic diseases.

The characteristics of COVID-19 patients with autoimmune rheumatic diseases (AIRD) have rarely been reported. Patients with AIRD have suppressed immune defense function, which may increase their susceptibility to COVID-19. However, the immunosuppressive agents AIRD patients routinely used may be beneficial for protecting the cytokine storm caused by SARS-CoV-2. In this retrospective study, we included all confirmed cases in Huoshenshan Hospital from February 4 to April 9. Data were extracted from electronic medical records and were analyzed for clinical and laboratory features using SPSS (version 25.0). Of 3059 patients, 21 had the comorbidities with systematic lupus erythematosus (SLE) and/or rheumatoid arthritis (RA), including 5 with SLE, 15 with RA, and 1 with Rhupus. The proportion was 57.1% for severe cases, 61.9% for either severe or critical cases, and 4.8% for critical cases. The main manifestations, ARDS and ICU admission rate, as well as the mortality and length of hospital stay of COVID-19 in AIRD patients were similar to COVID-19 patients in the general population. Our preliminary experience shows that patients with AIRD tend to have a higher risk of SARS-CoV-2 infection, and may be at risk for a severe but less likely critical disease course. Further investigation is needed to understand the immunological features of these diseases.

Cytokine storm intervention in the early stages of COVID-19 pneumonia.

Clinical intervention in patients with corona virus disease 2019 (COVID-19) has demonstrated a strong upregulation of cytokine production in patients who are critically ill with SARS-CoV2-induced pneumonia. In a retrospective study of 41 patients with COVID-19, most patients with SARS-CoV-2 infection developed mild symptoms, whereas some patients later developed aggravated disease symptoms, and eventually passed away because of multiple organ dysfunction syndrome (MODS), as a consequence of a severe cytokine storm. Guidelines for the diagnosis and treatment of SARS-CoV-2 infected pneumonia were first published January 30th, 2020; these guidelines recommended for the first time that cytokine monitoring should be applied in severely ill patients to reduce pneumonia related mortality. The cytokine storm observed in COVID-19 illness is also an important component of mortality in other viral diseases, including SARS, MERS and influenza. In view of the severe morbidity and mortality of COVID-19 pneumonia, we review the current understanding of treatment of human coronavirus infections from the perspective of a dysregulated cytokine and immune response.