Predictive value of immunoglobulin G, activated partial thromboplastin time, platelet, and indirect bilirubin for delayed viral clearance in patients infected with the Omicron variant.

Background: Omicron is the recently emerged highly transmissible severe acute respiratory syndrome coronavirus 2 variant that has caused a dramatic increase in coronavirus disease-2019 infection cases worldwide. This study was to investigate the association between demographic and laboratory findings, and the duration of Omicron viral clearance. Methods: Approximately 278 Omicron cases at the Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine were retrospectively analyzed between August 11 and August 31, 2022. Demographic and laboratory data were also collected. The association between demographics, laboratory findings, and duration of Omicron viral clearance was analyzed using Pearson correlation analysis and univariate and multivariate logistic regression. Results: Univariate logistic regression analyses showed that a prolonged viral clearance time was significantly associated with older age and lower immunoglobulin (Ig) G and platelet (PLT) levels. Using multinomial logistic regression analyses, direct bilirubin, IgG, activated partial thromboplastin time (APTT), and PLT were independent factors for longer viral shedding duration. The model combining direct bilirubin, IgG, APTT, and PLT identifies patients infected with Omicron whose viral clearance time was ≥7 days with 62.7% sensitivity and 83.4% specificity. Conclusion: These findings suggest that direct bilirubin, IgG, PLT, and APTT are significant risk factors for a longer viral shedding duration in patients infected with Omicron. Measuring levels of direct bilirubin, IgG, PLT, and APTT is advantageous to identify patients infected with Omicron with longer viral shedding duration.

Factors Affecting Self-Harm- or Violence-Related Urgent Psychiatric Consultation During the COVID-19 Pandemic in Taiwan.

Purpose: People's health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals. Patients and Methods: We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4-18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded. Results: We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs. Conclusion: Patient's demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic.

Visual fields in glaucoma: Where are we now?

Visual fields are an integral part of glaucoma diagnosis and management. COVID has heightened the awareness of the potential for viral spread with the practice of visual fields modified. Mask artefacts can occur due to fogging of the inferior rim of the trail lens. Fortunately, the risk of airborne transmission when field testing is low. The 24-2c may be useful to detect early disease and the 10-2 more sensitive to detect advanced loss. The SITA faster test algorithm is able to reduce testing time thereby improving clinic efficiency, however, may show milder results for moderate or severe glaucoma. The technician has an important role of supervising the visual field performance to achieve reliable output. Home monitoring can provide earlier detection of progression and thus improve monitoring of glaucoma as well as reduce the burden of in-clinic assessments. Artificial Intelligence has been found to have high sensitivity and specificity compared to expert observers in detecting field abnormalities and progression as well as integrating structure with function. Although these advances will improve efficiency and guide accuracy, there will remain a need for clinicians to interpret the results and instigate management.

GS-2: A Novel Broad-Spectrum Agent for Environmental Microbial Control.

The environmental control of microbial pathogens currently relies on compounds that do not exert long-lasting activity on surfaces, are impaired by soil, and contribute to the growing problem of antimicrobial resistance. This study presents the scientific development and characterization of GS-2, a novel, water-soluble ammonium carboxylate salt of capric acid and L-arginine that demonstrates activity against a range of bacteria (particularly Gram-negative bacteria), fungi, and viruses. In real-world surface testing, GS-2 was more effective than a benzalkonium chloride disinfectant at reducing the bacterial load on common touch-point surfaces in a high-traffic building (average 1.6 vs. 32.6 CFUs recovered from surfaces 90 min after application, respectively). Toxicology testing in rats confirmed GS-2 ingredients were rapidly cleared and posed no toxicities to humans or animals. To enhance the time-kill against Gram-positive bacteria, GS-2 was compounded at a specific ratio with a naturally occurring monoterpenoid, thymol, to produce a water-based antimicrobial solution. This GS-2 with thymol formulation could generate a bactericidal effect after five minutes of exposure and a viricidal effect after 10 min of exposure. Further testing of the GS-2 and thymol combination on glass slides demonstrated that the compound retained bactericidal activity for up to 60 days. Based on these results, GS-2 and GS-2 with thymol represent a novel antimicrobial solution that may have significant utility in the long-term reduction of environmental microbial pathogens in a variety of settings.

Emerging technologies of 3D printing and mHealth in COVID-19 immunity and regenerative dentistry.

The ongoing COVID-19 pandemic highlights the importance of developing point-of-care (POC) antibody tests for monitoring the COVID-19 immune response upon viral infection or following vaccination, which requires three key aspects to achieve optimal monitoring, including 3D printed POC device, mobile health, and non-invasive sampling. As a critical tissue engineering concept, additive manufacturing (3D printing) enables accurate control over the dimensional and architectural features of the devices. Mobile health (mHealth) refers to use of portable digital devices, such as smartphones, tablet computers, and fitness and medical wearables, to support health, which facilitates contact tracing, and telehealth consultations during the pandemic. Compared to invasive biosample - blood, saliva is of great importance in the spread and surveillance of COVID-19 as a non-invasive diagnostic method for virus detection and immune status monitoring. However, investigations into 3D printed POC antibody tests and mHealth using non-invasive saliva is relatively limited. and further exploration of 3D-printed antibody POC tests and mHealth applications to monitor antibody production either for disease onset or immune response following vaccination is warranted. This review briefly describes the SARS-CoV-2 virus and immune response after infection and vaccination, then discusses current widely used binding antibody tests using blood samples and enzyme-linked immunosorbent assays on 2D microplates before focusing upon emerging POC technological platforms, such as field-effect transistor biosensors, lateral flow assay, microfluidics, and additive manufacturing for fabricating immunoassays, and the possibility of their combination with mHealth. This review proposes that non-invasive biofluid sampling combined with 3D POC antibody tests and mHealth technologies is a promising and novel approach for POC detection and surveillance of SARS-CoV-2 immune response. Furthermore, as key concepts in Dentistry, the application of 3D printing and mHealth was also included to facilitate the appreciation of cutting-edge techniques in regenerative dentistry. This review highlights the potential of 3D printing and mHealth in both COVID-19 immunity monitoring and regenerative dentistry.

Posttraumatic stress disorder symptoms among Chinese college students following the COVID-19 outbreak.

Objective: This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms in college students 1 month after the lockdown of Wuhan to identify possible risk factors for PTSD symptoms in a cross-sectional study. Methods: Out of 10,502 who responded, 9,274 students impacted by the COVID-19 pandemic were included in our study. PTSD symptoms was evaluated by the Impact of Event Scale-revised (IES-R). Anxiety/depression symptoms were evaluated by the Kessler Psychological Distress Scale (K10). Personality traits, coping style, and social support were assessed by the Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC), the Simplified Coping Style Questionnaire (SCSQ), and the Social Support Rating Scale (SSRS). Logistic regression analysis was utilized to further explore risk factors for PTSD symptoms. Results: More than 1 month after the COVID-19 outbreak, 13.1% of college students developed PTSD symptoms, indicating that COVID-19 associated stressful experiences were connected with PTSD symptoms. After the COVID-19 outbreak, subjects with symptomatologic PTSD symptoms were more likely to experience strained relationships with their family, to have close contact with COVID-19 patients and to drop out of college. The logistic regression model demonstrated the association factors of PTSD symptoms. Neuroticism, psychoticism and an avoidant coping style were associated with increased risk for PTSD symptoms, while an active coping style was protective against PTSD symptoms during this pandemic. Conclusion: The results showed that PTSD symptoms was prevalent in Chinese college students 1 month after the COVID-19 outbreak. Effective psychological support work should be carried out accordingly.

Neutropenia after the coadministration of clozapine and nirmatrelvir-ritonavir in a patient with SARS-CoV-2 infection: A case report with a literature review.

Background: Schizophrenia is considered one of the major risk factors for mortality from SARS-CoV-2 infection. Early antiviral treatment is important to decrease the risk of mortality. Currently, Paxlovid (nirmatrelvir-ritonavir) has been widely used in SARS-CoV-2 patients with risk factors. However, drug-drug interactions with anti-psychotics are prominent and complicated. Case presentation: We report a clozapine-treated patient with SARS-CoV-2 infection who developed neutropenia after coadministration with Paxlovid. In this case, clozapine was used for over 15 years, without neutropenia development. However, severe neutropenia (absolute neutrophil count = 523/µl) developed 3 days after the coadministration of Paxlovid 2 doses per day, valproic acid 1,000 mg per day and clozapine 100 mg per day. The development of neutropenia may be attributed to the complicated interaction among Paxlovid, SARS-CoV-2 infection, valproic acid, fluvoxamine and clozapine. Conclusions: Neutropenia is a rare but life-threatening event if a concomitant infection occurs. The risk may increase during SARS-CoV-2 infection and the coadministration of clozapine and Paxlovid. Although the exact causes of neutropenia in this patient are not fully clear, the white blood cell count and absolute neutrophil count should be closely monitored during the administration of Paxlovid in clozapine-treated patients with SARS-CoV-2 infection.

Offshore Bridge Detection in Polarimetric SAR Images Based on Water Network Construction Using Markov Tree

It is difficult to detect bridges in synthetic aperture radar (SAR) images due to the inherent speckle noise of SAR images, the interference generated by strong coastal scatterers, and the diversity of bridge and coastal terrain morphologies. In this paper, we present a two-step bridge detection method for polarimetric SAR imagery, in which the probability graph model of a Markov tree is used to build the water network, and bridges are detected by traversing the graph of the water network to determine all adjacent water branch pairs. In the step of the water network construction, candidate water branches are first extracted by using a region-based level set segmentation method. The water network is then built globally as a tree by connecting the extracted water branches based on the probabilistic graph model of a Markov tree, in which a node denotes a single branch and an edge denotes the connection of two adjacent branches. In the step of the bridge detection, all adjacent water branch pairs related to bridges are searched by traversing the constructed tree. Each bridge is finally detected by merging the two contours of the corresponding branch pair. Three polarimetric SAR data acquired by RADARSAT-2 covering Singapore and Lingshui, China, and by TerraSAR-X covering Singapore, are used for testing. The experimental results show that the detection rate, the false alarm rate, and the intersection over union (IoU) between the recognized bridge body and the ground truth are all improved by using the proposed method, compared to the method that constructs a water network based on water branches merging by contour distance.

Impact of COVID-19 by Pandemic Wave among Patients with Gastroenterology Symptoms in the Emergency Departments at a Medical Center in Taiwan.

The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack periods of the pandemic in Taiwan. This retrospective observational study was conducted at a referral medical center in northern Taiwan. We recorded the number of weekly ED visits for GI bleeding, AGE, and constipation from 2019 to 2021. We then compared the baseline period (calendar weeks 4-18 and 21-31, 2019) with two peak pandemic periods (period 1, calendar weeks 4-18, 2020; period 2, calendar weeks 21-31, 2021) and their corresponding slack periods. The decline in the number of ED visits during the two peak pandemic periods for GI bleeding (-18.4% and -30.2%) were not as substantial as for AGE (-64.1% and -76.7%) or for constipation (-44.4% and -63.6%), but GI bleeding cases were still significantly lower in number relative to the baseline. During the slack period, the number of ED visits for all three diagnoses rebounded but did not exceed the baseline. Our study revealed that there was a significant decline of GI complaint during the pandemic. This phenomenon was more prominent in nonemergency complaints (AGE and constipation) and less prominent in serious complaints (GI bleeding).

Artificial intelligence against the first wave of COVID-19: evidence from China.

BACKGROUND: The COVID-19 pandemic unexpectedly broke out at the end of 2019. Due to the highly contagious, widespread, and risky nature of this disease, the pandemic prevention and control has been a tremendous challenge worldwide. One potentially powerful tool against the COVID-19 pandemic is artificial intelligence (AI). This study systematically assessed the effectiveness of AI in infection prevention and control during the first wave of COVID-19 in China.  METHODS: To better evaluate the role of AI in a pandemic emergency, we focused on the first-wave COVID-19 in the period from the early December 2019 to the end of April 2020 across 304 cities in China. We employed three sets of dependent variables to capture various dimensions of the effect of AI: (1) the time to the peak of cumulative confirmed cases, (2) the case fatality rate and whether there were severe cases, and (3) the number of local policies for work and production resumption and the time span to having the first such policy. The main explanatory variable was the local AI development measured by the number of AI patents. To fit the features of different dependent variables, we employed a variety of estimation methods, including the OLS, Tobit, Probit, and Poisson estimations. We included a large set of control variables and added interaction terms to test the mechanisms through which AI took an effect. RESULTS: Our results showed that AI had highly significant effects on (1) screening and detecting the disease, and (2) monitoring and evaluating the epidemic evolution. Specifically, AI was useful to screen and detect the COVID-19 in cities with high cross-city mobility. Also, AI played an important role for production resumption in cities with high risk to reopen. However, there was limited evidence supporting the effectiveness of AI in the diagnosis and treatment of the disease. CONCLUSIONS: These results suggested that AI can play an important role against the pandemic.

PBL teaching in ultrasonography resident standardization training in the COVID-19 pandemic.

OBJECTIVE: To study the effect of the problem-based learning (PBL) method in ultrasonography (US) resident standardization training during the COVID-19 pandemic. METHODS: Fifty residents were divided into two groups to participate in a 30-day US training program. The residents in the observation group underwent PBL combined with the lecture-based learning (LBL) method, while the residents in the control group experienced the LBL method alone, with 25 residents in each group. A basic theoretical test, practical examination, and questionnaire were used to evaluate the teaching effect of the PBL + LBL method and the LBL method alone. RESULTS: The basic theoretical pretest score of the observation group was not significantly different from that of the control group. However, the posttest theoretical score and practical score were significantly higher in the observation group than in the control group (P < 0.01). The results of the questionnaire showed that the resident satisfaction level in the observation group with PBL combined with the LBL method was 96%, which was significantly higher than that of the control group with the LBL method alone (80%) (P < 0.05). CONCLUSION: The combination of PBL with the LBL method has obvious advantages over the LBL method alone in regard to the training of US residents during the COVID-19 pandemic.

Mask Wearing Detection Based on Inceptionv4 and Multi-Scale Retinex Image Enhancement Algorithm

The novel coronavirus is a contagious virus with a high mortality rate, and the international health emergency due to COVID-19 has never stopped since the outbreak, due to this situation, wearing masks has become a basic recommended public epidemic prevention approach for many countries. In the current shortage of medical human resources, we urgently need a non-artificial mask-wearing detection method. In this paper, the multi-scale Retinex algorithm is involved as the preprocessing step of the input image. The mask-wearing detection is based on the InceptionV4 convolutional neural network model. During the experiment, we compared and verified the superiority of the Inception part of the InceptionV4 model compared with the Stem structure of the GoogLenet model, and from LFW (Labeled Faces in the Wild), RMFD (Real-World-Masked-Face-Dataset) more than 10,000 samples were selected from the public datasets for model training. Finally, the precise rate reaches 97.3 %.

Impact of COVID-19 by Pandemic Wave among Patients with Gastroenterology Symptoms in the Emergency Departments at a Medical Center in Taiwan

The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack periods of the pandemic in Taiwan. This retrospective observational study was conducted at a referral medical center in northern Taiwan. We recorded the number of weekly ED visits for GI bleeding, AGE, and constipation from 2019 to 2021. We then compared the baseline period (calendar weeks 4–18 and 21–31, 2019) with two peak pandemic periods (period 1, calendar weeks 4–18, 2020;period 2, calendar weeks 21–31, 2021) and their corresponding slack periods. The decline in the number of ED visits during the two peak pandemic periods for GI bleeding (−18.4% and −30.2%) were not as substantial as for AGE (−64.1% and −76.7%) or for constipation (−44.4% and −63.6%), but GI bleeding cases were still significantly lower in number relative to the baseline. During the slack period, the number of ED visits for all three diagnoses rebounded but did not exceed the baseline. Our study revealed that there was a significant decline of GI complaint during the pandemic. This phenomenon was more prominent in nonemergency complaints (AGE and constipation) and less prominent in serious complaints (GI bleeding).

Effect of the COVID-19 Pandemic on Emergency Department Visits of Patients with an Emergent or Urgent Diagnosis.

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, visits to emergency department (ED) have significantly declined worldwide. The purpose of this study was to identify the trend of visits to ED for different diseases at the peak and slack stages of the epidemic. Patients and Methods: This was a retrospective observational study conducted in a tertiary referral medical center in northern Taiwan. We recorded weekly ED visits for myocardial infarction with or without ST-elevation (STEMI or NSTEMI), out-of-hospital cardiac arrest (OHCA), acute stroke, and congestive heart failure from 2016 to 2021. We compared the local epidemic peak periods (calendar weeks 4-18, 2020 and calendar weeks 21-31, 2021) and its corresponding slack periods (calendar weeks 4-18, 2021 and calendar weeks 21-31, 2020) with the baseline period (2016-2019) using Mann-Whitney test to identify the difference. Results: We observed a significant decline in ED visits (median [Q1, Q3]) during the epidemic for OHCA (6 [5, 7] and 5 [4, 6], p = 0.046, for baseline and peak period, respectively, in week 4-18), acute stroke (41.5 [38, 47] and 35 [28, 39], p < 0.001, in week 4-18, 40 [35, 45] and 35 [28, 40], p = 0.039, in week 21-31) and CHF (28 [24.25, 33] and 19 [12, 23], p < 0.001, in week 4-18, 18 [16, 23] and 13 [11, 16], p = 0.001, in week 21-31). Significant difference was not observed in patients with NSTEMI and STEMI in both week 4-18 and 21-31, and cardiac arrest in week 21-31. There was a rebound in ED visits in the slack period. Conclusion: This study revealed that ED visits significantly declined during the COVID-19 epidemic and rebounded in the slack period. The trend was significant for acute stroke and heart failure but was relatively less prominent effect for emergent events such as cardiac arrest or myocardial infarction.

Changes in self-harm- and violence-related urgent psychiatric consultation in the emergency department during the different stages of the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic significantly affected emergency department (ED) visits and urgent psychiatric consultation (UPC) seeking behavior in EDs. Our study explored the changes in UPCs during and after the pandemic peak. METHODS: This retrospective observational study evaluated UPCs in the ED of a referral medical center in Taiwan, where treated both physical and psychiatric complaints. We defined the COVID-19 pandemic peak period as calendar week 4-18, 2020. The corresponding baseline as calendar week 4-18, 2019, and the slack period as week 4-18, 2021. The total number of UPCs, patient demographic data such as sex and age of the patients seen, the referral system (whether police or emergency medical service [EMS] or other sources), and the chief complaint (self-harm or violence) were recorded. RESULTS: Compared with the baseline period, a significant decline in UPCs was observed in the pandemic peak period, and a rebound was observed in the slack period, with the median [IQR] Q1, Q3 values of 22 [18, 26], 12 [10, 17]), and 16 [15, 23], respectively. We observed significantly few men (34.9% vs 45.2%) and less violence (10.2% vs 17.6%) in the peak period compared with in the baseline period, but no significant difference was found compared with the slack period. Throughout the pandemic, younger patients (41.8 ± 17.4 in 2019, 39.2 ± 18.5 [p = 0.121] in 2020, and 35.6 ± 17.2 [p < 0.001] in 2021), higher proportions of police/EMS referral (38.7% in 2019, 41.9% [p = 0.473] in 2020, and 51.9% [p = 0.001] in 2021) and self-harm-related complaints (57% in 2019, 62.4% [p = 0.233] in 2020, and 64.9% [p = 0.049] in 2021) was noted among UPC seekers during the pandemic. However, the proportion of violence-related UPCs (17.6% in 2019, 10.2% [p = 0.023] in 2020, and 12.3% [p = 0.072] in 2021) declined. CONCLUSIONS: This study found that UPCs changed throughout the pandemic. This result raises the concern that mental health needs are masked during the pandemic.

A multitope SARS-CoV-2 vaccine provides long-lasting B cell and T cell immunity against Delta and Omicron variants.

BackgroundThe Delta and Omicron variants of SARS-CoV-2 are currently responsible for breakthrough infections due to waning immunity. We report phase I/II trial results of UB-612, a multitope subunit vaccine containing S1-RBD-sFc protein and rationally designed promiscuous peptides representing sarbecovirus conserved helper T cell and cytotoxic T lymphocyte epitopes on the nucleocapsid (N), membrane (M), and spike (S2) proteins.MethodWe conducted a phase I primary 2-dose (28 days apart) trial of 10, 30, or 100 µg UB-612 in 60 healthy young adults 20 to 55 years old, and 50 of them were boosted with 100 µg of UB-612 approximately 7 to 9 months after the second dose. A separate placebo-controlled and randomized phase II study was conducted with 2 doses of 100 µg of UB-612 (n = 3,875, 18-85 years old). We evaluated interim safety and immunogenicity of phase I until 14 days after the third (booster) dose and of phase II until 28 days after the second dose.ResultsNo vaccine-related serious adverse events were recorded. The most common solicited adverse events were injection site pain and fatigue, mostly mild and transient. In both trials, UB-612 elicited respective neutralizing antibody titers similar to a panel of human convalescent sera. The most striking findings were long-lasting virus-neutralizing antibodies and broad T cell immunity against SARS-CoV-2 variants of concern (VoCs), including Delta and Omicron, and a strong booster-recalled memory immunity with high cross-reactive neutralizing titers against the Delta and Omicron VoCs.ConclusionUB-612 has presented a favorable safety profile, potent booster effect against VoCs, and long-lasting B and broad T cell immunity that warrants further development for both primary immunization and heterologous boosting of other COVID-19 vaccines.Trial RegistrationClinicalTrials.gov: NCT04545749, NCT04773067, and NCT04967742.FundingUBI Asia, Vaxxinity Inc., and Taiwan Centers for Disease Control, Ministry of Health and Welfare.

Epidemiological Study and Clinical Characterization of COVID-19 Cases in Xuzhou, China

In this paper, an epidemiological study was performed by focusing on all confirmed patients with COVID-19 in Xuzhou, a prefecture-level city, and a transportation hub with 10.44 million population in the east region of China. The median age of the patients is 42-year-old and 45.57% are male;25 cases (31.65%) are imported. 23 cases (29.11%) were confirmed between January 26 to 31, 2020 while 56 cases (70.89%) were from February 1 to 16, 2020. Among the ten administrative divisions of Xuzhou city, Suining county (n=31) and Pizhou City (n=15) have the most cases while Tongshan district has none. A representative familial cluster with 6 cases was analyzed in detail in order to get a better understanding of the transmission routes of the virus. Furthermore, we performed a retrospective, single-centre study of 41 COVID-19 patients at Xuzhou Infectious Diseases Hospital in terms of clinical findings, which provided an insightful understanding of the disease.

Nitric Oxide Inhalation Therapy Attenuates Postoperative Hypoxemia in Obese Patients with Acute Type A Aortic Dissection.

Objective: To investigate the differences between inhaled nitric oxide (iNO) treatment and conventional therapy in the treatment of postoperative hypoxemia in obese patients with acute type A aortic dissection (ATAAD). Methods: ATAAD patients diagnosed and treated with emergency surgery in our hospital from June 2017 to December 2019 were retrospectively analyzed. Patients with postoperative hypoxemia were divided into the iNO group and control group. Propensity score matching was used to analyze clinical characteristics and results of the two groups. Results: A total of 218 ATAAD patients with BMI ≥ 25 were treated with surgery. Among them, 115 patients developed refractory hypoxemia (64 in the control group and 51 in the iNO group). Patients in the iNO group had significantly shorter invasive mechanical ventilation time, intensive care unit (ICU) stay, and hospital stay. After 6 h of iNO treatment, the PaO2/FiO2 ratio in the iNO group increased significantly, and this ratio was higher than that in the control group at 6, 12, 24, 48, and 72 h after treatment. Conclusion: Low-dose iNO could improve oxygenation and shorten mechanical ventilation and ICU stay in patients with hypoxemia after ATAAD surgery, but without significant side effects or increase in postoperative mortality or morbidity. These findings provide a basis for a randomized multicenter controlled trial to assess the efficacy of iNO in the treatment of hypoxemia after ATAAD surgery.