Clinical value of admission blood glucose level on prognosis of COVID-19 patients

Objective: To explore the clinical value of admission blood glucose level on prognosis of COVID- 19 patients. Methods A total of 420 novel coronavirus pneumonia (COVID-19) patients admitted to Tongji Hospital of Tongji MedicalCollege from January 18, 2020 to February 26, 2020 were selected as the subjects of study. The data of diabetes or not, admissionblood glucose level(GLU), clinical severity grade were collected through the electronic medical record system, and the outcome, which defined as in-hospital motality, was also monitored. The patients were divided into diabetes group and non-diabetes groupin terms of the complication of diabetes, and then, firstly, stratified these two groups into survival subgroup and non-survivalsubgroup in according to the event of in-hospital motality, GLU between these two subgroups were compared. Secondly, according to the clinical severity grade, these two groups were stratified into moderate subgroup, severe subgroup and criticalsubgroup, and GLU among these subgroups were also compared. Thirdly, according to the admission blood glucose level, stratified these two groups into GLU 3.9~7.8 mmol /L subgroup, GLU 7.8~10.0 mmol/L subgroup and GLU>10.0 mmol/Lsubgroup, the in-hospital motality rates among these subgroups were compared. Finally, the multivariate logistic regression wasused to explore whether increased GLU were independent risk factor for in-hospital motality in diabetes group and non-diabetesgroup when adjusted for sex, age and underlying disease. Results In non-diabetes group, compared with Survival subgroup, GLUwas significantly elevated in non-Survival subgroup[6.96(5.95, 8.23)mmol/L vs 5.96 (5.32, 6.92) mmol/L], the difference wasstatistically significant(U=6047.0, P < 0.001), but in diabetes group, there was no significant difference between non-survivalsubgroup and Survival subgroup [12.42(8.41, 18.17) mmol/L vs 9.88 (7.79, 14.02) mmol/L], the difference was statisticallysignificant(U=1 200.5, P=0.059).In Non-diabetes group, GLU elevated remarkably along with the clinical severity gradeincreased, moderate subgroup, severe subgroup, critical subgroup GLU were 5.87(5.24, 6.69) mmol/L, 6.94(5.95, 7.90) mmol/L,9.73 (6.22, 11.64) mmol/L, the difference were statistically significant, respectively(U=723.0~4978.0, all P < 0.01). However indiabetes group, there was no significant difference on GLU when the clinical severity grade increased, moderate subgroup, severesubgroup, critical subgroup GLU were 9.88(7.81, 11.93)mmol/L, 12.42(8.43, 16.94)mmol/L, 11.43(7.89, 18.76)mmol/L, the difference were statistically significant, respectively (U=262.0~946.5, all P>0.05).In non-diabetes group, GLU> 10.0 mmol/L subgroup had the hightest in-hospital motality rate (72.0%) among all three subgroups, the differences were statisticallysignificant(X2=24.607, 9.625, all P < 0.01), when compared between GLU 3.9~7.8 mmol/L subgroup (in-hospital motality rate24.8%) and GLU 7.8~10.0 mmol/L subgroup (in-hospital motality rate 30.0%), there was no significant difference on in-hospitalmotality rate (X2=0.383, P > 0.05). However, in diabetes group, along with GLU increased, it had no significant difference on inhospitalmotality rate, GLU 3.9~7.8 mmol/L subgroup, GLU 7.8~10.0 mmol/L subgroup, GLU> 10.0 mmol/L subgroup, the inhospitalmotality rate were 34.8%, 41.4%, 49.2%, respectively(X2=0.236~1.380, all P> 0.05). Multivariate logistic regressionshowed, in non-diabets group, GLU>10.0 mmol/L was the independent risk factor when adjusted for sex, age and underlyingdisease, odds ratio was 7.969, and 95% confidence interval was 3.022~21.013, but in diabets group.It seemed that GLU>10.0 mmol/L was not the independent risk factor. Conclusion Admission blood glucose is a good predictor for disease severity andoutcome in non-diabetes patients with COVID-19. When admission hyperglycemia occurs, it tends to predict a poor prognosis.

Tissue Specific Age Dependence of the Cell Receptors Involved in the SARS-CoV-2 Infection (preprint)

The coronavirus disease 2019 (COVID-19) pandemic has affected tens of millions of individuals and caused hundreds of thousands of deaths worldwide. Due to its rapid surge, there is a shortage of information on viral behavior and host response after SARS-CoV-2 infection. Here we present a comprehensive, multiscale network analysis of the transcriptional response to the virus. We particularly focus on key-regulators, cell-receptors, and host-processes that are hijacked by the virus for its advantage. ACE2 -controlled processes involve a key-regulator CD300e (a TYROBP receptor) and the activation of IL-2 pro-inflammatory cytokine signaling. We further investigate the age-dependency of such receptors and identify the adipose and the brain as potentially contributing tissues for the disease’s severity in old patients. In contrast, several other tissues in the young population are more susceptible to SARS-CoV-2 infection. In summary, this present study provides novel insights into the gene regulatory organization during the SARS-CoV-2 infection and the tissue-specific age dependence of the cell receptors involved in COVID-19.

A combination regimen by lopinave/litonawe, emtricitabine and tenofovir alafenamide fumarate for treatment of novel coronavirus pneumonia (TARCoV)

Objective: To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia.