Association of coagulation disturbances with severity of COVID-19: a longitudinal study.

OBJECTIVES: Coagulation dysfunction is an evident factor in the clinical diagnosis and treatment of patients with coronavirus disease 2019 (COVID-19), appearing even in COVID-19 patients with normal inflammation indices. Therefore, this study aimed to analyze the characteristics of coagulation function indices in COVID-19 patients to investigate possible mechanisms through the comparison of non-severe and severe COVID-19 patients. METHODS: We included 143 patients whose clinical characteristics, coagulation function, and other indices such as inflammatory factors were collected and compared based on disease severity. RESULTS: Activated partial thromboplastin time (APTT), D-dimer, and fibrinogen levels were evidently higher in the severe group than in the non-severe group. Among non-severe COVID-19 patients, the aforementioned indicators depicted increasing trends, but the fibrinogen level alone was higher than normal. However, in severe COVID-19 patients, values of all three indices were higher than normal. In severe COVID-19 patients, fibrinogen and D-dimer were correlated with several inflammation indices during the early stage of the disease. However, no correlation between fibrinogen and inflammatory factors was observed in non-severe COVID-19 patients at any time point. DISCUSSION: Results revealed that the hypercoagulability tendency of severe COVID-19 patients was more evident. The relationship between coagulation function and inflammatory factors showed that changes in coagulation function in severe COVID-19 patients may be related to abnormal increase in inflammatory factors at an early stage; however, in non-severe COVID-19 patients, there might be other factors leading to abnormal coagulation. CONCLUSION: Inflammatory factors were not the only cause of abnormal coagulation function in COVID-19 patients.

A Security Awareness and Protection System for 5G Smart Healthcare Based on Zero-Trust Architecture.

The key features of 5G network (i.e., high bandwidth, low latency, and high concurrency) along with the capability of supporting big data platforms with high mobility make it valuable in coping with emerging medical needs, such as COVID-19 and future healthcare challenges. However, enforcing the security aspect of a 5G-based smart healthcare system that hosts critical data and services is becoming more urgent and critical. Passive security mechanisms (e.g., data encryption and isolation) used in legacy medical platforms cannot provide sufficient protection for a healthcare system that is deployed in a distributed manner and fail to meet the need for data/service sharing across "cloud-edge-terminal" in the 5G era. In this article, we propose a security awareness and protection system that leverages zero-trust architecture for a 5G-based smart medical platform. Driven by the four key dimensions of 5G smart healthcare including "subject" (i.e., users, terminals, and applications), "object" (i.e., data, platforms, and services), "behavior," and "environment," our system constructs trustable dynamic access control models and achieves real-time network security situational awareness, continuous identity authentication, analysis of access behavior, and fine-grained access control. The proposed security system is implemented and tested thoroughly at industrial-grade, which proves that it satisfies the needs of active defense and end-to-end security enforcement of data, users, and services involved in a 5G-based smart medical system.

[Development, operational dilemma and tentative idea for construction mechanism of fever clinic in China].

Establishing fever clinic was an important achievement of the fight against severe acute respiratory syndrome (SARS) in 2003, and played an important role in the subsequent outbreaks of H1N1, H7N9 and Middle East respiratory syndrome (MERS). Fever clinics have significant emergency characteristics, but there are no rescue conditions in the fever clinics. Consequently, the problem of establishment and management of fever clinics is still outstanding. Based on the development of fever clinics, this paper analyzes the operational dilemma of fever clinics, explores the measures of establishment and management of fever clinics, and constructs the operational mechanism of fever clinics in order to provide the basis for the emergency management system of public health emergencies, which is suitable for Chinese health system.