ABSTRACT
Background The continued spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains an international public health emergency, resulting in a significant global disease burden. The long-term effects of SARS-CoV-2 infection in humans and the long-term prognosis of patients with coronavirus disease 2019 (COVID-19) after discharge remain unclear. We aimed to assess the quality of life (QoL) and sequelae in patients with COVID-19 after discharge from the hospital by conducting multiple follow-up visits to understand the long-term effects of SARS-CoV-2 on patients' health and its possible influencing factors. Methods COVID-19 patients discharged from Huoshenshan Hospital (Wuhan, China) between February 15 and April 5, 2020, were followed up at 6, 9, and 12 months after discharge. They completed questionnaires on postdischarge QoL and sequelae under the guidance of medical staff with professional training. The demographic and clinical characteristics of the COVID-19 patients were analyzed using descriptive statistics. A generalized estimating equation model was used to analyze the QoL-related factors. The χ2 test (or Fisher exact test) and multivariate logistic regression analysis were used to analyze the sequelae and influencing factors. Results A total of 175 patients participated in at least 1 follow-up visit, and 120 completed all 3 follow-up visits. Patients diagnosed with severe and critically ill COVID-19 had worse mental conditions (χ2 = 7.653, P = 0.022) than those with the nonsevere type (not severe or critical) and were more likely to feel fatigued (χ2 = 4.836, P = 0.028). Female patients had a higher risk of sleep disturbance (χ2 = 10.026, P = 0.002) and dyspnea (χ2 = 5.672, P = 0.017) and had more difficulty returning to their original work and life (χ2 = 8.922, P = 0.003) than male patients. Patients with diabetes had a worse appetite (χ2 = 4.669, P = 0.031) and were more prone to sleep disturbance (χ2 = 4.417, P = 0.036) after discharge. The proportion of patients with at least 1 sequela increased from 29.76% (50/168) at 6 months to 51.11% (69/135) at 9 months (χ2 = 14.305, P < 0.001). Compared with the nonsevere type, patients diagnosed with severe and critically ill COVID-19 had an odds ratio (OR) of 4.325 (95% confidence interval [CI], 1.215-15.401) for memory decline. Female patients had an OR of 4.632 (95% CI, 1.716-12.501) for joint or muscle pain. Patients with hypertension had an OR of 3.014 (95% CI, 1.193-7.615) for joint or muscle pain. Conclusion One year after discharge, there were still some patients with varying degrees of decline in QoL and sequelae, which occurred in all follow-up visits. Moreover, QoL and sequelae after discharge were related to sex, clinical classification of COVID-19, and underlying diseases. © Wolters Kluwer Health, Inc. All rights reserved.
ABSTRACT
SARS-CoV-2 continues to accumulate mutations to evade immunity, leading to breakthrough infections after vaccination. How researchers can anticipate the evolutionary trajectory of the virus in advance in the design of next-generation vaccines requires investigation. Here, we performed a comprehensive study of 11,650,487 SARS-CoV-2 sequences, which revealed that the SARS-CoV-2 spike (S) protein evolved not randomly but into directional paths of either high infectivity plus low immune resistance or low infectivity plus high immune resistance. The viral infectivity and immune resistance of variants are generally incompatible, except for limited variants such as Beta and Kappa. The Omicron variant has the highest immune resistance but showed high infectivity in only one of the tested cell lines. To provide cross-clade immunity against variants that undergo diverse evolutionary pathways, we designed a new pan-vaccine antigen (Span). Span was designed by analyzing the homology of 2675 SARS-CoV-2 S protein sequences from the NCBI database before the Delta variant emerged. The refined Span protein harbors high-frequency residues at given positions that reflect cross-clade generality in sequence evolution. Compared with a prototype wild-type (Swt) vaccine, which, when administered to mice, induced serum with decreased neutralization activity against emerging variants, Span vaccination of mice elicited broad immunity to a wide range of variants, including those that emerged after our design. Moreover, vaccinating mice with a heterologous Span booster conferred complete protection against lethal infection with the Omicron variant. Our results highlight the importance and feasibility of a universal vaccine to fight against SARS-CoV-2 antigenic drift.
ABSTRACT
Zhejiang Province was approved to establish the first batch of national digital economy innovation and development pilot zones, the development trend in five years will focus on digital industrialization, industry digitization and governance digitization. Cross-border e-commerce is one of the important components of the digital economy, has experienced rapid development in recent years, especially during the COVID-19 pandemic. As the largest small commodity wholesale market in the world and the only county-level city in the approved comprehensive test area of cross-border e-commerce, Yiwu should pay more attention to the integration of online and offline markets to promote the steady and healthy development. By analyzing the pain points and difficulties in the development of traditional cross-border e-commerce, this paper discusses the ways to realize the transformation and upgrading of Yiwu's foreign trade and accelerate the transformation and development of regional economy, to promote mass entrepreneurship and innovation. Strive to build a new mechanism for the integrated development of online and offline marketing channels of cross-border e-commerce based on big data and promote the faster and more orderly development of cross-border e-commerce industry in central and western Zhejiang and even surrounding areas in the digital economy era. © 2022 The Authors. Published by Elsevier B.V.
ABSTRACT
Recently, the pandemic of Coronavirus disease 2019 (COVID-19) highlights the great potential of remote health for resisting infectious diseases. The remote healthcare methodologies have achieved significant development based on reliable and low-latency transmissions of 5G. In remote health monitoring, the Internet of Things (IoT)-based physical monitoring devices need to transmit collected physical data in a real time and highly reliable manner to ensure accurate monitoring of patients. However, due to the unreliability of wireless link and the latency of data queue, it is a challenging issue to achieve high reliability communication and low delay transmission at the same time. Meanwhile, the available bandwidth is limited and the cost of renting spectrum is not negligible. Thus, it is essential for the devices to reduce communication costs while ensuring the efficient data transmission. Toward this end, our goal is to minimize the total costs of leasing bandwidth by jointly optimizing the access link and backhaul transmission, subject to the delay and reliability constraints. Considering the requirements of access link and queue together, a cost minimization problem is formulated, which is non-linear and non-convex and is hard to solve straightforwardly. Through problem equivalent transforming, a gradient descent-based algorithm is proposed to find a suboptimal solution. Simulation results validate the performance through cost, reliability, delay and those under harsh conditions.
ABSTRACT
RATIONALE: The long-term impact of severe COVID-19 on pulmonary function, chest high-resolution CT (HRCT) pictures, and related physiological characteristics have not been understood clearly. METHODS: 25 survivors with confirmed severe COVID-19 were evaluated pulmonary function, HRCT, and health-related quality of life at seven months after discharge. The data during hospitalization were analyzed retrospectively. RESULTS: Table1 summarized the characteristics of all 25 patients at seven months after discharge. Patients with abnormal CT at seven months (n = 10) had lower albumin level (29.5[26.5-31.2] vs 32.4[30.0-36.5], p = 0.016), higher CT peak scores (24[15-24] vs 13[9-18], p = 0.002), longer cumulative days of receiving glucocorticoids (12[10-14] vs 6[0-11], p = 0.013) compared with patients with normal or basically normal CT. Then survivors were categorized as patients with abnormal DLCO and DLCO/VA, abnormal DLCO but normal DLCO/VA, and normal DLCO and DLCO/VA (n = 7, 5, and 13 respectively). Abnormal DLCO and DLCO/VA group had lower serum IL-2R level (433[326-514] vs 1218[581-1754] vs 710[562-927], p = 0.005), IL-8 level (7.20[3.15-13.25] vs 33.40[23.25-121.35] vs 17.50[6.63-47.48], p = 0.018), TNF-α level (5.80[4.80-7.80] vs 10.10[8.60-11.90] vs 9.00[7.73-12.70], p = 0.010), but higher PCT level (0.08[0.04-0.10] vs 0.03[0.03-0.10] vs 0.03[0-0.04], p = 0.036) compared with other two groups. Correlation analyses indicated that, CT scores after discharge positively correlated with age, PCT level, LDH level, cumulative days of receiving glucocorticoids, total dosage of glucocorticoids used, and CT peak scores (R = 0.409, 0.426, 0.479, 0.537, 0.528, and 0.738 respectively, p = 0.042, 0.043, 0.015, 0.007, 0.008, and < 0.001 respectively), negatively correlated with albumin level (R = -0.561, p = 0.004). DLCO% negatively correlated with total dosage of glucocorticoids used (R = -0.410, p = 0.047). DLCO/VA% positively correlated with BMI, serum IL-2R, and TNF-α level (R= 0.427, 0.560, and 0.525 respectively, p = 0.033, 0.016, and 0.025 respectively), negatively correlated with PCT level (R = -0.467, p = 0.025). Multiple linear regression analysis found that age, PCT level, and CT peak scores were associated with CT scores after discharge (β = 0.290, 0.302, and 0.428 respectively, p = 0.049, 0.030, and 0.036 respectively). BMI and PCT level were associated with DLCO/VA% (β = 0.536 and -0.463 respectively, p = 0.023 and 0.028 respectively). CONCLUSIONS: Radiological and functional impairment were still found in a considerable proportion of survivors with severe COVID-19. These statuses may be related to the severity of the disease and the level of inflammation.
ABSTRACT
To investigate the material basis and mechanism of Liupao tea on preventing COVID-19 by network pharmacology and molecular docking. The active ingredients and targets of Liupao tea were searched through the literature and the TCMSP databases and the network between the two was built by Cytoscape 3. 7. 1. Then using GenCards platform to predict the disease targets,mapping the common targets between Liupao tea and disease. The common targets were imported into the STRING database for exploring the protein-protein interaction. Core targets were enriched by gene ontology (GO) enrichment analysis and KEGG (kyoto encyclopedia of genes and genomes) pathway enrichment analysis using DAVID database etc.. Finally,the screened active components were docked with the receptor protein SARS-CoV-2 3CL hydrolase (Mpro). Six active ingredients of Liupao tea were screened,such as (-)-epigallocatechin gallate (EGCG),(+)-catechin,(-)-eatechin gallate, α-spinasterol,pelargonidin chloride and squalene,and 156 targets were identified. Among them, there were 112 common targets and 38 core targets with COVID-19. GO enrichment analysis (P<0. 01) involved lipopolysaccharide,cell response to hypoxia, etc.. And the KEGG pathway enrichment analysis (P<0. 01)was conducted to obtain the HIF-1,IL-17,T cell receptor and other signaling pathways associated with COVID-19. The results of molecular docking showed that the active ingredients of Liupao tea were well bound to the receptor protein Mpro. The active ingredients of Liupao tea may control HIF-1,IL-17,T cell receptors signaling pathways by binding Mprohydrolase and acting on inflammation and immune related targets such as MAPK1,TNF to prevent COVID-19. The EGCG of Mproactivity was determined,and the IC50was 3. 4 μmol/L,which confirmed that EGCG was a certain inhibition effect on Mpro © 2020 China Pharmaceutical University. All rights reserved.