Risk factors analysis on the death of COVID‑19 patients combined with diabetes mellitus

Objective: To investigate the risk factors for death in COVID‑19 patients combined with diabetes mellitus. Methods: A retrospective analysis on COVID‑19 patients combined with diabetes mellitus admitted to Renmin Hospital of Wuhan University from February 2020 to April 2020 were performed, and the gender, age, time of onset to admission, clinical symptoms, whether combined with hypertension, whether to use hormones, multiple organ function damage and other basic informations were recorded. At the same time, we collected the on admission neutrophil count, platelet count, lymphocyte count, C‑creactive protein (CRP), serum calcitonin (PCT), random blood glucose, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminot‑ransferase (AST), allergic troponin I, finger vein oxygen saturation, D‑dimer, NT‑proBNP, and other indicators. According to the clinical outcomes, the patients were divided into survival group and death group. The general data and test results between the two groups were compared, and the risk of death from diabetes and COVID‑19 was analyzed by Logistic regression. Results: Two patients were excluded due to death within 24 hours. Finally, 108 patients were included in the study, including 65 males and 43 females, aged from 31 to 98 years old, with a median age of 65 years, of which 91 survived (survival group) and 17 died (death group), with a mortality rate of 17.27% (19/110). The univariate analysis showed that age, levels of neutrophils, lymphocytes, platelets, LDH, and NT‑proBNP, organ damage, hypertension, finger pulse oxygen saturation less than 93%, PCT, hypersensitive troponin I, D‑dimer(P<0.05) were risk factors for death. There was no differrence in sex, time from onset to admission, CRP, ALB, ALT, AST, random blood glucose and hormone therapy between the two groups. Multivariate Logistic regression analysis showed that age, lymphocyte counts ≤0.8×109/L and LDH ≥550 U/L were risk factors for death in COVID‑19 patients with diabetes mellitus. Conclusion: The COVID‑19 patients combined with diabetes mellitus have high mortality. The risk factors of death in patients with diabetes mellitus complicated with COVID‑19 are advanced age, lymphocyte counts ≤0.8×109/L, and LDH ≥550 U/L. © 2022, Editorial Board of Medical Journal of Wuhan University. All right reserved.

Using cfw-net deep learning models for x-ray images to detect covid-19 patients

COVID-19 is an infectious disease caused by severe acute respiratory syndrome (SARS)-CoV-2 virus. So far, more than 20 million people have been infected. With the rapid spread of COVID-19 in the world, most countries are facing the shortage of medical resources. As the most extensive detection technology at present, reverse transcription polymerase chain reaction (RT-PCR) is expensive, long-time (time consuming) and low sensitivity. These problems prompted us to propose a deep learning model to help radiologists and clinicians detect COVID-19 cases through chest X-ray. According to the characteristics of chest X-ray image, we designed the channel feature weight extraction (CFWE) module, and proposed a new convolutional neural network, CFW-Net, based on the CFWE module. Meanwhile, in order to improve recognition efficiency, the network adopts three classifiers for classification: one fully connected (FC) layers, global average pooling fully-connected (GFC) module and point convolution global average pooling (CGAP) module. The latter two methods have fewer parameters, less calculation and better real-time performance. In this paper, we have evaluated CFW-Net based on two open-source datasets. The experimental results show that the overall accuracy of our model CFW-Net56-GFC is 94.35% and the accuracy and sensitivity of COVID-19 are 100%. Compared with other methods, our method can detect COVID-19 disease more accurately. © 2021 The Authors. Published by Atlantis Press B.V.

Seropositivity rate and diagnostic accuracy of serological tests in 2019-nCoV cases: a pooled analysis of individual studies.

OBJECTIVE: Currently, detection of SARS-CoV-2 RNA is standard in the diagnosis of COVID-19 (2019-nCoV). However, reliable and rapid serological diagnostic methods to screen SARS-CoV-2 infected patients, including those who do not have overt symptoms, are urgently needed. Most studies have described serological tests based on the detection of SARS-CoV-2-specific IgM and IgG. Here, we attempted to systematically analyze the positive rates and comprehensive diagnostic efficacy of IgM and IgG in response to SARS-CoV-2 infection. MATERIALS AND METHODS: By systematically searching PubMed, medRxiv, bioRxiv and other databases, studies regarding the detection of peripheral blood IgM and/or IgG related to SARS-CoV-2 were collected. The positive rate, sensitivity (SEN), specificity (SPE), area under the curve (AUC) and corresponding 95% CIs were obtained by weighted quantitative mergence, and the source of heterogeneity was explored by performing a subgroup study and sensitivity analysis. RESULTS: A total of 30 studies were included, which were comprised of 3856 confirmed SARS-CoV-2 RNA positive cases, 368 suspected RNA negative cases, 1167 asymptomatic carriers, and 2526 RNA negative controls. The corresponding meta-analysis showed that in confirmed cases with 2019-nCoV, the positive rates of single IgM, single IgG and their joint detection related to SARS-CoV-2 were 61.2% (95% CI: 53.4%-69.0%), 58.8% (95% CI: 49.6%-68.0%) and 62.1% (52.7%-71.4%), respectively. In suspected RNA negative cases, the positive rates of single IgM, single IgG and their joint detection were 29.0% (95% CI: 14.0%-44.0%), 37.0% (95% CI: 20.0%-55.0%) and 55.0% (95% CI: 19.0%-90.0%), respectively. Interestingly, IgM/IgG detection also demonstrated a positive rate of 19% (95% CI: 10.0%-27.0%) in asymptomatic cases. Using RT-PCR test as reference, the AUCs of IgM, IgG and IgM/IgG in the diagnosis of 2019-nCoV infection were 0.9656, 0.9766, and 0.9838, respectively. The stratified analyses showed that among confirmed cases with 2019-nCoV, the positive rates of IgM and IgG were 27.3% (95%CI: 19.8%-34.8%) and 22.3% (95% CI: 11.3%-33.3%), respectively, 0-7days following the onset of symptoms, whereas the positive rate of parallel IgM/IgG testing attained 39.3% (95% CI: 24.2%-54.4%). Moreover, the efficacy of antibody testing based on CLIA (chemiluminescence enzyme immunoassays) in diagnosing 2019-nCoV infection was higher than that of LFIA (lateral flow immunoassays) and ELISA (enzyme linked immunosorbent assay). CONCLUSIONS: IgM, IgG and their joint testing exhibited high clinical value in the diagnosis of 2019-nCoV, which may assist in making up for the deficiency of throat swab RNA tests.

Effectiveness Analysis of the Intelligent Family Physician-Optimized Collaborative Model of Fangzhuang Community for COVID-19 Joint Control and Prevention

To actively fight against COVID-19,Fangzhuang Community Health Service Center,in collaboration with Fangzhuang Subdistrict Office and community committees,have established 16 family physician teams(including teams working in the community and in the center),taking charge of COVID-19 prevention and control within the working area using a gridded,categorized and hierarchical method with an intelligent family physician-optimized collaborative model (IFOCM).The specific management measures using the innovatively applied IFOCM in combating the pandemic include:an intelligent call system is used to screen the COVID-19 in all community-living residents via telephone.Based on the population data registered by Fangzhuang Subdistrict Office and community committees for screening COVID-19,and data from China National Notifiable Infectious Diseases Reporting Information System and Fengtai Center for Disease Control and Prevention,community-living residents are divided into general population and key population(including people returning to Beijing from other countries and domestic regions,high-risk people,close contacts,suspected and confirmed cases),giving different management.The general population received various forms of popular science education on COVID-19 prevention and control measures classified as 12 topic modules,and grid management using online and offline physician-nurse care and physician-patient coordination with the help of internet-based and AI technologies(including intelligent call system,intelligent chronic disease management system and mobile intelligent terminal APP) covered in the IFOCM.The key population received three-level management of infectious diseases implemented(by healthcare workers within their working area) and one-on-one offline tracking.Fangzhuang Community Health Service Center applies IFOCM to comprehensively improve the awareness level and prevention and control ability of COVID-19 in residents from multiple perspectives and channels,to help residents prevent and control COVID-19 scientifically.This practice may be used as a reference for other urban communities. Copyright © 2020 by the Chinese General Practice.

Clinical features of coronavrius disease 2019 with leukocytosis

Objective: To analyze the clinical features of coronavrius disease 2019 (COVID-19) with leukocytosis, and to explore the relationship between serum inflammatory parameters and severity of the disease. Methods: COVID-19 patients with increased white blood cells (WBC) in the Renmin Hospital of Wuhan University from January 31, 2020 to February 14, 2020 were selected as the research objects to collect the clinical data, such as general conditions, clinical symptoms, and blood tests. Patients were divided into three groups according to the relevant diagnostic criteria: normal type (9 cases), severe type (62 cases), and critical type (39 cases). Furthermore, the patients were divided into two groups according to whether the WBC counts were increased for the first time or not. The levels of inflammation-related markers in each group were detected, and the relationship between the levels of inflammation-related markers and clinical types of diseases was analyzed and compared. Results: There were 110 cases of COVID-19 patients with leukocytosis, most of them were male patients or severe and critically elderly patients, and moreover, the mortality rate was high in critical cases. In the severe type and critical type patients, the levels of WBC, lactate dehydrogenase (LDH) and CRP were higher than in the normal type patients (P0.05), while the proportion of lymphocyte was lower (P0.05). In the critical type patients, the LDH, the proportion of neutrocyte, and CRP levels were higher than in the severe type (P0.05). The proportion of lymphocyte of critical type was lower than that of the normal type (P0.05). And no significant difference was found in procalcitonin (PCT) levels between different type groups. When comparing between the first-time leukocytosis and non-first-time leukocytosis in COVID-19 patients, we found that the patients in the first-time leukocytosis group, the age, basic diseases, proportion of critical mass, mortality, the expression of LDH, neutrophil ratio, CRP and PCT were significantly higher than those in non-first-time leukocytosis group (P0.05), while the proportion of lymphocyte was lower (P0.05). Conclusion: COVID-19 patients with increased white blood cells were more severe. In the cases of leukocytosis was found at COVID-19 on-set, severe and critical types are common, and the mortality rate was high. COVID-19 patients with increased white blood cells were often complicated with bacterial infection, which has certain guiding significance for clinical treatment. © 2020, Editorial Board of Medical Journal of Wuhan University. All right reserved.

Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China.

The study analysed healthcare workers' (HCWs) knowledge, practices, and attitudes regarding coronavirus disease 2019 (COVID-19). A cross-sectional survey was conducted from February 4th to February 8th, 2020, involving a total of 1357 HCWs across 10 hospitals in Henan, China. Of those surveyed, 89% of HCWs had sufficient knowledge of COVID-19, more than 85% feared self-infection with the virus, and 89.7% followed correct practices regarding COVID-19. In addition to knowledge level, some risk factors including work experience and job category influenced HCWs' attitudes and practice concerning COVID-19. Measures must be taken to protect HCWs from risks linked to job category, work experience, working hours, educational attainment, and frontline HCWs.