Decreased Hospital-Acquired Respiratory Infections among elder Inpatients in General Hospital during the COVID-19 Pandemic (preprint)

Background In order to avoid nosocomial transmission of COVID-19, various prevention and control measures have been strictly implemented in medical institutions. These strict measures can probably reduce the incidence of hospital acquired respiratory infections. We conducted this study to assess changes in the prevalence of hospital acquired respiratory infections during a period of national attention to the prevention the COVID-19 pandemic.Methods We retrospectively analyzed the clinical data of patients from October to December 2019 and from October to December 2020. The diagnostic of hospital acquired respiratory infections was based on CDC/NHSN criteria. We compared the incidence and mortality rate of hospital acquired respiratory infections between these 2 periods. We also used multivariate logistics regression analysis for risk factors associated with mortality.Results In 2020, a total of 2921 patients’ data were surveyed, as compared with 2211 patients in 2019. Incidence of hospital acquired respiratory infections was lower in 2020 (2.9% vs. 4.7%, P = 0.001). In hospital mortality of patients with hospital acquired respiratory infections had no significant difference (38.4% vs. 30.5%, p = 0.252). Multivariate logistics regression analysis showed that severe pneumonia (RR = 28.235, 95%CI: 10.122, 78.759, p = 0.000), previous malignant tumor (RR = 4.599, 95%CI: 1.768, 11.963, p = 0.002) and cardiac injury (RR = 2.264, 95%CI: 0.935, 5.485, p = 0.07) were associated with an increased risk of mortality.Conclusions The incidence of hospital acquired respiratory tract infections was significantly decreased during COVID-19 period as a result of the adoption of infection prevention and control measures in medical institutions. Elder patients with severe pneumonia and previous malignant tumor were at high risk for death in hospital.

Discovery of SARS-CoV-2-E channel inhibitors as antiviral candidates.

Lack of efficiency has been a major problem shared by all currently developed anti-SARS-CoV-2 therapies. Our previous study shows that SARS-CoV-2 structural envelope (2-E) protein forms a type of cation channel, and heterogeneously expression of 2-E channels causes host cell death. In this study we developed a cell-based high throughput screening (HTS) assay and used it to discover inhibitors against 2-E channels. Among 4376 compounds tested, 34 hits with cell protection activity were found. Followed by an anti-viral analysis, 15 compounds which could inhibit SARS-CoV-2 replication were identified. In electrophysiological experiments, three representatives showing inhibitory effect on 2-E channels were chosen for further characterization. Among them, proanthocyanidins directly bound to 2-E channel with binding affinity (KD) of 22.14 µM in surface plasmon resonance assay. Molecular modeling and docking analysis revealed that proanthocyanidins inserted into the pore of 2-E N-terminal vestibule acting as a channel blocker. Consistently, mutations of Glu 8 and Asn 15, two residues lining the proposed binding pocket, abolished the inhibitory effects of proanthocyanidins. The natural product proanthocyanidins are widely used as cosmetic, suggesting a potential of proanthocyanidins as disinfectant for external use. This study further demonstrates that 2-E channel is an effective antiviral drug target and provides a potential antiviral candidate against SARS-CoV-2.