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Immunosuppressive drugs are used for treating coronavirus disease 2019COVID-19pneumonia. This study examined the current status of screening and monitoring patients with COVID-19 pneumonia treated with immunosuppressive agents for hepatitis B virusHBVreactivation. Of 123 patients whose hepatitis B surface antigen level was measured, 2 were HBsAg-positive. Antihepatitis B core/surface antibodies were measured in all 121 HBsAg-negative patients. HBV DNA was measured in 31 of 32 patients who were positive for either or both antihepatitis B core/surface antibodies. Of 34 patients requiring regular monitoring, only 4 were monitored. The HBV monitoring rate at the initiation of COVID-19 treatment was high. How-ever, HBV monitoring after COVID-19 treatment was difficult because most patients were transferred to other hospitals or had their treatment terminated.Copyright © 2022 Takeshi Matsui et al.
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The patient presented with fever and appetite loss. Computed tomography (CT) revealed a moderate grade 2 pneumonia. Besides, further blood examination showed his HB antigen as negative, anti-HBs/c anti-body as positive, and HBV DNA level as 1.0 LIU/mL. Therefore, he was diagnosed with COVID-19. Administered treatments comprised oxygen inhalation and steroid therapy, including pulses, remdesivir, and baricitinib, which improved pneumonia. Interestingly, one month posttreatment, his HBV DNA level in-creased to 1.4 LIU/mL, followed by a further increase to 1.7 LIU/Ml, showing an improvement. Tenofovir alafenamide fumarate was thus administered. In clinical practice, immunosuppressive therapy is used for patients with moderate-to-severe COVID-19 pneumo-nia. However, close attention should also be paid to the elevation of blood HBV DNA levels during and after treatment.Copyright © 2022 The Japan Society of Hepatology.
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Background and Aim: Immunosuppressive agents (e.g., baricitinib [BAR], tricizumab [TCZ]) and steroids are used for treating coronavirus disease 2019 (COVID-19) pneumonia. These immunosuppressive agents are known to cause HBV reactivation. The current guidelines recommend HBV screening and HBV reactivation monitoring in Japan. However, the status of compliance among treated patients with COVID-19 pneumonia remains unclear. Herein, we report the status of compliance with the current guidelines on HBV reactivation. Method(s): We investigated the implementation of HBV screening and HBV reactivation monitoring for patients who received immunosuppressive agents in our hospital from April 2021 up to June 2021. Background factors related to the presence or absence of screening were analyzed. Result(s): There were 123 patients who received immunosuppressive agents in our hospital from April 2021 up to June 2021. The patients median age was 63 years old (31-95 years), and 90 patients were men. BAR/steroid therapy was given in 115 patients and TCZ/steroid therapy in 8 patients. Of the 123 patients in whom HBs antigen level was measured, 2 patients were positive for HBs antigen. Anti-HBc/ HBs antibodies were measured in all 121 HBsAg-negative patients according to the guidelines. Of 32 patients who were positive for either or both anti-HBc/HBs antibodies, HBV DNA was measured in 31 patients. Of 34 patients who required regular reactivation monitoring, 30 did not receive regular monitoring (6 died in the hospital, 11 were transferred to other hospitals, and 13 were terminated of their treatment early in the outpatient department of the hospital). Only 4 patients were monitored according to the guidelines. Of the 4 patients monitored, 1 was positive for HBs antigen and was given a nucleic acid analogue. In 1 patient, HBV DNA increased from signal-positive to 1.4 LIU/mL and then to 1.7 LIU/mL and nucleic acid analogue was started. The remaining 2 patients had undetectable HBV DNA or remained signal-positive. Conclusion(s): The HBV reactivation monitoring rate at the start of COVID-19 pneumonia treatment was high. However, HBV reactivation monitoring after the COVID-19 pneumonia treatment was difficult because most patients were transferred to other hospitals or had their treatment terminated.
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Digital technology such as virtual meetings is key to communication and collaboration. However, a firm-level survey in Japan during the COVID-19 pandemic shows that foreign firms regarded digital communication as a key business obstacle. This paper estimates the determinants of the likelihood that foreign firms regard digital communication as an obstacle. The results show that digital communication is hindered by language differences, employees' nationality differences, employment size, and time differences from foreign headquarters. Contrary to common assertions, digital communication is regarded as an obstacle in remote-work feasible sectors, but not so in in-person service sectors. Thus, digital communication does not completely eliminate barriers to face-to-face communication. © 2023 Elsevier B.V.
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[Purpose] The purpose of this study was to clarify the characteristics of patients who were hospitalized for severe COVID-19 pneumonia and discharged from hospital after they could walk independently. [Participants and Methods] We compared 112 patients who underwent ventilator management and rehabilitation in an intensive care unit, and divided them into two groups: the independent group (76 patients) and non-independent group (36 patients) according to whether they could walk at the time of discharge. [Results] The independent and non-independent groups differed significantly in age (55.8 ± 12.3 vs. 66.7 ± 13.0), delirium (12 vs. 12 patients), Sequential Organ Failure Assessment score (SOFA) score (7 vs. 8), ferritin (1813 vs. 1168 ng/mL) and duration of intubation (6.1 days vs. 11.1 days). [Conclusion] Age, presence of delirium, SOFA score, ferritin, and duration of intubation were associated with the ability of patients with severe COVID-19 pneumonia to walk independently at discharge. © 2022, Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai). All rights reserved.
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Objectives: In April 2020, a state of emergency was declared regarding COVID-19, and refraining from going out was requested. Although there is concern about weight gain after the spread of the infection, there are few reports of studies in Japan. The present study examined the association between refraining from going out and weight gain after the spread of COVID-19 infection. Methods: Cross-sectional and longitudinal analyses were conducted. Cross-sectional: Data from an internet survey conducted in August 2020 among the general population in Japan were used. Of the 25482 valid responses, 18116 persons aged 20-64 were included in the analysis. Information on refraining from going out was ascertained by a self-administered questionnaire. The outcome variable, subjective weight gain, was categorized as "increased" or "same as before/reduced" based on the question of subjective weight change in the last month compared to before January 2020. Longitudinal: In addition to cross-sectional data, data from the February 2019, February 2020, and February 2021 surveys were collated;4399 individuals participated in all four time points, of which 4337 were included in the analysis after excluding outliers. Two outcome variables were used: (1) weight change of "> 0 kg" from February 2020 to February 2021, and (2) weight change of "> 0 kg" from February 2020 to February 2021 and subjective weight change of "increased". Logistic regression analysis was used for analysis, adjusting for sex, age, occupation, hospitalization, breakfast deprivation, and snacking (in the longitudinal, the rate of weight change in the year before baseline was also adjusted). In addition, the indirect effect of snacking was examined using the Sobel test. Results: Cross-sectional: 5168 (28.5%) of 18116 subjects reported weight gain. Multivariate-adjusted odds ratios (95% confidence intervals) for weight gain in comparison with "never refrained" were 1.46 (1.16-1.83) for "almost never refrained," 1.87 (1.54-2.27) for "sometimes refrained," and 2.07 (1.71-2.51) for "always refrained" (p-trend < 0.001). Snacking had a significant indirect effect on the association between refraining from going out and weight gain (p < 0.001). Longitudinal (1) No significant association was found (p-trend =0.401). Longitudinal (2) Similar to the cross-sectional, we found a significant association (p-trend =0.003) and a significant indirect effect of snacking (p < 0.001). Conclusions: Our results implied that refraining from going out after the spread of COVID-19 infection contributed to weight gain, and snacking mediated this association.
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Purpose: As the average salt intake of Japanese people is as high as 10 gram per day, it is necessary to reduce the salt intake for the prevention and treatment of cardiovascular diseases. We held a less salt recipe contest to promote delicious less salt recipes among society and examined the potentiality of 'deliciously less salt meals'. Method: National Cerebral and Cardiovascular Center (NCVC) held the 'The 5th S-1 Grand Prix', a contest to develop delicious and less salt bento recipes on a nationwide scale. The contest named after its goal of reducing the salt intake by 1 gram in each meal. Under the theme of a delicious and attractive less salt bento meeting to the nutritional value standards (such as less than 2 gram of salt equivalent per meal), NCVC called for the bento recipe ideas from the 10th of May to 26th of July 2021. All the applied recipes are evaluated and tasted by NCVC contest board members, then the best one was decided for a 'Grand-Prix' award. Contest was held on-line due to the COVID-19, the video presentation made by the applicants were evaluated for the final selection. Result: A total of 67 teams (25 teams in the general category, 15 teams in the student category, 27 teams in the disaster nutrition category) were applied to this contest. We encouraged governments, hospitals, dietitian training schools, and convention-related companies and organizations nationwide to apply the contest. Compared to the 4th tournament, the number of applicants were increased by 16 teams. More than half of the applicants were from 'educational institutions such as universities'. Although the 5th tournament was held online, we were able to hold a recipe contest in a new format, such as using applicants' video presentation for the final selection. Discussion: In the disaster nutrition category, many recipes for the delicious, preserved foods and cooking methods under the disaster were gathered, so that these less salt recipes can be widely adopted in the disaster foods. Through this attempt, we created an opportunity to make a delicious less salt meals, and motivated participants to cook 'deliciously less salt meals'. In the future, more people will participate in this contest in order to get them to participate, we will consider the conditions of the recipe and the recruitment method.
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OBJECTIVE: The aim of this study was to investigate the epidemiology of post-COVID conditions beyond 12 months and identify factors associated with the persistence of each condition. STUDY DESIGN: This was a cross-sectional questionnaire-based survey. METHODS: We conducted the survey among patients who had recovered from COVID-19 and visited our institute between February 2020 and November 2021. Demographic and clinical data and data regarding the presence and duration of post-COVID conditions were obtained. We identified factors associated with the persistence of post-COVID conditions using multivariable linear regression analyses. RESULTS: Of 1148 surveyed patients, 502 completed the survey (response rate, 43.7%). Of these, 393 patients (86.4%) had mild disease in the acute phase. The proportion of participants with at least one symptom at 6, 12, 18, and 24 months after symptom onset or COVID-19 diagnosis was 32.3% (124/384), 30.5% (71/233), 25.8% (24/93), and 33.3% (2/6), respectively. The observed associations were as follows: fatigue persistence with moderate or severe COVID-19 (ß = 0.53, 95% confidence interval [CI] = 0.06-0.99); shortness of breath with moderate or severe COVID-19 (ß = 1.39, 95% CI = 0.91-1.87); cough with moderate or severe COVID-19 (ß = 0.84, 95% CI = 0.40-1.29); dysosmia with being female (ß = -0.57, 95% CI = -0.97 to -0.18) and absence of underlying medical conditions (ß = -0.43, 95% CI = -0.82 to -0.05); hair loss with being female (ß = -0.61, 95% CI = -1.00 to -0.22), absence of underlying medical conditions (ß = -0.42, 95% CI = -0.80 to 0.04), and moderate or severe COVID-19 (ß = 0.97, 95% CI = 0.41-1.54); depressed mood with younger age (ß = -0.02, 95% CI = -0.04 to -0.004); and loss of concentration with being female (ß = -0.51, 95% CI = -0.94 to -0.09). CONCLUSIONS: More than one-fourth of patients after recovery from COVID-19, most of whom had had mild disease in the acute phase, had at least one symptom at 6, 12, 18, and 24 months after onset of COVID-19, indicating that not a few patients with COVID-19 suffer from long-term residual symptoms, even in mild cases.
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COVID-19 , Humans , Female , Male , Post-Acute COVID-19 Syndrome , COVID-19 Testing , Cross-Sectional Studies , CoughABSTRACT
[Purpose] The purpose of this study was to elucidate the effect of prone positioning on the respiratory function of patients with the severe coronavirus disease (COVID-19) which emerged in 2019. [Participants and Methods] We examined 24 COVID-19 patients who underwent mechanical ventilation at the Japanese Red Cross Medical Center from March 2020 to November 2021. The respiratory function of these patients before and after prone positioning was compared. The indices of respiratory function were the P/F ratio obtained from the blood data and peak pressure (Ppeak), positive end expiratory pressure (PEEP), delta P (⊿P), and static compliance (Cstat) displayed on the graphic monitor of the ventilator. [Results] After prone positioning, significant increases in the P/F ratio and Cstat were observed. Although Ppeak, PEEP and ⊿P decreased, their differences were not significant. [Conclusion] The results of this study demonstrate that prone positioning was effective at contributing to improvement of the respiratory status of patients with severe COVID-19. © 2022, Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai). All rights reserved.
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Background. Little is known about how social media platforms can be used to increase COVID-19 vaccine intent. We aimed to investigate the effect of social mediabased interventions on vaccine hesitancy in Japan. Methods. We conducted a three-arm randomized controlled trial between 5 November 2021 and 9 January 2022. Japanese aged 20 or above who had not received any COVID-19 vaccine and did not intend to be vaccinated were randomly assigned to one of the following three groups: (i) a control group (with no intervention), (ii) a group with a free chatbot in a popular messenger app called 'LINE,' which provided general information on COVID-19 vaccines and (iii) a group with free webinars where healthcare professionals interactively provided participants with the information on COVID-19 vaccines. The vaccine intention (VI) and three pre-defined Vaccine Confidence Index (VCI), including the importance, safety, and effectiveness of COVID-19 vaccines, were compared. Results. 1,158 persons were included, and the baseline characteristics and demographics were balanced across three groups (Table 1). Among 386 persons assigned to the chatbot group, 231 (59.8%) accessed the chatbot and answered the post-survey. The post-survey revealed no significant difference in VI or VCI between the chatbot group and the control group (Table 2).Among 386 persons assigned to the webinar group, 207 (53.6%) attended webinars and answered the post-survey. The post-survey revealed no difference in VI between the webinar group and the control group. However, the VCI for the importance and the effectiveness significantly increased in the webinar group. There was no difference in VCI for the safety. VCI for the importance and the effectiveness in the control group decreased without any intervention during the study period. Vaccine intention and confidence after interventions Conclusion. While this study demonstrated that neither the chatbot nor the webinar changed VI, VCI for the importance and the effectiveness significantly increased with the webinar intervention. Interactive webinars with live Q and A provided by professionals may have a role in increasing COVID-19 vaccine confidence. Given the degree of vaccine hesitancy worsened over time in the control group, timely intervention is required.
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Part of the economic recovery plans implemented by governments following COVID-19 is directed towards the energy transition. To understand the potential effects of these post-COVID green recovery packages on reductions of global greenhouse gas emissions until 2030, we investigated three different approaches. First, we analyzed simulation results of Integrated Assessment Models (IAMs) to infer the change in CO2 intensity of GDP that could result from post-COVID low-carbon investment plans. Second, we investigated the scenarios the International Energy Agency (IEA) provided based on a bottom-up energy system model. Combining the two approaches, we found that green recovery packages implemented and planned globally can lead to an emissions reduction of merely 1%-6% from the 2030 baseline levels at most. Third, we looked into the results of the Adaptative Regional Input-Output model, which simulates the dynamic effects of economic crisis and fiscal stimuli through supply chains following labor shortage. The third approach shows that the increase of activity driven by fiscal stimuli leads to a rebound of CO2 emissions even if they do not target carbon-intensive sectors. We conclude that green recovery packages targeting low-carbon technologies have a limited impact on near-term CO2 emissions and that demand-side incentives, as well as other policy efforts to disincentivize the use of fossil fuels, are also crucial for scaling up climate mitigation.
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Immunosuppressive drugs are used for treating coronavirus disease 2019(COVID-19)pneumonia. This study examined the current status of screening and monitoring patients with COVID-19 pneumonia treated with immunosuppressive agents for hepatitis B virus(HBV)reactivation. Of 123 patients whose hepatitis B surface antigen level was measured, 2 were HBsAg-positive. Antihepatitis B core/surface antibodies were measured in all 121 HBsAg-negative patients. HBV DNA was measured in 31 of 32 patients who were positive for either or both antihepatitis B core/surface antibodies. Of 34 patients requiring regular monitoring, only 4 were monitored. The HBV monitoring rate at the initiation of COVID-19 treatment was high. How-ever, HBV monitoring after COVID-19 treatment was difficult because most patients were transferred to other hospitals or had their treatment terminated. Copyright © 2022 Takeshi Matsui et al.
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The coronavirus disease pandemic has significantly affected delivery of medical care in Japan, including gastrointestinal endoscopy services. In this study, we analyzed the data provided to the Japan Endoscopy Database and its effect. Gastrointestinal endoscopy was significantly affected by the initial spread of infection in April 2020;the number of gastrointestinal endoscopy procedures was reduced by nearly 50%. Specifically, upper and lower gastrointestinal endoscopy and endoscopic treatment of the lower gastrointestinal tract were significantly affected. In contrast, endoscopic retrograde cholangiopancreatography-related procedures, which are usually performed on an emergency basis and for cancer treatment, were relatively unaffected. However, from May 2020, following gradual recovery from the public health crisis, the number of cases returned to the pre-pandemic level (cases during the previous year until December 2020). Thereafter, the third wave from the end of 2020 to the beginning of 2021, followed by the fourth wave in May 2021, and the fifth wave in August 2021, led to a remarkably large increase in the number of infected patients;however, we did not observe a significant reduction in the number of endoscopic procedures performed, in contrast to the situation in May 2020. From the social viewpoint, the pandemic significantly affected diagnostic evaluation;however, normalcy was rapidly restored owing to the combined efforts of gastrointestinal endoscopists. It will be important to monitor the effects of the pandemic on gastrointestinal endoscopy practice in 2021. © 2022 Japan Gastroenterological Endoscopy Society. All rights reserved.
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This paper presents a newly developed microfluidic flow control theory for autonomous sample dispensing into an array of reaction microchambers. The theoretical predictions for the possible dispensing number and maximum flow rate were validated by comparison to experimental results. Moreover, we successfully demonstrated the rapid genetic detection of multiple infectious viruses including SARS-CoV-2 in fabricated polydimethylsiloxane (PDMS)-based microfluidic devices based on the loop-mediated isothermal amplification (LAMP) method. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.
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OBJECTIVES: To investigate the prevalence of post coronavirus disease (COVID-19) condition of the Omicron variant in comparison to other strains. STUDY DESIGN: A single-center cross-sectional study. METHODS: Patients who recovered from Omicron COVID-19 infection (Omicron group) were interviewed via telephone, and patients infected with other strains (control group) were surveyed via a self-reporting questionnaire. Data on patients' characteristics, information regarding the acute-phase COVID-19, as well as presence and duration of COVID-19-related symptoms were obtained. Post COVID-19 condition in this study was defined as a symptom that lasted for at least 2 months, within 3 months of COVID-19 onset. We investigated and compared the prevalence of post COVID-19 condition in both groups after performing propensity score matching. RESULTS: We conducted interviews for 53 out of 128 patients with Omicron and obtained 502 responses in the control group. After matching cases with controls, 18 patients from both groups had improved covariate balance of the factors: older adult, female sex, obesity, and vaccination status. There were no significant differences in the prevalence of each post COVID-19 condition between the two groups. The number of patients with at least one post COVID-19 condition in the Omicron and control groups were 1 (5.6%) and 10 (55.6%) (p = 0.003), respectively. CONCLUSIONS: The prevalence of post Omicron COVID-19 conditions was less than that of the other strains. Further research with a larger sample size is needed to investigate the precise epidemiology of post COVID-19 condition of Omicron, and its impact on health-related quality of life and social productivity.
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COVID-19 , SARS-CoV-2 , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Quality of LifeABSTRACT
Observed daily changes in CO2 emissions from across the globe reveal the sectors and countries where pandemic-related emissions declines were most pronounced in 2020. Day-to-day changes in CO2 emissions from human activities, in particular fossil-fuel combustion and cement production, reflect a complex balance of influences from seasonality, working days, weather and, most recently, the COVID-19 pandemic. Here, we provide a daily CO2 emissions dataset for the whole year of 2020, calculated from inventory and near-real-time activity data. We find a global reduction of 6.3% (2,232 MtCO(2)) in CO2 emissions compared with 2019. The drop in daily emissions during the first part of the year resulted from reduced global economic activity due to the pandemic lockdowns, including a large decrease in emissions from the transportation sector. However, daily CO2 emissions gradually recovered towards 2019 levels from late April with the partial reopening of economic activity. Subsequent waves of lockdowns in late 2020 continued to cause smaller CO2 reductions, primarily in western countries. The extraordinary fall in emissions during 2020 is similar in magnitude to the sustained annual emissions reductions necessary to limit global warming at 1.5 degrees C. This underscores the magnitude and speed at which the energy transition needs to advance.
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Objective: We aim to report clinical characteristics of an extremely rare case of myelitis with Guillain-Barré syndrome (GBS) and cerebellar ataxia (CA) after COVID-19 infection. Background: There have been many reports about neurological complications following the world pandemic of COVID-19. We found about 100 GBS, 50 myelitis, and 10 CA cases after COVID-19 infection. To best our knowledge, this is the first report of myelitis with GBS and CA accompanied by multiple autoantibodies. Design/Methods: NA Results: A 60-year-old man with fever and cough was diagnosed with mild COVID-19 infection. Fourteen days later from the onset, he developed gait disturbance and fell frequently. On hospitalization, he exhibited fever, hypoxemia, mild consciousness disturbance, flaccid paraplegia, mild numbness and severe deep sensory disturbance in the lower limbs, bladder and bowel disturbance, mild muscle weakness in the fingers, myoclonus in the extremities, and CA. The PCR of COVID-19 was negative. Blood investigations showed elevated inflammatory markers with dehydration, rhabdomyolysis, and hypercoagulation. Cerebrospinal fluid (CSF) analysis presented mild pleocytosis and elevated protein without anti-COVID-19 antibodies. Contrast-enhanced CT showed massive pulmonary embolisms and deep venous thromboses. Brain SPECT showed cerebellar hypoperfusion despite no abnormalities in brain MRI. Spine MRI revealed longitudinal hyperintense lesions mainly in the dorsal white matter, compatible with myelitis. Additional investigations of autoantibodies realized anti-GM3, TPI, GluR, and NMDAR IgG antibodies in serum, and anti-GluR and NMDAR IgG antibodies with increased granzyme B in CSF. Treatments of corticosteroid and intravenous immunoglobulin resulted in complete recovery to consciousness disturbance, muscle weakness of fingers, myoclonus, and CA, while paraparesis with deep sensory and bladder and bowel disturbance remained. Conclusions: We highlight the possibility of the coexistence of several post-infectious autoimmune neurological complications in patients of COVID-19. It is important to search autoantibodies carefully corresponding to clinical manifestations for appropriate treatments and understanding of pathophysiology.
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Although the online campaigns of anti-vaccine advocates, or anti-vaxxers, severely threaten efforts for herd immunity, their reply behavior - -the form of directed messaging that can be sent beyond follow-follower relationships-remains poorly understood. Here, we examined the characteristics of anti-vaxxers' reply behavior on Twitter to attempt to comprehend their characteristics of spreading their beliefs in terms of interaction frequency, content, and targets. Among the results, anti-vaxxers more frequently conducted reply behavior with other clusters, especially neutral accounts. Anti-vaxxers' replies were significantly more toxic than those from neutral accounts and pro-vaxxers, and their toxicity, in particular, was higher with regard to the rollout of vaccines. Anti-vaxxers' replies were more persuasive than the others in terms of the emotional aspect, rather than linguistical styles. The targets of anti-vaxxers' replies tend to be accounts with larger numbers of followers and posts, including accounts that relate to health care or represent scientists, policy-makers, or media figures or outlets. We discussed how their reply behaviors are effective in spreading their beliefs, as well as possible countermeasures to restrain them. These findings should prove useful for pro-vaxxers and platformers to promote trusted information while reducing the effect of vaccine disinformation. © 2021 ACM.
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Background: Coronavirus Disease 2019 (COVID-19) impacted public health systems, overwhelming the intensive care units(ICU)(1).Epicardial adipose tissue (EAT) thickness is a potential novel parameter, which can be assessed using standard computer tomography(CT) for the prediction of worse prognosis in COVID-19(2,3). Purpose: We aimed to investigate the association of right ventricle (RV)-EAT thickness with the need for invasive mechanical ventilation, vasopressor support or ICU admission and in-hospital mortality in COVID-19. Methods: We analyzed 310 consecutive hospitalized patients with confirmed COVID-19 by RT-PCR, between March and April 2020.EAT thickness was assessed during the acute setting of the disease using low dose non-contrast chest CT.Maximal EAT thickness was determined on axial image series at the level of the RV free wall perpendicular to the surface of the heart(Figure 1).Intra-and interobserver reproducibility for the RV-EAT thickness measurement was assessed in 20 random patients after two weeks, by the primary and a second investigator. Data included demographics, clinical evaluation, comorbidities, treatment and complications.Peak lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) were defined as the highest level during hospitalization.The primary combined endpoint was ICU admission, invasive mechanical ventilation and vasopressor therapy.The secondary outcome was in-hospital mortality. Results: Median age was 64 years (interquartile range:53 to 79 years,58.1% males).106(34.2%) patients reached the primary endpoint.Inhospital mortality rate was 19.5% (59 patients).Among patients with combined endpoint, the mortality rate was 35.8% (38 patients).RV-EAT thickness was higher in patients with combined endpoint (5.0 ±2.6 mm versus 4.3 ± 2.2 mm, p = 0.021).Additionally, patients with the composite endpoint had more diabetes mellitus (p = 0.028) and history of coronary artery disease (p = 0.020).Multivariable analysis showed that RV-EAT thickness predicted the primary endpoint, irrespective of risk factors and disease severity (p = 0.014, OR 1.157,95%CI 1.030-1.300;p = 0.031, OR 1.146,95%CI 1.013-1.298, respectively)(Figure 2).Moreover, peak CRP and peak LDH were associated with both endpoints( Figure 2).However, RV-EAT thickness was not predictive for mortality (p = 0.561, OR 1.039, 95%CI 0.913-1.183). Intraobserver and interobserver reproducibility were good:0.88 (95%CI 0.66-0.95) and 0.86 (95%CI 0.65-0.94). Conclusion: RV-EAT thickness, easily and rapidly assessed by standard low dose non-contrast chest CT was associated with higher incidence of ICU admission, need for mechanical ventilation and vasopressor support in hospitalized COVID-19 patients.Although no independent association between RV-EAT and in-hospital mortality was found, RV-EAT thickness may serve as surrogate marker of severity, before the rise of inflammatory biomarkers and may reflect inflammation changes within the myocardium in COVID-19.
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The patient presented with fever and appetite loss. Computed tomography (CT) revealed a moderate grade 2 pneumonia. Besides, further blood examination showed his HB antigen as negative, anti-HBs/c anti-body as positive, and HBV DNA level as 1.0 LIU/mL. Therefore, he was diagnosed with COVID-19. Administered treatments comprised oxygen inhalation and steroid therapy, including pulses, remdesivir, and baricitinib, which improved pneumonia. Interestingly, one month posttreatment, his HBV DNA level in-creased to 1.4 LIU/mL, followed by a further increase to 1.7 LIU/Ml, showing an improvement. Tenofovir alafenamide fumarate was thus administered. In clinical practice, immunosuppressive therapy is used for patients with moderate-to-severe COVID-19 pneumo-nia. However, close attention should also be paid to the elevation of blood HBV DNA levels during and after treatment.