Circulating eosinophils associated with responsiveness to COVID-19 vaccine and the disease severity in patients with SARS-CoV-2 omicron variant infection.

OBJECTIVE: This study aimed to investigate the longitudinal circulating eosinophil (EOS) data impacted by the COVID-19 vaccine, the predictive role of circulating EOS in the disease severity, and its association with T cell immunity in patients with SARS-CoV-2 Omicron BA.2 variant infection in Shanghai, China. METHODS: We collected a cohort of 1,157 patients infected with SARS-CoV-2 Omicron/BA.2 variant in Shanghai, China. These patients were diagnosed or admitted between Feb 20, 2022, and May 10, 2022, and were classified as asymptomatic (n = 705), mild (n = 286) and severe (n = 166) groups. We compiled and analyzed data of patients' clinical demographic characteristics, laboratory findings, and clinical outcomes. RESULTS: COVID-19 vaccine reduced the incidence of severe cases. Severe patients were shown to have declined peripheral blood EOS. Both the 2 doses and 3 doses of inactivated COVID-19 vaccines promoted the circulating EOS levels. In particular, the 3rd booster shot of inactivated COVID-19 vaccine was shown to have a sustained promoting effect on circulating EOS. Univariate analysis showed that there was a significant difference in age, underlying comorbidities, EOS, lymphocytes, CRP, CD4, and CD8 T cell counts between the mild and the severe patients. Multivariate logistic regression analysis and ROC curve analysis indicate that circulating EOS (AUC = 0.828, p = 0.025), the combination of EOS and CD4 T cell (AUC = 0.920, p = 0.017) can predict the risk of disease severity in patients with SARS-CoV-2 Omicron BA.2 variant infection. CONCLUSIONS: COVID-19 vaccine promotes circulating EOS and reduces the risk of severe illness, and particularly the 3rd booster dose of COVID-19 vaccine sustainedly promotes EOS. Circulating EOS, along with T cell immunity, may have a predictive value for the disease severity in SARS-CoV-2 Omicron infected patients.

Clinical study of qingke pingchuan granules in treatment of light and common type of novel Coronavirus infection

Objective To observe the clinical efficacy and safety of Qingke Pingchuan Granules in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome). Methods Sixty patients with novel coronavirus infection(phlegm heat stagnating lung syndrome) hospitalized in the Novel Coronavirus Unit of Shanghai Public Health Clinical Center from March 2022to June 2022 were selected and divided into control group and treatment group according to different therapeutic drugs, with 30 cases in each group. Patients in the control group were given conventional treatment. Patients in the treatment group were po administered with Qingke Pingchuan Granules on the basis of conventional treatment, 10 g/time, 3 times daily. The efficacy of TCM syndromes, inflammatory indexes and adverse reactions were observed before and after treatment. Results After treatment, the total effective rate in the treatment group(86.7%) was significantly higher than that in the control group(66.7%)(P < 0.05). After treatment, daytime and nighttime cough scores in 2 groups were lower than before treatment(P < 0.05), and daytime and nighttime cough scores in the treatment group were lower than those in the control group(P < 0.05). There was no significant difference in the levels of peripheral blood leukocytes and procalcitonin between the two groups before and after treatment. After treatment, the level of C-reactive protein(CRP) in the two groups was significantly lower than that before treatment(P < 0.05), and the CRP level in the treatment group was lower than that in the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Qingke Pingchuan Granules has good clinical efficacy in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome), and can relieve the clinical symptoms of patients, which has good safety.

Clinical observation of qingke pingchuan granule in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective: To observe the clinical efficacy of Qingke Pingchuan Granules in treatment of patients with chronic obstructive pulmonary disease (COPD) in acute exacerbations. Methods 70 patients with acute exacerbation of COPD hospitalized in the respiratory department of Shanghai Public Health Clinical Center (affiliated to Fudan University) from November 2019 to may 2021 were selected retrospectively. According to the drug treatment methods, they were divided into experimental group and control group, with 35 cases in each group. Pateints in the control group were given low flow oxygen therapy, anti-infection, antispasmodic, asthma and phlegm treatment according to the condition. Pateints in the experimental group were treated with Qingke Pingchuan Granule, 10 g each time, three times a day. Both groups were treated for ten days. The curative effects of TCM syndromes, chronic obstructive pulmonary disease symptom assessment test (CAT) score, pulmonary function, arterial blood gas, inflammatory indexes and adverse reactions were observed before and after treatment. Results The total effective rate of TCM syndrome in the experimental group (88.6%) was significantly higher than that in the control group (68.6%) (P < 0.05). There was no significant difference in CAT score, arterial blood gas and pulmonary function between the experimental group and the control group before treatment (P > 0.05). After treatment, the CAT score and arterial carbon dioxide partial pressure (pCO2) of the two groups were significantly lower than those before treatment (P < 0.05). Arterial oxygen partial pressure(pO2), the first second forced expiratory volume (FEV1) and the first second forced expiratory volume/forced vital capacity (FEV1/FVC) were significantly higher than those before treatment (P < 0.05). After treatment, the CAT score, arterial blood gas and pulmonary function indexes in the experimental group were significantly improved compared with those in the control group (P < 0.05). Before treatment, there was no significant difference in peripheral blood leukocyte (WBC), C-reactive protein (CRP) and serum procalcitonin (PCT) levels between the two groups (P > 0.05). After treatment, the levels of WBC, CRP and PCT in two groups were significantly lower than those before treatment (P < 0.05), and the levels of WBC, CRP and PCT in the experimental group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions in the experimental group was 14.3%, and there was no significant difference between the experimental group and the control group (8.6%) (P > 0.05). Conclusion Qingke Pingchuan Granule has synergistic effect in treatment of patients with acute exacerbation of COPD, alleviating clinical symptoms and improving pulmonary function. It has good curative effect and safety.

Analysis of the causes and countermeasures for positive recurrence of SARS CoV-2 RNA in discharged patients with COVID-19

At the end of December 2019, COVID-19 broke out in Wuhan, China and swept the whole world. Although the current domestic epidemic situation has been basically controlled, it was found that there were still some patients who have returned positive for the virus nucleic acid test after their recovery from the disease and being discharged from hospital, suggesting that the prevention and control of the pandemic is still a difficult challenge. There are two reasons for the recurrence of the positive result of nucleic acid test, one is the impact of the test itself, the other is the remnant of the virus. Most of the patients with recurrent positive result of nucleic acid test did not show aggravation of the condition, but they still need to be isolated after discharge. In order to reduce the probability of recurrent cases in discharged patients, more accurate diagnostic methods must be adopted, and individualized discharge standards can be developed according to different patients.

Analysis of pathogens and risk factors of secondary pulmonary infection in patients with COVID-19.

To investigate the distribution and risk factors of pathogens in secondary pulmonary infection in patients with COVID-19.142 patients with confirmed COVID-19 from Shanghai Public Health Clinical Center were collected, and 32 patients with pulmonary infection were taken as the infection group. The distribution of pathogens in the sputum specimens was applied for retrospective analysis. Meanwhile, 110 patients diagnosed with COVID-19, but without pulmonary infection were regarded as the asymptomatic group. The risk factors of pulmonary infection were analyzed with generalized linear models and logistic regression. The pathogens in the lung infection group were mainly gram-negative bacteria (22, 68.8%), especially Klebsiella pneumoniae. Gram-positive bacteria and fungi accounted for 13 (40.6%), mainly Staphylococcus aureus, and 11 (34.4%), mainly Candida albicans. There were 14 cases (43.8%) infected with two or more pathogens. The comparison between the two groups found that, patients with elder age, underlying diseases, more lung lesions and low protein contents, were more likely to develop lung infections. At last, univariate analysis showed that 6 factors, including indwelling gastric catheter, the number of deep vein catheters, tracheal intubation tracheotomy, invasive mechanical ventilation, hormonal application, and the use of more than three antibacterial drugs, are risk factors for COVID-19 secondary pulmonary infection. Generalized linear models and logistic regression analysis showed antimicrobial use as an independent risk factor for COVID-19 secondary lung infection. There are many risk factors for secondary lung infection in severe COVID-19 patients, and it is recommended to use antibiotics reasonably.