Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China.

OBJECTIVE: Omicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, is responsible for numerous infections in China. This study investigates the association between the use of Seven-Flavor Herb Tea (SFHT) and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019 (COVID-19). METHODS: This case-control study was conducted at shelter hospitals and quarantine hotels in China. A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31, 2022, while 2190 uninfected individuals served as healthy controls. Structured questionnaires were used to collect data on demographics, underlying diseases, vaccination status, and use of SFHT. Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score. Subsequently, a conditional logistic regression model was used for data analysis. RESULTS: Overall, 7538 eligible subjects were recruited, with an average age of [45.54 ± 16.94] years. The age of COVID-19 patients was significantly higher than that of uninfected individuals ([48.25 ± 17.48] years vs [38.92 ± 13.41] years; t = 22.437, P < 0.001). A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio. The use of SFHT (odds ratio = 0.753, 95% confidence interval: 0.692, 0.820) was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals. CONCLUSION: Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection. This is a useful study in the larger picture of COVID-19 management, but data from large-sample multi-center, randomized clinical trial are warranted to confirm the finding. Please cite this article as: Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China. J Integr Med. 2023; 21(4):369-376.

Efficacy and Safety of Longyizhengqi Granule in Treatment of Mild COVID-19 Patients Caused by SARS-CoV-2 Omicron Variant: A Prospective Study.

Purpose: This study aimed to evaluate the clinical efficacy of Longyizhengqi granule, a traditional Chinese medicine, in patients with mild COVID-19. Patients and Methods: We conducted a prospective study including mild COVID-19 participants conducted at Mobile Cabin Hospital in Shanghai, China. Participants were assigned to receive Longyizhengqi granule or conventional treatment. The primary outcome was the time for nucleic acid to turn negative and the secondary outcomes are hospital stay and changes in cycle threshold (Ct) values for N gene and Orf gene. Multilevel random-intercept model was performed to analyze the effects of treatment. Results: A total of 3243 patients were included in this study (Longyizhengqi granule 667 patients; conventional treatment 2576 patients). Age (43.5 vs 42.1, p<0.01) and vaccination doses (not vaccinated: 15.8% vs 21.7%, 1 dose: 3.5% vs 2.9%, 2 doses: 27.9% vs 25.6%, 3 doses: 52.8% vs 49.8%. p<0.01) show statistical difference between Conventional treatment group and LYZQ granules group. The use of Longyizhengqi granule could significantly reduce the time for nucleic acid to turn negative (14.2 days vs 10.7 days, p<0.01), shorten hospital stay (12.5 days vs 9.9 days, p<0.01), and increase the changes in Ct value for N gene (8.44 vs 10.33, p<0.01) and Orf gene (7.31 vs 8.44, p<0.01) to approximately 1.5. Moreover, the difference in the changes of Ct values on the 4th, 6th, 8th, and 10th days seem to increase between two groups. No serious adverse events were reported. Conclusion: Longyizhengqi granule might be a promising drug for the treatment of mild COVID-19, and it might be beneficial to effectively shorten the negative transition time of nucleic acid, the total days of hospitalization, and increase the changes of Ct values. Long-term randomized controlled trials with follow-up evaluations are required to confirm its long-term efficacy.

The expression profile of 79 genes from 107 viruses revealed new insights into disease susceptibility in rats, mice and muskrats.

The coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread over the world, resulting in a global severe pneumonia pandemic. Both the cell receptor angiotensin-converting enzyme 2 (ACE2) and the breakdown of S protein by transmembrane serine protease 2 (TMPRSS2) are required by SARS-CoV-2 to enter the host cells. Similarly, the expression level of viral receptor genes in various organs determines the likelihood of viral infection. Several animal species have been found to be infected by the SARS-CoV-2, such as minks, posing an enormous threat to humans. Because the mice and rats were closely related to human and the fact that rats and mice have a risk of infection by SARS-CoV-2 with specific variants, we investigated the expression patterns of 79 receptor genes from 107 viruses ,including SARS-CoV-2, in 14 organs of the rat and mouse, and 5 organs of the muskrat, to find the most likely host organs to become infected with certain viruses. The findings of this study are anticipated to aid in prevention of zoonotic infections spread by rats, mice, muskrats, and other rodents.

Clinical characteristics of 1139 mild cases of the SARS-CoV-2 Omicron variant infected patients in Shanghai.

In March 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surged during the Coronavirus Disease 2019 (COVID-19) pandemic in Shanghai, but over 90% of patients were mild. This study included 1139 COVID-19 patients mildly infected with the Omicron variant of SARS-CoV-2 in Shanghai from May 1 to 10, 2022, aiming to clarify the demographic characteristics and clinical symptoms of patients with mild Omicron infection. The clinical phenotypes of Omicron infection were identified by model-based cluster analysis to explore the features of different clusters. The median age of the patients was 41.0 years [IQR: 31.0-52.0 years] and 73.0% were male. The top three clinical manifestations are cough (57.5%), expectoration (48.3%), and nasal congestion and runny nose (43.4%). The prevalence of nasal congestion and runny nose varied significantly across the doses of vaccinations, with 23.1% in the unvaccinated population and 30%, 45.9%, and 44.3% in the 1-dose, 2-dose and 3-dose vaccinated populations, respectively. In addition, there were significant differences for fever (23.1%, 26.0%, 28.6%, 18.4%), head and body heaviness (15.4%, 14.0%, 26.7%, 22.4%), and loss of appetite (25.6%, 30.0%, 33.6%, 27.7%). The unvaccinated population had a lower incidence of symptoms than the vaccinated population. Cluster analysis revealed that all four clusters had multisystemic symptoms and were dominated by both general and respiratory symptoms. The more severe the degree of the symptoms was, the higher the prevalence of multisystemic symptoms will be. The Omicron variant produced a lower incidence of symptoms in mildly infected patients than previous SARS-CoV-2 variants, but the clinical symptoms caused by the Omicron variant are more complex, so that it needs to be differentiated from influenza.

Experiences of healthcare workers following occupational exposure to COVID-19 at the early stages of the pandemic: A phenomenological qualitative study.

AIM: To explore the experiences of healthcare workers (HCWs) following occupational exposure to coronavirus disease 2019 (COVID-19) during the early stage of the pandemic. DESIGN: A Husserl descriptive phenomenological study design was employed. METHODS: Convenient and snowball sampling was used. In-depth semi-structured telephone interviews were conducted from February to March 2020 with the frontline HCWs who were exposed to COVID-19 during work. Data analysis was conducted following the 7-step analysis method developed by Colaizzi. RESULTS: Fifteen HCWs participated in the study. Four themes were identified, including (1) traumatic experiences since the occupational exposure; (2) getting through the hard time; (3) struggling to return to work; (4) reflections on occupational exposures. CONCLUSION: The HCWs had traumatic and painful experiences after the occupational exposure. But they returned to work with strong resilience, professional obligation and social support. Training and supervision, and adequate supply of personal protective equipment are suggested to prevent professional exposure. Social and organizational support should be provided for the exposed HCWs.

An achromatic colorimetric nanosensor for sensitive multiple pathogen detection by coupling plasmonic nanoparticles with magnetic separation.

Rapid screening of multiple pathogens will greatly improve the efficiency of pandemic prevention and control. Colorimetric methods exhibit the advantages of convenience, portability, low cost, time efficiency, and free of sophisticated instruments, yet usually have difficulties in simultaneous detection and suffer from monotonous color changes with low visual resolution and sensitivity. Hence, coupled three kinds of plasmonic nanoparticles (NPs) with magnetic separation, we developed an achromatic colorimetric nanosensor with highly enhanced visual resolution for simultaneous detection of SARS-CoV-2, Staphylococcus aureus, and Salmonella typhimurium. The achromatic nanosensor was composed of SARS-CoV-2-targeting red gold NPs, S. aureus-targeting yellow silver NPs and S. typhimurium-targeting blue silver triangle NPs mixed as black color. In the detection, three corresponding magnetic probes were added into the above mixture. In the presence of a target pathogen, it would be recognized and combined with corresponding colored reporters and magnetic probes to form sandwich complexes, which were removed by magnetic separation, and the sensor changed from black to a chromatic color (the color of the reporters remained in supernatant). Consequently, different target pathogen induced different color. For example, SARS-CoV-2, S. aureus, and S. typhimurium respectively produced green, purple, and orange. While coexistence of S. aureus and S. typhimurium produced red, and coexistence of S. aureus and SARS-CoV-2 produced blue, etc. Therefore, by observing the color change or measuring the absorption spectra, multiple pathogen detection was achieved conveniently. Compared with most colorimetric sensors, this achromatic nanosensor involved rich color change, thus significantly enhancing visual resolution and inspection sensitivity. Therefore, this sensor opened a promising avenue for efficient monitoring and early warning of food safety and quality.

Forecast daily tourist volumes during the epidemic period using COVID-19 data, search engine data and weather data.

The COVID-19 epidemic has brought a devastating blow to the tourism industry. Affected by the epidemic situation, the change of tourism volume of scenic spots is very unstable. Therefore, forecasting tourist volume in the context of COVID-19 epidemic is a new and challenging problem. In response, a novel multivariate time series forecasting framework based on variational mode decomposition (VMD) and gated recurrent unit network (GRU), i.e., VMD-GRU, is proposed to forecast daily tourist volumes during the epidemic. It takes the lead in using COVID-19 data, search traffic data and weather data. Through sufficient experiments and comparisons, the superiority of the approach is illustrated, and the predictive power of the above three types of data, especially the COVID-19 data, is revealed. Accurate forecast results from the method can help relevant government officials and tourism practitioners to better adjust tourism resources, cooperate with anti-epidemic work and reduce operational risks.

Deny or bolster? A comparative study of crisis communication strategies between Trump and Cuomo in COVID-19.

This study applied the situational crisis communication theory (SCCT) in political crisis communication amidst the COVID-19 outbreak, a "sticky crisis" that is longitudinal and politicized, thereby involving multiple challenges and complexities. Considering the critical role of Twitter in the information transmissions during the ongoing pandemic, this study considered politicians' tweets as a proxy to access their crisis communication strategies and conducted a systematic content analysis to critically evaluate COVID-19 crisis communication strategies of two politicians, Trump and Cuomo, according to their perceived day-to-day circumstances during COVID-19. Three strategies categorized by SCCT, deny, diminish, and bolstering, surfaced with significance for both Trump and Cuomo. A new strategy specific to the political context, cohesion, was also identified. In addition, significant differentiation was observed in the strategic narratives between Trump and Cuomo, which reveals the evolving political dynamics in disease representation and crisis messaging. For example, Trump emphasized social exclusion and accusations of Democrats whilst Cuomo stressed care for vulnerable and minority groups and compassion delivery. Moreover, deny strategy, especially accusing other races, significantly boosted audience engagement for Trump. The results are discussed in relation to the idiosyncrasy of the complex COVID-19 pandemic and crisis communication in the political realm. Our findings demonstrate practical implications including online crisis messaging recommendations that foster public trust during politicized and polarized health emergencies and cultivate grounds for information exchange beyond partisan barriers.

Positioning a Handshake Bay for Twin Stacking Cranes in an Automated Container Terminal Yard Block

At automated container terminals (ACTs), twin automated stacking cranes (ASCs) can carry out the tasks—store and retrieve containers simultaneously in a yard block using a handshake bay, where a primary ASC stacks the container at the handshake bay and the other crane carries it to the destination bay. Although the handshake bay increases the degree of crane utilization, the ASCs will interfere with each other at the bay, decreasing the stacking efficiency. This study formulates a mixed-integer linear program (MILP) to position the handshake bay and simultaneously schedule the twin ASCs to minimize the tasks’ makespan. The proposed formulation considers the safe time interval to avoid crane collisions during adjacent crane movements. To solve the model, we developed a random-key genetic algorithm with a priority-based decoding scheme to optimize the task sequences and tasks assigned to the cranes. The priority-based GA can always generate feasible solutions by ranking the container-handling tasks. Numerical experiments prove that the safe temporal interval affects the makespan and the handshake bay’s position. An optimal handshake bay reduces 35% of the makespan compared with a nonoptimal bay, and the proposed algorithm is competitive compared with the on-the-shelf MILP solver and can solve medium- and large-scale instances in short computing time with gaps lower than 5% compared with ideal solutions.

Intermolecular Interaction Analyses on SARS-CoV-2 Spike Protein Receptor Binding Domain and Human Angiotensin-Converting Enzyme 2 Receptor-Blocking Antibody/Peptide Using Fragment Molecular Orbital Calculation.

The spike glycoprotein (S-protein) mediates SARS-CoV-2 entry via intermolecular interaction with human angiotensin-converting enzyme 2. The receptor binding domain (RBD) of the S-protein has been considered critical for this interaction and acts as the target of numerous neutralizing antibodies and antiviral peptides. This study used the fragment molecular orbital method to analyze the interactions between the RBD and antibodies/peptides and extracted crucial residues that can be used as epitopes. The interactions evaluated as interfragment interaction energy values between the RBD and 12 antibodies/peptides showed a fairly good correlation with the experimental activity pIC50 (R2 = 0.540). Nine residues (T415, K417, Y421, F456, A475, F486, N487, N501, and Y505) were confirmed as being crucial. Pair interaction energy decomposition analyses showed that hydrogen bonds, electrostatic interactions, and π-orbital interactions are important. Our results provide essential information for understanding SARS-CoV-2-antibody/peptide binding and may play roles in future antibody/antiviral drug design.

Structural Design and Preliminary Tests of a Novel Patient Transfer Apparatus for Medical Scenarios.

Patient transfer has always been a difficult problem, usually requiring multiple caregivers to work together, which is time consuming and can easily cause secondary injuries to the patient. In addition, with the crisis of COVID-19, the issue of patient transfer is even more critical, as caregivers are at a high risk of infection, causing significant damage to healthcare resources. In this paper, a patient transfer assist system named E-pat-plus (Easy Patient Transfer plus) has been proposed; it can assist caregivers in transferring patients, reduce direct contact between them, and avoid secondary injuries. In the mechanical structure of this apparatus, a novel five-gear assembly module and a synchronous belt pulley set are proposed; they are the key points to the basic functional realization of the device and can reduce the cost of the prototype. Furthermore, a fuzzy (proportion-integration-differentiation) PID-based cross-coupling control strategy is applied to the apparatus to ensure the stability and safety of the operation. Finally, some preliminary experiments, including current experiments and error experiments, are carried out to verify the reliability of the device and lay the foundation for clinical tests.

Target-Based In Silico Screening for Phytoactive Compounds Targeting SARS-CoV-2.

Coronavirus disease 2019 (COVID-19), resulting from infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can cause severe and fatal pneumonia along with other life-threatening complications. The COVID-19 pandemic has taken a heavy toll on the healthcare system globally and has hit the economy hard in all affected countries. As a result, there is an unmet medical need for both the prevention and treatment of COVID-19 infection. Several herbal remedies have claimed to show promising clinical results, but the mechanisms of action are not clear. We set out to identify the anti-viral natural products of these herbal remedies that presumably inhibit the life cycle of SARS-CoV-2. Particularly we chose four key SARS-CoV-2 viral enzymes as targets: Papain-like protease, Main protease, RNA dependent RNA polymerase, and 2'-O-ribose methyltransferase, which were subjected to an unbiased in silico screening against a small molecule library of 33,765 compounds originating from herbs and medicinal plants. The small molecules were then ranked based on their free energy of fitting into the "druggable" pockets on the surface of each target protein. We have analyzed the best "fit" molecules and annotated them according to their plant sources and pharmacokinetic properties. Here we present a list of potential anti-viral ingredients of herbal remedies targeting SARS-CoV-2 and explore the potential mechanisms of action of these compounds as a framework for further development of chemoprophylaxis agents against COVID-19.

"Others are more vulnerable to fake news than I Am": Third-person effect of COVID-19 fake news on social media users.

Fake news have pervaded the social media landscape during the COVID-19 outbreak. To further explore what contributed to fake news susceptibility of social media users, the research 1) integrated a widely-adopted mass communication theory of third-person perception (TPP) with digital disinformation; 2) examined users' social media engagement and individual characteristics toward risk as antecedents of TPP; and lastly, 3) tested TPP of fake news under a context of COVID-19 outbreak, an uncertain situation flooded with baseless news and information. An online survey was conducted on 871 respondents via Amazon Mechanical Turk. As a result, we found that in the context of COVID-19, social media engagement 1) directly increased TPP; and 2) indirectly increased TPP via self-efficacy and perceived knowledge. However, negative affect failed to mediate a positive relationship between communal engagement and TPP, as the respondents rated themselves more attentive to fake news than are others. Therefore, the fact that social media directly and indirectly provoked higher TPP implicates that a potential harm of social media is not confined to a rumor mill that propagates false stories, as widely recognized, but can further extend to an echo chamber to cultivate a slanted belief that he or she is fake-news-proof.

Temporal associations among loneliness, anxiety, and depression during the COVID-19 pandemic period.

Numerous studies have reported that individuals' loneliness, anxiety, and depression levels increased during the COVID-19 pandemic period. However, reciprocal associations among loneliness, anxiety, and depression, as well as gender differences in these associations, have not been investigated. Therefore, temporal associations among loneliness, anxiety, and depression and gender differences in these associations were examined in a longitudinal study during the COVID-19 pandemic period. The loneliness, anxiety, and depression levels of 458 university students were evaluated at three timepoints (T1, T2, and T3) during the COVID-19 pandemic period in China. The timepoints were separated by 1 month. Cross-lagged panel designs were used to examine reciprocal associations among loneliness, anxiety, and depression as well as the stability and gender differences of these associations. Cross-lagged panel analysis revealed that T1 depression positively predicted T2 anxiety and loneliness, T1 loneliness positively predicted T2 depression, T2 anxiety positively predicted T3 depression, T2 depression positively predicted T3 anxiety and loneliness, T2 loneliness positively predicted T3 depression, and T1 loneliness positively predicted T3 anxiety through the mediating role of T2 depression. No gender differences were observed in the cross-lagged associations. During the COVID-19 pandemic period, loneliness and depression predicted each other across time, and loneliness predicted anxiety across time, mediated by depression. No gender differences were observed in the cross-lagged associations among loneliness, anxiety, and depression.

Associations Among the Big Five Personality Traits, Maladaptive Cognitions, and Internet Addiction Across Three Time Measurements in 3 Months During the COVID-19 Pandemic.

The present study examined the longitudinal association among the Big Five personality traits, maladaptive cognitions, and Internet addiction during the COVID-19 pandemic. A total of 481 Chinese university students (247 men; mean age = 20.31 years) were surveyed three times (interval of 1 month) by using the Chinese version of the Big Five Personality Traits Scale, Maladaptive Cognitions Scale, and Internet Addiction Scale. The results of a cross-lagged panel analysis highlighted that (i) extraversion, agreeableness, conscientiousness, and openness were negatively associated with maladaptive cognitions and Internet addiction, whereas neuroticism was found to be positively associated with maladaptive cognitions and Internet addiction across time; (ii) associations among the Big Five personality traits, maladaptive cognitions, and Internet addiction were dynamic and bidirectional; and (iii) maladaptive cognitions played mediating roles in extraversion, agreeableness, conscientiousness, openness, and Internet addiction across time. The Big Five personality traits, maladaptive cognitions, and Internet addiction predicted each other across time, and maladaptive cognitions were likely to be the key mediating factor in the associations between the Big Five personality traits and Internet addiction, which supported and expanded the Davis' cognitive-behavioral model.

Gut Microbiota May Not Be Fully Restored in Recovered COVID-19 Patients After 3-Month Recovery.

Coronavirus disease 2019 (COVID-19) has infected over 124 million people worldwide. In addition to the development of therapeutics and vaccines, the evaluation of the sequelae in recovered patients is also important. Recent studies have indicated that COVID-19 has the ability to infect intestinal tissues and to trigger alterations of the gut microbiota. However, whether these changes in gut microbiota persist into the recovery stage remains largely unknown. Here, we recruited seven healthy Chinese men and seven recovered COVID-19 male patients with an average of 3-months after discharge and analyzed their fecal samples by 16S rRNA sequencing analysis to identify the differences in gut microbiota. Our results suggested that the gut microbiota differed in male recovered patients compared with healthy controls, in which a significant difference in Chao index, Simpson index, and ß-diversity was observed. And the relative abundance of several bacterial species differed clearly between two groups, characterized by enrichment of opportunistic pathogens and insufficiency of some anti-inflammatory bacteria in producing short chain fatty acids. The above findings provide preliminary clues supporting that the imbalanced gut microbiota may not be fully restored in recovered patients, highlighting the importance of continuous monitoring of gut health in people who have recovered from COVID-19.

Anxiety and depression levels of the general population during the rapid progressing stage in the coronavirus disease 2019 outbreak: a cross-sectional online investigation in China.

OBJECTIVE: The outbreak of COVID-19 has major impacts on the psychological health of the public. This study aimed to investigate the anxiety and depression levels of the general population during the rapid progressing stage of COVID-19 pandemic in China and to explore the associated factors. DESIGN AND SETTING: A cross-sectional online survey. PARTICIPANTS: 2651 Chinese people. MEASURES: The Hospital Anxiety and Depression Scale was used to measure their psychological health. A structured questionnaire collected possible associated factors, including sociodemographic characteristics, health information, contact history-related information, experience and perceptions, knowledge and education and adopted precautions. Multiple linear regression was conducted to explore the factors associated with anxiety and depression. RESULTS: The mean score of anxiety and depression was 4.35 and 4.38, respectively. The rates of people with anxiety and depressive symptoms (with >7 score in the subscale) were 14.15% and 17.35%, respectively. Participants without political party membership, with contact history of COVID-19, going out or gathering, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher risks of infection, lower knowledge and poorer health presented higher anxiety and depression levels. Moreover, those who were females, married, lived alone and wore mask were more anxious; whereas people who were younger, experienced public health crisis, did not take precautions (regular work-rest, exercise) had higher depression level. CONCLUSIONS: During the rapid progressing stage of COVID-19 pandemic in China, one-seventh and one-sixth respondents presented anxiety and depression symptoms, respectively. The risk factors for anxiety and depression included the following: without political party membership, with contact history of COVID-19, going out or gathering, wearing masks, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher susceptibility, lower knowledge and poorer health status. Extensive information and psychological support should be provided to improve the mental health of the general population.

Administration of Statins Can Improve Survival and Coagulation Function in Patients with Severe COVID-19 in Intensive Care Units: A Retrospective Study (preprint)

Background: COVID-19 is a global epidemic posing threat to public health. Without specific drugs and therapies, it is important to evaluate the effectiveness of currently applicable drugs.This study was a retrospective analysis of the effect of the administration of statins on survival in patients with severe COVID-19.Design: This study was a retrospective analysis of data collected in the ICU of Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology (HUST) during the COVID-19 outbreak.Data from69 patients with severe COVID-19 treated in the ICU from February to March 2020 were collected for the analysis.Patients with severe COVID-19 were treated with the standard of care at the time, and some patients were also treated with statins.Results: Sixty-four patients with complete records were enrolled in the final stage of analysis. Statin administration had a beneficial effect on the overall survival of the patients. The statin administration cohorthad a significantly shorter activated partial thromboplastin time (aPTT) and prothrombin time (PT) according to t-tests. The aPTT and PT were also stable, as shown by locally weighted smoothing (LOESS) analysis. The use of statins combined with corticosteroids, anti-coagulants and anti-hypertensive drugs had a relatively greater effect on survival.Conclusions: Statins can be therapeutic agents that may promote patient survival, possibly by improving coagulation function. Trial registration: HIRB 2020-1119 September 11th, 2020, retrospectively registered.