Experience of the use of hydroxychloroquine on patients with COVID-19: A perspective on viral load and cytokine kinetics.

Until now, there are no approved treatment against COVID-19. Hydroxychloroquine (HCQ) was hypothesized to be active against SARS-CoV2 via antiviral and anti-inflammatory effect; however, HCQ for COVID-19 in clinical use remained debating. In this preliminary report, we presented six patients with mild to moderate COVID-19. They were treated with HCQ for 14 days from the day of COVID-19 diagnosis. Serial viral load from respiratory specimens were performed every other day. Cytokine profile was checked before HCQ initiation and on the 14th day of HCQ treatment. All patients receiving HCQ completed 14-day course without complication. Among the six patients, the mean duration from symptom onset to last detectable viral load was 34 ± 12 days, which was similar to those without specific treatment in previous reports. Low level of interferon-gamma was noted in all patients of different stage of infection and three patients had elevation of IL-17 level. Prolonged virus shedding is still observed regardless HCQ. The impact of HCQ on cytokine kinetics remained unclear; however, IL-17 could be an inflammatory marker for disease status monitor and a potential therapeutic target.

Research Progress of Diagnosis and Treatment of Severe Patients of Novel Coronavirus Pneumonia

Novel Coronavirus Pneumonia is highly infectious and the overall mortality rate is low, but the mortality rate of severe patients is high. Compared with mild patients, the disease is progressing rapidly, imaging features are typical, and many laboratory indexes are more remarkable. Some patients need intensive care unit treatment and mechanical ventilation. Early diagnosis, close attention to the changes of the condition and comprehensive treatment are very important.

Optimization of the Working Procedure of Radionuclide Treatment Ward during 2019-nCoV Prevention

Since the end of 2019, Novel Coronavirus Pneumonia (2019-nCov) has appeared and spread rapidly in the world. During the epidemic period, how to control the infection in the working procedure of radionuclide treatment ward is a clinical protection problem that must be solved. If a novel coronavirus pneumonia (NCP) is suspected or diagnosed, the most important thing is to isolate the relevant doctors and patients on the spot in time and initiate relevant NCP clinical emergency plans and procedures. When the radioactive infected medical waste is disinfected, it should be treated as radioactive waste. Therefore, it is necessary to optimize the working procedures of radionuclide therapy ward.

Reducing the consumption of personal protective equipment by setting up a multifunctional sampling station in the emergency department to screen for COVID-19 infection in Taiwan.

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.

Association of ABO blood groups with SARS-COV-2 infection (preprint)

In view of the influence of ABO blood group antigens on infectious diseases, we explore the effect of ABO blood types on SARS-COV-2 infection. In this report, demographic data of 80 COVID-19 patients and 26 SARS-COV-2 asymptomatic carriers were collected based on electronic medical records. The results indicated that the distribution of ABO blood group in the confirmed patients was significantly different from asymptomatic carriers; importantly, antigen A carrier have significantly higher risk of developing into severe or critically cases than other types. These data present further evidence for the association of the blood groups to susceptibility to SARS-COV-2 infection.

SARS-CoV-2 Neutralizing Antibody Responses Are More Robust in Patients with Severe Disease (preprint)

We studied plasma antibody responses of 35 patients about 1 month after SARS-CoV-2 infection. Titers of antibodies binding to the viral nucleocapsid and spike proteins were significantly higher in patients with severe disease. Likewise, mean antibody neutralization titers against SARS-CoV-2 pseudovirus and live virus were higher in the sicker patients, by ~5-fold and ~7-fold, respectively. These findings have important implications for those pursuing plasma therapy, isolation of neutralizing monoclonal antibodies, and determinants of immunity.