Lung ultrasound an alternative to computed tomography and chest X-ray in the diagnosis of children infected with SARS-CoV-2: a systematic review of literature (preprint)

Abstract Background: Lung ultrasound (LUS) has become an important tool in diagnosing and following an adult patient with COVID-19; however, the literature for the pediatric age group is limited. Herein, we reviewed the up-to-date literatures on ultrasound use for COVID-19 pediatric patients for better management of COVID-19 in children. Methods and Objectives: The search terms “COVID-19,” “SARS-CoV2,” “coronavirus,” “2019-nCoV,” “lung ultrasound,” “sonography,” “adolescents” “children,” “childhood” and “newborn” were searched on the online databases PubMed, Embase and Medline. Articles meeting the inclusion criteria were included in the analysis and review. Results: We identified only fifteen studies to date using LUS to diagnose SARS-CoV-2 infection in children. These studies involved a total of 334 newborns, children and adolescents. Regarding the use of chest X-ray (CXR) and LUS in pediatric patients with COVID-19, we identified six studies with a total of 162 participants, with the following results: 33patients(14.11%) with lung abnormalities on lung US had a normal CXR; however, no patients with normal lung US had abnormalities on the CXR. In addition, regarding the use of computed tomography (CT) and LUS in pediatric patients with COVID-19 infection, we identified five studies with a total of 50 participants and 3 patients(6%) with lung abnormalities on chest LUS had a normal CT. Conclusion: Our findings suggest that LUS is a useful tool in the diagnosis of children and reduction in chest CT assessments may be possible when LUS is used in early diagnosis and follow-up monitoring of COVID-19 pneumonia in the children.

The lncRNAs involved in regulating the RIG-I signaling pathway

Understanding the targets and interactions of long non-coding RNAs (lncRNAs) related to the retinoic acid-inducible gene-I (RIG-I) signaling pathway is essential for developing interventions, which would enable directing the host inflammatory response regulation toward protective immunity. In the RIG-I signaling pathway, lncRNAs are involved in the important processes of ubiquitination, phosphorylation, and glycolysis, thus promoting the transport of the interferon regulatory factors 3 and 7 (IRF3 and IRF7) and the nuclear factor kappa B (NF-κB) into the nucleus, and activating recruitment of type I interferons (IFN-I) and inflammatory factors to the antiviral action site. In addition, the RIG-I signaling pathway has recently been reported to contain the targets of coronavirus disease-19 (COVID-19)-related lncRNAs. The molecules in the RIG-I signaling pathway are directly regulated by the lncRNA–microRNAs (miRNAs)–messenger RNA (mRNA) axis. Therefore, targeting this axis has become a novel strategy for the diagnosis and treatment of cancer. In this paper, the studies on the regulation of the RIG-I signaling pathway by lncRNAs during viral infections and cancer are comprehensively analyzed. The aim is to provide a solid foundation of information for conducting further detailed studies on lncRNAs and RIG-I in the future and also contribute to clinical drug development.

Nucleic acid detection of fecal samples from confirmed cases of COVID-19

To investigate the status of viral infection in the feces of confirmed COVID-19, cases fecal samples or anal swabs from 36 confirmed cases were collected, 2019-nCoV was detected by real-time fluorescence RT-PCR, and the infection rates of the cases were compared by statistical analysis software SPSS 19.0. Among the 36 samples, 20 (55.56%) were positive for 2019-nCoV. The positive rate of critical cases (2/3) and severe cases(6/9) were both 66.67%, the positive rate of common pneumonia was 62.50% (10/16), and the positive rate of mild pneumonia was 25.00% (2/8). The 36 confirmed COVID-19 cases included 22 males and 14 females, with a detection rate of 54.55% and 57.14%, respectively. The age distribution range of the cases was ranging between 17 and 86 years old, with an average age of 48.75 years. Among the 36 samples, 2 positive specimens in 5 anal swab specimens and 18 positive specimens in 31 fecal specimens were detected. There were no statistically significant differences in the positive detection rates among clinical types, genders, ages and specimen types, respectively. From these results, we deduced that fecal samples of confirmed COVID-19 cases contained 2019-nCoV, which can cause infection through potential fecal-oral transmission and be significant for clinical treatment and epidemiological study.

Eight Months Into The COVID-19 Outbreak, Whether This Pandemic Still Psychologically Affected Convalescent Psychiatric Patients: A Cross-Sectional Study. (preprint)

BackgroundThis study aimed to find out eight months into the COVID-19 outbreak, how much psychological effect was experienced by convalescent psychiatric patients, and identify the potential risk and protective factors related to their psychological response.MethodsData from 136 convalescent psychiatric patients were collected. We used binary logistic regression analyses to identify participants’ SRQ score and the factors associated with it.ResultsThere were 47 (34.5%) participants scored eight or higher. Working or marital status and annual income were significantly associated with a higher score in SRQ. Similarly, sleep duration, interpersonal relationship, exercise time, special events, and general condition were linked to SRQ grade.ConclusionsEight months into the COVID-19 pandemic, this widespread virus psychologically impacted convalescent psychiatric patients. This result was related to less annual income, which stressed the necessity to provide closer follow-up and financial support in this crisis's late stage.

Epidemiological characteristics of COVID-19 in Hainan Province, China

The epidemiology characteristics of 2019 novel coronavirus diseases (COVID-19) cases in Hainan were collected and analyzed for providing next stage control and prevention strategy in next stage. Spatial and temporal distribution, population characteristic, cluster, the interval between onset, visiting clinic, admitted were analyzed. Local cases and severe cases were also included in the analysis. Result showed that a total of 168 confirmed cases, including 36 severe cases and 5 fatal cases were reported. Cases were mainly distributed in Haikou, Sanya etc tourism cities and counties. The first case occurred in Jan 13th and the epidemic peak occurred in Jan 24th. Since Feb 6th, onset of illness has declined. The male-to-female ratio was 0.9:1. The median age was 51 years. Cases older than 50 years accounted for 54.8%. Retirees accounted for 36.9%, which was highest in all cases. Since Feb, the proportion of local cases rose dramatically. The period from onset to visiting clinic (OTV), from first visiting clinic to diagnosis (VTF), from onset to diagnosis (OTD) and from onset to be admitted (OTA) was longer in local cases than imported cases. Median age and the percentage of underlying diseases of severe/extreme cases were higher than mild/ordinary cases. OTV of severe/extreme cases was longer than mild/ordinary cases, while for VTF, the former was shorter than latter. The epidemic was divided into three stages. Most of cases in the first stage were imported cases, while in the second stage most of cases were local cases. There were few cases in the third stages. We should strengthen personal protection and health monitoring for people in service industry, isolate the close contacts, and carry out publicity and education to raise the awareness of medical treatment for people, especially for old people. Clinical doctors should monitor the state of the patients older than 60 years and with underlying diseases. We should step up epidemic monitoring prevention and control measure for people return from holiday and immigrant to consolidate the effects of prevention and control work.