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1.
Journal of Hospitality and Tourism Management ; : 10-20, 2022.
Article in English | APA PsycInfo | ID: covidwho-2298822

ABSTRACT

Wearing a facemask is an effective part of personal hygiene management (WHO, 2020). Not only can it offer healthy people some protection against coronavirus disease 2019 (COVID-19) infection, but it can also reduce the spread of the virus. Wearing facemasks, as a part of the various regulations and guidelines encouraged by the Chinese government and hospitality firms, has been widely accepted by the public in the post-COVID-19 era in China. But few studies have considered the effects of employees wearing facemasks on the customer service experience. Based on signaling theory, this experimental study explores the effects of hotel employees wearing facemasks on customer perceptions of service quality. The results indicate three main effects. (a) Having employees wear facemasks can improve perceptions of customer service quality. (b) Customers commonly feel that female employees wearing facemasks could provide higher service quality than male mask-wearing employees, but the improvement in customer perception with male employees wearing facemasks is greater than the situation between facemask-less and facemask-wearing females. (c) Customer perceptions of employee expertise, employee trustworthiness, and hotel trustworthiness play serial mediating roles. Recommendations to help hotel managers improve customers' service evaluations during the COVID-19 pandemic are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

2.
Front Med (Lausanne) ; 9: 859682, 2022.
Article in English | MEDLINE | ID: covidwho-2246410

ABSTRACT

Background: The safety of the COVID-19 vaccine in patients at stroke risk is poorly understood. Methods: A survey was conducted on risk factors related to stroke and adverse reactions to vaccines. The participants were divided into low-, medium-, and high-risk groups, according to the stroke risk scorecard recommended by the Stroke Prevention and Control Engineering Committee of the National Health and Family Planning Commission. Factors associated with adverse reactions were analyzed. Reasons for non-vaccination and the aggravation of underlying diseases after vaccination were investigated. Results: 1747 participants participated (138 unvaccinated) and 36.8, 22.1, 41.1% of the vaccinated participants had low, medium, high risk of stroke, respectively. The incidence of adverse reactions after the first and second injection was 16.6, 13.7%, respectively. There was no difference in the incidence of adverse reactions among different risk groups. Sex, vaccine type, sleep quality, worry of adverse reactions, age, and education level were significantly related to adverse reactions to vaccination. The most popular reason for non-vaccination for medium- or high risk-participants was the aggravation of the existing disease. Only 0.3% of vaccinated participants reported slight changes in blood pressure, sugar levels, and lipid levels. No aggravation of stroke sequelae, atrial fibrillation, or transient ischemic attack was reported. Conclusions: Vaccination against COVID-19 (inactive virus) is safe for people at risk of stroke when the existing disease condition is stable. It is suggested to strengthen vaccine knowledge and ensure good sleep before vaccination.

3.
Anal Biochem ; 663: 115034, 2023 02 15.
Article in English | MEDLINE | ID: covidwho-2229607

ABSTRACT

Because the spike (S) protein of the severe acute respiratory syndrome coronavirus (SARS-CoV) is the immunodominant antigen, the S protein and its receptor-binding domain (RBD) are both targets currently to be genetically engineered for designing the broad-spectrum vaccine. In theory, the expressed protein exists as a set of variants that are roughly the same but slightly different, which depends on the protein expression system. The variants can be phenotypically manifested as charge heterogeneity. Here, we attempted to depict the charge heterogeneity of the trimeric SARS-CoV-2 RBD by using capillary isoelectric focusing with whole-column imaging detection (cIEF-WCID). In its nature form, the electropherogram fingerprints of the trimeric RBD were presented under optimized experimental conditions. The peaks of matrix buffers can be fully distinguishable from peaks of trimeric RBD. The isoelectric point (pI) was determined to be within a range of 6.67-9.54 covering the theoretical pI of 9.02. The fingerprints of three batches of trimeric RBDs are completely the same, with the intra-batch and batch-to-batch relative standard deviations (RSDs) of both pI values and area percentage of each peak no more than 1.0%, indicating that the production process is stable and this method can be used to surveillance the batch-to-batch consistency. The fingerprint remained unchanged after incubating at 37 °C for 7 d and oxidizing by 0.015% H2O2. In addition, the fingerprint was destroyed when adjusting the pH value to higher than 10.0 but still stable when the pH was lower than 4.0. In summary, the cIEF-WCID fingerprint can be used for the identification, batch-to-batch consistency evaluation, and stability study of the trimeric SARS-CoV-2 RBD, as part of a quality control strategy during the potential vaccine production.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Isoelectric Focusing/methods , Capillary Isoelectric Focusing , Hydrogen Peroxide , Protein Binding
4.
J Inflamm (Lond) ; 19(1): 9, 2022 Jul 07.
Article in English | MEDLINE | ID: covidwho-1919118

ABSTRACT

BACKGROUND: Severe sepsis and its subsequent complications cause high morbidity and mortality rates worldwide. The lung is one of the most vulnerable organs sensitive to the sepsis-associated inflammatory storm and usually develops into acute respiratory distress syndrome (ARDS)/acute lung injury (ALI). The pathogenesis of sepsis-associated ALI is accompanied by coordinated transmembrane signal transduction and subsequent programmed cell death; however, the underlying mechanism remains largely unclear. RESULTS: Here we find that the expression of serine incorporator 2 (Serinc2), a protein involved in phosphatidylserine synthesis and membrane incorporation, is upregulated in cecal ligation and puncture (CLP)-induced ALI. Furthermore, the Serinc2-knockout (KO) mouse line is generated by the CRISPR-cas9 approach. Compared with wild-type mice, the Serinc2-KO mice exhibit exacerbated ALI-related pathologies after CLP. The expressions of pro-inflammatory factors, including IL1ß, IL6, TNFα, and MCP1, are significantly enhanced by Serinc2 deficiency, concurrent with over-activation of STAT3, p38 and ERK pathways. Conversely, Serinc2 overexpression in RAW264.7 cells significantly suppresses the inflammatory responses induced by lipopolysaccharide (LPS). Serinc2 KO aggravates CLP-induced apoptosis as evidenced by increases in TUNEL-positive staining, Bax expression, and cleaved caspase-3 and decreases in BCL-2 expression and Akt phosphorylation, whereas these changes are suppressed by Serinc2 overexpression in LPS-treated RAW264.7 cells. Moreover, the administration of AKTin, an inhibitor of Akt, abolishes the protective effects of Serinc2 overexpression against inflammation and apoptosis. CONCLUSIONS: Our findings demonstrate a protective role of Serinc2 in the lung through activating the Akt pathway, and provide novel insight into the pathogenesis of sepsis-induced ALI.

5.
Journal of Theoretical and Applied Electronic Commerce Research ; 17(4):1493-1511, 2022.
Article in English | MDPI | ID: covidwho-2116264

ABSTRACT

The impact of the COVID-19 pandemic on fresh food e-commerce has led to a loss of consumers, and 'e-commerce temperature';is seen as an important means of alleviating consumer dissatisfaction and retaining consumers. To explore the connotation and effect of it, and to break through possible 'comfort';bottlenecks, we used online reviews of the Jingdong fresh food platform as research data, mined the characteristics of 'e-commerce temperature';with the help of the LDA topic model, and evaluated the mechanism of 'e-commerce temperature';on consumer satisfaction during the pandemic by using quasi-natural experiments and Word2vec-based sentiment analysis. The results show that 'e-commerce temperature';has five connotations of logistics commitment, humanized delivery, health pledge, pandemic perseverance, and consumer care, which can effectively mitigate the loss of consumer satisfaction. Interestingly, we found that the 'e-commerce temperature';has a limited 'comfort';effect. Additionally, further social network analysis shows that the bottleneck is mainly due to the consumers' psychological gaps when comparing the usual e-commerce services, and cretailers can repair them through financial compensation and spiritual solace. The study explores e-commerce service quality at different pandemic stages with the help of text mining techniques, enriches the theory of e-commerce research, and alleviates the Hawthorne bias in traditional empirical studies. This study also provides a reference for e-retailers to improve service quality and respond to emergencies in a changing post-pandemic era.

6.
Frontiers in medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-2047051

ABSTRACT

Background The safety of the COVID-19 vaccine in patients at stroke risk is poorly understood. Methods A survey was conducted on risk factors related to stroke and adverse reactions to vaccines. The participants were divided into low-, medium-, and high-risk groups, according to the stroke risk scorecard recommended by the Stroke Prevention and Control Engineering Committee of the National Health and Family Planning Commission. Factors associated with adverse reactions were analyzed. Reasons for non-vaccination and the aggravation of underlying diseases after vaccination were investigated. Results 1747 participants participated (138 unvaccinated) and 36.8, 22.1, 41.1% of the vaccinated participants had low, medium, high risk of stroke, respectively. The incidence of adverse reactions after the first and second injection was 16.6, 13.7%, respectively. There was no difference in the incidence of adverse reactions among different risk groups. Sex, vaccine type, sleep quality, worry of adverse reactions, age, and education level were significantly related to adverse reactions to vaccination. The most popular reason for non-vaccination for medium- or high risk-participants was the aggravation of the existing disease. Only 0.3% of vaccinated participants reported slight changes in blood pressure, sugar levels, and lipid levels. No aggravation of stroke sequelae, atrial fibrillation, or transient ischemic attack was reported. Conclusions Vaccination against COVID-19 (inactive virus) is safe for people at risk of stroke when the existing disease condition is stable. It is suggested to strengthen vaccine knowledge and ensure good sleep before vaccination.

7.
Front Public Health ; 10: 854977, 2022.
Article in English | MEDLINE | ID: covidwho-1903208

ABSTRACT

Background: The COVID-19 pandemic has a serious impact on the mental health of the public due to its economic and social impact. And psychological effects have led to drug and alcohol abuse. After the city lifted the lockdown, we consecutively encountered several young nitrous oxide abusers admitted to hospital for neurological treatment. Purpose: To inform physician decisions and social intervention, this observational study aimed at investigating the neurological and psychological characteristics of nitrous oxide abusers and its underlying causes during the COVID-19 lockdown. Methods: The nitrous oxide abusers who sought neurological treatment at our hospital between May 2020 and June 2020 were enrolled. Clinical data including socio-demographic, physical examination, laboratory examination, electromyography and neuroimaging were collected. Their motivations for inhaling nitrous oxide, knowledge about the nitrous oxide abuse and the accompanying of family were investigated face to face. Psychological status was assessed by the Symptom Checklist 90 (SCL-90) psychological evaluation. Results: Six nitrous oxide abusers were enrolled and the age was 22 ± 4.3. Clinical presentations included varying degrees of limb numbness and an ataxic gait. Laboratory examination revealed that all the patients did not have pernicious anemia, 4 patients had decreased vitamin B12 while 3 patients exhibited elevated homocysteine levels. MR of the spinal cord revealed that 4 patients had abnormal signals in the cervical spinal cord of high symmetry with splayed or inverted V sign after T2WI. Electromyogram (EMG) test showed 5 patients had peripheral nerve damage. The SCL-90 psychological evaluation results indicated that all patients had severe anxiety, depression and psychosis and they had severer psychological problems than ordinary citizens. Their motives for inhaling nitrous oxide are to relieve boredom, curiosity and buddy pressure. Their family spent <1 day per week to stay with them during city lockdown. Conclusion: The enrolled patients caused by abuse of nitrous oxide presented with symptoms of subacute combined with spinal degeneration. They had more serious psychological problems related to the COVID-19 pandemic. These cases make us value the psychological problems of young people under the outbreak and take multi-layered measures from families, schools (companies), hospitals, and governments to address it.


Subject(s)
COVID-19 , Nitrous Oxide , Adolescent , COVID-19/epidemiology , Communicable Disease Control , Humans , Magnetic Resonance Imaging , Nitrous Oxide/adverse effects , Pandemics , Vitamin B 12/therapeutic use
8.
Immunohorizons ; 6(6): 344-355, 2022 06 13.
Article in English | MEDLINE | ID: covidwho-1893080

ABSTRACT

Epitope mapping of the interactions between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Abs is challenging because of complexity in protein three-dimensional structures. Protein structure fingerprint technology was applied for epitope mapping of 44 SARS-CoV-2 Abs with three-dimensional structure complexes. The results defined how the epitopes were distributed on SARS-CoV-2 and how the patterns of six CDRs from Abs participated in neutralization. Also, the residue-residue recognition revealed that certain residues had higher frequencies on the interfaces between SARS-CoV-2 and Abs, and the activity correlated with the physicochemical properties of the residues at the interface. Thus, epitope mapping provides significant lead information for development of epitope-based designs for Abs, vaccines, and diagnostic reagents. This is a bioinformatics project of structural data analysis; no animals or cells were used.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Epitope Mapping , Epitopes , Humans , Membrane Glycoproteins , Spike Glycoprotein, Coronavirus , Viral Envelope Proteins
9.
Proc Natl Acad Sci U S A ; 119(18): e2123560119, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-1805767

ABSTRACT

The duper mutation is a recessive mutation that shortens the period length of the circadian rhythm in Syrian hamsters. These animals show a large phase shift when responding to light pulses. Limited genetic resources for the Syrian hamster (Mesocricetus auratus) presented a major obstacle to cloning duper. This caused the duper mutation to remain unknown for over a decade. In this study, we did a de novo genome assembly of Syrian hamsters with long-read sequencing data from two different platforms, Pacific Biosciences and Oxford Nanopore Technologies. Using two distinct ecotypes and a fast homozygosity mapping strategy, we identified duper as an early nonsense allele of Cryptochrome 1 (Cry1) leading to a short, unstable protein. CRY1 is known as a highly conserved component of the repressive limb of the core circadian clock. The genome assembly and other genomic datasets generated in this study will facilitate the use of the Syrian hamster in biomedical research.


Subject(s)
COVID-19 , Cryptochromes , Animals , Circadian Rhythm/genetics , Cricetinae , Cryptochromes/genetics , Humans , Loss of Function Mutation , Mesocricetus , Mutation , Transcription Factors/genetics
10.
Nat Immunol ; 23(5): 781-790, 2022 05.
Article in English | MEDLINE | ID: covidwho-1778617

ABSTRACT

Although mRNA vaccine efficacy against severe coronavirus disease 2019 remains high, variant emergence has prompted booster immunizations. However, the effects of repeated exposures to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens on memory T cells are poorly understood. Here, we utilize major histocompatibility complex multimers with single-cell RNA sequencing to profile SARS-CoV-2-responsive T cells ex vivo from humans with one, two or three antigen exposures, including vaccination, primary infection and breakthrough infection. Exposure order determined the distribution between spike-specific and non-spike-specific responses, with vaccination after infection leading to expansion of spike-specific T cells and differentiation to CCR7-CD45RA+ effectors. In contrast, individuals after breakthrough infection mount vigorous non-spike-specific responses. Analysis of over 4,000 epitope-specific T cell antigen receptor (TCR) sequences demonstrates that all exposures elicit diverse repertoires characterized by shared TCR motifs, confirmed by monoclonal TCR characterization, with no evidence for repertoire narrowing from repeated exposure. Our findings suggest that breakthrough infections diversify the T cell memory repertoire and current vaccination protocols continue to expand and differentiate spike-specific memory.


Subject(s)
COVID-19 , SARS-CoV-2 , CD8-Positive T-Lymphocytes , Humans , Phenotype , Receptors, Antigen, T-Cell/genetics , Spike Glycoprotein, Coronavirus/genetics , Vaccines, Synthetic , mRNA Vaccines
11.
Journal of Hospitality and Tourism Management ; 50:10-20, 2021.
Article in English | EuropePMC | ID: covidwho-1602190

ABSTRACT

Wearing a facemask is an effective part of personal hygiene management (WHO, 2020). Not only can it offer healthy people some protection against coronavirus disease 2019 (COVID-19) infection, but it can also reduce the spread of the virus. Wearing facemasks, as a part of the various regulations and guidelines encouraged by the Chinese government and hospitality firms, has been widely accepted by the public in the post-COVID-19 era in China. But few studies have considered the effects of employees wearing facemasks on the customer service experience. Based on signaling theory, this experimental study explores the effects of hotel employees wearing facemasks on customer perceptions of service quality. The results indicate three main effects. (a) Having employees wear facemasks can improve perceptions of customer service quality. (b) Customers commonly feel that female employees wearing facemasks could provide higher service quality than male mask-wearing employees, but the improvement in customer perception with male employees wearing facemasks is greater than the situation between facemask-less and facemask-wearing females. (c) Customer perceptions of employee expertise, employee trustworthiness, and hotel trustworthiness play serial mediating roles. Recommendations to help hotel managers improve customers’ service evaluations during the COVID-19 pandemic are provided.

12.
MAbs ; 14(1): 2005507, 2022.
Article in English | MEDLINE | ID: covidwho-1585297

ABSTRACT

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a serious public health crisis worldwide, and considering the novelty of the disease, preventative and therapeutic measures alike are urgently needed. To accelerate such efforts, the development of JS016, a neutralizing monoclonal antibody directed against the SARS-CoV-2 spike protein, was expedited from a typical 12- to 18-month period to a 4-month period. During this process, transient Chinese hamster ovary cell lines are used to support preclinical, investigational new drug-enabling toxicology research, and early Chemistry, Manufacturing and Controls development; mini-pool materials to supply Phase 1 clinical trials; and a single-clone working cell bank for late-stage and pivotal clinical trials were successively adopted. Moreover, key process performance and product quality investigations using a series of orthogonal and state-of-the-art techniques were conducted to demonstrate the comparability of products manufactured using these three processes, and the results indicated that, despite observed variations in process performance, the primary and high-order structures, purity and impurity profiles, biological and immunological functions, and degradation behaviors under stress conditions were largely comparable. The study suggests that, in particular situations, this strategy can be adopted to accelerate the development of therapeutic biopharmaceuticals and their access to patients.


Subject(s)
Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/therapeutic use , Antibody Affinity/immunology , Antibody Specificity/immunology , CHO Cells , COVID-19/prevention & control , COVID-19/virology , Chromatography, High Pressure Liquid/methods , Circular Dichroism , Clone Cells , Cricetinae , Cricetulus , Humans , Immunoglobulin G/chemistry , Immunoglobulin G/immunology , Immunoglobulin G/therapeutic use , Isoelectric Point , SARS-CoV-2/metabolism , SARS-CoV-2/physiology , Spike Glycoprotein, Coronavirus/metabolism
13.
researchsquare; 2021.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-800496.v1

ABSTRACT

The mutation of SARS-CoV-2 influences viral function as residue replacements affect both physiochemical properties and folding conformations. Although a large amount of data on SARS-CoV-2 is available, the investigation of how viral functions change in response to mutations is hampered by a lack of effective structural analysis. Here, we exploit advances in protein structure fingerprint technology to study the folding conformational changes induced by mutations. With the integration of both protein sequences and folding conformations and alignments of SARS-CoV to SARS-CoV-2, the UK variant and India variant, we found that structural variations in the spike protein at the binding interface interacting with ACE2 play a critical role in coronavirus entry into human cells. Additionally, the structural variations impact vaccine effectiveness and drug function over the course of SARS-CoV-2 evolution. The analysis of structural variations revealed how the coronavirus has gradually evolved in both structure and function and how the SARS-CoV-2 variants have contributed to more severe acute disease worldwide.

14.
Emerg Microbes Infect ; 10(1): 1519-1529, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1316787

ABSTRACT

The spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutated continuously and newly emerging variants escape from antibody-mediated neutralization raised great concern. S protein is heavily glycosylated and the glycosylation sites are relatively conserved, thus glycans on S protein surface could be a target for the development of anti-SARS-CoV-2 strategies against variants. Here, we collected 12 plant-derived lectins with different carbohydrate specificity and evaluated their anti-SARS-CoV-2 activity against mutant strains and epidemic variants using a pseudovirus-based neutralization assay. The Lens culinaris-derived lentil lectin which specifically bind to oligomannose-type glycans and GlcNAc at the non-reducing end terminus showed most potent and broad antiviral activity against a panel of mutant strains and variants, including the artificial mutants at N-/O-linked glycosylation site, natural existed amino acid mutants, as well as the epidemic variants B.1.1.7, B.1.351, and P.1. Lentil lectin also showed antiviral activity against SARS-CoV and MERS-CoV. We found lentil lectin could block the binding of ACE2 to S trimer and inhibit SARS-CoV-2 at the early steps of infection. Using structural information and determined N-glycan profile of S trimer, taking together with the carbohydrate specificity of lentil lectin, we provide a basis for the observed broad spectrum anti-SARS-CoV-2 activity. Lentil lectin showed weak haemagglutination activity at 1 mg/mL and no cytotoxicity activity, and no weight loss was found in single injection mouse experiment. This report provides the first evidence that lentil lectin strongly inhibit infection of SARS-COV-2 variants, which should provide valuable insights for developing future anti-SARS-CoV-2 strategies.


Subject(s)
Antiviral Agents/pharmacology , Lens Plant/chemistry , Plant Extracts/pharmacology , Plant Lectins/pharmacology , SARS-CoV-2/drug effects , Animals , Antiviral Agents/chemistry , Humans , Mice , Mice, Inbred BALB C , Plant Extracts/chemistry , Plant Lectins/chemistry , SARS-CoV-2/growth & development , Seeds/chemistry
15.
Int J Hosp Manag ; 97: 102996, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1267695

ABSTRACT

The attractiveness of service employees can have a significant impact on customer attitudes and behaviors. While frontline employees can reduce the risk of the COVID-19 transmission and infection by wearing facemasks, doing so can also influence customers' perceptions of employees' attractiveness and thus affect customer satisfaction. Based on the Gestalt theory, this study explores the impact of hotel employees' facemask-wearing on customer satisfaction through two experimental studies. The results indicate that average-looking frontline employees who wear facemasks induce high levels of customer satisfaction. However, while the impact of wearing facemasks on customer satisfaction is not significant for attractive-looking male frontline employees, attractive-looking female frontline employees who wear facemasks induce lower customer satisfaction. Customers' perception of employees' physical attractiveness fully mediates the effects of wearing facemasks on customer satisfaction in the case of average-looking employees. Customers' self-perceived physical attractiveness moderates the mediated effects. Implications that can help hotel managers improve customers' service evaluations during the COVID-19 pandemic are provided.

16.
Eur J Radiol Open ; 8: 100338, 2021.
Article in English | MEDLINE | ID: covidwho-1191646

ABSTRACT

The clinical and imaging data of 121 ICU patients with SARS-CoV-2 infection (63 survivors and 58 non-survivors) were retrospectively reviewed. The clinical results and radiographic features were compared between survivors and non-survivors. Compared with survivors, non-survivors were more likely to develop ARDS (53 [91 %] vs. 22 [35 %], P < 0.0001), shock (6 [10 %] vs. 0, P = 0.009), cardiac injury(18 [31 %] vs. 6 [10 %], P = 0.003), acute kidney injury(21 [36 %] vs. 10 [16 %], P = 0.01), and pneumothorax(5 [9%] vs. 0, P = 0.017). There were typical radiographic features for ICU patients with SARS-CoV-2 pneumonia. Extensive air-space opacities could be seen in all patients. Middle and lower lung involvement was significantly more serious than upper lung (score 6.8 ±â€¯1.9, 7.2 ±â€¯2.1, and 5.7 ±â€¯1.7, respectively, P < 0.0001). Based on X-ray involvement score, non-survivors were in a more critical condition than survivors (20.3 ±â€¯4.6 vs. 19.1 ±â€¯3.1, P = 0.038).

17.
Medicine (Baltimore) ; 99(43): e22766, 2020 Oct 23.
Article in English | MEDLINE | ID: covidwho-894694

ABSTRACT

The aim of this study was to evaluate the association between overweight and severity, drug response, and clinical outcomes of novel coronavirus disease 2019 (COVID-19).In this retrospective cohort study, we reviewed medical records of 240 COVID-19 patients admitted to Union Hospital in Wuhan, China, between December 24, 2019, and March 25, 2020. Physical, clinical, laboratory, radiological characteristics, treatment, and outcome data were abstracted. Patients who were obese [body mass index (BMI) ≥28 kg/m], underweight (BMI < 18.5 kg/m), under 18 years old, pregnant, or still in hospital were excluded. Disease severity was classified as moderate or severe pneumonia based on the World Health Organization interim guidance. Overweight was defined as BMI ≥24 kg/m and <28 kg/m. Patients were followed for discharge or death through April 10, 2020. We used logistic regression models to identify risk factors for severe disease, Cox proportional hazard models to explore associations between medications and patient outcomes (discharge or in-hospital death), and Kaplan-Meier survival curves and Cox regression models to evaluate risk factors for in-hospital death.One-half of patients (120, 50.0%) had severe pneumonia, while nearly one-half (114, 47.5%) were overweight. Among patients over 45 years old, overweight patients had significantly lower rates of fatigue, higher rates of headache, and higher median C-reactive protein levels. Patients under 45 years old had higher rates of cough and myalgia and higher proportions of increased alanine aminotransferase and lactic dehydrogenase, as well as more pulmonary lobes involved in the pneumonia revealed by chest computed tomography scans. Overweight patients were at higher risk of developing severe pneumonia. Although weight was not a risk factor for in-hospital death, overweight patients showed different responses to medications compared with normal weight patients. Intravenous interferon-α, intravenous glucocorticoids, and antifungal drugs were associated with reduced mortality in overweight patients. Intravenous immunoglobulin, oseltamivir, and ribavirin were associated with reduced mortality in normal weight patients.Overweight is a worldwide health problem. We found overweight to be related to the COVID-19 severity but not to in-hospital death. Clinicians should be aware that overweight COVID-19 patients require increased attention for different clinical features and treatment response.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Overweight/complications , Pneumonia, Viral/diagnosis , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19 , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Coronavirus Infections/mortality , Female , Follow-Up Studies , Hospital Mortality , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Pneumonia, Viral/mortality , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Survival Analysis , COVID-19 Drug Treatment
18.
EClinicalMedicine ; 26: 100503, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-805325

ABSTRACT

BACKGROUND: Cancer patients had been profoundly affected by the outbreak of COVID-19 especially after quarantine restrictions in China. We aimed to explore the treatment changes and delays of early breast cancer (EBC) during the first quarter of 2020. METHODS: We did this retrospective, multicentre, cohort study at 97 cancer centres in China. EBC patients who received treatment regardless of preoperative therapy, surgery or postoperative therapy during first quarter of 2020 were included. FINDINGS: 8397 patients were eligible with a median age of 50 (IQR 43-56). 0·2% (15/8397) of EBC patients were confirmed as COVID-19 infection. Only 5·2% of breast cancer diagnosis occurred after quarantine in Hubei compared with 15·3% in other provinces (OR= 0·30, 95%CI 0·24-0·38). postoperative endocrine therapy were least affected compared with different regions after quarantine (OR=0·37 [95%CI 0·19-0·73]). The proportion of surgery decreased from 16·4% in December last year to 2·6% in February in Hubei. Compared with intervals from diagnosis to treatment before quarantine restrictions, the average time increased with significance from 3·5 to 7·7 days in Hubei and 5·7 to 7·7 days in other provinces (p< 0·001). There were also 18·5 and 7·2 days delay in Hubei and other provinces respectively when calculating interval from surgery to postoperative therapy. INTERPRETATION: EBC from high risk regions had a comparative rate of COVID-19 infection. After implementation of COVID-19 quarantine restrictions, fewer diagnosis and surgery with significant delays were seen when compared with treatment before. FUNDING: Beijing Medical Award Foundation (YJ0120).

20.
Sci Rep ; 10(1): 14042, 2020 08 20.
Article in English | MEDLINE | ID: covidwho-725830

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in thousands of deaths in the world. Information about prediction model of prognosis of SARS-CoV-2 infection is scarce. We used machine learning for processing laboratory findings of 110 patients with SARS-CoV-2 pneumonia (including 51 non-survivors and 59 discharged patients). The maximum relevance minimum redundancy (mRMR) algorithm and the least absolute shrinkage and selection operator logistic regression model were used for selection of laboratory features. Seven laboratory features selected in the model were: prothrombin activity, urea, white blood cell, interleukin-2 receptor, indirect bilirubin, myoglobin, and fibrinogen degradation products. The signature constructed using the seven features had 98% [93%, 100%] sensitivity and 91% [84%, 99%] specificity in predicting outcome of SARS-CoV-2 pneumonia. Thus it is feasible to establish an accurate prediction model of outcome of SARS-CoV-2 pneumonia based on laboratory findings.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/blood , Models, Statistical , Pneumonia, Viral/blood , Aged , Bilirubin/blood , COVID-19 , Coronavirus Infections/therapy , Coronavirus Infections/virology , Data Accuracy , Feasibility Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Forecasting/methods , Humans , Leukocytes , Machine Learning , Male , Myoglobin/blood , Pandemics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Prognosis , Prothrombin/analysis , Receptors, Interleukin-2/blood , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity , Treatment Outcome , Urea/blood
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