Bioinformatics Analysis of Candidate Genes and Pathways Related to Hepatocellular Carcinoma in China: A Study Based on Public Databases.

Background and Objective: Hepatocellular carcinoma (HCC) is a highly aggressive malignant tumor of the digestive system worldwide. Chronic hepatitis B virus (HBV) infection and aflatoxin exposure are predominant causes of HCC in China, whereas hepatitis C virus (HCV) infection and alcohol intake are likely the main risk factors in other countries. It is an unmet need to recognize the underlying molecular mechanisms of HCC in China. Methods: In this study, microarray datasets (GSE84005, GSE84402, GSE101685, and GSE115018) derived from Gene Expression Omnibus (GEO) database were analyzed to obtain the common differentially expressed genes (DEGs) by R software. Moreover, the gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed by using Database for Annotation, Visualization and Integrated Discovery (DAVID). Furthermore, the protein-protein interaction (PPI) network was constructed, and hub genes were identified by the Search Tool for the Retrieval of Interacting Genes (STRING) and Cytoscape, respectively. The hub genes were verified using Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, and Kaplan-Meier Plotter online databases were performed on the TCGA HCC dataset. Moreover, the Human Protein Atlas (HPA) database was used to verify candidate genes' protein expression levels. Results: A total of 293 common DEGs were screened, including 103 up-regulated genes and 190 down-regulated genes. Moreover, GO analysis implied that common DEGs were mainly involved in the oxidation-reduction process, cytosol, and protein binding. KEGG pathway enrichment analysis presented that common DEGs were mainly enriched in metabolic pathways, complement and coagulation cascades, cell cycle, p53 signaling pathway, and tryptophan metabolism. In the PPI network, three subnetworks with high scores were detected using the Molecular Complex Detection (MCODE) plugin. The top 10 hub genes identified were CDK1, CCNB1, AURKA, CCNA2, KIF11, BUB1B, TOP2A, TPX2, HMMR and CDC45. The other public databases confirmed that high expression of the aforementioned genes related to poor overall survival among patients with HCC. Conclusion: This study primarily identified candidate genes and pathways involved in the underlying mechanisms of Chinese HCC, which is supposed to provide new targets for the diagnosis and treatment of HCC in China.

Protein nanopore reveals the renin-angiotensin system crosstalk with single-amino-acid resolution.

The discovery of crosstalk effects on the renin-angiotensin system (RAS) is limited by the lack of approaches to quantitatively monitor, in real time, multiple components with subtle differences and short half-lives. Here we report a nanopore framework to quantitatively determine the effect of the hidden crosstalk between angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) on RAS. By developing an engineered aerolysin nanopore capable of single-amino-acid resolution, we show that the ACE can be selectively inhibited by ACE2 to prevent cleavage of angiotensin I, even when the concentration of ACE is more than 30-fold higher than that of ACE2. We also show that the activity of ACE2 for cleaving angiotensin peptides is clearly suppressed by the spike protein of SARS-CoV-2. This leads to the relaxation of ACE and the increased probability of accumulation of the principal effector angiotensin II. The spike protein of the SARS-CoV-2 Delta variant is demonstrated to have a much greater impact on the crosstalk than the wild type.

Short-term ex vivo tissue culture models help study human lung infectionsA review.

Most studies on human lung infection have been performed using animal models, formalin or other fixed tissues, and in vitro cultures of established cell lines. However, the experimental data and results obtained from these studies may not completely represent the complicated molecular events that take place in intact human lung tissue in vivo. The newly developed ex vivo short-term tissue culture model can mimic the in vivo microenvironment of humans and allow investigations of different cell types that closely interact with each other in intact human lung tissues. Therefore, this kind of model may be a promising tool for future studies of different human lung infections, owing to its special advantages in providing more realistic events that occur in vivo. In this review, we have summarized the preliminary applications of this novel short-term ex vivo tissue culture model, with a particular emphasis on its applications in some common human lung infections.

Multi-Criteria Decision Analysis In Healthcare: Scientometric And Bibliometric Analysis

IntroductionMulti-criteria decision analysis (MCDA) is a useful tool in complex decision-making situations and has been used in medical fields to evaluate treatment options and drug selection. We aimed to provide valuable insights on the use of MCDA in health care through examining the research focus of existing studies, major fields, major applications, most productive authors and countries, and most common journals in the domain using a scientometric and bibliometric analysis.MethodsPublications related to MCDA in health care were identified by searching the Web of Science Core Collection on 14 July 2021. Three bibliometric software programs (VOSviewer, Bibliometrix, and CiteSpace) were used to conduct the analysis.ResultsA total of 410 publications were identified from 196 academic journals (average yearly growth rate of 32% from 1999 to 2021), with 23,637 co-cited references by 871 institutions from 70 countries or regions. The USA was the most productive country (n=80), while the Universiti Pendidikan Sultan Idris (n=16), Université de Montréal (n= 13), and Syreon Research Institute (n=12) were the most productive institutions. The biggest nodes in every cluster of author networks were Aos Alaa Zaidan, Mireille Goetghebeur, and Zoltan Kalo. The top journals in terms of number of articles (n=17) and citations (n=1,673) were Value in Health and the Journal of Medical Systems, respectively. The research hotspots mainly included the analytic hierarchy process (AHP), decision-making, health technology assessment, and healthcare waste management. In the recent literature there was more emphasis on coronavirus disease 2019 (COVID-19) and fuzzy Technique for Order Preference by Similarities to Ideal Solution (TOPSIS). Big data, telemedicine, TOPSIS, and the fuzzy AHP, which are well-developed and important themes, may be the trends in future research.ConclusionsThis study provides a holistic picture of the MCDA-related literature published in health care. MCDA has a broad application in different topic areas and would be helpful for practitioners, researchers, and decision makers working in health care when faced with complex decisions. It can be argued that the door is still open for improving the role of MCDA in health care, both in its technologies and its application.

Analysis of the Incidence and Risk Factors of Precocious Puberty in Girls during the COVID-19 Pandemic

Home quarantine due to the global coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on children. Lifestyle changes have led to an increase in precocious puberty (PP) among girls, and the underlying risk factors for this remain unclear. Thus, we aimed to assess the influence of environmental, genetic, nutritional, and other lifestyle factors on the risk of PP in girls. We evaluated the incidence of new-onset PP in girls during home quarantine for COVID-19 and analyzed the potential risk factors. This was a retrospective questionnaire and medical record-based study involving 22 representative medical units from 13 cities in Henan Province, China. Girls with new-onset PP (central precocious puberty, 58;premature thelarche, 58;age, 5–9 years) between February 2020 and May 2020 were included, along with 124 healthy, age-matched controls. The number of new-onset PP cases reported during the study period was compared with that reported between February and May in 2018 and 2019. Patients' families completed a questionnaire to assess potential risk factors. There was a 5.01- and 3.14-fold increase in the number of new-onset PP cases from 2018 to 2020 and from 2019 to 2020, respectively;the differences were statistically significant (p < 0.01). High-risk factors for PP included longer time spent using electronic devices, decreased exercise time, higher body mass index, vitamin D deficiency, young age (<12 years) of mother during menarche, consumption of fried food and processed meat, residence in rural areas, and consumption of off-season fruits. Thus, we found that lifestyle changes caused due to the COVID-19 pandemic led to a significant increase in PP in girls. Management of the risk factors identified in this study may help in PP prevention.

Knowledge Mapping of Multicriteria Decision Analysis in Healthcare: A Bibliometric Analysis.

Objective: Multicriteria decision analysis (MCDA) is a useful tool in complex decision-making situations, and has been used in medical fields to evaluate treatment options and drug selection. This study aims to provide valuable insights into MCDA in healthcare through examining the research focus of existing studies, major fields, major applications, most productive authors and countries, and most common journals in the domain. Methods: A bibliometric analysis was conducted on the publication related to MCDA in healthcare from the Web of Science Core Collection (WoSCC) database on 14 July 2021. Three bibliometric software (VOSviewer, R-bibliometrix, and CiteSpace) were used to conduct the analysis including years, countries, institutes, authors, journals, co-citation references, and keywords. Results: A total of 410 publications were identified with an average yearly growth rate of 32% (1999-2021), from 196 academic journals with 23,637 co-citation references by 871 institutions from 70 countries/regions. The United States was the most productive country (n = 80). Universiti Pendidikan Sultan Idris (n = 16), Université de Montréal (n = 13), and Syreon Research Institute (n = 12) were the top productive institutions. A A Zaidan, Mireille Goetghebeur and Zoltan Kalo were the biggest nodes in every cluster of authors' networks. The top journals in terms of the number of articles (n = 17) and citations (n = 1,673) were Value in Health and Journal of Medical Systems, respectively. The extant literature has focused on four aspects, including the analytic hierarchy process (AHP), decision-making, health technology assessment, and healthcare waste management. COVID-19 and fuzzy TOPSIS received careful attention from MCDA applications recently. MCDA in big data, telemedicine, TOPSIS, and fuzzy AHP is well-developed and an important theme, which may be the trend in future research. Conclusion: This study uncovers a holistic picture of the performance of MCDA-related literature published in healthcare. MCDA has a broad application on different topics and would be helpful for practitioners, researchers, and decision-makers working in healthcare to advance the wheel of medical complex decision-making. It can be argued that the door is still open for improving the role of MCDA in healthcare, whether in its methodology (e.g., fuzzy TOPSIS) or application (e.g., telemedicine).

Home Quarantine: A Double-Edged Sword During COVID-19 Pandemic for Hypertensive Disorders of Pregnancy and the Related Complications.

Object: COVID-19 pandemic and worldwide quarantine seriously affected the physical and mental health of the general public. Our study aimed to investigate the effects of the COVID-19 quarantine on pregnancy outcomes among pregnant women with hypertensive disorders of pregnancy (HDP). Methods: This single-center retrospective cohort study collected complete clinical data of HDP patients with a history of home quarantine in The First Affiliated Hospital of Chongqing Medical University (Chongqing, China) in 2020 as well as the patients without home quarantine in 2018 and 2019. Then, the maternal and neonatal outcomes of two subtypes of HDP, gestational hypertension (GH) and preeclampsia/eclampsia (PE/E), were analyzed over the three years. Results: The incidence of HDP increased from 0.84% in 2018 and 0.51% in 2019 to 2.30% in 2020. The data suggested that home quarantine was associated with higher gestational weight gain, obesity rates, blood pressure, and uric acid among the patients with HDP in 2020. Furthermore, HDP patients with a history of home quarantine may have worse neonatal outcomes, including lower newborn weight, shorter body length, lower Apgar score, and higher risk of fetal growth restriction. Conclusion: Our results suggested that COVID-19 quarantine may be a risk factor for poor pregnancy outcomes in HDP patients. Lifestyle guidance and antenatal care may be necessary for HDP patients with home quarantine in an epidemic outbreak.

Tea and tea drinking: China's outstanding contributions to the mankind.

BACKGROUND: Tea trees originated in southwest China 60 million or 70 million years ago. Written records show that Chinese ancestors had begun drinking tea over 3000 years ago. Nowadays, with the aging of populations worldwide and more people suffering from non-communicable diseases or poor health, tea beverages have become an inexpensive and fine complementary and alternative medicine (CAM) therapy. At present, there are 3 billion people who like to drink tea in the world, but few of them actually understand tea, especially on its development process and the spiritual and cultural connotations. METHODS: We searched PubMed, Google Scholar, Web of Science, CNKI, and other relevant platforms with the key word "tea", and reviewed and analyzed tea-related literatures and pictures in the past 40 years about tea's history, culture, customs, experimental studies, and markets. RESULTS: China is the hometown of tea, tea trees, tea drinking, and tea culture. China has the oldest wild and planted tea trees in the world, fossil of a tea leaf from 35,400,000 years ago, and abundant tea-related literatures and art works. Moreover, tea may be the first Chinese herbal medicine (CHM) used by Chinese people in ancient times. Tea drinking has many benefits to our physical health via its antioxidant, anti-inflammatory, immuno-regulatory, anticancer, cardiovascular-protective, anti-diabetic, and anti-obesity activities. At the moment, COVID-19 is wreaking havoc across the globe and causing severe damages to people's health and lives. Tea has anti-COVID-19 functions via the enhancement of the innate immune response and inhibition of viral growth. Besides, drinking tea can allow people to acquire a peaceful, relaxed, refreshed and cheerful enjoyment, and even longevity. According to the meridian theory of traditional Chinese medicine, different kinds of tea can activate different meridian systems in the human body. At present, black tea (fermented tea) and green tea (non-fermented tea) are the most popular in the world. Black tea accounts for over 90% of all teas sold in western countries. The world's top-grade black teas include Qi Men black in China, Darjeeling and Assam black tea in India, and Uva black tea in Sri Lanka. However, all top ten famous green teas in the world are produced in China, and Xi Hu Long Jing tea is the most famous among all green teas. More than 700 different kinds of components and 27 mineral elements can be found in tea. Tea polyphenols and theaflavin/thearubigins are considered to be the major bioactive components of black tea and green tea, respectively. Overly strong or overheated tea liquid should be avoided when drinking tea. CONCLUSIONS: Today, CAM provides an array of treatment modalities for the health promotion in both developed and developing countries all over the world. Tea drinking, a simple herb-based CAM therapy, has become a popular man-made non-alcoholic beverage widely consumed worldwide, and it can improve the growth of economy as well. Tea can improve our physical and mental health and promote the harmonious development of society through its chemical and cultural elements.

Impact of chemotherapy and immunotherapy on the composition and function of immune cells in COVID-19 convalescent with gynecological tumors.

Ongoing pandemic and potential resurgence of Coronavirus disease 2019 (COVID-19) has prompted urgent efforts to investigate the immunological memory of convalescent patients, especially in patients with active cancers. Here we performed single-cell RNA sequencing in peripheral blood samples of 3 healthy donors (HDs), 4 COVID-19 patients (Covs) and 4 COVID-19 patients with active gynecological tumor (TCs) pre- and post- anti-tumor treatment. All Covs patients had recovered from their acute infection. Interestingly, the molecular features of PBMCs in TCs are similar to that in Covs, suggesting that convalescent COVID-19 with gynecologic tumors do not have major immunological changes and may be protected against reinfection similar to COVID-19 patients without tumors. Moreover, the chemotherapy given to these patients mainly caused neutropenia, while having little effect on the proportion and functional phenotype of T and B cells, and T cell clonal expansion. Notably, anti-PD-L1 treatment massively increased cytotoxic scores of NK cells, and T cells, and facilitated clonal expansion of T cells in these patients. It is likely that T cells could protect patients from SARS-CoV-2 virus reinfection and anti-PD-L1 treatment can enhance the anti-viral activity of the T cells.

No significant association of repeated messages with changes in health compliance in the COVID-19 pandemic: a registered report on the extended parallel process model.

When people are confronted with health proposals during the coronavirus disease 2019 (COVID-19) pandemic, it has been suggested that fear of COVID-19 can serve protective functions and ensure public health compliance. However, health proposal repetition and its perceived efficacy also influence the behavior intention toward the proposal, which has not yet been confirmed in the COVID-19 context. The present study examined whether the extended parallel process model (EPPM) could be generalized to a naturalistic context like the COVID-19 pandemic. Additionally, we explored how repetition of a health proposal is involved with the EPPM. In this study, two groups of participants were exposed to the same health proposal related to COVID-19, where one group was exposed once and another group twice. Participants then filled out a questionnaire consisting of items concerning behavior intention and adapted from the Risk Behavior Diagnosis Scale. Structural equation modeling was used to determine the multivariate associations between the variables. Although the results showed that behavior intention is predicted by perceived efficacy, no significant influence of perceived threat was detected. Furthermore, no significant effect of repetition was found toward either response efficacy or perceived susceptibility. These findings indicate that to promote health compliance during the COVID-19 pandemic, it is more efficient to focus on health proposals' perceived efficacy rather than the disease's perceived threat. For future health communication research, the present study suggests improved analysis strategies and repeated manipulation of messages.

Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study.

BACKGROUND: Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19. OBJECTIVE: This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria. METHODS: Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling. RESULTS: A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: ß=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: ß=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (ß=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (ß=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=-2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=-3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=-3.69, P<.001, Cohen d=0.29). CONCLUSIONS: The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.

Dynamics and Correlation Among Viral Positivity, Seroconversion, and Disease Severity in COVID-19 : A Retrospective Study.

BACKGROUND: The understanding of viral positivity and seroconversion during the course of coronavirus disease 2019 (COVID-19) is limited. OBJECTIVE: To describe patterns of viral polymerase chain reaction (PCR) positivity and evaluate their correlations with seroconversion and disease severity. DESIGN: Retrospective cohort study. SETTING: 3 designated specialty care centers for COVID-19 in Wuhan, China. PARTICIPANTS: 3192 adult patients with COVID-19. MEASUREMENTS: Demographic, clinical, and laboratory data. RESULTS: Among 12 780 reverse transcriptase PCR tests for severe acute respiratory syndrome coronavirus 2 that were done, 24.0% had positive results. In 2142 patients with laboratory-confirmed COVID-19, the viral positivity rate peaked within the first 3 days. The median duration of viral positivity was 24.0 days (95% CI, 18.9 to 29.1 days) in critically ill patients and 18.0 days (CI, 16.8 to 19.1 days) in noncritically ill patients. Being critically ill was an independent risk factor for longer viral positivity (hazard ratio, 0.700 [CI, 0.595 to 0.824]; P < 0.001). In patients with laboratory-confirmed COVID-19, the IgM-positive rate was 19.3% in the first week, peaked in the fifth week (81.5%), and then decreased steadily to around 55% within 9 to 10 weeks. The IgG-positive rate was 44.6% in the first week, reached 93.3% in the fourth week, and then remained high. Similar antibody responses were seen in clinically diagnosed cases. Serum inflammatory markers remained higher in critically ill patients. Among noncritically ill patients, a higher proportion of those with persistent viral positivity had low IgM titers (<100 AU/mL) during the entire course compared with those with short viral positivity. LIMITATION: Retrospective study and irregular viral and serology testing. CONCLUSION: The rate of viral PCR positivity peaked within the initial few days. Seroconversion rates peaked within 4 to 5 weeks. Dynamic laboratory index changes corresponded well to clinical signs, the recovery process, and disease severity. Low IgM titers (<100 AU/mL) are an independent risk factor for persistent viral positivity. PRIMARY FUNDING SOURCE: None.

Knowledge, Attitudes, and Preventative Practices (KAPs) Towards COVID-19 Among International Students in China.

PURPOSE: The study aimed to find out about the knowledge, attitudes, and preventative practices of COVID-19 among international students in China during the pandemic. MATERIAL AND METHODS: A cross-section survey was conducted among 300 international students from 13 different universities in Hubei province of China between March and April 2020 which relied upon convenience sampling method. RESULTS: Out of 300 respondents, 153 (51%) of the respondents were female students, of which the majority were single, undergraduate students who were doing medicine (163, 54.3%) and engineering programs (68, 22.7%). The majority of international students had an impressive knowledge on the causes, risks, and spread of COVID-19, and that they were no misconception of the pandemic 229 (76%) to 281 (98%) respectively. These students also demonstrated a markedly positive attitude towards the virus and a feeling that they were almost completely safe being in China (264, 84%). Variations were found on Knowledge scores in age group (P<0.01) and majors (P=0.025), attitude scores on major of study (P=0.015), and experience (P<0.01). Furthermore, the results revealed that all the students (300, 100%) adhered to and practiced set preventive measures against COVID-19 and that there was a positive correlation between attitudes and preventative practices (r=0.219, P<0.01). CONCLUSION: This study found that social media platform was contributing enormously towards information dissemination and Chinese universities were commended for their continuous notifications on COVID-19 which helped students to have full knowledge. This, in turn, was instrumental in helping students to form good attitudes and practices towards COVID-19.

Changing health compliance through message repetition based on the extended parallel process model in the COVID-19 pandemic.

When people are confronted with health proposals during the coronavirus disease 2019 (COVID-19) pandemic, it has been suggested that fear of COVID-19 can serve protective functions and ensure public health compliance. However, health proposal repetition and its perceived efficacy also influence the behavior intention toward the proposal, which has not yet been confirmed in the COVID-19 context. The present study aims to examine whether the extended parallel process model (EPPM) can be generalized to a naturalistic context like the COVID-19 pandemic. Additionally, we will explore how repetition of a health proposal is involved with the EPPM. In this study, two groups of participants are exposed to the same health proposal related to COVID-19, where one group is exposed once and another group twice. They then fill out a questionnaire consisting of items concerning behavior intention and adapted from the Risk Behavior Diagnosis Scale. Structural equation modeling will be used to determine the multivariate associations between the variables. We predict that repetition of the health proposal will associate with response efficacy (i.e., a belief about the effectiveness of the health proposal in deterring the threat) and perceived susceptibility (i.e., a belief about the risk of experiencing the threat). It is also predicted that following the EPPM, behavior intention will associate with both perceived efficacy of the health proposal, which will underlie response efficacy, and perceived threat of COVID-19, which will underlie perceived susceptibility. We will discuss the process, based on the model, where health message repetition affects behavior intention during the COVID-19 pandemic.

In Silico Screening of Potential Spike Glycoprotein Inhibitors of SARS-CoV-2 with Drug Repurposing Strategy.

OBJECTIVE: To select potential molecules that can target viral spike proteins, which may potentially interrupt the interaction between the human angiotension-converting enzyme 2 (ACE2) receptor and viral spike protein by virtual screening. METHODS: The three-dimensional (3D)-coordinate file of the receptor-binding domain (RBD)-ACE2 complex for searching a suitable docking pocket was firstly downloaded and prepared. Secondly, approximately 15,000 molecular candidates were prepared, including US Food and Drug Administration (FDA)-approved drugs from DrugBank and natural compounds from Traditional Chinese Medicine Systems Pharmacology (TCMSP), for the docking process. Then, virtual screening was performed and the binding energy in Autodock Vina was calculated. Finally, the top 20 molecules with high binding energy and their Chinese medicine (CM) herb sources were listed in this paper. RESULTS: It was found that digitoxin, a cardiac glycoside in DrugBank and bisindigotin in TCMSP had the highest docking scores. Interestingly, two of the CM herbs containing the natural compounds that had relatively high binding scores, Forsythiae fructus and Isatidis radix, are components of Lianhua Qingwen (), a CM formula reportedly exerting activity against severe acute respiratory syndrome (SARS)-Cov-2. Moreover, raltegravir, an HIV integrase inhibitor, was found to have a relatively high binding score. CONCLUSIONS: A class of compounds, which are from FDA-approved drugs and CM natural compounds, that had high binding energy with RBD of the viral spike protein. Our work provides potential candidates for other researchers to identify inhibitors to prevent SARS-CoV-2 infection, and highlights the importance of CM and integrative application of CM and Western medicine on treating COVID-19.

Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis.

BACKGROUND: Although research on the effects of comorbidities on coronavirus disease 2019 (COVID-19) patients is increasing, the risk of cancer history has not been evaluated for the mortality of patients with COVID-19. METHODS: In this retrospective study, we included 3232 patients with pathogen-confirmed COVID-19 who were hospitalized between January 18th and March 27th, 2020, at Tongji Hospital in Wuhan, China. Propensity score matching was used to minimize selection bias. RESULTS: In total, 2665 patients with complete clinical outcomes were analyzed. The impacts of age, sex, and comorbidities were evaluated separately using binary logistic regression analysis. The results showed that age, sex, and cancer history are independent risk factors for mortality in hospitalized COVID-19 patients. COVID-19 patients with cancer exhibited a significant increase in mortality rate (29.4% vs. 10.2%, P < 0.0001). Furthermore, the clinical outcomes of patients with hematological malignancies were worse, with a mortality rate twice that of patients with solid tumors (50% vs. 26.1%). Importantly, cancer patients with complications had a significantly higher risk of poor outcomes. One hundred nine cancer patients were matched to noncancer controls in a 1:3 ratio by propensity score matching. After propensity score matching, the cancer patients still had a higher risk of mortality than the matched noncancer patients (odds ratio (OR) 2.98, 95% confidence interval (95% CI) 1.76-5.06). Additionally, elevations in ferritin, high-sensitivity C-reactive protein, erythrocyte sedimentation rate, procalcitonin, prothrombin time, interleukin-2 (IL-2) receptor, and interleukin-6 (IL-6) were observed in cancer patients. CONCLUSIONS: We evaluated prognostic factors with epidemiological analysis and highlighted a higher risk of mortality for cancer patients with COVID-19. Importantly, cancer history was the only independent risk factor for COVID-19 among common comorbidities, while other comorbidities may act through other factors. Moreover, several laboratory parameters were significantly different between cancer patients and matched noncancer patients, which may indicate specific immune and inflammatory reactions in COVID-19 patients with cancer.