Comprehensive analysis of the novel omicron receptor AXL in cancers.

The SARS-CoV-2 is constantly mutating, and the new coronavirus such as Omicron has spread to many countries around the world. Anexelekto (AXL) is a transmembrane protein with biological functions such as promoting cell growth, migration, aggregation, metastasis and adhesion, and plays an important role in cancers and coronavirus disease 2019 (COVID-19). Unlike angiotensin-converting enzyme 2 (ACE2), AXL was highly expressed in respiratory system cells. In this study, we verified the AXL expression in cancer and normal tissues and found AXL expression was strongly correlated with cancer prognosis, tumor mutation burden (TMB), the microsatellite instability (MSI) in most tumor types. Immune infiltration analysis also demonstrated that there was an inextricable link between AXL expression and immune scores in cancer patients, especially in BLCA, BRCA and CESC. The NK-cells, plasmacytoid dendritic cells, myeloid dendritic cells, as one of the important components of the tumor microenvironment, were highly expressed AXL. In addition, AXL-related tumor neoantigens were identified and might provide the novel potential targets for tumor vaccines or SARS-Cov-2 vaccines research in cancer patients.

Depression, anxiety and post-traumatic growth among COVID-19 survivors six-month after discharge Depresión, ansiedad y crecimiento postraumático entre sobrevivientes de COVID-19 seis meses después del alta COVID-19 幸存者出院六个月后的抑郁、焦虑和创伤后成长

Background Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors. Objective Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors. Method A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7;53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients’ suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument. Results The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG. Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors. HIGHLIGHTS • Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.

Depression, anxiety and post-traumatic growth among COVID-19 survivors six-month after discharge.

Background: Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors. Objective: Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors. Method: A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7; 53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients' suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument. Results: The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG.Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors. HIGHLIGHTS: • Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.

Antecedentes: Los factores pre-hospitalización, durante la hospitalización y post-hospitalización pueden afectar significativamente la depresión, la ansiedad y el crecimiento postraumático (CPT) en los sobrevivientes de COVID-19.Objetivo: Nuestro estudio investigó la depresión, la ansiedad y el CPT y sus correlatos en sobrevivientes de COVID-19.Método: Una encuesta telefónica transversal reclutó a 199 pacientes con COVID-19 (edad promedio = 42,7; 53,3% mujeres) a los seis meses de seguimiento después del alta hospitalaria en cinco ciudades chinas (Wuhan, Shenzhen, Zhuhai, Dongguan y Nanning). Su información demográfica, registros clínicos y experiencias durante la hospitalización (e.g. gravedad de los síntomas de COVID-19, tratamiento, exposición al sufrimiento de otros pacientes) y después de la hospitalización (e.g. impacto percibido de COVID-19, síntomas somáticos después de la hospitalización) y factores psicosociales (e.g. discriminación percibida, autoestigma, estigma de afiliación, resiliencia, apoyo social) fueron investigados. Los síntomas depresivos y de ansiedad se midieron mediante el Cuestionario de Salud del Paciente (PHQ-9 en su sigla en inglés) y la escala de trastorno de ansiedad generalizada (GAD-7 en su sigla en inglés) respectivamente, el CPT se examinó mediante el instrumento Inventario de Crecimiento Postraumático (PTGI en su sigla en inglés).Resultados: La proporción de síntomas depresivos <5, ≥5 y <10, y ≥10 fue 76,9%, 12,0% y 11,1% respectivamente. La proporción de síntomas de ansiedad <5, ≥5 y <10, y ≥10 fue del 77,4%, 15,1% y 7,5% respectivamente. La regresión logística multivariante mostró que recibir servicios de atención de salud mental durante la hospitalización, los síntomas somáticos después del alta, el estigma de afiliación percibido y el impacto percibido de estar infectado con COVID-19 se asociaron significativa y positivamente con una probable depresión. Los correlatos significativos de ansiedad probable también incluyeron ser residente permanente de la ciudad, síntomas somáticos después del alta, impacto percibido de estar infectado con COVID-19 y autoestigma. El apoyo social, el autoestigma y recibir servicios de salud mental durante la hospitalización se asociaron positivamente con el CPT.Conclusiones: Los resultados sugieren que los factores psicosociales y posteriores a la hospitalización tuvieron asociaciones relativamente más fuertes con la depresión, la ansiedad y el CPT que los factores previos a la hospitalización y hospitalización. Promover el apoyo social y la inclusión social pueden ser estrategias útiles para mejorar la salud mental de los sobrevivientes de COVID-19.

Hospitalization, interpersonal and personal factors of social anxiety among COVID-19 survivors at the six-month follow-up after hospital treatment: the minority stress model.

Background: As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. Objectives: This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. Methods: A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan); adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. Results: The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. Conclusions: The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion.

Antecedentes: Como una enfermedad altamente infecciosa con características de transmisión de persona a persona, el COVID-19 ha causado pánico en el público en general. Aquellos que se han recuperado del COVID-19 pueden experimentar discriminación y estigma internalizado. Es más probable que se preocupen por la interacción social y desarrollen ansiedad social.Objetivos: Este estudio investigó las asociaciones entre factores de hospitalización, factores sociales /interpersonales, factores personales y ansiedad social para revelar el mecanismo de ansiedad social en sobrevivientes de COVID-19.Métodos: Se realizó una encuesta telefónica transversal multicentro de julio a septiembre de 2020 en cinco ciudades chinas (es decir, Wuhan, Nanning, Shenzhen, Zhuhai y Dongguan). Se reclutaron sobrevivientes adultos de COVID-19 seis meses después de ser dados de alta del hospital. Se realizaron regresiones lineales y análisis de ruta basados en el modelo de estrés de minoría para probar las relaciones entre la hospitalización, los factores sociales/interpersonales, los factores personales y la ansiedad social.Resultados: La tasa de respuesta fue del 74,5% (N = 199, 55,3% mujeres). Los análisis de regresión lineal mostraron que varios factores de hospitalización, sociales/interpersonales y personales se asociaron de manera estadísticamente significativa con la ansiedad social. El análisis de ruta mostró que el modelo propuesto se ajustaba bien a los datos (χ2 (df) = 3.196 (3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). El estigma internalizado medió completamente la asociación entre discriminación/apoyo social percibido y ansiedad social, mientras que medió parcialmente la asociación entre el estigma percibido de afiliados y ansiedad social.Conclusiones: Los resultados sugieren que los factores sociales/interpersonales y personales tienen una asociación más fuerte con la ansiedad social que los factores de hospitalización y resaltan la importancia del estigma internalizado en la comprensión de los mecanismos de estas relaciones. Los psicólogos clínicos pueden referirse a estos factores psicosociales modificables para desarrollar intervenciones eficientes para la promoción de la salud mental.

Hospitalization, interpersonal and personal factors of social anxiety among COVID-19 survivors at the six-month follow-up after hospital treatment: the minority stress model Hospitalización, factores interpersonales y personales de ansiedad social entre los sobrevivientes de COVID-19 en el seguimiento seis meses después del tratamiento hospitalario: el modelo de estrés de minoría 基于少数群体压力模型的新冠康复者住院经历, 出院后六个月人际及个人因素与社交焦虑之间的关联分析

Background As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. Objectives This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. Methods A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan);adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. Results The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. Conclusions The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion. HIGHLIGHTS Internalized stigma fully mediated the effects of perceived discrimination and social support on social anxiety and partially mediated the effect of perceived affiliate stigma on social anxiety.

Post-traumatic Stress Disorder Symptoms in COVID-19 Survivors 6 Months After Hospital Discharge: An Application of the Conservation of Resource Theory.

COVID-19 survivors who had acute respiratory symptoms might experience prolonged post-traumatic stress disorder (PTSD) due to further rehabilitation, somatic symptoms and related distress. The conservation of resource (COR) theory is a well-developed theory to understand how people develop PTSD symptoms in traumatic events. The current study aimed to examine the potential factors of PTSD symptoms and interrelationships among this factors among COVID-19 survivors based on the COR theory. This cross-sectional telephone survey enrolled 199 COVID-19 patients (Mean age = 42.7; 53.3% females) 6 months after their hospital discharge in five Chinese cities (i.e., Wuhan, Shenzhen, Zhuhai, Dongguan, and Nanning). The results showed that 7% of participants were classified as having probable PTSD. The significant potential factors relating to PTSD symptoms included socio-demographic status, hospitalization experiences, post-hospitalization experiences, and psychological status. Besides, the proposed statistical mediation model based on the COR framework showed good model fit, χ2(df) = 17.286 (5), p = 0.004, CFI = 0.962, NNFI = 0.951, RMSEA = 0.077. Perceived resource loss/gain fully mediated the association between exposure to other patients' suffering during hospitalization and PTSD symptoms, and partially mediated the relationships from somatic symptoms/perceived impact of being infected with COVID-19 after discharge to PTSD symptoms. On the other hand, resilience was a full mediator in the relationship from ICU experience to PTSD symptoms and a partial mediator in the relationship from perceived impact to PTSD symptoms. The results provide preliminary support on applying the COR theory to understand the factors of PTSD symptoms among COVID-19 survivors. Interventions to reduce PTSD symptoms in this population can be developed based on the modifiable psychosocial mediators.

Associations between COVID-19 related stigma and sleep quality among COVID-19 survivors six months after hospital discharge.

BACKGROUND: Many COVID-19 survivors reported stigmatization after recovery. This study investigated the association between stigma (discrimination experiences, self-stigma and perceived affiliate stigma) and sleep quality among COVID-19 survivors six months after hospital discharge. METHODS: Participants were recovered adult COVID-19 survivors discharged between February 1 and April 30, 2020. Medical staff of five participating hospitals approached all discharged COVID-19 period during this period. A total of 199 participants completed the telephone interview during July to September, 2020. Structural equation modeling was performed to test the hypothesize that resilience and social support would mediate the associations between stigma and sleep quality. RESULTS: The results showed that 10.1% of the participants reported terrible/poor sleep quality, 26.1% reported worse sleep quality in the past week when comparing their current status versus the time before COVID-19. After adjusting for significant background characteristics, participants who had higher number of discrimination experience, perceived stronger self-stigma and stronger perceived affiliate stigma reported poorer sleep quality. Resilience and social support were positively and significantly associated with sleep quality. The indirect effect of self-stigma on sleep quality through social support and resilience was significant and negative. Perceived affiliate stigma also had a significant and negative indirect effect on sleep quality through social support and resilience. CONCLUSIONS: Various types of stigma after recovery were associated with poor sleep quality among COVID-19 survivors, while social support and resilience were protective factors. Resilience and social support mediated the associations between self-stigma/perceived affiliate stigma and sleep quality.

Pre-hospital, in-hospital and post-hospital factors associated with sleep quality among COVID-19 survivors 6 months after hospital discharge: cross-sectional survey in five cities in China.

Background: Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development. Aims: This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge. Method: Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted. Results: Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = -1.15, 95% CI = -1.70, -0.33) or death (adjusted B = -1.55, 95% CI = -2.62, -0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = -0.26, 95% CI = -0.31, -0.20), anxiety symptoms (adjusted B = -0.25, 95% CI = -0.33, -0.17), post-traumatic stress disorders (adjusted B = -0.16, 95% CI = -0.22, -0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10). Conclusions: COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.

Compound hazards: An examination of how hurricane protective actions could increase transmission risk of COVID-19.

Hurricane season brings new and complex challenges as we continue to battle the COVID-19 pandemic. In May 2020, the National Oceanic and Atmospheric Administration has predicted nearly twice the normal number of tropical storms and hurricanes this season, while projections of COVID-19 models continue to rise in the United States as the Atlantic hurricane season progresses. Our research examines the critical intersection of hurricane response and public health in Harris County, Texas. We examine a hypothetical case of the 2017 Hurricane Harvey occurring amid the current pandemic. This research uses point of interest visitations as location intelligence data provided by SafeGraph together with Social Vulnerability Index and historical flood data to examine the critical intersection of natural hazard planning and response and the COVID-19 pandemic to assess the risks of a compound hazard situation. COVID-19 transmission hotspots and businesses in a community due to storm preparation activity were identified. The main drivers of transmission risk arise from overall pandemic exposure and increased interpersonal contact during hurricane preparation. Residents of health-risk areas will need to make logistical arrangements to visit alternative medical facilities for treatments related to either COVID-19 or physical impacts, such as injuries, due to the hurricane risks. Points of interest needed for disaster preparation are more likely to be situated in high-risk areas, therefore making cross-community spread more likely. Moreover, greater susceptibility could arise from social vulnerability (socioeconomic status and demographic factors) and disrupted access to healthcare facilities. Results from this study can be used to identify high-risk areas for COVID-19 transmission for prioritization in planning for temporary healthcare centers and other essential services in low-risk areas. Understanding the interplay between disaster preparation and the restrictive environment laid out by the pandemic is critical for community leaders and public health officials for ensuring the population has sufficient access to essential infrastructure services. The findings from this study can help guide the direction of disaster planning and pandemic response strategies and policies.

Unraveling the dynamic importance of county-level features in trajectory of COVID-19.

The objective of this study was to investigate the importance of multiple county-level features in the trajectory of COVID-19. We examined feature importance across 2787 counties in the United States using data-driven machine learning models. Existing mathematical models of disease spread usually focused on the case prediction with different infection rates without incorporating multiple heterogeneous features that could impact the spatial and temporal trajectory of COVID-19. Recognizing this, we trained a data-driven model using 23 features representing six key influencing factors affecting the pandemic spread: social demographics of counties, population activities, mobility within the counties, movement across counties, disease attributes, and social network structure. Also, we categorized counties into multiple groups according to their population densities, and we divided the trajectory of COVID-19 into three stages: the outbreak stage, the social distancing stage, and the reopening stage. The study aimed to answer two research questions: (1) The extent to which the importance of heterogeneous features evolved at different stages; (2) The extent to which the importance of heterogeneous features varied across counties with different characteristics. We fitted a set of random forest models to determine weekly feature importance. The results showed that: (1) Social demographic features, such as gross domestic product, population density, and minority status maintained high-importance features throughout stages of COVID-19 across 2787 studied counties; (2) Within-county mobility features had the highest importance in counties with higher population densities; (3) The feature reflecting the social network structure (Facebook, social connectedness index), had higher importance for counties with higher population densities. The results showed that the data-driven machine learning models could provide important insights to inform policymakers regarding feature importance for counties with various population densities and at different stages of a pandemic life cycle.

Air-Filtering Masks for Respiratory Protection from PM2.5 and Pandemic Pathogens.

Air-filtering masks, also known as respirators, protect wearers from inhaling fine particulate matter (PM2.5) in polluted air, as well as airborne pathogens during a pandemic, such as the ongoing COVID-19 pandemic. Fibrous medium, used as the filtration layer, is the most essential component of an air-filtering mask. This article presents an overview of the development of fibrous media for air filtration. We first synthesize the literature on several key factors that affect the filtration performance of fibrous media. We then concentrate on two major techniques for fabricating fibrous media, namely, meltblown and electrospinning. In addition, we underscore the importance of electret filters by reviewing various methods for imparting electrostatic charge on fibrous media. Finally, this article concludes with a perspective on the emerging research opportunities amid the COVID-19 crisis.

Disparate patterns of movements and visits to points of interest located in urban hotspots across US metropolitan cities during COVID-19.

We examined the effect of social distancing on changes in visits to urban hotspot points of interest. In a pandemic situation, urban hotspots could be potential superspreader areas as visits to urban hotspots can increase the risk of contact and transmission of a disease among a population. We mapped census-block-group to point-of-interest (POI) movement networks in 16 cities in the United States. We adopted a modified coarse-grain approach to examine patterns of visits to POIs among hotspots and non-hotspots from January to May 2020. Also, we conducted chi-square tests to identify POIs with significant flux-in changes during the analysis period. The results showed disparate patterns across cities in terms of reduction in hotspot POI visitors. Sixteen cities were divided into two categories using a time series clustering method. In one category, which includes the cities of San Francisco, Seattle and Chicago, we observed a considerable decrease in hotspot POI visitors, while in another category, including the cities of Austin, Houston and San Diego, the visitors to hotspots did not greatly decrease. While all the cities exhibited overall decreased visitors to POIs, one category maintained the proportion of visitors to hotspot POIs. The proportion of visitors to some POIs (e.g. restaurants) remained stable during the social distancing period, while some POIs had an increased proportion of visitors (e.g. grocery stores). We also identified POIs with significant flux-in changes, indicating that related businesses were greatly affected by social distancing. The study was limited to 16 metropolitan cities in the United States. The proposed methodology could be applied to digital trace data in other cities and countries to study the patterns of movements to POIs during the COVID-19 pandemic.

[Potential therapies for COVID-19 cardiovascular complications using artemisinin and its derivatives intervene based on its cardiovascular protection].

Corona virus disease 2019(COVID-19) has brought untold human sufferings and economic tragedy worldwide. It causes acute myocardial injury and chronic damage of cardiovascular system, which has attracted much attention from researchers. For the immediate strategy for COVID-19, "drug repurposing" is a new opportunity for developing drugs to fight COVID-19. Artemisinin and its derivatives have a wide range of pharmacological activities. Recent studies have shown that artemisinin has clear cardiovascular protective effects. This paper summarizes the research progress on the pathogenesis the pathogenesis of COVID-19 in cardiovascular damage by 2019 novel coronavirus(2019-nCoV) virus from myocardial cell injury directly by 2019-nCoV virus,viral ligands competitively bind to ACE2 and then reduce the protective effect of ACE2 on cardiovascular disease, "cytokine storm" related myocardial damage, arrhythmia and sudden cardiac death induced by the infection and stress, myocardial injury by hypoxemia, heart damage side effects from COVID-19 drugs and summarizing the cardiovascular protective effects of artemisinin and its derivatives have activities of anti-arrhythmia, anti-myocardial ischemia, anti-atherosclerosis and plaque stabilization. Then analyzed the possible multi-pathway intervention effects of artemisinin-based drugs on multiple complications of COVID-19 based on its specific immunomodulatory effects, protective effects of tissue and organ damage and broad-spectrum antiviral effect, to provide clues for the treatment of cardiovascular complications of COVID-19, and give a new basis for the therapy of COVID-19 through "drug repurposing".

Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms.

OBJECTIVE: The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics. DESIGN: COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. RESULTS: Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5°C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m6A methylation and changed binding capacity with ACE2. CONCLUSION: We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.

Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series.

OBJECTIVE: To study the clinical characteristics of patients in Zhejiang province, China, infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease 2019 (covid-2019). DESIGN: Retrospective case series. SETTING: Seven hospitals in Zhejiang province, China. PARTICIPANTS: 62 patients admitted to hospital with laboratory confirmed SARS-Cov-2 infection. Data were collected from 10 January 2020 to 26 January 2020. MAIN OUTCOME MEASURES: Clinical data, collected using a standardised case report form, such as temperature, history of exposure, incubation period. If information was not clear, the working group in Hangzhou contacted the doctor responsible for treating the patient for clarification. RESULTS: Of the 62 patients studied (median age 41 years), only one was admitted to an intensive care unit, and no patients died during the study. According to research, none of the infected patients in Zhejiang province were ever exposed to the Huanan seafood market, the original source of the virus; all studied cases were infected by human to human transmission. The most common symptoms at onset of illness were fever in 48 (77%) patients, cough in 50 (81%), expectoration in 35 (56%), headache in 21 (34%), myalgia or fatigue in 32 (52%), diarrhoea in 3 (8%), and haemoptysis in 2 (3%). Only two patients (3%) developed shortness of breath on admission. The median time from exposure to onset of illness was 4 days (interquartile range 3-5 days), and from onset of symptoms to first hospital admission was 2 (1-4) days. CONCLUSION: As of early February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in Zhejiang province are relatively mild.