Coronavirus Disease 2019 Combined with T. marneffei Infection Complicated by Undiagnosed HIV：A case report and literature review (preprint)

Background: Talaromycosis(TSM) commonly occurs in immunodeficient or immunosuppressed individuals, but it can also occur in healthy populations. The present case reports the COVID-19 together with human immunodeficiency virus(HIV) and TSM. Case Presentation: This report describes a 26-year-old male who presented with a fever and cough for 20 days. He was diagnosed with COVID-19 and viral pneumonia through a real-time RT-PCR assay and chest CT scan. However, his symptoms failed to improve significantly despite being treated with high-flow oxygen, levofloxacin antibiotic, and dexamethasone for 5 days. The presence of white streaks in his oral cavity, combined with the patient's history of multiple antibiotics, raised the possibility of a fungal infection. The results of the oral pharyngeal swabs indicated that he was infected with T. marnefii, which led to testing for HIV and eventually confirmed the diagnosis. Conclusion: This case demonstrates the importance of being alert to concurrent fungal infections when infecting with COVID-19 and using multiple antimicrobial agents. Additionally, when infecting with T. marnefii, it is crucial to focus on the presence of HIV infection.

Factors associated with prolonged viral shedding in older patients infected with Omicron BA.2.2

Background This study explores the risk factors associated with viral shedding time in elderly Chinese patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron. Methods Participants infected with SARS-CoV-2 omicron were enrolled in a retrospective study, and divided into two groups according to shedding time (≥10 days, "late clearance group” and <10 days, "early clearance group”). Results A total of 180 patients were enrolled in the study (88 early, 92 late), with a median viral shedding time of 10 days and a mean age of 77.02 years. Prolonged SARS-CoV-2 omicron shedding was associated with old age (p = 0.007), lack of vaccination (p = 0.001), delayed admission to hospital after onset of diagnosis (p = 0.001), D-dimer (p = 0.003), and methylprednisolone treatment (p = 0.048). In multivariate analysis, vaccination (OR, 0.319, 95% CI, 0.130–0.786, p = 0.013), Paxlovid (OR, 0.259, 95% CI, 0.104–0.643, p = 0.004), and time from onset of diagnosis to admission (OR, 1.802, 95% CI, 1.391–2.355, p = 0.000) were significantly associated with viral clearance. Conclusions Time from onset of diagnosis to hospitalization, lack of treatment with Paxlovid, and lack of vaccination were independent risk factors in elderly Chinese patients infected with SARS-CoV-2 omicron for prolonged viral shedding.

Chemical composition and pharmacological mechanism of Ephedra-Glycyrrhiza drug pair against coronavirus disease 2019 (COVID-19) (preprint)

Background: Coronavirus disease 2019 (COVID-19) is currently spreading all over the world, and the prospect of a very rapid increase in COVID-19 cases prompted us to seek effective antiviral therapeutics, from the identification of possible drugs to their potential mechanisms. Purpose: The aim of this study was to explore the efficacy of the Ephedra-Glycyrrhiza (EG) drug pair on coronavirus disease 2019 (COVID-19) by network pharmacology and molecular docking. Methods: The main active compounds, target information, meridians and properties of EG were obtained through the TCMSP and ETCM databases. The targeted information of COVID-19 was acquired from the GeneCards database. EG drug pair applied diseases were analysed by DAVID and the drug-bank database, and visualized by Rstudio and Cytoscape 3.7.2. Then, we carried out targeted intersection of the EG drug pair and COVID-19 to map the compound-target-disease interactions and visualize them with Cytoscape 3.7.2 and Venny 2.1. In addition, the enrichment analysis of the GO and KEGG pathways were visualized with Rstudio and PathVisio software through the DAVID database. Finally, we carried out the molecular docking of the EG active compounds with M hydrolase (Mpro), spike protein (S protein) and angiotensin-converting enzyme 2 (ACE2), and the binding modes between GE and the protein were verified via molecular dynamics (MD) simulation. Results: We identified 112 active EG compounds by network pharmacological analysis. Drug pair enrichment analysis demonstrated that these compounds may participate in the cAMP, PI3K-Akt, JAK-STAT and chemokine signalling pathways, which had a high correlation with respiratory system, nervous system, blood circulation system and digestive system related diseases. Pathway analysis between EG and COVID-19 showed that the key targets were TNF, IL2, FOS, ALB and PTGS2. They may regulate the PI3K-Akt signalling pathway and natural killer cell-mediated cytotoxicity to play roles in immune regulation, organ protection, antiviral, immune regulation, and organ protection as well as having antiviral effects. Molecular docking results showed that the active EG compounds bind well to Mpro, S protein and ACE2. The binding modes between the active compounds of the EG and protein were verified via MD simulation. Conclusion: The EG drug pair can treat COVID-19 through multiple targets and pathways, which can provide a theoretical basis for further study of the mechanism of action of the EG drug pair on COVID-19.

Mental health status and coping strategy of medical workers in China during The COVID-19 outbreak (preprint)

The authors have withdrawn their manuscript whilst they perform additional experiments to test some of their conclusions further. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.