The psychological stress response of COVID-19 to medical staff and prevention: A large sample study from China.

Objectives: In the face of the COVID-19 pandemic, medical staff in China were more likely to suffer from psychological problems. By investigating the actual state of psychological stress response of medical staff during the COVID-19 outbreak, the study discussed and analyzed the influencing factors of different psychological states in order to prevent the occurrence of serious adverse emotional events in medical staff. Methods: In the Xiangyang Central Hospital, 1,466 medical staff members have adopted the Psychological Questionnaire for Emergencies Events of Public Health (PQEEPH), which includes questions about depression, neurasthenia, fear, obsessive anxiety, and hypochondriac disorders. The questionnaire also asks about gender, age, education level, health, department, position, and whether personnel exposure history correlation analysis has been confirmed. Results: The survey revealed that 55% had depression, 26.7% had neurasthenia, 95% had fear, 47.9% had obsessive anxiety, and 69.3% had hypochondria. The effects of depression and hypochondriac emotional stress were significantly greater in female workers than in male workers (p < 0.05). Those with higher educational levels had a stronger emotional stress response. Medical professionals with or without contact histories, those who were suspected or confirmed, as well as those in various positions and departments, all demonstrated significant differences in their stress emotions (p < 0.05). Conclusion: Emotional stress affected medical professionals, especially doctors and nurses, who were on the front lines of clinical work in the face of significant public health emergencies. Therefore, to reduce the stress burden and enhance mental health on medical staff, hospitals were suggested to improve their emergency management practices. In addition, the sensitization knowledge training and psychological counseling for front-line clinical staff should be strengthened.

Screening of sperm antigen epitopes by phage display technique and its preliminary clinical application.

BACKGROUND: At present, there is a lack of standardized preparation methods of sperm antigen for the detection of antisperm antibody (AsAb). To screen sperm antigen mimotopes from a phage display random peptide library and use them to establish an enzyme-linked immunosorbent assay (ELISA) for the detection of AsAb, immunoglobulins were extracted from the sera of rabbits with positive AsAb and negative AsAb, respectively, by the saturated ammonium sulfate method, and a phage display 12-mer peptide library was affinity panned by the extracted immunoglobins coated on the ELISA plate. Then, the obtained positive phage clones were identified by ELISA and sent for sequencing and peptides synthesis. Last, a diagnostic ELISA was established to detect clinical serum and seminal plasma samples. RESULTS: A total of sixty phage clones were chosen by affinity panning, and sixteen of them reacted positively with AsAb in indirect ELISA and sandwich ELISA. Following DNA sequencing and translation, the peptide sequences of the sixteen positive clones were obtained. By comparison in Blast database, four of sixteen positive clones were found to be closely related to male reproduction. Two (#1 and #25) of four mimotopes were synthesized, and an ELISA method was established using the two mimotopes as sperm specific antigens. One hundred and thirty-four serum samples and seventy-four seminal plasma samples from infertile couples were analyzed by the established ELISA with #1 and #25 mimotopes, respectively. The positive rates of AsAb in serum samples were 20.15% (27/134) for #1 and 11.19% (15/134) for #25, respectively, and the coincidence rate between them was 91.04% (122/134). The positive rates of AsAb in seminal plasma samples were 1.35% (1/74) for both #1 and #25, and the coincidence rate was 100%. CONCLUSION: Sperm antigen mimotopes can be obtained successfully by the phage display technique, and can be used as standard sperm specific antigens to establish an ELISA method for the detection of AsAb.

RéSUMé: CONTEXTE: À ce jour, il n'existe pas de méthodes normalisées de préparation d'antigènes spermatiques pour la détection des anticorps anti-spermatozoïdes (ACAS). Dans le but d'élaborer un tel test ELISA (enzyme-linked immunosorbent assay), nous avons extrait de sérum de lapins des anticorps anti-spermatozoïdes humains via la technique du sulfate d'ammonium saturé et en ayant recours à une librairie phagique de peptides (12-mer). Les clones positifs ont été identifiés par ELISA, séquencés à façon et les peptides correspondants ont été synthétisés. In fine, un test ELISA diagnostic a été conçu pour être utilisé avec des échantillons cliniques de sérum et de plasmas séminaux. RéSULTATS: Au total, soixante clones de phages ont été sélectionnés, et seize d'entre eux se sont avérés interagir avec les ACAS en ELISA indirect comme en ELISA sandwich. Les séquences peptidiques de ces seize clones positifs ont été obtenues. Par comparaison avec les bases de données (Blast), quatre de ces seize clones positifs se sont révélés être étroitement liés à la reproduction masculine. Deux des quatre mimotopes (#1 et #25) ont été synthétisés, et un test ELISA a été généré en utilisant ces deux mimotopes comme antigènes spécifiques des spermatozoïdes. Cent trente-quatre échantillons de sérum et soixante-quatorze échantillons de plasma séminal de patients de couples infertiles ont alors été analysés avec ce test ELISA. Respectivement, les échantillons sériques se sont révélés positifs à 20,15% (27/134) pour le mimotope #1 et à 11,19% (15/134) pour le mimotope #25, avec un taux de coïncidence de 91,04% (122/134). Seul un échantillon de plasma séminal (1/74, soit 1, 35%) s'est révélé positif à la fois pour le mimotope #1 et #25 (coïncidence 100%). CONCLUSION: La technique « phage display¼ nous a permis d'identifier des mimotopes d'antigènes spermatiques qui ont pu être utilisés afin de générer un test ELISA pour la détection d'anticorps anti-spermatozoïdes.

Dynamic Emergency Transit Forecasting with IoT Sequential Data

Medical emergency transit counts minutes as real human lives. It is important to plan emergency transport routes according to real-time traffic flow status which leads to the the essential requirement of correct dynamic traffic prediction. Many Internet of Things (IoT) devices have been employed to assist emergency transit. Dynamic traffic flow patterns can be better predicted using data given by those devices. In small cities, however, the data are sent into separated management offices or just saved inside edge devices due to system compatibility or the cost of mobile network to computer centres. This condition leads to small and local datasets. Making full use of small local data to conduct prediction is one way to solve local emergency planning problems. In this work, we design a dynamic graph structure to work with Graph Neural Network (GNN) algorithm to forecast traffic flow levels considering this scenario. The proposed graph considers both geographical and time information with the potential to grow within a local mobile communication network. The commonly used Extreme Gradient Boosting (XGBoost) is included in the comparison. Experimental results show that our new design provides high prediction efficiency and accuracy.

Collective memory and social imaginaries of the epidemic situation in COVID-19-based on the qualitative research of college students in Wuhan, China.

This study conducted in-depth interviews with 20 students from a university in Wuhan so as to obtain data regarding their collective memory at the early stage of the COVID-19 outbreak and their social imaginaries in the longitudinal dimension of time. Compared with those in other regions, interviewees from Wuhan show more fear and dissatisfaction and think that others find it difficult to empathize with their first-hand experiences. Interviewees from Wuhan are more dependent on the media. However, media use can cause problems related to redundant information and emotional impact. While one is confined to home, he/she is forced to participate in communication with family members and the topic of the body is discussed again from a new angle. Trauma leads to self-reconciliation, as facilitated by the re-examination of and reflection on one' nomination of and reflection on n family members and the months in the wake of the COVID-19 outbreak. However, having received a collectivist education since childhood and having been guided by the discourse system created by the state media, they have since been able to shape their sense of identity and strengthen their sense of national honor.

Collective memory and social imaginaries of the epidemic situation in COVID-19—based on the qualitative research of college students in Wuhan, China

This study conducted in-depth interviews with 20 students from a university in Wuhan so as to obtain data regarding their collective memory at the early stage of the COVID-19 outbreak and their social imaginaries in the longitudinal dimension of time. Compared with those in other regions, interviewees from Wuhan show more fear and dissatisfaction and think that others find it difficult to empathize with their first-hand experiences. Interviewees from Wuhan are more dependent on the media. However, media use can cause problems related to redundant information and emotional impact. While one is confined to home, he/she is forced to participate in communication with family members and the topic of the body is discussed again from a new angle. Trauma leads to self-reconciliation, as facilitated by the re-examination of and reflection on one’ nomination of and reflection on n family members and the months in the wake of the COVID-19 outbreak. However, having received a collectivist education since childhood and having been guided by the discourse system created by the state media, they have since been able to shape their sense of identity and strengthen their sense of national honor.

Carbon Emission Variations for Plug-In Hybrid Electric Vehicles after Coronavirus Disease 19: An Empirical Case in Chongqing, China

Owing to the lockdowns associated with the Coronavirus Disease 2019(COVID-19) pandemic, carbon emissions were significantly reduced. However, the accurate impacts on the personal transport sector since then remain unclear. To further investigate the influence of sudden public health emergencies on actual carbon emissions from personal electric vehicles, this paper examined the travel patterns and corresponding carbon emissions of plug-in hybrid electric vehicles (PHEVs) operating in Chongqing, China, before and after COVID-19. The results revealed that the pandemic has reshaped the travel patterns of vehicle drivers, with a 9 % reduction in the postpandemic fleet average daily travel mileage. Currently, the total daily carbon emissions of a PHEV with a range of 80 km (PHEV80) are 6.24 kg, which is 13 % lower than emissions from conventional vehicles and 32 % higher than those from electric battery-powered vehicles before the pandemic. Since COVID-19, there has been a 24 % decrease in carbon emissions from PHEV80 vehicles for the fleet and a 30 % maximum increase for individuals. Furthermore, considering the integration of 50 % renewable energy into China’s power grid by 2025, PHEVs can better mitigate the fluctuations in carbon emissions associated with sudden public health emergencies compared with conventional vehicles.

Longitudinal Serum Proteome Characterization of COVID-19 Patients With Different Severities Revealed Potential Therapeutic Strategies.

The COVID-19 pandemic caused by SARS-CoV-2 is exerting huge pressure on global healthcare. Understanding of the molecular pathophysiological alterations in COVID-19 patients with different severities during disease is important for effective treatment. In this study, we performed proteomic profiling of 181 serum samples collected at multiple time points from 79 COVID-19 patients with different severity levels (asymptomatic, mild, moderate, and severe/critical) and 27 serum samples from non-COVID-19 control individuals. Dysregulation of immune response and metabolic reprogramming was found in severe/critical COVID-19 patients compared with non-severe/critical patients, whereas asymptomatic patients presented an effective immune response compared with symptomatic COVID-19 patients. Interestingly, the moderate COVID-19 patients were mainly grouped into two distinct clusters using hierarchical cluster analysis, which demonstrates the molecular pathophysiological heterogeneity in COVID-19 patients. Analysis of protein-level alterations during disease progression revealed that proteins involved in complement activation, the coagulation cascade and cholesterol metabolism were restored at the convalescence stage, but the levels of some proteins, such as anti-angiogenesis protein PLGLB1, would not recovered. The higher serum level of PLGLB1 in COVID-19 patients than in control groups was further confirmed by parallel reaction monitoring (PRM). These findings expand our understanding of the pathogenesis and progression of COVID-19 and provide insight into the discovery of potential therapeutic targets and serum biomarkers worth further validation.

Explaining expedited energy transition toward renewables by COVID-19 in India

Energy transition toward renewables, mainly wind and solar, has gained momentum in the past decade. Although the COVID-19 pandemic brought unprecedented, multi-faceted challenges and uncertainties, India witnessed an expedited energy transition in 2020. With our newly constructed Electric System Dispatch Model for India (ESDMI), this study aims to provide an explanation of the underlining mechanisms. The Janta Curfew (7am-9pm) in India was observed on March 22, 2020 followed by a 21-day complete lockdown starting March 25, 2020 to control the spread of the virus. Electricity demand in India dropped by nearly a quarter. We model the supply-side dynamics prior to and during the pandemic response as well as in a counterfactual scenario in the pandemic's absence. We find that the expedited energy transition could be explained by (i) the higher priority of a large renewables fleet to access electric grid either through stipulations and the merit order effect, and (ii) coal-fired electricity generation is less flexible than natural gas and hydropower units. A substantial amount of coal-fired power plants in India are still far from reaching their designed lifetimes. Their low resilience in such crises could exacerbate the problem of stranded assets.

Prediction of COVID-19 manipulation by selective ACE inhibitory compounds of Potentilla reptant root: In silico study and ADMET profile.

In the novel SARS-CoV-2 (COVID-19) as a global emergency event, the main reason of the cardiac injury from COVID-19 is angiotensin-converting enzyme 2 (ACE2) targeting in SARS-CoV-2 infection. The inhibition of ACE2 induces an increase in the angiotensin II (Ang II) and the angiotensin II receptor type 1 (AT1R) leading to impaired cardiac function or cardiac inflammatory responses. The ethyl acetate fraction of Potentilla reptans L. root can rescue heart dysfunction, oxidative stress, cardiac arrhythmias and apoptosis. Therefore, isolated components of P. reptans evaluated to identify natural anti-SARS-CoV-2 agents via molecular docking. In silico molecular docking study were carried out using the Auto Dock software on the isolated compounds of Potentilla reptans root. The protein targets of selective ACE and others obtained from Protein Data Bank (PDB). The best binding pose between amino acid residues involved in active site of the targets and compounds was discovered via molecular docking. Furthermore, ADMET properties of the compounds were evaluated. The triterpenoids of P. reptans showed more ACE inhibitory potential than catechin in both domains. They were selective on the nACE domain, especially compound 5. Also, the compound 5 & 6 had the highest binding affinity toward active site of nACE, cACE, AT1R, ACE2, and TNF-α receptors. Meanwhile, compound 3 showed more activity to inhibit TXA2. Drug likeness and ADMET analysis showed that the compounds passed the criteria of drug likeness and Lipinski rules. The current study depicted that P. reptans root showed cardioprotective effect in COVID-19 infection and manipulation of angiotensin II-induced side effects.

Drug repositioning: Progress and challenges in drug discovery for various diseases.

Compared with traditional de novo drug discovery, drug repurposing has become an attractive drug discovery strategy due to its low-cost and high efficiency. Through a comprehensive analysis of the candidates that have been identified with drug repositioning potentials, it is found that although some drugs do not show obvious advantages in the original indications, they may exert more obvious effects in other diseases. In addition, some drugs have a synergistic effect to exert better clinical efficacy if used in combination. Particularly, it has been confirmed that drug repositioning has benefits and values on the current public health emergency such as the COVID-19 pandemic, which proved the great potential of drug repositioning. In this review, we systematically reviewed a series of representative drugs that have been repositioned for different diseases and illustrated successful cases in each disease. Especially, the mechanism of action for the representative drugs in new indications were explicitly explored for each disease, we hope this review can provide important insights for follow-up research.

Impacts of Extreme Climate Events on Future Rice Yields in Global Major Rice-Producing Regions.

Under the dual impacts of climate change and COVID-19, there are great risks to the world's food security. Rice is one of the three major food crops of the world. Assessing the impact of climate change on future rice production is very important for ensuring global food security. This article divides the world's main rice-producing regions into four regions and uses a multivariate nonlinear model based on historical economic and climatic data to explore the impacts of historical extreme climatic events and economic factors on rice yield. Based on these historical models, future climatic data, and economic data under different shared socioeconomic pathways (SSPs), the yields of four major rice-producing regions of the world under different climate change scenarios (SSP126, SSP245, and SSP585) are predicted. The research results reveal that under different climate change scenarios, extreme high-temperature events (Tx90p) and extreme precipitation events (Rx5day, R99pTOT) in the four major rice-producing regions have an upward trend in the future. Extreme low-temperature events (Tn10p) have a downward trend. In the rice-producing regions of Southeast Asia and South America, extreme precipitation events will increase significantly in the future. The prediction results of this model indicate that the rice output of these four major rice-producing regions will show an upward trend in the future. Although extreme precipitation events will have a negative impact on rice production, future increases in rice planting areas, economic development, and population growth will all contribute to an increase in rice production. The increase in food demand caused by population growth also brings uncertainty to global food security. This research is helpful for further understanding climate change trends and risks to global rice-production areas in the future and provides an important reference for global rice-production planning and risk management.

Reversible Hydration Composite Films for Evaporative Perspiration Control and Heat Stress Management.

Donning of personal protective equipment (PPE) in the healthcare sector has been intensified by the on-going COVID-19 pandemic around the globe. While extensive PPE provides protection, it typically limits moisture permeability and severely hinders the sweat evaporation process, resulting in greater heat stress on the personnel. Herein, a zinc-poly(vinyl alcohol) (Zn-PVA) composite film is fabricated by embedding a super-hygroscopic zinc-ethanolamine complex (Zn-complex) in the PVA matrix. By attaching the Zn-PVA composite film, the relative humidity (RH) inside the protective suit decreases from 91.0% to 48.2%. The reduced RH level, in turn, enhances evaporative cooling, hence bringing down the heat index from 64.6 to 40.0 °C at an air temperature of 35 °C, remarkably lowering the likelihood of heat stroke. The American Society for Testing and Materials tests conducted on a sweating manikin have also proven that the Zn-PVA composite films can significantly reduce the evaporative resistance of the protective suit by 90%. The low material cost, facile fabrication process, and reusability allow the Zn-PVA composition films to be readily available for healthcare workers worldwide. This application can be further extended to other occupations that are facing severe thermal discomfort and heat stress.

Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study.

OBJECTIVE: To evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations. DESIGN: Retrospective cohort study. SETTING: Acute care hospitals and emergency departments (EDs) in Alberta, Canada. PARTICIPANTS: Patients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code. MAIN OUTCOME MEASURES: The sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted. RESULTS: Two overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3-14) for cohort A and 8 days (IQR: 3-19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%-83.2%) with a PPV of 93.1% (92.6%-93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%-83.2%) and PPV of 92.9% (92.4%-93.4%). CONCLUSIONS: In Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.

Treatment Effects of Integrated TCM and Western Medicine Treatment Scheme on COVID-19: A Single-armed Clinical Trial

Backgroud : The outbreak of COVID-19 has brought unprecedented perils to human health and raised public health concerns in more than two hundred countries. Safe and effective treatment scheme is needed urgently. Objective : To evaluate the effects of integrated TCM and western medicine treatment scheme on COVID-19. Methods : A single-armed clinical trial was carried out in Hangzhou Xixi Hospital, an affiliated hospital with Zhejiang Chinese Medical University. 102 confirmed cases were screened out from 725 suspected cases and 93 of them were treated with integrated TCM and western medicine treatment scheme. Results : 83 cases were cured, 5 cases deteriorated, and 5 cases withdrew from the study. No deaths were reported. The mean relief time of fever, cough, diarrhea, and fatigue were (4.78±4.61) days, (7.22±4.99) days, (5.28± 3.39) days, and (5.28± 3.39) days, respectively. It took (14.84±5.50) days for SARS-CoV-2 by nucleic acid amplification-based testing to turn negative. Multivariable cox regression analysis revealed that age, BMI, PISCT, BPC, AST, CK, BS, and UPRO were independent risk factors for COVID-19 treatment. Conclusion : Our study suggested that integrated TCM and western medicine treatment scheme was effective for COVID-19.

Profile of Immunoglobulin G N-Glycome in COVID-19 Patients: A Case-Control Study.

Coronavirus disease 2019 (COVID-19) remains a major health challenge globally. Previous studies have suggested that changes in the glycosylation of IgG are closely associated with the severity of COVID-19. This study aimed to compare the profiles of IgG N-glycome between COVID-19 patients and healthy controls. A case-control study was conducted, in which 104 COVID-19 patients and 104 age- and sex-matched healthy individuals were recruited. Serum IgG N-glycome composition was analyzed by hydrophilic interaction liquid chromatography with the ultra-high-performance liquid chromatography (HILIC-UPLC) approach. COVID-19 patients have a decreased level of IgG fucosylation, which upregulates antibody-dependent cell cytotoxicity (ADCC) in acute immune responses. In severe cases, a low level of IgG sialylation contributes to the ADCC-regulated enhancement of inflammatory cytokines. The decreases in sialylation and galactosylation play a role in COVID-19 pathogenesis via the activation of the lectin-initiated alternative complement pathway. IgG N-glycosylation underlines the complex clinical phenotypes of SARS-CoV-2 infection.

The Clinical Implication of Dynamic Hematological Parameters in COVID-19: A Retrospective Study in Chongqing, China.

PURPOSE: To analyze the clinical characteristics of patients with coronavirus disease 19 (COVID-19) in Chongqing, and identify the potential hematological markers for reference. PATIENTS AND METHODS: 78 COVID-19-infected patients in Chongqing were recruited and divided into the non-severe and the severe group. The clinical characteristics and hematological features of the patients of the two groups were compared. Receiver-operating characteristic curves (ROC) were calculated to evaluate the diagnostic performance of potential markers, and the dynamic changes of blood routine analyzing items were compared between the non-severe and severe groups. RESULTS: 78 patients (median age of 45 years, 41 females and 37 males) were enrolled. The patients in the severe group exhibited significantly lower lymphocyte (P<0.05) but higher neutrophil to lymphocyte ratio (NLR) (P<0.05) than the patients in the non-severe group. The highest area under the ROC curve (AUC) was lymphocyte (0.74). The patients in the severe group had a lower level of lymphocyte during hospitalization (P<0.01) and lymphocyte-monocyte ratio (LMR) in the progressive and convalescent phases (P<0.05) than the patients in the non-severe group. However, the level of neutrophil of the patients in the severe group was higher in the progressive phase (P<0.05), and so was NLR in the acute, progressive, and convalescent-phase (P<0.05). CONCLUSION: Infected with COVID-19 changed the levels of lymphocyte, neutrophil, LMR, and NLR in the blood, and these analyzing items were significantly different between the non-severe and severe groups. Furthermore, the dynamic changes of lymphocyte and NLR levels may help discriminate the severe group from the non-severe group.

Serum Albumin Levels are a Predictor of COVID-19 Patient Prognosis: Evidence from a Single Cohort in Chongqing, China.

BACKGROUND: COVID-19 infections are still at pandemic levels globally and there are currently no specific drugs to treat these infections. Previous studies have demonstrated that serum albumin levels were abnormally low in COVID-19 patients and might be used as a prognosis biomarker. Supplemental albumin has been used as an experimental therapeutic method. However, dynamic evaluation of albumin in patients with COVID-19 was limited and whether serum albumin could predict the prognosis of these patients is unknown. METHODS: We enrolled 79 COVID-19 patients in the present study and reviewed electronic medical laboratory records. Data was processed using SPSS software (Version 20.0) and correlation analysis was performed between serum albumin and other clinical and laboratory findings. RESULTS: Serum albumin levels were gradually decreased both in severe and non-severe COVID-19 patients. Moreover, 17.7% of the patients presented with hypoalbuminemia at least one time during 3 consecutive weekly time points. The hypoalbuminemia group displayed more severe disease and comorbidity that included fever, fatigue, headache, and dizziness on admission. Moreover, serum albumin levels were positively correlated with lymphocyte and RBC numbers, Hb and prealbumin levels as well as with total T cell numbers and the presence of CD4+ and CD8+ T cells. In contrast, there was a negative correlation with C-reactive protein levels and this was an indicator of patient recovery. CONCLUSION: Our results demonstrated that hypoalbuminemia was common in COVID-19 patients and its levels were linked to disease severity. Patients with fever, fatigue and headache or dizziness on admission were more likely to experience hypoalbuminemia. Dynamic monitoring of serum albumin is therefore necessary and should be performed during COVID-19 patient treatments as a tool for evaluating the prognosis of COVID-19 infections.

Abnormal apelin-ACE2 and SGLT2 signaling contribute to adverse cardiorenal injury in patients with COVID-19.

BACKGROUND: Angiotensin converting enzyme 2 (ACE2) has recently been identified as the functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent response for novel coronavirus disease 2019 (COVID-19). This study aimed to explore the roles of ACE2, apelin and sodium-glucose cotransporter 2 (SGLT2) in SARS-CoV-2-mediated cardiorenal damage. METHODS AND RESULTS: The published RNA-sequencing datasets of cardiomyocytes infected with SARS-CoV-2 and COVID-19 patients were used. String, UMAP plots and single cell RNA sequencing data were analyzed to show the close relationship and distinct cardiorenal distribution patterns of ACE2, apelin and SGLT2. Intriguingly, there were decreases in ACE2 and apelin expression as well as marked increases in SGLT2 and endothelin-1 levels in SARS-CoV-2-infected cardiomyocytes, animal models with diabetes, acute kidney injury, heart failure and COVID-19 patients. These changes were linked with downregulated levels of interleukin (IL)-10, superoxide dismutase 2 and catalase as well as upregulated expression of profibrotic genes and pro-inflammatory cytokines/chemokines. Genetic ACE2 deletion resulted in upregulation of pro-inflammatory cytokines containing IL-1ß, IL-6, IL-17 and tumor necrosis factor α. More importantly, dapagliflozin strikingly alleviated cardiorenal fibrosis in diabetic db/db mice by suppressing SGLT2 levels and potentiating the apelin-ACE2 signaling. CONCLUSION: Downregulation of apelin and ACE2 and upregulation of SGLT2, endothelin-1 and pro-inflammatory cytokines contribute to SARS-CoV-2-mediated cardiorenal injury, indicating that the apelin-ACE2 signaling and SGLT2 inhibitors are potential therapeutic targets for COVID-19 patients.

Sinonasal manifestations and dynamic profile of RT-PCR results for SARS-CoV-2 in COVID-19 patients.

BACKGROUND: Sinonasal symptoms were usually reported to appear initially, yielding the symptoms important for the early detection of coronavirus disease 2019 (COVID-19). This study was conducted retrospectively to investigate the detailed sinonasal manifestations and dynamic profile of real-time reverse transcription polymerase chain reaction (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in COVID-19 patients longitudinally. METHODS: This retrospective study included 11 consecutive patients. The prevalence, timing and severity of sinonasal manifestations were analyzed. Oropharyngeal, nasal, sputum and stool specimens were collected to detect RT-PCR for SARS-CoV-2 over COVID-19 period. RESULTS: Among the 11 patients, 6 (54.5%) were female, and the median age was 51 (IQR, 36-62) years. Seven patients (63.6%) experienced sinonasal symptoms, with 6 (54.5%) exhibiting sinonasal symptoms on the onset day. Seven patients (63.6%) demonstrated nasal obstruction, 5 (45.5%) had rhinorrhea, and 4 (36.4%) exhibited olfactory dysfunction. All six patients with sinonasal symptoms on the onset day had non-severe infections. Most patients (85.7%) with sinonasal symptoms had non-severe infections. Sinonasal symptoms commonly appeared early. The positive RT-PCR rate for SARS-CoV-2 in various specimens was highest in the first week (73.3%), then gradually decreased over the disease course, but 3 patients (27.3%) had experienced a long-lasting fluctuated positive RT-PCR results since 29 days of illness in both groups, especially for two patients with airway comorbidities. CONCLUSIONS: Sinonasal symptoms were more prevalent in patients with mild or moderate COVID-19 and usually appeared early. In addition, regular nucleic acid testing for SARS-CoV-2 should be considered for COVID-19 patients with certain airway comorbidities.

Public Knowledge, Attitudes, and Practices Behaviors Towards Coronavirus Disease 2019 (COVID-19) During a National Epidemic-China.

Background: The rapid outbreak of coronavirus disease 2019 (COVID-19) posed a serious threat to China, followed by compulsive measures taken against the national emergency to control its further spread. This study was designed to describe residents' knowledge, attitudes, and practice behaviors (KAP) during the outbreak of COVID-19. Methods: An anonymous online questionnaire was randomly administrated to residents in mainland China between Mar 7 and Mar 16, 2020. Residents' responses to KAP were quantified by descriptive and stratified analyses. A Multiple Logistic Regression model was employed to identify risk factors associated with KAP scores. Results: A total of 10,195 participants were enrolled from 32 provinces of China. Participants of the ≥61 years group had higher KAP scores [adjusted Odds Ratio (ORadj) = 4.8, 95% Confidence Interval (CI): 3.0-7.7, P < 0.0001], and the married participants and those in low-income families had higher scores of KAP (ORadj = 1.2, 95% CI: 1.1-1.3; ORadj = 1.8, 95% CI: 1.6-2.2, respectively, both P < 0.0001). The participants living with more than two family members had higher scores in an increasing ORs when the family members increased (ORadj = 1.3, 95% CI: 1.1-1.6, P = 0.013; ORadj = 1.3, 95% CI: 1.1-1.6, P = 0.003; ORadj = 1.3, 95% CI: 1.0-1.6, P = 0.02; for groups of 2, 3-4 and ≥5, respectively). Conclusions: Out of the enrolled participants who completed the survey, 85.5% responded positively toward the mandatory public health interventions implemented nationwide by the Chinese authorities. These effective practices seem to be related to a proper attitude generated by the increased knowledge and better awareness of the risks related to the COVID-19 pandemic and the consequent need for safe and responsible behavior.