ABSTRACT
PURPOSE: This study was conducted to explore the value of noninvasive assessment of bedside ultrasound in diagnosing cardiac changes of COVID-19. METHODS: We performed a retrospective study in 34 patients with COVID-19 and analyzed their clinical data, biochemistry test results (creatine kinase-MB [CK-MB], cardiac troponin I [cTnI] and C-reactive protein [CRP]), and parameters of cardiac ultrasound (left atrium [LA], left ventricular end-diastolic dimensions [LVDD], right atrium [RA], right ventricle [RV], main pulmonary artery [MPA], left ventricular ejection fraction [LVEF], tricuspid valve [TV], pulmonic valve [PV] and pulmonary artery systolic pressure [PASP]). We classified the patients based on their clinical symptoms: mild, moderate, severe, and critical groups, and compared the parameters. RESULTS: As the disease progressed, the parameters of both biochemical blood tests and cardiac ultrasound changed regularly, manifested as enlargement of LA, LVDD, RA, RV, and MPA and increase of PASP, CRP, CK-MB, and cTnI. Of these parameters, CRP, LA, LVDD, MPA, and PASP of the severe group were more notably elevated than those of the mild and the moderate groups (p<0.05). The critical group increased more markedly in CK-MB, cTnI, and RA than the other groups (p<0.05), and rose more sharply in CRP, LA, LVDD, RV, MPA, and PASP than the mild and the moderate groups (p<0.05). CONCLUSION: As the disease progressed, the patients had the enlarged heart with expanded pulmonary arteries and elevated PASP. Bedside ultrasound can be a noninvasive assessment of the above changes and a guidance of clinical treatment.
Subject(s)
COVID-19ABSTRACT
Coronavirus disease (COVID-19) causes a serious threat to human health. To production of SARS-COV-2 virus-like particles (VLPs) in insect cells for vaccine development and scientific research. The E, M and S genes were cloned into multiple cloning sites of the new triple expression plasmid with one p10 promoter, two pPH promoters and three multiple cloning sites. The plasmid was transformed into DH10 BacTM Escherichia coli competent cells to obtain recombinant bacmid. Then the recombinant bacmid was transfected in ExpiSf9 insect cells to generate recombinant baculovirus. After ExpiSf9 infected with the recombinant baculovirus, the E, M, and S protein co-expressed in insect cells. Finally, SARS-CoV-2 VLPs were self-assembled in insect cells after infection. The morphology and the size of SARS-CoV-2 VLPs are similar to the native virions.
Subject(s)
COVID-19ABSTRACT
This paper proposed a quarantine-susceptible-exposed-infectious-resistant (QSEIR) model which considers the unprecedented strict quarantine measures in almost the whole of China to resist the epidemic. We estimated model parameters from published information with the statistical method and stochastic simulation, we found the parameters that achieved the best simulation test result. The next stage involved quantitative predictions of future epidemic developments based on different containment strategies with the QSEIR model, focused on the sensitivity of the outcomes to different parameter choices in mainland China. The main results are as follows. If the strict quarantine measures are being retained, the peak value of confirmed cases would be in the range of [52438, 64090] and the peak date would be expected in the range February 7 to February 19, 2020. During March18-30, 2020, the epidemic would be controlled. The end date would be in the period from August 20 to September 1, 2020. With 80% probability, our prediction on the peak date was 4 days ahead of the real date, the prediction error of the peak value is 0.43%, both estimates are much closer to the observed values compared with published studies. The sensitive analysis indicated that the quarantine measures (or with vaccination) are the most effective containment strategy to control the epidemic, followed by measures to increase the cured rate (like finding special medicine). The long-term simulation result and sensitive analysis in mainland China showed that the QSEIR model is stable and can be empirically validated. It is suggested that the QSEIR model can be applied to predict the development trend of the epidemic in other regions or countries in the world. In mainland China, the quarantine measures can't be relaxed before the end of March 2020. China can fully resume production with appropriate anti-epidemic measures beginning in early April 2020. The results of this study also implied that other countries now facing the epidemic outbreaks should act more decisively and take in time quarantine measures though it may have negative short-term public and economic consequences.