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1.
Research (Wash D C) ; 2022: 9769803, 2022.
Article in English | MEDLINE | ID: covidwho-1970043

ABSTRACT

Identification of epitopes targeted following virus infection or vaccination can guide vaccine design and development of therapeutic interventions targeting functional sites, but can be laborious. Herein, we employed peptide microarrays to map linear peptide epitopes (LPEs) recognized following SARS-CoV-2 infection and vaccination. LPEs detected by nonhuman primate (NHP) and patient IgMs after SARS-CoV-2 infection extensively overlapped, localized to functionally important virus regions, and aligned with reported neutralizing antibody binding sites. Similar LPE overlap occurred after infection and vaccination, with LPE clusters specific to each stimulus, where strong and conserved LPEs mapping to sites known or likely to inhibit spike protein function. Vaccine-specific LPEs tended to map to sites known or likely to be affected by structural changes induced by the proline substitutions in the mRNA vaccine's S protein. Mapping LPEs to regions of known functional importance in this manner may accelerate vaccine evaluation and discovery of targets for site-specific therapeutic interventions.

2.
Biosci Trends ; 16(3): 242-244, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1964373

ABSTRACT

As a new variant of COVID-19 with varied mutations, Omicron is more transmissible, more rapidly contagious, and has a greater risk of reinfection. Given those facts, a precise manage strategy needs to be formulated and implemented in designated megacities. Here, the precise COVID-19 prevention and control strategy for a designated hospital in Shenzhen, China is summarized, including implementation of a two-wing "On duty/On standby" approach based on busy and calm periods, an identification, classification, and grading system for the occupational exposure risks of medical staff, classification of patient transmission risks, separate admission, and an innovative treatment (nasal irrigation). The strategy has enabled the efficient and orderly integration of resources, it has resulted in zero infections among medical staff even during the peak hours of the pandemic at the hospital (1,930 patients admitted to both wings in a single day), and it has significantly reduced the initial period of no virus detection when patients infected with Omicron received saline nasal irrigation (P < 0.001). This strategy has provided evidence of precise prevention and control in a hospital, infection control, and efficient patient treatment in an era when Omicron is widespread.


Subject(s)
COVID-19 , Cities , Hospitals , Humans , Infection Control , Pandemics/prevention & control
3.
Biosci Trends ; 16(2): 163-166, 2022 May 17.
Article in English | MEDLINE | ID: covidwho-1856153

ABSTRACT

Since COVID-19 was first reported in 2019, the pandemic has posed a great threat to human health. Due to its multiple transmission pathways and virus mutation, this epidemic may be protracted further, and it has already placed a heavy burden on healthcare systems. A strategy needs to be devised to address both needs for COVID-19 treatment and demands for general medical service. A two-wing model of hospital operation, which provides a safe treatment environment for patients, an On duty/On Standby work approach for medical staff, and a reliable surveillance system for hospital operation, is an effective management template to help achieve a balance between multiple demands for medical service in this new era of a long-term war against COVID-19.


Subject(s)
COVID-19 , COVID-19/drug therapy , China/epidemiology , Hospitals , Humans , Inpatients , SARS-CoV-2
4.
Advanced Intelligent Systems ; 4(5), 2022.
Article in English | ProQuest Central | ID: covidwho-1848431

ABSTRACT

A number of recently developed mass spectrometry (MS)‐based metabolic fingerprinting analyses are promoting metabolic analysis systems into practical clinical applications, including but not limited to disease diagnosis. Herein, recent cutting‐edge research on mass spectrometry‐based metabolic fingerprinting analytical methodology and clinical applications are described. These developments resolve challenges regarding the practical clinical applications of MS‐based metabolic fingerprinting analysis systems, such as rapid signal readout, high throughput and direct MS analysis, and intelligent data mining of complex biological samples.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325246

ABSTRACT

Background: Dental staff were characterized with the tolerance of enduring stress and they are at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences. Methods: : Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Beck Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer’s V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS. Results: : In general, FDS were 4.342 (95% CI: 2.427-7.768) times more likely to suffer from anxiety disorders than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it. Conclusions: : During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. An elder age, sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325151

ABSTRACT

Background: A great number of studies have explored the association between frailty and mortality among COVID-19 patients, suggesting inconsistent results. The aim of this meta-analysis was to synthesize the evidence on this issue. MethodsThree databases, including PubMed, Embase, and Cochrane Library from inception to 20th October, 2020 were conducted to search for relevant literature. The Newcastle–Ottawa Scale (NOS) was used to assess quality bias, and STATA was employed to pool the effect size. Additionally, potential publication bias and sensitivity analysis was performed.ResultsThere are 11 studies that were included, with a total of 22105 COVID-19 patients for quantitative analysis. Overall, the pooled prevalence of frailty was 51% (95%CI:42%-60%). Patients infected with COVID-19 with frailty had an increased risk of mortality, compared to those without frailty, and the pooled HR was 2.27 (95%CI:1.79-2.89). In addition, subgroup analysis based on population showed that the pooled HR for hospitalized patients and nursing home residents was 2.24 (95%CI:1.74-2.89) and 2.95 (95%CI:1.19-7.32), respectively. Subgroup analysis using the frailty assessment tool indicated that this association still existed when using the clinical frailty scale (CFS)(HR=2.41;95%CI:1.60-3.62), frailty index(HR=2.95;95%CI:1.19-7.32), hospital frailty risk score (HR=1.96;95%CI:1.79-2.15) and palliative performance scale (HR= 2.89;95%CI:1.42-5.87). ConclusionOur study indicates that frailty was an independent predictor for mortality among patients with COVID-19. Thus, frailty could be a prognostic factor for clinicians to stratify high-risk groups, and remind doctors and nurses to perform early screening and corresponding interventions urgently needed to reduce mortality rates in patients infected by SARS-CoV-2.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324189

ABSTRACT

Background: A very serious new type of coronavirus infection has recently erupted in China. For new viruses, data and information in all aspects need to be improved.Case Presentations: During the early COVID-19 outbreak, a 38-year-old man experienced COVID-19 infection in Shenzhen (nonendemic area-related personnel) and underwent SARS-CoV-2 nucleic acid screening multiple times due to an initial positive COVID-19 screening at the beginning of the disease. The results of these additional tests were negative, and the initial SARS-CoV-2 nucleic acid screening result for this patient was suspected as being a false positive.Diagnosis: After nearly 17 days of hospitalization in two hospitals, a variety of tests were performed to diagnosis this new coronavirus infection (due to the positive results of the initial screening).Intervention: Early in the onset of the disease, treatment was given to maintain water and electrolyte balance, and antibiotics and proprietary Chinese medicines were given as the treatment. The symptoms were controlled at an early stage.Outcomes: The patient developed symptoms on the first day and had pneumonia in the lungs, as shown by a chest CT examination on the 7th day of onset. The subsequent prognosis was good. The family members living with this patient did not show similar symptoms. Conclusion: The diagnostic process of COVID-19 needs to be improved, and the development of SARS-CoV-2 diagnostic reagents needs to be strengthened under certain conditions. Screening should be performed at an early stage when a COVID-19 infection is suspected and should distinguish between patients with a COVID-19 infection and with a non-COVID-19 infection. Patients are more conducive to controlling the COVID-19 epidemic.

8.
Ann Palliat Med ; 11(1): 378-383, 2022 01.
Article in English | MEDLINE | ID: covidwho-1687682

ABSTRACT

In this paper, we report a case of coronavirus disease 2019 (COVID-19) complicated with human immunodeficiency virus (HIV) infection. The 50-year-old male patient had unexplained "intermittent fever with sore throat" on February 9th, 2020. Chest computed tomography (CT) showed bilateral multiple patchy opacities and ground-glass opacities. A COVID-19 RNA test was positive. After admission, additional laboratory tests revealed the following: white blood cell (WBC) count, 4.7×109/L; neutrophil percentage, 85.1%; lymphocyte percentage, 12.3%; lymphocyte count, 0.59×109/L; hypersensitivity C-reactive protein, 5.52 mg/L; four coagulation factors, +; D-dimer, 1.32 mg/L; and procalcitonin, normal. He was HIV (+). The patient was diagnosed with COVID-19 complicated with HIV infection. The healthcare team administered symptomatic care, including nasal oxygen, oseltamivir, Lianhua Qingwen capsule, moxifloxacin, ribavirin, and thymus faxin, as well as nutritional support, mental care, diet and life management, and close monitoring. Moreover, the team implemented strict disinfection and quarantine and occupational protection. The patient's temperature returned to normal and sore throat significantly improved by day 10, and COVID-19 RNA tests were negative on February 19th, February 21st, and February 22nd. Reexamination by chest CT on February 22nd showed significant absorption of inflammation. After rounds by the chief physician and consultation with specialists, the patient was released from quarantine and discharged on February 23rd per the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 6). Patients with COVID-19 and HIV infection face both physical and mental challenges. More attention should be paid to nursing as we understand more about COVID-19. We hope to share our nursing experience through this case.


Subject(s)
COVID-19 , HIV Infections , HIV , Humans , Male , Middle Aged , Quarantine , SARS-CoV-2
9.
Front Med (Lausanne) ; 8: 686878, 2021.
Article in English | MEDLINE | ID: covidwho-1662590

ABSTRACT

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge. Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement. Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time. Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

10.
Mikrochim Acta ; 189(1): 14, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1556195

ABSTRACT

In the ongoing COVID-19 pandemic, simple, rapid, point-of-care tests not requiring trained personnel for primary care testing are essential. Saliva-based antigen rapid tests (ARTs) can fulfil this need, but these tests require overnight-fasted samples; without which independent studies have demonstrated sensitivities of only 11.7 to 23.1%. Herein, we report an Amplified Parallel ART (AP-ART) with sensitivity above 90%, even with non-fasted samples. The virus was captured multimodally, using both anti-spike protein antibodies and Angiotensin Converting Enzyme 2 (ACE2) protein. It also featured two parallel flow channels. The first contained spike protein binding gold nanoparticles which produced a visible red line upon encountering the virus. The second contained signal amplifying nanoparticles that complex with the former and amplify the signal without any linker. Compared to existing dual gold amplification techniques, a limit of detection of one order of magnitude lower was achieved (0.0064 ng·mL-1). AP-ART performance in detecting SARS-CoV-2 in saliva of COVID-19 patients was investigated using a case-control study (139 participants enrolled and 162 saliva samples tested). Unlike commercially available ARTs, the sensitivity of AP-ART was maintained even when non-fasting saliva was used. Compared to the gold standard reverse transcription-polymerase chain reaction testing on nasopharyngeal samples, non-fasting saliva tested on AP-ART showed a sensitivity of 97.0% (95% CI: 84.7-99.8); without amplification, the sensitivity was 72.7% (95% CI: 83.7-94.8). Thus, AP-ART has the potential to be developed for point-of-care testing, which may be particularly important in resource-limited settings, and for early diagnosis to initiate newly approved therapies to reduce COVID-19 severity.


Subject(s)
Antigens/analysis , COVID-19/diagnosis , Point-of-Care Testing , Saliva/virology , COVID-19/virology , Case-Control Studies , Gold/chemistry , Immunoassay/instrumentation , Immunoassay/methods , Metal Nanoparticles/chemistry , SARS-CoV-2/isolation & purification , SARS-CoV-2/metabolism , Sensitivity and Specificity
11.
Front Cardiovasc Med ; 8: 604736, 2021.
Article in English | MEDLINE | ID: covidwho-1403460

ABSTRACT

Low-density lipoprotein cholesterol (LDL-C) is a well-known risk factor for coronary heart disease but protects against infection and sepsis. We aimed to disclose the exact association between LDL-C and severe 2019 novel coronavirus disease (COVID-19). Baseline data were retrospectively collected for 601 non-severe COVID-19 patients from two centers in Guangzhou and one center in Shenzhen, and patients on admission were medically observed for at least 15 days to determine the final outcome, including the non-severe group (n = 460) and the severe group (severe and critical cases) (n = 141). Among 601 cases, 76 (12.65%) received lipid-lowering therapy; the proportion of patients taking lipid-lowering drugs in the severe group was higher than that in the non-severe group (22.7 vs. 9.6%). We found a U-shaped association between LDL-C level and risk of severe COVID-19 using restricted cubic splines. Using univariate logistic regression analysis, odds ratios for severe COVID-19 for patients with LDL-C ≤1.6 mmol/L (61.9 mg/dL) and above 3.4 mmol/L (131.4 mg/dL) were 2.29 (95% confidence interval 1.12-4.68; p = 0.023) and 2.02 (1.04-3.94; p = 0.039), respectively, compared to those with LDL-C of 2.81-3.40 mmol/L (108.6-131.4 mg/dL); following multifactorial adjustment, odds ratios were 2.61 (1.07-6.37; p = 0.035) and 2.36 (1.09-5.14; p = 0.030). Similar results were yielded using 0.3 and 0.5 mmol/L categories of LDL-C and sensitivity analyses. Both low and high LDL-C levels were significantly associated with higher risk of severe COVID-19. Although our findings do not necessarily imply causality, they suggest that clinicians should pay more attention to lipid-lowering therapy in COVID-19 patients to improve clinical prognosis.

13.
Psychiatry Res ; 305: 114180, 2021 11.
Article in English | MEDLINE | ID: covidwho-1370667

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused widespread panic due to its highly infectious and pandemic transmission. We aimed to evaluate the psychological impact of the COVID-19 outbreak on infected subjects in China. METHODS: This case-control, survey-based study assessed the psychological status of COVID-19 patients and non-infected controls from February 10 to March 18, 2020, in China. Sex, age, education years, marital status, jobs, annual household income, living status, and geographic origin were matched between the two groups. The main outcome measures included anxiety, depression, insomnia, help-seeking behaviors, and treatment for mental problems. RESULTS: A total of 326 patients and 1304 (1:4 ratio) matched non-infected controls were enrolled. Compared with controls, patients had higher scores on the Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) (all p<0.01). Patients had higher rate of any mental problems (62.6% vs 42.5%, p<0.01), anxiety (27.3% vs 12.2%, p<0.01), depression (26.7% vs 14.6%, p<0.01), suicidal ideation (16.0% vs 10.7%, p<0.01), and insomnia (57.7% vs 36.7%, p<0.01). Among the subjects with mental problems, the proportion of seeking help (15.2% vs 6.9%, p<0.01) and receiving treatment (11.3% vs 4.3%, p<0.01) was higher in patients than controls. CONCLUSIONS: Our study showed a higher prevalence of mental problems in COVID-19 patients compared to controls, suggesting a great psychological impact of COVID-19 infection. Our findings highlighted the urgent need for psychological assistance for COVID-19 patients.


Subject(s)
COVID-19 , Anxiety , Case-Control Studies , China/epidemiology , Cross-Sectional Studies , Depression , Disease Outbreaks , Humans , Mental Health , SARS-CoV-2
15.
Nat Nanotechnol ; 16(9): 1039-1044, 2021 09.
Article in English | MEDLINE | ID: covidwho-1322483

ABSTRACT

Plasma SARS-CoV-2 RNA may represent a viable diagnostic alternative to respiratory RNA levels, which rapidly decline after infection. Quantitative PCR with reverse transcription (RT-qPCR) reference assays exhibit poor performance with plasma, probably reflecting the dilution and degradation of viral RNA released into the circulation, but these issues could be addressed by analysing viral RNA packaged into extracellular vesicles. Here we describe an assay approach in which extracellular vesicles directly captured from plasma are fused with reagent-loaded liposomes to sensitively amplify and detect a SARS-CoV-2 gene target. This approach accurately identified patients with COVID-19, including challenging cases missed by RT-qPCR. SARS-CoV-2-positive extracellular vesicles were detected at day 1 post-infection, and plateaued from day 6 to the day 28 endpoint in a non-human primate model, while signal durations for 20-60 days were observed in young children. This nanotechnology approach uses a non-infectious sample and extends virus detection windows, offering a tool to support COVID-19 diagnosis in patients without SARS-CoV-2 RNA detectable in the respiratory tract.


Subject(s)
COVID-19/diagnosis , Extracellular Vesicles/metabolism , Liposomes/therapeutic use , RNA, Viral/blood , SARS-CoV-2/isolation & purification , Animals , Biosensing Techniques , COVID-19/blood , COVID-19 Nucleic Acid Testing , Chlorocebus aethiops , Disease Models, Animal , HEK293 Cells , Humans , Kinetics , Liposomes/metabolism , RNA, Viral/genetics , SARS-CoV-2/genetics , Tetraspanin 28/immunology , Tetraspanin 28/metabolism
16.
Vaccines (Basel) ; 9(7)2021 Jun 30.
Article in English | MEDLINE | ID: covidwho-1289046

ABSTRACT

BACKGROUND: Lung-transplant (LT) recipients are at high risk for COVID-19 due to immunosuppression and respiratory tropism of SARS-CoV-2. The information on the effect of COVID-19 mRNA vaccines to elicit immunogenic responses after a two-dose (2D) regimen in LT recipients is sparse. Thus, we assessed the effect of Pfizer-BioNTech and Moderna mRNA vaccines' 2D regimen on anti-spike responses in immunocompromised LT recipients. METHODS: We utilized serum samples from LT recipients vaccinated for SARS-CoV-2 with 2D of either the Pfizer-BioNTech or Moderna vaccines and 2D-vaccinated naïve (non-transplanted and non-exposed to COVID-19) group. Antibody responses were assessed using the FDA-approved SARS-CoV-2 anti-nucleocapsid protein IgG assay (IgGNC), the SARS-CoV-2 anti-spike protein IgM assay (IgMSP), and the SARS-CoV-2 anti-spike protein IgG II assay (IgGSP). CD4+ T-cell activity was assessed as a marker of immune competence using the ImmuKnow® assay. RESULTS: About 25% (18/73) of SARS-CoV-2 uninfected-LT patients generated a positive spike-IgG response following 2D of vaccines, with 36% (9/25) in the Moderna cohort and only 19% (9/48) in the Pfizer cohort. 2D in LT patients elicited a significantly lesser median IgGSP response (1.7 AU/mL, 95% CI: 0.6-7.5 AU/mL) compared to non-transplanted, uninfected naïve subjects (14,209 AU/mL, 95% CI: 11,261-18,836 AU/mL; p < 0.0001). In LT patients, the Moderna-evoked seropositivity trend was higher than Pfizer. CONCLUSION: 2D COVID-19 vaccination elicits a dampened serological response in LT patients. Whether assessing other arms of host immunity combined with a higher vaccine dose can better capture and elicit improved immunogenicity in this immunocompromised population warrants investigation.

17.
Int Dent J ; 72(2): 230-235, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1275349

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been identified as a pandemic by the World Health Organization in March 2020, and it affects all aspects of life, including dental care. OBJECTIVES: The purpose of this article is to explore the impact of COVID-19 on the daily operations of the stomatology department and provide some guidance for dental health care personnel around the world in continuing to provide exemplary care while limiting the spread of COVID-19. MATERIALS AND METHODS: Retrospective analyses were performed on dental patients' medical records from the stomatology department of the First People's Hospital of Yichang, China, which were collected in the pre-epidemic, epidemic, and post-epidemic periods. Hospital-wide triage and stomatology department-specific protocols were established in the hospital to prevent cross-infection during the COVID-19 pandemic. RESULTS: The number of patients decreased and proportion of emergency cases increased during the epidemic period. With prevention protocols in place, the number of dental patients returned to the normal range with a slight elevation during the post-epidemic period. Thus far, there has not been a single documented case of COVID-19 related to dental treatment in the hospital. CONCLUSIONS: COVID-19 has a major impact on daily life, including dental care services. Effective prevention and control measures including 3 levels of protection-zoning, instrumentation, and environmental disinfection-are needed for dental settings to provide care.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Dentistry , Humans , Pandemics/prevention & control , Retrospective Studies , SARS-CoV-2
19.
BMC Geriatr ; 21(1): 186, 2021 03 17.
Article in English | MEDLINE | ID: covidwho-1140479

ABSTRACT

BACKGROUND: A large number of studies have explored the association between frailty and mortality among COVID-19 patients, with inconsistent results. The aim of this meta-analysis was to synthesize the evidence on this issue. METHODS: Three databases, PubMed, Embase, and Cochrane Library, from inception to 20th January 2021 were searched for relevant literature. The Newcastle-Ottawa Scale (NOS) was used to assess quality bias, and STATA was employed to pool the effect size by a random effects model. Additionally, potential publication bias and sensitivity analyses were performed. RESULTS: Fifteen studies were included, with a total of 23,944 COVID-19 patients, for quantitative analysis. Overall, the pooled prevalence of frailty was 51% (95% CI: 44-59%). Patients with frailty who were infected with COVID-19 had an increased risk of mortality compared to those without frailty, and the pooled hazard ratio (HR) and odds ratio (OR) were 1.99 (95% CI: 1.66-2.38) and 2.48 (95% CI: 1.78-3.46), respectively. In addition, subgroup analysis based on population showed that the pooled ORs for hospitalized patients in eight studies and nursing home residents in two studies were 2.62 (95% CI: 1.68-4.07) and 2.09 (95% CI: 1.40-3.11), respectively. Subgroup analysis using the frailty assessment tool indicated that this association still existed when using the clinical frailty scale (CFS) (assessed in 6 studies, pooled OR = 2.88, 95% CI: 1.52-5.45; assessed in 5 studies, pooled HR = 1.99, 95% CI: 1.66-2.38) and other frailty tools (assessed in 4 studies, pooled OR = 1.98, 95% CI: 1.81-2.16). In addition, these significant positive associations still existed in the subgroup analysis based on study design and geographic region. CONCLUSION: Our study indicates that frailty is an independent predictor of mortality among patients with COVID-19. Thus, frailty could be a prognostic factor for clinicians to stratify high-risk groups and remind doctors and nurses to perform early screening and corresponding interventions urgently needed to reduce mortality rates in patients infected by SARS-CoV-2.


Subject(s)
COVID-19 , Frailty , Aged , Frail Elderly , Frailty/diagnosis , Humans , Prevalence , SARS-CoV-2
20.
World J Clin Cases ; 9(5): 1132-1138, 2021 Feb 16.
Article in English | MEDLINE | ID: covidwho-1079830

ABSTRACT

BACKGROUND: Although the imaging features of coronavirus disease 2019 (COVID-19) are starting to be well determined, what actually occurs within the bronchi is poorly known. Here, we report the processes and findings of bronchoscopy in a patient with COVID-19 accompanied by respiratory failure. CASE SUMMARY: A 65-year-old male patient was admitted to the Hainan General Hospital on February 3, 2020 for fever and shortness of breath for 13 d that worsened for the last 2 d. The severe acute respiratory syndrome coronavirus 2 nucleic acid test was positive. Routine blood examination on February 28 showed a white blood cell count of 11.02 × 109/L, 86.9% of neutrophils, 6.4% of lymphocytes, absolute lymphocyte count of 0.71 × 109/L, procalcitonin of 2.260 ng/mL, and C-reactive protein of 142.61 mg/L. Oxygen saturation was 46% at baseline and turned to 94% after ventilation. The patient underwent video bronchoscopy. The tracheal cartilage ring was clear, and no deformity was found in the lumen. The trachea and bilateral bronchi were patent, while the mucosa was with slight hyperemia; no neoplasm or ulcer was found. Moderate amounts of white gelatinous secretions were found in the dorsal segment of the left inferior lobe, and the bronchial lumen was patent after sputum aspiration. The right inferior lobe was found with hyperemia and mucosal erosion, with white gelatinous secretion attachment. The patient's condition did not improve after the application of therapeutic bronchoscopy. CONCLUSION: For patients with COVID-19 and respiratory failure, bronchoscopy can be performed under mechanical ventilation to clarify the airway conditions. Protection should be worn during the process. Considering the risk of infection, it is not necessary to perform bronchoscopy in the mild to moderate COVID-19 patients.

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