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1.
Front Med (Lausanne) ; 8: 739857, 2021.
Article in English | MEDLINE | ID: covidwho-1581303

ABSTRACT

To retrospectively analyze whether traction bronchiectasis was reversible in coronavirus disease 2019 (COVID-19) survivors with acute respiratory distress syndrome (ARDS), and whether computed tomography (CT) findings were associated with the reversibility, 41 COVID-19 survivors with ARDS were followed-up for more than 4 months. Demographics, clinical data, and all chest CT images were collected. The follow-up CT images were compared with the previous CT scans. There were 28 (68%) patients with traction bronchiectasis (Group I) and 13 (32%) patients without traction bronchiectasis (Group II) on CT images. Traction bronchiectasis disappeared completely in 21 of the 28 (75%) patients (Group IA), but did not completely disappear in seven of the 28 (25%) patients (Group IB). In the second week after onset, the evaluation score on CT images in Group I was significantly higher than that in Group II (p = 0.001). The proportion of reticulation on the last CT images in Group IB was found higher than that in Group IA (p < 0.05). COVID-19 survivors with ARDS might develop traction bronchiectasis, which can be absorbed completely in most patients. Traction bronchiectasis in a few patients did not disappear completely, but bronchiectasis was significantly relieved. The long-term follow-up is necessary to further assess whether traction bronchiectasis represents irreversible fibrosis.

2.
Mathematical Problems in Engineering ; 2021, 2021.
Article in English | ProQuest Central | ID: covidwho-1546588

ABSTRACT

The purpose is to avert the systematic financial risks from the Internet financial bubble and improve the efficiency of legal service companies’ credit risk assessment ability. Firstly, this study analyzes the commonly used classification model, Support Vector Machine (SVM), and linear regression model, Logistic model, and then puts forward the integrated SVM-Logistic + Fuzzy Multicriteria Decision-Making (FMCDM) to evaluate and analyze the credit risk level of listed companies. In the proposed integrated model, the SVM model classifies the data sample from listed companies, and the Logistic model is used for regression analysis on the credit risk assessment. Based on the credit risk indexes and weight uncertain factors of sample companies, FMCDM based on fuzzy set is applied to obtain the evaluation indexes. Then, the Analytic Hierarchy Process (AHP) is used to obtain the weight of key indexes. Finally, the fit analysis is carried out according to the existing risk status of the sample company and the risk status results of the proposed integrated model. The results show that the integrated SVM-Logistic model is complementary and has high intensive evaluation. According to the fitness value obtained by FMCDM, the company's credit risk status can be accurately evaluated, and the intermediate threshold of corporate credit default risk measurement is 0.56152;if Fit is lower than the threshold, the company’s credit is low, and if Fit is higher than the threshold, the company’s credit is high. Therefore, the data mining technology based on integrated SVM-Logistic model + FMCDM has high precision and feasible application in the credit risk assessment from legal service companies. This study creates a new method model for legal service companies in the field of corporate credit risk assessment and can provide references and ideas for corporate credit risk assessment.

3.
Future Virol ; 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1526740

ABSTRACT

Aim: COVID-19 is a major threat to public health worldwide. A large proportion of COVID-19 patients is proved to develop anemia. Herein, we investigate the association between anemia and severe pneumonia. Materials & methods: 137 of COVID-19-confirmed patients admitted to Wuhan Union Hospital (Wuhan, China) from 13 February to 17 March 2020 were included. Their clinical characteristics and laboratory data were studied, and multivariable logistic regression analyses were performed. Results: The anemic patients were less likely to develop fever in the early stage of COVID-19. Elevated IL-6 levels were found in anemic COVID-19 patients compared with those without anemia. COVID-19 patients with anemia had an 8.2 times greater possibility of developing severe pneumonia compared with their counterparts without anemia. Conclusion: This study comprehensively describes the clinical characteristics of anemic patients with ordinary, severe and critical COVID-19 and demonstrates the close relationship between the anemia and severe COVID-19.

5.
Leukemia ; 35(6): 1661-1670, 2021 06.
Article in English | MEDLINE | ID: covidwho-1232063

ABSTRACT

We performed a meta-analysis to determine safety and efficacy of tocilizumab in persons with coronavirus disease-2019 (COVID-19). We searched PubMed, Web of Science and Medline using Boolean operators for studies with the terms coronavirus OR COVID-19 OR 2019-nCoV OR SARS-CoV-2 AND tocilizumab. Review Manager 5.4 was used to analyze data and the modified Newcastle-Ottawa and Jadad scales for quality assessment. We identified 32 studies in 11,487 subjects including three randomized trials and 29 cohort studies with a comparator cohort, including historical controls (N = 5), a matched cohort (N = 12), or concurrent controls (N = 12). Overall, tocilizumab decreased risk of death (Relative Risk [RR] = 0.74; 95% confidence interval [CI], 0.59, 0.93; P = 0.008; I2 = 80%) but not of surrogate endpoints including ICU admission (RR = 1.40 [0.64,3.06]; P = 0.4; I2 = 88%), invasive mechanical ventilation (RR = 0.83 [0.57,1.22]; P = 0.34; I2 = 65%) or secondary infections (RR = 1.30 [0.97,1.74]; P = 0.08; I2 = 65%) and increased interval of hospitalization of subjects discharged alive(mean difference [MD] = 2 days [<1, 4 days]; P = 0.006; I2 = 0). RRs of death in studies with historical controls (RR = 0.28 [0.16,0.49; P < 0.001]; I2 = 62%) or a matched cohort (RR = 0.68 [0.53, 0.87]; P = 0.002; I2 = 42%) were decreased. In contrast, RRs of death in studies with a concurrent control (RR = 1.10 [0.77, 1.56]; P = 0.60; I2 = 85%) or randomized (RR = 1.18 [0.57,2.44]; P = 0.66; I2 = 0) were not decreased. A reduced risk of death was not confirmed in our analyses which questions safety and efficacy of tocilizumab in persons with COVID-19.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/drug therapy , SARS-CoV-2/drug effects , Antibodies, Monoclonal, Humanized/adverse effects , COVID-19/mortality , Hospitalization , Humans , Intensive Care Units , Treatment Outcome
6.
Leukemia ; 35(9): 2616-2620, 2021 09.
Article in English | MEDLINE | ID: covidwho-1228235

ABSTRACT

We analyzed reports on safety and efficacy of JAK-inhibitors in patients with coronavirus infectious disease-2019 (COVID-19) published between January 1st and March 6th 2021 using the Newcastle-Ottawa and Jadad scales for quality assessment. We used disease severity as a proxy for time when JAK-inhibitor therapy was started. We identified 6 cohort studies and 5 clinical trials involving 2367 subjects treated with ruxolitinib (N = 3) or baricitinib 45 (N = 8). Use of JAK-inhibitors decreased use of invasive mechanical ventilation (RR = 0.63; [95% Confidence Interval (CI), 0.47, 0.84]; P = 0.002) and had borderline impact on rates of intensive care unit (ICU) admission (RR = 0.24 [0.06, 1.02]; P = 0.05) and acute respiratory distress syndrome (ARDS; RR = 0.50 [0.19, 1.33]; P = 0.16). JAK-inhibitors did not decrease length of hospitalization (mean difference (MD) -0.18 [-4.54, 4.18]; P = 0.94). Relative risks of death for both drugs were 0.42 [0.30, 0.59] (P < 0.001), for ruxolitinib, RR = 0.33 (0.13, 0.88; P = 0.03) and for baricitinib RR = 0.44 (0.31, 0.63; P < 0.001). Timing of JAK-inhibitor treatment during the course of COVID-19 treatment may be important in determining impact on outcome. However, these data are not consistently reported.


Subject(s)
Azetidines/therapeutic use , COVID-19/drug therapy , Janus Kinase Inhibitors/therapeutic use , Purines/therapeutic use , Pyrazoles/therapeutic use , SARS-CoV-2/drug effects , Sulfonamides/therapeutic use , COVID-19/pathology , COVID-19/virology , Clinical Trials as Topic , Humans , Nitriles , Patient Safety , Pyrimidines , SARS-CoV-2/isolation & purification , Treatment Outcome
7.
Front Med (Lausanne) ; 7: 605088, 2020.
Article in English | MEDLINE | ID: covidwho-983762

ABSTRACT

Objectives: To analyze follow-up CTs of patients recovering from COVID-19 in Wuhan, focusing on fibrotic change and its relevant risk factors. Methods: From January 13 to February 27, 2020, 166 hospitalized patients meeting our criteria were included. The scores of fibrotic patterns on follow-up CT were evaluated. Patients were designated as group 1 (with CT evidence of fibrotic pattern) and group 2 (without CT evidence of fibrotic pattern). Multivariate logistic regression was performed to explore risk factors for fibrotic change in patients with COVID-19. Results: The follow-up CTs were obtained on 56 days (median, IQR 51-63 days) after symptom onset. Of the 166 patients (mean age, 57 ± 15 years; 69/166 male), 46% (76/166) had CT evidence of fibrotic change and 77% (127/166) were severe or critical cases. Among patients with fibrotic change on CT, 84% (64/76) got a minimal or mild score of fibrosis. The high total score on peak CT, peak eosinophils, erythrocyte sedimentation rate (ESR) and advancing age were related to lung fibrotic change in patients with COVID-19. Conclusion: Forty six percentages of patients (mainly severe or critical cases) with COVID-19 showed fibrotic change on follow-up CT at early recovery phase, while the extent of fibrosis was not large. The advancing age, high total score on peak CT, peak eosinophils and ESR were associated with fibrotic change depicted by CT in patients recovering from COVID-19. An extended follow up by CT imaging and pulmonary function testing is necessary to fully assess the sequela of COVID-19.

8.
BMC Infect Dis ; 20(1): 698, 2020 Sep 22.
Article in English | MEDLINE | ID: covidwho-781450

ABSTRACT

BACKGROUND: A new coronavirus disease 2019 (COVID-19) has escalated to a pandemic since its first outbreak in Wuhan, China. A small proportion of patients may have difficulty in generating IgM or IgG antibodies against SARS-CoV-2, and little attention has been paid to them. CASE PRESENTATIONS: We present two cases of confirmed COVID-19 patients and characterize their initial symptoms, chest CT results, medication, and laboratory test results in detail (including RT-PCR, IgM/ IgG, cytokine and blood cell counts). CONCLUSION: Both of patients with confirmed COVID-19 pneumonia failed to produce either IgM or IgG even 40 to 50 days after their symptoms onset. This work provides evidence demonstrating that at least a small proportion of patients may have difficulty in rapidly gaining immunity against SARS-CoV-2.


Subject(s)
Antibodies, Viral/blood , Coronavirus Infections/diagnosis , Immunoglobulin G/blood , Immunoglobulin M/blood , Pneumonia, Viral/diagnosis , Adult , Betacoronavirus , COVID-19 , COVID-19 Testing , China/epidemiology , Clinical Laboratory Techniques , Coronavirus Infections/immunology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/immunology , SARS-CoV-2
9.
Eye (Lond) ; 34(7): 1212-1219, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-227466

ABSTRACT

PURPOSE: To determine the expressions of SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2) genes in human and mouse ocular cells and comparison to other tissue cells. METHODS: Human conjunctiva and primary pterygium tissues were collected from pterygium patients who underwent surgery. The expression of ACE2 and TMPRSS2 genes was determined in human primary conjunctival and pterygium cells, human ocular and other tissue cell lines, mesenchymal stem cells as well as mouse ocular and other tissues by reverse transcription-polymerase chain reaction (RT-PCR) and SYBR green PCR. RESULTS: RT-PCR analysis showed consistent expression by 2 ACE2 gene primers in 2 out of 3 human conjunctival cells and pterygium cell lines. Expression by 2 TMPRSS2 gene primers could only be found in 1 out of 3 pterygium cell lines, but not in any conjunctival cells. Compared with the lung A549 cells, similar expression was noted in conjunctival and pterygium cells. In addition, mouse cornea had comparable expression of Tmprss2 gene and lower but prominent Ace2 gene expression compared with the lung tissue. CONCLUSION: Considering the necessity of both ACE2 and TMPRSS2 for SARS-CoV-2 infection, our results suggest that conjunctiva would be less likely to be infected by SARS-CoV-2, whereas pterygium possesses some possibility of SARS-CoV-2 infection. With high and consistent expression of Ace2 and Tmprss2 in cornea, cornea rather than conjunctiva has higher potential to be infected by SARS-CoV-2. Precaution is necessary to prevent possible SARS-CoV-2 infection through ocular surface in clinical practice.


Subject(s)
Betacoronavirus/metabolism , Conjunctiva/abnormalities , Conjunctiva/metabolism , Coronavirus Infections , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral , Pterygium/metabolism , Serine Endopeptidases/metabolism , Angiotensin-Converting Enzyme 2 , Animals , Betacoronavirus/enzymology , Betacoronavirus/genetics , COVID-19 , Cell Line , Cornea , Humans , Lung/metabolism , Mice , SARS-CoV-2
10.
Eur J Radiol ; 128: 109017, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-72263

ABSTRACT

PURPOSE: To analyse the high-resolution computed tomography (HRCT) early imaging features and the changing trend of coronavirus disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS: Forty-six patients with COVID-19 pneumonia who had an isolated lesion on the first positive CT were enrolled in this study. The following parameters were recorded for each lesion: sites, sizes, location (peripheral or central), attenuation (ground-glass opacity or consolidation), and other abnormalities (supply pulmonary artery dilation, air bronchogram, interstitial thickening, etc.). The follow-up CT images were compared with the previous CT scans, and the development of the lesions was evaluated. RESULTS: The lesions tended to be peripheral and subpleural. All the lesions exhibited ground-glass opacity with or without consolidation. A higher proportion of supply pulmonary artery dilation (89.13 % [41/46]) and air bronchogram (69.57 % [32/46]) were found. Other findings included thickening of the intralobular interstitium and a halo sign of ground glass around a solid nodule. Cavitation, calcification or lymphadelopathy were not observed. The reticular patterns were noted from the 14 days after symptoms onset in 7 of 20 patients (45 %). At 22-31 days, the lesions were completely absorbed only in 2 of 7 patients (28.57 %). CONCLUSION: The typical early CT features of COVID-19 pneumonia are ground-glass opacity, and located peripheral or subpleural location, and with supply pulmonary artery dilation. Reticulation was evident after the 2nd week and persisted in half of patients evaluated in 4 weeks after the onset. Long-term follow-up is required to determine whether the reticulation represents irreversible fibrosis.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Lung/pathology , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Disease Progression , Female , Humans , Lung/physiopathology , Lung/virology , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , SARS-CoV-2 , Tomography, X-Ray Computed/methods
11.
Radiology ; 296(2): E32-E40, 2020 08.
Article in English | MEDLINE | ID: covidwho-2449

ABSTRACT

Background Chest CT is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with RT-PCR assay in COVID-19. Materials and Methods This study included 1014 patients in Wuhan, China, who underwent both chest CT and RT-PCR tests between January 6 and February 6, 2020. With use of RT-PCR as the reference standard, the performance of chest CT in the diagnosis of COVID-19 was assessed. In addition, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative) was analyzed as compared with serial chest CT scans for those with a time interval between RT-PCR tests of 4 days or more. Results Of the 1014 patients, 601 of 1014 (59%) had positive RT-PCR results and 888 of 1014 (88%) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95% confidence interval: 95%, 98%; 580 of 601 patients) based on positive RT-PCR results. In the 413 patients with negative RT-PCR results, 308 of 413 (75%) had positive chest CT findings. Of those 308 patients, 48% (103 of 308) were considered as highly likely cases and 33% (103 of 308) as probable cases. At analysis of serial RT-PCR assays and CT scans, the mean interval between the initial negative to positive RT-PCR results was 5.1 days ± 1.5; the mean interval between initial positive to subsequent negative RT-PCR results was 6.9 days ± 2.3. Of the 1014 patients, 60% (34 of 57) to 93% (14 of 15) had initial positive CT scans consistent with COVID-19 before (or parallel to) the initial positive RT-PCR results. Twenty-four of 57 patients (42%) showed improvement on follow-up chest CT scans before the RT-PCR results turned negative. Conclusion Chest CT has a high sensitivity for diagnosis of coronavirus disease 2019 (COVID-19). Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. © RSNA, 2020 Online supplemental material is available for this article. A translation of this abstract in Farsi is available in the supplement. ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Adolescent , Adult , Aged , COVID-19 , COVID-19 Testing , Child , Child, Preschool , China , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Reproducibility of Results , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Sensitivity and Specificity , Tomography, X-Ray Computed/methods , Young Adult
12.
Preprint in English | medRxiv | ID: ppmedrxiv-20023267

ABSTRACT

The CoViD-19 outbreak has escalated to a pandemic in the last few months. Pharmaceutical solutions based upon virologic studies, at this point, remain inconclusive, with no proven pharmaceutical solution so far. In contrast, this paper looks towards creating more accurate epidemiological models during this phase of viral growth in order to provide better feedback measures to public health officials and agencies, in particular, by providing a responsive, timely model of the R value based on the previous few days results. Such an R value, although bearing less statistical precision due to limited sampling, could allow R to become a more effective, responsive standalone measure of infectious transmission. It demonstrates that the R value can be used as a dynamic, time-dependent indicator without the use of curve-fitting, and also estimates the most recent R-value of the CoViD-19 outbreak to be between 1.32 and 1.35.

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