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3.
PLoS One ; 17(9): e0274571, 2022.
Article in English | MEDLINE | ID: covidwho-2054344

ABSTRACT

MAIN OBJECTIVE: There is limited information on how patient outcomes have changed during the COVID-19 pandemic. This study characterizes changes in mortality, intubation, and ICU admission rates during the first 20 months of the pandemic. STUDY DESIGN AND METHODS: University of Wisconsin researchers collected and harmonized electronic health record data from 1.1 million COVID-19 patients across 21 United States health systems from February 2020 through September 2021. The analysis comprised data from 104,590 adult hospitalized COVID-19 patients. Inclusion criteria for the analysis were: (1) age 18 years or older; (2) COVID-19 ICD-10 diagnosis during hospitalization and/or a positive COVID-19 PCR test in a 14-day window (+/- 7 days of hospital admission); and (3) health system contact prior to COVID-19 hospitalization. Outcomes assessed were: (1) mortality (primary), (2) endotracheal intubation, and (3) ICU admission. RESULTS AND SIGNIFICANCE: The 104,590 hospitalized participants had a mean age of 61.7 years and were 50.4% female, 24% Black, and 56.8% White. Overall risk-standardized mortality (adjusted for age, sex, race, ethnicity, body mass index, insurance status and medical comorbidities) declined from 16% of hospitalized COVID-19 patients (95% CI: 16% to 17%) early in the pandemic (February-April 2020) to 9% (CI: 9% to 10%) later (July-September 2021). Among subpopulations, males (vs. females), those on Medicare (vs. those on commercial insurance), the severely obese (vs. normal weight), and those aged 60 and older (vs. younger individuals) had especially high mortality rates both early and late in the pandemic. ICU admission and intubation rates also declined across these 20 months. CONCLUSIONS: Mortality, intubation, and ICU admission rates improved markedly over the first 20 months of the pandemic among adult hospitalized COVID-19 patients although gains varied by subpopulation. These data provide important information on the course of COVID-19 and identify hospitalized patient groups at heightened risk for negative outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04506528 (https://clinicaltrials.gov/ct2/show/NCT04506528).


Subject(s)
COVID-19 , Intensive Care Units , Adult , Aged , COVID-19/mortality , COVID-19/therapy , Female , Hospital Mortality , Hospitalization , Humans , Intubation, Intratracheal , Male , Medicare , Middle Aged , Pandemics , United States/epidemiology
4.
J Racial Ethn Health Disparities ; 2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2048693

ABSTRACT

BACKGROUND: COVID-19 disproportionately impacts the elderly, particularly racial/ethnic minorities and those with low socioeconomic status (SES). These latter groups may also have higher vaccine hesitancy. We aim to evaluate if access to care improves COVID-19 vaccination rates and improves health disparities. METHODS: We conducted a retrospective cohort study of Medicare patients receiving care in a high-touch capitated network across ten states. We collected type and date of COVID-19 vaccine and demographic and clinical data from the inpatient and outpatient electronic health records and socioeconomic status from the US census. Our primary outcome was completing vaccination using logistic regression. RESULTS: Our cohort included 93,224 patients enrolled in the network during the study period. Sixty nine percent of all enrolled patients completed full vaccination. Those who completed vaccination did it with Pfizer (46%), Moderna (49%), and Jannsen (4.6%) vaccines. In adjusted models, we found that the following characteristics increased the odds of being vaccinated: being male, increasing age, BMI, and comorbidities, being Black or Hispanic, having had the flu vaccine in 2020, and increasing number of office primary care visits. Living in a neighborhood with higher social deprivation and having dual Medicaid/Medicare enrollment decreased the odds of completing full vaccination. CONCLUSIONS: Increasing office visit in a high-touch primary care model is associated with higher vaccination rates among elderly populations who belong to racial/ethnic minorities or have low socioeconomic status. However, lower SES and Medicaid populations continue to have difficulty in completing vaccination. KEY POINTS: • High COVID-19 vaccination rates of minorities enrolled in Medicare can be achieved. • Lower socioeconomic status is associated with completing vaccination. • Increasing office visits can lead to higher vaccination rates.

5.
Chinese Journal of Zoonoses ; 38(8):685-692, 2022.
Article in Chinese | GIM | ID: covidwho-2040046

ABSTRACT

An investigation of coronavirus (CoV) and hepatitis E virus (HEV) in rodents was performed to understand CoV and HEV infection of rodents in Dali City, Yunnan Province. Rodent samples were obtained in the four towns of Dali city through traps from August 2020 to August 2021. A total of 76 rodents belonging to six species and five genera were captured: Rattus tanezumi, Rattus norvegicus, Apodemus chevrieri, Eothenomys miletus, Niviventer fulvescens, and Mus Pahari. Detection of CoV and HEV was performed by nested-PCR. The infection rate of CoV was 40.74% (11/27) and 2.38% (1/42) in R. norvegicus and R. tanezumi, respectively. The infection rate of HEV was 14.81% (4/27) and 2.38% (1/42) in R. norvegicus and R. tanezumi, respectively. Co-infection with CoV and HEV was detected in two R. norvegicus, with a co-infection rate of 7.41% (2/27). A Basic Local Alignment Search Tool (BLAST) search was performed on partial RNA-dependent RNA polymerase (RdRp) sequences of CoV and HEV. Eleven strains from R. norvegicus were a-CoV, and matched best to strain KY370050 from Rattus losea (Fujian, China), with 99.73% to 99.74% nucleotide (nt) sequency identity. One strain was ss-CoV from R. tanezumi, which displayed 98.21% nt sequence identity with strain MT820632 from Bandicota indica (Yunnan, China). Five strains from R. norvegicus were all HEV-C, and showed 95.87% to 96.21% sequence similarity to strain MN450853 from a patient in Hong Kong, China. In conclusion, CoV and HEV infections are present in rodents in Dali City. Because the host animals of the two viruses are closely related to humans, surveillance and investigations of related viruses should be strengthened.

6.
Nat Commun ; 13(1): 5459, 2022 09 17.
Article in English | MEDLINE | ID: covidwho-2036822

ABSTRACT

The recently emerged Omicron (B.1.1.529) variant has rapidly surpassed Delta to become the predominant circulating SARS-CoV-2 variant, given the higher transmissibility rate and immune escape ability, resulting in breakthrough infections in vaccinated individuals. A new generation of SARS-CoV-2 vaccines targeting the Omicron variant are urgently needed. Here, we developed a subunit vaccine named RBD-HR/trimer by directly linking the sequence of RBD derived from the Delta variant (containing L452R and T478K) and HR1 and HR2 in SARS-CoV-2 S2 subunit in a tandem manner, which can self-assemble into a trimer. In multiple animal models, vaccination of RBD-HR/trimer formulated with MF59-like oil-in-water adjuvant elicited sustained humoral immune response with high levels of broad-spectrum neutralizing antibodies against Omicron variants, also inducing a strong T cell immune response in vivo. In addition, our RBD-HR/trimer vaccine showed a strong boosting effect against Omicron variants after two doses of mRNA vaccines, featuring its capacity to be used in a prime-boost regimen. In mice and non-human primates, RBD-HR/trimer vaccination could confer a complete protection against live virus challenge of Omicron and Delta variants. The results qualified RBD-HR/trimer vaccine as a promising next-generation vaccine candidate for prevention of SARS-CoV-2, which deserved further evaluation in clinical trials.


Subject(s)
COVID-19 , Viral Vaccines , Animals , Antibodies, Neutralizing , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Mice , Mice, Inbred BALB C , Protein Subunits , SARS-CoV-2 , Vaccines, Subunit , Water
7.
European Journal of Inflammation ; : 1-8, 2022.
Article in English | Academic Search Complete | ID: covidwho-2029597

ABSTRACT

Objectives: Association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and kidney injury has been noted in previous studies. However, the mechanisms remain unknown. The present study aimed to explore the potential mechanisms of kidney injury in COVID-19. Methods: Demographic characteristics, underlying diseases, signs, symptoms, and laboratory data of 100 COVID-19 patients were collected and analyzed in this retrospective study. Patients were divided into three groups: mild, moderate, and severe to critical group. Kidney injury was evaluated by markers including estimated glomerular filtration rate (eGFR), serum creatinine, blood urea nitrogen, and cystatin C. Results: A total of 100 patients with 12 mild, 63 moderate, and 25 severe to critical COVID-19 were included in this study. The kidney injury markers including eGFR, serum creatinine, blood urea nitrogen, and cystatin C all worsened significantly with an increase in disease severity. The correlation test showed that cytokines IL-2R, IL-6, IL-8, and tumor necrosis factor (TNF)-α were statistically correlated with eGFR and cystatin C. In multivariate analysis, log IL-6 (β = −0.331, p =.001 for eGFR and β = 0.405, p <.001 for cystatin C) and log TNF-α (β = −0.316, p =.001 for eGFR and β = 0.534, p <.001 for cystatin C) were found to be the major independent predictors of kidney injury. Conclusion: Serum IL-6 and TNF-α levels were the major independent predictors of kidney injury in COVID-19. [ FROM AUTHOR] Copyright of European Journal of Inflammation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

8.
BMC Psychol ; 10(1): 217, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2029738

ABSTRACT

BACKGROUND: The global COVID-19 pandemic is still not under effective control, and strong workplace supports with comprehensive mental health interventions are urgently needed to help medical staff effectively respond to the pandemic. This study aimed to verify the effect of an online resourcefulness training program on the resourcefulness, and psychological variables of front-line medical staff working in the COVID-19 isolation ward. DESIGN: A pre-test and post-test quasi-experimental design with control group was employed. PARTICIPANTS: A total of 60 participants working in two isolation wards were recruited via convenience sampling. The two isolation wards were randomly assigned to the control group (isolation ward 1, n = 30) and the intervention group (isolation ward 2, n = 30). INTERVENTION: The participants were trained online by video conferences and WeChat. The control group received conventional training (e.g., psychological training, psychological counseling), while the intervention group received a 4-h online resourcefulness training. Both groups learned updated guidelines of COVID-19 simultaneously via video conference. The primary outcomes (resourcefulness, anxiety, depression and coping styles) and the secondary outcome (psychological resilience) were measured before intervention and three time points after intervention. RESULTS: After the intervention and one week after the intervention, the resourcefulness, resilience, and positive response scores of the participants in the intervention group were significantly higher than those of the control group. The anxiety and negative response scores in the intervention group were significantly lower than those of the control group (all p < 0.05). One month after the intervention, the scores of resourcefulness, tenacity, and positive response of the intervention group were higher than those of the control group (all p < 0.05). Repeated measures analysis of variance showed that the two groups of participants had statistically significant changes in the time-based effect and group-based effect in resourcefulness, resilience, anxiety scores and coping styles (p < 0.01). CONCLUSION: The results showed that our online resourcefulness training can significantly improve the resourcefulness, resilience, and positive response scores and effectively reduce anxiety and depression scores of front-line medical staff. This demonstrates that online resourcefulness training would be an effective tool for the psychological adjustment of front-line medical staff in fighting against COVID-19.


Subject(s)
COVID-19 , Adaptation, Psychological , Anxiety/prevention & control , COVID-19/prevention & control , Humans , Medical Staff , Pandemics/prevention & control
9.
Nicotine Tob Res ; 2022 Sep 07.
Article in English | MEDLINE | ID: covidwho-2018021

ABSTRACT

INTRODUCTION: Available evidence is mixed concerning associations between smoking status and COVID-19 clinical outcomes. Effects of nicotine replacement therapy (NRT) and vaccination status on COVID-19 outcomes in smokers are unknown. METHODS: Electronic health record data from 104 590 COVID-19 patients hospitalized February 1, 2020 to September 30, 2021 in 21 U.S. health systems were analyzed to assess associations of smoking status, in-hospital NRT prescription, and vaccination status with in-hospital death and ICU admission. RESULTS: Current (n = 7764) and never smokers (n = 57 454) did not differ on outcomes after adjustment for age, sex, race, ethnicity, insurance, body mass index, and comorbidities. Former (vs never) smokers (n = 33 101) had higher adjusted odds of death (aOR, 1.11; 95% CI, 1.06-1.17) and ICU admission (aOR, 1.07; 95% CI, 1.04-1.11). Among current smokers, NRT prescription was associated with reduced mortality (aOR, 0.64; 95% CI, 0.50-0.82). Vaccination effects were significantly moderated by smoking status; vaccination was more strongly associated with reduced mortality among current (aOR, 0.29; 95% CI, 0.16-0.66) and former smokers (aOR, 0.47; 95% CI, 0.39-0.57) than for never smokers (aOR, 0.67; 95% CI, 0.57, 0.79). Vaccination was associated with reduced ICU admission more strongly among former (aOR, 0.74; 95% CI, 0.66-0.83) than never smokers (aOR, 0.87; 95% CI, 0.79-0.97). CONCLUSIONS: Former but not current smokers hospitalized with COVID-19 are at higher risk for severe outcomes. SARS-CoV-2 vaccination is associated with better hospital outcomes in COVID-19 patients, especially current and former smokers. NRT during COVID-19 hospitalization may reduce mortality for current smokers. IMPLICATIONS: Prior findings regarding associations between smoking and severe COVID-19 disease outcomes have been inconsistent. This large cohort study suggests potential beneficial effects of nicotine replacement therapy on COVID-19 outcomes in current smokers and outsized benefits of SARS-CoV-2 vaccination in current and former smokers. Such findings may influence clinical practice and prevention efforts and motivate additional research that explores mechanisms for these effects.

10.
Chinese Journal of Nosocomiology ; 32(10):1468-1472, 2022.
Article in English, Chinese | CAB Abstracts | ID: covidwho-2011846

ABSTRACT

OBJECTIVE: To systematically describe the outcomes of patients with COVID-19-associated pulmonary aspergillosis (CAPA). METHODS: All of the researches covering the clinical outcomes of CAPA were retrieved from databases such as ScienceDirect, PubMed, CNKI and MEDLINE (OVID) from Dec 31, 2019 to Dec 1, 2021. The literatures were screened out based on inclusion and exclusion criteria by 2 writers, the data were extracted, the quality of the literatures was evaluated, and meta-analysis was performed. RESULTS: Totally 14 cohort studies were included in this study, with 2 056 severe COVID-19 patients involved, including 338 CAPA patients and 1 718 non-CAPA patients. The incidence rate of CAPA was 16.4% among the ICU patients. As compared with the non-CAPA patients, the mortality rate of the CAPA patients was increased by 21% [risk difference (RD)]=0.21, 95% CI:0.15-0.27, (I-2=0%). No heterogeneity or publication bias was detected (t=1.98, P=0.069). Among the patients with underlying diseases, the patients with chronic obstructive pulmonary disease (COPD) were 2.37 times the risk of CAPA as high as the patients of the non-CAPA group (95% CI: 1.15-4.88, P=0.020). The creatinine level of the CAPA patients was higher than that of the non-CAPA patients (33.32 micro mol/L, 95% CI: 6.81-59.83, P=0.014). As compared with the non-CAPA patients, the patients who received renal replacement therapy were 2.33 times the risk of CAPA (95% CI: 1.43-3.80, P=0.001). CONCLUSION: 16.4% of the severe COVID-19 patients have CAPA, the mortality rate is high. COPD, serum creatinine and renal replacement therapy may remarkably increase the risk of CAPA, and it is suggested that a prospective screening of CAPA should be carried out for the severe COVID-19 patients.

11.
J Craniofac Surg ; 33(5): 1300-1302, 2022.
Article in English | MEDLINE | ID: covidwho-2008691

ABSTRACT

ABSTRACT: To report 2 successfully managed cases of graft rejection with acellular porcine corneal stroma (APCS) transplantation in patients with fungal corneal ulcer. Two patients were diagnosed with fungal corneal ulcer and received APCS transplantation. Graft rejection developed due to the lost follow-up during the period of coronavirus disease 2019 outbreak. Amniotic membranes transplantation and cauterization of neovascularization was performed, respectively. The graft failure resolved successfully after the procedure. To the best of our knowledge, amniotic membranes transplantation and cauterization of new vessels are the firstly reported in treating APCS graft failure. Amniotic membranes transplantation or cauterization of neovascularization appear to be a safe and costeffective method for treating graft failure.


Subject(s)
COVID-19 , Corneal Transplantation , Corneal Ulcer , Animals , Corneal Stroma/transplantation , Corneal Transplantation/methods , Graft Rejection , Pandemics , Swine
12.
Medicine (Baltimore) ; 101(34): e30261, 2022 Aug 26.
Article in English | MEDLINE | ID: covidwho-2008667

ABSTRACT

The neutrophil-to-lymphocyte ratio (NLR) is used to predict the prognosis of various diseases, such as coronavirus disease 2019, community-acquired pneumonia, bacteremia, and endocarditis. However, NLR has never been reported to predict patient discharge in geriatric patients with influenza infection. This retrospective case-control study enrolled geriatric patients (≥65 years) with influenza virus infection who visited the emergency department of a medical center between January 01, 2010 and December 31, 2015. Demographic data, vital signs, past histories, influenza subtypes, outcomes, and disposition were analyzed. The optimal NLR cut-off value to predict patient discharge was determined using the Youden index. We also evaluated the accuracy of NLR in predicting patient discharge using logistic regression and receiver operating characteristic analysis. The study included 409 geriatric patients in the emergency department with a mean age of 79.5 years and an approximately equal sex ratio. NLR was significantly lower in the discharged group than in the nondischarged group (5.8 ± 3.7 vs 9.7 ± 8.4). Logistic regression revealed that patients with NLR ≤ 6.5 predicted discharge with an odds ratio of 3.62. The Hosmer-Lemeshow goodness-of-fit test was calculated as 0.36, and the adjusted area under the receiver operating characteristic was 0.75. The negative predictive value of NLR ≤ 6.5, to predict patient discharge, was 91.8%. NLR ≤ 6.5 is a simple and easy-to-obtain laboratory tool to guide the physicians to discharge geriatric patients with influenza infection in the crowded emergency department.


Subject(s)
COVID-19 , Influenza, Human , Aged , Case-Control Studies , Emergency Service, Hospital , Humans , Influenza, Human/diagnosis , Lymphocytes , Neutrophils , Patient Discharge , Prognosis , ROC Curve , Retrospective Studies
13.
Front Microbiol ; 13: 956887, 2022.
Article in English | MEDLINE | ID: covidwho-2005888

ABSTRACT

Recently, acute hepatitis of unknown etiology in children has gained great concern since March 2022. The disease was first reported by Public Health Scotland. Cases increased rapidly and are now reported in 33 countries worldwide. All cases are predominantly aged under 5 years old. Most patients presented with jaundice, and remarkably, some cases progress to acute liver failure. Until now, the etiology is not fully elucidated, and the investigations are ongoing. Adenovirus infection seems to be an important factor. Several hypotheses on the etiology have been proposed. This review aims to summarize current research progress and put forward some suggestions.

14.
J Inflamm Res ; 15: 4751-4761, 2022.
Article in English | MEDLINE | ID: covidwho-1997375

ABSTRACT

Objective: To explore the long-term effects of SARS-Cov-2 infection on the pulmonary function in the severe convalescent COVID-19 patients for 6 to 9 months follow-up in Beijing, China. Methods: A total of 64 cases of COVID-19 patients were recruited for the study and discharged from the Beijing Ditan Hospital, Capital Medical University, for 6 to 9 months. COVID-19 patients were divided into non-severe (mild and moderate) and severe groups. The follow-up investigated the lung function tests, the novel coronavirus antibody (IgM and IgG), chest CT and blood tests. Results: About 25.00% (16/64) patients had pulmonary ventilation dysfunction and 35.9% (23/64) had diffusion dysfunction. In the severe group, 56.50% (13/23) individuals showed decreased diffusion function. The diffusion dysfunction of the severe group was significantly decreased than the non-severe group (P = 0.01). Among 56 cases, the positive rate of IgG titers was 73.2% (41/56). The result of chest CT showed 55.36% (31/56) cases in nodules, 44.64% (25/56) in strip-like changes, 37.5% (21/56) in-ground glass shadow, and 5.36% (3/56) in grid shadow, which was significantly different between the severe group and the non-severe group. Patients tended to have ground glass changes in the severe group while nodules in the non-severe group. Conclusion: For the 6 to 9 months in convalescent COVID-19 patients, 56.50% (13/23) of severe patients had pulmonary diffusion dysfunction. Convalescent COVID-19 patients should have their pulmonary function regularly tested, especially those with severe illness.

15.
Cancer Epidemiol Biomarkers Prev ; 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-1993148

ABSTRACT

BACKGROUND: There is mixed evidence about the relations of current versus past cancer with severe COVID-19 outcomes and how they vary by patient and cancer characteristics. METHODS: Electronic health record data of 104,590 adult hospitalized patients with COVID-19 were obtained from 21 United States health systems from February 2020 through September 2021. In-hospital mortality and ICU admission were predicted from current and past cancer diagnoses. Moderation by patient characteristics, vaccination status, cancer type, and year of the pandemic was examined. RESULTS: 6.8% of the patients had current (n = 7,141) and 6.5% had past (n = 6,749) cancer diagnoses. Current cancer predicted both severe outcomes but past cancer did not; adjusted odds ratios (aORs) for mortality were 1.58 (95% CI: 1.46, 1.70) and 1.04 (95% CI: 0.96, 1.13), respectively. Mortality rates decreased over the pandemic but the incremental risk of current cancer persisted, with the increment being larger among younger vs. older patients. Prior COVID-19 vaccination reduced mortality generally and amongst those with current cancer (aOR = 0.69, 95% CI = 0.53 to 0.90). CONCLUSIONS: Current cancer, especially amongst younger patients, posed a substantially increased risk for death and ICU admission among COVID-19 patients; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types. IMPACT: This study clarifies the characteristics that modify the risk associated with cancer on severe COVID-19 outcomes across the first 20 months of the COVID-19 pandemic.

16.
Pharmaceutics ; 14(7)2022 Jun 28.
Article in English | MEDLINE | ID: covidwho-1987922

ABSTRACT

The lymphatic system plays an indispensable role in humoral balance, lipid metabolism, and immune regulation. The lymph nodes (LNs) are known as the primary sites of tumor metastasis and the metastatic LNs largely affected the prognosis of the patiens. A well-designed lymphatic-targeted system favors disease treatment as well as vaccination efficacy. In recent years, development of nanotechnologies and emerging biomaterials have gained increasing attention in developing lymph-node-targeted drug-delivery systems. By mimicking the endogenous macromolecules or lipid conjugates, lymph-node-targeted nanocarries hold potential for disease diagnosis and tumor therapy. This review gives an introduction to the physiological functions of LNs and the roles of LNs in diseases, followed by a review of typical lymph-node-targeted nanomaterial-based drug-delivery systems (e.g., liposomes, micelles, inorganic nanomaterials, hydrogel, and nanocapsules). Future perspectives and conclusions concerned with lymph-node-targeted drug-delivery systems are also provided.

17.
Bioconjug Chem ; 33(8): 1574-1583, 2022 08 17.
Article in English | MEDLINE | ID: covidwho-1977960

ABSTRACT

The pentasaccharide Fondaparinux, a synthetic selective factor Xa inhibitor, is one of the safest anticoagulants in the heparin family that is recommended as an alternative drug for patients with hypersensitivity to other drugs such as heparin-induced thrombocytopenia (HIT). However, some observations of Fondaparinux-induced thrombocytopenia (FIT) have been reported while others claimed that FIT does not occur in patients with fondaparinux therapy, indicating that the mechanism of FIT remains controversial. Here, we utilized different methodologies including dynamic light scattering, immunosorbent and platelet aggregation assays, confocal laser scanning microscopy, and flow cytometry to gain insights into FIT. We found that at a certain concentration, Fondaparinux formed sufficient large and stable complexes with PF4 that facilitated binding of the HIT-like monoclonal KKO antibody and enhanced platelet aggregation and activation. We proposed a model to describe the role of Fondaparinux concentration in the formation of complexes with platelet factor 4 and how it promotes the binding of KKO. Our results clarify controversial observations of FIT in patients as each contains a dissimilar PF4:Fondaparinux concentration ratio.


Subject(s)
Thrombocytopenia , Antibodies, Monoclonal/therapeutic use , Anticoagulants/adverse effects , Fondaparinux/adverse effects , Heparin/adverse effects , Humans , Platelet Factor 4/metabolism , Platelet Factor 4/therapeutic use , Polysaccharides , Thrombocytopenia/chemically induced , Thrombocytopenia/drug therapy
18.
Frontiers in immunology ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1970343

ABSTRACT

Background Asthma patients potentially have impaired adaptive immunity to virus infection. The levels of SARS-CoV-2-specific adaptive immunity between COVID-19 survivors with and without asthma are presently unclear. Methods COVID-19 survivors (patients with asthma n=11, with allergies n=8, and COVID-19 only n=17) and non-COVID-19 individuals (asthmatic patients n=10 and healthy controls n=9) were included. The COVID-19 patients were followed up at about 8 months and 16 months after discharge. The clinical characteristics, lymphocyte subsets, memory T cells, and humoral immunity including SARS-CoV-2 specific antibodies, SARS-CoV-2 pseudotyped virus neutralization assay, and memory B cells were analyzed in these subjects. Results The strength of virus-specific T cell response in COVID-19 survivors was positively correlated with the percentage of blood eosinophils and Treg cells (r=0.4007, p=0.0188;and r=0.4435, p=0.0086 respectively) at 8-month follow-up. There were no statistical differences in the levels of SARS-CoV-2-specific T cell response between the COVID-19 survivors with, and without, asthma. Compared to those without asthma, the COVID-19 with asthma survivors had higher levels of SARS-CoV-2-specific neutralizing antibodies (NAbs) at the 8-month follow-up (p<0.05). Moreover, the level of NAbs in COVID-19 survivors was positively correlated with the percentage of Treg and cTfh2 cells (r=0.5037, p=0.002;and r=0.4846, p=0.0141), and negatively correlated with the percentage of Th1 and Th17 cells (r=-0.5701, p=0.0003;and r=-0.3656, p=0.0308), the ratio of Th1/Th2, Th17/Treg, and cTfh1/cTfh2 cell (r=-0.5356, r=-0.5947, r=-0.4485;all p<0.05). The decay rate of NAbs in the COVID-19 survivors with asthma was not significantly different from that of those without asthma at 16-month follow-up. Conclusion The level of SARS-CoV-2-specific NAbs in COVID-19 survivors with asthma was higher than that of those without asthma at 8-month follow-up. The SARS-CoV-2-specific T cell immunity was associated with blood eosinophils and Treg percentages. The SARS-CoV-2-specific humoral immunity was closely associated with cTfh2/cTfh1 imbalance and Treg/Th17 ratio. According to the findings, asthmatic patients in COVID-19 convalescent period may benefit from an enhanced specific humoral immunity, which associates with skewed Th2/Th1 and Treg/Th17 immune.

19.
Healthcare (Basel) ; 10(8)2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-1969178

ABSTRACT

OBJECTIVES: During the coronavirus disease 2019 (COVID-19) pandemic, nursing aides (NAs) experienced greater work stress than they do typically because they worked in highly contagious environments. This may have influenced their work morale and willingness to work, which can reduce patient satisfaction, influence their physical and mental health, and even endanger patient safety or cause medical system collapse. DESIGN: A cross-sectional survey with a structured self-report questionnaire was conducted. SETTING AND PARTICIPANTS: 144 NAs from a medical center in Central Taiwan participated. METHODS: We recruited NAs through convenience sampling to discuss their work stress, willingness to work, and patients' satisfaction with them during the COVID-19 pandemic. RESULT: Of the 144 recruited NAs, 115 (79.9%) were women and 29 (20.1%) were men, and 89 (61.8%) had completed COVID-19 training courses. NAs with different work tenure lengths exhibited significant differences in work stress (p = 0.022), willingness to work (p = 0.029), and patient satisfaction (p = 0.029) scores during the pandemic. CONCLUSION: The study findings provide crucial data for the management of NAs during pandemics to prevent them from neglecting patients due to excessive work stress or losing their willingness to work, which may cause the medical system to collapse.

20.
Animal Husbandry and Feed Science ; 43(4):109-115, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-1964619

ABSTRACT

Objective: To gather information on the research status and the hot spots of zoonosis and zoonotic microorganisms worldwide, and to provide references for the prevention and control of zoonotic diseases in China. Method: COOC 12.6 and Citespace 5.8 R1 software were used to carry out frequency statistics, co-occurrence analysis, cluster analysis, timeline analysis and burst analysis on the keywords associated with zoonosis and zoonotic microorganisms in PubMed database. Result: According to the keywords frequency statistics and co-occurrence analysis results from the year of 2001 to 2021 in pubMed database, the zoonosis and zoonotic microorganisms arousing high international attentions were classified into the following three categories: the first category was commonly observed zoonotic microorganisms such as Brucella, hepatitis E virus, Streptococcus, Escherichia coli (E. coli) and Salmonella, to which continuous public attentions were still needed to be paid;the second category was the zoonotic microorganisms worldwide concerned in recent years such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and influenza A virus, which were worthy of more in-depth research to control the spread of these diseases as soon as possible;the third category was the zoonosis that had massively prevailed in specific regions abroad such as Q fever and middle east respiratory syndrome (MERS), and these diseases were expected to be noticed in terms of imported risks to avoid their outbreaks in China. In addition to the above mentioned zoonosis and zoonotic microorganisms, some keywords associated with detection and diagnosis such as phylogeny and PCR were also of high interests. The cluster analysis generated a total of 10 clusters, in which the tick-borne infectious disease cluster suggested the role of ticks in the transmission of zoonotic diseases;the results of timeline and burst analysis demonstrated that among the zoonotic microorganisms, the attentions being paid to influenza A virus and SARS-CoV-2 were gradually increasing. At the same time, the detection technology of zoonotic microorganisms was evolving from specific sequence detection to whole genome sequencing. These fields were likely to be the research direction and trend in the future.

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