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2.
Gen Hosp Psychiatry ; 2022 Oct 17.
Article in English | MEDLINE | ID: covidwho-2069012
3.
Psychol Health Med ; : 1-11, 2022 Sep 27.
Article in English | MEDLINE | ID: covidwho-2042448

ABSTRACT

This study aimed to evaluate the influence of COVID-19 on the mental health of Chinese medical students at 1-year of follow-up. From 2 February 2020 to 23 February 2021, we conducted three waves of research online (T1 = during outbreak, T2 = controlling period, T3 = 1 year after outbreak). The survey collected demographic data and several self reporting questionnaires to measure the depressive, anxiety and stress symptoms. A total of 4002 participants complete the whole research phases. The study major, grade level and gender were the main factors related to psychological distress caused by the COVID-19 crisis. Importantly, medical knowledge has a protective effect on medical students' psychological distress during the COVID-19 period.

5.
Front Microbiol ; 13: 854630, 2022.
Article in English | MEDLINE | ID: covidwho-1952414

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented public health crisis worldwide. Although several vaccines are available, the global supply of vaccines, particularly within developing countries, is inadequate, and this necessitates a need for the development of less expensive, accessible vaccine options. To this end, here, we used the Escherichia coli expression system to produce a recombinant fusion protein comprising the receptor binding domain (RBD) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; residues 319-541) and the fragment A domain of Cross-Reacting Material 197 (CRM197); hereafter, CRMA-RBD. We show that this CRMA-RBD fusion protein has excellent physicochemical properties and strong reactivity with COVID-19 convalescent sera and representative neutralizing antibodies (nAbs). Furthermore, compared with the use of a traditional aluminum adjuvant, we find that combining the CRMA-RBD protein with a nitrogen bisphosphonate-modified zinc-aluminum hybrid adjuvant (FH-002C-Ac) leads to stronger humoral immune responses in mice, with 4-log neutralizing antibody titers. Overall, our study highlights the value of this E. coli-expressed fusion protein as an alternative vaccine candidate strategy against COVID-19.

6.
Pharm Biol ; 60(1): 862-878, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1860677

ABSTRACT

CONTEXT: Coronavirus disease 2019 is a global pandemic. Studies suggest that folic acid has antiviral effects. Molecular docking shown that folic acid can act on SARS-CoV-2 Nucleocapsid Phosphoprotein (SARS-CoV-2 N). OBJECTIVE: To identify novel molecular therapeutic targets for SARS-CoV-2. MATERIALS AND METHODS: Traditional Chinese medicine targets and virus-related genes were identified with network pharmacology and big data analysis. Folic acid was singled out by molecular docking, and its potential target SARS-CoV-2 N was identified. Inhibition of SARS-CoV-2 N of folic acid was verified at the cellular level. RESULTS: In total, 8355 drug targets were potentially involved in the inhibition of SARS-CoV-2. 113 hub genes were screened by further association analysis between targets and virus-related genes. The hub genes related compounds were analysed and folic acid was screened as a potential new drug. Moreover, molecular docking showed folic acid could target on SARS-CoV-2 N which inhibits host RNA interference (RNAi). Therefore, this study was based on RNAi to verify whether folic acid antagonises SARS-CoV-2 N. Cell-based experiments shown that RNAi decreased mCherry expression by 81.7% (p < 0.001). This effect was decreased by 8.0% in the presence of SARS-CoV-2 N, indicating that SARS-CoV-2 N inhibits RNAi. With increasing of folic acid concentration, mCherry expression decreased, indicating that folic acid antagonises the regulatory effect of SARS-CoV-2 N on host RNAi. DISCUSSION AND CONCLUSIONS: Folic acid may be an antagonist of SARS-CoV-2 N, but its effect on viruses unclear. In future, the mechanisms of action of folic acid against SARS-CoV-2 N should be studied.


Subject(s)
COVID-19 , Coronavirus Nucleocapsid Proteins , Folic Acid , SARS-CoV-2 , COVID-19/drug therapy , Coronavirus Nucleocapsid Proteins/antagonists & inhibitors , Folic Acid/pharmacology , Humans , Molecular Docking Simulation , Phosphoproteins/antagonists & inhibitors
7.
BMJ Open ; 12(5): e058323, 2022 05 10.
Article in English | MEDLINE | ID: covidwho-1832459

ABSTRACT

OBJECTIVE: To explore the psychological, social and financial outcomes of COVID-19-and the sociodemographic predictors of those outcomes-among culturally and linguistically diverse communities in Sydney, Australia. DESIGN: Cross-sectional survey informed by the Framework for Culturally Competent Health Research conducted between March and July 2021. SETTING: Participants who primarily speak a language other than English at home were recruited from Greater Western Sydney, New South Wales. PARTICIPANTS: 708 community members (mean age: 45.4 years (range 18-91)). 88% (n=622) were born outside of Australia, 31% (n=220) did not speak English well or at all, and 41% (n=290) had inadequate health literacy. OUTCOME MEASURES: Thirteen items regarding COVID-19-related psychological, social and financial outcomes were adapted from validated scales, previous surveys or co-designed in partnership with Multicultural Health and interpreter service staff. Logistic regression models (using poststratification weighted frequencies) were used to identify sociodemographic predictors of outcomes. Surveys were available in English or translated (11 languages). RESULTS: In this analysis, conducted prior to the 2021 COVID-19 outbreak in Sydney, 25% of the sample reported feeling nervous or stressed most/all of the time and 22% felt lonely or alone most/all of the time. A quarter of participants reported negative impacts on their spousal relationships as a result of COVID-19 and most parents reported that their children were less active (64%), had more screen time (63%) and were finding school harder (45%). Mean financial burden was 2.9/5 (95% CI 2.8 to 2.9). Regression analyses consistently showed more negative outcomes for those with comorbidities and differences across language groups. CONCLUSION: Culturally and linguistically diverse communities experience significant psychological, social and financial impacts of COVID-19. A whole-of-government approach is needed to support rapid co-design of culturally safe support packages in response to COVID-19 and other national health emergencies, tailored appropriately to specific language groups and accounting for pre-existing health disparities.


Subject(s)
COVID-19 , Health Literacy , Adolescent , Adult , Aged , Aged, 80 and over , Australia/epidemiology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Humans , Language , Middle Aged , Young Adult
8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315306

ABSTRACT

The emergence of numerous variants of SARS-CoV-2, the causative agent of COVID-19, has presented new challenges to the global efforts to control the still ravaging COVID-19 pandemic. Here, we obtain two cross-neutralizing antibodies (7D6 and 6D6) that target Sarbecoviruses’ receptor binding domain (RBD) with sub-picomolar affinities and potently neutralize authentic SARS-CoV-2. Crystal structures show that both antibodies bind a cryptic site different from that recognized by existing antibodies and highly conserved across Sarbecovirus isolates. Binding of these two antibodies to the RBD clashes with the adjacent N-terminal domain and disrupts the viral spike. Significantly, both antibodies confer good mutation resistance to the currently circulating SARS-CoV-2 variants. Thus, our results have direct relevance to public health as options for passive antibody therapeutics and even active prophylactics, and can also inform the design of pan-sarbecovirus vaccines.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312581

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19) respiratory disease rapidly caused a global pandemic and social and economic disruption. The combination of Traditional Chinese medicine (TCM) and Conventional Western medicine (CWM) is more effective for COVID-19 treatment. Moreover, TCM and CWM are important data source for developing new drug targets and promote strategies treat SARS-CoV-2 infections. However, many studies have analyzed the therapeutic mechanism of CWM or TCM alone for COVID-19, it is still unclear the interaction mechanism between TCM and CWM on COVID-19. Methods: This paper integrates network pharmacology and GEO database to mine and identify COVID-19 molecular therapeutic targets, providing potential targets and new ideas for COVID-19 gene therapy and new drug development. It includes: 1) using TCMSP, TTD, PubChem and CTD databases to analyze drug interactions and associated phenotypes for SARS-CoV-2, to correlate drug and disease interaction mechanisms to screen key drug targets;2) using GEO database to correlate differential genes and drug targets to screen potential antiviral gene therapy targets, to construct regulatory network and key points of SARS-CoV-2 therapeutic drugs;3) using computer simulation of molecular docking to screen virus-related proteins for new drugs. Results: Integrated analysis of network pharmacology discovered that baicalein, estrone and quercetin are the pivotal active ingredients in TCM and CWM. Combining drug target genes in pharmacology database and virus induced genes in GEO database, the result showed the core hub genes related to COVID-19: STAT1 , IL1B , IL6 , IL8 , PTGS2 and NFKBIA , and these genes were significantly downregulated in A549 and NHBE cells by SARS-CoV-2 infection. Moreover, chemical interaction and molecular docking analysis of hub genes showed that folic acid might as be potential therapeutic drug for COVID-19 treatment, and SARS-CoV-2 nucleocapsid phosphoprotein was a potential drug target. The network of “drug-target-SARS-CoV-2 related genes” provide noval potential compounds and targets for further studies of SARS-CoV-2. Conclusions: Integrated analysis of network pharmacology and big data mining provided noval potential compounds and targets for further studies of SARS-CoV-2. Our research implied folic acid and SARS-CoV-2 N as therapeutic target in TCM and CWM. Our research also suggests that targeting SARS-CoV-2 N protein is likely to be a common mechanism of TCM and CWM. On the one hand, the identification of pivotal genes provides a target for COVID-19 molecular therapy, on the other hand, it provides ideas for the analysis of interaction mechanism between virus and host.

10.
Am J Infect Control ; 50(5): 516-524, 2022 05.
Article in English | MEDLINE | ID: covidwho-1676380

ABSTRACT

BACKGROUND: Face masks from worldwide satisfy different standards during the COVID-19 pandemic, which led to the public misunderstanding of the concepts. METHODS: We systematically evaluated the quality of face masks provided by different companies according to multi-national standards, including EN 149-2001+A1: 2009, GB 2626-2019 and NIOSH 42 CFR Part 84-2019, focusing particularly on the particulate filtration efficiency (PFE) and respiratory resistance performance. RESULTS: Three types of masks (planar, folding and cup type masks) were measured based on different standard protocols. The results indicated that the PFE of the mask decreased in sequence of folding mask ≈ cup type mask > planar mask. The respiratory resistance of the masks ranked as follows: cup type mask > folding mask> planar mask. Overall, when PFE was used as the quality indicator, all the masks have a higher chance of meeting criteria of the EN149-2001+A1:2009, followed by the stricter standard set by the GB2626-2019 and NIOSH 42 CFR Part84-2019. Conversely, the respiratory resistance of the masks fulfilled the highest requirement of the EN149-2001+A1:2009 standard, while it is easier to satisfied the standard of GB 2626-2019 and NIOSH 42 CFR Part 84-2019. CONCLUSIONS: We believe that our study provides effective guidance for customers worldwide to choose proper face masks under different epidemic situations.


Subject(s)
COVID-19 , COVID-19/prevention & control , Filtration , Humans , Pandemics/prevention & control , Respiratory System
11.
Int J Mol Sci ; 23(1)2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1622609

ABSTRACT

Kiwifruit is moderately sweet and sour and quite popular among consumers; it has been widely planted in some areas of the world. In 2019, the crown gall disease of kiwifruit was discovered in the main kiwifruit-producing area of Guizhou Province, China. This disease can weaken and eventually cause the death of the tree. The phylogeny, morphological and biological characteristics of the bacteria were described, and were related to diseases. The pathogenicity of this species follows the Koch hypothesis, confirming that A. fabacearum is the pathogen of crown gall disease of kiwifruit in China. In this study, Loop-mediated isothermal amplification (LAMP) analysis for genome-specific gene sequences was developed for the specific detection of A. fabacearum. The detection limit of the LAMP method is 5 × 10-7 ng/µL, which has high sensitivity. At the same time, the amplified product is stained with SYBR Green I after the reaction is completed, so that the amplification can be detected with the naked eye. LAMP analysis detected the presence of A. fabacearum in the roots and soil samples of the infected kiwifruit plant. The proposed LAMP detection technology in this study offers the advantages of ease of operation, visibility of results, rapidity, accuracy and high sensitivity, making it suitable for the early diagnosis of crown gall disease of kiwifruit.


Subject(s)
Actinidia/microbiology , Agrobacterium/physiology , Fruit/microbiology , Molecular Diagnostic Techniques/methods , Nucleic Acid Amplification Techniques/methods , Plant Tumors/microbiology , Agrobacterium/pathogenicity , Base Sequence , China , Phylogeny , RNA, Ribosomal, 16S/genetics , Species Specificity
12.
J Int Med Res ; 49(9): 3000605211043245, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1486544

ABSTRACT

OBJECTIVE: Pulmonary complication is common in older patients after surgery. We analyzed risk factors of lower respiratory tract infection after general anesthesia among older patients. METHODS: In this retrospective investigation, we included older patients who underwent surgery with general anesthesia. Logistic regression analyses were performed to determine risk factors of lower respiratory tract infection. RESULTS: A total 418 postoperative patients with general anesthesia were included; the incidence of lower respiratory tract infection was 9.33%. Ten cases were caused by gram-positive bacteria, 26 cases by gram-negative bacteria, and 2 cases by fungus. We found significant differences in age, smoking, diabetes, oral/nasal tracheal intubation, and surgery duration. Logistic regression analysis indicated that age ≥70 years (odds ratio [OR] 2.028, 95% confidence interval [CI] 1.115-3.646), smoking (OR 2.314, 95% CI 1.073-4.229), diabetes (OR 2.185, 95% CI 1.166-4.435), nasotracheal intubation (OR 3.528, 95% CI 1.104-5.074), and duration of surgery ≥180 minutes (OR 1.334, 95% CI 1.015-1.923) were independent risk factors of lower respiratory tract infections. CONCLUSIONS: Older patients undergoing general anesthesia after tracheal intubation have a high risk of lower respiratory tract infections. Clinical interventions should be provided to prevent pulmonary infections in patients with relevant risk factors.


Subject(s)
Anesthesia, General , Respiratory Tract Infections , Aged , Anesthesia, General/adverse effects , Humans , Intubation, Intratracheal , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Retrospective Studies , Risk Factors
13.
Hum Vaccin Immunother ; 17(12): 4999-5006, 2021 12 02.
Article in English | MEDLINE | ID: covidwho-1442977

ABSTRACT

The mortality rate from COVID-19 appears to be higher in solid organ transplant (SOT) recipients when compared with other populations. Vaccination is a key strategy to prevent the COVID-19 pandemic. However, it is unclear how readily SOT recipients will get vaccinated against COVID-19. We conducted an internet-based survey to investigate the vaccination willingness among Chinese SOT recipients and further explore possible influencing factors. Eight hundred and thirteen respondents participated in the survey. Overall, 46 (5.7%) recipients were vaccinated against COVID-19, while 767 (94.3%) were not. Among those not vaccinated, 175 (22.8%) intended to be vaccinated, while 592 (77.2%) were categorized as vaccine-hesitant. The most common reason for vaccination hesitancy is fear of preexisting comorbidities, followed by fear of side effects and doctors' negative advice. Factors associated with vaccination willingness were as follows: with liver transplantation, the main source of information on COVID-19 vaccines was from medical doctors, scientists, and scientific journals, with at least college-level education, positive intention toward influenza vaccination during the current season, perceived importance of vaccination for SOT recipients, and having been vaccinated against influenza during the last season. Our survey indicated the necessity for SOT recipients to receive more comprehensive and accessible health education about vaccination and emphasized the critical role of transplantation physicians in promoting vaccine acceptance among SOT recipients. We hope that our survey results will help governments to better target communication in the ongoing COVID-19 vaccination campaign.


Subject(s)
COVID-19 , Influenza Vaccines , Organ Transplantation , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics/prevention & control , SARS-CoV-2 , Transplant Recipients , Vaccination
14.
Nat Commun ; 12(1): 5652, 2021 09 27.
Article in English | MEDLINE | ID: covidwho-1440473

ABSTRACT

The emergence of numerous variants of SARS-CoV-2, the causative agent of COVID-19, has presented new challenges to the global efforts to control the COVID-19 pandemic. Here, we obtain two cross-neutralizing antibodies (7D6 and 6D6) that target Sarbecoviruses' receptor-binding domain (RBD) with sub-picomolar affinities and potently neutralize authentic SARS-CoV-2. Crystal structures show that both antibodies bind a cryptic site different from that recognized by existing antibodies and highly conserved across Sarbecovirus isolates. Binding of these two antibodies to the RBD clashes with the adjacent N-terminal domain and disrupts the viral spike. Both antibodies confer good resistance to mutations in the currently circulating SARS-CoV-2 variants. Thus, our results have direct relevance to public health as options for passive antibody therapeutics and even active prophylactics. They can also inform the design of pan-sarbecovirus vaccines.


Subject(s)
Antibodies, Viral/immunology , Broadly Neutralizing Antibodies/immunology , COVID-19/therapy , Immunization, Passive/methods , SARS-CoV-2/immunology , Animals , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/immunology , Antibodies, Monoclonal/isolation & purification , Antibodies, Monoclonal/metabolism , Antibodies, Viral/administration & dosage , Antibodies, Viral/isolation & purification , Antibodies, Viral/metabolism , Binding Sites/genetics , Binding Sites/immunology , Broadly Neutralizing Antibodies/administration & dosage , Broadly Neutralizing Antibodies/isolation & purification , Broadly Neutralizing Antibodies/metabolism , CHO Cells , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Chlorocebus aethiops , Cricetulus , Epitopes/immunology , HEK293 Cells , Humans , Mice , Middle East Respiratory Syndrome Coronavirus/genetics , Middle East Respiratory Syndrome Coronavirus/immunology , Neutralization Tests , Pandemics/prevention & control , Protein Multimerization , Receptors, Virus/metabolism , SARS-CoV-2/genetics , Sf9 Cells , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Spike Glycoprotein, Coronavirus/metabolism , Vero Cells
15.
Intelligent Medicine ; 2021.
Article in English | ScienceDirect | ID: covidwho-1253040

ABSTRACT

In recent years, noncontact crewless operations have become prominent in the field of environmental disinfection. Robots that automatically disinfect the air and surfaces of hospital environments can help reduce the human resources spent on environmental cleaning and disinfection and minimize the risk of occupational exposure for staff. These robots also facilitate informatized management of environmental disinfection, reduce costs, and increase the efficiency of disinfection efforts.

16.
Journal of Advanced Transportation ; : 1-22, 2021.
Article in English | Academic Search Complete | ID: covidwho-1150264

ABSTRACT

Medical services are essential to public concerns and living qualities. Facing new public health events, the spatio-temporal variation of healthcare accessibility can be different, which is ignored in the previous accessibility studies. In this paper, we study the spatio-temporal variation of healthcare accessibility and residents' accessibility to the designated hospitals under public health emergencies such as COVID-19. Metropolitan Beijing is chosen as the study area. Then, we analyze the spatial disparity and the temporal variation and measure the matching degree between healthcare accessibility and population density. From the perspective of epidemic prevention, we evaluate the medical capacity of the designated hospitals. The autocorrelation method is used to analyze the spatial correlation of residents' accessibility to designated hospitals in the study area. A conclusion can be drawn that 74.14% grids in the study area have proportionate population density and healthcare accessibility. We find that the 5th Medical Center has sufficient medical resources, and Puren hospital is less affected by time. Moreover, the result of residents' accessibility to the designated hospitals presents a pattern of high-value aggregation in the arterial road neighborhood. At the same time, the peripheral areas show a trend of low-value aggregation. The research in healthcare accessibility can provide a reference for policymakers in medical service development and public emergency management. [ABSTRACT FROM AUTHOR] Copyright of Journal of Advanced Transportation is the property of Hindawi Limited 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

17.
J Appl Psychol ; 106(1): 4-14, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1059851

ABSTRACT

During normal and predictable circumstances, employees' occupational calling (i.e., a transcendent passion to use their talent and competencies toward positive societal impact and a sense of meaningfulness derived from working in a chosen occupational domain) is observed to be relatively stable. However, with the onset of the COVID-19 pandemic, circumstances have become anything but normal and predictable, thus putting employees' sense of occupational calling to the test. In this study, we investigate the possibility that occupational calling fluctuates across days during situations of crisis, and we identify antecedents and consequence of such fluctuations. To test our model, we conducted a daily diary study of 66 nurses working in intensive care units over 5 consecutive work days in a specialized Wuhan hospital that only admitted confirmed COVID-19 patients during the peak of the pandemic in China. We found that the daily number of code blue events (i.e., cardiopulmonary resuscitation efforts with the primary goal of patient revival) was positively related to daily occupational calling for nurses. Moreover, individual differences in prosocial motivation predicted the average level and variability of occupational calling over the 5 days, which subsequently related to the nurses' job performance. Our study sheds light on how occupational calling enables people with the needed occupational knowledge and skills to function effectively in crisis situations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19/nursing , Critical Care Nursing/methods , Job Satisfaction , Motivation , Nurses/psychology , Work Performance/statistics & numerical data , Adult , COVID-19/psychology , China , Female , Humans , Intensive Care Units , Male , Nurses/statistics & numerical data , Pandemics , SARS-CoV-2
18.
SciFinder; 2020.
Preprint | SciFinder | ID: ppcovidwho-3707

ABSTRACT

A review. The main clin. manifestations of CoronaVirus Disease 2019 (COVID-19) are fever, cough, fatigue, head and body pain, chest distress or shortness of breath, poor appetite, pharyngeal pain, chills, nausea or vomiting, but without aversion to cold. The pathogenesis is similar to that of exogenous contraction hurting fluid described in Treatise on Cold Damage Diseases, belonging to the category of "pestilence" in febrile diseases. In syndrome differentiation of six meridians, at the early stage of the disease, the pathogenesis is exogenous contraction and internal heat. The medicinals for releasing exterior with pungent and dispersing nature combined with the ones for nourishing yin and clearing away heat should be used. For the patients with nausea and vomiting, the treatment should focus on releasing exterior pathogens, and harmonizing shaoyang. For the one swith syndrome of taiyin spleen deficiency and dampness manifested as nausea and vomiting, poor appetite, diarrhea, combined with taiyang exterior syndrome manifested as head and body pain, the pathogenesis may be taiyin disease due to interior deficiency affecting exterior, so the treating principle should be warming and moistening spleen yang, fortifying the spleen and draining dampness. And the treatment should be given according to the severity of the exterior and the interior syndromes. For those with diarrhea, vomiting, even repeated fever, limb coldness, the pathogenesis may be interior deficiency, intermingled cold and heat, so protecting healthy qi is the most important. When the patient is in a coma state of extreme mental exhaustion, no matter cold syndrome or heat syndrome, it is the most critical stage in the six meridians, so supporting yang and nourishing yin are necessary. When the patient has cold syndrome, warming and nourishing are necessary when supporting yang. When the patient has heat syndrome, clearing away interior heat is necessary when nourishing yin. According to defense-qi-nutrient-blood syndrome differentiation and triple energizer syndrome differentiation, at the early stage of COVID-19, it is defense aspect syndrome, the pathogen is on the upper energizer, and the disease location is in the lung, so the medicinals for dispersing lung defense qi should be adopted. If the remaining pathogenic factors are not removed in time or the pathogenic factors enter qi aspect directly, and the disease is located in upper energizer or energizer, it is advisable to use the medicinals of clearing the lung, descending qi and resolving phlegm, and promoting qi and dampness;At the stage of heat at qi aspect with viscera pathol., combined with the needs of disease stages, the medicinals of clearing heat, generating body fluid, nourishing yin, opening the orifices, cooling the blood and extinguishing the wind should be given. If the syndrome of lower energizer with yin exhaustion and yang desertion occurs, the disease is located in the kidney. Besides symptomatic and supportive treatment, the medicinals of clearing heat and cooling blood, detoxifying and activating blood, nourishing yin and yang should be given. At the early stage of COVID-19, we should combine three yang meridians syndrome, defense aspect syndrome, qi aspect early stage syndrome, middle and upper energizer syndrome, and middle energizer syndrome for syndrome differentiation and treatment. At the critical stage o COVID-19, we should combine shaoyin meridians syndrome, nutrient-blood syndrome and lower energizer syndrome for syndrome differentiation and treatment.

19.
Front Pharmacol ; 11: 561674, 2020.
Article in English | MEDLINE | ID: covidwho-945686

ABSTRACT

Background: The pandemic of coronavirus disease 2019 (COVID-19) resulted in grave morbidity and mortality worldwide. There is currently no effective drug to cure COVID-19. Based on analyses of available data, we deduced that excessive prostaglandin E2 (PGE2) produced by cyclooxygenase-2 was a key pathological event of COVID-19. Methods: A prospective clinical study was conducted in one hospital for COVID-19 treatment with Celebrex to suppress the excessive PGE2 production. A total of 44 COVID-19 cases were enrolled, 37 cases in the experimental group received Celebrex as adjuvant (full dose: 0.2 g, bid; half dose: 0.2 g, qd) for 7-14 days, and the dosage and duration was adjusted for individuals, while seven cases in the control group received the standard therapy. The clinical outcomes were evaluated by measuring the urine PGE2 levels, lab tests, CT scans, vital signs, and other clinical data. The urine PGE2 levels were measured by mass spectrometry. The study was registered and can be accessed at http://www.chictr.org.cn/showproj.aspx?proj=50474. Results: The concentrations of PGE2 in urine samples of COVID-19 patients were significantly higher than those of PGE2 in urine samples of healthy individuals (mean value: 170 ng/ml vs 18.8 ng/ml, p < 0.01) and positively correlated with the progression of COVID-19. Among those 37 experimental cases, there were 10 cases with age over 60 years (27%, 10/37) and 13 cases (35%, 13/37) with preexisting conditions including cancer, atherosclerosis, and diabetes. Twenty-five cases had full dose, 11 cases with half dose of Celebrex, and one case with ibuprofen. The remission rates in midterm were 100%, 82%, and 57% of the full dose, half dose, and control group, respectively, and the discharged rate was 100% at the endpoint with Celebrex treatment. Celebrex significantly reduced the PGE2 levels and promoted recovery of ordinary and severe COVID-19. Furthermore, more complications, severity, and death rate were widely observed and reported in the COVID-19 group of elders and with comorbidities; however, this phenomenon did not appear in this particular Celebrex adjunctive treatment study. Conclusion: This clinical study indicates that Celebrex adjuvant treatment promotes the recovery of all types of COVID-19 and further reduces the mortality rate of elderly and those with comorbidities.

20.
Emerg Microbes Infect ; 9(1): 2076-2090, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-913103

ABSTRACT

The current coronavirus disease 2019 (COVID-19) pandemic was the result of the rapid transmission of a highly pathogenic coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for which there is no efficacious vaccine or therapeutic. Toward the development of a vaccine, here we expressed and evaluated as potential candidates four versions of the spike (S) protein using an insect cell expression system: receptor binding domain (RBD), S1 subunit, the wild-type S ectodomain (S-WT), and the prefusion trimer-stabilized form (S-2P). We showed that RBD appears as a monomer in solution, whereas S1, S-WT, and S-2P associate as homotrimers with substantial glycosylation. Cryo-electron microscopy analyses suggested that S-2P assumes an identical trimer conformation as the similarly engineered S protein expressed in 293 mammalian cells but with reduced glycosylation. Overall, the four proteins confer excellent antigenicity with convalescent COVID-19 patient sera in enzyme-linked immunosorbent assay (ELISA), yet show distinct reactivities in immunoblotting. RBD, S-WT and S-2P, but not S1, induce high neutralization titres (>3-log) in mice after a three-round immunization regimen. The high immunogenicity of S-2P could be maintained at the lowest dose (1 µg) with the inclusion of an aluminium adjuvant. Higher doses (20 µg) of S-2P can elicit high neutralization titres in non-human primates that exceed 40-times the mean titres measured in convalescent COVID-19 subjects. Our results suggest that the prefusion trimer-stabilized SARS-CoV-2 S-protein from insect cells may offer a potential candidate strategy for the development of a recombinant COVID-19 vaccine.


Subject(s)
Antigens, Viral/immunology , Betacoronavirus/immunology , Coronavirus Infections/prevention & control , Immunogenicity, Vaccine/immunology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Spike Glycoprotein, Coronavirus/immunology , Viral Vaccines/immunology , Angiotensin-Converting Enzyme 2 , Animals , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Antibodies, Viral/blood , Antibodies, Viral/immunology , COVID-19 , COVID-19 Vaccines , Cell Line , Coronavirus Infections/immunology , Cryoelectron Microscopy , Enzyme-Linked Immunosorbent Assay , Humans , Macaca fascicularis , Mice , Mice, Inbred BALB C , Neutralization Tests , Peptidyl-Dipeptidase A/metabolism , Protein Domains/genetics , Protein Domains/immunology , SARS-CoV-2 , Sf9 Cells , Spike Glycoprotein, Coronavirus/genetics , Spodoptera , Vaccination , Viral Envelope Proteins/immunology
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