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1.
One Health ; : 100395, 2022.
Article in English | ScienceDirect | ID: covidwho-1819579

ABSTRACT

Background South Africa was the first country with a case of Omicron variant infection diagnosed;therefore, this study aimed to elucidate the impact of the Omicron mutant strain outbreak on the health behavior of the South African population and encourage the population to adopt timely protective behaviors against Omicron mutant strain infection. Study design and methods This was a population-based, cross-sectional study conducted in Cape Town, South Africa, in December 2021. We distributed 300 questionnaires to adults aged >18 years, and they were all returned. Results Of the South African population, 60.3% expressed a high level of concern regarding Omicron;89.3% improved on at least one of the following three health behaviors: mask-wearing, washing hands, and reducing socialization;and only 10.7% exhibited no improvement in health behaviors. Of these, 71.3% and 57.0% increased the length of time they wore a mask and washed their hands, respectively, and 47% decreased the number of times they socialized. Age, residence, education level, chronic disease, and whether they had received the COVID-19 vaccine were significantly different (p < 0.05) between the presence and absence of enhanced health behaviors. The levels of concern and knowledge regarding the Omicron virus significantly influenced health-behavior change (all P < 0.05). Conclusion There has been a positive change in the South African population toward adopting mask-wearing, hand washing, and reducing socialization in response to the Omicron virus strain epidemic. Based on one health approach, it is important to focus on populations with chronic diseases, those who have not yet received the COVID-19 vaccine, and other populations with low rates of health behavior change.

2.
International Journal of Ophthalmology ; 15(4):533-540, 2022.
Article in English | PMC | ID: covidwho-1798637

ABSTRACT

AIM: To investigate the effects of baffle and intraocular pressure (IOP) on the aerosols generated in the noncontact tonometer (NCT) measurement and provide recommendations for the standardized use of the NCT during coronavirus disease 2019 (COVID-19). METHODS: This clinical trial included 252 subjects (312 eyes) in The Eye Hospital, Wenzhou Medical University from March 7, 2020, to March 28, 2020. Sixty subjects (120 eyes) with normal IOP were divided into two groups. One group used an NCT without a baffle, another group used an NCT with a baffle. Another 192 subjects (192 eyes) were divided into four groups: Group A1 (without a baffle+normal IOP), Group A2 (without a baffle+high IOP), Group B1 (with a baffle+normal IOP) and Group B2 (with a baffle+high IOP). Particulate matter (PM) 2.5 and PM10 generated by all subjects were quantified during the NCT measurement. The IOP values were recorded simultaneously. Effects of baffle and IOP on aerosols generated during the NCT measurement were analyzed. RESULTS: In the normal eye group with a baffle, the aerosol density decreased in a wave-like shape near the NCT with the increase in the number of people measured for IOP, demonstrating no cumulative effect. However, in the normal eye group without a baffle, there was a cumulative effect. PM2.5 and PM10 in Group A2 were higher than Group A1 (both P<0.001). The PM2.5 and PM10 in Group B2 were higher than Group B1 (P<0.01, P<0.001 respectively). The PM10 of Group B1 was lower than Group A1 (P<0.01). PM2.5 in Group B2 were lower than Group A2 (P<0.01). The median of per capita PM2.5 and PM10 in the combined Group A1+A2 were 0.80 and 1.10 μg/m3 respectively, which were higher than 0.20 and 0.60 μg/m3 in the combined Group B1+B2 (both P<0.01). The median of per capita PM2.5 and PM10 in the combined Group A1+B1 were 0.10 and 0.20 μg/m3 respectively, which were lower than 1.30 and 1.70 μg/m3 in the combined Group A2+B2 (both P<0.001). CONCLUSION: More aerosols could be generated in patients with high IOP. After the NCT is equipped with a baffle, per capita aerosol density generated decreased significantly near the NCT;And with the increase in the number of people measured for IOP, the aerosols gradually dissipated near the NCT, demonstrating no cumulative effect. Therefore, it is suggested that the NCT should be equipped with a baffle, especially for patients with high IOP.

3.
Water Research ; : 118451, 2022.
Article in English | ScienceDirect | ID: covidwho-1783834

ABSTRACT

As a cost-effective and objective population-wide surveillance tool, wastewater-based epidemiology (WBE) has been widely implemented worldwide to monitor the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA concentration in wastewater. However, viral concentrations or loads in wastewater often correlate poorly with clinical case numbers. To date, there is no reliable method to back-estimate the coronavirus disease 2019 (COVID-19) case numbers from SARS-CoV-2 concentrations in wastewater. This greatly limits WBE in achieving its full potential in monitoring the unfolding pandemic. The exponentially growing SARS-CoV-2 WBE dataset, on the other hand, offers an opportunity to develop data-driven models for the estimation of COVID-19 case numbers (both incidence and prevalence) and transmission dynamics (effective reproduction rate). This study developed artificial neural network (ANN) models by innovatively expanding a conventional WBE dataset to include catchment, weather, clinical testing coverage and vaccination rate. The ANN models were trained and evaluated with a comprehensive state-wide wastewater monitoring dataset from Utah, USA during May 2020 to December 2021. In diverse sewer catchments, ANN models were found to accurately estimate the COVID-19 prevalence and incidence rates, with excellent precision for prevalence rates. Also, an ANN model was developed to estimate the effective reproduction number from both wastewater data and other pertinent factors affecting viral transmission and pandemic dynamics. The established ANN model was successfully validated for its transferability to other states or countries using the WBE dataset from Wisconsin, USA.

4.
Circulation ; 2022 Apr 07.
Article in English | MEDLINE | ID: covidwho-1779500

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of COVID-19, enters human cells using the angiotensin-converting enzyme 2 (ACE2) protein as a receptor. ACE2 is thus key to the infection and treatment of the coronavirus. ACE2 is highly expressed in the heart, respiratory and gastrointestinal tracts, playing important regulatory roles in the cardiovascular and other biologic systems. However, the genetic basis of the ACE2 protein levels is not well understood. Methods: We conduct so far the largest genome-wide association meta-analysis of plasma ACE2 levels in over 28,000 individuals of the SCALLOP Consortium. We summarize the cross-sectional epidemiologic correlates of circulating ACE2. Using the summary-statistics-based high-definition likelihood method, we estimate relevant genetic correlations with cardiometabolic phenotypes, COVID-19, and other human complex traits and diseases. We perform causal inference of soluble ACE2 on vascular disease outcomes and COVID-19 disease severity using Mendelian randomization. We also perform in silico functional analysis by integrating with other types of omics data. Results: We identified ten loci, including eight novel, capturing 30% of the protein's heritability. We detected that plasma ACE2 was genetically correlated with vascular diseases, severe COVID-19, and a wide range of human complex diseases and medications. An X-chromosome cis-pQTL-based Mendelian randomization analysis suggested a causal effect of elevated ACE2 levels on COVID-19 severity (odds ratio (OR), 1.63; 95% CI, 1.10 to 2.42; P = 0.01), hospitalization (OR, 1.52; 95% CI, 1.05 to 2.21; P = 0.03), and infection (OR, 1.60; 95% CI, 1.08 to 2.37; P = 0.02). Tissue- and cell-type-specific transcriptomic and epigenomic analysis revealed that the ACE2 regulatory variants were enriched for DNA methylation sites in blood immune cells. Conclusions: Human plasma ACE2 shares a genetic basis with cardiovascular disease, COVID-19, and other related diseases. The genetic architecture of the ACE2 protein is mapped, providing a useful resource for further biological and clinical studies on this coronavirus receptor.

5.
Front Public Health ; 10: 757481, 2022.
Article in English | MEDLINE | ID: covidwho-1775973

ABSTRACT

Background: Some studies found that family doctor contract services (FDCSs) had positive impact on the self-measurement behaviors of hypertension patients. However, evidence concerning the association between FDCSs and blood pressure measurement awareness among hypertension patients is not clear. Objective: This study aims to explore the relationship between FDCSs and blood pressure measurement awareness among the hypertension patients, and examine whether there is a difference in this relationship among middle-aged and aged adults in rural Shandong, China. Methods: A multi-stage stratified random sampling was adopted in 2018 in Shandong Province to conduct a questionnaire survey among the sample residents, in which 982 hypertension patients were included in the study. Pearson chi-square test and logistic regression model were employed using SPSS 24.0 to explore the association between FDCSs and blood pressure measurement awareness. Results: 76.8% of hypertension patients would measure blood pressure regularly. The blood pressure measurement awareness of the signing group was significantly higher than that of the non-signing group when controlling other variables (P < 0.001, OR = 2.075, 95% CI 1.391-3.095). The interaction of age and contracting status were significantly correlated with blood pressure measurement awareness (P = 0.042, OR = 1.747, 95% CI 1.020-2.992; P = 0.019, OR = 2.060, 95% CI 1.129-3.759). Factors including gender (P = 0.011, OR = 0.499, 95% CI 0.291-0.855), household income (P = 0.031, OR = 1.764, 95% CI 1.052-2.956), smoking status (P = 0.002, OR = 0.439, 95% CI 0.260-0.739), sports habits (P < 0.001, OR = 2.338, 95% CI 1.679-3.257), self-reported health (P = 0.031, OR = 1.608, 95% CI 1.043-2.477), distance to the village clinic (P = 0.006, OR = 1.952, 95% CI 1.208-3.153) and medications (P < 0.001, OR = 3.345, 95% CI 2.282-4.904) were also found to be associated with the blood pressure measurement awareness of hypertension patients. Conclusion: The government should take efforts to strengthen publicity and education of family doctors and pay more attention to uncontracted, middle-aged, female patients and patients with unhealthy life behaviors to improve the blood pressure measurement awareness.


Subject(s)
Blood Pressure , Contract Services , Health Knowledge, Attitudes, Practice , Hypertension , Adult , China , Cross-Sectional Studies , Female , Humans , Hypertension/diagnosis , Middle Aged , Physicians, Family , Rural Population
6.
BMJ Open ; 12(3): e059067, 2022 03 25.
Article in English | MEDLINE | ID: covidwho-1765126

ABSTRACT

INTRODUCTION: COVID-19 is a public health emergency of international concern, which is characterised by rapid and widespread transmission, high mortality and complications. Several studies have shown the benefits of tai chi and qigong for recovery after COVID-19; however, no meta-analysis has been reported. Therefore, the purpose of this study is to evaluate the efficacy and safety of tai chi and/or qigong on rehabilitation after COVID-19 through a systematic review and meta-analysis to provide a reference and basis for clinical application. METHODS AND ANALYSIS: This study will use the Cochrane Library, PubMed, Web of Science, Embase, China Knowledge Network, China Biomedical Literature Database, Chinese Scientific Journal Database and Wanfang Database. The time period is from the inception of the database to November 2021, with no language restrictions. Searches will be conducted using the subject terms "Taichi","Qigong" and "COVID-19" plus free-text words. Articles will be screened and collected by two reviewers independently. Included studies will be assessed for quality using the Cochrane Risk of Bias Assessment Tool. Statistical analyses will be performed using the Revman V.5.3 software. The primary outcomes include 1-second forced expiratory volume and 1-second forced vital capacity, oxygen saturation, total white cell count and quality of life score. Secondary outcomes include time to remission of major symptoms, incidence of adverse events, clinical cure rate and mortality. Subgroup and sensitivity analyses will also be used to explore and interpret the heterogeneity. This protocol is written based on the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol. ETHICS AND DISSEMINATION: Ethical approval and consent are unnecessary because no primary data will be collected. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CRD42021288962.


Subject(s)
COVID-19 , Qigong , Tai Ji , Humans , Meta-Analysis as Topic , Quality of Life , Systematic Reviews as Topic
7.
Vaccine ; 40(9): 1208-1212, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1757896

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in catastrophic damage worldwide. Accordingly, the development of powerful, safe, easily accessible vaccines with long-term effectiveness is understood as an urgently needed countermeasure against this ongoing pandemic. Guided by this strong promise of using AAVs, we here designed, optimized, and developed an AAV-based vaccines (including AAV-RBD(max), AAV-RBD(wt), AAV-2xRBD, and AAV-3xRBD) that elicit strong immune responses against the RBD domain of the SARS-CoV-2 S protein. These immunogenic responses have proven long-lived, with near peak levels for at least six months in mice. Notably, the sera immunized with AAV-3xRBD vaccine contains powerful neutralizing antibodies against the SARS-CoV-2 pseudovirus. Further evidence proven that potent specific antibodies could also be elicited in canines after vaccination with AAV-3xRBD vaccine.


Subject(s)
COVID-19 , Viral Vaccines , Animals , Antibodies, Neutralizing , Antibodies, Viral , COVID-19 Vaccines , Dogs , Humans , Mice , Mice, Inbred BALB C , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/genetics , Viral Vaccines/genetics
8.
PLoS Pathog ; 18(2): e1010259, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1690683

ABSTRACT

At the end of 2019 Wuhan witnessed an outbreak of "atypical pneumonia" that later developed into a global pandemic. Metagenomic sequencing rapidly revealed the causative agent of this outbreak to be a novel coronavirus denoted SARS-CoV-2. To provide a snapshot of the pathogens in pneumonia-associated respiratory samples from Wuhan prior to the emergence of SARS-CoV-2, we collected bronchoalveolar lavage fluid samples from 408 patients presenting with pneumonia and acute respiratory infections at the Central Hospital of Wuhan between 2016 and 2017. Unbiased total RNA sequencing was performed to reveal their "total infectome", including viruses, bacteria and fungi. We identified 35 pathogen species, comprising 13 RNA viruses, 3 DNA viruses, 16 bacteria and 3 fungi, often at high abundance and including multiple co-infections (13.5%). SARS-CoV-2 was not present. These data depict a stable core infectome comprising common respiratory pathogens such as rhinoviruses and influenza viruses, an atypical respiratory virus (EV-D68), and a single case of a sporadic zoonotic pathogen-Chlamydia psittaci. Samples from patients experiencing respiratory disease on average had higher pathogen abundance than healthy controls. Phylogenetic analyses of individual pathogens revealed multiple origins and global transmission histories, highlighting the connectedness of the Wuhan population. This study provides a comprehensive overview of the pathogens associated with acute respiratory infections and pneumonia, which were more diverse and complex than obtained using targeted PCR or qPCR approaches. These data also suggest that SARS-CoV-2 or closely related viruses were absent from Wuhan in 2016-2017.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Pneumonia/epidemiology , Respiratory Tract Infections/epidemiology , SARS-CoV-2/isolation & purification , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Bronchoalveolar Lavage Fluid/microbiology , COVID-19/virology , China/epidemiology , Cohort Studies , Female , Gene Expression Profiling , Humans , Male , Metagenomics , Middle Aged , Phylogeny , Pneumonia/microbiology , Respiratory Tract Infections/microbiology , Young Adult
9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324958

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia. Methods: In China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database, and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia and asymptomatic without pneumonia). Results: According to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both noninvasive (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) were applied in only the symptomatic with pneumonia group. There were no differences in the durations of viral shedding and hospitalization among the four groups. Conclusion: We have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral shedding duration as the symptomatic COVID-19 group. Trial registration Not available

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324552

ABSTRACT

Background: With the widespread outbreak of novel coronavirus diseases 2019(COVID-19), more and more death cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths with COVID-19 pneumonia Methods: : We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death cases with COVID-19 pneumonia in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020. Results: : Of the 83 deaths, none was the medical staff. The mean age was 71.8 years (SD 13.2;range, 34-97 years) and 53(63.9%) were male. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death was 17days (IQR 14-21: range, 6-54 days). Most deaths (66[80%]) had underlying comorbid diseases, the most of which was hypertension [47(57%)]. The main initial symptoms of these 83 deaths were shortness of breath(98.8%), fever(94%) and myalgia or fatigue(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths, hypoalbuminemia in 77(93%) deaths, the elevation of lactate dehydrogenase in 79(95%) deaths, procalcitonin in 69(83%) deaths and C-reactive protein in 79(95%) deaths. All 83 patients received antiviral treatment, 81(97.6%) deaths received antibiotic therapy, and 54(65.1%) deaths received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation. Conclusion: Most of the deaths with COVID-19 pneumonia were elderly patients with underlying comorbid diseases, especially those over 70 years of age. The time of death was mostly 15-21 days after the onset of the disease. More care should be given to the elderly in the further prevention and control strategies of COVID-19.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315502

ABSTRACT

Background: The spread of coronavirus disease 2019 (COVID-19) has posed great threat to the global population’s health and nearly every medical school throughout the world suspended classes as a precaution against the virus. The aim of this research is to explore the most suitable teaching and learning pattern in medical school during COVID-19 Outbreak. Methods: : This was a case-control study which conducted in a medical school. We applied a new blended teaching model based on 5G network that combined team-based learning (TBL) and online interaction to the students before the outbreak and when universities responded to the COVID-19 outbreak by closing campuses, they shifted to different forms of distance learning. Fifty fourth-year medical students receiving the “5+3” pattern courses regarding internal medicine were enrolled in the study. A five-point Likert scale questionnaire that contains 20 items was used to compare the effect of the two kinds of teaching patterns. It evaluated the indicators of core competencies of students including professionalism, attitude towards learning, knowledge and learning skills, teamwork skills, motivation in learning, adaptability and acceptance of the courses and network environment. Results: : According to the descriptive statistical analysis of the first part of the questionnaire (question 1-16), the average score of adaptability and acceptance of the courses is 2.60 less than 3, indicating that students are more adapted to other forms of distance learning during COVID-19 outbreak;the average score of the rest of the questions is greater than 3, indicating that blended teaching model based on 5G network is superior to other forms of distance learning. The number of male students who are inclined to the blended teaching model based on 5G network is 0.13 times as much as that of female students (95%CI:0.028~0.602, p=0.009). Conclusion: The results that medical education based on 5G network that combined team-based learning (TBL) and online interaction is a more suitable option to teach medical students.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315501

ABSTRACT

Background: The spread of coronavirus disease 2019 (COVID-19) has posed great threat to the global population’s health and nearly every medical school throughout the world suspended classes as a precaution against the virus. This study is aimed at exploring a more advanced online teaching and learning pattern for medical school in the future especially during a Public Health Emergency of International Concern (PHEIC) and to evaluate the efficacy of the teaching methods in improving students’ professionalism, knowledge and learning skills including problem analyzing and solving, teamwork skills, self-directed learning, as well as adaptability and acceptance to the courses. Methods: : Fifty fourth-year medical students receiving the “5+3” pattern courses regarding internal medicine were enrolled in the study. A five-point Likert scale questionnaire that contains 20 items was used to compare the effect between online TBL via 5G network (hereinafter referred as blended teaching model) and home-based online learning which is not based on TBL via other prevalent forms of wireless internet connection(hereinafter referred as traditional online teaching model). It evaluated the network environment and indices of students’ competencies we put forward based on six core competencies Results: : According to the descriptive statistical analysis of the first part of the questionnaire (question 1-16), the average score of adaptability and acceptance of the courses is 2.60 less than 3, indicating that students are more adapted to traditional online teaching model;the average score of the rest of the questions is greater than 3, indicating that blended teaching model is superior to traditional online teaching model. The number of male students who are inclined to blended teaching model is 0.13 times as much as that of female students (95%CI:0.028~0.602, p=0.009). Conclusion: Online TBL via 5G network is a more advanced online teaching and learning pattern for medical school and may be a more suitable method during PHEIC in the future.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315183

ABSTRACT

Background: To investigate the diagnostic value of three different examination methods of chest radiography (CXR), digital tomosynthesis (DTS) and Computed tomography (CT) scan on the diagnosis of novel coronavirus pneumonia (COVID-19). Methods: A retrospective analysis of three examination methods of chest: CXR, DTS, and CT scan of COVID-19 pneumonia patients diagnosed in our hospital from January, 23, 2020 to February, 29, 2020. And we compared three different imaging methods to COVID-19 display ability of pneumonia intrapulmonary lesions. Results: A total of 37 patients diagnosed as COVID-19 by nucleic acid testing were included. The CXR group (10/37) and DTS group (21/28) of 37 patients with COVID-19 pneumonia showed significant differences in intrapulmonary ground glass opacities ( P <0.05);DTS group (21/28) and CT group (25/27) showed no statistically significant differences in intrapulmonary ground glass opacities ( P > 0.05). Conclusion: Comparison of the three imaging methods of COVID-19 pneumonia, the diagnostic efficiency of CXR is low, which is easy to be false negative and miss lesions;diagnostic resolutions of DTS are higher than CXR, which can improve the ability to display the fine structure of intrapulmonary lesions;CT scan shows the intrapulmonary of COVID-19 pneumonia low-density ground glass opacities and internal structures have equal capacity compared with DTS. Therefore, DTS and CT are the best choices for the image diagnosis of COVID-19 pneumonia.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313372

ABSTRACT

The spread of 2019 novel coronavirus disease (COVID-19) throughout the world has been a severe challenge for public health. The human angiotensin-converting enzyme 2 (ACE2) has a remarkably high affinity binding to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). By the search for network database and re-analysis of pubic data, we found the level of ACE2 expression in adipose tissue was higher than that in lung tissue, which indicated the adipose tissue might be vulnerable to SARS-CoV-2 as well;the levels of ACE2 expressed by adipocytes and adipose progenitor cells were similar between non-obese individuals and obese individuals, but obese individuals have more adiposes so as to increase the number of ACE2-expressing cells;the expression of ACE2 in tumor tissues posed by five different types of cancers increased significantly compared with that in adjacent tissues. Thus, we suggest that more attentions might be given to obese individuals and the five types of cancer patients during the outbreak of COVID-19.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312736

ABSTRACT

Background: Health care workers in intensive care units (ICU) have been prioritized for COVID-19 vaccination. In a nationwide vaccination campaign since March in China, better understanding of concerns and preferences of COVID-19 vaccines remain crucial for improving vaccination uptake.Methods: ICU clinicians throughout China’s mainland were contacted to participate in an online survey during March 24-April 10, 2021. We compared concerns by vaccination outcome, and through a discrete choice experiment (DCE) assessed preferences for vaccines in terms of effectiveness (95% vs 80%), risk of adverse reactions (5% vs 10%), duration of immunity (6 vs 12 months), and whether or not coworkers have been vaccinated.Findings: Among 11,951 ICU respondents from 252 prefecture-level cities, vaccination coverage of COVID-19 vaccines was 75·4%, with an additional 9·2% not vaccinated but planning to, and 16·1% not vaccinated and not intending to. Among women not pregnant, vaccination coverage was 82·6%, with lower coverage in those pregnant (11·4%) or breastfeeding (19·7%). ICU clinicians not intending to be vaccinated significantly expressed more concerns about the speed of vaccine development (30·1%) and adverse reactions (65·9%), compared to those already vaccinated. In the DCE, by COVID-19 vaccination status, the only significant difference in preferences of a COVID-19 vaccine was for safety, with those not vaccinated having a stronger preference for a vaccine with fewer adverse reactions (OR=4·49) compared to those already vaccinated (OR=2·90) or those intending to vaccinate (OR=3·46) (P<0·0001).Interpretation: Increasing vaccination coverage among Chinese ICU clinicians will require strong norms surrounding vaccination and transparency about safety information. Funding Information: This work was supported by the National Natural Science Foundation of China (#82041028) and Science and Technology Commission of Shanghai Municipality (#20692110200).Declaration of Interests: The authors declared that they have no conflict of interest to this work.Ethics Approval Statement: The study was approved by the Institutional Review Board (IRB) of the Fudan University School of Public Health (IRB 00002408 and FWA 00002399) under IRB #2021-03-0888. Secondary data analysis at the University of Michigan was deemed exempt by the University of Michigan Health Sciences and Behavioral Sciences Institutional Review Board (#HUM00198183). Online informed consent was obtained when the interviewees agreed to fulfill the online questionnaire.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308300

ABSTRACT

A novel coronavirus, SARS-CoV-2, has caused over 85 million cases and over 1.8 million deaths worldwide since it occurred twelve months ago in Wuhan, China. Here we conceptualized the time-series evolutionary and expansion dynamics of SARS-CoV-2 by taking a series of cross-sectional view of viral genomes from early outbreak in January in Wuhan to early phase of global ignition in early April, and finally to the subsequent global expansion by late December 2020. By scrutinizing cases from early outbreak, we found a viral genotype from the Seafood Market in Wuhan featured with two concurrent mutations has become the overwhelmingly dominant genotype (95.3%) of the pandemic. By analyzing 4,013 full-length SARS-CoV-2 genomes from different continents by early April, we were able to visualize the genomic diversity over a 14-week timespan since the outbreak in Wuhan. 2,954 unique nucleotide substitutions were identified with 31 of the 4,013 genomes remaining as ancestral type, and 952 (32.2%) mutations recurred in more than one genome. 11 major viral genotypes with unique geographic distributions were identified. As the pandemic has been unfolding for more than one year, we also used the same approach to analyze 261,323 full-length SARS-CoV-2 genomes from the world since the outbreak in Wuhan (i.e. including all the available viral genomes in the GISAID database as of 25 December 2020) in order to recapitulate our findings in a real-time fashion and to present a full catalogue of SARS-CoV-2 mutations. We demonstrated the viral genotypic dynamics from different geographic locations over one-year timespan reveal transmission routes and indicate subsequent expansion. This study, to our knowledge, is heretofore the largest and most comprehensive genomic study of SARS-CoV-2. It indicates the viral genotypes can be utilized as molecular barcodes in combination with epidemiologic data to monitor the spreading routes of the pandemic and evaluate the effectiveness of control measures. Moreover, the dynamics of viral mutational spectrum in the study may help the early identification of new strains in patients to reduce further spread of infection, and guide the development of molecular diagnosis and vaccines against COVID-19, and last but not the least help assess their accuracy and efficacy.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308293

ABSTRACT

Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, Hubei province, China, 1 the epidemic has spread rapidly in Hubei province and other regions in China. A total of 80,552 patients confirmed with COVID-19 have been reported in the main land China up to March 5th, 2020. 2 They included a huge number of patients discharged from hospital. A total of 53726 cases have met the discharge criteria (one of the criteria includes two continued negative result of nucleic acid test with repeated interval period of at least 1day or 24 hours.) in mainland China up to March 5th, 2020. Previous studies have paid more attention to the epidemic situation of COVID-19 and patient's diagnosis and treatment.Closely attention should be paid to the discharged patients. Surprising, previous follow-up reported that some patients nucleic acid retest result was positive again after discharge. 3 Impact factors should be further investigated. Since the first confirmed case was diagnosed in our hospital (Chongqing Emergency Medical Center, the designated transfer hospital) on February 4th, we have confirmed a total of 17 cases. All the patients infected with the novel coronavirus have been transferred to a designated hospital in Southwest China's Chongqing by ambulance with an inbuilt negative-pressure chamber. 4 In the follow-up of these patients, all patients accepted RT-PCR tests again after having discharged from designated hospital 3 days later. Four of them showed recurrence of positive results after few days of discharge. Thus, we reported these cases aiming to provide information on policy formulation and modification of discharge plans.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307613

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently spread worldwide partly through environmental and airborne contamination. The number of patients requiring intensive care unit (ICU)-based healthcare services exceeds the available negative-pressure isolation ICU room capacity. Some general wards of Wuhan hospitals have been temporarily converted into COVID-19 ICU wards and pose safety concerns. We explored the safety of these temporary COVID-19 ICU wards. Methods: : Fifteen air samples and 128 environmental surface swabs were collected from 14 patients in 4 departments with temporary COVID-19 ICU wards. Quantitative real-time PCR (RT-PCR) methods confirmed the existence of COVID-19 pathogens. Results: : Four of the 15 air samples were obtained during aerosol-generating medical procedures (1 tracheostomy, 1 high-flow nasal cannula [HFNC], 1 HFNC+nebulization, 1 non-invasive positive pressure ventilation). Five patients were administered invasive positive pressure ventilation through tracheostomy. All air samples tested negative for SARS-CoV-2 by RT-PCR. Viruses were detected on the surface of a patient’s gastric tube, and an anal tube swab tested positive. Five days later, the anal swab of the patient remained positive, although viral RNA of the nasopharyngeal swap turned negative. Conclusions: : Establishing temporary isolation COVID-19 ICU wards is a safe and effective method to increase surge capacity in a hospital. SARS-CoV-2 sheds from the enteric canal after viral clearance in the respiratory tract. Reinforcing disinfection of tubes and circuits given to the patients is essential in COVID-19 isolation wards to decrease nosocomial transmission.

19.
Front Immunol ; 12: 738532, 2021.
Article in English | MEDLINE | ID: covidwho-1686470

ABSTRACT

Background: The benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients. Methods: We analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis. Results: Between January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes. Conclusion: No significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.


Subject(s)
COVID-19/mortality , COVID-19/therapy , Immunoglobulins, Intravenous/therapeutic use , Aged , China , Critical Care/methods , Critical Illness/therapy , Female , Humans , Immunization, Passive/methods , Immunization, Passive/mortality , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/immunology , Treatment Outcome
20.
Nucleic Acids Res ; 2022 Jan 31.
Article in English | MEDLINE | ID: covidwho-1662127

ABSTRACT

Omics-based biomedical learning frequently relies on data of high-dimensions (up to thousands) and low-sample sizes (dozens to hundreds), which challenges efficient deep learning (DL) algorithms, particularly for low-sample omics investigations. Here, an unsupervised novel feature aggregation tool AggMap was developed to Aggregate and Map omics features into multi-channel 2D spatial-correlated image-like feature maps (Fmaps) based on their intrinsic correlations. AggMap exhibits strong feature reconstruction capabilities on a randomized benchmark dataset, outperforming existing methods. With AggMap multi-channel Fmaps as inputs, newly-developed multi-channel DL AggMapNet models outperformed the state-of-the-art machine learning models on 18 low-sample omics benchmark tasks. AggMapNet exhibited better robustness in learning noisy data and disease classification. The AggMapNet explainable module Simply-explainer identified key metabolites and proteins for COVID-19 detections and severity predictions. The unsupervised AggMap algorithm of good feature restructuring abilities combined with supervised explainable AggMapNet architecture establish a pipeline for enhanced learning and interpretability of low-sample omics data.

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