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1.
Front Endocrinol (Lausanne) ; 13: 839895, 2022.
Article in English | MEDLINE | ID: covidwho-1785328

ABSTRACT

Objective: To compared the incidence rates and clinical features of precocious girls before and during the COVID-19 pandemic among Shanghai school-aged girls, and explored the potential mechanisms. Methods: This cross-sectional study collected medical data about precocious girls between 2016 and 2020 from Shanghai Children's Medical Center. Data of inpatient precocious girls from March to August in 2016-2019 (n=246) and 2020 (n=237) were collected. Subjects with abnormal brain and pituitary gland MRI reports, other endocrine diseases or chronic diseases were excluded. Finally, 209 precocious girls were included in the 2016-2019 group and 191 precocious girls were include in the 2020 group. Monthly incidence rates and clinical features were compared between before and during the COVID-19 pandemic. Linear regression models were used to examine the associations between biomarkers to explore the potential mechanisms. Results: Monthly incidence rates of precocious puberty in outpatient girls from March to December 2020 (0.44-1.36%) and in inpatient girls from March to August 2020 (27.04-47.83%) were higher than those in 2016-2019 (0.30-0.52% and 10.53-18.42%, respectively). Serum concentrations of GnRH were higher in the 2020 group than in the 2016-2019 group (2.81 vs 1.99 mg/L). Serum concentrations of MKRN3 (1.02 vs 1.93 ng/ml) and ghrelin (0.38 vs 0.88 ng/ml) were lower in the 2020 group than in the 2016-2019 group. Moreover, the serum concentration of ghrelin was positively associated with the serum concentration of MKRN3 [ß=0.891 (95% CI, 0.612, 1.171); p<0.001]. Conclusions: These findings suggest an increased incidence of precocious puberty during the COVID-19 pandemic among Shanghai school-aged girls, which may be associated with decreased serum concentrations of MKRN3 and ghrelin, and indicated ghrelin as a potential regulatory mechanism of puberty.


Subject(s)
COVID-19 , Puberty, Precocious , COVID-19/epidemiology , Child , China/epidemiology , Cross-Sectional Studies , Female , Ghrelin , Humans , Pandemics , Puberty, Precocious/epidemiology , Ubiquitin-Protein Ligases
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325065

ABSTRACT

Background: Many Pre-exposure prophylaxis (PrEP) users have difficulty attending the quarterly facility-based HIV testing, which leads to the potential risk of drug resistance in the context of breakthrough infection with low drug compliance. We explored the acceptance of HIV self-testing (HIVST) service among PrEP recipients. Methods: : MSM were recruited for the PrEP demonstration in four major cities in China from December 2018 to September 2019, provided with regimens of both daily and on-demand PrEP. Facility-based HIV testing was provided quarterly at clinic visits. Previous HIV testing history and acceptance of free HIVST kits to use between each quarterly clinic visit was collected. Correlates of levels of acceptance were analysed using multivariable ordinal logistic regression. Results: : We recruited 1,222 MSM. among which 48.5% preferred daily PrEP and 51.5% preferred on-demand PrEP. There was 26.8% (321/1222) had never been to any facility-based HIV testing previously, and the self-reported major reason was that they had already routinely used HIVST. A quarter of the participants (74.5%, 910/1222) had used HIVST previously. There were 1184 MSM (96.9%) accepted to use HIVST between each quarterly clinic visits during PrEP usage, composing 947 ( 77.5%) very willing to, 237(19.4%)willing to, 29 (2.4%) unwilling to, and 9 (0.7%) very unwilling to. Participants preferred daily PrEP (vs. on-demand PrEP, aOR=1.8, 95% CI:1.3-2.4) and had less than 2 times of facility-based HIV testing in the past year (vs. ³2, aOR=1.4,95% CI:1.1-1.9) were more likely to have higher level of acceptance of HIVST. Conclusions: : MSM had high acceptance of HIVST, especially among those preferred daily PrEP and with less facility-based HIV testing in the previous year. Offering HIVST services PrEP recipients is feasible and necessary. Above result is of great significance for promoting HIVST among PrEP users during COVID-19, improving awareness of their HIV infection status and ensuring compliance with medication. Future study should exam the impact of HIVST on HIV testing frequency among PrEP users. Trial registration: ChiCTR1800020374 on 27 th Dec 2018. http://www.chictr.org.cn/searchproj.aspx

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324269

ABSTRACT

Objective: To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19. Methods: : We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy (the corticosteroid group) and patients with severe COVID-19 who did not receive corticosteroid therapy (the non-corticosteroid group). Results: : Seventy-five patients were included in this study. Of these, 47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group. There were no differences between the two groups in the total length of hospital stay (LOS), the length of ICU stay, high-flow oxygen days, non-invasive ventilator days, invasive ventilation days, and mortality rate. Total lesion volume ratio, consolidation volume ratio and GGO volume ratio in the corticosteroid group decreased significantly on day 14, while those in the non-corticosteroid group did not show a significant decrease. Conclusions: : Our results show that adjunctive corticosteroid use did not significantly improve clinical outcomes in severe COVID-19 patients, but might promote the absorption of pulmonary lesions. Larger multicenter randomized controlled studies may be needed to confirm this.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310885

ABSTRACT

Background: &nbsp;The coronavirus disease (COVID-19) pandemic has impacted HIV prevention strategies globally. However, changes in pre-exposure prophylaxis (PrEP) adherence and HIV-related behaviors, and their associations with medication adherence among MSM PrEP users remains unclear since the onset of the COVID-19 pandemic.&nbsp;Methods:&nbsp;A longitudinal observational study of HIV-negative MSM PrEP users was conducted in four Chinese metropolises from February to March 2020, assessing the changes in PrEP adherence and HIV-related behaviours before and during the COVID-19. The primary outcome was poor PrEP adherence determined from self-reported missing at least one PrEP dose in the previous month. We used mulitivariable logistic regression to determine factors correlated with poor adherence during the COVID-19. Findings:&nbsp;We enrolled 791 eligible participants (418 [52·8%] in daily PrEP, 373 [47·2%] in event-driven PrEP). Compared with the data conducted before the COVID-19, the proportion of PrEP users decreased from 97·9% to 64·3%, and the proportion of poor PrEP adherence increased from 23.6% to 50·1% during the COVID-19 (odds ratio [OR] 3·24, 95% confidence interval (CI) 2·61–4·02). While the percentage of condomless anal intercourse (CAI) with regular partners (11·8% vs 25·7%) and with casual partners (4·4% vs 9·0%) both significantly increased. The proportion of those who were tested for HIV decreased from 50·1% to 25·9%. Factors correlated with poor PrEP adherence during the COVID-19 included not being tested for HIV (adjusted odds ratio [aOR]=1·38 [95% CI: 1·00, 1·91]), using condoms consistently with regular partners (vs. never, aOR=2·19 [95% CI: 1·16, 4·13]) and being married or cohabitating with a woman (vs. not married, aOR=3·08 [95% CI: 1·60, 5·95]). Interpretation: &nbsp;Increased poor PrEP adherence and CAI along with the decrease in HIV testing can lead to increases in HIV acquisition and of drug resistance to PrEP. Targeted interventions are needed to improve PrEP adherence and HIV prevention strategies. Trial Registration: Chinese Clinical Trial Registry (ChiCTR-IIN-17013762). Funding Statement: The Mega-Projects of national science research for the13th Five-Year Plan (2017ZX10201101), the National Natural Science Foundation of China (81872674), and the National Science and Technology Major Project (2018ZX10101001-001-003). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: This study was reviewed and approved by the Medical Science Research Ethics Committee of the First Affiliated Hospital of China Medical University ([2018]2015-139-5).

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313733

ABSTRACT

Although human antibodies elicited by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) protein are profoundly boosted upon infection, little is known about the function of N-reactive antibodies. Herein, we isolated and profiled a panel of 32 N protein-specific monoclonal antibodies (mAbs) from a quick recovery coronavirus disease-19 (COVID-19) convalescent patient who had dominant antibody responses to the SARS-CoV-2 N protein rather than to the SARS-CoV-2 spike (S) protein. The complex structure of the N protein RNA binding domain with the mAb with the highest binding affinity (nCoV396) revealed changes in the epitopes and antigen’s allosteric regulation. Functionally, a virus-free complement hyper-activation analysis demonstrated that nCoV396 specifically compromises the N protein-induced complement hyper-activation, which is a risk factor for the morbidity and mortality of COVID-19 patients, thus laying the foundation for the identification of functional anti-N protein mAbs.

6.
Int J Environ Res Public Health ; 19(3)2022 01 27.
Article in English | MEDLINE | ID: covidwho-1674612

ABSTRACT

The Severe Acute Respiratory Syndrome-associated Coronavirus 2 (SARS-CoV-2) was an outbreak in December, 2019 and rapidly spread to the world. All variants of SARS-CoV-2, including the globally and currently dominant Delta variant (Delta-SARS-CoV-2), caused severe disease and mortality. Among all variants, Delta-SARS-CoV-2 had the highest transmissibility, growth rate, and secondary attack rate than other variants except for the new variant of Omicron that still exists with many unknown effects. In Taiwan, the pandemic Delta-SARS-CoV-2 began in Pingtung from 14 June 2021 and ceased at 11 July 2021. Seventeen patients were infected by Delta-SARS-CoV-2 and 1 person died during the Pingtung outbreak. The Public Health Bureau of Pingtung County Government stopped the Delta-SARS-CoV-2 outbreak within 1 month through measures such as epidemic investigation, rapid gene sequencing, rapidly expanding isolation, expanded screening of the Delta-SARS-CoV-2 antigen for people who lived in regional villages, and indirect intervention, including rapid vaccination, short lockdown period, and travel restrictions. Indirect environmental factors, such as low levels of air pollution, tropic weather in the summer season, and rural areas might have accelerated the ability to control the Delta-SARS-CoV-2 spread. This successful experience might be recommended as a successful formula for the unvaccinated or insufficiently vaccinated regions.


Subject(s)
COVID-19 , Communicable Disease Control , Disease Outbreaks , Humans , SARS-CoV-2 , Taiwan/epidemiology
7.
Decis Support Syst ; : 113745, 2022 Feb 07.
Article in English | MEDLINE | ID: covidwho-1670419

ABSTRACT

Prior research has confirmed the importance of IT-business alignment (ITBA) and big data analytics capability (BDAC) in supporting firms' strategic decision-making under normal circumstances. However, the global outbreak of COVID-19 has significantly changed firms' strategic decision-making landscapes and raised questions regarding the effects of ITBA and BDAC on strategic decision-making as conditioned by COVID-19 characteristics. In this study, we contextualize two important event impact factors (i.e., event criticality and event disruption) in the context of COVID-19 and examine their contingent roles in the effects of ITBA and BDAC on strategic decision-making. Our analyses, based on two-round, multi-respondents matched survey data collected from 175 Chinese firms to elucidate the differential moderating roles of event criticality and disruption of COVID-19 in the impact of ITBA and BDAC on strategic decision speed and quality. The results indicate the event criticality of COVID-19 strengthens the effects of ITBA on decision speed and quality but weakens the influence of BDAC on decision quality. Meanwhile, the event disruption of COVID-19 weakens the influence of ITBA on decision speed and quality but strengthens the effect of BDAC on decision speed and quality. These findings have important theoretical and practical implications, which we discuss in the conclusion.

8.
Eur J Psychotraumatol ; 13(1): 2019980, 2022.
Article in English | MEDLINE | ID: covidwho-1665830

ABSTRACT

Background: As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. Objectives: This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. Methods: A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan); adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. Results: The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. Conclusions: The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion.


Antecedentes: Como una enfermedad altamente infecciosa con características de transmisión de persona a persona, el COVID-19 ha causado pánico en el público en general. Aquellos que se han recuperado del COVID-19 pueden experimentar discriminación y estigma internalizado. Es más probable que se preocupen por la interacción social y desarrollen ansiedad social.Objetivos: Este estudio investigó las asociaciones entre factores de hospitalización, factores sociales /interpersonales, factores personales y ansiedad social para revelar el mecanismo de ansiedad social en sobrevivientes de COVID-19.Métodos: Se realizó una encuesta telefónica transversal multicentro de julio a septiembre de 2020 en cinco ciudades chinas (es decir, Wuhan, Nanning, Shenzhen, Zhuhai y Dongguan). Se reclutaron sobrevivientes adultos de COVID-19 seis meses después de ser dados de alta del hospital. Se realizaron regresiones lineales y análisis de ruta basados en el modelo de estrés de minoría para probar las relaciones entre la hospitalización, los factores sociales/interpersonales, los factores personales y la ansiedad social.Resultados: La tasa de respuesta fue del 74,5% (N = 199, 55,3% mujeres). Los análisis de regresión lineal mostraron que varios factores de hospitalización, sociales/interpersonales y personales se asociaron de manera estadísticamente significativa con la ansiedad social. El análisis de ruta mostró que el modelo propuesto se ajustaba bien a los datos (χ 2 (df) = 3.196 (3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). El estigma internalizado medió completamente la asociación entre discriminación/apoyo social percibido y ansiedad social, mientras que medió parcialmente la asociación entre el estigma percibido de afiliados y ansiedad social.Conclusiones: Los resultados sugieren que los factores sociales/interpersonales y personales tienen una asociación más fuerte con la ansiedad social que los factores de hospitalización y resaltan la importancia del estigma internalizado en la comprensión de los mecanismos de estas relaciones. Los psicólogos clínicos pueden referirse a estos factores psicosociales modificables para desarrollar intervenciones eficientes para la promoción de la salud mental.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Hospitalization , Adolescent , Adult , Aged , Aged, 80 and over , China , Cross-Sectional Studies , Fear , Female , Follow-Up Studies , Humans , Male , Mental Health , Middle Aged , SARS-CoV-2 , Social Stigma , Social Support , Surveys and Questionnaires , Survivors , Young Adult
9.
European Journal of Psychotraumatology ; 13(1), 2022.
Article in English | EuropePMC | ID: covidwho-1661180

ABSTRACT

Background As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. Objectives This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. Methods A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan);adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. Results The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. Conclusions The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion. HIGHLIGHTS Internalized stigma fully mediated the effects of perceived discrimination and social support on social anxiety and partially mediated the effect of perceived affiliate stigma on social anxiety.

10.
Front Psychiatry ; 12: 773106, 2021.
Article in English | MEDLINE | ID: covidwho-1643547

ABSTRACT

COVID-19 survivors who had acute respiratory symptoms might experience prolonged post-traumatic stress disorder (PTSD) due to further rehabilitation, somatic symptoms and related distress. The conservation of resource (COR) theory is a well-developed theory to understand how people develop PTSD symptoms in traumatic events. The current study aimed to examine the potential factors of PTSD symptoms and interrelationships among this factors among COVID-19 survivors based on the COR theory. This cross-sectional telephone survey enrolled 199 COVID-19 patients (Mean age = 42.7; 53.3% females) 6 months after their hospital discharge in five Chinese cities (i.e., Wuhan, Shenzhen, Zhuhai, Dongguan, and Nanning). The results showed that 7% of participants were classified as having probable PTSD. The significant potential factors relating to PTSD symptoms included socio-demographic status, hospitalization experiences, post-hospitalization experiences, and psychological status. Besides, the proposed statistical mediation model based on the COR framework showed good model fit, χ2(df) = 17.286 (5), p = 0.004, CFI = 0.962, NNFI = 0.951, RMSEA = 0.077. Perceived resource loss/gain fully mediated the association between exposure to other patients' suffering during hospitalization and PTSD symptoms, and partially mediated the relationships from somatic symptoms/perceived impact of being infected with COVID-19 after discharge to PTSD symptoms. On the other hand, resilience was a full mediator in the relationship from ICU experience to PTSD symptoms and a partial mediator in the relationship from perceived impact to PTSD symptoms. The results provide preliminary support on applying the COR theory to understand the factors of PTSD symptoms among COVID-19 survivors. Interventions to reduce PTSD symptoms in this population can be developed based on the modifiable psychosocial mediators.

11.
Nat Med ; 26(6): 845-848, 2020 06.
Article in English | MEDLINE | ID: covidwho-1641979

ABSTRACT

We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.


Subject(s)
Antibodies, Viral/blood , Antibody Formation/drug effects , Betacoronavirus/pathogenicity , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Adult , Aged , Antibody Formation/immunology , Antiviral Agents/therapeutic use , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/immunology , Coronavirus Infections/virology , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/blood , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , SARS-CoV-2
13.
Discrete Dynamics in Nature and Society ; 2021, 2021.
Article in English | ProQuest Central | ID: covidwho-1556854

ABSTRACT

Corporate social responsibility (CSR) is the concrete practice of sustainable development at the enterprise level, emphasizing the human value in the production process. The proposal of Industry 5.0 begins to take the coordinated development between human and various production factors as one of the key points of corporate sustainable management. Therefore, this paper studies the optimization of medical enterprise’s operations management considering enterprise CSR under Industry 5.0. A mixed-integer programming (MIP) model is developed to maximize the CSR with the consideration of the impact of precision medical technologies such as surgical robots (SRs) and 3D bone printing on employee social welfare, corporate profits, social environment, and customer surplus value. An improved variable neighborhood tabu search (IVNTS) algorithm which combines the variable neighborhood tabu search (VNTS) algorithm and simulated annealing (SA) algorithm is designed to solve the model, and numerical experiments are analyzed to verify the effectiveness of the proposed IVNTS. The research aids medical enterprise to make reasonable operations management decisions, while providing a reference for the government to draft and implement related policies, thereby achieving sustainable social development.

14.
Talanta ; 239: 123086, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1556287

ABSTRACT

Asymptomatic infection of COVID-19 is a global threat for public health. Unfortunately, the study about metabolic dysregulation of asymptomatic infection is barely investigated. Here, we performed carboxylic submetabolome profiling of serum from 62 asymptomatic and 122 control individuals, by a highly sensitive chemical isotope labelling method. Twenty-one discriminative carboxylic features, including 12-hydroxyeicosatetraenoic acid, cholic acid, glycoursodeoxycholic acid and 15,16-dihydroxyoctadeca-9,12-dienoic acid were discovered to be dysregulated in asymptomatic patients. This panel containing 21 carboxylic features could accurately identify asymptomatic patients based on a random forest model, providing an accuracy of 85.7% with only 3.6% false positive rate and 7.1% false negative rate. The dysregulated metabolites found in asymptomatic patients covered several important pathways, such as arachidonic acid metabolism, synthesis of bile acid, ß-oxidation of fatty acids, activation of macrophage and platelet aggregation. This work provided valuable knowledge about serum biomarkers and molecular clues associated with asymptomatic COVID-19 patients.


Subject(s)
COVID-19 , Asymptomatic Infections , Fatty Acids , Humans , Isotope Labeling , SARS-CoV-2
15.
Sleep Med ; 91: 273-281, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1527859

ABSTRACT

BACKGROUND: Many COVID-19 survivors reported stigmatization after recovery. This study investigated the association between stigma (discrimination experiences, self-stigma and perceived affiliate stigma) and sleep quality among COVID-19 survivors six months after hospital discharge. METHODS: Participants were recovered adult COVID-19 survivors discharged between February 1 and April 30, 2020. Medical staff of five participating hospitals approached all discharged COVID-19 period during this period. A total of 199 participants completed the telephone interview during July to September, 2020. Structural equation modeling was performed to test the hypothesize that resilience and social support would mediate the associations between stigma and sleep quality. RESULTS: The results showed that 10.1% of the participants reported terrible/poor sleep quality, 26.1% reported worse sleep quality in the past week when comparing their current status versus the time before COVID-19. After adjusting for significant background characteristics, participants who had higher number of discrimination experience, perceived stronger self-stigma and stronger perceived affiliate stigma reported poorer sleep quality. Resilience and social support were positively and significantly associated with sleep quality. The indirect effect of self-stigma on sleep quality through social support and resilience was significant and negative. Perceived affiliate stigma also had a significant and negative indirect effect on sleep quality through social support and resilience. CONCLUSIONS: Various types of stigma after recovery were associated with poor sleep quality among COVID-19 survivors, while social support and resilience were protective factors. Resilience and social support mediated the associations between self-stigma/perceived affiliate stigma and sleep quality.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Adult , Hospitals , Humans , Patient Discharge , Social Support , Survivors
16.
BMC Bioinformatics ; 22(Suppl 5): 147, 2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1505775

ABSTRACT

BACKGROUND: To classify chest computed tomography (CT) images as positive or negative for coronavirus disease 2019 (COVID-19) quickly and accurately, researchers attempted to develop effective models by using medical images. RESULTS: A convolutional neural network (CNN) ensemble model was developed for classifying chest CT images as positive or negative for COVID-19. To classify chest CT images acquired from COVID-19 patients, the proposed COVID19-CNN ensemble model combines the use of multiple trained CNN models with a majority voting strategy. The CNN models were trained to classify chest CT images by transfer learning from well-known pre-trained CNN models and by applying their algorithm hyperparameters as appropriate. The combination of algorithm hyperparameters for a pre-trained CNN model was determined by uniform experimental design. The chest CT images (405 from COVID-19 patients and 397 from healthy patients) used for training and performance testing of the COVID19-CNN ensemble model were obtained from an earlier study by Hu in 2020. Experiments showed that, the COVID19-CNN ensemble model achieved 96.7% accuracy in classifying CT images as COVID-19 positive or negative, which was superior to the accuracies obtained by the individual trained CNN models. Other performance measures (i.e., precision, recall, specificity, and F1-score) obtained bythe COVID19-CNN ensemble model were higher than those obtained by individual trained CNN models. CONCLUSIONS: The COVID19-CNN ensemble model had superior accuracy and excellent capability in classifying chest CT images as COVID-19 positive or negative.


Subject(s)
COVID-19 , Deep Learning , Humans , Neural Networks, Computer , Research Design , SARS-CoV-2 , Tomography, X-Ray Computed
17.
Pharmacol Res ; 174: 105955, 2021 12.
Article in English | MEDLINE | ID: covidwho-1487920

ABSTRACT

Severe Coronavirus Disease 2019 (COVID-19) is characterized by numerous complications, complex disease, and high mortality, making its treatment a top priority in the treatment of COVID-19. Integrated traditional Chinese medicine (TCM) and western medicine played an important role in the prevention, treatment, and rehabilitation of COVID-19 during the epidemic. However, currently there are no evidence-based guidelines for the integrated treatment of severe COVID-19 with TCM and western medicine. Therefore, it is important to develop an evidence-based guideline on the treatment of severe COVID-19 with integrated TCM and western medicine, in order to provide clinical guidance and decision basis for healthcare professionals, public health personnel, and scientific researchers involved in the diagnosis, treatment, and care of COVID-19 patients. We developed and completed the guideline by referring to the standardization process of the "WHO handbook for guideline development", the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and the Reporting Items for Practice Guidelines in Healthcare (RIGHT).


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Infectious Disease Medicine/trends , Medicine, Chinese Traditional/trends , SARS-CoV-2/drug effects , Antiviral Agents/adverse effects , COVID-19/diagnosis , COVID-19/virology , Consensus , Delphi Technique , Drugs, Chinese Herbal/adverse effects , Evidence-Based Medicine/trends , Host-Pathogen Interactions , Humans , Patient Acuity , SARS-CoV-2/pathogenicity , Treatment Outcome
18.
Zhongguo Zhong Yao Za Zhi ; 46(19): 5117-5122, 2021 Oct.
Article in Chinese | MEDLINE | ID: covidwho-1485611

ABSTRACT

In order to standardize the clinical diagnosis and treatment decision-making with traditional Chinese medicine for pa-tients of coronavirus disease 2019(COVID-19) and put the latest clinical study evidence into clinical practice, the international trust-worthy traditional Chinese medicine recommendations( TCM Recs) working group started the compilation of Living Evidence-based Guideline for Combination of Traditional Chinese and Western Medicine for Treatment of COVID-19 on the basis of the standards and re-quirements of WHO handbook, GRADE and RIGHT. This proposal mainly introduces the formulation methods and processes of the living guidelines in details, such as the composition of the working group, the collection and identification of clinical issues and out-comes, the production of the living systematic review and the consensus of recommendations. The guidelines will continue to monitor the clinical study evidences of TCM in the prevention and treatment of COVID-19, and conduct regular evidence updating, retrieval and screening. When there is new study evidence, the steering committee will evaluate the possibility of the evidence to change clinical practice or previous recommendations, so as to decide whether the recommendations for the guidelines shall be implemented or upda-ted. The main criteria considered in the guideline updating are as follows:(1) There are new high-quality randomized controlled trial(RCT) evidences for TCM uninvolved in the previous edition of the guidelines;(2) as for the TCM involved in the guidelines, living sys-tematic review shows that new evidence may change the direction or strength of the existing recommendations. The specific implementation of the living evidence-based guidelines will take this proposal as the study basis and framework, in order to ensure the standardization of the formulation process and methods. This will be the first exploration of the methodology for living guidelines in the field of TCM.


Subject(s)
COVID-19/therapy , China , Evidence-Based Medicine , Humans , Medicine, Chinese Traditional , Practice Guidelines as Topic , SARS-CoV-2
19.
Aging (Albany NY) ; 13(18): 21903-21913, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1436455

ABSTRACT

The mortality rate of young female COVID-19 patients is reported to be lower than that of young males but no significant difference in mortality was found between female and male COVID-19 patients aged over 65 years, and the underlying mechanism is unknown. We retrospectively analyzed clinical characteristics and outcomes of severely ill pre- and post-menopausal COVID-19 patients and compared with age-matched males. Of the 459 patients included, 141 aged ≤55, among whom 19 died (16 males vs. 3 females, p<0.005). While for patients >55 years (n=318), 115 died (47 females vs. 68 males, p=0.149). In patients ≤55 years old, the levels of NLR, median LDH, median c-reactive protein and procalcitonin were significantly higher while the median lymphocyte count and LCR were lower in male than in female (all p<0.0001). In patients over 55, these biochemical parameters were far away from related normal/reference values in the vast majority of these patients in both genders which were in contrast to that seen in the young group. It is concluded that the mortality of severely ill pre-menopausal but not post-menopausal COVID-19 female patients is lower than age-matched male. Our findings support the notion that estrogen plays a beneficial role in combating COVID-19.


Subject(s)
COVID-19/mortality , Estrogens/metabolism , Menopause , Severity of Illness Index , Adult , Aged , Aged, 80 and over , C-Reactive Protein/metabolism , COVID-19/metabolism , Female , Gender Identity , Humans , Lymphocyte Count , Male , Middle Aged , Neutrophils/metabolism , Postmenopause , Premenopause , Procalcitonin/blood , Retrospective Studies , SARS-CoV-2 , Sex Factors
20.
Front Cell Infect Microbiol ; 11: 670823, 2021.
Article in English | MEDLINE | ID: covidwho-1399128

ABSTRACT

Objective: To analyze the epidemiological history, clinical symptoms, laboratory testing parameters of patients with mild and severe COVID-19 infection, and provide a reference for timely judgment of changes in the patients' conditions and the formulation of epidemic prevention and control strategies. Methods: A retrospective study was conducted in this research, a total of 90 patients with COVID-19 infection who received treatment from January 21 to March 31, 2020 in the Ninth People's Hospital of Dongguan City were selected as study subject. We analyzed the clinical characteristics of laboratory-confirmed patients with COVID-19, used the oversampling method (SMOTE) to solve the imbalance of categories, and established Lasso-logistic regression and random forest models. Results: Among the 90 confirmed COVID-19 cases, 79 were mild and 11 were severe. The average age of the patients was 36.1 years old, including 49 males and 41 females. The average age of severe patients is significantly older than that of mild patients (53.2 years old vs 33.7 years old). The average time from illness onset to hospital admission was 4.1 days and the average actual hospital stay was 18.7 days, both of these time actors were longer for severe patients than for mild patients. Forty-eight of the 90 patients (53.3%) had family cluster infections, which was similar among mild and severe patients. Comorbidities of underlying diseases were more common in severe patients, including hypertension, diabetes and other diseases. The most common symptom was cough [45 (50%)], followed by fever [43 (47.8%)], headache [7 (7.8%)], vomiting [3 (3.3%)], diarrhea [3 (3.3%)], and dyspnea [1 (1.1%)]. The laboratory findings of patients also included leukopenia [13(14.4%)] and lymphopenia (17.8%). Severe patients had a low level of creatine kinase (median 40.9) and a high level of D-dimer. The median NLR of severe patients was 2.82, which was higher than that of mild patients. Logistic regression showed that age, phosphocreatine kinase, procalcitonin, the lymphocyte count of the patient on admission, cough, fatigue, and pharynx dryness were independent predictors of COVID-19 severity. The classification of random forest was predicted and the importance of each variable was displayed. The variable importance of random forest indicates that age, D-dimer, NLR (neutrophil to lymphocyte ratio) and other top-ranked variables are risk factors. Conclusion: The clinical symptoms of COVID-19 patients are non-specific and complicated. Age and the time from onset to admission are important factors that determine the severity of the patient's condition. Patients with mild illness should be closely monitored to identify those who may become severe. Variables such as age and creatine phosphate kinase selected by logistic regression can be used as important indicators to assess the disease severity of COVID-19 patients. The importance of variables in the random forest further complements the variable feature information.


Subject(s)
COVID-19 , Lymphopenia , Adult , China/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
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