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1.
J Ethnopharmacol ; : 115763, 2022.
Article in English | PubMed | ID: covidwho-2049460

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Acute lung injury (ALI) is one of the fatal complications of respiratory virus infections such as influenza virus and coronavirus, which has high clinical morbidity and mortality. Jinhua Qinggan granules (JHQG) has been approved by China Food and Drug Administration in the treatment of H1N1 influenza and mild or moderate novel coronavirus disease 2019 (COVID-19), which is an herbal formula developed based on Maxingshigan decoction and Yinqiao powder that have been used to respiratory diseases in China for thousands of years. However, the underlying mechanism of JHQG in treating infectious diseases remains unclear. AIM OF THE STUDY: This study investigated the effects of JHQG on neutrophil apoptosis and key signaling pathways in lipopolysaccharide (LPS) -induced ALI mice in order to explore its mechanism of anti-inflammation. MATERIALS AND METHODS: The effect of JHQG on survival rate was observed in septic mouse model by intraperitoneal injection of LPS (20 mg/kg). To better pharmacological evaluation, the mice received an intratracheal injection of 5 mg/kg LPS. Lung histopathological changes, wet-to-dry ratio of the lungs, and MPO activity in the lungs and total protein concentration, total cells number, TNF-α, IL-1β, IL-6, and MIP-2 levels in BALF were assessed. Neutrophil apoptosis rate was detected by Ly6G-APC/Annexin V-FITC staining. Key proteins associated with apoptosis including caspase 3/7 activity, Bcl-xL and Mcl-1 were measured by flow cytometry and confocal microscope, respectively. TLR4 receptor and its downstream signaling were analyzed by Western blot assay and immunofluorescence, respectively. RESULTS: JHQG treatment at either 6 or 12 g/kg/day resulted in 20% increase of survival in 20 mg/kg LPS-induced mice. In the model of 5 mg/kg LPS-induced mice, JHQG obviously decreased the total protein concentration in BALF, wet-to-dry ratio of the lungs, and lung histological damage. It also attenuated the MPO activity and the proportion of Ly6G staining positive neutrophils in the lungs, as well as the MIP-2 levels in BALF were reduced. JHQG inhibited the expression of Mcl-1 and Bcl-xL and enhanced caspase-3/7 activity, indicating that JHQG partially acted in promoting neutrophil apoptosis via intrinsic mitochondrial apoptotic pathway. The levels of TNF-α, IL-1β, and IL-6 were significantly declined in LPS-induced mice treated with JHQG. Furthermore, JHQG reduced the protein expression of TLR4, MyD88, p-p65 and the proportion of nuclei p65, suggesting that JHQG treatment inhibited TLR4/MyD88/NF-κB pathway. CONCLUSION: JHQG reduced pulmonary inflammation and protected mice from LPS-induced ALI by promoting neutrophil apoptosis and inhibition of TLR4/MyD88/NF-κB pathway, suggesting that JHQG may be a promising drug for treatment of ALI.

2.
Fundamental Research ; 2(3):476-486, 2022.
Article in English | Web of Science | ID: covidwho-2041756

ABSTRACT

Global pandemics such as COVID-19 have resulted in significant global social and economic disruption. Although polymerase chain reaction (PCR) is recommended as the standard test for identifying the SARS-CoV-2, conventional assays are time-consuming. In parallel, although artificial intelligence (AI) has been employed to contain the disease, the implementation of AI in PCR analytics, which may enhance the cognition of diagnostics, is quite rare. The information that the amplification curve reveals can reflect the dynamics of reactions. Here, we present a novel AI-aided on-chip approach by integrating deep learning with microfluidic paper-based analytical devices (mu PADs) to detect synthetic RNA templates of the SARS-CoV-2 ORFlab gene. The mu PADs feature a multilayer structure by which the devices are compatible with conventional PCR instruments. During analysis, real-time PCR data were synchronously fed to three unsupervised learning models with deep neural networks, including RNN, LSTM, and GRU. Of these, the GRU is found to be most effective and accurate. Based on the experimentally obtained datasets, qualitative forecasting can be made as early as 13 cycles, which significantly enhances the efficiency of the PCR tests by 67.5% (similar to 40 min). Also, an accurate prediction of the end-point value of PCR curves can be obtained by GRU around 20 cycles. To further improve PCR testing efficiency, we also propose AI-aided dynamic evaluation criteria for determining critical cycle numbers, which enables real-time quantitative analysis of PCR tests. The presented approach is the first to integrate AI for on-chip PCR data analysis. It is capable of forecasting the final output and the trend of qPCR in addition to the conventional end-point Cq calculation. It is also capable of fully exploring the dynamics and intrinsic features of each reaction. This work leverages methodologies from diverse disciplines to provide perspectives and insights beyond the scope of a single scientific field. It is universally applicable and can be extended to multiple areas of fundamental research.

3.
Annals of Oncology ; 33:S958, 2022.
Article in English | EMBASE | ID: covidwho-2041540

ABSTRACT

Background: Surufatinib (a small-molecule inhibitor of VEGFR1-3, FGFR1, and CSF-1R) has exhibited encouraging antitumor activity for the treatment of advanced neuroendocrine tumors (including NEN and NEC) in multiple registration studies. Here, we report the preliminary results of advanced neuroendocrine tumors of an ongoing, multicenter, real-world study of surufatinib + MDT (ChiCTR2100049999). Challenges in tumor clinical trials management in the face of the COVID-19 resurgence period in Shanghai. Methods: In this multicenter, single-arm real-world study, adults (18-80) with advanced neuroendocrine tumors (including NEN and NEC) were eligible and received surufatinib (300mg orally, QD) with MDT(multidisciplinary collaborative diagnosis and treatment). The primary endpoint was progression-free survival (PFS) per RECIST 1.1. We minimized the interruptions caused by the pandemic using telemedicine platforms for all patients. This included online consultations, follow-up drug distributions, and health management services. Results: Twenty-three pts were enrolled, with 20 NEN and 3 NEC. At the data cutoff date (April 10, 2022), 15 pts had at least one post-baseline tumor assessment;of them, the confirmed ORR (95%CI) was 20% (4.3-48.1), and DCR (95%CI) was 93.33% (68.1-99.8). Median PFS (mPFS) (95%CI): 10.640 mo (3.796-17.484);median OS: not reached and median duration of follow up was 6.870 mo (6.797-6.943). A pNET patient (NO. 010007) was interrupted by asymptomatic COVID-19 infection 9 mo after enrollment. There are no interruptions caused by COVID-19 for other patients. An NEC patient treated with single agent had a 5.85 mo PFS, evaluated as NE, in whom target lesion resected after baseline. In overall pts (n=23), most commonly (≥3 pts) with hemorrhage, anemia, hypertension, proteinuria, and abdominal pain. Three pts had TRAEs that led to treatment discontinuation. Conclusions: Surufatinib + MDT exhibited promising efficacy and manageable toxicity in pts with advanced neuroendocrine tumors. Now and in the future, it is necessary to design regulatory changes in telehealth adoption for clinical trial design in the pandemic era. Clinical trial identification: ChiCTR2100049999. Legal entity responsible for the study: The authors. Funding: Hutchison MediPharma Limited. Disclosure: All authors have declared no conflicts of interest.

4.
ASAIO Journal ; 68:66, 2022.
Article in English | EMBASE | ID: covidwho-2032186

ABSTRACT

Background: SARS-CoV-2 (i.e., COVID-19) has brought extracorporeal membrane oxygenation (ECMO) into the forefront of critical care. Its unique pathophysiology has added a level of complexity to ECMO therapy, particularly, the hematologic manifestations. Here we detail the spectrum and outcomes of bleeding complications in ECMO for COVID-19 and identify potential contributing factors. Methods: All patients who received ECMO for SARS-CoV-2 pneumonia severe acute respiratory distress syndrome at our institution between March 1, 2020 and April 12, 2021 were reviewed. Patient characteristics, laboratory results, and overall outcomes were recorded. Bleeding events were reviewed with regard to the type/location and intervention required. Severity was graded according to the degree of intervention for treatment (1 [conservative or minor] - 3 [major, life-threatening, or operative]). Laboratory results and patient characteristics were compared between patients with bleeding events and those without to identify factors associated with bleeding risk. Results: Fifty-four patients (mean age 53.2 years, 61.1% female, 51.9% Caucasian) underwent ECMO cannulation for SARSCoV-2 pneumonia at our institution. Thirty-eight (70.4%) received veno-pulmonary artery ECMO. The mean duration of support was 33.2 days with an in-hospital mortality of 42.6%. 68.5% of patients experienced at least one bleeding event during their ECMO course with 92 bleeding events (n=23 [grade 1], n=31 [grade 2], n=38 [grade 3]) over 1804 cannulation days. The most common types of bleeding types were nasal/oropharyngeal (n=30, 32.6%), pulmonary (n=18, 19.6%), and gastrointestinal (n=11, 12.0%). Eight (16.0%) patients required operative intervention and 11 (20.3%) died as a result of a bleeding event, mainly due to intracranial hemorrhages (n=5, 9.3%). There was no difference in the mean cumulative function for bleeding events between different ECMO support modalities (p=0.85) which demonstrated a linear pattern over time. Factors that increased the risk of bleeding included patient cumulative volume balance (OR 1.22 per 1000 mL increase from admission, p<0.001) while higher platelet count (OR 0.83 per 50x103/uL increase, p=0.03) was protective. Conclusion: ECMO for SARS-CoV-2 pneumonia is associated with a diverse and unique profile of bleeding complications. The incidence of bleeding complications is linearly related to cannulation duration. Certain patient factors may affect the risk of bleeding while on ECMO.

5.
Materials Chemistry Frontiers ; : 14, 2022.
Article in English | Web of Science | ID: covidwho-1984453

ABSTRACT

Bacterial infection is a major threat to public health around the world. Currently, antibiotics remain the most extensive mode of medical treatment for bacterial infection. However, the overuse and misuse of antibiotics have exacerbated the emergence of antibiotic-resistant strains, especially during the COVID-19 pandemic. In addition, the improper and excessive use of biocides and disinfectants has a catastrophic impact on antibiotic management plans worldwide. Therefore, there is an urgent need for alternative antibacterial treatments to alleviate this crisis. In recent years, nanozymes have become promising new antibacterial agents because of their broad-spectrum antibacterial activity, less drug resistance, and high stability. This review focuses on the classification of nanozymes and research progress of nanozymes as antibacterial agents, as well as perspectives for future research in this field.

6.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-337392

ABSTRACT

The coronavirus disease 2019 (COVID-19) has been ravaging throughout the world for more than two years and has severely impaired both human health and the economy. The causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs the viral RNA-dependent RNA polymerase (RdRp) complex for genome replication and transcription, making RdRp an appealing target for antiviral drug development. Here, we reveal that RdRp can recognize and utilize nucleoside diphosphates (NDPs) as a substrate to synthesize RNAs with an efficiency of about two thirds of using nucleoside triphosphates (NTPs) as a substrate. NDPs incorporation is also template-specific and has high fidelity. Moreover, RdRp can incorporate β-d-N4-hydroxycytidine (NHC) into RNA while using diphosphate form molnupiravir (MDP) as a substrate. We also observed that MDP is a better substrate for RdRp than the triphosphate form molnupiravir (MTP).

7.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333502

ABSTRACT

INTRODUCTION: the current worldwide outbreak of Coronavirus disease 2019 (COVID-19) due to a novel coronavirus (SARS-CoV-2) is seriously threatening the public health. The number of infected patients is continuously increasing and the need for Intensive Care Unit admission ranges from 5 to 26%. The mortality is reported to be around 3.4% with higher values for the elderly and in patients with comorbidities. Moreover, this condition is challenging the healthcare system where the outbreak reached its highest value. To date there is still no available treatment for SARS-CoV-2. Clinical and preclinical evidence suggests that nitric oxide (NO) has a beneficial effect on the coronavirus-mediated acute respiratory syndrome, and this can be related to its viricidal effect. The time from the symptoms' onset to the development of severe respiratory distress is relatively long. We hypothesize that high concentrations of inhaled NO administered during early phases of COVID-19 infection can prevent the progression of the disease. METHODS AND ANALYSIS: This is a multicenter randomized controlled trial. Spontaneous breathing patients admitted to the hospital for symptomatic COVID-19 infection will be eligible to enter the study. Patients in the treatment group will receive inhaled NO at high doses (140-180 parts per million) for 30 minutes, 2 sessions every day for 14 days in addition to the hospital care. Patient in the control group will receive only hospital care. The primary outcome is the percentage of patients requiring endotracheal intubation due to the progression of the disease in the first 28 days from enrollment in the study. Secondary outcomes include mortality at 28 days, proportion of negative test for SARS-CoV-2 at 7 days and time to clinical recovery. ETHICS AND DISSEMINATION: The trial protocol has been approved at the Investigation Review Boards of Xijing Hospital (Xi'an, China) and The Partners Human Research Committee of Massachusetts General Hospital (Boston, USA) is pending. Recruitment is expected to start in March 2020. Results of this study will be published in scientific journals, presented at scientific meetings, and on related website or media in fighting this widespread contagious disease.

8.
Economic Change and Restructuring ; : 27, 2022.
Article in English | Web of Science | ID: covidwho-1616188

ABSTRACT

COVID-19 pandemic and its recovery bring opportunities and threats for global climate governance and further challenge climate related assets. In this study, we analyze the efficiency of government response policies and fiscal policies on green recovery by observing the variation characteristics of carbon allowance prices in the EU emission trading system (EU ETS). Using the OLS and threshold methods in the original time scales, we find that: (1) The EUA prices had an inverted U-shaped relationship with the number of new confirmed cases and deaths. (2) Government response policies had a better effect than fiscal policies when mitigating the negative impact of the pandemic. After decomposing and reconstructing the time series, the multiscale analysis indicates that: (3) The carbon price fluctuated in the short term with the increasing number of newly confirmed cases (or deaths) but gradually recovered due to the recovery policies. (4) Government response policies had a "stop-loss" effect in the short term, and then working alongside fiscal policies, sustained and promoted the development of the EU ETS and green recovery. In the post-COVID-19 era, we suggest the combination of various policies to convert the current health crisis into opportunities for climate change mitigation.

9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(12): 2088-2095, 2021 Dec 10.
Article in Chinese | MEDLINE | ID: covidwho-1600051

ABSTRACT

Objective: To understand the epidemiological characteristics of three local COVID-19 epidemics in Guangzhou and provide reference for optimizing strategies and measures of COVID-19 prevention and control. Methods: The data of local COVID-19 cases in Guangzhou reported as of June 18, 2021 were collected from National Notifiable Disease Report System of China. The software Excel 2019 and SPSS 22.0 were applied for data cleaning and statistical analysis. Results: A total of 726 COVID-19 cases were reported in the three local epidemics in Guangzhou. In the epidemic associated with the outbreak of COVID-19 in Hubei province, 366 cases were reported. Most cases were female (51.6%, 189/366), aged 18-65 years (81.4%, 298/366), jobless/unemployed (32.2%, 118/366) and retired persons (20.2%,74/366). The initial symptoms of most cases were fever (71.6%, 250/349) and cough (60.7%, 212/349). In the epidemic associated with the imported COVID-19 cases from Africa, 207 cases were reported. Most cases were aged 18-40 years (72.9%, 151/207), male (69.6%, 144/207), and engaged in commercial services (62.3%,129/207). The initial symptoms of most cases were no obvious discomfort (55.6%, 15/27) and cough (37.0%, 10/27). In the epidemic associated with Delta variant of SARS-CoV-2, 153 cases were reported, in which women accounted for 58.8% (90/153), most cases were over 41 years old (64.7%,99/153), and retired persons accounted for the highest proportion (32.0%,49/153). The initial symptoms of most cases were cough (32.9%, 48/146) and no obvious discomfort (28.1%, 41/146). The household secondary attack rates of the three local epidemics were 11.2%, 5.7% and 11.5%, respectively. The median (P25, P75) of incubation periods were 6.5 (4.0,10.8) d, 4.0 (2.5, 6.0) d and 4.0 (3.0,5.0) d. The serial intervals median (P25, P75) were 4.0 (3.0, 8.0) d, 4.0 (2.5, 6.0) d and 3.0 (2.0,5.0) d. There were significant differences in gender, age, occupation, initial symptoms, household secondary attack rate and incubation period among the three local COVID-19 epidemics (all P<0.05). In the proportion of the case finding way, passive detection in patient treatment were mainly 44.3%(162/366) in the epidemic associated with the outbreak of COVID-19 in Hubei province,but active community case screening [58.5% (121/207) and 27.5% (24/153)] and close contact management in imported case were mostly [33.3% (69/207) and 67.3% (103/153)] in the epidemic associated with the imported COVID-19 cases from Africa and with Delta variant of SARS-CoV-2, respectively. Conclusions: Due to the different sources of infection, strain types and prevention and control strategies, the epidemiological characteristics of the three local COVID-19 epidemics in Guangzhou differed in demographics, clinical symptoms, transmission routes and case finding, which suggested that it is necessary to improve the key population and common symptom monitoring in the routine prevention and control of COVID-19 to prevent the reemerge of the epidemic.


Subject(s)
COVID-19 , Epidemics , Adult , China/epidemiology , Female , Humans , Male , SARS-CoV-2
10.
PUBMED; 2021.
Preprint in English | PUBMED | ID: ppcovidwho-293027

ABSTRACT

As SARS-CoV-2 continues to cause morbidity and mortality around the world, there is an urgent need for the development of effective medical countermeasures. Here, we assessed the antiviral capacity of a minimal RIG-I agonist, stem-loop RNA 14 (SLR14), in viral control, disease prevention, post-infection therapy, and cross-variant protection in mouse models of SARS-CoV-2 infection. A single dose of SLR14 prevented viral replication in the lower respiratory tract and development of severe disease in a type I interferon (IFN-I) dependent manner. SLR14 demonstrated remarkable protective capacity against lethal SARS-CoV-2 infection when used prophylactically and retained considerable efficacy as a therapeutic agent. In immunodeficient mice carrying chronic SARS-CoV-2 infection, SLR14 elicited near-sterilizing innate immunity by inducing IFN-I responses in the absence of the adaptive immune system. In the context of infection with variants of concern (VOC), SLR14 conferred broad protection and uncovered an IFN-I resistance gradient across emerging VOC. These findings demonstrate the therapeutic potential of SLR14 as a host-directed, broad-spectrum antiviral for early post-exposure treatment and for treatment of chronically infected immunosuppressed patients.

11.
Sci Immunol ; 6(65): eabk1741, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1443345

ABSTRACT

Severe coronavirus disease 2019 (COVID-19) pneumonia survivors often exhibit long-term pulmonary sequelae, but the underlying mechanisms or associated local and systemic immune correlates are not known. Here, we have performed high-dimensional characterization of the pathophysiological and immune traits of aged COVID-19 convalescents, and correlated the local and systemic immune profiles with pulmonary function and lung imaging. We found that chronic lung impairment was accompanied by persistent respiratory immune alterations. We showed that functional severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)­specific memory T and B cells were enriched at the site of infection compared with those of blood. Detailed evaluation of the lung immune compartment revealed that dysregulated respiratory CD8+ T cell responses were associated with the impaired lung function after acute COVID-19. Single-cell transcriptomic analysis identified the potential pathogenic subsets of respiratory CD8+ T cells contributing to persistent tissue conditions after COVID-19. Our results have revealed pathophysiological and immune traits that may support the development of lung sequelae after SARS-CoV-2 pneumonia in older individuals, with implications for the treatment of chronic COVID-19 symptoms.


Subject(s)
B-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , COVID-19/microbiology , Immunologic Memory , Lung/immunology , SARS-CoV-2/immunology , B-Lymphocytes/pathology , CD8-Positive T-Lymphocytes/pathology , COVID-19/pathology , Female , Humans , Lung/pathology , Lung/virology , Male , Middle Aged
12.
2nd International Conference on Neural Computing for Advanced Applications, NCAA 2021 ; 1449:154-165, 2021.
Article in English | Scopus | ID: covidwho-1437240

ABSTRACT

The 2019 Coronavirus Disease (COVID-19), with the characteristics of rapid onset, strong infectivity, fast transmission and wide susceptibility, has quickly swept China since its appearance in Wuhan, Hubei province. COVID-19 spreads among people mainly by movement and close contact. Railway plays an important role in transport people national-wide as its essential role in public transportation, which conduced to the spreading of COVID-19 from Hubei province to other provinces in some sense. Inspired by this, this paper collected the data of Trains with Infectors (TwI) reported by the national health commission of the People’s Republic of China. Then the spreading of COVID-19 via railway network with the concept of complex network is analyzed. Results show that nodes with higher centrality tends to provide more TwI, and the closure of Wuhan railway station significantly prevents the spreading of COVID-19. © 2021, Springer Nature Singapore Pte Ltd.

13.
2nd International Conference on Education, Knowledge and Information Management, ICEKIM 2021 ; : 233-237, 2021.
Article in English | Scopus | ID: covidwho-1345852

ABSTRACT

Online education is a new educational pattern relying on netwok, Which adds flexibility and availability, regards of time, place, or pace of learning. Best of all, with online education, we can stick to our jobs and at the same time study and absorb the latest knowledge. AI, big data and 5G are the scinetific technology which lead the online education industry to decelop into a richer ecosystem and make Online education promote its advantages. In the second half of 2020, the COVID-19 pandemic in China has been under control, and China's online education will face both opportunities and challenges. This paper mainly adopts the method of questionnaire survey analysis, SPSS 20.0 statistical software and PLS to analyze the influencing factors of China's online education in the post-epidemic era. Finding that the education level, income level, education level and the purpose of the education have positive effect on online education, the education cost of online education has the reverse effect, the lower the price of online education, the larger the quantity of online education that will be demanded. At the same time, this paper finds that when students spend more time in online classes and the fewer exams they pass, the more students spend on online education platforms. According to the results, some countermeasures and suggestions are put forward. © 2021 IEEE.

14.
Strategic Design Research Journal ; 13(3):511-524, 2020.
Article in English | Scopus | ID: covidwho-1289094

ABSTRACT

At the start of the COVID-19 outbreak, many countries lacked personal protective equipment (PPE) to protect healthcare workers. To address this problem, open design and 3D printing technologies were adopted to provide much-in-need PPEs for key workers. This paper reports an initiative by designers and engineers in the UK and China. The case study approach and content analysis method were used to study the stakeholders, the design process, and other relevant issues such as regulation. Good practice and lessons were summarised, and suggestions for using distributed 3D printing to supply PPEs were made. It concludes that 3D printing has played an important role in producing PPEs when there was a shortage of supply, and distributed manufacturing has the potential to quickly respond to local small-bench production needs. In the future, clearer specification, better match of demands and supply, and quicker evaluation against relevant regulations will provide efficiency and quality assurance for 3D printed PPE supplies. © 2020 Universidade do Vale do Rio dos Sinos. All rights reserved.

15.
Jama Internal Medicine ; 181(5):727-727, 2021.
Article in English | Web of Science | ID: covidwho-1241424
16.
The International Journal of High Performance Computing Applications ; : 10943420211010930, 2021.
Article in English | Sage | ID: covidwho-1223726

ABSTRACT

We improved the quality and reduced the time to produce machine learned models for use in small molecule antiviral design. Our globally asynchronous multi-level parallel training approach strong scales to all of Sierra with up to 97.7% efficiency. We trained a novel, character-based Wasserstein autoencoder that produces a higher quality model trained on 1.613 billion compounds in 23 minutes while the previous state of the art takes a day on 1 million compounds. Reducing training time from a day to minutes shifts the model creation bottleneck from computer job turnaround time to human innovation time. Our implementation achieves 318 PFLOPs for 17.1% of half-precision peak. We will incorporate this model into our molecular design loop enabling the generation of more diverse compounds;searching for novel, candidate antiviral drugs improves and reduces the time to synthesize compounds to be tested in the lab.

17.
Chinese Journal of Anesthesiology ; 40(3):275-280, 2020.
Article in Chinese | Scopus | ID: covidwho-1061456

ABSTRACT

Obstetric anesthesia is an important part of clinical anesthesia during the coronavirus disease 2019(COVID-19 )epidemic. Obstetric anesthesia management faces challenges such as difficulty in evaluation, in managing patients with emergent or fluctuating conditions, and in taking care of both the mother and the fetus/newborn.Obstetric anesthesia should focus on the following aspects.First, detailed evaluation of COVID-19 should be carried out.Except for epidemic-related evaluation, the effect of physiologic changes during pregnancy and complex condition of the parturient and critical condition on COVID-19 evaluation should be considered.The possible effects of maternal lung conditions on the fetus should be paid attention to simultaneously to determine the optimal timing for delivery, delivery mode and degree of protection.Second, tight infection control of the environment, staff and devices is necessary.Delivery of the suspected or diagnosed cases of novel coronavirus infection should be performed in an isolation delivery room or in a negative pressure operating room.Anesthetic personnel should be minimized, and skilled anesthetists should be arranged in priority.Medical staff should wear personal protective equipment according to standards.Third, the keypoint of optimizing anesthesia management is to maintain sufficient oxygenation and stable circulation.For neuraxial anesthesia, coughing and hypotension should be minimized.For general anesthesia, protection from infection during airway management is essential.Fourth, humanistic care should be implemented, and psychological health education and psychological crisis intervention should be conducted for parturients.Fifth, though no evidence supported the vertical transmission yet, the newborn of the suspected or diagnosed mother of novel coronavirus infection should be isolated, and breastfeeding is not permitted until the mother recover.To minimize the risk of infection and optimize clinical safety, multi-discipline-based teamwork by the obstetricians, anesthetists, neonatologists, infect-control experts and intensive care unit staff on infection control and maternal-fetal management is important. © 2020 Chinese Medical Association

18.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-6292

ABSTRACT

Severe Acute Respiratory Syndrome- Coronavirus 2 (SARS-Cov-2) has caused over 5,000,000 cases of Coronavirus disease (COVID-19) with significant fatality rate. Due to the urgency of this global pandemic, numerous therapeutic and vaccine trials have begun without customary safety and efficacy studies. Laboratory mice have been the stalwart of these types of studies;however, they do not support infection by SARS-CoV-2 due to the inability of its spike (S) protein to engage the mouse ortholog of its human entry receptor angiotensin-converting enzyme 2 (hACE2). While hACE2 transgenic mice support infection and pathogenesis, these mice are currently limited in availability and are restricted to a single genetic background. Here we report the development of a mouse model of SARS-CoV-2 based on adeno associated virus (AAV)-mediated expression of hACE2. These mice support viral replication and antibody production and exhibit pathologic findings found in COVID-19 patients as well as non-human primate models. Moreover, we show that type I interferons are unable to control SARS-CoV2 replication and drive pathologic responses. Thus, the hACE2-AAV mouse model enables rapid deployment for in-depth analysis following robust SARS-CoV-2 infection with authentic patient-derived virus in mice of diverse genetic backgrounds. This represents a much-needed platform for rapidly testing prophylactic and therapeutic strategies to combat COVID-19. Funding: This study was supported by awards from National Institute of Health grants, 2T32AI007517-16 (to BI), T32GM007205 and F30CA239444 (to ES), AI054359 and AI127429 (to AI), T32AI007019 (to TM),K08 AI128043 (to CBW), as well as Women's Health Research at Yale Pilot Project Program (AI, AR), Fast Grant from Emergent Ventures at the Mercatus Center (AI, ES), Mathers Foundation (AR, CBW, AI), and the Ludwig Family Foundation (AI, AR, CBW). A.I. is an investigator of the Howard Hughes Medical Institute. Conflict of Interest: None of the authors declare interests related to the manuscript. Ethical Approval: All procedures were performed in a BSL-3 facility (for SARS-CoV-2 infected mice) with approval from the Yale Environmental Health and Safety office.

19.
MicroTAS - Int. Conf. Miniaturized Syst. Chem. Life Sci. ; : 474-475, 2020.
Article in English | Scopus | ID: covidwho-1001382

ABSTRACT

Novel microfluidic paper-based analytical devices (μPADs) were developed for qualitatively detecting biological pathogens. 32 reaction units for parallelized nucleic acid analysis were built on a single device. Also, an integrated system including modules of on-chip heating, temperature control, ultraviolet illumination and nucleic acid detection were designed and constructed. We first demonstrated the performance of the devices by detecting synthesized templates using Eiken loop-mediated isothermal amplification (LAMP) kit. Furthermore, the utility of the devices, system and protocols were verified by clinical tests. Multiple samples from COVID-19 cases were concurrently identified within 15 minutes using TianDZ RT-LAMP kit. © 2020 CBMS-0001

20.
Chinese Pharmacological Bulletin ; 36(4):459-469, 2020.
Article in Chinese | EMBASE | ID: covidwho-904677

ABSTRACT

The outbreaks of severe acute respiratory syndrome (SARS) in February 2003 in Guangdong, China, middle east respiratory syndrome (MERS) in September2012 in Kingdom of Saudi Arabia, and the current COVID-19 pandemics in December 2019 in Wuhan, China, are all caused by coronaviruses, and patients primarily died of acute respiratory distress syndrome (ARDS). Compared with more than 5 years of wreaking havoc from MERS-CoV and Ebor, China successfully contains the SARS-CoV within one year, which shows her advantages in political governance controlling such pandemics. Many coronaviruses have been separated and their molecular structures analyzed. However, there is no specific anti-coronavirus drug developed in the world since the outbreaks. The problems come from not only pharmaceutical technology per se that must treat both coronaviruses and their life-threatening ARDS, but also the small size of patients who could immune against the coronaviruses after infections resulting in pharmaceutical reluctance to invest in the area. Facing both the pharmaceutical and social-economic bottlenecks, here, we summarized the current development of anti-coronavirus drugs, and proposed the strategies of repurposing existing drugs and preparing their pharmacological combinations to fight the viruses including COVID-19 based on a well-understanding of how the coronaviruses enter the host and damage our respiratory system.

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