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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-318615

ABSTRACT

Background: To explore the changes in lymphocyte subsets and cytokine profiles in patients with coronavirus disease 2019 (COVID-19) and their relationship with disease severity. Methods: : This study included 228 patients with COVID-19 who were treated at Chongqing University Three Gorges Hospital from January 1, 2020 to February 20, 2020. The characteristics of lymphocyte subsets and cytokine profiles of severe and mild COVID-19 patients were compared. Of the 228 patients enrolled, 48 were severe patients and 180 were mild patients. Results: : Lymphocyte counts, absolute number of total T lymphocytes, CD 4+ T cells, CD 8+ T cells, and total B lymphocytes were significantly lower in severe patients (0.8×10 9 /L, 424.5×10 6 /L, 266×10 6 /L, 145.5×10 6 /L, 109.5×10 6 /L, respectively) than in mild patients (1.2×10 9 /L, 721×10 6 /L, 439.5×10 6 /L, 281.5×10 6 /L, 135×10 6 /L, respectively). A multivariate logistic regression analysis showed that age, C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR) were independent risk factors for developing into severe condition. The lymphocyte subsets decreased and cytokine profiles increased more significantly in severe patients than in mild patients. Conclusions: : CRP, NLR, and age may serve as powerful factors for early identification of severe patients.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325201

ABSTRACT

This is the first report of a successful treatment of a severe feline infectious peritonitis (FIP) case using Lianhuaqingwen (LH) capsule, a Chinese patent medicine (natural products)and it has been used for the treatment of coronavirus disease 2019. A 1-year-old cat was diagnosed FIP and presented with severe ascites, aphagia, inflammation, breathing difficulties and weight loss. Within 22 days of LH capsule treatment, all indicators of the cat eventually returned to normal, and the ascites gradually disappeared. This case report is the first description of the clinical recovery features of a cat with a systemic FCoV infection using LH capsules.

4.
Zhongguo Bingdubing Zazhi = Chinese Journal of Viral Diseases ; - (5):330, 2021.
Article in English | ProQuest Central | ID: covidwho-1567566

ABSTRACT

In the initial phase 3 clinical trial of the new coronavirus pneumonia (coronavirus disease 2019, COVID-19) vaccine, pregnant and lactating women were not included, resulting in the current effectiveness of COVID-19 vaccination in pregnant and lactating women Data on sex and safety are extremely limited. Since the end of 2020, relevant domestic and foreign government departments and academic associations have issued some consensus or guidance on the vaccination of COVID-19, including those during pregnancy, lactation or planned pregnancy (naturally or with assisted reproductive technology). Females, but due to the timing of the release and other reasons, there are different opinions on women's vaccination against COVID-19 during the special period mentioned above. This expert consensus is based on the latest research progress at home and abroad, recommendations from relevant institutions, and relevant policies and regulations in my country, and was formed after discussions by experts. Its purpose is to provide guidance on the vaccination of COVID-19 vaccines for women in my country during pregnancy, pregnancy, and lactation.

5.
Lancet Reg Health West Pac ; 19: 100335, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1561295

ABSTRACT

BACKGROUND: Consequences of reduced acute coronary syndrome (ACS) admissions during COVID-19 pandemic periods were reported by different countries. However, admissions, treatments, and prognosis of ACS during and after COVID-19 pandemic in Beijing, China was unknown. METHODS: Information on ACS admissions and heart failure (HF) admission were identified from database of Beijing Municipal Health Commission Information Center. Study period was defined as December 1, 2019 to June 30, 2020, and control period was defined as December 1, 2018 to June 30, 2019. Numbers of admission for HF during the control period, the study period, and seven months after study period were compared to evaluate the consequence of changed ACS care during the COVID-19 pandemic. FINDINGS: Admissions for ST-elevation myocardial infarction (STEMI), Non-ST-elevation myocardial infarction (Non-STEMI), and unstable angina (UAP) reduced by 38·0%, 41·0%, and 63·3% (N = 1953, 1991, 7664 between January 24, 2020 to June 30, 2020 vs. N = 3150, 3373, and 20,868 between January 24, 2019 to June 30, 2019) in study period. Percutaneous coronary intervention performed within 24 h were significantly more frequent during study period in patients with STEMI (37·9% vs. 31·7%, P<0·0001), but significantly less frequent in patients with Non-STEMI (7·9% vs. 9·5%, P = 0·049), and in patients with UAP (1·7% vs. 3·5%, P<0·0001). In-hospital mortality rates in patients with ACS were similar during the study period and the control period (3·1% vs 2·5%, P = 0·174 for STEMI; 2·7% vs 2·3%, P = 0·429 for Non-STEMI; 0·2% vs 0·1%, P = 0·222 for UAP). A fall by 23.9% for HF admissions was also observed during the seven months following the study period than equivalent period in 2019. INTERPRETATION: During COVID-19 pandemic, ACS admissions reduced significantly in Beijing; however, increase of HF admissions was not observed within seven months post-pandemic period, implying the pandemic didn't deteriorate the short-term prognosis for ACS. FUNDING: the National Natural Science Foundation of China (82,103,904), the National Key Research and Development Program of China (Grant number: 2020YFC2004803).

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294915

ABSTRACT

Background: Consequences of reduced acute coronary syndrome (ACS) admissions during COVID-19 pandemic periods were reported by different countries. However, admissions, treatments, and prognosis of ACS during and after COVID-19 pandemic in Beijing, China was unknown.Methods: Information on ACS admissions and heart failure (HF) admission were identified from database of Beijing Municipal Health Commission Information Center. Study period was defined as December 1, 2019 to June 30, 2020, and control period was defined as December 1, 2018 to June 30, 2019. Numbers of admission for HF during the control period, the study period, and 5 months after study period were compared to evaluate the consequence of changed ACS care during the COVID-19 pandemic.Findings: Admissions for ST-elevation myocardial infarction (STEMI), Non-ST-elevation myocardial infarction (Non-STEMI), and unstable angina (UAP) reduced by 38·0%, 41·0%, and 63·3% in study period. Percutaneous coronary intervention performed within 24 hours were significantly more frequent during study period in patients with STEMI ( 37·9% vs. 31·7%, P<0·0001), but significantly less frequent in patients with Non-STEMI (7·9% vs. 9·5%, P=0·049), and in patients with UAP ( 1·7% vs. 3·5%, P<0·0001). In-hospital mortality rates in patients with ACS were similar during the study period and the control period (3·1% vs 2·5%, P=0·174 for STEMI;2·7% vs 2·3%, P=0·429 for Non-STEMI;0·2% vs 0·1%, P=0·222 for UAP). A fall by 26·3% for HF admissions was also observed during the five months following the study period than equivalent period in 2019.Interpretation: During COVID-19 pandemic, ACS admissions reduced significantly in Beijing;however, increase of HF admissions was not observed within five months post-pandemic period, implying the pandemic didn’t deteriorate the prognosis for ACS.Funding Information: This work was supported by the National Natural Science Foundation of China (82103904) and the National Key Research and Development Program of China (Grant number: 2020YFC2004803). Declaration of Interests: Chang-Sheng Ma has received honoraria from Bristol-Myers Squibb (BMS), Pfizer, Johnson & Johnson, Boehringer-Ingelheim (BI) and Bayer for giving lectures. Jian-Zeng Dong has received honoraria from Johnson & Johnson for giving lectures. The remaining authors have no disclosures to report.Ethics Approval Statement: Our research protocol was approved by the Medical Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. Informed consent was waived in this study.

7.
Comput Methods Programs Biomed ; 211: 106412, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1415299

ABSTRACT

BACKGROUND: COVID-19 is a global pandemic leading to high death tolls worldwide day by day. Clinical evidence suggests that COVID-19 patients can be classified as non-severe, severe, and critical cases. In particular, studies have highlighted the relationship between lymphopenia and the severity of the illness, where CD8+ T cells have the lowest levels in critical cases. However, a quantitative understanding of the immune responses in COVID-19 patients is still missing. OBJECTIVES: In this work, we aim to elucidate the key parameters that define the course of the disease deviating from severe to critical cases. The dynamics of different immune cells are taken into account in mechanistic models to elucidate those that contribute to the worsening of the disease. METHODS: Several mathematical models based on ordinary differential equations are proposed to represent data sets of different immune response cells dynamics such as CD8+ T cells, NK cells, and also CD4+ T cells in patients with SARS-CoV-2 infection. Parameter fitting is performed using the differential evolution algorithm. Non-parametric bootstrap approach is introduced to abstract the stochastic environment of the infection. RESULTS: The mathematical model that represents the data more appropriately is considering CD8+ T cell dynamics. This model had a good fit to reported experimental data, and in accordance with values found in the literature. The NK cells and CD4+ T cells did not contribute enough to explain the dynamics of the immune responses. CONCLUSIONS: Our computational results highlight that a low viral clearance rate by CD8+ T cells could lead to the severity of the disease. This deregulated clearance suggests that it is necessary immunomodulatory strategies during the course of the infection to avoid critical states in COVID-19 patients.


Subject(s)
COVID-19 , SARS-CoV-2 , CD8-Positive T-Lymphocytes , Humans , Immunity , Pandemics
8.
China CDC Wkly ; 3(26): 553-556, 2021 Jun 25.
Article in English | MEDLINE | ID: covidwho-1282826

ABSTRACT

What is already known on this topic? The coronavirus disease 2019 (COVID-19) pandemic has disrupted the tuberculosis (TB) service system. However, the impact on TB patients in China remains unknown. What is added by this report? This report firstly addressed the impact of COVID-19 on TB patients in China. About half of TB patients did not revisit the hospital due to personal reasons. The reasons for irregular medication and postponing or cancelling examination after full treatment course were different. What are the implications for public health practice? Health education and risk communication should be strengthened for better TB patient management and treatment adherence, especially in light of the COVID-19 pandemic.

9.
Gynecology and Obstetrics Clinical Medicine ; 2021.
Article in English | ScienceDirect | ID: covidwho-1141780

ABSTRACT

At present, China is in the stage of the COVID-19 epidemic where regular prevention and control measures are required to contain the spread of disease. Reports of new sporadic cases are still widespread across China and medical personnel remain at high risk of exposure to infection. This is especially the case for medical staff working within emergency departments. Most gynecological emergency cases are complex and a high proportion require emergency surgical treatment. By referring to national regulations and requirements on COVID-19 prevention and control, and by summarizing our experiences in the battle against COVID-19 within Wuhan, this consensus report provides recommendations on the triage, reception, consultation, admission and surgical management of gynecological emergency patients. We also make suggestions for the environmental layout and disinfection and the medical waste management. This consensus aims to optimize the diagnosis and treatment process of gynecological emergency patients and reduce the exposure risk of medical staff within the current context of routine COVID-19 prevention and control.

10.
J Hematol Oncol ; 14(1): 24, 2021 02 12.
Article in English | MEDLINE | ID: covidwho-1084770

ABSTRACT

Mesenchymal stromal cells (MSCs), also known as mesenchymal stem cells, have been intensely investigated for clinical applications within the last decades. However, the majority of registered clinical trials applying MSC therapy for diverse human diseases have fallen short of expectations, despite the encouraging pre-clinical outcomes in varied animal disease models. This can be attributable to inconsistent criteria for MSCs identity across studies and their inherited heterogeneity. Nowadays, with the emergence of advanced biological techniques and substantial improvements in bio-engineered materials, strategies have been developed to overcome clinical challenges in MSC application. Here in this review, we will discuss the major challenges of MSC therapies in clinical application, the factors impacting the diversity of MSCs, the potential approaches that modify MSC products with the highest therapeutic potential, and finally the usage of MSCs for COVID-19 pandemic disease.


Subject(s)
Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/cytology , Animals , Artificial Intelligence , COVID-19/therapy , CRISPR-Cas Systems , Cell Differentiation , Cell Movement , Clinical Trials as Topic , Extracellular Vesicles/genetics , Extracellular Vesicles/immunology , Extracellular Vesicles/transplantation , Genetic Engineering/methods , Humans , Mesenchymal Stem Cell Transplantation/methods , Mesenchymal Stem Cells/immunology , Mesenchymal Stem Cells/metabolism
11.
CMAJ ; 192(47): E1585-E1596, 2020 Nov 23.
Article in French | MEDLINE | ID: covidwho-941709

ABSTRACT

CONTEXTE: On donne de façon empirique des agents antiviraux à certains patients atteints de la maladie à coronavirus 2019 (COVID-19). Dans le but d'appuyer la rédaction de lignes directrices sur la prise en charge de la COVID-19, nous avons réalisé une revue systématique des bénéfices et des préjudices associés à 7 traitements antiviraux contre cette infection. MÉTHODES: Nous avons effectué des recherches dans MEDLINE, Embase, le Cochrane Central Register of Controlled Trials (CENTRAL), PubMed et 3 bases de données chinoises (CNKI, Wanfang Data et SinoMed) jusqu'au 19 avril 2020, dans medRxiv et ChinaXiv jusqu'au 27 avril 2020, ainsi que dans Chongqing VIP jusqu'au 30 avril 2020. Nous avons sélectionné des études sur la ribavirine, la chloroquine, l'hydroxychloroquine, l'umifénovir (Arbidol), le favipiravir, l'interféron et le lopinavir/ritonavir. Lorsqu'il n'y avait pas de données directes d'études sur la COVID-19, nous avons retenu des données indirectes d'études sur le syndrome respiratoire aigu sévère (SRAS) et le syndrome respiratoire du Moyen-Orient (SRMO) pour l'analyse de l'efficacité, et d'études sur d'autres infections respiratoires virales aiguës pour l'analyse de l'innocuité. RÉSULTATS: Le taux de décès chez les patients atteints d'une forme sans signe clinique de gravité de COVID-19 était extrêmement bas, ce qui ne permet pas de conclure à un effet important sur la mortalité. Nous n'avons obtenu que des données de très faible qualité indiquant que la plupart des traitements avaient peu ou pas de bénéfices sur les paramètres à l'étude, quelle que soit la gravité de la COVID-19. Seule exception : le traitement au lopinavir/ritonavir, pour lequel nous avons obtenu des données de faible qualité faisant état d'une réduction de la durée du séjour en unité de soins intensifs (différence des risques [DR] 5 jours de moins, intervalle de confiance [IC] de 95 % 0 à 9 jours) et de la durée d'hospitalisation (DR 1 jour de moins, IC de 95 % 0 à 2 jours). En ce qui concerne l'innocuité, les données étaient de faible ou de très faible qualité, sauf pour le traitement au lopinavir/ritonavir, où des données de qualité moyenne laissaient supposer une augmentation probable de la diarrhée, des nausées et des vomissements. INTERPRÉTATION: À l'heure actuelle, rien ne prouve de façon convaincante que les traitements antiviraux apportent des bénéfices importants dans la lutte contre la COVID-19, bien que les données propres à chaque traitement n'excluent pas cette possibilité. D'autres essais randomisés et contrôlés menés auprès de patients atteints de la COVID-19 sont nécessaires avant de pouvoir recourir à ces traitements en toute confiance.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Pandemics , SARS-CoV-2 , COVID-19/epidemiology , Humans , Treatment Outcome
12.
CMAJ ; 192(27): E734-E744, 2020 07 06.
Article in English | MEDLINE | ID: covidwho-661875

ABSTRACT

BACKGROUND: Antiviral medications are being given empirically to some patients with coronavirus disease 2019 (COVID-19). To support the development of a COVID-19 management guideline, we conducted a systematic review that addressed the benefits and harms of 7 antiviral treatments for COVID-19. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and 3 Chinese databases (CNKI, WANFANG and SinoMed) through Apr. 19, medRxiv and Chinaxiv through Apr. 27, and Chongqing VIP through Apr. 30, 2020. We included studies of ribavirin, chloroquine, hydroxychloroquine, umifenovir (arbidol), favipravir, interferon and lopinavir/ritonavir. If direct evidence from COVID-19 studies was not available, we included indirect evidence from studies of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) for efficacy outcomes and other acute respiratory viral infections for safety outcomes. RESULTS: In patients with nonsevere COVID-19 illness, the death rate was extremely low, precluding an important effect on mortality. We found only very low-quality evidence with little or no suggestion of benefit for most treatments and outcomes in both nonsevere and severe COVID-19. An exception was treatment with lopinavir/ritonavir, for which we found low-quality evidence for a decrease in length of stay in the intensive care unit (risk difference 5 d shorter, 95% confidence interval [CI] 0 to 9 d) and hospital stay (risk difference 1 d shorter, 95% CI 0 to 2 d). For safety outcomes, evidence was of low or very low quality, with the exception of treatment with lopinavir/ritonavir for which moderate-quality evidence suggested likely increases in diarrhea, nausea and vomiting. INTERPRETATION: To date, persuasive evidence of important benefit in COVID-19 does not exist for any antiviral treatments, although for each treatment evidence has not excluded important benefit. Additional randomized controlled trials involving patients with COVID-19 will be needed before such treatments can be administered with confidence.


Subject(s)
Antiviral Agents , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Influenza, Human/drug therapy , Lopinavir/pharmacology , Pneumonia, Viral/drug therapy , Amides , Antiviral Agents/pharmacology , COVID-19 , Chloroquine , Evidence-Based Medicine , Humans , Hydroxychloroquine , Indoles , Observational Studies as Topic , Pandemics , Pyrazines , Ribavirin , Ritonavir , SARS-CoV-2
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