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Open Forum Infectious Diseases ; 8(SUPPL 1):S267, 2021.
Article in English | EMBASE | ID: covidwho-1746669

ABSTRACT

Background. The data on CAPA in the U.S. are limited to date and clinical characteristics unique to this phenomenon have not been widely reported. Methods. This retrospective observational study was conducted at multiple VA hospitals across southern California and Arizona. CAPA cases were identified in inpatients with laboratory-confirmed COVID-19 based on microbiologic or serologic evidence of aspergillosis and pulmonary abnormalities on imaging, and were classified according to ECMM/ISHAM consensus definitions. Characteristics of interest included immunosuppressive/modulatory agents used prior to onset of CAPA, COVID-19 disease course, length of hospitalization, and mortality. Results. Seventeen patients with probable (18%) or possible (82%) CAPA were identified from April 2020 to March 2021. Values below reported as medians. All patients were male and 13 (76%) were white, with age 74 years and BMI 26 kg/m2. Baseline comorbidities included diabetes mellitus (47%), cardiovascular disease (65%), and pulmonary disease (71%). Evidence of aspergillosis was mostly based on respiratory culture, with mainly A. fumigatus (75%). Systemic corticosteroids were used in 14 patients, with a total dose of 400 mg prednisone equivalents starting 10 days prior to Aspergillus detection. Patients also received tocilizumab (18%), leflunomide (6%), tacrolimus (6%), mycophenolate (6%), and investigational agent LSALT or placebo (6%);2 patients (12%) did not receive any immunosuppression/modulation. Length of hospitalization for COVID-19 was 22 days. Death occurred in 12 patients (71%), including all patients with probable CAPA, at 34 days after COVID-19 diagnosis and 16 days after CAPA diagnosis. Eight patients (47%) were treated for aspergillosis;mortality did not appear to differ with treatment (75% vs. 67%). Conclusion. This case series reports high mortality among patients with CAPA;the primary contributor to this outcome is unclear. Frequency of lower respiratory tract sampling in patients with COVID-19 may have limited diagnosis of CAPA. Interestingly, inpatient respiratory cultures with Aspergillus spp. increased compared to previous years. Future work will attempt to identify risk factors for CAPA and attributable mortality via comparison to inpatients with COVID-19 without CAPA.

2.
16th IEEE International Conference on Automatic Face and Gesture Recognition, FG 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1711316

ABSTRACT

Wearing a mask has proven to be one of the most effective ways to prevent the transmission of SARS-Co V-2 coronavirus. However, wearing a mask poses challenges for different face recognition tasks and raises concerns about the performance of masked face presentation detection (PAD). The main issues facing the mask face PAD are the wrongly classified bona fide masked faces and the wrongly classified partial attacks (covered by real masks). This work addresses these issues by proposing a method that considers partial attack labels to supervise the PAD model training, as well as regional weighted inference to further improve the PAD performance by varying the focus on different facial areas. Our proposed method is not directly linked to specific network architecture and thus can be directly incorporated into any common or custom-designed network. In our work, two neural networks (DeepPixBis [21] and MixFaceNet [4]) are selected as backbones. The experiments are demonstrated on the collaborative real mask attack (CRMA) database [17]. Our proposed method outperforms established PAD methods in the CRMA database by reducing the mentioned shortcomings when facing masked faces. Moreover, we present a detailed step-wise ablation study pointing out the individual and joint benefits of the proposed concepts on the overall PAD performance. © 2021 IEEE.

3.
European Journal of Integrative Medicine ; 48, 2021.
Article in English | EMBASE | ID: covidwho-1587783

ABSTRACT

Introduction: Chinese patent medicine (CPM) is an indispensable part of traditional Chinese medicine. Coronavirus Disease 2019 (COVID-19) manifests is an acute respiratory infectious disease. This systematic review aimed to evaluate the therapeutic effects and safety of oral CPM for COVID-19. Methods: We included randomized controlled trials (RCTs) that tested oral CPM for the treatment of COVID-19 identified from publications in CNKI, Wanfang, VIP, Web of Science, SinoMed, PubMed, Embase, BioRxiv, MedRxiv and arXiv before November 2nd, 2020. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. Results: Seven RCTs including 1079 participants were identified. The overall bias was assessed as “some concerns” for all included trials. Oral CPM investigated were: Lianhua Qingwen capsule/granules (连花清瘟胶囊/颗粒, LHQW), Jinhua Qinggan granules (金花清感颗粒, JHQG), Huoxiang Zhengqidripping pills (藿香正气滴丸, HXZQ), Toujie Quwen granules (透解祛瘟颗粒, TJQW) and Lianhua Qingke granules (连花清咳颗粒, LHQK). Compared with conventional western therapy alone for people with COVID-19: regarding the main outcomes, the results showed that oral CPM combined with conventional western therapy improved cure rate (RR = 1.20, 95% CI 1.04 to 1.38, involving LHQW and TJQW), reduced aggravation rate (RR = 0.50, 95% CI 0.29 to 0.85, involving LHQW, JHQG, LHQK and TJQW);with regard to additional outcomes, the results showed that add-on oral CPM shortened the duration of fever, cough and fatigue, improved the recovery rate of cough and fatigue, and increased the improvement and recovery rate of chest CT manifestations. There were some differences in therapeutic effects among various CPMs for the same COVID-19 outcome. The use of TJQW and LHQG appeared not to increase the risk of adverse events, but JHQG may cause mild diarrhea. Conclusions: Low-certainty or very low-certainty evidence demonstrated that oral CPM may have add-on potential therapeutic effects for patients with non-serious COVID-19. There are some differences in therapeutic effects between different oral CPMs for the same outcome of COVID-19. The use of TJQW and LHQG probably does not increase the risk of adverse events, but JHQG may cause mild diarrhea in patients. The conclusion of this review needs to be further confirmed by well-designed clinical trials with adequate sample sizes. Keywords: Coronavirus Disease 2019;COVID-19;Chinese patent medicine;Chinese herbal medicine;Systematic review;Meta-analysis

4.
Circulation ; 143(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1325210

ABSTRACT

Introduction: Mechanistic research suggests that diabetes may increase susceptibility to infection. However, few epidemiologic studies have examined this association. Hypothesis: We hypothesize that adults with diabetes will have a higher risk for infection compared to those without diabetes. Methods: We conducted a prospective cohort analysis of diabetes and incident hospitalization with infection using data from the Atherosclerosis Risk in Communities (ARIC) Study. We used Cox regression models with adjustments for demographics, health behaviors, and cardiometabolic and kidney functioning measures. Diabetes status at baseline (1987-1989) was defined as a fasting glucose ≥126 mg/dL or non-fasting glucose ≥200 mg/dL, or self-report of a diagnosis of diabetes, or current diabetes medication use. First hospitalization with any infection and specific types of infections (respiratory, urinary, foot, sepsis, and postoperative wound) were ascertained from ICD-9 codes in hospital discharge records, with follow-up to September 30, 2015. Results: We included 13,356 participants (mean age, 55;26% black;54% female). During a median follow-up of 18.8 years, there were 7,791 incident hospitalizations with infection. Compared to those without diabetes at baseline, those with diabetes had a greater risk for hospitalization with any infection (adjusted HR: 1.55 [95% CI: 1.45-1.66], Table ). Results were generally consistentacross infection type, and differences were especially pronounced for foot infections (adjusted HR:6.35 [95% CI: 5.27-7.64]). Conclusion: The COVID-19 pandemic has heightened interest in the link between diabetes and susceptibility to infection. Our study suggests diabetes confers significant risk for infection.Enhancing diabetes prevention and management may reduce infection-related morbidity and mortality.

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