Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 21
Filter
1.
Journal of the American Board of Family Medicine : JABFM ; 02, 2023.
Article in English | EMBASE | ID: covidwho-2198398

ABSTRACT

BACKGROUND: Declining COVID-19 vaccination rates have led to implementation of monetary incentives to increase vaccine uptake. The Ohio Vax-a-Million lottery and subsequent $100 incentives were created to encourage individuals to become vaccinated. The purpose of this survey was to determine the efficacy of these monetary incentives on vaccination rates. METHOD(S): A 38-item questionnaire was given to outpatients at MetroHealth and Cleveland Veteran Affairs Hospitals between August 2021 and February 2022 who either waited 2 or more months to receive the COVID-19 vaccination or have not yet been vaccinated. The survey contained questions regarding demographics and perceptions of COVID-19 monetary incentives on vaccination likelihood. RESULT(S): Of the 471 participants surveyed, 0.95% reported that the Ohio Vax-a-Million lottery increased their vaccination likelihood, while 29.7% reported that it decreased their likelihood. 6.8% of respondents reported the $100 incentive increased their vaccination likelihood while 17.4% reported it decreased their vaccination chances. 20.6% of participants stated news of the Delta (delta) variant increased their vaccination likelihood. CONCLUSION(S): Our study results suggest that monetary incentives were not associated with increased COVID-19 vaccination rates. Instead, more participants believed that these incentives decreased their vaccination likelihood. Expansion of the survey across a wider sociodemographic range can provide further evidence of the efficacy of these programs before reimplementation. © Copyright by the American Board of Family Medicine.

2.
Open Forum Infectious Diseases ; 9(Supplement 2):S483-S484, 2022.
Article in English | EMBASE | ID: covidwho-2189785

ABSTRACT

Background. ADI is a fully human IgG1 monoclonal antibody engineered to have an extended half-life with high potency and broad neutralization against SARS-CoV-2 and other SARS-like coronaviruses. The goal of our analysis was to develop a QSP model in which ADI concentrations in upper airway (UA) epithelial lining fluid (ELF) were linked to a viral dynamic model to describe the impact of ADI on SARS-CoV-2 viral load relative to placebo. Methods. The QSP model was fit inNONMEMVersion 7.4 using PK data from a Phase 1 study (N=24, IV and IM) and from Phase 2/3 COVID-19 prevention (EVADE;N=659, IM) and treatment (STAMP;N=189, IM) studies. Saliva and NP samples were collected from STAMP study participants (pts) infected with the delta or omicron variants. The viral dynamic model was based on a published model and was modified to include both active (V) and deactivated (DV) virus (Fig). The viral dynamic model was fit to the NP swab viral load data (2 samples/pt) standardized to time since infection based upon recorded symptom onset. Saliva data (7-8 samples/ pt) was fit sequentially using a biophase compartment given the peak viral load was modestly lower and peaked later than Day 1. Viral dynamic model (A) and simulated median (90% PI) NP viral load reduction in ADI-treated or placebo participants for delta (B) and omicron (C) variants Results. The QSP model provided an excellent fit to serum ADI concentrationtime data after estimation of a transit rate to account for IM absorption, plasma volume, and the ADI-neonatal Fc receptor dissociation rate constant. The linked viral dynamic model captured the NP swab viral load data after estimating differences in within-host replication factor (R0) and viral production rate (p) by variant. Maximal ADI-induced effect (Smax) on stimulating viral clearance (c) was fixed to 0.43 based upon prior modeling. ADI concentration in UA ELF resulting in 50% of Smax (SC50) was estimated to be 0.086 for delta and 1.05 mg/L for omicron. Figure B and C show model-based simulated median (90% PI) viral load reduction in ADI-treated or placebo pts for delta and omicron variants. Conclusion. This QSP model, in conjunction with information on new variants available early in outbreaks (IC50, infectivity (R0), viral production rate [each a model parameter]), allows for rapid dose identification in response to emerging variants.

3.
Open Forum Infectious Diseases ; 9(Supplement 2):S323, 2022.
Article in English | EMBASE | ID: covidwho-2189666

ABSTRACT

Background. ADI is a fully human IgG1 monoclonal antibody engineered to have an extended half-life with high potency and broad neutralization against SARS-CoV-2 and other SARS-like coronaviruses with pandemic potential. Our objective was to develop a PPK model that describes the serum ADI concentration time profile following intravenous (IV) and intramuscular (IM) administration. Methods. The ADI PPK model was developed on PK data from a Phase 1 single ascending dose study (24 adults, IV and IM) and from Phase 2/3 COVID-19 prevention (EVADE;659 adults, IM) and treatment (STAMP;189 adults, IM) studies. 1,486 PK samples were included in the analysis. The impact of covariates (e.g. body weight, age, and baseline viral load) on ADI serum disposition were evaluated. Prediction-corrected visual predictive check (PC-VPC) plots were used to qualify the PPK model. Participant-specific ADI exposure estimates were generated using individual post hoc PK parameters. Results. The PPK model is comprised of 2 systemic compartments, zero-order infusion for IV administration and first-order absorption for IM administration and provided a robust fit to the data based on the PC-VPC plots and goodness-of-fit plots (data not shown). Body weight influenced clearance, inter compartmental clearance, and central and peripheral volume compartments. The relationship between body weight and clearance was not suggestive of the need for dose adjustment over the population weight range studied (38.6 to 178.7 kg). There was no apparent impact of baseline viral load or age on ADI clearance. The median [range] half-lives in days by study;Phase 1 (alpha1.71 [1.18-2.46];beta 125 [117-149]), Phase 2/3 prevention (alpha 1.86 [0.640-3.13];beta 136 [105-209]), and Phase 2/3 treatment (alpha 1.89 [0.631-3.01];beta 136 [108-206]). The population mean IM bioavailability estimate was 90.5%. The figure shows the PPK model median (90% confidence interval) concentration-time profile following a single 300 mg IM ADI dose by study. Conclusion. The PPK model provided a precise and unbiasedfit to the observed ADI concentration-time data and will be useful for future PK-pharmacodynamic analyses. Moreover, ADI demonstrated high IM bioavailability and a median terminal elimination half-life of 125 to 136 days.

4.
Open Forum Infectious Diseases ; 9(Supplement 2):S159, 2022.
Article in English | EMBASE | ID: covidwho-2189552

ABSTRACT

Background. Adintrevimab is a fully human IgG1 monoclonal antibody engineered to have potent and broad neutralization against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other SARS-like CoVs with pandemic potential. Adintrevimab is being assessed in two separate phase 2/3 clinical trials: the EVADE trial for prevention of COVID-19 in both post-exposure and preexposure settings and the STAMP trial for treatment of COVID-19. Here we report higher doses being evaluated in a healthy volunteer study given that emerging variants may have varying susceptibilities to adintrevimab. Previous results 300 mg IM, 600 mg IM, and 500 mg IV cohorts have been reported. Methods. This is an ongoing Phase 1, randomized, placebo (PBO)-controlled, single ascending-dose study of adintrevimab administered intramuscularly (IM) or intravenously (IV) to healthy adults aged 18-50 years with no current SARS-CoV-2 infection. Participants were randomized 8:2 in 3 high dose cohorts (N=10/cohort: n=8 adintrevimab, n=2 PBO): adintrevimab 1200 mg IM, 1200 mg IV, and 4500 mg IV. Safety, tolerability, and pharmacokinetics (PK) were assessed up to 21 days post dose. Results. Overall, 30 participants received adintrevimab (n=24) or PBO (n=6). Blinded safety data for all cohorts and PK for 1200 mg IV are reported. Through 21 days post dose all doses were well-tolerated, with no study drug-related adverse events (AEs), serious AEs, injection site reactions, or hypersensitivity reactions reported. The observed PK profile of the 1200 mg IV dose included Cmax of 423+/-105 mug/ml. Comparison of 500 mg and 1200 mg IV doses indicate dose proportionality of Cmax and exposure (AUC Day 21). Conclusion. A single dose of adintrevimab, up to 4500 mg, was well tolerated. These preliminary safety data and PK support potential use of higher doses of adintrevimab as needed to address emerging SARS-CoV-2 variants.

5.
Particuology ; 2022.
Article in English | Scopus | ID: covidwho-2182173

ABSTRACT

With the outbreak of COVID-19, disinfection protection has become a necessary measure to prevent infection. As a new type of disinfectant, potassium peroxymonosulfate compound salt (PMS) has the advantages of good bactericidal effect, non-toxicity, high safety and stability. However, the current PMS products with irregular particle shapes lead to poor flowability, high hygroscopicity, poor stability of reactive oxygen species (ROS) and serious caking problems. In this work, an agglomeration-dissolution mechanism was designed to prepare spherical PMS particles with large size (>300 μm) and high sphericity (up to 90%), effectively addressing the above problems. Shaping (dissolution and abrasion) is the key to improving sphericity, which is mainly controlled by the design of the heating mode, residence time and stirring rate. Compared with the irregular PMS particles, the large spherical particles present better flowability (angle of repose decreased by 35.80%, Carr's index decreased by 64.29%, Hausner's ratio decreased by 19.14%), lower hygroscopicity (decreased by 38.0%), lower caking ratio (decreased by 84.50%), and higher stability (the monthly loss of ROS was reduced by 61.68%). The agglomeration-dissolution mechanism demonstrates the crystallization, agglomeration, dissolution and abrasion process of inorganic salt crystals, providing an opportunity to prepare high-end inorganic crystal materials with high-quality morphologies. © 2022 Chinese Society of Particuology and Institute of Process Engineering, Chinese Academy of Sciences

6.
Translational Pediatrics ; 11(11):1787-1795, 2022.
Article in English | Web of Science | ID: covidwho-2164454

ABSTRACT

Background: This study sought to investigate the surgical workflow and practical effects of infection prevention and control in specialist pediatric hospitals during the Corona Virus Disease 2019 (COVID-19) epidemic to provide a foundation for ensuring the safety of children and medical staff. Methods: The Guidelines for the Management of Surgical Procedures and Infection Prevention and Control of COVID-19 Pneumonia in Children were formulated according to the industry specifications and standards, the prevention and control work system for hospitals in China, and the experiences of the Chinese Nursing Association in infection prevention and control in the operating room. These guidelines focus on the characteristics of children, and provide management priorities in relation to personnel management, infection prevention and control during surgery, intraoperative safety, and the cooperation of medical staff teams. These operation management and prevention and control strategies were applied to children who were suspected or confirmed to have COVID-19. Results: The operation process and prevention and control measures were effectively implemented. During the epidemic, a total of 219 surgeries which patients' COVID-19 nucleic test result are not out were completed. No medical staff or nosocomial infection occurred during the surgeries. Conclusions: As a special group, children are susceptible to COVID-19, and should receive special attention. As the only hospital designated to treat children with COVID-19 in Hubei Province, our hospital effectively implemented the infection prevention and control measures in surgery according to the characteristics of children. These measures ensured the safety of the surgeries and reduced the risk of infection in children and medical staff.

7.
BMC Neurol ; 22(1):462, 2022.
Article in English | PubMed | ID: covidwho-2162318

ABSTRACT

BACKGROUND: JC virus (JCV) is common among healthy individuals and remains latent but may be reactivated under immunosuppressive conditions, resulting in progressive multifocal leukoencephalopathy (PML). Here, we present a rare case of PML caused by JC virus infection in a previously healthy and immunocompetent patient. CASE PRESENTATION: A 67-year-old female without any disease history was admitted after presenting with rapidly progressive dementia. The preoperative diagnosis was progressive multifocal leukoencephalopathy, and corticosteroid treatment did not improve the symptoms. Brain lesions were surgically sampled, and JCV infection was confirmed by high-throughput DNA gene detection. This patient received a combined treatment of mirtazapine, mefloquine, and traditional Chinese herbs, and had stabilization of the disease on followed-up. CONCLUSIONS: Although it is a rare, this case demonstrates that JC virus infection within the brain occurs in apparently healthy people. This case may increase our understanding of virus infection when facing the coronavirus epidemic in recent years, considering that similar medications were used.

8.
Journal of Safety Science and Resilience ; 3(3):229-234, 2022.
Article in English | Scopus | ID: covidwho-1945738

ABSTRACT

COVID-19 is a constantly challenging global health issue due to its strong intensity, rapid mutation and high infectiousness. The new Delta and Omicron variants have triggered massive outbreaks worldwide. Even China, which has done a good job in outbreak prevention, is still heavily affected by the virus. The long-term fight against multiple COVID-19 outbreaks is ongoing. In this study, we propose an SEIQR model that considers the incubation period and quarantine measurement. We verified our model using actual outbreak data from four Chinese cities. Numerical simulations show that a five-day delay results in a double resurgence scale. Our model can be used as a tool to understand the spread of the virus quantitatively and provide a reference for policymaking accordingly. © 2022

9.
International Journal of Human Resource Management ; : 25, 2022.
Article in English | Web of Science | ID: covidwho-1868154

ABSTRACT

During the COVID-19 crisis, telecommuting has gradually attracted the public's attention. Past studies on the subject have produced inconsistent findings, suggesting that telecommuting can lead to simultaneous benefits and drawbacks. To discuss the deeper reasons for this finding, we divided telecommuting into two types-voluntary and involuntary telecommuting. Based on the job demands-resources model, we explored the impact of voluntary-involuntary telecommuting on employee innovative behaviour through co-worker emotional support, and we examined the cross-level moderating effect of organisational identification. Using the daily diary method, we collected 455 valid observations from 65 employees for eight consecutive days. The results show that compared with involuntary telecommuting, voluntary telecommuting leads to more co-worker emotional support, in a mediating role, and employee innovative behaviour. Furthermore, a high level of organisational identification enlarges the difference in co-worker emotional support for employees voluntarily or involuntarily telecommuting. Our results uncover those differences and fill the research gap on telecommuter motivation.

10.
2022 IEEE International Conference on Electrical Engineering, Big Data and Algorithms, EEBDA 2022 ; : 667-670, 2022.
Article in English | Scopus | ID: covidwho-1831760

ABSTRACT

Several problems were found in the attempt and practice of bilingual teaching in Food safety, mainly including inconsistent foreign language quality of students, messy textbooks and teaching content, inadequate bilingual ability of teachers and lack of supervision of English auxiliary teachers, lack of online network construction, and single teaching methods and other issues. Through summing up experience, it is found that a series of methods, such as combining social hot spots and conducting scientific research hot spots introduction teaching, rationally using English textbooks and correspondingly constructing teaching content, can solve the above problems and promote English teaching of Food safety. During pandemic (COVID-19/Corona Virus Disease 2019) period, we boldly carried out bilingual and online teaching attempts, this time also carried out a summary, hoping to provide some guidance for the teaching reform of Food safety © 2022 IEEE.

11.
IEEE International Conference on Robotics and Automation (ICRA) ; : 8600-8606, 2021.
Article in English | Web of Science | ID: covidwho-1799303

ABSTRACT

We carry out a structural and algorithmic study of a mobile sensor coverage optimization problem targeting 2D surfaces embedded in a 3D workspace. The investigated settings model multiple important applications including camera network deployment for surveillance, geological monitoring/survey of 3D terrains, and UVC-based surface disinfection for the prevention of the spread of disease agents (e.g., SARS-CoV-2). Under a unified general "sensor coverage" problem, three concrete formulations are examined, focusing on optimizing visibility, single-best coverage quality, and cumulative quality, respectively. After demonstrating the computational intractability of all these formulations, we describe approximation schemes and mathematical programming models for near-optimally solving them. The effectiveness of our methods is thoroughly evaluated under realistic and practical scenarios.

12.
2021 IEEE International Conference on Robotics and Automation, ICRA 2021 ; 2021-May:8600-8606, 2021.
Article in English | Scopus | ID: covidwho-1730972

ABSTRACT

We carry out a structural and algorithmic study of a mobile sensor coverage optimization problem targeting 2D surfaces embedded in a 3D workspace. The investigated settings model multiple important applications including camera network deployment for surveillance, geological monitoring/survey of 3D terrains, and UVC-based surface disinfection for the prevention of the spread of disease agents (e.g., SARS-CoV-2). Under a unified general “sensor coverage” problem, three concrete formulations are examined, focusing on optimizing visibility, single-best coverage quality, and cumulative quality, respectively. After demonstrating the computational intractability of all these formulations, we describe approximation schemes and mathematical programming models for near-optimally solving them. The effectiveness of our methods is thoroughly evaluated under realistic and practical scenarios. © 2021 IEEE

14.
American Journal of Emergency Medicine ; 02:02, 2020.
Article in English | MEDLINE | ID: covidwho-1208490

ABSTRACT

BACKGROUND: we aimed to explore the relationship of acute kidney injury (AKI) with the severity and mortality of coronavirus disease 2019 (COVID-19). METHODS: A systematic literature search was conducted in PubMed, EMBASE, Scopus, Web of Science, MedRxiv Database. We compared the laboratory indicators of renal impairment and incidences of AKI in the severe versus non-severe cases, and survival versus non-survival cases, respectively. RESULTS: In 41 studies with 10,335 COVID-19 patients, the serum creatinine (sCr) in severe cases was much higher than that in non-severe cases (SMD = 0.34, 95% CI: 0.29-0.39), with a similar trend for blood urea nitrogen (BUN) (SMD = 0.66, 95%CI: 0.51-0.81), hematuria (OR = 1.59, 95% CI: 1.15-2.19), and proteinuria (OR = 2.92, 95% CI: 1.58-5.38). The estimated glomerular filtration rate decreased significantly in severe cases compared with non-severe cases (SMD = -0.45, 95% CI: -0.67- -0.23). Moreover, the pooled OR of continuous renal replacement therapy (CRRT) and AKI prevalence for severe vs. non-severe cases was 12.99 (95%CI: 4.03-41.89) and 13.16 (95%CI: 10.16-17.05), respectively. Additionally, 11 studies with 3759 COVID-19 patients were included for analysis of disease mortality. The results showed the levels of sCr and BUN in non-survival cases remarkably elevated compared with survival patients, respectively (SMD = 0.97, SMD = 1.49). The pooled OR of CRRT and AKI prevalence for non-survival vs. survival cases was 31.51 (95%CI: 6.55-151.59) and 77.48 (95%CI: 24.52-244.85), respectively. CONCLUSIONS: AKI is closely related with severity and mortality of COVID-19, which gives awareness for doctors to pay more attention for risk screening, early identification and timely treatment of AKI.

15.
Eur Rev Med Pharmacol Sci ; 25(5): 2409-2414, 2021 03.
Article in English | MEDLINE | ID: covidwho-1148418

ABSTRACT

The COVID-19 (Corona Virus Disease 2019) outbreak, which seriously affected people's lives across the world, has not been effectively controlled. Previous studies have demonstrated that SARS-COV-2 (Severe acute respiratory syndrome coronavirus 2) infecting host cells mainly rely on binding to receptor proteins, namely ACE2 and TMPRSS2. COVID-19 transmission is faster than the severe acute respiratory syndrome (SARS) pneumonia outbreak in 2002. This is mainly attributed to the different pathways of virus-infected host cells, coupled with patients' atypical clinical characteristics. SARS-CoV-2 is mainly transmitted through respiratory droplets and contact, infecting lung tissues before damaging other body organs, such as the liver, brain, kidney and heart. The present study identified potential target genes for SARS-COV-2 receptors, ACE2 and TMPRSS2, in normal human lung tissue. The findings provide novel insights that will guide future drug development approaches for treatment of COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/genetics , Receptors, Virus/genetics , Serine Endopeptidases/genetics , Angiotensin-Converting Enzyme 2/biosynthesis , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/metabolism , COVID-19/virology , Correlation of Data , Gene Expression , Humans , Receptors, Virus/biosynthesis , Receptors, Virus/metabolism , SARS-CoV-2/isolation & purification , SARS-CoV-2/metabolism , Serine Endopeptidases/biosynthesis , Serine Endopeptidases/metabolism
16.
Eur Rev Med Pharmacol Sci ; 25(3): 1724-1731, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1102758

ABSTRACT

The outbreak of COVID-19 seriously affected people's life and safety, and it has not been effectively controlled all over the world at present. The binding of S protein of SARS-COV-2 virus to ACE2 receptor requires the assistance of Transmembrane Serine Protease 2 (TMPRSS2), which can activate the S protein on the surface of virus and promote its binding to the ACE2 receptor. With the continuous accumulation of experience in the treatment of COVID-19 patients and the experimental studies of a large number of scientific researchers, it was found that COVID-19 patients had a higher mortality rate in patients with underlying diseases. Therefore, for COVID-19 patients with tumors, the mortality rate may be significantly higher than other people. Clinical studies had found that some patients were complicated with cytokine storm in clinical treatment, which was also the direct cause of death for some patients. The infiltration of immune cells and the release of a variety of cytokines were important factors causing cytokine storm. Therefore, for COVID-19 patients with tumors, it was of great clinical significance to explore the relationship between COVID-19 virus receptor ACE2, TMPRSS2 and immune cell infiltration, which can help clinicians to make some more appropriate treatment plans.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/immunology , Neoplasms/immunology , SARS-CoV-2 , Serine Endopeptidases/genetics , COVID-19/complications , COVID-19/genetics , Gene Expression Regulation, Neoplastic , Humans , Neoplasms/complications , Neoplasms/genetics , Protein Binding , Spike Glycoprotein, Coronavirus/genetics
18.
Eur Rev Med Pharmacol Sci ; 25(1): 527-540, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1052580

ABSTRACT

OBJECTIVE: The pathogenesis of coronavirus disease 2019 (COVID-19) remains clear, and no effective treatment exists. SARS-CoV-2 is the virus that causes COVID-19 and uses ACE2 as a cell receptor to invade human cells. Therefore, ACE2 is a key factor to analyze the SARS-CoV-2 infection mechanism. MATERIALS AND METHODS: We included 9,783 sequencing results of different organs, analyzed the effects of different ACE2 expression patterns in organs and immune regulation. RESULTS: We found that ACE2 expression was significantly increased in the lungs and digestive tract. The cellular immunity of individuals with elevated ACE2 expression is activated, whereas humoral immunity is dampened, leading to the release of many inflammatory factors dominated by IL6. Furthermore, by studying the sequencing results of SARS-CoV-2-infected and uninfected cells, IL6 was found to be an indicator of a significant increase in the number of infected cells. However, although patients with high expression of ACE2 will release many inflammatory factors dominated by IL6, cellular immunity in the colorectum is significantly activated. This effect may explain why individuals with SARS-CoV-2 infection have severe lung symptoms and digestion issues, which are important causes of milder symptoms. CONCLUSIONS: This finding indicates that ACE2 and IL6 inhibitors have important value in COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/immunology , Immunity, Cellular , Interleukin-6/immunology , Lung/metabolism , SARS-CoV-2 , COVID-19/genetics , COVID-19/metabolism , Gastrointestinal Tract/immunology , Gastrointestinal Tract/metabolism , Gene Expression Profiling , Gene Ontology , Humans , Immunity, Cellular/genetics , Immunity, Humoral/genetics , Lung/immunology , Organ Specificity , Transcriptome
19.
Chemistry and Technology of Fuels and Oils ; 2021.
Article in English | Scopus | ID: covidwho-1049676

ABSTRACT

In this study, we have analyzed the impact of COVID-19 on natural gas supply reliability. Natural gas supply reliability is defined as the ability to satisfy the market demand and is determined by both supply-side and demand-side policy. To evaluate the gas supply reliability of the natural gas pipeline system, we have applied the method of gas supply capacity calculation based on the results of the previous gas supply reliability studies. The method combines the unsteady flow hydraulic analysis, simulation of the state transition process, and the forecasting analysis of the demand and consumption. The analysis presents a case study based on the gas pipeline system in China. The analysis results indicate that the COVID-19 consequences will cause a decrease in gas supply reliability. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.

20.
Chinese Journal of Laboratory Medicine ; 43(12):1205-1211, 2020.
Article in Chinese | EMBASE | ID: covidwho-1041110

ABSTRACT

Objective: To explore the prognosis value of PT, DD and PLT and validation of the efficacy of the SIC score on initiating anticoagulant therapy in severe COVID-19 patients. Methods: We retrospectively enrolled 420 consecutive patients with severe COVID-19 admitted to Tongji Hospital of Huazhong University of Science and Technology in Wuhan from January 1 to February 11, 2020. A retrospective review of the characteristics of these patients(mainly including PT,DD, PLT and SIC score at the point of meeting severity criteria, underlying disease and so on) were collected through the electronic medical record system of our hospital. The medications for anticoagulant therapy and outcomes (28-day mortality event) were also monitored.1.The patients were divided into Survivor group and Non-survivor group based on the event of 28 d motality.the parameters of coagulation tests and clinical characteristics between these two groups were compared. Furthermore, the association between PT, DD, PLT and 28-day mortality were analyzed by logistic regression analysis. The predictive value of PT, DD, PLT for 28-day mortality were explored by ROC curve analysis. 2.Based on the SIC score, the patients were divided into SIC group and Non-SIC group. The 28-day mortality rates were compared among cases which were receiving anticoagulant therapy or not in SIC group and Non-SIC group The logistic regression was performed to validate the receiving anticoagulant therapy and 28-day mortality between SIC group and Non-SIC group. Results: 1.PT in Non-survivor group was significantly prolonged compared with Survivor group[15.1(14.2, 16.6)s vs.14.3(13.6, 15.1s, Z=-5.922, P<0.001].DD in Non-survivor group was significantly elevated compared with Survivor group[4.52(1.37, 21.0) μg/ml.vs 1.42 (0.77, 3.66) μg/ml, Z=-6.206, P<0.001].PLT in Non-survivor group was significantly declined compared with Survivor group[165 (120, 226)×109/L.vs 218(157, 281)×109/L, Z=-5.171, P<0.001].Furthermore, the logistic regression and ROC curve analysis discovered that PT>14.5s, DD>3.0 μg/ml and PLT<125×109/L were independent risk factors for 28-day mortality event when adjusted for age, sex and chronic pulmonary disease, the odds ratio(OR), 95% confidence interval(95%CI) and P value were (2.697, 1.735-4.195, P<0.001), (2.929,1.880-4.562, P<0.001), (2.632, 1.549-4.470, P<0.001), respectively, and all these three parameters had some degree of predictive value for 28-day mortality event, the areas under the ROC curve(AUC) were 0.676, 0.685, 0.659, respectively. When combined together, it had the biggest predictive value(AUC= 0.729). 2. In SIC group, patients who receiving anticoagulant therapy had lower mortality rate compared with ones who not receiving anticoagulant therapy (40%.vs 66.1%, χ²=5.417, P=0.020). However, in Non-SIC group, there was no significant difference on mortality rate between ones who receiving anticoagulant therapy and ones who not (29% vs 23.9%, χ²=0.713, P=0.398). The logistic regression showed that when adjusted for age, sex and chronic pulmonary disease, receiving anticoagulant therapy was independent protective factor for 28-day mortality event only in SIC Group, the OR, 95%CI and P value were 0.304, 0.115-0.802, P=0.016, respectively. Conclusions: PT>14.5 s, DD>3.0 μg/ml and PLT<125×109/L were independent risk factors for 28-day mortality of severe COVID-19 patients;Initiating anticoagulant therapy guided by SIC score may improve the outcome of the specific patients with severe COVID-19.

SELECTION OF CITATIONS
SEARCH DETAIL