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1.
J Hazard Mater ; 432: 128667, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1788119

ABSTRACT

Wastewater-based epidemiology (WBE) approach for COVID-19 surveillance is largely based on the assumption of SARS-CoV-2 RNA shedding into sewers by infected individuals. Recent studies found that SARS-CoV-2 RNA concentration in wastewater (CRNA) could not be accounted by the fecal shedding alone. This study aimed to determine potential major shedding sources based on literature data of CRNA, along with the COVID-19 prevalence in the catchment area through a systematic literature review. Theoretical CRNA under a certain prevalence was estimated using Monte Carlo simulations, with eight scenarios accommodating feces alone, and both feces and sputum as shedding sources. With feces alone, none of the WBE data was in the confidence interval of theoretical CRNA estimated with the mean feces shedding magnitude and probability, and 63% of CRNA in WBE reports were higher than the maximum theoretical concentration. With both sputum and feces, 91% of the WBE data were below the simulated maximum CRNA in wastewater. The inclusion of sputum as a major shedding source led to more comparable theoretical CRNA to the literature WBE data. Sputum discharging behavior of patients also resulted in great fluctuations of CRNA under a certain prevalence. Thus, sputum is a potential critical shedding source for COVID-19 WBE surveillance.


Subject(s)
COVID-19 , Wastewater-Based Epidemiological Monitoring , COVID-19/epidemiology , Humans , RNA, Viral , SARS-CoV-2 , Waste Water
2.
Hepatol Int ; 16(3): 691-701, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1782952

ABSTRACT

BACKGROUND: Data on safety and immunogenicity of coronavirus disease 2019 (COVID-19) vaccination in patients with compensated (C-cirrhosis) and decompensated cirrhosis (D-cirrhosis) are limited. METHODS: In this prospective multicenter study, adult participants with C-cirrhosis and D-cirrhosis were enrolled and received two doses of inactivated whole-virion COVID-19 vaccines. Adverse events were recorded within 14 days after any dose of vaccination, and serum samples of enrolled patients were collected and tested for SARS-CoV-2 neutralizing antibodies at least 14 days after the second dose. Risk factors for negative neutralizing antibody were analyzed. RESULTS: In total, 553 patients were enrolled from 15 centers in China, including 388 and 165 patients with C-cirrhosis and D-cirrhosis. The vaccines were well tolerated, most adverse reactions were mild and transient, and injection site pain (23/388 [5.9%] vs 9/165 [5.5%]) and fatigue (5/388 [1.3%] vs 3/165 [1.8%]) were the most frequently local and systemic adverse events in both the C-cirrhosis and D-cirrhosis groups. Overall, 4.4% (16/363) and 0.3% (1/363) of patients were reported Grades 2 and 3 alanine aminotransferase (ALT) elevations (defined as ALT > 2 upper limit of normal [ULN] but ≤ 5 ULN, and ALT > 5 ULN, respectively). The positive rates of COVID-19 neutralizing antibodies were 71.6% (278/388) and 66.1% (109/165) in C-cirrhosis and D-cirrhosis groups. Notably, Child-Pugh score of B and C levels was an independent risk factor of negative neutralizing antibody. CONCLUSIONS: Inactivated COVID-19 vaccinations are safe with acceptable immunogenicity in cirrhotic patients, and Child-Pugh score of B and C levels is associated with hyporesponsive to COVID-19 vaccination.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Immunogenicity, Vaccine , Liver Cirrhosis , Prospective Studies , SARS-CoV-2
3.
Front Public Health ; 10: 842303, 2022.
Article in English | MEDLINE | ID: covidwho-1776049

ABSTRACT

Novel Coronary Pneumonia is the most infectious disease with the highest number of morbidity and mortality in 100 years. Despite aggressive and effective COVID-19 prevention and control measures, countries have been unable to stop its outbreaks. With the widespread use of vaccines, the occurrence of COVID-19 has declined markedly. April 21, 2021, New York scholars reported Vaccine Breakthrough Infections with SARS-CoV-2 Variants, which immediately attracted widespread attention. In this mini-review, we focus on the characteristics of SARS-CoV-2 and its mutant strains and vaccine breakthrough infections. We have found that outbreaks of vaccine-breaking SARS-CoV-2 Delta infections in many countries are primarily the result of declining vaccine-generated antibody titers and relaxed outbreak management measures. For this reason, we believe that the main response to vaccine-breaking infections with the SARS-CoV-2 variant is to implement a rigorous outbreak defense policy and vaccine application. Only by intensifying the current vaccination intensity, gradually improving the vaccine and its application methods, and strengthening non-pharmaceutical measures such as travel restrictions, social distancing, masking and hand hygiene, can the COVID-19 outbreak be fully controlled at an early date.


Subject(s)
COVID-19 , Communicable Diseases , Viral Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , Humans , SARS-CoV-2
4.
Front Public Health ; 9: 741083, 2021.
Article in English | MEDLINE | ID: covidwho-1775896

ABSTRACT

This study aimed to investigate the association between passive smoking and physical and psychological health in Chinese nurses. Participants of this cross-sectional study comprised 2,484 non-smoking nurses. Passive smoking and demographic information were assessed using a self-administered questionnaire. Physical, psychological, and overall health status of nurses were measured using the Cornell Medical Index (CMI) health questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for nurses' health were estimated by exposure to passive smoking using unconditional logistic regression models. A total of 1,219 nurses (49.07%) were exposed to passive smoking. Of these, 609 (24.52%), 160 (6.44%), and 587 (23.63%) nurses had poorer physical, mental, and overall health, respectively. After adjusting for other confounding factors, compared with the non-passive smoking group, passive smoking was associated with poor physical (OR = 1.51, 95% CI: 1.25-1.83), mental (OR = 1.48, 95% CI: 1.07-2.07), and overall (OR = 1.58, 95% CI: 1.30-1.93) health of nurses, respectively. We also carried out subgroup analyses stratified by age, department, and professional title, which showed that most findings supported the main results. This study demonstrated that exposure to passive smoking was a risk factor for overall decreased physical and mental health status among Chinese nurses.


Subject(s)
Health Status , Nurses , Tobacco Smoke Pollution , China/epidemiology , Cross-Sectional Studies , Humans , Surveys and Questionnaires
5.
Front Cell Infect Microbiol ; 12: 802147, 2022.
Article in English | MEDLINE | ID: covidwho-1753359

ABSTRACT

Owing to the outbreak of the novel coronavirus (SARS-CoV-2) worldwide at the end of 2019, the development of a SARS-CoV-2 vaccine became an urgent need. In this study, we developed a type 9 adeno-associated virus vectored vaccine candidate expressing a dimeric receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S protein) and evaluated its immunogenicity in a murine model. The vaccine candidate, named AAV9-RBD virus, was constructed by inserting a signal peptide to the N-terminus of two copies of RBD, spaced by a linker, into the genome of a type 9 adeno-associated virus. In vitro assays showed that HeLa cells infected by the recombinant AAV virus expressed high levels of the recombinant RBD protein, mostly found in the cell culture supernatant. The recombinant AAV9-RBD virus was cultured and purified. The genome titer of the purified recombinant AAV9-RBD virus was determined to be 2.4 × 1013 genome copies/mL (GC/mL) by Q-PCR. Balb/c mice were immunized with the virus by intramuscular injection or nasal drip administration. Eight weeks after immunization, neutralizing antibodies against the new coronavirus pseudovirus were detected in the sera of all mice; the mean neutralizing antibody EC50 values were 517.7 ± 292.1 (n=10) and 682.8 ± 454.0 (n=10) in the intramuscular injection group and nasal drip group, respectively. The results of this study showed that the recombinant AAV9-RBD virus may be used for the development of a SARS-CoV-2 vaccine.


Subject(s)
COVID-19 Vaccines , COVID-19 , Animals , COVID-19/prevention & control , Dependovirus/genetics , HeLa Cells , Humans , Mice , Mice, Inbred BALB C , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus
6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310845

ABSTRACT

Objective: To analyze and compare the imaging workflow, radiation dose and image quality for COVID-19 patients examined using either the conventional manual positioning (MP) method or an AI-based automatic positioning (AP) method. Materials: and Methods: 127 adult COVID-19 patients underwent chest CT scans on a CT scanner using the same scan protocol except with the manual positioning (MP group) for the initial scan and an AI-based automatic positioning method (AP group) for the follow-up scan. Radiation dose, patient positioning time and off-center distance, of the two groups were recorded and compared. Image noise and signal-to-noise ratio (SNR) were assessed by three experienced radiologists and were compared between the two groups. Results: : The AP operation was successful for all patients in the AP group and reduced the total positioning time by 28% compared with the MP group. Compared with the MP group, the AP group had significantly less patient off-center distance (AP:1.56cm±0.83 vs. MP: 4.05cm±2.40, p <0.001) and higher proportion of positioning accuracy (AP: 99% vs. MP: 92%), resulted in 16% radiation dose reduction (AP: 6.1mSv±1.3 vs. MP: 7.3mSv±1.2, p< 0.001) and 9% image noise reduction in erector spinae and lower noise and higher SNR for lesions in the pulmonary peripheral areas. Conclusion: The AI-based automatic positioning and centering in CT imaging is a promising new technique for reducing radiation dose, optimizing imaging workflow and image quality in imaging the chest. This technique has important added clinical value in imaging COVID-19 patients to reduce the cross-infection risks.

7.
Clin Gastroenterol Hepatol ; 20(7): 1516-1524.e2, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1670285

ABSTRACT

BACKGROUND & AIMS: We aimed to assess the safety and immunogenicity of inactivated whole-virion severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in patients with chronic liver diseases (CLD) in this study. METHODS: This was a prospective, multi-center, open-label study. Participants aged over 18 years with confirmed CLD and healthy volunteers were enrolled. All participants received 2 doses of inactivated whole-virion SARS-CoV-2 vaccines. Adverse reactions were recorded within 14 days after any dose of SARS-CoV-2 vaccine, laboratory testing results were collected after the second dose, and serum samples of enrolled subjects were collected and tested for SARS-CoV-2 neutralizing antibodies at least 14 days after the second dose. RESULTS: A total of 581 participants (437 patients with CLD and 144 healthy volunteers) were enrolled from 15 sites in China. Most adverse reactions were mild and transient, and injection site pain (n = 36; 8.2%) was the most frequently reported adverse event. Three participants had grade 3 aminopherase elevation (defined as alanine aminopherase >5 upper limits of normal) after the second dose of inactivated whole-virion SARS-CoV-2 vaccination, and only 1 of them was judged as severe adverse event potentially related to SARS-CoV-2 vaccination. The positive rates of SARS-CoV-2 neutralizing antibodies were 76.8% in the noncirrhotic CLD group, 78.9% in the compensated cirrhotic group, 76.7% in the decompensated cirrhotic group (P = .894 among CLD subgroups), and 90.3% in healthy controls (P = .008 vs CLD group). CONCLUSION: Inactivated whole-virion SARS-CoV-2 vaccines are safe in patients with CLD. Patients with CLD had lower immunologic response to SARS-CoV-2 vaccines than healthy population. The immunogenicity is similarly low in noncirrhotic CLD, compensated cirrhosis, and decompensated cirrhosis.


Subject(s)
COVID-19 , Liver Diseases , Viral Vaccines , Adult , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Double-Blind Method , Humans , Liver Cirrhosis , Middle Aged , Prospective Studies , SARS-CoV-2 , Viral Vaccines/adverse effects
8.
Signal Transduct Target Ther ; 6(1): 428, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1585884

ABSTRACT

SARS-CoV-2 infection-induced hyper-inflammation links to the acute lung injury and COVID-19 severity. Identifying the primary mediators that initiate the uncontrolled hypercytokinemia is essential for treatments. Mast cells (MCs) are strategically located at the mucosa and beneficially or detrimentally regulate immune inflammations. In this study, we showed that SARS-CoV-2-triggered MC degranulation initiated alveolar epithelial inflammation and lung injury. SARS-CoV-2 challenge induced MC degranulation in ACE-2 humanized mice and rhesus macaques, and a rapid MC degranulation could be recapitulated with Spike-RBD binding to ACE2 in cells; MC degranulation altered various signaling pathways in alveolar epithelial cells, particularly, the induction of pro-inflammatory factors and consequential disruption of tight junctions. Importantly, the administration of clinical MC stabilizers for blocking degranulation dampened SARS-CoV-2-induced production of pro-inflammatory factors and prevented lung injury. These findings uncover a novel mechanism for SARS-CoV-2 initiating lung inflammation, and suggest an off-label use of MC stabilizer as immunomodulators for COVID-19 treatments.


Subject(s)
COVID-19/metabolism , Cell Degranulation , Lung Injury/metabolism , Mast Cells/metabolism , Pulmonary Alveoli/metabolism , SARS-CoV-2/metabolism , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/metabolism , Animals , COVID-19/genetics , Cell Line, Tumor , Female , Humans , Lung Injury/genetics , Lung Injury/virology , Macaca mulatta , Male , Mice, Inbred BALB C , Mice, Transgenic , Pulmonary Alveoli/virology , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism
9.
Chinese Journal of School Health ; 42(5):679-682, 2021.
Article in English | CAB Abstracts | ID: covidwho-1502918

ABSTRACT

Objective: Explored the characteristics of parental rearing styles, and its association with depressive symptoms and the self-directed learning ability among high school students during COVID-19 epidemic, while providing a basis for family intervention in the area of adolescent mental health and students' learning abilities.

10.
Preprint in English | bioRxiv | ID: ppbiorxiv-449680

ABSTRACT

SARS-CoV-2 infection-induced hyper-inflammation links to the acute lung injury and COVID-19 severity. Identifying the primary mediators that initiate the uncontrolled hypercytokinemia is essential for treatments. Mast cells (MCs) are strategically located at the mucosa and beneficially or detrimentally regulate immune inflammations. Here we showed that SARS-CoV-2-triggeed MC degranulation initiated alveolar epithelial inflammation and lung injury. SARS-CoV-2 challenge induced MC degranulation in ACE-2 humanized mice and rhesus macaques, and a rapid MC degranulation could be recapitulated with Spike-RBD binding to ACE2 in cells; MC degranulation alterred various signaling pathways in alveolar epithelial cells, particularly, led to the production of pro-inflammatory factors and consequential disruption of tight junctions. Importantly, the administration of clinical MC stabilizers for blocking degranulation dampened SARS-CoV-2-induced production of pro-inflammatory factors and prevented lung injury. These findings uncover a novel mechanism for SARS-CoV-2 initiating lung inflammation, and suggest an off-label use of MC stabilizer as immunomodulators for COVID-19 treatments. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=135 SRC="FIGDIR/small/449680v1_ufig1.gif" ALT="Figure 1"> View larger version (29K): org.highwire.dtl.DTLVardef@899996org.highwire.dtl.DTLVardef@1c26c0eorg.highwire.dtl.DTLVardef@1442cdcorg.highwire.dtl.DTLVardef@dd4204_HPS_FORMAT_FIGEXP M_FIG C_FIG In BriefSARS-CoV-2 triggers an immediate mast cell (MC) degranulation, which initiates the alveolar epithelial inflammation and disrupts the tight junction. MC stabilizers that block degranulation reduce virus-induced lung inflammation and injury. HighlightsO_LIThe binding of RBD of Spike protein of SARS-CoV-2-to ACE2 receptor protein triggers an immediate MC degranulation C_LIO_LIMC degranulation induces transcriptomic changes include an upregulated inflammatory signaling and a downregulated cell-junction signaling C_LIO_LIMC degranulation leads to alveolar epithelial inflammation and disruption of tight junctions C_LIO_LIMC stabilizer that inhibits degranulation reduces SARS-CoV-2-induced lung inflammation and injury in vivo C_LI

11.
Intell Med ; 1(1): 3-9, 2021 May.
Article in English | MEDLINE | ID: covidwho-1244750

ABSTRACT

BACKGROUND: The ongoing coronavirus disease 2019 (COVID-19) pandemic has put radiologists at a higher risk of infection during the computer tomography (CT) examination for the patients. To help settling these problems, we adopted a remote-enabled and automated contactless imaging workflow for CT examination by the combination of intelligent guided robot and automatic positioning technology to reduce the potential exposure of radiologists to 2019 novel coronavirus (2019-nCoV) infection and to increase the examination efficiency, patient scanning accuracy and better image quality in chest CT imaging . METHODS: From February 10 to April 12, 2020, adult COVID-19 patients underwent chest CT examinations on a CT scanner using the same scan protocol except with the conventional imaging workflow (CW group) or an automatic contactless imaging workflow (AW group) in Wuhan Leishenshan Hospital (China) were retrospectively and prospectively enrolled in this study. The total examination time in two groups was recorded and compared. The patient compliance of breath holding, positioning accuracy, image noise and signal-to-noise ratio (SNR) were assessed by three experienced radiologists and compared between the two groups. RESULTS: Compared with the CW group, the total positioning time of the AW group was reduced ((118.0 ± 20.0) s vs. (129.0 ± 29.0) s, P = 0.001), the proportion of scanning accuracy was higher (98% vs. 93%), and the lung length had a significant difference ((0.90±1.24) cm vs. (1.16±1.49) cm, P = 0.009). For the lesions located in the pulmonary centrilobular and subpleural regions, the image noise in the AW group was significantly lower than that in the CW group (centrilobular region: (140.4 ± 78.6) HU vs. (153.8 ± 72.7) HU, P = 0.028; subpleural region: (140.6 ± 80.8) HU vs. (159.4 ± 82.7) HU, P = 0.010). For the lesions located in the peripheral, centrilobular and subpleural regions, SNR was significantly higher in the AW group than in the CW group (centrilobular region: 6.6 ± 4.3 vs. 4.9 ± 3.7, P = 0.006; subpleural region: 6.4 ± 4.4 vs. 4.8 ± 4.0, P < 0.001). CONCLUSIONS: The automatic contactless imaging workflow using intelligent guided robot and automatic positioning technology allows for reducing the examination time and improving the patient's compliance of breath holding, positioning accuracy and image quality in chest CT imaging.

12.
Int J Clin Pract ; 75(7): e14197, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1165969

ABSTRACT

BACKGROUND: COVID-19 has been sweeping the world since it emerged in late December 2019. However, little is known about cardiac injury in hospitalised COVID-19 patients. This study is to investigate the incidence and characteristics of myocardial injury in COVID-19 patients admitted in hospital. METHODS: Fifty-four COVID-19 patients were enrolled in one ward in Tongji Hospital, Wuhan, China, and 5 were excluded caused by missing cardiac troponin I levels. Forty-nine participants were included in the final analysis. The clinical manifestations of hospitalised patients were analysed. Patients were divided into two groups, cardiac injury group and non-cardiac injury group, based on whether cardiac troponin I was elevated. Epidemic characteristics and laboratory test results were analysed in these two group. RESULTS: The average age of patients in the cardiac injury group was older (68.0 years old) than that in the non-cardiac injury group (61.5 years old). The percentages of patients with diabetes and critically severe pneumonia in the cardiac injury group were 38.5% and 38.5% respectively. Lymphocytes were decreased in 53.1% of all enrolled patients, but this decrease was more prominent (76.9%) in the cardiac injury group than the non-cardiac injury group (44.4%). Patients in the cardiac injury group also had lower platelet counts. CONCLUSIONS: COVID-19 can cause cardiac injury in many patients. It is more common in older patients and patients with diabetes and is associated with a significant decrease in lymphocytes.


Subject(s)
COVID-19 , Heart Injuries , Aged , China/epidemiology , Heart Injuries/epidemiology , Heart Injuries/etiology , Humans , Middle Aged , Retrospective Studies , SARS-CoV-2
13.
Eur Radiol ; 31(8): 6049-6058, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1141412

ABSTRACT

OBJECTIVE: To analyze and compare the imaging workflow, radiation dose, and image quality for COVID-19 patients examined using either the conventional manual positioning (MP) method or an AI-based automatic positioning (AP) method. MATERIALS AND METHODS: One hundred twenty-seven adult COVID-19 patients underwent chest CT scans on a CT scanner using the same scan protocol except with the manual positioning (MP group) for the initial scan and an AI-based automatic positioning method (AP group) for the follow-up scan. Radiation dose, patient positioning time, and off-center distance of the two groups were recorded and compared. Image noise and signal-to-noise ratio (SNR) were assessed by three experienced radiologists and were compared between the two groups. RESULTS: The AP operation was successful for all patients in the AP group and reduced the total positioning time by 28% compared with the MP group. Compared with the MP group, the AP group had significantly less patient off-center distance (AP 1.56 cm ± 0.83 vs. MP 4.05 cm ± 2.40, p < 0.001) and higher proportion of positioning accuracy (AP 99% vs. MP 92%), resulting in 16% radiation dose reduction (AP 6.1 mSv ± 1.3 vs. MP 7.3 mSv ± 1.2, p < 0.001) and 9% image noise reduction in erector spinae and lower noise and higher SNR for lesions in the pulmonary peripheral areas. CONCLUSION: The AI-based automatic positioning and centering in CT imaging is a promising new technique for reducing radiation dose and optimizing imaging workflow and image quality in imaging the chest. KEY POINTS: • The AI-based automatic positioning (AP) operation was successful for all patients in our study. • AP method reduced the total positioning time by 28% compared with the manual positioning (MP). • AP method had less patient off-center distance and higher proportion of positioning accuracy than MP method, resulting in 16% radiation dose reduction and 9% image noise reduction in erector spinae.


Subject(s)
Artificial Intelligence , COVID-19 , Adult , Humans , Radiation Dosage , SARS-CoV-2 , Tomography, X-Ray Computed
14.
Front Public Health ; 8: 588578, 2020.
Article in English | MEDLINE | ID: covidwho-1084624

ABSTRACT

The psychological condition of medical students may be influenced by the 2019 novel coronavirus (COVID-19) outbreak. This study investigated the prevalence and influencing factors of depressive symptoms, poor sleep quality and poor diet in students at Kunming Medical University during the early part of the COVID-19 outbreak. A cross-sectional study was used from a questionnaire survey in February 2020. Of a total of 1,026 study participants, the prevalence of depressive symptoms, poor sleep quality, and poor diet was, respectively, 22.4, 33.2, and 17.4%. Male students and students with a low degree of focus on COVID-19 had a high risk of depressive symptoms. A high percentage of females and students in the fifth grade, as well as students with high levels of concern about the negative impact of COVID-19 on their education or employment, comprised those with poor sleep quality. Students in the fifth grade and students with high levels of concern about the negative impact of COVID-19 on their education or employment were more likely to report poor diet. This study suggests the importance of monitoring medical students' depressive state during the COVID-19 outbreak, and universities are encouraged to institute policies and programs to provide educational counseling and psychological support to help students to cope with these problems.


Subject(s)
COVID-19/psychology , Depression/epidemiology , Diet , Sleep Wake Disorders/epidemiology , Students, Medical , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Sleep , Students, Medical/psychology , Surveys and Questionnaires , Young Adult
15.
Travel Med Infect Dis ; 39: 101950, 2021.
Article in English | MEDLINE | ID: covidwho-966342

ABSTRACT

BACKGROUND: To investigate and compare the clinical and imaging features among family members infected with COVID-19. METHODS: We retrospectively collected a total of 34 COVID-19 cases (15 male, 19 female, aged 48 ± 16 years, ranging from 10 to 81 years) from 13 families from January 17, 2020 through February 15, 2020. Patients were divided into two groups: Group 1 - part of the family members (first-generation) who had exposure history and others (second-generation) infected through them, and Group 2 - patients from the same family having identical exposure history. We collected clinical symptoms, laboratory findings, and high-resolution computed tomography (HRCT) features for each patient. Comparison tests were performed between the first- and second-generation patients in Group 1. RESULTS: In total there were 21 patients in Group 1 and 20 patients in Group 2. For Group 1, first-generation patients had significantly higher white blood cell count (6.5 × 109/L (interquartile range (IQR): 4.9-9.2 × 109/L) vs 4.5 × 109/L (IQR: 3.7-5.3 × 109/L); P = 0.0265), higher neutrophil count (4.9 × 109/L (IQR: 3.6-7.3 × 109/L) vs 2.9 × 109/L (IQR: 2.1-3.3 × 109/L); P = 0.0111), and higher severity scores on HRCT (3.9 ± 2.4 vs 2.0 ± 1.3, P = 0.0362) than the second-generation patients. Associated underlying diseases (odds ratio, 8.0, 95% confidence interval: 3.4-18.7, P = 0.0013) were significantly correlated with radiologic severity scores in second-generation patients. CONCLUSION: Analysis of the family cluster cases suggests that COVID-19 had no age or sex predominance. Secondarily infected patients in a family tended to develop milder illness, but this was not true for those with existing comorbidities.


Subject(s)
COVID-19/pathology , Family , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Child , China/epidemiology , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Young Adult
17.
Journal of Chemical Education ; 97(9):2458-2465, 2020.
Article | Web of Science | ID: covidwho-806419

ABSTRACT

Georgia Gwinnett College (GGC) is an open-access, four-Year, Public liberal arts college that emphasizes excellent instruction through active learning and small class sizes. The COVID-19 pandemic presented unique challenges to GGC general chemistry instructors as they sought to actively engage students in a new online setting. We reflect on the challenges faced by our college during this Pandemic by analyzing student surveys, instructor reflections, and grade distributions across 20 sections of general chemistry 1 and 2 taught by 15 different instructors. We consider the most important challenges faced by students and the technology rapidly adopted by instructors We then present three main themes found in the instructor reflections and consider the implications for going forward.

18.
Saudi J Gastroenterol ; 26(5): 272-278, 2020.
Article in English | MEDLINE | ID: covidwho-706036

ABSTRACT

Background/Aims: We aimed to evaluate the distribution of abnormal liver-related biomarkers in patients with coronavirus disease (COVID-19) and explore the prognostic value of elevated liver enzymes and abnormal liver synthetic capacity with regards to patient mortality. Patients and Methods: This retrospective observational study included 80 laboratory-confirmed COVID-19 cases. Data were collected from the electronic medical record system by a trained team of physicians. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin, and prealbumin levels at admission and on day 7 after admission were collected. The primary outcome of the current study was patient mortality. Results: Abnormal ALT, AST, TB, albumin, and prealbumin levels were observed in 11 (13.8%), 15 (18.8%), 5 (6.3%), 22 (27.5%), and 31 (38.8%) patients, respectively. Male gender correlated with elevated ALT and AST levels (p = 0.027 and 0.036, respectively). Higher levels of AST and lower levels of albumin and prealbumin were associated with patient mortality (p = 0.009, 0.002, and 0.003, respectively). Multivariate Cox regression analysis identified patient age (p = 0.013, HR 1.108) and prealbumin levels (p = 0.015, HR 0.986) as independent predictors for patient mortality. However, changes in liver-related biomarkers were not associated with poor outcome in multivariate analysis (p > 0.05). Conclusions: Abnormalities in albumin and prealbumin levels are common among COVID-19 patients and hypoprealbuminemia independently predicts adverse outcome and should be carefully considered in clinical practice. Moreover, changes in liver-related biomarkers is not a salient feature of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/blood , Liver Diseases/blood , Pneumonia, Viral/blood , Prealbumin/metabolism , Aged , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Bilirubin/blood , Biomarkers/blood , COVID-19 , Comorbidity , Coronavirus Infections/epidemiology , Female , Follow-Up Studies , Humans , Liver Diseases/epidemiology , Liver Function Tests , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Prognosis , Retrospective Studies , SARS-CoV-2 , Saudi Arabia/epidemiology
19.
Int J Infect Dis ; 96: 467-474, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-291418

ABSTRACT

OBJECTIVES: Studies reported associations of inflammatory markers with the severity of COVID-19, but conclusions were inconsistent. We aimed to provide an overview of the association of inflammatory markers with the severity of COVID-19. METHODS: We searched PubMed, Embase, Cochrane Library, Wanfang and China National Knowledge Infrastructure (CNKI) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models. RESULTS: A total of 16 studies comprising 3962 patients with COVID-19 were included in our analysis. Random-effect results demonstrated that patients with COVID-19 in the nonsevere group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, -31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL-6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = -8 mm/h, 95% CI = [-14, -2], P = 0.005), SAA (WMD = -43.35 µg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [-625.89, -171.71], P < 0.001), compared with those in the severe group. Moreover, survivors had a lower level of IL-6 than non-survivors (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment. CONCLUSIONS: The meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might assist clinicians to monitor and evaluate the severity and prognosis of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections , Inflammation/diagnosis , Pandemics , Pneumonia, Viral , Biomarkers/analysis , COVID-19 , China , Humans , Prognosis , SARS-CoV-2
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