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1.
Front Psychol ; 12: 614193, 2021.
Article in English | MEDLINE | ID: covidwho-1417124

ABSTRACT

Objective: To analyze the discrepancy between self-rating and professional evaluation of mental health status in coronavirus disease 2019 (COVID-19) cluster cases. Method: A total of 65 COVID-19 cluster cases admitted to Beijing Ditan Hospital Capital Medical University from June 14, 2020 to June 16, 2020 were included in the study. Mental health assessment was completed by self-rating and professional evaluation. The gaps between self-rating and professional evaluation in different demographic characteristics were compared. Results: The results of self-rating were inconsistent with those of professional evaluation. The gap was statistically different among certain demographic subgroups. As for anxiety, the gaps had remarkable statistics differences in subgroups of sex, monthly income, infection way, and anxiety/depression medical history. Similarly, in the terms of depression, the gaps had significant statistic differences in the subgroups of the medical history of anxiety/depression, history of physical disease, employment status and the insurance type, marriage, education (year), residing in Beijing (year), and the monthly income. Conclusion: Compared to the professional evaluation, patients had a higher self-rating, which may be related to some demographic characteristics. It suggests that screening can be conducted in patients with COVID-19 by self-rating first, and then professional evaluation should be carried out in the patients with suspicious or positive results.

2.
Prev Med Rep ; 23: 101449, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1267887

ABSTRACT

Adherence to guidelines for face coverings and physical distancing are critical strategies to stem the COVID-19 pandemic but are not uniformly followed. Understanding factors associated with adherence to mask-wearing and physical distancing may help guide future control efforts. We conducted an observational study using Systematic Observation of Mask Adherence and Distancing (SOMAD) in August 2020 in parks, playgrounds and commercial streets in each of 10 City Council Districts in Philadelphia, PA. Wearing a mask correctly varied by setting with highest adherence in commercial areas and lowest in playgrounds. Almost 17% wore visible masks that did not cover the nose and/or mouth. There were multiple disparities in correct mask use. Females had higher rates than males (unadjusted relative risk = 1.40, p < .0001) and seniors higher than any other age group (unadjusted chi-square p < .0001). Asians wore masks correctly the most often [adjusted log odds ratio (LOR) = 0.53 compared with non-Hispanic white, p = 0.02]. Correct mask-wearing was higher in areas with a higher population density (adjusted LOR = 0.03 per one thousand/square mile, p = 0.02) and lower in higher poverty areas (adjusted LOR = -0.01, p = .03). Disparities in adherence to mask wearing and physical distancing likely reflect differences in perception of risk by gender, age group, and race/ethnicity. While the risk of COVID-19 transmission is lower in outdoor settings, it is unlikely to be zero. The lower rates of mask use by males and minority groups suggest increased efforts are needed to enhance adherence to recommended guidelines.

3.
Front Immunol ; 12: 640644, 2021.
Article in English | MEDLINE | ID: covidwho-1133916

ABSTRACT

Infection with SARS-CoV-2 can lead to Coronavirus disease-2019 (COVID-19) and result in severe acute respiratory distress syndrome (ARDS). Recent reports indicate an increased rate of fungal coinfections during COVID-19. With incomplete understanding of the pathogenesis and without any causative therapy available, secondary infections may be detrimental to the prognosis. We monitored 11 COVID-19 patients with ARDS for their immune phenotype, plasma cytokines, and clinical parameters on the day of ICU admission and on day 4 and day 7 of their ICU stay. Whole blood stimulation assays with lipopolysaccharide (LPS), heat-killed Listeria monocytogenes (HKLM), Aspergillus fumigatus, and Candida albicans were used to mimic secondary infections, and changes in immune phenotype and cytokine release were assessed. COVID-19 patients displayed an immune phenotype characterized by increased HLA-DR+CD38+ and PD-1+ CD4+ and CD8+ T cells, and elevated CD8+CD244+ lymphocytes, compared to healthy controls. Monocyte activation markers and cytokines IL-6, IL-8, TNF, IL-10, and sIL2Rα were elevated, corresponding to monocyte activation syndrome, while IL-1ß levels were low. LPS, HKLM and Aspergillus fumigatus antigen stimulation provoked an immune response that did not differ between COVID-19 patients and healthy controls, while COVID-19 patients showed an attenuated monocyte CD80 upregulation and abrogated release of IL-6, TNF, IL-1α, and IL-1ß toward Candida albicans. This study adds further detail to the characterization of the immune response in critically ill COVID-19 patients and hints at an increased susceptibility for Candida albicans infection.


Subject(s)
Aspergillus fumigatus/immunology , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , COVID-19/immunology , Candida albicans/immunology , Listeria monocytogenes/immunology , SARS-CoV-2/physiology , Aged , Cells, Cultured , Cytokines/metabolism , Disease Susceptibility , Female , Humans , Immune Tolerance , Male , Middle Aged , Programmed Cell Death 1 Receptor/metabolism , Respiratory Distress Syndrome
4.
Drugs Real World Outcomes ; 8(2): 131-140, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1077714

ABSTRACT

BACKGROUND: Several pharmacological agents, such as chloroquine/hydroxychloroquine, have been promoted for COVID-19 treatment or pre-exposure prophylaxis. However, no comprehensive evaluation of the safety of these possible agents is available, and is urgently needed. OBJECTIVE: The purpose of this study was to investigate the risks of cardiac adverse events associated with the possible pharmacotherapies for COVID-19, including certain antimalarial, antiviral, and antibiotic drugs. PATIENTS AND METHODS: We conduced retrospective pharmacovigilance analyses of the US Food and Drug Administration Adverse Event Reporting System database. The reporting odds ratio (ROR), a data mining algorithm commonly used in pharmacovigilance assessment, was generated to quantify the detection signal of adverse events. RESULTS: Among individuals without coronavirus infection from 2015 Q1 to 2020 Q1, increased risks for cardiac disorders were found for antiviral agents such as chloroquine/hydroxychloroquine (ROR: 1.68; 95% confidence interval [CI] 1.66-1.70), lopinavir/ritonavir (ROR: 1.52; 95% CI 1.39-1.66), and antibiotics such as azithromycin (ROR: 1.37; 95% CI 1.30-1.44) and ceftriaxone (ROR: 1.92; 95% CI 1.80-2.05). Increased serious cardiac adverse events, including myocardial infarction, arrhythmia, and cardiac arrest, were also reported for these drugs. Further analyses of individuals with coronavirus infections revealed that 40% of individuals receiving chloroquine/hydroxychloroquine reported serious cardiac adverse events. Two cases resulted in QT prolongations and one case resulted in cardiac arrest. Chloroquine/hydroxychloroquine and azithromycin contributed to all the QT prolongation and cardiac arrest cases. CONCLUSIONS: The current pharmacotherapies for COVID-19 are associated with increased risks of cardiac adverse events. Variations in the cardiac safety profiles of these pharmacotherapies were also observed. Clinicians should closely monitor patients with COVID-19, especially those at high risk, using chloroquine/hydroxychloroquine and azithromycin.

5.
Int J Infect Dis ; 104: 77-82, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065180

ABSTRACT

BACKGROUND AND PURPOSE: An increasing number of reports have observed thrombosis in severe cases of COVID-19. The aim of this study was to evaluate the incidence of thromboembolism in mild/moderate cases of COVID-19. All of the patients had normal coagulation tests and none had any overt thrombotic complications. Our findings indicate that it is important to screen the thrombotic status of cases with mild/moderate COVID-19. METHODS: Between 11 June and 8 July 2020, 23 patients with mild/moderate COVID-19 pneumonia consented to having computed tomography pulmonary angiography (CPTA) and computed tomography venography (CTV) scans of the lungs and extremity veins. Doppler ultrasound (DUS) was also performed in all patients for screening. The incidence, clinical manifestations, laboratory examinations, imaging features, and prognosis, of patients with venous thromboembolism (VTE) were analyzed and compared with those of patients with COVID-19 pneumonia without VTE. RESULTS: Nineteen patients (82.6%) had VTE, mainly distal limb thrombosis. Only one of the VTE patients was positive when screened by DUS; the other VTE patients were negative by DUS. All of the mild/moderate patients with VTE were screened by CTPA + CTV. Blood tests for inflammatory, coagulation, and biochemical, parameters were all within the normal range, except for WBC and LDH. CONCLUSIONS: When using CTV screening for DVT, we found that the incidence of thrombosis in patients with mild/moderate COVID-19 markedly increased to 82.6% (19/23). Screening for thrombosis is therefore important in patients with COVID-19. CTV is more sensitive than DUS for the detection of thrombosis. More research is now needed to evaluate the significance of thrombosis in COVID-19 pneumonia.


Subject(s)
COVID-19/complications , SARS-CoV-2 , Venous Thromboembolism/epidemiology , Adult , Female , Humans , Male , Middle Aged , Prevalence , Tomography, X-Ray Computed/methods , Ultrasonography, Doppler , Venous Thromboembolism/diagnostic imaging
7.
Parkinsons Dis ; 2020: 1216568, 2020.
Article in English | MEDLINE | ID: covidwho-852753

ABSTRACT

Introduction: This study investigated the influence of lockdown during the 2019 coronavirus disease (COVID-19) pandemic on the quality of life of patients with Parkinson's disease (PD). Methods: We conducted a questionnaire survey involving 113 patients with PD from Xihu District, Hangzhou, Zhejiang. During the epidemic prevention and control period (February 1 to March 31, 2020), patients enrolled were asked to fill out questionnaires, including the "COVID-19 Questionnaire for PD Patients during the Period of Epidemic Prevention and Control" and "39-item Parkinson's Disease Questionnaire (PDQ-39)." During the phase of gradual release of epidemic prevention and control (April 1 to April 30, 2020), all patients were followed up again, and PDQ-39 questionnaires were completed. Results: The quality of life for patients during the period of epidemic prevention and control was worse than that after epidemic prevention and control (P < 0.001). The biggest problem that they faced was that they could not receive their doctor's advice or guidance regularly. The quality of life of patients who had difficulty getting doctors' guidance or those who changed their routine medication due to lockdown was even worse. Telemedicine was quite effective and efficient for patients to get doctors' guidance during lockdown. Conclusions: The inconvenient treatment during the pandemic directly caused the aggravation of patients' symptoms and the decline in their quality of life. It is suggested that social media (such as WeChat or Tencent QQ) are used for regular interactions and follow-up appointments for patients with inconvenient medical treatment.

8.
Preprint | CAplus | ID: ppcovidwho-2056

ABSTRACT

A review. The damage of organs caused by new coronavirus pneumonia was reviewed. Tha damage includes lung, heart, liver, kidney and other organ damages. The author also summarized strategy for treatment of the organ damage caused by the new coronavirus pneumonia.

9.
Preprint | SSRN | ID: ppcovidwho-627

ABSTRACT

Background: The sudden epidemic of COVID-19 in China caused attention globally. Health staff are in heavy workload and at high-risk infection. The aims of this

10.
Open Forum Infect Dis ; 7(5): ofaa169, 2020 May.
Article in English | MEDLINE | ID: covidwho-623975

ABSTRACT

Background: There is currently a lack of nonspecific laboratory indicators as a quantitative standard to distinguish between the 2019 coronavirus disease (COVID-19) and an influenza A or B virus infection. Thus, the aim of this study was to establish a nomogram to detect COVID-19. Methods: A nomogram was established using data collected from 457 patients (181 with COVID-19 and 276 with influenza A or B infection) in China. The nomogram used age, lymphocyte percentage, and monocyte count to differentiate COVID-19 from influenza. Results: Our nomogram predicted probabilities of COVID-19 with an area under the receiver operating characteristic curve of 0.913 (95% confidence interval [CI], 0.883-0.937), greater than that of the lymphocyte:monocyte ratio (0.849; 95% CI, 0.812-0.880; P = .0007), lymphocyte percentage (0.808; 95% CI, 0.768-0.843; P < .0001), monocyte count (0.780; 95% CI, 0.739-0.817; P < .0001), or age (0.656; 95% CI, 0.610-0.699; P < .0001). The predicted probability conformed to the real observation outcomes of COVID-19, according to the calibration curves. Conclusions: We found that age, lymphocyte percentage, and monocyte count are risk factors for the early-stage prediction of patients infected with the 2019 novel coronavirus. As such, our research provides a useful test for doctors to differentiate COVID-19 from influenza.

11.
Front Med ; 15(1): 139-143, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-597942

ABSTRACT

The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.


Subject(s)
Community-Acquired Infections , Pneumonia , Adult , Anti-Bacterial Agents/therapeutic use , Biomarkers , Calcitonin , Community-Acquired Infections/drug therapy , Humans , Pneumonia/drug therapy , Protein Precursors
13.
J Transl Med ; 18(1): 206, 2020 05 20.
Article in English | MEDLINE | ID: covidwho-324357

ABSTRACT

BACKGROUND: Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19. METHODS: The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness. RESULTS: The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process. CONCLUSIONS: We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.


Subject(s)
Coronavirus Infections/diagnosis , Critical Illness , Lymphocytes/pathology , Neutrophils/pathology , Pneumonia, Viral/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/pathogenicity , COVID-19 , Child , Child, Preschool , Cohort Studies , Coronavirus Infections/blood , Coronavirus Infections/pathology , Disease Progression , Female , History, 21st Century , Humans , Infant , Leukocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/pathology , Prognosis , Prospective Studies , SARS-CoV-2 , Severity of Illness Index , Young Adult
14.
J Inflamm (Lond) ; 17: 19, 2020.
Article in English | MEDLINE | ID: covidwho-260363

ABSTRACT

Background: To investigate the efficacy and safety of aerosol inhalation of recombinant human interferon α1b (IFNα1b) injection for noninfluenza viral pneumonia. Methods: One hundred sixty-four patients with noninfluenza viral pneumonia were divided into IFNα1b and control groups. The IFNα1b group received routine treatment + aerosol inhalation of recombinant human IFNα1b injection (50 µg × 2 injections, bid). The control group received routine treatment + IFN analog (two injections, bid). Overall response rate (ORR) of five kinds clinical symptoms. Further outcomes were daily average score and the response rate of each of the symptoms above. Results: A total of 163 patients were included in the full analysis set (FAS) and 151 patients were included in the per-protocol set (PPS). After 7 days of treatment, ORR of clinical symptoms was higher in IFNα1b group than that in control group for both the FAS and PPS. Moreover, after 7 days of treatment, the daily score of three efficacy indexes including expectoration, respiratory rate, and pulmonary rales were improved. The ORRs for expectoration and pulmonary rales were higher in the IFNα1b group than in the control group (P < 0.05). There were no significant differences of the ORRs for coughing, chest pain and respiratory rate between the two groups (P > 0.05). The incidence of adverse events was 6.5% (n = 5) in IFNα1b group and 3.5% (n = 3) in control group (P > 0.05). Conclusion: Aerosol inhalation of recombinant human IFNα1b is safe and it can improve the clinical symptoms of noninfluenza viral pneumonia.

15.
J Infect ; 81(2): e26-e30, 2020 08.
Article in English | MEDLINE | ID: covidwho-108718

ABSTRACT

BACKGROUND: Since its discovery, SARS-CoV-2 has been spread throughout China before becoming a global pandemic. In Beijing, family clusters are the main mode of human-human transmission accounting for 57.6% of the total confirmed cases. METHOD: We present the epidemiological and clinical features of the clusters of three large and one small families. RESULT: Our results revealed that SARS-CoV-2 is transmitted quickly through contact with index case, and a total of 22/24 infections were observed. Among those infected, 20/22 had mild symptoms and only two had moderate to severe clinical manifestations. Children in the families generally showed milder symptoms. The incubation period varied from 2 to 13 days, and the shedding of virus from the upper respiratory tract lasted from 5 to over 30 days. A prolonged period of virus shedding (>30 days) in upper respiratory tract was observed in 6/24 cases. CONCLUSION: SARS-CoV-2 is transmitted quickly in the form of family clusters. While the infection rate is high within the cluster, the disease manifestations, latent period, and virus shedding period varied greatly. We therefore recommend rigorously testing contacts even during the no-symptom phase and consider whether viral shedding has ceased before stopping isolation measures for an individual.


Subject(s)
Coronavirus Infections/epidemiology , Family , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Adult , Aged , Aged, 80 and over , Beijing/epidemiology , Betacoronavirus , COVID-19 , Child , Child, Preschool , Coronavirus Infections/pathology , Coronavirus Infections/transmission , Female , Humans , Infant , Male , Middle Aged , Pneumonia, Viral/pathology , Pneumonia, Viral/transmission , SARS-CoV-2
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