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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325393

ABSTRACT

Objectives: To discuss the prevention and containment of COVID-19 at a general hospital in Shenzhen China;to analyze the epidemiological and clinical characteristics of its confirmed patients, which is intended to provide a model for other hospitals in COVID-19 management. Methods: : The General Hospital of Shenzhen University sets up 4 medical zones relative to the COVID-19 prevention and containment. In so doing, the suspected patients classified into different kind of ward receive different treatment (Classified and Separated Treatment). The epidemiological distribution and clinical characteristics of 28 confirmed cases in the hospital were analyzed. Results: : There are no medical personnel infected cases, no cross-infection among the patients in the hospital, and no misdiagnosis or missed diagnosis of COVID-19. The majority of cases in the group is from 15 to 60 years old, 25 cases had a definite travel history or close contact history in the epidemic area, and parents and spouses of the confirmed patients are the main contact groups. Fever and respiratory symptoms have a high proportion, 4 diarrhea and 4 asymptomatic cases. Additionally, the decrease of lymphocyte is observed in 8 cases. Chest CT scan shows viral pneumonia in 14 cases,All patients were confirmed by nucleic acid tests. Conclusions: : Classified and Separated Treatment facilitates management of COVID-19 in the general hospital. Relative to suspected patients in the general hospital, diagnosis matters more than treatment. Epidemiological history, lymphocyte count, and chest CT scan play an important role as the indicator in early diagnosis of COVID-19.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325392

ABSTRACT

An outbreak of novel coronavirus(2019-nCoV) that began in Wuhan, China, is rapidly spreading to all over China, and gradually to multiple countries. Regarding to put the epidemic prevention and spread under the control, early identification and diagnosis play a critical role. Patients with initially no or mild symptoms of Novel Coronavirus Pneumonia (2019-nCoV), namely “stealth”infection, often lack of typical clinical evidence to establish the diagnosis. Based on the clinical analysis of 4 cases in stealth infection, the results of this study highlight that early diagnosis requires a combination of epidemiological history, clinical manifestations, early chest CT examination, and 2019-nCoV RNA test (nucleic acid test), with particular emphasis on definite epidemiological history and early chest CT findings when positive nucleic acid tests lag behind.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324341

ABSTRACT

We present an unusual case of a patient with bilateral lung transplantation due to severe Coronavirus Disease 2019 (COVID-19), who subsequently complicated with acute myocardial infarction and underwent primary percutaneous coronary intervention.

4.
Proc Assoc Inf Sci Technol ; 58(1): 768-770, 2021.
Article in English | MEDLINE | ID: covidwho-1469544

ABSTRACT

In the fight against COVID-19, the Pfizer and BioNTech vaccine announcement marked a significant turning point. Analysing the topics discussed surrounding the announcement is critical to shed light on how people respond to the vaccination against COVID-19. Specifically, since the COVID-19 vaccine was developed at unprecedented speed, different segments of the public with a different understanding of the issues may react and respond differently. We analysed Twitter tweets to uncover the issues surrounding people's discussion of the vaccination against COVID-19. Through the use of Latent Dirichlet Allocation (LDA), nine topics were identified pertaining to vaccine-related tweets. We analysed the temporal differences in the nine topics, prior and after the official vaccine announcement.

5.
Front Psychol ; 12: 678369, 2021.
Article in English | MEDLINE | ID: covidwho-1359230

ABSTRACT

Objective: The central issue of this research is to evaluate the extent of cognitive appraisal and coping processes within the pandemic encounter and determines their influence on frontline healthcare providers who had been dispatched to the coronavirus disease 2019 (COVID-19) epicenter (HPDE) distress symptoms. Materials and methods: An electronic survey of the HPDE and frontline healthcare providers who worked in their original medical facility (HPOF) was conducted from March 1 to 15, 2020. Two variables, appraisal (measured with an 18-item questionnaire) and coping (measured The Brief Cope questionnaire), were used in the analysis to explain distress symptoms (Impact of Event Scale-Revised). Results: A total of 723 eligible respondents completed the survey with a response rate of 57.3% (351 HPDE and 372 HPOF). The mean IES-R scores of HPDE respondents were 26.47 ± 11.7. Of HPDE respondents, 246 (70.09%) reported distress symptoms (score 9-88). The scores of intrusion, avoidance, and hyperarousal for HPDE were 10.28 ± 4.7, 8.97 ± 4.3, and 7.20 ± 3.2, respectively. The respondents had higher scores in overall distress and three subscales than HPOF. Appraisal and coping variables explained 77% of the distress variance. Five appraisal variables (health of self, health of family/others, virus spread, vulnerability or loss of control, and general health) were positively associated with distress symptoms. Four coping variables (active coping, positive reframing, self-distraction, and behavioral disengagement) were negatively associated with distress level, whereas self-blame was positively associated with distress symptoms. Regarding the appraisal, the scores of HPDE were significantly higher than HPOF (all p-values < 0.05), whereas being isolated was not significantly different between HDPE nurses and HPOF nurses. HPDE was significantly more likely to use humor, emotional support, instrumental support, self-distractions, venting, substance use, denial, behavioral disengagement, and self-blame (P < 0.05), whereas HPOF was significantly more likely to use active coping and acceptance (P < 0.05). HPDE doctors were significantly more likely than nurses to use active coping and acceptance (P < 0.05), whereas HPDE nurses were significantly more likely to use emotional support and use self-blame (P < 0.05). Conclusion: Frontline healthcare providers who had been dispatched to the COVID-19 epicenter respondents had a higher distress level. Therefore, we should provide proactive psychological support based on specific appraisal and coping variables.

6.
Int J Environ Res Public Health ; 18(15)2021 07 25.
Article in English | MEDLINE | ID: covidwho-1346476

ABSTRACT

Deep vein thrombosis causes several acute and chronic vessel complications and puts patients at risk of subsequent sepsis development. This unique study aimed to estimate the risk of sepsis development in DVT patients compared with non-DVT patients. This population-based cohort study used records of a longitudinal health insurance database containing two million patients defined in Taiwan's National Health Insurance Research Database (NHIRD). Our study included patients aged over 20 years with a new diagnosis of DVT with at least two outpatient department visits or an admission between 2001 and 2014. Patients with a diagnosis of sepsis before the index date were excluded. Propensity score matching (PSM) was used to homogenize the baseline characteristics between the two groups. To define the independent risk of the DVT group, a multivariate Cox proportional hazard model was used to estimate the hazard ratios. After PSM, the DVT group (n = 5753) exhibited a higher risk of sepsis (adjusted hazard ratio, aHR, 1.74; 95% CI, 1.59-1.90) compared with non-DVT group (n = 5753). Patients with an increased risk of sepsis were associated with being elderly aged, male, having diabetes, chronic kidney disease, chronic obstructive pulmonary disease, stroke, malignancy, and use of antibiotics. In conclusion, this population-based cohort study demonstrated an increased risk of sepsis in DVT patients compared with non-DVT patients. Thus, early prevention and adequate treatment of DVT is necessary in clinical practice.


Subject(s)
Pulmonary Embolism , Sepsis , Venous Thrombosis , Aged , Cohort Studies , Humans , Incidence , Male , Retrospective Studies , Risk Factors , Sepsis/epidemiology , Venous Thrombosis/epidemiology
7.
Med Sci Monit ; 27: e931467, 2021 Oct 06.
Article in English | MEDLINE | ID: covidwho-1344552

ABSTRACT

BACKGROUND Effective identification of patients with suspected COVID-19 is vital for the management. This study aimed to establish a simple clinical prediction model for COVID-19 in primary care. MATERIAL AND METHODS We consecutively enrolled 60 confirmed cases and 152 suspected cases with COVID-19 into the study. The training cohort consisted of 30 confirmed and 78 suspected cases, whereas the validation cohort consisted of 30 confirmed and 74 suspected cases. Four clinical variables - epidemiological history (E), body temperature (T), leukocytes count (L), and chest computed tomography (C) - were collected to construct a preliminary prediction model (model A). By integerizing coefficients of model A, a clinical prediction model (model B) was constructed. Finally, the scores of each variable in model B were summed up to build the ETLC score. RESULTS The preliminary prediction model A was Logit (YA)=2.657X1+1.153X2+2.125X3+2.828X4-10.771, while the model B was Logit (YB)=2.5X1+1X2+2X3+3X4-10. No significant difference was found between the area under the curve (AUC) of model A (0.920, 95% CI: 0.875-0.953) and model B (0.919, 95% CI: 0.874-0.952) (Z=0.035, P=0.972). When ETLC score was more than or equal to 9.5, the sensitivity and specificity for COVID-19 was 76.7% (46/60) and 90.1% (137/152), respectively, and the positive and negative predictive values were 75.4% (46/61) and 90.7% (137/151), respectively. CONCLUSIONS The ETLC score is helpful for efficiently identifying patients with suspected COVID-19.


Subject(s)
COVID-19/diagnosis , Diagnosis, Computer-Assisted/methods , Primary Health Care/methods , Body Temperature , COVID-19/epidemiology , Humans , Leukocyte Count , Logistic Models , SARS-CoV-2 , Tomography, X-Ray Computed
8.
Transplant Cell Ther ; 27(10): 870.e1-870.e7, 2021 10.
Article in English | MEDLINE | ID: covidwho-1292829

ABSTRACT

Late-onset severe pneumonia (LOSP) is defined as severe pneumonia developing during the late phase of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Because of the high mortality in patients with LOSP, it is important to identify prognostic factors. In this study, we aimed to develop a risk score system with broad applicability that can help predict the risk of LOSP-associated mortality. We retrospectively analyzed 100 patients with LOSP after allo-HSCT between June 2009 and July 2017. The assessment variables included immune, nutritional, and metabolic parameters at the onset of LOSP. Of these 100 patients, 45 (45%) eventually died, and 55 (55%) were positive for organisms, most commonly viruses. In the multivariate analysis, higher monocyte count (≥0.20 × 109/L versus <0.20 × 109/L; P = .001), higher albumin level (≥30.5 g/L versus <30.5 g/L; P = .044), lower lactic dehydrogenase level (<250 U/L versus ≥250 U/L; P = .008) and lower blood urea nitrogen concentration (<7.2 mmol/L versus ≥7.2 mmol/L; P = .026) at the onset of LOSP were significantly associated with better 60-day survival. A risk score system based on the foregoing results showed that the probability of 60-day survival decreased with increasing risk factors, from 96.3% in the low-risk group to 49.1% in the intermediate-risk group and 12.5% in the high-risk group. Our results indicate that this scoring system using 4 variables can stratify patients with different probabilities of survival after LOSP, which suggests that patients' immune, nutritional, and metabolic status are crucial factors in determining outcome.


Subject(s)
Hematopoietic Stem Cell Transplantation , Pneumonia , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Pneumonia/diagnosis , Prognosis , Retrospective Studies , Transplantation, Homologous
9.
Front Psychiatry ; 12: 566990, 2021.
Article in English | MEDLINE | ID: covidwho-1291006

ABSTRACT

Chinese emergency department (ED) staff encountered significant mental stress while fighting the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the prevalence and associated factors for depressive symptoms among ED staff (including physicians, nurses, allied health, and auxiliary ED staff). A cross-sectional national survey of ED staff who were on duty and participated in combating the COVID-19 pandemic was conducted March 1-15, 2020. A total of 6,588 emergency medical personnel from 1,060 hospitals responded to this survey. A majority of respondents scored above 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. Those aged 31-45, those working in the COVID-19 isolation unit, and those with relatives ≤ 16 or ≥70 years old at home all had statistically significant associations with scoring >10 points. Depressive symptoms among Chinese emergency medical staff were likely quite common during the response to the COVID-19 pandemic and reinforce the importance of targeted ED staff support during future outbreaks.

10.
JNMA J Nepal Med Assoc ; 59(236): 417-424, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1257585

ABSTRACT

Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.


Subject(s)
COVID-19 , Mucocutaneous Lymph Node Syndrome , Child , Humans , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/drug therapy , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
11.
Sensors and Actuators B: Chemical ; : 129864, 2021.
Article in English | ScienceDirect | ID: covidwho-1157736

ABSTRACT

Circulating lymphocytes are integral components of our adaptive immunity with emerging clinical applications in immune status monitoring in infectious diseases and cell-mediated cancer immunotherapies. Herein we present a novel impedance-based microfluidic assay for label-free lymphocyte activation profiling based on native or antigen-specific T-lymphocyte biophysical responses. Single cell impedance profiling of T-lymphocytes first revealed distinct biophysical differences in cell size and membrane electrical impedance of healthy, activated (CD3/CD28) and dead lymphocyte populations. Impedance characterization of peripheral blood mononuclear cells (PBMCs) stimulated with mitogen phytohemagglutinin (PHA) or Tuberculin Purified Protein Derivative antigen (PPD) after 24 hours also showed an increase in lymphocyte cell size (∼8 to 10 µm) which corresponded to activated lymphocytes (CD69+CD137+). We next developed a spiral inertial microfluidics cell sorter integrated with coplanar electrodes for direct impedance quantification of activated lymphocytes. By removing non-activated smaller lymphocytes (< 8 µm) and employing hydrodynamic-based single stream particle focusing, we demonstrated significant enrichment of activated lymphocytes (∼11.7-fold) to electrically detect low levels of lymphocyte activation (< 5%). Finally, the developed biochip is coupled with magnetic activated cell sorting (MACS) to quantify CD4+ T-lymphocytes response in PBMCs stimulated with PPD. A differential impedance cell count ratio (stimulated/unstimulated) was defined to distinguish activated T-lymphocytes, which showed better sensitivity as compared to immunophenotyping by flow cytometry. Taken together, the integrated impedance biosensor can be further developed as a rapid multiplexed screening assay to detect antigen-specific T-lymphocyte responses to characterize host immunity and diagnosis of infectious diseases (e.g tuberculosis, dengue and COVID-19).

12.
Nat Commun ; 12(1): 1383, 2021 03 02.
Article in English | MEDLINE | ID: covidwho-1114711

ABSTRACT

In this study, we investigate the seroprevalence of SARS-CoV-2 antibodies among blood donors in the cities of Wuhan, Shenzhen, and Shijiazhuang in China. From January to April 2020, 38,144 healthy blood donors in the three cities were tested for total antibody against SARS-CoV-2 followed by pseudotype SARS-CoV-2 neutralization tests, IgG, and IgM antibody testing. Finally, a total of 398 donors were confirmed positive. The age- and sex-standardized SARS-CoV-2 seroprevalence among 18-60 year-old adults (18-65 year-old in Shenzhen) was 2.66% (95% CI: 2.24%-3.07%) in Wuhan, 0.033% (95% CI: 0.0029%-0.267%) in Shenzhen, and 0.0028% (95% CI: 0.0001%-0.158%) in Shijiazhuang, respectively. Female sex and older-age were identified to be independent risk factors for SARS-CoV-2 seropositivity among blood donors in Wuhan. As most of the population of China remained uninfected during the early wave of the COVID-19 pandemic, effective public health measures are still certainly required to block viral spread before a vaccine is widely available.


Subject(s)
SARS-CoV-2/pathogenicity , Antibodies, Viral/blood , Blood Donors/statistics & numerical data , COVID-19/blood , COVID-19/epidemiology , COVID-19/immunology , China/epidemiology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Neutralization Tests , Prevalence , Risk Factors , SARS-CoV-2/immunology
13.
Front Immunol ; 11: 621441, 2020.
Article in English | MEDLINE | ID: covidwho-1081856

ABSTRACT

Although COVID-19 has become a major challenge to global health, there are currently no efficacious agents for effective treatment. Cytokine storm syndrome (CSS) can lead to acute respiratory distress syndrome (ARDS), which contributes to most COVID-19 mortalities. Research points to interleukin 6 (IL-6) as a crucial signature of the cytokine storm, and the clinical use of the IL-6 inhibitor tocilizumab shows potential for treatment of COVID-19 patient. In this study, we challenged wild-type and adenovirus-5/human angiotensin-converting enzyme 2-expressing BALB/c mice with a combination of polyinosinic-polycytidylic acid and recombinant SARS-CoV-2 spike-extracellular domain protein. High levels of TNF-α and nearly 100 times increased IL-6 were detected at 6 h, but disappeared by 24 h in bronchoalveolar lavage fluid (BALF) following immunostimulant challenge. Lung injury observed by histopathologic changes and magnetic resonance imaging at 24 h indicated that increased TNF-α and IL-6 may initiate CSS in the lung, resulting in the continual production of inflammatory cytokines. We hypothesize that TNF-α and IL-6 may contribute to the occurrence of CSS in COVID-19. We also investigated multiple monoclonal antibodies (mAbs) and inhibitors for neutralizing the pro-inflammatory phenotype of COVID-19: mAbs against IL-1α, IL-6, TNF-α, and granulocyte-macrophage colony-stimulating factor (GM-CSF), and inhibitors of p38 and JAK partially relieved CSS; mAbs against IL-6, TNF-α, and GM-CSF, and inhibitors of p38, extracellular signal-regulated kinase, and myeloperoxidase somewhat reduced neutrophilic alveolitis in the lung. This novel murine model opens a biologically safe, time-saving avenue for clarifying the mechanism of CSS/ARDS in COVID-19 and developing new therapeutic drugs.


Subject(s)
Anti-Inflammatory Agents/pharmacology , COVID-19/immunology , Cytokine Release Syndrome/immunology , Disease Models, Animal , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Neutralizing/pharmacology , Antibodies, Viral/pharmacology , Cytokine Release Syndrome/virology , Cytokines/immunology , Male , Mice , Mice, Inbred BALB C , Poly I-C/immunology , SARS-CoV-2/immunology
17.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-724

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease transmitted human-to-human by the coronavirus SARS-CoV-2. The SARS-CoV-2 RNA has

19.
J Zhejiang Univ Sci B ; 21(5): 411-415, 2020 May.
Article in English | MEDLINE | ID: covidwho-209415

ABSTRACT

We present an unusual case of a patient with bilateral-lung transplantation due to severe coronavirus disease 2019 (COVID-19), who subsequently suffered complications with acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI).


Subject(s)
Coronavirus Infections/complications , Lung Diseases/virology , Lung Transplantation , Percutaneous Coronary Intervention , Pneumonia, Viral/complications , ST Elevation Myocardial Infarction/surgery , Aged , Betacoronavirus , COVID-19 , China , Humans , Lung Diseases/surgery , Male , Pandemics , SARS-CoV-2 , ST Elevation Myocardial Infarction/virology
20.
Acta Ophthalmol ; 2020 Apr 26.
Article in English | MEDLINE | ID: covidwho-117130

ABSTRACT

PURPOSE: The SARS-CoV-2 RNA has been detected in tears and conjunctival samples from infected individuals. Conjunctivitis is also reported in a small number of cases. We evaluated ocular symptoms and ocular tropism of SARS-CoV-2 in a group of patients with COVID-19. METHOD: Fifty-six patients infected with SARS-CoV-2 were recruited as subjects. Relevant medical histories were obtained from the electronic medical record system. Ocular history and ocular symptoms data were obtained by communicating directly with the subjects. The Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ) were used to assess the anterior ocular surface condition before and after the onset of disease. RESULTS: Patients classified as severe COVID-19 cases were more likely to have hypertension compared to mild cases (p = 0.035). Of the 56 subjects, thirteen patients (23%) were infected in Wuhan, 32 patients (57%) were community-infected, 10 patients (18%) were unknown origin, 1 (2%) was a physician likely infected by a confirmed patient. Three patients wore face mask with precaution when contacting the confirmed patients. Fifteen (27%) had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. The differences in mean scores of OSDI questionnaire and SEEQ between before and after onset of COVID-19 were all significant (p < 0.05 for both). CONCLUSIONS: Ocular symptoms are relatively common in COVID-19 disease and may appear just before the onset of respiratory symptoms. Our data provided the anecdotal evidences of transmission of SARS-CoV-2 via ocular surface.

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