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2.
Chemosphere ; 308(Pt 1): 136265, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2003926

ABSTRACT

The effective treatment of hospital sewage is crucial to human health and eco-environment, especially during the pandemic of COVID-19. In this study, a demonstration project of actual hospital sewage using electron beam technology was established as advanced treatment process during the outbreak of COVID-19 pandemic in Hubei, China in July 2020. The results indicated that electron beam radiation could effectively remove COD, pathogenic bacteria and viruses in hospital sewage. The continuous monitoring date showed that the effluent COD concentration after electron beam treatment was stably below 30 mg/L, and the concentration of fecal Escherichia coli was below 50 MPN/L, when the absorbed dose was 4 kGy. Electron beam radiation was also an effective method for inactivating viruses. Compared to the inactivation of fecal Escherichia coli, higher absorbed dose was required for the inactivation of virus. Absorbed dose had different effect on the removal of virus. When the absorbed dose ranged from 30 to 50 kGy, Hepatitis A virus (HAV) and Astrovirus (ASV) could be completely removed by electron beam treatment. For Rotavirus (RV) and Enterovirus (EV) virus, the removal efficiency firstly increased and then decreased. The maximum removal efficiency of RV and EV was 98.90% and 88.49%, respectively. For the Norovirus (NVLII) virus, the maximum removal efficiency was 81.58%. This study firstly reported the performance of electron beam in the removal of COD, fecal Escherichia coli and virus in the actual hospital sewage, which would provide useful information for the application of electron beam technology in the treatment of hospital sewage.


Subject(s)
COVID-19 , Enterovirus , Viruses , Bacteria , Electrons , Escherichia coli , Hospitals , Humans , Pandemics , Sewage , Waste Water/microbiology
3.
Medicine (Baltimore) ; 101(29): e29438, 2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1961222

ABSTRACT

The relationship between smoking and coronavirus disease 2019 (COVID-19) severity remains unclear. This study aimed to investigate the effect of smoking status (current smoking and a smoking history) on the clinical severity of COVID-19. Data of all enrolled 588 patients, who were referred to 25 hospitals in Jiangsu province between January 10, 2020 and March 14, 2020, were retrospectively reviewed. Univariate and multivariate regression, random forest algorithms, and additive interaction were used to estimate the importance of selective predictor variables in the relationship between smoking and COVID-19 severity. In the univariate analysis, the proportion of patients with a current smoking status in the severe group was significantly higher than that in the non-severe group. In the multivariate analysis, current smoking remained a risk factor for severe COVID-19. Data from the interaction analysis showed a strong interaction between the number of comorbidities in patients with COVID-19 and smoking. However, no significant interaction was found between smoking and specific comorbidities, such as hypertension, diabetes, etc. In the random forest model, smoking history was ranked sixth in mean decrease accuracy. Active smoking may be significantly associated with an enhanced risk of COVID-19 progression towards severe disease. However, additional prospective studies are needed to clarify the complex relationship between smoking and COVID-19 severity.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Retrospective Studies , Risk Factors , SARS-CoV-2 , Smoking/adverse effects , Smoking/epidemiology
4.
Advanced Energy Materials ; : 1, 2022.
Article in English | Academic Search Complete | ID: covidwho-1905775

ABSTRACT

Under the growing crisis of the coronavirus disease 2019 pandemic, the global medical system is facing the predicament of an acute shortage of medical‐grade oxygen (O2, ≥ 99.5% purity). Herein, an oxygen generation device is manufactured that relies on electrochemical technology. The performance of the electrochemical oxygen generator (EOG) is remarkably improved to a practically applicable level, achieving long‐term (>200 h), stable, and quick production (>1.5 L min−1) of high purity O2 (99.9%) at high energy efficiency (496 L kW−1 h−1), via simultaneous optimization for intrinsic electrochemical reaction mechanisms, electrocatalysts, and external cell structure. The EOG also presents powerful competitiveness in user experience, which finds expression in high portability (4.7 kg), nearly instant O2 production (<1 s), and a quiet working condition (<39 dB). The EOG shows great potential to substitute commercial pressure swing adsorption O2 generation devices, which may significantly impact the traditional oxygen production industry. [ FROM AUTHOR] Copyright of Advanced Energy Materials is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

5.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335237

ABSTRACT

Summary Background People living with chronic disease, particularly seniors older than 60 years old, are lagging behind in the national vaccination campaign in China due to uncertainty of safety and effectiveness. However, this special population made up of most severe symptom and death cases among infected patients and should be prioritized in vaccination program. In this retrospective study, we assessed the safety and immunogenicity of the CoronaVac inactivated vaccines in people with underlying medical conditions to address the vaccine hesitation in this special population. Methods In this cohort study, volunteers aged 40 years and older, had received two doses of CoronaVac inactivated vaccines (3-5 weeks interval), been healthy or with at least one of the six diseases: coronary heart disease (CAD), hypertension, diabetes mellitus (DM), chronic respiratory disease (CRD), obesity and cancer, were recruited from 4 study sites in China. The primary safety outcome was the incidence of adverse events within 14 days after each dose of vaccination. The primary immunogenic outcome was geometric mean titer (GMT) of neutralizing antibodies to living SARS-CoV-2 virus at 14-28 days, 3 months, and 6 months after full two-dose vaccination. This study is registered with ChiCTR.org.cn (ChiCTR2200058281) and is active but no longer recruiting. Findings Among 1,302 volunteers screened between Jul 5 and Dec 30, 2021, 969 were eligible and enrolled in our cohort, including 740 living with underlying medical conditions and 229 as healthy control. All of them formed the safety cohort. The overall incidence of adverse reactions was 150 (20.27%) of 740 in the comorbidities group versus 32 (13.97%) of 229 in the healthy group, with significant difference (P=0.0334). The difference was mainly contributed by fatigue and injection-site pain in some groups. Most adverse reactions were mild (Grade 1). We did not observe any serious adverse events related to vaccination. By day 14-28 post vaccination, the seroconversion rates and GMT of neutralizing antibody showed no significant difference between disease group and healthy group, except CAD group (P=0.03) and CRD group (P=0.04) showed slight reduction. By day 90, the neutralizing antibody GMTs were significantly reduced in each group, with no significant difference between diseases and healthy group. By day 180, the neutralizing antibody continued to decrease in each group, but with slower declination. Interpretation For people living with chronic disease especially seniors older than 60 years, the CoronaVac vaccines are as safe as in healthy people. Although the immunogenicity is slightly different in subgroup of some diseases compared with that of the healthy population, the overall trend was consistent. Our findings highlight the evidence to address vaccine hesitancy for seniors and people living with chronic diseases. Funding Yunnan Provincial Science and Technology Department (202102AA100051 and 202003AC100010, China), Sinovac Biotech Ltd (PRO-nCOV-4004).

6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331100

ABSTRACT

Under the growing crisis of coronavirus disease 2019 pandemic, the global medical system is facing the predicament of an acute shortage of medical-grade oxygen (O 2 , ≥ 99.5% purity). Herein, we manufactured an oxygen generation device relying on electrochemical technology. The performance of electrochemical oxygen generator (EOG) was remarkably improved to a practically applicable level, achieving long-term (>200 h), stable, and quick production (>1.5L/min) of high purity O 2 (99.9%) under high energy efficiency (496 L/kW·h), viasimultaneous optimizations for intrinsic electrochemical reaction mechanism, electrocatalysts, and external cell structure. The EOG also presents powerful competitiveness in user experience, which finds expression in high portability (4.7 kg), nearly instant O 2 production (<1 s), and a quiet working condition (<39 dB). The EOG shows great potential to substitute commercial pressure swing adsorption O 2 generation devices, which may significantly impact the traditional oxygen production industry.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324550

ABSTRACT

Background: An ongoing global pandemic of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused thousands of deaths in China since December, 2019. We aimed to describe the clinical course of patients died of SARS-CoV-2 infection.Methods In this retrospective study, we reviewed 194 patients with SARS-CoV-2 infection, who died consecutively between Feb 3 to 24, 2020 in Tongji Hospital (Wuhan, China). Basic demographic and clinical information, laboratory findings, complications and treatments were extracted from electronic medical records of Hospital Information System. Unpaired t test was employed to evaluate the statistical differences of the serum level of high-sensitive cardiac troponin I (hs-cTnI) among different age or sex groups. The relationship between hs-cTnI and inflammatory cytokines were estimated using Spearman correlation analysis.Results The death patients aged 69.62 ± 10.98, in which 68.6% were male. 74.7% patients had underlying chronic illnesses. The most common symptoms were fever (83%), cough (69.3%), and dyspnea (65.6%). Decreased lymphocyte count (91.4%), elevated level of hs-cTnI (82.9%) and inflammatory parameters in serum were commonly seen. The hs-cTnI level was significantly higher in the group aged 60–79 and male patients. A week positive correlation was observed between hs-cTnI values and D-dimer values ( r  = 0.343, p༜0.05). Acute respiratory distress syndrome was the main complication. Assisted respiration, antimicrobial drugs, glucocorticoids and immune globulin were the major treatments.Conclusion Most non-survivors with SARS-CoV-2 infection were old with chronic illnesses, complicated by multiple organ dysfunction. Prevention is better than cure in high-risk population.

8.
Frontiers in psychology ; 12, 2021.
Article in English | EuropePMC | ID: covidwho-1651972

ABSTRACT

The continuous increase of carbon emissions is a serious challenge all over the world, and many countries are striving to solve this problem. Since 2020, a widespread lockdown in the country to prevent the spread of COVID-19 escalated, severely restricting the movement of people and unnecessary economic activities, which unexpectedly reduced carbon emissions. This paper aims to analyze the carbon emissions data of 30 provinces in the 2020 and provide references for reducing emissions with epidemic lockdown measures. Based on the method of time series visualization, we transform the time series data into complex networks to find out the hidden information in these data. We found that the lockdown would bring about a short-term decrease in carbon emissions, and most provinces have a short time point of impact, which is closely related to the level of economic development and industrial structure. The current results provide some insights into the evolution of carbon emissions under COVID-19 blockade measures and valuable insights into energy conservation and response to the energy crisis in the post-epidemic era.

9.
Front Public Health ; 9: 794195, 2021.
Article in English | MEDLINE | ID: covidwho-1553534

ABSTRACT

In the post-epidemic era, green finance plays a more significant role in supporting the "green recovery" of the economy, so it is necessary to evaluate the implementation effect of previous green financial policies. In 2017, the green finance reform and innovation pilot zone set up in five provinces and autonomous regions made an exploration in the development of green finance. From the perspective of micro-enterprises, can this policy play a beneficial policy effect in the long run? Based on the quasi-natural experiment of green finance pilot, using the data of A-share listed companies, this paper empirically tests the impact of pilot policies on the long-term value of green enterprises in pilot areas. It is found that, compared with non-pilot zones, the green finance pilot enables a significant increase in the Tobin Q-measured value of green enterprises in the pilot zones. Heterogeneity analysis shows that green finance pilot has a more significant impact on non-state-owned enterprises, enterprises in traditional industries, large enterprises, and enterprises in the eastern region of China. Green finance pilot zone can achieve better policy effects in areas with stronger environmental impact regulation and higher financial development levels. The mechanism test shows that the green finance pilot affects the long-term value of green enterprises through the capital market effect improving the stock trading activity of enterprises and through the real effect improving the operational efficiency and profitability of enterprises. From the perspective of micro-enterprises, this paper enriches the research on the development effect of green finance and provides theoretical support for the effect evaluation of green finance pilot policies.


Subject(s)
Environment , Industry , China , Efficiency
10.
Microbiol Spectr ; 9(3): e0059721, 2021 12 22.
Article in English | MEDLINE | ID: covidwho-1532976

ABSTRACT

Early and effective identification of severe coronavirus disease 2019 (COVID-19) may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. This study analyzed plasma concentrations of heat shock protein gp96 in nonsevere (including mild and typical) and severe (including severe and critical) patients with COVID-19 to evaluate its potential as a predictive and prognostic biomarker for disease severity. Plasma gp96 levels that were positively correlated with interleukin-6 (IL-6) levels were significantly elevated in COVID-19 patients admitted to the hospital but not in non-COVID-19 patients with less severe respiratory impairment. Meanwhile, significantly higher gp96 levels were observed in severe than nonsevere patients. Moreover, the continuous decline of plasma gp96 levels predicted disease remission and recovery, whereas its persistently high levels indicated poor prognosis in COVID-19 patients during hospitalization. Finally, monocytes were identified as the major IL-6 producers under exogenous gp96 stimulation. Our results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19. IMPORTANCE Early and effective identification of severe COVID-19 may allow us to improve the outcomes of associated severe acute respiratory illness with fever and respiratory symptoms. Some heat shock proteins (Hsps) are released during oxidative stress, cytotoxic injury, and viral infection and behave as danger-associated molecular patterns (DAMPs). This study analyzed plasma concentrations of Hsp gp96 in nonsevere and severe patients with COVID-19. Significantly higher plasma gp96 levels were observed in severe than those in nonsevere patients, and its persistently high levels indicated poor prognosis in COVID-19 patients. The results demonstrate that plasma gp96 may be a useful predictive and prognostic biomarker for disease severity and outcome of COVID-19.


Subject(s)
Biomarkers/blood , COVID-19 Testing/methods , COVID-19/diagnosis , Membrane Glycoproteins/blood , Severity of Illness Index , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Cytokines/blood , Female , Humans , Interleukin-6/blood , Male , Middle Aged , Monocytes , SARS-CoV-2/isolation & purification , Young Adult
11.
Biosens Bioelectron ; 198: 113810, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1517064

ABSTRACT

Exploring reliable and highly-sensitive SARS-CoV-2 antibody diagnosis by point-of-care (POC) manner, holds great public health significance for extensive COVID-19 screening and controlling. Unfortunately, the currently applied gold based lateral flow immunoassay (GLFIA) may expose both false-negative and false-positive interpretations owing to the sensitivity and specificity limitations, which may cause significant risk and waste of public resources for large population screening. To simultaneously overcome the drawbacks of GLFIA, a novel fluorescent LFIA based on signal amplification and dual-antigen sandwich structure was established with largely improved sensitivity and specificity. The compact three-dimensional incorporation of hydrophobic quantum dots within dendritic affinity templates and multilayer surface derivation guaranteed a high and robust fluorescence of single label, which lowered the false negative rate of GLFIA prominently. A dual-antigen sandwich structure using labeled/immobilized SARS-CoV-2 spike receptor binding domain antigen for capturing total human SARS-CoV-2 antibody was developed, instead of general indirect antibody capturing approach, to reduce the false positive rate of GLFIA. Over 300 cases of COVID-19 negative and 97 cases of COVID-19 positive samples, the current assay revealed a 100% sensitivity and 100% specificity confirmed by both polymerase chain reaction (PCR) and chemiluminescence immunoassay (CLIA), compared with the considerable misinterpretation cases by currently applied GLFIA. The quantitative results verified by receiver operating characteristic curve and other statistical analysis indicated a well-distinguished positive/negative sample groups. The proposed strategy is highly sensitive towards low concentrated SARS-CoV-2 antibody serums and highly specific towards serums from COVID-19 negative persons and patients infected by other viruses.


Subject(s)
Biosensing Techniques , COVID-19 , Quantum Dots , Antibodies, Viral , Humans , Immunoassay , SARS-CoV-2 , Sensitivity and Specificity
12.
J Hazard Mater ; 423(Pt B): 127152, 2022 02 05.
Article in English | MEDLINE | ID: covidwho-1401614

ABSTRACT

Chlorine disinfection is a key global public health strategy for the prevention and control of diseases, such as COVID-19. However, little is known about effects of low levels of residual chlorine on freshwater microbial communities and antibiotic resistomes. Here, we treated freshwater microcosms with continuous low concentrations of chlorine and quantified the effects on aquatic and zebrafish intestinal microbial communities and antibiotic resistomes, using shotgun metagenome and 16S rRNA gene sequencing. Although chlorine rapidly degraded, it altered the aquatic microbial community composition over time and disrupted interactions among microbes, leading to decreases in community complexity and stability. However, community diversity was unaffected. The majority of ecological functions, particularly metabolic capacities, recovered after treatment with chlorine for 14 d, due to microbial community redundancy. There were also increased levels of antibiotic-resistance gene dissemination by horizontal and vertical gene transfer under chlorine treatment. Although the zebrafish intestinal microbial community recovered from temporary dysbiosis, growth and behavior of zebrafish adults were negatively affected by chlorine. Overall, our findings demonstrate the negative effects of residual chlorine on freshwater ecosystems and highlight a possible long-term risk to public health.


Subject(s)
COVID-19 , Microbiota , Animals , Chlorine/toxicity , Drug Resistance, Microbial , Fresh Water , RNA, Ribosomal, 16S/genetics , SARS-CoV-2 , Zebrafish
13.
Modern Physics Letters B ; : 1, 2021.
Article in English | Academic Search Complete | ID: covidwho-1255628

ABSTRACT

Most of the existing researches on public health events focus on the number and duration of events in a year or month, which are carried out by regression equation. COVID-19 epidemic, which was discovered in Wuhan, Hubei Province, quickly spread to the whole country, and then appeared as a global public health event. During the epidemic period, Chinese netizens inquired about the dynamics of COVID-19 epidemic through Baidu search platform, and learned about relevant epidemic prevention information. These groups’ search behavior data not only reflect people’s attention to COVID-19 epidemic, but also contain the stage characteristics and evolution trend of COVID-19 epidemic. Therefore, the time, space and attribute laws of propagation of COVID-19 epidemic can be discovered by deeply mining more information in the time series data of search behavior. In this study, it is found that transforming time series data into visibility network through the principle of visibility algorithm can dig more hidden information in time series data, which may help us fully understand the attention to COVID-19 epidemic in Chinese provinces and cities, and evaluate the deficiencies of early warning and prevention of major epidemics. What’s more, it will improve the ability to cope with public health crisis and social decision-making level. [ABSTRACT FROM AUTHOR] Copyright of Modern Physics Letters B is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

14.
Int J Med Sci ; 18(11): 2366-2371, 2021.
Article in English | MEDLINE | ID: covidwho-1222282

ABSTRACT

Coronavirus Disease 2019 (COVID-19) emerges as a global pandemic and there is a lack of evidence about the clinical course and outcome of patients on maintenance hemodialysis (MHD). Here we conducted a retrospective longitudinal study aimed to analyze the clinical features and outcome of MHD patients hospitalized with COVID-19. Of 3126 inpatients with COVID-19 at 3 Branches of Wuhan Tongji Hospital from Jan 18th to Mar 9th, 2020, 19 patients were undergoing maintenance hemodialysis. Among the 19 MHD patients with COVID-19, 6 patients (31.6%) died, and 13 patients (68.4%) were able to be discharged. Baseline characteristics, clinical courses, laboratory findings, and dynamic trajectories of major laboratory markers were compared between survivors and nonsurvivors. According to our findings, MHD patients with COVID-19 who experienced non-surviving outcome had more elevated CRP, IL6 and procalcitonin as well as fibrinogen levels at various points compared to survivors. Thus the dysregulation of immune response as well as coagulation abnormalities might be highly involved in the pathological process of COVID-19, contributing to the poor prognosis in MHD patients.


Subject(s)
COVID-19/etiology , Kidney Failure, Chronic/complications , Renal Dialysis , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , C-Reactive Protein/analysis , COVID-19/drug therapy , COVID-19/immunology , Female , Hospitalization , Humans , Longitudinal Studies , Male , Middle Aged , Retrospective Studies
15.
J Perianesth Nurs ; 37(3): 351-356, 2022 06.
Article in English | MEDLINE | ID: covidwho-1202168

ABSTRACT

OBJECTIVE: This study assessed oxygen saturation variation and comfort in adult surgical patients wearing masks in PACU during the COVID-19 epidemic. DESIGN: Retrospective observation was applied in this study. METHODS: One hundred thirty-seven patients wearing no medical masks (Group A, aged from 20 to 87) and 136 patients wearing medical masks (Group B, aged from 18 to 91) were selected in this retrospective study after extubation in PACU. After extubation their pulse oxygen saturation, noninvasive mean blood pressure and heart rate were recorded at two different time points (treated with 40% O2 oxygen therapy for 10 minutes and breathing room air for 10 minutes). The comfort, arterial blood gas data, complications and duration of patients were also reviewed in PACU. FINDINGS: There were no significant differences in the pulse oxygen saturation between the two groups after inhaling 40% O2 or air. Compared with Group A, patients in Group B have lower comfort (6 [4-7] vs 7 [6-8]; P < .001), with shortened duration after extubation in PACU (50 [45-55] vs 56 [48-60]; P < .001). No significant differences were found in heart rate, noninvasive mean blood pressure, arterial blood gas data and complications. And no hypoxemia and respiratory adverse events happened in two groups. CONCLUSIONS: Wearing medical masks does not reduce oxygen saturation in adult surgical patients during recovery from general anesthesia. The discomfort caused by masks is the concern in PACU.


Subject(s)
COVID-19 , Adult , Airway Extubation , Anesthesia, General , Humans , Retrospective Studies
16.
ACS Omega ; 6(11): 7951-7958, 2021 Mar 23.
Article in English | MEDLINE | ID: covidwho-1155694

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic. To understand the changes in plasma proteomics upon SARS-CoV-2 infection, we analyzed the protein profiles of plasma samples from 10 COVID-19 patients and 10 healthy volunteers by using the DIA quantitative proteomics technology. We compared and identified differential proteins whose abundance changed upon SARS-CoV-2 infection. Bioinformatic analyses were then conducted for these identified differential proteins. The GO/KEEG database was used for functional annotation and enrichment analysis. The interaction relationship of differential proteins was evaluated with the STRING database, and Cytoscape software was used to conduct network analysis of the obtained data. A total of 323 proteins were detected in all samples. Difference between patients and healthy donors was found in 44 plasma proteins, among which 36 proteins were up-regulated and 8 proteins were down-regulated. GO functional annotation showed that these proteins mostly composed of cellular anatomical entities and proteins involved in biological regulation, cellular processes, transport, and other processes. KEEG functional annotation further showed that these proteins were mainly involved in complement system activation and infectious disease processes. Importantly, a KEEG pathway (natural killer cell-mediated cytotoxicity) was enriched, with three important activators of this pathway, ICAM1/2 and IgG, being up-regulated. Protein-protein interaction (PPI) statistics indicated that, among these 44 proteins, 6 were the most significantly up-regulated (DBH, SHGB, TF, ICAM2, THBS1, and C1RL) while 2 were the most significantly down-regulated (APCS and ORM1). Results from this study showed that a few proteins associated with immune activation were up-regulated in patient plasma. In addition, this study established a method for extraction and quantitative determination of plasma components in convalescent plasma from COVID-19 patients.

17.
J Aerosol Med Pulm Drug Deliv ; 34(2): 108-114, 2021 04.
Article in English | MEDLINE | ID: covidwho-1127303

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 infection is associated with strong infectiousness and has no effective therapy. We aimed to explore the efficacy and safety of Mycobacterium vaccae nebulization in the treatment of Coronavirus Disease 2019 (COVID-19). Methods: In this randomized, double-blind, placebo-controlled clinical trial, we included 31 adult patients with moderate COVID-19 who were admitted to the Fourth People's Hospital of Nanning (Nanning, China) between January 22, 2020 and February 17, 2020. Patients were randomly divided into two groups: group A (standard care group) and group B (M. vaccae in combination with standard care group). The primary outcome was the time interval from admission to viral RNA negative conversion (oropharyngeal swabs were used in this study). Secondary outcomes included chest computed tomography (CT), mortality, length of hospital stay, complications during treatment, and so on. Patients were followed up to 4 weeks after discharge (reexamination of viral RNA, chest CT, etc.). Results: Nucleic acid test negative conversion time in group B was shorter than that in group A (2.9 days [2.7-8.7] vs. 6.8 days [3.3-13.8]; p = 0.045). No death and no conversion to severe or critical cases were observed in both groups. Two weeks after discharge, neither "relapse" nor "return to positive" cases were found. Four weeks after discharge, it was found that there was no case of " relapse " or "return to positive" in group B, and 1 patient in group A showed "return to positive", but there was no clinical manifestation and imaging progression. No adverse reactions related to M. vaccae were found during observation period. Conclusion: M. vaccae treatment might shorten the time interval from admission to viral RNA negative conversion, which might be beneficial to the prevention and treatment of COVID-19. Clinical Trial Registration: ChiCTR2000030016.


Subject(s)
COVID-19/therapy , Length of Stay , Mycobacteriaceae/immunology , Tomography, X-Ray Computed , Administration, Inhalation , Adolescent , Adult , Aged , COVID-19/immunology , COVID-19/mortality , Double-Blind Method , Female , Humans , Male , Middle Aged , Time Factors , Treatment Outcome , Young Adult
18.
J Hepatol ; 74(6): 1295-1302, 2021 06.
Article in English | MEDLINE | ID: covidwho-988355

ABSTRACT

BACKGROUND & AIMS: The evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues. METHODS: This large retrospective cohort study included 2,073 patients with coronavirus disease 2019 (COVID-19) and definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted, with associated factors and risk of death determined by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19, with and without hepatitis B, were compared after 1:3 propensity score matching. RESULTS: Of the 2,073 patients, 1,282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of aspartate aminotransferase (AST) and direct bilirubin (D-Bil) increased early after symptom onset in deceased patients and showed disparity compared to levels in discharged patients throughout the clinical course of the disease. Abnormal AST (adjusted hazard ratio [HR] 1.39; 95% CI 1.04-1.86, p = 0.027) and D-Bil (adjusted HR 1.66; 95% CI 1.22-2.26; p = 0.001) levels at admission were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes. CONCLUSIONS: Abnormal AST and D-Bil levels at admission were independent predictors of COVID-19-related mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, is necessary in hospitalized patients with COVID-19. LAY SUMMARY: Liver test abnormalities (in particular elevations in the levels of aspartate aminotransferase [AST] and direct bilirubin [D-Bil]) were observed after symptom onset in patients who went on to die of coronavirus disease 2019 (COVID-19). Abnormal levels of AST and D-Bil at admission were independent predictors of COVID-19-related mortality. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes.


Subject(s)
Aspartate Aminotransferases/blood , Bilirubin/blood , COVID-19/mortality , Hospital Mortality , Liver Diseases/complications , SARS-CoV-2 , Aged , Female , Hepatitis B/complications , Humans , Male , Middle Aged , Propensity Score , Retrospective Studies
19.
Alzheimer's & Dementia ; 16(S8):e047175, 2020.
Article in English | Wiley | ID: covidwho-959091

ABSTRACT

Abstract Objective We present a case report of recovery from severe COVID - 19 (novel coronavirus 2019) in a patient with cognitive decline (84-year old, female), behavioral and psychiatric symptoms, hip arthroplasty, sacroiliac decubital necrosis, cachexia, after comprehensive therapy. Background Because of cognitive and behavioral disorders, patients with Alzheimer?s disease have poor coordination of treatment especially in an unfamiliar environment. Communicating with close family members through WeChat video can relieve patients' anxiety and other mental symptoms, leading to better cooperating with drug treatment and nasal feeding diet. Methods Patient received 1 hour daily WeChat video communication with her son at isolation ward, including psychological comfort, care and positive words. The WeChat video communication were last for 4 weeks, during this time, the elderly patient was also treated with methylprednisolone (for 5 days), immunoglobulin (for 5 days), ulinastatin, thymus methoxide (for twice a week), acetylcysteine, antibiotics, low molecular weight heparin, probiotics, nutrition and other symptomatic support therapy. Results Before WeChat video communication about 4 weeks, the patient refused medical treatment, consisting of extraction of infusion set and removal of gastric tube, which greatly affects the treatment of drugs and the nutritional intake of patients;and the state of the patient?s condition became even worse. However, after 4 weeks WeChat video communication, the patient showed a significant improvement in the Mini-mental state examination scores from 8 to 12 (Education: illiterate) and in the Neuropsychiatric questionnaire scores from 35 to 10. Besides, after 4 weeks WeChat video communication and comprehensive therapy, the patient?s pneumonia improved significantly and the nucleic acid test turned negative. Conclusions WeChat video communication may be a promising noninvasive approach for patients with Alzheimer?s Disease, which may help alleviate neuropsychiatric behavioral symptoms and can be more cooperative with medical workers.

20.
Chinese Science Bulletin ; 65(22):2363-2370, 2020.
Article | WHO COVID | ID: covidwho-740397

ABSTRACT

Coronavirus disease (COVID-19) is an acute infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reverse transcription real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) was the firstly authorized method for the detection of SARS-CoV-2 RNA. As this method is sensitive, specific, it has been widely recognized as the golden standard for the diagnosis of COVID-19. Unfortunately, several false-negative cases have been reported after the outbreak of COVID-19, probably due to the quality of the kits or the improper operation of RT-qPCR. Nucleic acid reference materials (RM) are the key element for the metrology traceability and quality control of SARS-CoV-2 RNA detection, but the development of RNA RM remains a challenge in the biology metrology field. Two main problems are the low stability of the RNA sample and the lack of proven absolute quantification methods. To establish the measurement traceability for SARS-CoV-2 RNA detection, a novel RNA reference material (RM) was developed. The RM is a mixed solution of 3 in vitro transcribed RNA molecules which cover different key target sequences of SARS-CoV-2 gene: The full-length of nucleoprotein (N) gene (28274-29533, GenBank: MT027064.1), the full-length of envelope protein (E) gene (26245-26472, GenBank: MT027064.1), and partial sequence of open reading frame 1ab (ORF1ab) (13321-15540, GenBank: MT027064.1). The purity of the transcribed RNA molecules was verified by a biological analyzer. The results showed that the molecular length of all the RNA molecules were consistent with our design. The clear peaks of our RNA RMs strongly demonstrated good purity. For absolute quantification of RNA RMs, we studied digital PCR (dPCR) for RNA samples. Digital PCR evenly partitioned the sample and PCR reaction solution to a very large number of units, on a microporous chip or in the liquid droplets, etc. After a PCR amplification reaction, the fluorescence signal was detected for each unit individually, with a binary readout of "0" or "1" for negative and positive results respectively. Through the statistics of positive results based on the Poisson distribution, the copy number of RNA sample was accurately determined without standard curves needed. Digital PCR has significantly higher reliability and accuracy. Mainly based on the PCR primers and probes for SARS-CoV-2 detection suggested by the Chinese CDC and WHO, we optimized the key factors of dPCR towards improved amplification efficiency. Through digital PCR measurements by 4 laboratories, the certified values of concentration (copies/mu L) were assigned for the N gene, E gene, and ORF1ab gene in the mixed RM. Single-stranded RNA is unstable and easy to be degraded by RNase in the environment, thus the optimization of RNA protectants is very important for the stability of RNA RMs. During the study of the stability, we found that a proper protector (1 mmol/L DTT and 0.5 U/L Rnase Inhibitor) can effectively increase the valid storage life of our RNA RM. Based on the latest data, the concentration of our RNA RMs was stable for at least 30 d under -80 degrees C storage and 13 d under -4 degrees C storage. In order to verify the applicability of our RNA RM in the actual virus detection process, we analyzed our RMs using 9 SARS-CoV-2 nucleic acid detection kits. These virus RNA detection kits were from different manufacturers with various detection principles, that are being applied in laboratories for virus detection. Finally, our RNA RMs showed high generalizability among 9 kits. The development of RNA RM provides the metrological basis for the quality control of SARS-CoV-2 detection kits.

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