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1.
Front Genet ; 13: 743905, 2022.
Article in English | MEDLINE | ID: covidwho-1775658

ABSTRACT

Aims: This study was aimed to apply a Mendelian randomization design to explore the causal association between coronavirus disease 2019 (COVID-19) and three cardio-cerebrovascular diseases, including atrial fibrillation, ischemic stroke, and coronary artery disease. Methods: Two-sample Mendelian randomization was used to determine the following: 1) the causal effect of COVID-19 on atrial fibrillation (55,114 case participants vs 482,295 control participants), coronary artery disease (34,541 case participants vs 261,984 control participants), and ischemic stroke (34,217 case participants vs 40,611 control participants), which were obtained from the European Bioinformatics Institute, and 2) the causal effect of three cardio-cerebrovascular diseases on COVID-19. The single-nucleotide polymorphisms (SNPs) of COVID-19 were selected from the summary-level genome-wide association study data of COVID-19-hg genome-wide association study (GWAS) meta-analyses (round 5) based on the COVID-19 Host Genetics Initiative for participants with European ancestry. The random-effects inverse-variance weighted method was conducted for the main analyses, with a complementary analysis of the weighted median and Mendelian randomization (MR)-Egger approaches. Results: Genetically predicted hospitalized COVID-19 was suggestively associated with ischemic stroke, with an odds ratio (OR) of 1.049 [95% confidence interval (CI) 1.003-1.098; p = 0.037] in the COVID-19 Host Genetics Initiative GWAS. When excluding the UK Biobank (UKBB) data, our analysis revealed a similar odds ratio of 1.041 (95% CI 1.001-1.082; p = 0.044). Genetically predicted coronary artery disease was associated with critical COVID-19, with an OR of 0.860 (95% CI 0.760-0.973; p = 0.017) in the GWAS meta-analysis and an OR of 0.820 (95% CI 0.722-0.931; p = 0.002) when excluding the UKBB data, separately. Limited evidence of causal associations was observed between critical or hospitalized COVID-19 and other cardio-cerebrovascular diseases included in our study. Conclusion: Our findings provide suggestive evidence about the causal association between hospitalized COVID-19 and an increased risk of ischemic stroke. Besides, other factors potentially contribute to the risk of coronary artery disease in patients with COVID-19, but not genetics.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309022

ABSTRACT

Background: The epidemic of Novel coronavirus disease 2019(COVID-19) has attracted the great attention of people all over the world. Gastrointestinal bleeding in patients with COVID-19 has been studied rarely. We mean to investigate the clinical characteristics of gastrointestinal bleeding in patients with severe coronavirus disease (COVID-19). Methods: : Nineteen severe COVID-19 patients with gastrointestinal bleeding were retrospectively studied. Clinical data, including medical history, symptoms, laboratory characteristics, and treatment, were collected and analyzed. We also compared the characteristics of patients with different degrees of bleeding. Results: : Fourteen patients (73.6%) were men. Mean age was 63.8 (±15.6) years. Most patients (89.4%) had no history of gastrointestinal bleeding. The most common presentation of gastrointestinal bleeding was a positive fecal occult blood test (15/19 cases, 78.9%). Fifteen patients (78.9%) did not require blood transfusion. Five of 15 patients (33%) received anticoagulants and antiplatelet drugs before gastrointestinal bleeding in the mild bleeding group, and 2/4 (50%) in the severe bleeding group. Four of 15 patients (27%) died in the mild bleeding group and no patients died in the severe bleeding group. Conclusions: : The presentations of gastrointestinal bleeding in severe COVID-19 patients are not obvious, and frequent fecal occult blood test is needed to detect gastrointestinal bleeding early. Patients receiving anticoagulants and antiplatelet drugs need a close observation for gastrointestinal bleeding. Gastrointestinal bleeding may not increase the mortality, after giving blood transfusion support therapy.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322526

ABSTRACT

The aim of our study was to describe the clinical characteristics and outcomes of patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who underwent elective tracheostomies. We investigated all COVID-19 patients who underwent elective tracheostomies in intensive care units (ICUs) of 23 hospitals in Hubei Province, China, from January 8, 2020 to March 25, 2020. Demographic information, clinical characteristics, treatment, details of the tracheostomy procedure, successful weaning after tracheostomy, and living status were collected and analyzed. A total of 80 patients were included. The median duration from endotracheal intubation to tracheostomy was 17.5 [IQR 11.3-27.0] days. Most tracheotomies were performed by ICU physicians (62 (77.5%)) and using percutaneous techniques (63 (78.8%)) at the ICU bedside (76 (95.0%)). At 60 days after intubation, 31 (38.8%) patients experienced successful weaning from the ventilator, 17 (21.2%) patients were discharged from the ICU, and 43 (53.8%) patients had died. Higher 60-day mortality (22 (73.3%) vs 21 (42.0%)) was identified in patients who underwent early tracheostomy. In patients with SARS-CoV-2 pneumonia, tracheostomies were feasible to conduct by ICU physicians at bedside with few major complications. However, tracheostomies within 14 days of endotracheal intubation should be avoided.

4.
Front Immunol ; 12: 750969, 2021.
Article in English | MEDLINE | ID: covidwho-1551506

ABSTRACT

The COVID-19 is an infectious disease caused by SARS-CoV-2 infection. A large number of clinical studies found high-level expression of pro-inflammatory cytokines in patients infected with SARS-CoV-2, which fuels the rapid development of the disease. However, the specific molecular mechanism is still unclear. In this study, we found that SARS-CoV-2 Nsp5 can induce the expression of cytokines IL-1ß, IL-6, TNF-α, and IL-2 in Calu-3 and THP1 cells. Further research found that Nsp5 enhances cytokine expression through activating the NF-κB signaling pathway. Subsequently, we investigated the upstream effectors of the NF-κB signal pathway on Nsp5 overexpression and discovered that Nsp5 increases the protein level of MAVS. Moreover, Nsp5 can promote the SUMOylation of MAVS to increase its stability and lead to increasing levels of MAVS protein, finally triggering activation of NF-κB signaling. The knockdown of MAVS and the inhibitor of SUMOylation treatment can attenuate Nsp5-mediated NF-κB activation and cytokine induction. We identified a novel role of SARS-CoV-2 Nsp5 to enhance cytokine production by activating the NF-κB signaling pathway.


Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Coronavirus 3C Proteases/immunology , Cytokines/biosynthesis , NF-kappa B/metabolism , SARS-CoV-2/immunology , Sumoylation/physiology , Adaptor Proteins, Signal Transducing/genetics , Animals , COVID-19/immunology , Cell Line , Chlorocebus aethiops , Enzyme Activation/drug effects , HEK293 Cells , Humans , Immunity, Innate/immunology , Interleukin-1beta/biosynthesis , Interleukin-2/biosynthesis , Interleukin-6/biosynthesis , Signal Transduction/physiology , Sumoylation/drug effects , THP-1 Cells , Tumor Necrosis Factor-alpha/biosynthesis , Vero Cells
5.
Pregnancy Hypertens ; 26: 17-23, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1364411

ABSTRACT

AIMS: The aim of this study was to apply the Mendelian randomization (MR) design to explore the potential causal association between COVID-19 and the risk of hypertension disorders in pregnancy. METHODS: Our primary genetic instrument comprised 8 single-nucleotide polymorphisms (SNPs) associated with COVID-19 at genome-wide significance. Data on the associations between the SNPs and the risk of hypertension disorders in pregnancy were obtained from study based on a very large cohort of European population. The random-effects inverse-variance weighted method was conducted for the main analyses, with a complementary analysis of the weighted median and MR-Egger approaches. RESULTS: Using IVW, we found that genetically predicted COVID-19 was significantly positively associated with hypertension disorders in pregnancy, with an odds ratio (OR) of 1.111 [95% confidence interval (CI) 1.042-1.184; P = 0.001]. Weighted median regression also showed directionally similar estimates [OR 1.098 (95% CI, 1.013-1.190), P = 0.023]. Both funnel plots and MR-Egger intercepts suggest no directional pleiotropic effects observed. CONCLUSIONS: Our findings provide direct evidence that there is a shared genetic predisposition so that patients infected with COVID-19 may be causally associated with increased risk of hypertension disorders in pregnancy.


Subject(s)
COVID-19/genetics , Genetic Predisposition to Disease , Hypertension/etiology , Mendelian Randomization Analysis/methods , Polymorphism, Single Nucleotide , Risk Assessment/methods , SARS-CoV-2 , COVID-19/complications , COVID-19/epidemiology , Female , Global Health , Humans , Hypertension/epidemiology , Hypertension/genetics , Incidence , Pregnancy , Risk Factors
6.
Journal of Transport & Health ; 22:101109, 2021.
Article in English | ScienceDirect | ID: covidwho-1271703

ABSTRACT

Introduction The optimization of public transport (PT) systems to ameliorate urban traffic problems and living environment requires a deep understanding of PT usage behaviour. However, there is a lack of scientific measurement of the influence on passengers’ PT dependence (PTD) during emergent public health events. Methods An extended theory of planned behaviour and an online survey scheme are proposed to investigate the influence of psychological and objective factors on passengers’ PTD under an emergent public health event in Beijing, China. Then, four structural equation models are estimated to analyse the PTD influence mechanism of different groups of passengers. Results The objective condition factors exert indirect effects on passengers' PTD via the psychological factors. Individual attributes have small influences on passengers' PTD, while the environment has a significant positive effect. Subjective norms have the highest influencing effect on passengers’ PTD, and passengers with a relatively high PTD level have the risk of shifting to other transportation modes under the emergent public health events. Conclusions The influence mechanism of emergency public health events on the PT dependence of different passengers is heterogeneous. The targeted policies should be implemented for different passengers to improve the PT market share and residents' health under emergent public health events.

7.
Aging (Albany NY) ; 13(12): 15770-15784, 2021 06 24.
Article in English | MEDLINE | ID: covidwho-1282781

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), and is highly contagious and pathogenic. TMPRSS2 and Neuropilin-1, the key components that facilitate SARS-CoV-2 infection, are potential targets for treatment of COVID-19. Here we performed a comprehensive analysis on NRP1 and TMPRSS2 in lung to provide information for treating comorbidity of COVID-19 with lung cancer. NRP1 is widely expressed across all the human tissues while TMPRSS2 is expressed in a restricted pattern. High level of NRP1 associates with worse prognosis in multiple cancers, while high level of TMPRSS2 is associated with better survival of Lung Adenocarcinoma (LUAD). Moreover, NRP1 positively correlates with the oncogenic Cancer Associated Fibroblast (CAF), macrophage and endothelial cells infiltration, negatively correlates with infiltration of CD8+ T cell, the tumor killer cell in Lung Squamous cell carcinoma (LUSC). TMPRSS2 shows negative correlation with the oncogenic events in LUAD. RNA-seq data show that NRP1 level is slightly decreased in peripheral blood of ICU admitted COVID-19 patients, unaltered in lung, while TMPRSS2 level is significantly decreased in lung of COVID-19 patients. Our analysis suggests NRP1 as a potential therapeutic target, while sets an alert on targeting TMPRSS2 for treating comorbidity of COVID-19 and lung cancers.


Subject(s)
Adenocarcinoma of Lung/metabolism , Gene Expression Regulation, Neoplastic , Lung Neoplasms/metabolism , Neuropilin-1/physiology , Serine Endopeptidases/physiology , Adenocarcinoma of Lung/mortality , CD8-Positive T-Lymphocytes/metabolism , COVID-19/genetics , COVID-19/metabolism , Cancer-Associated Fibroblasts/metabolism , Computer Simulation , Endothelial Cells/metabolism , Humans , Lung Neoplasms/mortality , Macrophages/metabolism , Neuropilin-1/genetics , RNA-Seq , SARS-CoV-2 , Serine Endopeptidases/genetics
8.
Front Med (Lausanne) ; 7: 615845, 2020.
Article in English | MEDLINE | ID: covidwho-1016068

ABSTRACT

Background: The outbreak of coronavirus disease 2019 (COVID-19) has led to a large and increasing number of patients requiring prolonged mechanical ventilation and tracheostomy. The indication and optimal timing of tracheostomy in COVID-19 patients are still unclear, and the outcomes about tracheostomy have not been extensively reported. We aimed to describe the clinical characteristics and outcomes of patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who underwent elective tracheostomies. Methods: The multi-center, retrospective, observational study investigated all the COVID-19 patients who underwent elective tracheostomies in intensive care units (ICUs) of 23 hospitals in Hubei province, China, from January 8, 2020 to March 25, 2020. Demographic information, clinical characteristics, treatment, details of the tracheostomy procedure, successful weaning after tracheostomy, and living status were collected and analyzed. Data were compared between early tracheostomy patients (tracheostomy performed within 14 days of intubation) and late tracheostomy patients (tracheostomy performed after 14 days). Results: A total of 80 patients were included. The median duration from endotracheal intubation to tracheostomy was 17.5 [IQR 11.3-27.0] days. Most tracheotomies were performed by ICU physician [62 (77.5%)], and using percutaneous techniques [63 (78.8%)] at the ICU bedside [76 (95.0%)]. The most common complication was tracheostoma bleeding [14 (17.5%)], and major bleeding occurred in 4 (5.0%) patients. At 60 days after intubation, 31 (38.8%) patients experienced successful weaning from ventilator, 17 (21.2%) patients discharged from ICU, and 43 (53.8%) patients had died. Higher 60 day mortality [22 (73.3%) vs. 21 (42.0%)] were identified in patients who underwent early tracheostomy. Conclusions: In patients with SARS-CoV-2 pneumonia, tracheostomies were feasible to conduct by ICU physician at bedside with few major complications. Compared with tracheostomies conducted after 14 days of intubation, tracheostomies within 14 days were associated with an increased mortality rate.

9.
Tianjin Medical Journal ; 48(7):577-582, 2020.
Article in Chinese | GIM | ID: covidwho-961861

ABSTRACT

Objective: To explore the epidemiological, clinical and imaging characteristics of patients with novel coronavirus disease 2019 (COVID-19) in Tianjin.

10.
Crit Care ; 24(1): 219, 2020 05 14.
Article in English | MEDLINE | ID: covidwho-260169

ABSTRACT

BACKGROUND: A COVID-19 outbreak started in Wuhan, China, last December and now has become a global pandemic. The clinical information in caring of critically ill patients with COVID-19 needs to be shared timely, especially under the situations that there is still a largely ongoing spread of COVID-19 in many countries. METHODS: A multicenter prospective observational study investigated all the COVID-19 patients received in 19 ICUs of 16 hospitals in Wuhan, China, over 24 h between 8 AM February 2h and 8 AM February 27, 2020. The demographic information, clinical characteristics, vital signs, complications, laboratory values, and clinical managements of the patients were studied. RESULTS: A total of 226 patients were included. Their median (interquartile range, IQR) age was 64 (57-70) years, and 139 (61.5%) patients were male. The duration from the date of ICU admission to the study date was 11 (5-17) days, and the duration from onset of symptoms to the study date was 31 (24-36) days. Among all the patients, 155 (68.6%) had at least one coexisting disease, and their sequential organ failure assessment score was 4 (2-8). Organ function damages were found in most of the patients: ARDS in 161 (71.2%) patients, septic shock in 34 (15.0%) patients, acute kidney injury occurred in 57 (25.2%) patients, cardiac injury in 61 (27.0%) patients, and lymphocytopenia in 160 (70.8%) patients. Of all the studied patients, 85 (37.6%) received invasive mechanical ventilation, including 14 (6.2%) treated with extracorporeal membrane oxygenation (ECMO) at the same time, 20 (8.8%) received noninvasive mechanical ventilation, and 24 (10.6%) received continuous renal replacement therapy. By April 9, 2020, 87 (38.5%) patients were deceased and 15 (6.7%) were still in the hospital. CONCLUSIONS: Critically ill patients with COVID-19 are associated with a higher risk of severe complications and need to receive an intensive level of treatments. COVID-19 poses a great strain on critical care resources in hospitals. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000030164. Registered on February 24, 2020, http://www.chictr.org.cn/edit.aspx?pid=49983&htm=4.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Critical Care , Disease Outbreaks , Intensive Care Units , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Aged , COVID-19 , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Prospective Studies , Treatment Outcome
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