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1.
Front Public Health ; 9: 710209, 2021.
Article in English | MEDLINE | ID: covidwho-1775826

ABSTRACT

Most cervical cancers were closely associated with human papillomavirus (HPV) infections. Therefore, understanding the ecological diversity of HPV prevalence and genotype distribution among various populations in different geographical regions was essential for optimizing HPV vaccination and maximizing the vaccination effects. A total of 12,053 patient data from the three-level hospitals in Hengyang city were retrospectively analyzed. In this study, the HPV prevalence was 10.16% overall, and the multiple-type infection rate was 1.83%. The HR-HPV infection rate was 8.52%. The top six HPV genotypes were as follows in descending order: HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53. The HPV prevalence in the group above 60 years old was the most, and their HR-HPV infection rate corresponded to the most too. The infection rates of HPV and HR-HPV among outpatients were both lower than those among the hospitalized-patients, respectively. Among the hospitalized-patients, the infection rates of HPV and HR-HPV among the 50-60 years group were the most in both. The HR-HPV ratio-in-positive among HPV-positive patients with the histopathologic examination was higher than that among those patients without. Among 52 HPV-positive patients with cervical squamous carcinoma, the ratio-in-positive of HPV16 was 61.54%. This study demonstrated that the HPV prevalence varied with age among women from Hengyang district of Hunan province in China and showed that HPV16, HPV58, HPV52, HPV39, HPV51, and HPV53 genotypes were more popularly distributed in this region, which could provide the experimental basis for Chinese public health measures on cervical cancer prevention.


Subject(s)
Papillomavirus Infections , China/epidemiology , Female , Genotype , Humans , Middle Aged , Papillomavirus Infections/complications , Papillomavirus Infections/epidemiology , Papillomavirus Infections/prevention & control , Prevalence , Retrospective Studies
2.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328528

ABSTRACT

Once challenged by the SARS-CoV-2 virus, the human host immune system triggers a dynamic process against infection. We constructed a simplistic mathematical model to describe host innate and adaptive immune response to viral challenge. Based on the dynamic properties of viral load and immune response, we classified the resulting dynamics into four modes, corresponding to the increasing severity of COVID-19 disease. We found immune efficacy against viral attack, clearance of infected cells, and IL-6 levels to be prognostic determinants, especially for severe and critical patients. We also investigated vaccine-induced protection against SARS-CoV-2 infection. Results strongly suggested that immune efficacy based on memory T cells, as well as neutralizing antibody titers, could be true indicators of vaccine protection rates. Finally, we analyzed infection dynamics of SARS-CoV-2 variants within the construct of our mathematical model. Overall, our results provide a systematic framework for understanding the dynamics of host response upon challenge by SARS-CoV-2 infection, and this framework can be used to predict vaccine protection and perform clinical diagnosis.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325441

ABSTRACT

Background: Coronavirus Disease (COVID-19) causes a sudden turn over to bad at some check-point and thus needs intervention of intensive care unit (ICU). This resulted in urgent and large needs of ICUs posed great risks to the medical system. Estimating the mortality of critical in-patients who were not admitted to the ICU (MI-mortality) will be valuable to optimize the management and assignment of ICU. Methods: . Retrospective, of the 733 in-patients diagnosed with COVD-19 at Huangpi Hospital of Traditional Chinese Medicine (Wuhan, China), as of March 18, 2020. This study aims to estimate the MI-mortality and build a model to identify the critical in-patients. Demographic, clinical and laboratory results were collected and analyzed. The mortality rate for the patients who failed to receive ICU and unfortunately died was analyzed. To this end, the key factors for prognostic of patients who may need ICU care were found. A prognostic classification model using machine learning was built to identify the patient who may need ICU. Results: . Considering the shortage of ICU beds at the beginning of disease emergence, we defined the mortality for those patients who were predicted to be in needing of ICU treatment yet they did not as MI-mortality. Patients who entered the ICU and died were defined as ICU-mortality. To estimate MI-mortality, a prognostic classification model was built to identify the in-patients who may need ICU care based on the medical factors collected in-hospital. Its predictive accuracies on whole patient set (733 [25 708]), training set (586 [20 566]) and testing set (147 [5 142]) dataset were 0.8513, 0.8935 and 0.8288, with the AUC of 0.8844, 0.8941 and 0.9120, respectively. Our analysis had shown that the MI-mortality is 41% and the ICU-mortality is 32%, implying that enough bed of ICU in treating patients in critical conditions. Conclusions: . On our cohort of 733 patients, 25 in-patients were admitted to ICU, among them 8 patients died. 25 in-patients who have been predicted by our model that they should need ICU care, yet they did not enter ICU due to lack of shorting ICU wards. The MI-mortality is 41%.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325375

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease, with significant morbidity and mortality. This meta-analysis is to evaluate the prevalence of disseminated intravascular coagulation (DIC) in COVID-19 patients and to determine the association of DIC with the severity and prognosis of COVID-19. Methods: : We searched the PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) database until August 12, 2020. The meta-analysis was performed using Stata 16.0 software. Results: : 15 studies were included in our meta-analysis. The pooled analysis revealed that the incidence of COVID-19 patients developing DIC was 4% (95%: 2%-5%, P<0.001). In addition, DIC was more likely to occur in the death group (Log OR = 2.4, 95% CI: 1.58-3.21, P<0.001) with statistical significance. Conclusions: : DIC is associated with the severity and poor prognosis of COVID-19 patients. Therefore, attention should be paid to coagulation dysfunction in COVID-19 patients. Monitoring of coagulation indicators may improve the prognosis of COVID-19 inpatients.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324261

ABSTRACT

Background: While 2019-nCoV nucleic acid swab tests has high false positives rate, How to diagnose 2019-nCoV pneumonia and predict prognosis by CT is very important. Methods: : In this retrospective single-center study, we consecutively included suspected 2019-nCoV pneumonia critical cases in the intensive care unit of Wuhan third hospital from January 31, 2020 to February 16, 2020. The cases were confirmed by real-time RT-PCR, and all patients were evaluated with CT, cutoff values were obtained according to the Yoden index, and were divided into high CT score group and low CT score group. Epidemiological, demographic, clinical, and laboratory data were collected. Results: : The major imaging feature of 2019-nCoV pneumonia is the ground glass opacity (GGO). Multivariate regression analysis found that CT score and absolute count of lymphocytes were independent risk factor for death, and CT score predicted mortality AUC-ROC =0.7, cutoff=1.45. When the absolute count of lymphocytes decreased, the patient's CT also deteriorated. Conclusion: CT score and absolute count of lymphocytes were independent risk factor for death, and patients with high CT score may have a worse prognosis. Lower absolute count of lymphocytes may indicated the patient's CT also deteriorated.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315606

ABSTRACT

Backgrounds: In December 2019, a pneumonia associated with the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) emerged in Wuhan city, China. As of 20 Feb 2020, a total of 2,055 medical staff infected with SARS-Cov-2 in China had been reported. The predominant cause of the infection and the failure of protection among medical staff remains unclear. We sought to explore the epidemiological, clinical characteristics and prognosis of novel coronavirus-infected medical staff. Methods: Medical staff who infected with SARS-Cov-2 and admitted to Union Hospital, Wuhan between 16 Jan, 2020 to 25 Feb, 2020 were included retrospectively. Epidemiological, clinical and radiological data were compared by occupation and analyzed with the Kaplan-Meier and Cox regression methods. Results: A total of 101 medical staff (32 males and 69 females;median age: 33 years old) were included in this study and 74% were nurses. None had an exposure to Huanan seafood wholesale market or wildlife. A small proportion of the cohort had contact with specimens (3%) as well as patients infected with SARS-Cov-2 in fever clinics (15%) and isolation wards (3%). 80% of medical staff showed abnormal IL-6 levels and 33% had lymphocytopenia. Chest CT mainly manifested as bilateral (62%), septal/subpleural (77%) and ground­glass opacities (48%). The major differences between doctors and nurses manifested in laboratory indicators. As of the last observed date, no patient was transferred to intensive care unit or died, and 98 (97%) had been discharged. Fever (HR=0.57;95% CI 0.36-0.90) and IL-6 levels greater than >2.9 pg/ml (HR=0.50;95% CI 0.30-0.86) on admission were unfavorable factors for discharge. Conclusions: Our findings suggested that the infection of medical staff mainly occurred at the early stages of SARS-CoV-2 epidemic in Wuhan, and only a small proportion of infection had an exact mode. Meanwhile, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course than other ordinary patients, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of presence of fever and IL-6 levels greater than >2.9 pg/ml could help to identify medical staff with poor prognosis at an early stage.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315065

ABSTRACT

BACKGROUND & AIMS: Liver injury is found in some of patients with COVID-19. Liver injury of patients based on severity grading and abdominal radiological signs have not been reported until now. The aim of our study is to determine clinical profiles of the patients based on severity grading, describe abdominal radiological signs, and investigate the correlations of the severity with clinical profiles and radiological signs. METHODS: This retrospective cohort study included 115 patients with COVID-19 from Jan 2020 to Feb 2020. Medical records of the patients were collected and CT images were reviewed. RESULTS: Common clinical manifestations of the patients with COVID-19 were fever (68.70%), cough (56.52%), fatigue (31.30%);some of them had gastrointestinal symptoms (diarrhea,12.17%;nausea or vomiting 7.83%;inappetence, 7.83%). Abnormal liver function was observed in some of the patients with COVID-19. Significant differences in the levels of AST, albumin,CRP were observed among different groups classified by the severity. Common findings of upper abdominal CT scan were liver hypodensity (26.09%) and pericholecystic fat stranding (21.27%);liver hypodensity were more frequently found in critical cases (58.82%). The semi-quantitative CT score of pulmonary lesions, CT-quantified liver/spleen attenuation ratio correlated with severity grading in patients with COVID-19. CONCLUSIONS: Some of patients with COVID-19 displayed liver damage revealed by liver functional tests and upper abdominal CT imaging, and some of liver functional tests and CT signs correlate with severity grading;thus, it will allow an earlier identification of high-risk patients for early effective intervention.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312663

ABSTRACT

We evaluate the role of foreign short-sale restrictions in muting the full return-response following negative earnings surprises for stocks cross-listed in unbanned markets. We update the global timeline of short-sale restrictions until the COVID-19 crisis period. Instead of regulatory price arbitrage, we surprisingly observe cross-border reach of bans manifested in a delayed price response, accompanied by a reduction in short interest and failures to deliver. Nonetheless, large profit opportunities result in price arbitrage and full return-response. Analysis of earnings management practices and CEO compensation structure reinforces the role of the profit opportunity in moderating the effects of short-sale restrictions.

9.
Front Immunol ; 12: 738532, 2021.
Article in English | MEDLINE | ID: covidwho-1686470

ABSTRACT

Background: The benefits of intravenous immunoglobulin administration are controversial for critically ill COVID-19 patients. Methods: We analyzed retrospectively the effects of immunoglobulin administration for critically ill COVID-19 patients. The primary outcome was 28-day mortality. Inverse probability of treatment weighting (IPTW) with propensity score was used to account for baseline confounders. Cluster analysis was used to perform phenotype analysis. Results: Between January 1 and February 29, 2020, 754 patients with complete data from 19 hospitals were enrolled. Death at 28 days occurred for 408 (54.1%) patients. There were 392 (52.0%) patients who received intravenous immunoglobulin, at 11 (interquartile range (IQR) 8, 16) days after illness onset; 30% of these patients received intravenous immunoglobulin prior to intensive care unit (ICU) admission. By unadjusted analysis, no difference was observed for 28-day mortality between the immunoglobulin and non-immunoglobulin groups. Similar results were found by propensity score matching (n = 506) and by IPTW analysis (n = 731). Also, IPTW analysis did not reveal any significant difference between hyperinflammation and hypoinflammation phenotypes. Conclusion: No significant association was observed for use of intravenous immunoglobulin and decreased mortality of severe COVID-19 patients. Phenotype analysis did not show any survival benefit for patients who received immunoglobulin therapy.


Subject(s)
COVID-19/mortality , COVID-19/therapy , Immunoglobulins, Intravenous/therapeutic use , Aged , China , Critical Care/methods , Critical Illness/therapy , Female , Humans , Immunization, Passive/methods , Immunization, Passive/mortality , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/immunology , Treatment Outcome
10.
Energy ; : 123272, 2022.
Article in English | ScienceDirect | ID: covidwho-1648481

ABSTRACT

The CNG2020 strategy proposed in 2016 has directly impacted the global aviation industry, and the ensuing COVID-19 pandemic has brought the global aviation industry to a standstill. This paper calculates the Pollution Abatement Costs (PAC) index and regulated profits of the global aviation industry by establishing Data Envelopment Analysis (DEA) model. Then, considering the airlines’ different recovery times from COVID-19, we predict the data of 25 international benchmark airlines from 2021 to 2027 based on the actual data during 2012–2019. The regulated profits can help judge whether airlines can achieve a win-win situation of carbon emission reduction and revenue growth in the future recovery process. We have some findings: 1. Air France-KLM has the maximum regulated profits, while EasyJet has the minimal regulated gains. 2. The setting of route conditions impacts whether airlines can achieve a win-win situation.

11.
Front Psychiatry ; 12: 774952, 2021.
Article in English | MEDLINE | ID: covidwho-1559290

ABSTRACT

Objectives: The incidence of psychological and behavioral problems and depression among adolescents is increasing year by year, which has become an important public health problem. Alexithymia, as an important susceptible factor of adolescent depression, may continue to develop and strengthen under the stimulation of COVID-19-related stressors. However, no studies have focused on alexithymia in adolescent depression during the pandemic in China. This study aims to investigate the incidence and related factors of alexithymia in adolescent depression during the pandemic. Methods: Three hundred adolescent patients were enrolled from October 2020 to May 2021. The general demographic information of all participants was collected, and the clinical characteristics were assessed by the 20-item Toronto Alexithymia Scale (TAS-20), the Adolescent Self-Rating Life Events Check (ASLEC) List, the Childhood Trauma Questionnaire (CTQ), and the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: The incidence of alexithymia was significantly higher among adolescents with depression (76.45%) during the pandemic. There were significant differences in school bullying, disease severity, ASLEC score, CTQ score and PANSI score between adolescents with and without alexithymia. In addition, learning stress, health and adaptation problems during the pandemic may be influential factors in alexithymia of adolescent depression (P < 0.05). Conclusions: According to the results, we found a high incidence of alexithymia in adolescent depression during the pandemic. More support and attention from families, schools and society is needed to develop preventive and targeted psychological interventions as early as possible.

12.
J Pers Med ; 11(12)2021 Dec 08.
Article in English | MEDLINE | ID: covidwho-1555025

ABSTRACT

Coronavirus disease 2019 (COVID-19), which is becoming a global pandemic, is caused by SARS-CoV-2 infection. In COVID-19, thrombotic events occur frequently, mainly venous thromboembolism (VTE), which is closely related to disease severity and clinical prognosis. Compared with historical controls, the occurrence of VTE in hospitalized and critical COVID-19 patients is incredibly high. However, the pathophysiology of thrombosis and the best strategies for thrombosis prevention in COVID-19 remain unclear, thus needing further exploration. Virchow's triad elements have been proposed as important risk factors for thrombotic diseases. Therefore, the three factors outlined by Virchow can also be applied to the formation of venous thrombosis in the COVID-19 setting. A thorough understanding of the complex interactions in these processes is important in the search for effective treatments for COVID-19. In this work, we focus on the pathological mechanisms of VTE in COVID-19 from the aspects of endothelial dysfunction, hypercoagulability, abnormal blood flow. We also discuss the treatment of VTE as well as the ongoing clinical trials of heparin anticoagulant therapy. In addition, according to the pathophysiological mechanism of COVID-19-associated thrombosis, we extended the range of antithrombotic drugs including antiplatelet drugs, antifibrinolytic drugs, and anti-inflammatory drugs, hoping to find effective drug therapy and improve the prognosis of VTE in COVID-19 patients.

14.
China CDC Wkly ; 3(46): 967-972, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1513532

ABSTRACT

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently emergent coronavirus of natural origin and caused the coronavirus disease (COVID-19) pandemic. The study of its natural origin and host range is of particular importance for source tracing, monitoring of this virus, and prevention of recurrent infections. One major approach is to test the binding ability of the viral receptor gene ACE2 from various hosts to SARS-CoV-2 spike protein, but it is time-consuming and labor-intensive to cover a large collection of species. METHODS: In this paper, we applied state-of-the-art machine learning approaches and created a pipeline reaching >87% accuracy in predicting binding between different ACE2 and SARS-CoV-2 spike. RESULTS: We further validated our prediction pipeline using 2 independent test sets involving >50 bat species and achieved >78% accuracy. A large-scale screening of 204 mammal species revealed 144 species (or 61%) were susceptible to SARS-CoV-2 infections, highlighting the importance of intensive monitoring and studies in mammalian species. DISCUSSION: In short, our study employed machine learning models to create an important tool for predicting potential hosts of SARS-CoV-2 and achieved the highest precision to our knowledge in experimental validation. This study also predicted that a wide range of mammals were capable of being infected by SARS-CoV-2.

15.
Transplant Proc ; 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1487992

ABSTRACT

We report a case of a heart transplant recipient who presented with a rapidly growing Epstein-Barr virus (EBV)-positive, diffuse large B-cell lymphoma 7 days after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. Because of the atypical radiologic presentation, the initial tentative diagnosis was a mediastinal abscess. This observation indicates a potential risk of EBV reactivation after coronavirus disease 2019 (COVID-19) vaccination, which might lead to or aggravate the presentation of posttransplant lymphoproliferative disorder in transplantation patients. Transplant surgeons should be aware of the potential immunomodulatory effects of the COVID-19 vaccination.

16.
Infect Dis Ther ; 11(1): 145-163, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1479541

ABSTRACT

INTRODUCTION: To assess the long-term consequences of coronavirus disease (COVID-19) among health care workers (HCWs) in China (hereafter surviving HCWs). METHODS: A total of 303 surviving HCWs were included. Lung (pulmonary function test, 6-min walk test [6MWT], chest CT), physical (St. George's Respiratory Questionnaire [SGRQ], Modified Medical Research Council dyspnea scale [mMRC], and Borg scale), and psychiatric functions (Essen Trauma Inventory) were evaluated during the 1-year follow-up. RESULTS: Surviving HCWs had an abnormal diffusion capacity 1 year post-discharge. Participants with a reduced carbon monoxide diffusing capacity (DLCO) comprised 43.48%. The proportion of HCWs with a median 6MWT distance below the lower limit of the normal was 19.4%. An abnormal CT pattern was observed in 37.5% of the HCWs. The SGRQ, mMRC, and Borg scores of surviving HCWs, especially those with critical/severe disease, were significantly higher than those in the normal population. Probable post-traumatic stress disorder (PTSD) was reported in 21.9% of the surviving HCWs. Diffusion capacity impairment was associated with women. Critical/severe illness and nurses were associated with impaired physical function. CONCLUSIONS: Most surviving HCWs, especially female HCWs, still had an abnormal diffusion capacity at 1 year. The physical and psychiatric functions of surviving HCWs were significantly worse than those of the healthy population. Long-term follow-up of pulmonary, physical, and psychiatric functions for surviving HCWs is required.

17.
Nat Commun ; 12(1): 6103, 2021 10 20.
Article in English | MEDLINE | ID: covidwho-1475296

ABSTRACT

Multiple SARS-CoV-2 variants of concern (VOCs) have been emerging and some have been linked to an increase in case numbers globally. However, there is yet a lack of understanding of the molecular basis for the interactions between the human ACE2 (hACE2) receptor and these VOCs. Here we examined several VOCs including Alpha, Beta, and Gamma, and demonstrate that five variants receptor-binding domain (RBD) increased binding affinity for hACE2, and four variants pseudoviruses increased entry into susceptible cells. Crystal structures of hACE2-RBD complexes help identify the key residues facilitating changes in hACE2 binding affinity. Additionally, soluble hACE2 protein efficiently prevent most of the variants pseudoviruses. Our findings provide important molecular information and may help the development of novel therapeutic and prophylactic agents targeting these emerging mutants.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Protein Interaction Domains and Motifs/genetics , SARS-CoV-2/metabolism , Spike Glycoprotein, Coronavirus/metabolism , Amino Acid Sequence , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/isolation & purification , Angiotensin-Converting Enzyme 2/ultrastructure , Animals , Cell Line, Tumor , Crystallography, X-Ray , HEK293 Cells , Humans , Molecular Dynamics Simulation , Mutation , Recombinant Proteins/genetics , Recombinant Proteins/isolation & purification , Recombinant Proteins/metabolism , Recombinant Proteins/ultrastructure , SARS-CoV-2/genetics , Sf9 Cells , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/isolation & purification , Spike Glycoprotein, Coronavirus/ultrastructure , Spodoptera , Surface Plasmon Resonance , Virus Attachment , Virus Internalization
18.
Engineering (Beijing) ; 2021 Oct 23.
Article in English | MEDLINE | ID: covidwho-1474517

ABSTRACT

Current knowledge of the risk factors predicting the progression to severe coronavirus disease 2019 (COVID-19) among patients in community isolation who either are asymptomatic or only suffer from mild COVID-19 is very limited. Using a multivariable competing risk survival analysis, we herein identify several important predictors of progression to severe COVID-19-rather than to recovery-among patients in community isolation. A competing risk survival analysis was performed on time-to-event data from a cohort study of all COVID-19 patients (n = 1753) in the largest community isolation center in Wuhan, China, from opening to closing. The exposures were age, sex, respiratory symptoms, gastrointestinal symptoms, general symptoms, and computed tomography (CT) scan signs. The main outcomes were time to COVID-19 deterioration or recovery. The factors predicting progression to severe COVID-19 among the patients in community isolation were: male sex (hazard ratio (HR) = 1.29, 95% confidence interval (95%CI), 1.04-1.58, p = 0.018), young and old age, dyspnea (HR = 1.58, 95%CI, 1.24-2.01, p < 0.001), and CT signs of ground-glass opacity (HR = 1.39, 95%CI, 1.04-1.86, p = 0.024) and infiltrating shadows (HR= 1.84, 95%CI, 1.22-2.78, p = 0.004). The risk of progression was found to be lower among patients with nausea or vomiting (HR = 0.53, 95%CI, 0.30-0.96, p = 0.036) and headaches (HR = 0.54, 95%CI, 0.29-0.99, p = 0.046). Based on the results of this study, resource-poor settings, dyspnea, sex, and age can easily be used to identify mild COVID-19 patients who are at increased risk of progression. Looking for CT signs of ground-glass opacity and infiltrating shadows may be an affordable option to support triage decisions in resource-rich settings. Common and unspecific symptoms including headaches, nausea, and vomiting likely induced the selection for community isolation of COVID-19 patients who were relatively unlikely to deteriorate. Triage and prioritization outcomes could be boosted if strategies are incorporated to minimize the inefficient prioritization of harmless comorbidities.

19.
Signal Transduct Target Ther ; 6(1): 345, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1434094

ABSTRACT

The SARS-CoV-2 infection causes severe immune disruption. However, it is unclear if disrupted immune regulation still exists and pertains in recovered COVID-19 patients. In our study, we have characterized the immune phenotype of B cells from 15 recovered COVID-19 patients, and found that healthy controls and recovered patients had similar B-cell populations before and after BCR stimulation, but the frequencies of PBC in patients were significantly increased when compared to healthy controls before stimulation. However, the percentage of unswitched memory B cells was decreased in recovered patients but not changed in healthy controls upon BCR stimulation. Interestingly, we found that CD19 expression was significantly reduced in almost all the B-cell subsets in recovered patients. Moreover, the BCR signaling and early B-cell response were disrupted upon BCR stimulation. Mechanistically, we found that the reduced CD19 expression was caused by the dysregulation of cell metabolism. In conclusion, we found that SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism, which may provide a new intervention target to cure COVID-19.


Subject(s)
Antigens, CD19/immunology , B-Lymphocytes/immunology , COVID-19/immunology , Down-Regulation/immunology , Immunologic Deficiency Syndromes/immunology , SARS-CoV-2/immunology , Animals , COVID-19/complications , Chlorocebus aethiops , Female , Humans , Immunologic Deficiency Syndromes/etiology , Immunologic Deficiency Syndromes/virology , Immunologic Memory , Male , Mice , Mice, Transgenic , Receptors, Antigen, B-Cell/immunology , Vero Cells
20.
N Engl J Med ; 382(18): 1708-1720, 2020 04 30.
Article in English | MEDLINE | ID: covidwho-1428982

ABSTRACT

BACKGROUND: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. METHODS: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. RESULTS: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. CONCLUSIONS: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).


Subject(s)
Betacoronavirus , Coronavirus Infections , Disease Outbreaks , Pandemics , Pneumonia, Viral , Adolescent , Adult , Aged , COVID-19 , Child , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Fever/etiology , Humans , Male , Middle Aged , Patient Acuity , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2 , Young Adult
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