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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322503

ABSTRACT

Background: The Corona Virus Disease 2019 (COVID-19) is spreading globally now. However, the clinical presentation that predict prognosis of the patients are still largely unknow. Methods: We enrolled 393 patients infected with COVID-19 and 30 patients with common pulmonary bulla and reviewed their clinical features to evaluate the potential prognostic value of pulmonary vesicles, especially in the patients with severe symptoms. One COVID-19 patient with vesicles was treated by bullectomy for last resort, and its characteristics of the patient’s perioperative laboratory tests was analyzed. The pathological findings of bullectomy were described and compared with those of common bulla cases. Results: Patients infected with COVID-19 showed more dependence on ventilator, occurrence of super resistant bacteria, and prone to vesicle formation than common bulla (p<0.05). Disease severity is associated with age, sex, and usage of ventilator, ECMO and antibiotics, super resistance bacteria and vesicle formation (p<0.05). The average mortality rate of COVID-19 patients was 4.10% (25.4% in severe patients, 0.00% in mild patients). Interestingly, the mortality rate further increased in severe patients with pulmonary vesicles than those without pulmonary vesicles (35.7% vs 22.4%, p=0.0442). One COVID-19 patient with vesicles underwent bullectomy and had a poor prognosis, who showed diffuse alveolar damage and extensive necrosis in bullectomy specimen. Conclusions: Patients infected with COVID-19 are more prone to form pulmonary vesicles showed on chest CT scans, as an important poor prognosis factor, especially in the severe patients.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312715

ABSTRACT

Objectives: To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) patients. Methods: : We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:4 was introduced to eliminate the potential confounders. Patients were assigned to the ACEI/ARB group (n=40) or control group (n=160) according to whether they were current users of medication. Results: : Compared to the control group, patients in the ACEI/ARB group had lower levels of plasma IL-1β [(6.27±0.50) vs. (8.23±0.39) pg/ml, P =0.028], IL-8 [(35.74±4.00) vs. (45.88±2.06) pg/ml, P =0.037] and TNF-α [(8.79±0.40) vs. (10.91±0.21) pg/ml, P <0.01]. Patients with the current use of ACEIs/ARBs had a higher risk of shock (23% vs. 8%, P <0.01). Decreased lymphocyte counts [(0.85±0.45) vs. (1.02±0.52)*10

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312650

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has spread to 216 countries and territories around the world. Most studies on response to public health emergencies, focus on health systems, local governments or medical organizations, but fewer studies focus on individuals. However, medical staff are the core strength for responding to public health emergencies. The aims of this study are to investigate the status of medical staff’s emergency capacity during the pandemic and to provide intellectual support to further enhance medical staff's ability to ensure the smooth operation of medical rescue. Methods: : This study conducted a cross-sectional survey of four hospitals designated to treat patients with COVID-19 in China. Based on the emergency capacity system of medical staff for infectious diseases, an improved Emergency Preparedness Information Questionnaire was used to evaluate the emergency capacity of medical staff. Linear regression and one-way analysis of variance were used to test the differences in the emergency capacity of medical staff. Spearman correlation analysis was used to study the correlation between the self-efficacy and emergency capacity of medical staff. Results: : The overall emergency capacity of the surveyed medical staff was at a medium level. There was a correlation between emergency capacity and age, working years, position, educational background and the area where medical staff worked. Emergency capacity was not related to the hospital grade. Emergency capacity was significantly related to whether medical staff had participated in frontline pandemic prevention work. There was also a positive correlation between emergency capacity and the self-efficacy of medical staff. Conclusions: : The results highlight the importance of the training mechanism for emergency personnel. The emergency input for public health emergencies should be increased to improve the emergency capacity of medical staff. In addition, it is necessary to pay attention to the mental health of medical staff.

4.
Remote Sensing ; 13(18):3664, 2021.
Article in English | MDPI | ID: covidwho-1410789

ABSTRACT

Air pollutant transport plays an important role in local air quality, but field observations of transport fluxes, especially their vertical distributions, are very limited. We characterized the vertical structures of transport fluxes in central Luoyang, Fen-Wei Plain, China, in winter based on observations of vertical air pollutant and wind profiles using multi-axis differential optical absorption spectroscopy (MAX-DOAS) and Doppler wind lidar, respectively. The northwest and the northeast are the two privileged wind directions. The wind direction and total transport scenarios were dominantly the northwest during clear days, turning to the northeast during the polluted days. Increased transport flux intensities of aerosol were found at altitudes below 400 m on heavily polluted days from the northeast to the southwest over the city. Considering pollution dependence on wind directions and speeds, surface-dominated northeast transport may contribute to local haze events. Northwest winds transporting clean air masses were dominant during clean periods and flux profiles characterized by high altitudes between 200 and 600 m in Luoyang. During the COVID-19 lockdown period in late January and February, clear reductions in transport flux were found for NO2 from the northeast and for HCHO from the northwest, while the corresponding main transport altitude remained unchanged. Our findings provide better understandings of regional transport characteristics, especially at different altitudes.

5.
Front Cardiovasc Med ; 8: 710946, 2021.
Article in English | MEDLINE | ID: covidwho-1399130

ABSTRACT

Objectives: To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the inflammatory response and viral clearance in coronavirus disease 2019 (COVID-19) patients. Methods: We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:3 was introduced to eliminate potential confounders. Patients were assigned to the ACEI/ARB group (n = 38) or control group (n = 114) according to whether they were current users of medication. Results: Compared to the control group, patients in the ACEI/ARB group had lower levels of plasma IL-1ß [(6.20 ± 0.38) vs. (9.30 ± 0.31) pg/ml, P = 0.020], IL-6 [(31.86 ± 4.07) vs. (48.47 ± 3.11) pg/ml, P = 0.041], IL-8 [(34.66 ± 1.90) vs. (47.93 ± 1.21) pg/ml, P = 0.027], and TNF-α [(6.11 ± 0.88) vs. (12.73 ± 0.26) pg/ml, P < 0.01]. Current users of ACEIs/ARBs seemed to have a higher rate of vasoconstrictive agents (20 vs. 6%, P < 0.01) than the control group. Decreased lymphocyte counts [(0.76 ± 0.31) vs. (1.01 ± 0.45)*109/L, P = 0.027] and elevated plasma levels of IL-10 [(9.91 ± 0.42) vs. (5.26 ± 0.21) pg/ml, P = 0.012] were also important discoveries in the ACEI/ARB group. Patients in the ACEI/ARB group had a prolonged duration of viral shedding [(24 ± 5) vs. (18 ± 5) days, P = 0.034] and increased length of hospitalization [(24 ± 11) vs. (15 ± 7) days, P < 0.01]. These trends were similar in patients with hypertension. Conclusions: Our findings did not provide evidence for a significant association between ACEI/ARB treatment and COVID-19 mortality. ACEIs/ARBs might decrease proinflammatory cytokines, but antiviral treatment should be enforced, and hemodynamics should be monitored closely. Since the limited influence on the ACEI/ARB treatment, they should not be withdrawn if there was no formal contraindication.

6.
Preprint in English | medRxiv | ID: ppmedrxiv-21257710

ABSTRACT

AimTo investigate nursing students konwledge, attitudes and willingness to receive the COVID-19 vaccine, and the influencing factors. BackgroundVaccination is one of the effective measures to prevent COVID-19, but the vaccination acceptance varies across countries and populations. As reserve nurses, nursing students have both the professionalism of medical personnel and the special characteristics of school students, their attitudes, knowledge, and willingness to receive the COVID-19 vaccine may greatly affect the vaccine acceptance of the population now and in the future. But little research has been done on vaccine acceptance among nursing students. DesignA cross-sectional survey of nursing students was conducted via online questionnaires in March 2021. MethodsDescriptive statistics, independent sample t tests/one-way ANOVA (normal distribution), Mann-Whitney U tests/Kruskal-Wallis H tests (skewness distribution) and multivariate linear regression were performed. ResultsThe score rate of attitude, knowledge and vaccination willingness were 70.07%, 80.70% and 84.38% respectively. Attitude was significantly influenced by family economic conditions and whether a family member had been vaccinated. The main factors influencing knowledge were gender, grade and academic background. In terms of willingness, gender, academic background, visits to risk areas, whether family members were vaccinated, and whether they had side effects were significant influencing factors. ConclusionsThe vaccine acceptance of nursing students was fair. Greater focus needed to be placed on the males, those of younger age, with a science background, and having low grades, as well as on students whose family members had not received the COVID-19 vaccine or had side effects from the vaccine. Targeted intervention strategies were recommended to improve vaccination rates.

7.
Preprint in English | bioRxiv | ID: ppbiorxiv-428353

ABSTRACT

The emergence of SARS-CoV-2 variants poses greater challenges to the control of COVID-19 pandemic. Here, we parallelly investigated three important characteristics of seven SARS-CoV-2 variants, including two mink-associated variants, the B.1.617.1 variant, and the four WHO-designated variants of concerns (B.1.1.7, B.1.351, P.1, and B.1.617.2). We first investigated the ability of these variants to bind and use animal ACE2 orthologs as entry receptor. We found that, in contrast to a prototype variant, the B.1.1.7, B.1.351, and P.1 variants had significantly enhanced affinities to cattle, pig, and mouse ACE2 proteins, suggesting increased susceptibility of these species to these SARS-CoV-2 variants. We then evaluated in vitro neutralization sensitivity of these variants to four monoclonal antibodies in clinical use. We observed that all the variants were partially or completely resistant against at least one of the four tested antibodies, with B.1.351 and P.1 showing significant resistance to three of them. As ACE2-Ig is a broad-spectrum anti-SARS-CoV-2 drug candidate, we then evaluated in vitro neutralization sensitivity of these variants to eight ACE2-Ig constructs previously described in three different studies. All the SARS-CoV-2 variants were efficiently neutralized by these ACE2-Ig constructs. Interestingly, compared to the prototype variant, most tested variants including the variants of concern B.1.1.7, B.1.351, P.1, and B.1.617.2 showed significantly increased (up to [~]15-fold) neutralization sensitivity to ACE2-Ig constructs that are not heavily mutated in the spike-binding interface of the soluble ACE2 domain, suggesting that SARS-CoV-2 evolves toward better utilizing ACE2, and that ACE2-Ig is an attractive drug candidate for coping with SARS-CoV-2 mutations.

8.
Molecules ; 25(19):4588, 2020.
Article | MDPI | ID: covidwho-838432

ABSTRACT

The major groups of antioxidant compounds (isoflavonoids, xanthones, hydroxycinnamic acids) in the rhizome methanol extracts of four Ukrainian Iris sp. (Iris pallida, Iris hungarica, Iris sibirica, and Iris variegata) were qualitatively and quantitatively analyzed using HPLC-DAD and UPLC-MS/MS. Gallic acid, caffeic acid, mangiferin, tectoridin, irigenin, iristectorigenin B, irisolidone, 5,6-dihydroxy-7,8,3′,5′-tetramethoxyisoflavone, irisolidone-7-O-β-d-glucopyranoside, germanaism B, and nigricin were recognized by comparing their UV/MS spectra, chromatographic retention time (tR) with those of standard reference compounds. I. hungarica and I. variegata showed the highest total amount of phenolic compounds. Germanaism B was the most abundant component in the rhizomes of I. variegata (7.089 ±0.032 mg/g) and I. hungarica (6.285 ±0.030 mg/g). The compound analyses showed good calibration curve linearity (r2 >0.999) and low detection and quantifications limit. These results validated the method for its use in the simultaneous quantitative evaluation of phenolic compounds in the studied Iris sp. I. hungarica and I. variegata rhizomes exhibited antioxidant activity, as demonstrated by the HPLC-ABTS system and NRF2 expression assay and anti-inflammatory activity on respiratory burst in human neutrophils. Moreover, the extracts showed anti-allergic and cytotoxic effects against cancer cells. Anti-coronavirus 229E and lipid formation activities were also evaluated. In summary, potent antioxidant marker compounds were identified in the examined Iris sp.

9.
Int Immunopharmacol ; 89(Pt A): 107065, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-813647

ABSTRACT

BACKGROUND: Patients with severe coronavirus disease 2019 (COVID-19) develop acute respiratory distress and multi-system organ failure and are associated with poor prognosis and high mortality. Thus, there is an urgent need to identify early diagnostic and prognostic biomarkers to determine the risk of developing serious illness. METHODS: We retrospectively analyzed 114 patients with COVID-19 at the Jinyintan Hospital, Wuhan based on their clinical and laboratory data. Patients were categorized into severe and mild to moderate disease groups. We analyzed the potential of serological inflammation indicators in predicting the severity of COVID-19 in patients using univariate and multivariate logistic regression, receiver operating characteristic curves, and nomogram analysis. The Spearman method was used to understand the correlation between the serological biomarkers and duration of hospital stay. RESULTS: Patients with severe disease had reduced neutrophils and lymphocytes; severe coagulation dysfunction; altered content of biochemical factors (such as urea, lactate dehydrogenase); elevated high sensitivity C-reactive protein levels, neutrophil-lymphocyte, platelet-lymphocyte, and derived neutrophil-lymphocyte ratios, high sensitivity C-reactive protein-prealbumin ratio (HsCPAR), systemic immune-inflammation index, and high sensitivity C-reactive protein-albumin ratio (HsCAR); and low lymphocyte-monocyte ratio, prognostic nutritional index (PNI), and albumin-to-fibrinogen ratio. PNI, HsCAR, and HsCPAR correlated with the risk of severe disease. The nomogram combining the three parameters showed good discrimination with a C-index of 0.873 and reliable calibration. Moreover, HsCAR and HsCPAR correlated with duration of hospital stay. CONCLUSION: Taken together, PNI, HsCAR, and HsCPAR may serve as accurate biomarkers for the prediction of disease severity in patients with COVID-19 upon admission/hospitalization.


Subject(s)
C-Reactive Protein/analysis , COVID-19/blood , Inflammation/blood , Length of Stay , SARS-CoV-2 , Serum Albumin/analysis , Severity of Illness Index , Aged , Biomarkers/blood , COVID-19/complications , Female , Humans , Logistic Models , Male , Middle Aged , Retrospective Studies
11.
Chin. J. Microbiol. Immunol. ; 7(40): 489-494, 20200731.
Article in Chinese | WHO COVID, ELSEVIER | ID: covidwho-701952

ABSTRACT

Objective: To investigate the value of anal swabs positive for 2019-nCoV in patients with COVID-19 and the clinical features of the patients. Methods: Throat swabs, sputum and blood samples, and anal swabs were collected from 104 patients with COVID-19 at admission to test for 2019-nCoV nucleic acid. Clinical characteristics and hematological indexes were compared between viral nucleic acid-positive and -negative groups of different sample types. Fifteen patients whose anal swabs were positive for viral nucleic acid were selected to analyze the length of time before the nucleic acid turned negative in different specimens. Results: Compared with the patients having negative anal swab test results, those having positive test results showed decreased lymphocytes, increased lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (HsCRP), and higher incidence of severe COVID-19. The levels of HsCRP and IL-6 and the incidence of severe COVID-19 were significantly higher in patients with positive throat swab test results than in those with negative results. No significant difference in hematological indexes or the proportion of severe cases was detected between the patients with positive and negative sputum test results. Only 1.92% of the patients had positive blood test results, but all of them were severe patients. The positive rate of sputum test was the highest, which was 46.15%. Patients with positive results of both throat and anal swab test had significantly decreased lymphocytes, increased HsCRP and IL-6 levels, and higher incidence of critical COVID-19. It took longer time for patients to have negative anal swab and sputum test results. Moreover, it should be noticed that the viral nucleic acid in sputum might become positive again after it turned negative. Conclusions: Patients with positive anal swab test results had reduced lymphocytes, enhanced inflammatory response and higher incidence of severe COVID-19, suggesting that a positive anal swab test might be an indicator of severe COVID-19. Moreover, the time of 2019-nCoV nucleic acid turning negative in anal swabs was longer than that in throat swabs. The combined detection of throat swabs and anal swabs would help to predict the occurrence of severe COVID-19.

12.
Saf Sci ; 131: 104938, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-688760

ABSTRACT

Coronavirus disease 2019 (COVID-19) broke out in Wuhan, China. As of March 9, 2020, this epidemic has occurred in 102 countries and caused 3584 deaths with global serious concern. To cope with the outbreak, Chinese governments have strictly controlled urban traffic at all levels, especially in Wuhan. This article firstly reviews the urban traffic situation from January 23, 2020 to March 8, 2020, including safety problems of urban public transportation, traffic control methods, and emergency public transportation planning. Based on this, we present some emergency traffic control measures that are very urgent in the early stage of epidemic. Between cities, we strongly recommend blocking and controlling the flow of traffic in the early stage of epidemic. Inside a city, it is imperative to suspend the public transports, block all roads, restrict private cars, and close bridges and tunnels. Material isolation transfer stations are suggested to be established. A number of public transports should be organized to ensure transport of medical workers, patients, and daily necessities. We also give suggestions about the long-term planning and improvement methods. Considering the great success China has achieved in fighting COVID-19, we believe that this article offers a valuable reference of urban traffic control.

13.
Preprint in English | medRxiv | ID: ppmedrxiv-20078774

ABSTRACT

Due to the heterogeneity among the States in the US, predicting COVID-19 trends and quantitatively assessing the effects of government testing capability and control measures need to be done via a State-by-State approach. We develop a comprehensive model for COVID-19 incorporating time delays and population movements. With key parameter values determined by empirical data, the model enables the most likely epidemic scenarios to be predicted for each State, which are indicative of whether testing services and control measures are vigorous enough to contain the disease. We find that government control measures play a more important role than testing in suppressing the epidemic. The vast disparities in the epidemic trends among the States imply the need for long-term placement of control measures to fully contain COVID-19.

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