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1.
Signal Transduct Target Ther ; 7(1): 114, 2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1778593

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of novel coronavirus disease (COVID-19). The neutralizing monoclonal antibodies (mAbs) targeting the receptor-binding domain (RBD) of SARS-CoV-2 are among the most promising strategies to prevent and treat COVID-19. However, SARS-CoV-2 variants of concern (VOCs) profoundly reduced the efficacies of most of mAbs and vaccines approved for clinical use. Herein, we demonstrated mAb 35B5 efficiently neutralizes both wild-type (WT) SARS-CoV-2 and VOCs, including B.1.617.2 (delta) variant, in vitro and in vivo. Cryo-electron microscopy (cryo-EM) revealed that 35B5 neutralizes SARS-CoV-2 by targeting a unique epitope that avoids the prevailing mutation sites on RBD identified in circulating VOCs, providing the molecular basis for its pan-neutralizing efficacy. The 35B5-binding epitope could also be exploited for the rational design of a universal SARS-CoV-2 vaccine.


Subject(s)
Antibodies, Monoclonal , Antibodies, Viral , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Antibodies, Monoclonal/chemistry , Antibodies, Viral/chemistry , COVID-19 , Cryoelectron Microscopy , Humans , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/immunology
3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324447

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak is a global public health crisis that has affected the implementation of advance care planning (ACP) in Taiwan. The purpose of this study is to (1) confirm that COVID-19 significantly reduced public participation in ACP, (2) identify factors influencing the implementation of ACP during the COVID-19 pandemic and how they differ from those before the COVID-19 outbreak. Methods: An observational study from retrospective review of medical chart and clinical information.This is a hospital-based study to examine the characteristics of ACP implementation in Taiwan during COVID-19. A total of 1,253 participants were recruited, including 916 people who had completed ACP from September through December 2019, and 337 people from January through April 2020. Results: This study representing an approximately 65% decrease in ACP participation after COVID-19 outbreak. The cancellation rate of ACP during COVID-19 is higher before outbreak. After COVID-19 outbreak, Participation rate of disadvantaged populations increased from 16.92% to 21.66%. The percentage of participants with caregiver experiences decreased from 31.66%to to 23.44% . Participants who did not wish for their families to bear decision-making responsibilities increased from 44.00% to 52.52%. The percentage of offspring participation increased from 86.57% to 90.80%. The percentage of individuals completing ACP after the outbreak without signing an advance directive increased from 5.57% to 9.20%. The COVID-19 pandemic significantly reduced participation in ACP. Conclusions: This study directly compared the ACP implementation before and after COVID-19, which is a tremendous global health crisis influencing the conceptions of life and death.COVID-19 has threatened the public’s health and has changed ACP in the healthcare system by increasing public awareness of the topic of death. After COVID-19, both medical staff and the public should clearly express their opinions on terminal care.Policy supports and active participation of medical team can encourage disadvantages to complete ACP.Healthcare workers should provide palliative and terminal care services in which patient comfort and dignity are the primary focus of care.Trial registration:This study was approved on 3 June 2020 by the Taipei City Hospital Institutional Review Board (Case No.: TCHIRB-10808008-E).

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312692

ABSTRACT

Aims: To evaluate the health-related quality of life (HRQoL) status and explore its associated factors in pediatric medical staff during the COVID-19 epidemic so as to guide hospitals and administrators to formulate suitable interventions. Methods: A cross-sectional study was conducted to investigate the HRQoL of pediatric medical staff. Univariable and multivariable logistic regression were used to analyze the associated factors. Results: A total of 2,997 participants were recruited. Females scored worse than males in terms of emotional functioning ( OR  = 1.6, 95% CI : 1.2–2.1) and cognitive functioning ( OR  = 1.4, 95% CI : 1.1–1.8). The respondents aged 30–39 years and 40–49 years scored worse in nearly all domains of HRQoL compared health care professionals under 30 years old. Respondents with high education had lower scores in physical functioning ( OR  = 1.3, 95% CI : 1.0-1.7) and emotional functioning ( OR  = 1.5, 95% CI : 1.2–1.9).Compared with doctors, nurses had higher scores in all domains except for summary score and worry. The respondents whose working places had not set up pediatric fever clinics and isolated observation areas independently had better scores in all domains except for worry. The respondents who had ever treated patients with COVID-19 had lower scores in all domains. Conclusions: During the COVID-19 outbreak, the HRQoL of pediatric medical staff decreased. The factors associated with HRQoL can be used to develop intervention to improve HRQoL in pediatric medical staff.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312690

ABSTRACT

Background: Despite worldwide calls for precautionary measures to combat COVID-19, the public's preventive intention still varies significantly among different regions. Exploring the influencing factors of the public's preventive intention is very important to curtail the spread of COVID-19. Previous studies have found that fear can effectively improve the public's preventive intention, but they ignore the impact of differences in cultural values. The present study examines the combined effect of fear and collectivism on the public's preventive intention towards COVID-19 through the analysis of social media big data. Methods: : The Sina microblog posts of 108,914 active users from Chinese mainland 31 provinces were downloaded. The data was retrieved from January 11 to February 21 2020. Afterwards, we conducted a province-level analysis of the contents of downloaded posts. Three lexicons were applied to automatically recognise the scores of fear, collectivism, and preventive intention of 31 provinces. After that, a multiple regression model was established to examine the combined effect of fear and collectivism on the public's preventive intention towards COVID-19. The simple slope test and the Johnson-Neyman technique were used to test the interaction of fear and collectivism on preventive intention. Results: : The study reveals that: (a) both fear and collectivism can positively predict people's preventive intention and (b) there is an interaction of fear and collectivism on people's preventive intention, where fear and collectivism reduce each other's positive influence on people's preventive intention. Conclusion: The promotion of fear on people's preventive intention may be limited and conditional, and values of collectivism can well compensate for the promotion of fear on preventive intention. These results provide scientific inspiration on how to enhance the public's preventive intention towards COVID-19 effectively.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315312

ABSTRACT

Background: The COVID-19 disease is putting unprecedented pressure on the global healthcare system. The CT examination as a auxiliary confirmed diagnostic method can help clinicians quickly detect lesions locations of COVID-19 once screening by PCR test. Furthermore, the lesion subtypes classification plays a critical role in the consequent treatment decision. Identifying the subtypes of lesions accurately can help doctors discover changes in lesions in time and better assess the severity of COVID-19. Method: The most four typical lesion subtypes of COVID-19 are discussed in this paper, which are ground-glass opacity (GGO), cord, solid and subsolid. A computer aided diagnosis approach of lesion subtype is proposed in this paper. The radiomics data of lesions are segmented from COVID-19 patients CT images with diagnosis and lesions annotations by radiologists. Then the three dimensional texture descriptors are applied on the volume data of lesions as well as shape and First order features. The massive feature data are selected by hybrid adaptive selection algorithm and a classification model is trained at the same time. The classifier is used to predict lesion subtypes as side decision information for radiologists. Results: : There are 3734 lesions extracted from the dataset with 319 patients collection and then 189 radiomics features are obtained finally. The random forest classifier is trained with data augmentation that the number of different subtypes of lesions is imbalanced in initial dataset. The experimental results show that the accuracy of the four subtypes of lesions is (0.9306, 0.9684, 0.9958, and 0.9430), the recall is (0.9552, 0.9158, 0.9580 and 0.8075) and the f-score is (0.93.84, 0.92.37, 0.95.47, and 84.42). Conclusion: The method is evaluated in multiple sufficient experiments. The results show that the 3D radiomics features chosen by hybrid adaptive selection algorithm can better express the advanced information of the lesion data. The classification model obtains a good performance and is compared the models of COVID-19 in the stat of art, which can help clinicians more accurately identify the subtypes of COVID-19 lesions and provide help for further research.

7.
Biomed Eng Online ; 20(1): 123, 2021 Dec 05.
Article in English | MEDLINE | ID: covidwho-1555694

ABSTRACT

BACKGROUND: The COVID-19 disease is putting unprecedented pressure on the global healthcare system. The CT (computed tomography) examination as a auxiliary confirmed diagnostic method can help clinicians quickly detect lesions locations of COVID-19 once screening by PCR test. Furthermore, the lesion subtypes classification plays a critical role in the consequent treatment decision. Identifying the subtypes of lesions accurately can help doctors discover changes in lesions in time and better assess the severity of COVID-19. METHOD: The most four typical lesion subtypes of COVID-19 are discussed in this paper, which are GGO (ground-glass opacity), cord, solid and subsolid. A computer-aided diagnosis approach of lesion subtype is proposed in this paper. The radiomics data of lesions are segmented from COVID-19 patients CT images with diagnosis and lesions annotations by radiologists. Then the three-dimensional texture descriptors are applied on the volume data of lesions as well as shape and first-order features. The massive feature data are selected by HAFS (hybrid adaptive feature selection) algorithm and a classification model is trained at the same time. The classifier is used to predict lesion subtypes as side decision information for radiologists. RESULTS: There are 3734 lesions extracted from the dataset with 319 patients collection and then 189 radiomics features are obtained finally. The random forest classifier is trained with data augmentation that the number of different subtypes of lesions is imbalanced in initial dataset. The experimental results show that the accuracy of the four subtypes of lesions is (93.06%, 96.84%, 99.58%, and 94.30%), the recall is (95.52%, 91.58%, 95.80% and 80.75%) and the f-score is (93.84%, 92.37%, 95.47%, and 84.42%). CONCLUSION: The three-dimensional radiomics features used in this paper can better express the high-level information of COVID-19 lesions in CT slices. HAFS method aggregates the results of multiple feature selection algorithms intersects with traditional methods to filter out redundant features more accurately. After selection, the subtype of COVID-19 lesion can be judged by inputting the features into the RF (random forest) model, which can help clinicians more accurately identify the subtypes of COVID-19 lesions and provide help for further research.


Subject(s)
COVID-19 , Algorithms , Humans , Lung , SARS-CoV-2 , Tomography, X-Ray Computed
8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-293463

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of novel corona virus disease (COVID-19). The neutralizing monoclonal antibodies (mAbs) targeting the receptor binding domain (RBD) of SARS-CoV-2 are among the most promising strategies to prevent and treat COVID-19. However, SARS-CoV-2 variants of concern (VOCs) profoundly reduced the efficacies of most of mAbs and vaccines approved for clinical use. Herein, we demonstrated mAb 35B5 efficiently neutralizes both wild-type (WT) SARS-CoV-2 and VOCs, including B.1.617.2 (delta) variant, in vitro and in vivo . Cryo-electron microscopy (cryo-EM) revealed that 35B5 neutralizes SARS-CoV-2 by targeting a unique epitope that avoids the prevailing mutation sites on RBD identified in circulating VOCs, providing the molecular basis for its pan-neutralizing efficacy. The 35B5-binding epitope could also be exploited for the rational design of a universal SARS-CoV-2 vaccine.

9.
Healthcare (Basel) ; 9(6)2021 Jun 12.
Article in English | MEDLINE | ID: covidwho-1270021

ABSTRACT

The global COVID-19 pandemic may significantly affect the experiences of death and bereavement. This study aimed to learn from recent outbreaks of infectious diseases and further understand their impacts on bereavement. We obtained psychological status scores for 32 individuals bereaved due to COVID-19 and 127 individuals bereaved due to non-COVID-19 causes using the online ecological recognition (OER) approach. Next, a sentiment analysis and independent sample t-test were performed to examine the differences between these two groups. The results indicated that the individuals bereaved due to COVID-19 were more insecure and more preoccupied with the grief of the moment than those bereaved due to non-COVID-19 reasons, while the latter group had higher depression scores than the former group. This study can guide policy-makers and clinical practitioners to provide more targeted and sustainable post-bereavement support for both bereaved groups during the COVID-19 period.

10.
Proc Natl Acad Sci U S A ; 118(23)2021 06 08.
Article in English | MEDLINE | ID: covidwho-1238060

ABSTRACT

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic and has claimed over 2 million lives worldwide. Although the genetic sequences of SARS-CoV and SARS-CoV-2 have high homology, the clinical and pathological characteristics of COVID-19 differ significantly from those of SARS. How and whether SARS-CoV-2 evades (cellular) immune surveillance requires further elucidation. In this study, we show that SARS-CoV-2 infection leads to major histocompability complex class Ι (MHC-Ι) down-regulation both in vitro and in vivo. The viral protein encoded by open reading frame 8 (ORF8) of SARS-CoV-2, which shares the least homology with SARS-CoV among all viral proteins, directly interacts with MHC-Ι molecules and mediates their down-regulation. In ORF8-expressing cells, MHC-Ι molecules are selectively targeted for lysosomal degradation via autophagy. Thus, SARS-CoV-2-infected cells are much less sensitive to lysis by cytotoxic T lymphocytes. Because ORF8 protein impairs the antigen presentation system, inhibition of ORF8 could be a strategy to improve immune surveillance.


Subject(s)
Antigen Presentation , COVID-19/immunology , Down-Regulation/immunology , Histocompatibility Antigens Class I/immunology , Immune Evasion , SARS-CoV-2/immunology , Viral Proteins/immunology , Animals , Autophagy/genetics , Autophagy/immunology , COVID-19/genetics , Chlorocebus aethiops , HEK293 Cells , Histocompatibility Antigens Class I/genetics , Humans , Lysosomes/genetics , Lysosomes/immunology , Lysosomes/virology , Mice , Mice, Transgenic , SARS-CoV-2/genetics , Vero Cells , Viral Proteins/genetics
11.
Signal Transduct Target Ther ; 6(1): 189, 2021 05 12.
Article in English | MEDLINE | ID: covidwho-1226420

ABSTRACT

Since the outbreak of coronavirus disease 2019 (COVID-19), it has become a global pandemic. The spike (S) protein of etiologic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specifically recognizes human angiotensin-converting enzyme 2 (hACE2) as its receptor, which is recently identified as an interferon (IFN)-stimulated gene. Here, we find that hACE2 exists on the surface of exosomes released by different cell types, and the expression of exosomal hACE2 is increased by IFNα/ß treatment. In particular, exosomal hACE2 can specifically block the cell entry of SARS-CoV-2, subsequently inhibit the replication of SARS-CoV-2 in vitro and ex vivo. Our findings have indicated that IFN is able to upregulate a viral receptor on the exosomes which competitively block the virus entry, exhibiting a potential antiviral strategy.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , Exosomes/metabolism , Interferon-alpha/pharmacology , Interferon-beta/pharmacology , SARS-CoV-2/physiology , Virus Internalization/drug effects , Virus Replication/drug effects , Angiotensin-Converting Enzyme 2/genetics , Animals , Chlorocebus aethiops , Exosomes/genetics , Exosomes/virology , HEK293 Cells , Humans , Mice , Mice, Transgenic , Vero Cells
12.
Front Public Health ; 8: 565849, 2020.
Article in English | MEDLINE | ID: covidwho-1207746

ABSTRACT

Objective: To evaluate the health-related quality of life (HRQoL) status and explore its associated factors in pediatric medical staff during the COVID-19 epidemic so as to provide fundamental evidence for clinicians and administrators to formulate targeted intervention measures to improve the HRQoL and mental health status in pediatric medical staff during this, and future pandemics. Methods: A cross-sectional study was conducted to investigate the HRQoL of pediatric medical staff. Univariable and multivariable logistic regression were used to analyze the associated factors. Results: A total of 2,997 participants were recruited. Females scored worse than males in terms of emotional functioning (OR = 1.6, 95% CI: 1.2-2.1) and cognitive functioning (OR = 1.4, 95% CI: 1.1-1.8). The respondents aged 30-39 and 40-49 years scored worse in nearly all domains of HRQoL compared health care professionals under 30 years old. Respondents with high education had lower scores in physical functioning (OR = 1.3, 95% CI: 1.0-1.7) and emotional functioning (OR = 1.5, 95% CI: 1.2-1.9). Compared with doctors, nurses had higher scores in all domains except for summary score and worry. The respondents whose working places had not set up pediatric fever clinics and isolated observation areas independently had lower scores in all domains except for worry. The respondents who had ever treated patients with COVID-19 had lower scores in all domains. Conclusion: During the COVID-19 outbreak, the HRQoL of pediatric medical staff decreased. The factors associated with HRQoL can be used to develop intervention to improve HRQoL in pediatric medical staff.


Subject(s)
COVID-19 , Quality of Life , Adult , Child , Cross-Sectional Studies , Disease Outbreaks , Female , Humans , Male , Medical Staff , SARS-CoV-2
13.
BMC Public Health ; 20(1): 1707, 2020 Nov 16.
Article in English | MEDLINE | ID: covidwho-926330

ABSTRACT

BACKGROUND: Despite worldwide calls for precautionary measures to combat COVID-19, the public's preventive intention still varies significantly among different regions. Exploring the influencing factors of the public's preventive intention is very important to curtail the spread of COVID-19. Previous studies have found that fear can effectively improve the public's preventive intention, but they ignore the impact of differences in cultural values. The present study examines the combined effect of fear and collectivism on the public's preventive intention towards COVID-19 through the analysis of social media big data. METHODS: The Sina microblog posts of 108,914 active users from Chinese mainland 31 provinces were downloaded. The data was retrieved from January 11 to February 21, 2020. Afterwards, we conducted a province-level analysis of the contents of downloaded posts. Three lexicons were applied to automatically recognise the scores of fear, collectivism, and preventive intention of 31 provinces. After that, a multiple regression model was established to examine the combined effect of fear and collectivism on the public's preventive intention towards COVID-19. The simple slope test and the Johnson-Neyman technique were used to test the interaction of fear and collectivism on preventive intention. RESULTS: The study reveals that: (a) both fear and collectivism can positively predict people's preventive intention and (b) there is an interaction of fear and collectivism on people's preventive intention, where fear and collectivism reduce each other's positive influence on people's preventive intention. CONCLUSION: The promotion of fear on people's preventive intention may be limited and conditional, and values of collectivism can well compensate for the promotion of fear on preventive intention. These results provide scientific inspiration on how to enhance the public's preventive intention towards COVID-19 effectively.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Fear/psychology , Intention , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Social Values , Big Data , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , Social Media
14.
J Xray Sci Technol ; 28(5): 875-884, 2020.
Article in English | MEDLINE | ID: covidwho-721454

ABSTRACT

OBJECTIVE: To retrospectively analyze and stratify the initial clinical features and chest CT imaging findings of patients with COVID-19 by gender and age. METHODS: Data of 50 COVID-19 patients were collected in two hospitals. The clinical manifestations, laboratory examination and chest CT imaging features were analyzed, and a stratification analysis was performed according to gender and age [younger group: <50 years old, elderly group ≥50 years old]. RESULTS: Most patients had a history of epidemic exposure within 2 weeks (96%). The main clinical complaints are fever (54%) and cough (46%). In chest CT images, ground-glass opacity (GGO) is the most common feature (37/38, 97%) in abnormal CT findings, with the remaining 12 patients (12/50, 24%) presenting normal CT images. Other concomitant abnormalities include dilatation of vessels in lesion (76%), interlobular thickening (47%), adjacent pleural thickening (37%), focal consolidation (26%), nodules (16%) and honeycomb pattern (13%). The lesions were distributed in the periphery (50%) or mixed (50%). Subgroup analysis showed that there was no difference in the gender distribution of all the clinical and imaging features. Laboratory findings, interlobular thickening, honeycomb pattern and nodules demonstrated remarkable difference between younger group and elderly group. The average CT score for pulmonary involvement degree was 5.0±4.7. Correlation analysis revealed that CT score was significantly correlated with age, body temperature and days from illness onset (p < 0.05). CONCLUSIONS: COVID-19 has various clinical and imaging appearances. However, it has certain characteristics that can be stratified. CT plays an important role in disease diagnosis and early intervention.


Subject(s)
Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Child , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Coronavirus Infections/physiopathology , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Pneumonia, Viral/physiopathology , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , Young Adult
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