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1.
Computers in biology and medicine ; 2022.
Article in English | EuropePMC | ID: covidwho-1837393

ABSTRACT

Background and objectives The traditional method of detecting COVID-19 disease mainly rely on the interpretation of computer tomography (CT) or X-ray images (X-ray) by doctors or professional researchers to identify whether it is COVID-19 disease, which is easy to cause identification mistakes. In this study, the technology of convolutional neural network is expected to be able to efficiently and accurately identify the COVID-19 disease. Methods This study uses and fine-tunes seven convolutional neural networks including InceptionV3, ResNet50V2, Xception, DenseNet121, MobileNetV2, EfficientNet-B0, and EfficientNetV2 on COVID-19 detection. In addition, we proposes a lightweight convolutional neural network, LightEfficientNetV2, on small number of chest X-ray and CT images. Five-fold cross-validation was used to evaluate the performance of each model. To confirm the performance of the proposed model, LightEfficientNetV2 was carried out on three different datasets (NIH Chest X-rays, SARS-CoV-2 and COVID-CT). Results On chest X-ray image dataset, the highest accuracy 96.50% was from InceptionV3 before fine-tuning;and the highest accuracy 97.73% was from EfficientNetV2 after fine-tuning. The accuracy of the LightEfficientNetV2 model proposed in this study is 98.33% on chest X-ray image. On CT images, the best transfer learning model before fine-tuning is MobileNetV2, with an accuracy of 94.46%;the best transfer learning model after fine-tuning is Xception, with an accuracy of 96.78%. The accuracy of the LightEfficientNetV2 model proposed in this study is 97.48% on CT image. Conclusions Compared with the SOTA, LightEfficientNetV2 proposed in this study demonstrates promising performance on chest X-ray images, CT images and three different datasets.

2.
J Virol ; 96(5): e0208621, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1736026

ABSTRACT

Coronavirus infections induce the expression of multiple proinflammatory cytokines and chemokines. We have previously shown that in cells infected with gammacoronavirus infectious bronchitis virus (IBV), interleukin 6 (IL-6), and IL-8 were drastically upregulated, and the MAP kinase p38 and the integrated stress response pathways were implicated in this process. In this study, we report that coronavirus infection activates a negative regulatory loop that restricts the upregulation of a number of proinflammatory genes. As revealed by the initial transcriptomic and subsequent validation analyses, the anti-inflammatory adenine-uridine (AU)-rich element (ARE)-binding protein, zinc finger protein 36 (ZFP36), and its related family members were upregulated in cells infected with IBV and three other coronaviruses, alphacoronaviruses porcine epidemic diarrhea virus (PEDV), human coronavirus 229E (HCoV-229E), and betacoronavirus HCoV-OC43, respectively. Characterization of the functional roles of ZFP36 during IBV infection demonstrated that ZFP36 promoted the degradation of transcripts coding for IL-6, IL-8, dual-specificity phosphatase 1 (DUSP1), prostaglandin-endoperoxide synthase 2 (PTGS2) and TNF-α-induced protein 3 (TNFAIP3), through binding to AREs in these transcripts. Consistently, knockdown and inhibition of JNK and p38 kinase activities reduced the expression of ZFP36, as well as the expression of IL-6 and IL-8. On the contrary, overexpression of mitogen-activated protein kinase kinase 3 (MKK3) and MAPKAP kinase-2 (MK2), the upstream and downstream kinases of p38, respectively, increased the expression of ZFP36 and decreased the expression of IL-8. Taken together, this study reveals an important regulatory role of the MKK3-p38-MK2-ZFP36 axis in coronavirus infection-induced proinflammatory response. IMPORTANCE Excessive and uncontrolled induction and release of proinflammatory cytokines and chemokines, the so-called cytokine release syndrome (CRS), would cause life-threatening complications and multiple organ failure in severe coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and COVID-19. This study reveals that coronavirus infection also induces the expression of ZFP36, an anti-inflammatory ARE-binding protein, promoting the degradation of ARE-containing transcripts coding for IL-6 and IL-8 as well as a number of other proteins related to inflammatory response. Furthermore, the p38 MAP kinase, its upstream kinase MKK3 and downstream kinase MK2 were shown to play a regulatory role in upregulation of ZFP36 during coronavirus infection cycles. This MKK3-p38-MK2-ZFP36 axis would constitute a potential therapeutic target for severe coronavirus infections.


Subject(s)
Coronavirus Infections/metabolism , Interleukin-6/metabolism , Interleukin-8/metabolism , Tristetraprolin/metabolism , p38 Mitogen-Activated Protein Kinases/metabolism , Adenine/metabolism , Animals , Cell Line , Chlorocebus aethiops , Coronavirus Infections/genetics , Gene Expression Regulation , Humans , Infectious bronchitis virus/metabolism , Infectious bronchitis virus/pathogenicity , Interleukin-6/genetics , Interleukin-8/genetics , Intracellular Signaling Peptides and Proteins/metabolism , Phosphorylation , Transcriptional Activation , Up-Regulation , Uridine/metabolism , Vero Cells
4.
European Journal of Psychotraumatology ; 12(1), 2021.
Article in English | EuropePMC | ID: covidwho-1602102

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients’ perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54–14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13–212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12–1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17–0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19. HIGHLIGHTS More than one-third ofpatients met the diagnostic criteria of probable PTSD 1 month post-discharge. Providing timely emotional support during hospitaliza-tion may be one of the key measures for preventing PTSD in patients with COVID-19.

6.
Eur J Psychotraumatol ; 12(1): 1915576, 2021.
Article in English | MEDLINE | ID: covidwho-1284836

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients' perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54-14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13-212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12-1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17-0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19.


Antecedentes: El COVID-19 ha supuesto una inmensa carga psicológica para el paciente infectado. El malestar psicológico puede persistir aún después de la recuperación inicial de la infección.Objetivos: Este estudio tuvo como objetivo evaluar la prevalencia y los factores predictores del trastorno de estrés postraumático (TEPT) provisional en pacientes recuperados de COVID-2019.Métodos: El cuestionario inicial se realizó en pacientes con el COVID-19 desde el 10 de febrero del 2020 hasta el 25 de febrero del 2020 en un hospital designado. Se consideraron las variables demográficas y clínicas, además, se evaluaron los niveles de depresión y ansiedad mediante el cuestionario de salud del paciente de 9 elementos y el cuestionario del trastorno de ansiedad generalizada de 7 elementos, respectivamente. Un cuestionario de seguimiento fue realizado un mes después del alta. Los síntomas de TEPT fueron medidos por el Cuestionario de Eventos de Impacto 6 (IES-6 por sus siglas en ingles) y el nivel de percepción de los pacientes sobre el cuidado de soporte durante la hospitalización fue investigado utilizando un cuestionario auto-administrado.Resultados: Ciento catorce pacientes completaron tanto el cuestionario inicial como el de seguimiento. Cuarenta y un (36.0%) pacientes cumplieron con el punto de corte para el diagnóstico provisional de TEPT según el IES-6. El sexo femenino (OR = 4.69, 95% CI: 1.54-14.37), un nivel de educación secundaria o inferior (OR = 15.49, 95% CI: 1.13-212.71), niveles elevados de ansiedad (OR = 1.34, 95% CI: 1.12-1.61) y una menor percepción de soporte emocional durante la hospitalización (OR = 0.41, 95% CI: 0.17-0.96) fueron factores predictores de riesgo elevado para el desarrollo provisional de TEPT.Conclusiones: El TEPT es observado con frecuencia en pacientes con COVID-19 un mes después del alta. Las pacientes de sexo femenino, los pacientes con un nivel de educación bajo, los pacientes con un nivel elevado de ansiedad y una menor percepción de apoyo emocional durante la hospitalización podrían tener mayor probabilidad de desarrollar TEPT en el futuro cercano. El reforzamiento del apoyo emocional durante la hospitalización podría ayudar a prevenir el TEPT en pacientes con COVID-19.


Subject(s)
COVID-19/psychology , Stress Disorders, Post-Traumatic/epidemiology , Survivors/psychology , Adult , COVID-19/epidemiology , China/epidemiology , Female , Humans , Length of Stay , Longitudinal Studies , Male , Middle Aged , Pandemics , Prevalence , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
7.
Front Psychiatry ; 12: 585537, 2021.
Article in English | MEDLINE | ID: covidwho-1211866

ABSTRACT

Objective: Little is known about the factors affecting the recovery of mental health in COVID-19 patients. The purpose of this study is to look into the change of psychological distress and to explore the role of negative appraisals in the improvement of psychological distress in COVID-19 patients after they recovered from the infection. Methods: We conducted a longitudinal survey on patients with COVID-19 infection in Changsha. The 9-item Patient Health scale, the 7-item Generalized Anxiety Disorder scale, and a newly developed measure, the COVID-19 Impact Scale (CIS) were applied to assess patients' depression, anxiety, and negative appraisal toward COVID-19 infection during their hospitalization and 1 month post-discharge. Results: Seventy-two patients were included in the analysis. A significant decrease in anxiety and depression levels was observed after patients were discharged from hospital. Two meaningful factors of the CIS were extracted based on factor analysis, namely "health impact," and "social impact." The change of social impact explained the 12.7 and 10.5% variance in the depression and anxiety symptom improvement, respectively. Conclusions: Change in negative appraisals, especially the appraisals related to COVID-19 social impact may play a vital role in the relief of psychological distress of infected patients. Therefore, a cognitive and social care perspective might be considered when promoting the mental health recovery and readjustment to society among COVID-19 patients.

8.
BMJ Open ; 11(2): e043686, 2021 02 26.
Article in English | MEDLINE | ID: covidwho-1105493

ABSTRACT

INTRODUCTION: Frontline healthcare providers are redeployed to areas outside their clinical expertise and assigned high-loading workload to address the surge of patients with each coronavirus outbreak. Their importance in crisis is not in doubt. However, they experienced considerable physical distress and psychological stressors, even leading to psychological illness and infection in this environment. There is an urgent need to accurately, comprehensively and objectively understand their experiences, perceptions and current situation of burnout, post-traumatic stress disorder (PTSD), anxiety, depression, insomnia and coronavirus infection. Therefore, this protocol is to conduct a mixed-methods systematic review to summarise the evidence on the experiences of healthcare providers and impacts of the coronavirus on their psychological status and infection during the pandemics. METHODS: Published studies on experience, perspective, impact, burnout, PTSD, anxiety, depression, insomnia, and infection of healthcare providers with SARS, Middle East respiratory syndrome and COVID-19, and written in English and Chinese will be accepted. Databases (MEDLINE, EMBASE, CENTRAL, Web of Science, PubMed, Psychology Information, WanFang and SinoMed) from inception until 30 July 2020 will be searched. Two reviewers will select, screen, extract data and assess the risk of bias independently. Risk of bias of results will be using the Mixed-Methods Appraisal Tool. Using a convergent integrated approach on qualitative/quantitative studies, we will synthesise qualitative and quantitative data separately. The incidence and number of cases about burnout, PTSD, anxiety, depression, insomnia and coronavirus infection among medical staff will be extracted. Then we will transform quantitative data to synthesise narrative findings. This protocol will be reported per the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. ETHICS AND DISSEMINATION: Ethical assessment is not required due to the nature of the proposed systematic review. Findings of our research will be disseminated at conferences related to this field and through publication in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42020198506.


Subject(s)
Coronavirus Infections/psychology , Health Personnel/psychology , Pandemics , Research Design , Anxiety , Burnout, Professional , COVID-19 , Depression , Humans , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic , Systematic Reviews as Topic
9.
J Psychosom Res ; 143: 110365, 2021 04.
Article in English | MEDLINE | ID: covidwho-1036448

ABSTRACT

OBJECTIVE: This study aimed to evaluate the impact of isolation form on the recovery of psychological distress in patients with coronavirus disease 2019 (COVID-19) after being discharged from hospital. METHODS: Baseline survey was conducted from February 10, 2020 to February 25, 2020 in patients with COVID-19 in a designated hospital on the discharge day. After discharge, patients were free to choose whether isolate in a centralized isolation site (i.e. designated hotel) or their own home for another two weeks. A follow-up survey was conducted at the end of the 2-week post-discharge isolation. Depression, anxiety as well as self-rated health were assessed at both time points using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale and self-rated health scores, respectively. RESULTS: Fifty centrally isolated and 45 home isolated patients completed both the baseline and the follow-up assessments. Significant effects of time and time by isolation form were found on depression and anxiety levels, with a significant decrease in depression and anxiety shown in home isolated but not in centrally isolated patients. Besides, a significant time effect was identified on self-rated health with significant improvement found in home isolated but not in centrally isolated patients. CONCLUSIONS: Home isolation is superior to centralized isolation in the recovery of COVID-19-associated depression, anxiety as well as self-rated health. More attention needs to be paid to the psychological well-being of centrally isolated patients. A sustained and integrated rehabilitation plan is warranted for patients with COVID-19 to achieve both physical and psychological recovery.


Subject(s)
Anxiety/complications , COVID-19/psychology , COVID-19/therapy , Depression/complications , Patient Discharge , Patient Isolation/psychology , Psychological Distress , Adult , Aftercare , China/epidemiology , Continuity of Patient Care , Female , Humans , Longitudinal Studies , Male , Middle Aged , Patient Health Questionnaire , Residence Characteristics , Stress, Psychological , Surveys and Questionnaires
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 657-664, 2020 Jun 28.
Article in English, Chinese | MEDLINE | ID: covidwho-745335

ABSTRACT

OBJECTIVES: The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha. METHODS: We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney U test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample t-tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS). RESULTS: The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (P≤0.001 or P<0.05). Slight-ordinary patients with COVID-19 in Changsha showed lower factor scores of somatization, depression, anxiety, and hostility compared with the patients with SARS (P<0.001 or P<0.05). There was no difference in factor scores of SCL-90 between the patients with severe COVID-19 and those with SARS(P>0.05). CONCLUSIONS: The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.


Subject(s)
Coronavirus Infections/psychology , Health Status , Mental Health , Pneumonia, Viral/psychology , Anxiety , Betacoronavirus , COVID-19 , China , Depression , Feeding and Eating Disorders , Humans , Pandemics , SARS-CoV-2 , Sleep Wake Disorders , Surveys and Questionnaires
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