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1.
Computers in Biology and Medicine ; : 105601, 2022.
Article in English | ScienceDirect | ID: covidwho-1850901

ABSTRACT

Background The 2019 novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a major challenge threatening the global healthcare system. Respiratory virus infection is the most common cause of asthma attacks, and thus COVID-19 may contribute to an increase in asthma exacerbations. However, the mechanisms of COVID-19/asthma comorbidity remain unclear. Methods The “Limma” package or “DESeq2” package was used to screen differentially expressed genes (DEGs). Alveolar lavage fluid datasets of COVID-19 and asthma were obtained from the GEO and GSV database. A series of analyses of common host factors for COVID-19 and asthma were conducted, including PPI network construction, module analysis, enrichment analysis, inference of the upstream pathway activity of host factors, tissue-specific analysis and drug candidate prediction. Finally, the key host factors were verified in the GSE152418 and GSE164805 datasets. Results 192 overlapping host factors were obtained by analyzing the intersection of asthma and COVID-19. FN1, UBA52, EEF1A1, ITGB1, XPO1, NPM1, EGR1, EIF4E, SRSF1, CCR5, PXN, IRF8 and DDX5 as host factors were tightly connected in the PPI network. Module analysis identified five modules with different biological functions and pathways. According to the degree values ranking in the PPI network, EEF1A1, EGR1, UBA52, DDX5 and IRF8 were considered as the key cohost factors for COVID-19 and asthma. The H2O2, VEGF, IL-1 and Wnt signaling pathways had the strongest activities in the upstream pathways. Tissue-specific enrichment analysis revealed the different expression levels of the five critical host factors. LY294002, wortmannin, PD98059 and heparin might have great potential to evolve into therapeutic drugs for COVID-19 and asthma comorbidity. Finally, the validation dataset confirmed that the expression of five key host factors were statistically significant among COVID-19 groups with different severity and healthy control subjects. Conclusions This study constructed a network of common host factors between asthma and COVID-19 and predicted several drugs with therapeutic potential. Therefore, this study is likely to provide a reference for the management and treatment for COVID-19/asthma comorbidity.

2.
Int J Environ Res Public Health ; 19(9)2022 04 29.
Article in English | MEDLINE | ID: covidwho-1820255

ABSTRACT

During the 2020 COVID-19 pandemic in Taiwan, 6.5% of Generation Y required medical treatment for emotional and stress-related mental disorders. This study explores the moderating effect of mindfulness training on psychological needs and emotions to propose effective measures to promote the mental health of Generation Y. This study was carried out by questionnaire, using the data of respondents born in 1980-1999, collected in three different periods for quantitative analysis with compassionate mindfulness as the main variable. The results show that the compassionate mindfulness effect on emotion regulation varies greatly among different educational levels. However, it still plays a positive role in the psychological needs of Generation Y. Most members of Generation Y who receive compassionate mindfulness training have fewer basic needs and more interpersonal trust. They pay more attention to individual-oriented self-realization. Compassionate mindfulness has a greater positive moderating effect on the mental health of women aged 30-39 and those who are highly educated. Compassionate mindfulness has a more positive moderating effect on the psychological needs of members of Generation Y who were born more recently. During the COVID-19 pandemic, providing compassionate mindfulness has a significant positive effect on the prevention of mental disorders of Generation Y in Taiwan.


Subject(s)
COVID-19 , Mindfulness , Adult , COVID-19/epidemiology , Emotions , Female , Humans , Pandemics , Taiwan/epidemiology
3.
iScience ; 2022.
Article in English | EuropePMC | ID: covidwho-1755857

ABSTRACT

The global pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection confers great threat to the public health. Human breastmilk is a complex with nutritional composition to nourish infants and protect them from different kinds of infectious diseases including COVID-19. Here, we identified lactoferrin (LF), mucin1 (MUC1) and α-lactalbumin (α-LA) from human breastmilk inhibit SARS-CoV-2 infection using a SARS-CoV-2 pseudovirus system and transcription and replication-competent SARS-CoV-2 virus-like-particles (trVLP). Additionally, LF and MUC1 inhibited multiple steps including viral attachment, entry and post-entry replication, while α-LA inhibited viral attachment and entry. Importantly, LF, MUC1 and α-LA possessed potent antiviral activities towards variants such as B.1.1.7 (alpha), B.1.351 (beta), P.1 (gamma) and B.1.617.1 (kappa). Taken together, our study provides evidence that human breastmilk components (LF, MUC1 and α-LA) are promising antiviral and potential therapeutic candidates warranting further development or treating COVID-19. Graphical

5.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329783

ABSTRACT

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with immune escape ability raises the urgent need for developing cross-neutralizing vaccines against the virus. NVSI-06-08 is a potential broad-spectrum recombinant COVID-19 vaccine that integrates the antigens from multiple SARS-CoV-2 strains into a single immunogen. Here, we evaluated the safety and immunogenicity of NVSI-06-08 as a heterologous booster dose in adults previously vaccinated with the inactivated vaccine BBIBP-CorV in a randomized, double-blind, controlled, phase 2 trial conducted in the United Arab Emirates ( NCT05069129 ). Three groups of healthy adults over 18 years of age (600 participants per group) who had administered two doses of BBIBP-CorV 4-6-month, 7-9-month and >9-month earlier, respectively, were vaccinated with either a homologous booster of BBIBP-CorV or a heterologous booster of NVSI-06-08. The primary outcome was immunogenicity and safety of booster vaccinations. The exploratory outcome was cross-reactive immunogenicity against multiple SARS-CoV-2 variants of concerns (VOCs). The incidence of adverse reactions was low in both booster vaccinations, and the overall safety profile of heterologous boost was quite similar to that of homologous boost. Heterologous NVSI-06-08 booster was immunogenically superior to homologous booster of BBIBP-CorV. Both Neutralizing and IgG antibodies elicited by NVSI-06-08 booster were significantly higher than by the booster of BBIBP-CorV against not only SARS-CoV-2 prototype strain but also multiple VOCs. Especially, the neutralizing activity induced by NVSI-06-08 booster against the immune-evasive Beta variant was no less than that against the prototype strain, and a considerable level of neutralizing antibodies against Omicron (GMT: 367.67;95%CI, 295.50-457.47) was induced by heterologous booster, which was substantially higher than that boosted by BBIBP-CorV (GMT: 45.03;95%CI, 36.37-55.74). Our findings showed that NVSI-06-08 was safe and immunogenic as a booster dose following two doses of BBIBP-CorV, which was immunogenically superior to homologous boost with another dose of BBIBP-CorV. Our study also indicated that the design of hybrid antigen may provide an effective strategy for broad-spectrum vaccine developments.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316978

ABSTRACT

The COVID-19 pandemic has had and continues to have major impacts on planned and ongoing clinical trials. Its effects on trial data create multiple potential statistical issues. The scale of impact is unprecedented, but when viewed individually, many of the issues are well defined and feasible to address. A number of strategies and recommendations are put forward to assess and address issues related to estimands, missing data, validity and modifications of statistical analysis methods, need for additional analyses, ability to meet objectives and overall trial interpretability.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313360

ABSTRACT

The resurgence of coronavirus disease 2019 (COVID-19) has been seen in many counties where outbreaks appear to be leveling off. While China experienced a dramatic decline of COVID-19 at the outset of 2020, regional outbreaks continuously emerged in recent months. In Guangzhou, a small outbreak emerged in March and April involving less than 100 residents, and a comprehensive and near-real-time genomic surveillance of SARS-CoV-2 was conducted. When confirmed cases among overseas travelers increased, public health authorities enhanced measures as shifting self-quarantine to central quarantine and SARS-CoV-2 testing for all overseas travelers. From 109 imported cases we found diverse viral variants distributing in the global viral phylogeny, which were usually shared within households but not among passengers on the same flight. Nonetheless, local transmission was predominately attributed to two specific variants imported from Africa, including the local cases who reported no direct/indirect contact with imported cases. The introducing events of the virus were identified or deduced before enhanced measures were taken. These results show that the interventions are effective in containing the spread of SARS-CoV-2, and also rule out the possibility of cryptic transmission of viral variants from the first wave in January and February. Moreover, we found that intra-host viral diversity was usually different between close contacts, implying a transmission bottleneck of SARS-CoV-2. Our study provides evidence and emphasizes the importance of controls for oversea travelers in the context of the pandemic, and exemplifies how viral genomic data facilitates COVID-19 surveillance and prevention.Funding: This study was supported by National Natural Science Foundation of China (31870079, 91953122, 31871326), National Science and Technology Major Project of the Ministry of Science and Technology of China (2017ZX10103011, 2018ZX10305410, 2018ZX10201001), Guangdong Provincial Novel Coronavirus Scientific and Technological Project (2020111107001), Guangdong Basic and Applied Basic Research Foundation (2020A1515010776 and 2020B1515020057) and the Beijing Nova Program (Z181100006218114 and Z181100006218110) to M.N. and P.L..Conflict of Interest: The authors declare no competing interests.Ethical Approval: This study was approved by the ethics committee of the Center for Disease Control and Prevention (CDC) of Guangzhou (GZCDC-ECHR-2020P0002). Written informed consent was obtained from patients about the surveillance and data related to disease control and further analysis. All information regarding individual persons has been anonymized in this study.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311608

ABSTRACT

Background: The mental status of patients with Corona Virus Disease 2019 (COVID-19) (PCs), health care workers (HCWs) exposed to the COVID-19, and general population (GP) has be reported. However, no studies comprehensively investigated their mental status. Thus, this study investigated the prevalence, comparisons and risk factors of mental problems among three groups during the COVID-19 pandemic. Methods: 1300 participants including 137 PCs, 159 HCWs and 1003 GP were enrolled. The anxiety, depression and post-traumatic stress symptom (PTSS) were assessed by the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Findings: During the COVID-19 pandemic, the prevalence of anxiety, depression and PTSS were 21.7%, 76.1% and 19.5% in PCs, 9.3%, 25.3% and 9.5% in HCWs, and 12.7%, 25.8% and 6.9% in GP, respectively. The SAS, SDS and PCL-C total scores differed among three groups after controlling for covariates (all, p<0.01). The SAS, SDS and PCL-C total scores were significantly higher in PCs than HCWs and GP (all, p<0.01). Moreover, the distribution of age grouped differed between HCWs with and without depression (p<0.05). The frequency of having friend or relative infected was higher in PCs with than without PTSS as well as the higher married frequency in GP with than without PTSS (both, p<0.01). Further analyses showed the correlation of having friend or relative infected with PCL-C total score in PCs (p=0.004, OR=4.36, 95%CI: 1.60-11.91), the association of age 30-40 years with SDS total score in HCWs (p=0.014, OR=0.35, 95%CI: 0.16-0.81) and the relationship between married and PCL-C total score in GP (p=0.004, OR=3.89, 95%CI: 1.59-9.52). Interpretation: Our data revealed the high prevalence of mental problems among PCs, HCWs and GP, and more serious mental problems in PCs than HCWs and GP as well as the significant effects of having friend or relative infected, married and age 30-40 years on mental problems in the different population during the COVID-19 pandemic. Thus, these findings further suggested that mental problems in the different population should adopt the different psychological interventions to reduce their mental distress caused by the COVID-19.Funding Statement: This work was supported by the National Natural Science Foundation of China (81771439), Jiangsu Provincial Key Research and Development Program (BE2018662), Jiangsu Provincial Health Commission Science Research Program (QNRC2016228, H2019056 and LGY2018010), Jiangsu Provincial Six Talent Peaks Project (WSN-165), Suzhou Municipal Sci-Tech Bureau Program (SS2019009), and CAS Key Laboratory of Mental Health, Institute of Psychology (KLMH2019K03).Declaration of Interests: The authors declared no conflict of interest.Ethics Approval Statement: The protocol, questionnaire and informed consent of this study were approved by the Institutional Review Board at the Affiliated Guangji Hospital of Soochow University.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-309633

ABSTRACT

Background: Public health measures against COVID-19 may influence other disease epidemics. Many countries have reported significant reductions in influenza activity in 2020–2021, but the prevalence of other respiratory pathogens during the COVID-19 pandemic has rarely been reported, especially in China.Methods: Data from the Respiratory Pathogen Surveillance System in Beijing were analyzed to compare pathogen infection rates before the COVID-19 (from 1 February 2015 to 31 January 2020) and during the COVID-19 (from 1 February 2020 to 31 January 2021).Findings: Among 41630 acute respiratory tract infections 13630 had at least one pathogen positive result, which decreased from 32·16% (95% CI 31·69%, 32·64%) before the COVID-19 to 10·97% (95% CI 10·03%, 11·96%) during the COVID-19, representing a 65·90% decrease (P<0·001). The positivity rate fluctuated with the strictness of public health measures. Before the COVID-19 epidemic, the top five of the pathogenic spectrums were IFV (26·27%), MP (19·30%), HPIV (11·80%), HRV (9·38%), and EV (8·38%), while during the COVID-19, the top five were seasonal HCoV (21·10%), HRV (18·99%), HPIV (14·98%), IFV (13·08%), and RSV (10.76%).Interpretation: The prevalence of respiratory pathogens decreased significantly during the COVID-19, closely relating to public health measures against COVID-19;these measures can serve as useful strategies for the prevention and control of other respiratory tract infections.Funding Statement: The National Major Science and Technology Project for Control and Prevention of Major Infectious Diseases in China (2017ZX10103004).Declaration of Interests: FH received funds from the National Major Science and Technology Project for Control and Prevention of Major Infectious Diseases in China (2017ZX10103004). All other authors declare no competing interests.Ethics Approval Statement: Ethics approval for the protocol of this study was obtained from the Ethics Committee of the BJCDC. Written informed consent was obtained.

10.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-326548

ABSTRACT

Objective: To evaluate the immunogenicity and safety of COVID-19 vaccine (Vero cell), inactivated after inoculation in the geriatric population aged 60 years and above with hypertension and diabetes mellitus. Methods: 440 people aged 60 years and above were enrolled as study participants and divided into four groups, 330 in the hypertensive group, 330 in the diabetic group, 300 in the hypertensive combined with diabetes group, and 480 in the healthy control group. Two doses of COVID-19 vaccine (Vero cell), inactivated were administered at a 21 days interval and blood samples were collected before vaccination and 28 days after the second dose to evaluate the immunogenicity of the vaccine. Meanwhile, the occurrence of adverse events was actively observed and changes in blood pressure and blood glucose levels after vaccination were recorded. Results: The positive conversion rate was 100% for all participants. The post-inoculation GMT (geometric median titre) of the Covid-19 neutralizing antibodies in the four groups of hypertension, diabetes, combined disease and healthy population were 73.41, 69.93, 73.84 and 74.86, respectively, and the difference in post-vaccination GMT between groups was not statistically significant (P>0.05). The positive conversion rates and post-vaccination GMT in the hypertension, diabetes and co-morbidities groups were non-inferior compared with healthy controls. The incidence of vaccine-related adverse reactions was 11.93%, 14.29%, 12.50% and 9.38%, respectively. The differences in the incidence of adverse reactions among the four groups were not statistically significant (P>0.05). No serious adverse effects were reported during the study. No apparent abnormal fluctuations in blood pressure and blood glucose values were observed after vaccination in participants with hypertension and diabetes. Conclusion: The COVID-19 vaccine (Vero cell), inactivated showed good immunogenicity and safety in the elderly population aged 60 years and above suffering from hypertension and diabetes mellitus. Trial Registration Details: The study was registered on clinicaltrials.gov (registration number: NCT05065879). Funding Information: This study was supported by the National Key Research and Development Project of China (2020YFC0842100).

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325219

ABSTRACT

In the middle of March, the World Health Organization declared the outbreak of COVID-19 caused by SARS-CoV-2 infection a global pandemic. While China experienced a dramatic decline in daily growth rate of COVID-19, multiple importations of new cases from other countries and their related local infections caused a rapid rise. Between March 12 and April 15, we collected nasopharyngeal samples from 109 imported cases from 25 countries and 69 local cases in Guangzhou, China. In order to characterize the transmission patterns and genetic evolution of this virus among different populations, we sequenced the genome of SARS-CoV-2. The imported viral strains were assigned to lineages distributed in Europe (33.0%), America (17.4%), Africa (25.7%), or Southeast/West Asia (23.9%). Importantly, 10 imported cases from Africa formed two novel sub-lineages not identified in global tree previously. A detailed analysis showed that the imported viral strains from Philippines and Pakistan were closely related and within the same sub-lineage, whereas Ethiopia had varied lineages in the African phylogenetic tree. In spite of the diversity of imported SARS-CoV-2, 60 of 69 local infections could be traced back to two specific small lineages imported from Africa. A combined genetic and epidemiological analysis revealed a high-resolution transmission network of the imported SARS-CoV-2 in local communities, which might help inform the public health response and genomic surveillance in other cities and regions. Finally, we observed in-frame deletions on seven loci of SARS-CoV-2 genome, some of which were intra-host mutations, and they exhibited no enrichment on the S protein. Our findings provide new insight into the viral phylodynamics of SARS-CoV-2 and beta coronavirus.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325012

ABSTRACT

Many literatures believe that weather conditions such as temperature and humidity have effects on COVID-19 transmission. However, these effects are not clear due to the limited observations and difficulties in separating impacts of social distancing. COVID-19 data and social-economic features of 1236 regions in the world (1112 re-gions at the provincial level and 124 countries with small land area) were collected. A Large-scale satellite data was combined with these data with a regression analysis model to explore effects of temperature and relative humidity on COVID-19 spreading, as well as the possible transmission risk by seasonal cycles. The result show that temper-ature and relative humidity are shown to be negatively correlated with COVID-19 transmission throughout the world. Further, the effect of temperature and humidity is almost linear based on our samples, with uncertainty sur-rounding any nonlinear effects. Government intervention (e.g. lockdown policies) and lower population movement contributed to the decrease the new daily case ratio. The conclusions withstand several robustness checks, such as observation scales and maximum/minimum temperature. Weather conditions are not the decisive factor in COVID-19 transmission, in that government intervention as well as public awareness, could contribute to the miti-gation of the spreading of the virus. As temperature drops in winter, the transmission possibly speeds up again. It deserves a dynamic government policy to mitigate COVID-19 transmission in winter.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324956

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) broken out and spread rapidly nationwide at the beginning of 2020, which has brought huge impacts to people and work. The current situation of prevention and control is severe and urge guidance for clinicians, especially for medical systems. In the hope of providing a reference and recommendation for the prevention and control of the COVID-19, we carried out research to improve the quality of patients care and prevention during this epidemic. Methods: : All of the staff were trained rapidly to master personal protection in our department. We reviewed the patients’ discharged records who underwent surgery in our department during January 1st to March 1st in 2019 and January 1st to March 1st in 2020. The managements of the surgery patients and flow charts were described and analyzed. Post-operation outcomes of the patients including duration, complications, surgical site infection (SSI), system infection, re-operation, and mortality. Both chi-squared test and Student’s t-test were performed to determine the relationship between the two periods in term of post-operation outcomes. Results: : Descriptive statistics analysis revealed that demographic of the patients between the two periods is similar. We had been benefited from the strict flow charts, smart robot and protection equipment in management of perioperative for orthopedic patients. With the help of the strict flow charts and smart equipment, post-operation outcomes of the patients revealed that the rates of the complications and re-operation had been reduced significantly ( p <0.05), while duration of operation, SSI and system infection had no significantly difference between two periods ( p >0.05). No patient and staff caught COVID-19 infection or mortality during the epidemic. Conclusions: : Our study indicated that medical quality and efficiency were affected little with the help of strategies described above during the epidemic, which could be a reference tool for medical staff in routine clinical practice for admission of patients around the world. What’s more, the provided strategies, which may evolve over time, could be used as empirical guidance and reference for orthopedic peers to get through the pandemic and ensure the normal operation of the hospital.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324641

ABSTRACT

Purpose: Investigate clinical and CT manifestations of ordinary coronavirus disease (COVID-19) pneumonia. Materials: and methods: Patients with ordinary COVID-19 pneumonia (confirmed by RT-PCR) and performed initial chest CT were retrospectively enrolled. Fifty-eight patients were assigned to group 1 (<50 years, n=33) and group 2 (50≥years, n=25) on the basis of age. The clinical data, laboratory results, and imaging findings were evaluated. Imaging features were analyzed and compared across the two groups. Results: : On chest CT imaging, 44 (75.9%) patients showed bilateral lung involvement, 14(24.1%) showed unilateral lung involvement, with predominant peripheral distribution (26/58, 44.8%) and mixed distribution (30/58, 51.7%). 445(445/634, 70.2%) lesions occurred in the lung periphery, 189 (29.8%) in the center. There were more lobes involved in group 2(median 4, IQR 3-5) than group 1(median 3, IQR 1.5-4) (P=0.024). Ground glass opacity (GGO) (451/634, 71.1%) and consolidation (157/634, 24.8%) were the main CT findings. Lesions with a maximum diameter greater than 5cm were more common in group 2 (19/25, 76%) than group 1 (12/33, 36.4%) (P=0.003). The CT score of bilateral lungs, right lung, left lung and each lobe in group 2 was significantly higher than those of group 1 (all P < 0.05), except for the middle lobe of the right lung (P=0.979). Conclusions: : Ordinary COVID-19 pneumonia on chest CT generally manifested as multiple GGO and consolidation in the bilateral lung, with predominant peripheral or mixed distribution. Older age might be a risk factor for progression in ordinary COVID-19 pneumonia.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323635

ABSTRACT

Objectives: To investigate the appetite of COVID-19 patients treated in a makeshift hospital and to evaluate the effectiveness of abdominal massage and ST-36 (Zusanli) acupressure in improving their appetite. Design: Randomized controlled trial. Methods: This study was performed between February 15 and March 2, 2020, in a sports centre makeshift hospital in Wuhan, China. The appetite of 110 COVID-19 patients was assessed using a mobile app-based Simplified Nutritional Appetite Questionnaire (SNAQ). The experimental and control groups, 55 patients each, were randomized using a prepared randomization checklist. Through video guidance and on-the-spot instruction, patients in the experimental group mastered the methods of abdominal massage and ST-36 (Zusanli) acupressure and implemented the intervention for 7 days by themselves. The appetite of the patients was assessed again after intervention. Results: : In a total of 110 participants, 43 (39.1%) patients suffered from a poor appetite. A positive correlation between poor appetite and older age as well as fever was observed ( p <0.05). In the experimental group, the SNAQ scores were significantly increased (14.07±2.46 vs 15.55±1.77, p =0.0004), and the proportion of patients with a poor appetite was markedly reduced after the intervention (41.8% vs 10.9%, p =0.0002). Compared with the control group, the rate of poor appetite in the experimental group was significantly decreased postintervention (27.3% vs 10.9%, p =0.029). Conclusion: In COVID-19 patients, a poor appetite may be correlated with older age and fever. Abdominal massage and ST-36 (Zusanli) acupressure are applicable and effective in improving the appetite of COVID-19 patients during isolation treatment. Trial registration: Chinese clinical trial registry (ChiCTR2000033261), the trial was registered retrospectively.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323577

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiac magnetic resonance imaging (CMRI). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMRI Methods: : A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMRI examination in this study. The CMRI protocol consisted of black blood fat-suppressed T2 weighted imaging (BB-T2WI), T2 star mapping, left ventricle cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). Myocardium edema and LGE were assessed in recovered COVID-19 patients. The left ventricle (LV) and right ventricle (RV) function and LV mass were assessed and compared with normal controls. Results: : Finally, 44 recovered COVID-19 patients and 31 normal controls were included in this study. No edema was observed in any patient. LGE was found in 13 patients. All LGE lesions were located in the middle myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased left ventricle peak global circumferential strain (LVpGCS), right ventricle peak global circumferential strain (RVpGCS), right ventricle peak global longitudinal strain (RVpGLS) as compared to non-LGE patients ( p <0.05), while no difference was detected between the non-LGE patients and normal controls. Conclusion: Myocardium injury existed in about 30% of COVID-19 patients. These patients had peak right ventricle strain that decreased at the 3-month follow-up. Cardiac MRI can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of left ventricle circumferential contraction dysfunction and right ventricular dysfunction.

17.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-297101

ABSTRACT

It is challenging to quantitatively clarify the determining medical and social factors of COVID-19 mortality, which varied by 2-3 orders of magnitude across countries. Here, we present evidence that the whole-cycle patterns of mortality follow a logistic law for 52 countries. A universal linear law is found between the ICU time in the early stage and the most important quantity regarding the epidemic: its duration. Saturation mortality is found to have a power law relationship with median age and bed occupancy, which quantitatively explains the great variation in mortality based on the two key thresholds of median age (=38) and bed occupancy (=15%). We predict that deaths will be reduced by 36% when the number of beds is doubled for countries with older populations. Facing the next wave of the epidemic, this model can make early predictions on the epidemic duration and medical supply reservation.

18.
Preprint in English | bioRxiv | ID: ppbiorxiv-473774

ABSTRACT

Phagocytic responses by effector cells to antibody or complement-opsonised viruses have been recognized to play a key role in anti-viral immunity. These include antibody dependent cellular phagocytosis mediated via Fc-receptors, phagocytosis mediated by classically activated complement-fixing IgM or IgG1 antibodies and antibody independent phagocytosis mediated via direct opsonisation of viruses by complement products activated via the mannose-binding lectin pathway. Limited data suggest these phagocytic responses by effector cells may contribute to the immunological and inflammatory responses in SARS-CoV-2 infection, however, their development and clinical significance remain to be fully elucidated. In this cohort of 62 patients, acutely ill individuals were shown to mount phagocytic responses to autologous plasma-opsonised SARS-CoV-2 Spike protein-coated microbeads as early as 10 days post symptom onset. Heat inactivation of the plasma prior to use as an opsonin caused 77-95% abrogation of the phagocytic response, and pre-blocking of Fc-receptors on the effector cells showed only 18-60% inhibition. These results suggest that SARS-CoV-2 can provoke early phagocytosis, which is primarily driven by heat labile components, likely activated complements, with variable contribution from anti-Spike antibodies. During convalescence, phagocytic responses correlated significantly with anti-Spike IgG titers. Older patients and patients with severe disease had significantly higher phagocytosis and neutralisation functions when compared to younger patients or patients with asymptomatic, mild, or moderate disease. A longitudinal study of a subset of these patients over 12 months showed preservation of phagocytic and neutralisation functions in all patients, despite a drop in the endpoint antibody titers by more than 90%. Interestingly, surface plasmon resonance showed a significant increase in the affinity of the anti-Spike antibodies over time correlating with the maintenance of both the phagocytic and neutralisation functions suggesting that improvement in the antibody quality over the 12 months contributed to the retention of effector functions. Author SummaryLimited data suggest antibody dependent effector functions including phagocytosis may contribute to the immunological and inflammatory responses in SARS CoV-2 infection, however, their development, maintenance, and clinical significance remain unknown. In this study we show: O_LIPatients with acute SARS CoV-2 infection can mount phagocytic responses as early as 10 days post symptom onset and these responses were primarily driven by heat labile components of the autologous plasma. These results indicate that the current approach of studying phagocytosis using purified or monoclonal antibodies does not recapitulate contribution by all components in the plasma. C_LIO_LIIn convalescent patients, high phagocytic responses significantly correlated with increasing age, increasing disease severity, high neutralisation functions and high anti-Spike antibody titers, particularly IgG1. C_LIO_LILongitudinal study of convalescent patients over a 12-month period showed maintenance of phagocytic and neutralisation functions, despite a drop in the anti-Spike endpoint antibody titers by more than 90%. However, we found significant increase in the affinity of the anti-Spike antibodies over the 12-month period and these correlated with the maintenance of functions suggesting that improvement in the antibody quality over time contributed to the retention of effector functions. Clinically, measuring antibody titers in sera but not the quality of antibodies is considered a gold standard indicator of immune protection following SARS-CoV 2 infection or vaccination. Our results challenge this notion and recommends change in the current clinical practice. C_LI

19.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-295299

ABSTRACT

Backgroud: Virtual reality (VR) technology represents the future of medical education due to its unique advantages, especially with the Covid-19 pandemic lasting. We developed a laparoscopic VR surgery collaborative training platform hoping to shed light on future medical education in China. Methods: : We constructed a VR surgery training platform and designed surgery curriculum on laparoscopic cholecystectomy (LC). 36 first-year postgraduate students in China standardized training program for resident doctor (C-STRD) from the Third Xiangya Hospital of Central South University were enrolled for validation trials. In the Phase I trial, 12 students performed LC in the exploration mode. After training in the surgery learning mode, they performed LC again. The LC scores before and after training were compared. In the Phase II trial, another 12 students were randomly assigned to either the collaborative group or the control group. The former trained with a senior surgeon collaboratively in the surgery learning mode and then performed LC alone in the exploration mode. The latter trained in the surgery learning mode by themselves and performed LC in the exploration mode. The LC scores between groups were compared. The user experience (intention to use, skills improvement, usability, degree of enjoyment) were analyzed through questionnaires from the above 24 students. Interest in surgery learning of Phase I students was compared with 12 students who didn’t experience the VR platform. Results: : In Phase I trial, the mean LC scores of the students were elevated from 56.83 to 61.17 (p=0.042) after learning in surgery learning mode. In Phase II trial, collaborative group students had higher scores than their rivals (67.17 vs 61.33, p=0.014). Most students have a positive users’ experience regarding the intention to use and skills improvement. Collaborative group students had higher evaluation regarding usability. Students who experienced the VR platform were significantly more interested in future surgery learning (3.60 vs 2.58, p <0.05). Conclusion: Our study constructed a VR platform for collaborative surgery training, which showed an excellent training effect. Medical students rated the platform highly, and their interest in learning increased.

20.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-293357

ABSTRACT

Backgroud: Virtual reality (VR) technology represents the future of medical education due to its unique advantages, especially with the Covid-19 pandemic lasting. We developed a laparoscopic VR surgery collaborative training platform hoping to shed light on future medical education in China. Methods: : We constructed a VR surgery training platform and designed surgery curriculum on laparoscopic cholecystectomy (LC). 36 first-year postgraduate students in China standardized training program for resident doctor (C-STRD) from the Third Xiangya Hospital of Central South University were enrolled for validation trials. In the Phase I trial, 12 students performed LC in the exploration mode. After training in the surgery learning mode, they performed LC again. The LC scores before and after training were compared. In the Phase II trial, another 12 students were randomly assigned to either the collaborative group or the control group. The former trained with a senior surgeon collaboratively in the surgery learning mode and then performed LC alone in the exploration mode. The latter trained in the surgery learning mode by themselves and performed LC in the exploration mode. The LC scores between groups were compared. The user experience (intention to use, skills improvement, usability, degree of enjoyment) were analyzed through questionnaires from the above 24 students. Interest in surgery learning of Phase I students was compared with 12 students who didn’t experience the VR platform. Results: : In Phase I trial, the mean LC scores of the students were elevated from 56.83 to 61.17 (p=0.042) after learning in surgery learning mode. In Phase II trial, collaborative group students had higher scores than their rivals (67.17 vs 61.33, p=0.014). Most students have a positive users’ experience regarding the intention to use and skills improvement. Collaborative group students had higher evaluation regarding usability. Students who experienced the VR platform were significantly more interested in future surgery learning (3.60 vs 2.58, p <0.05). Conclusion: Our study constructed a VR platform for collaborative surgery training, which showed an excellent training effect. Medical students rated the platform highly, and their interest in learning increased.

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