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1.
Frontiers in medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-1940340

ABSTRACT

Background We intended to establish a novel critical illness prediction system combining baseline risk factors with dynamic laboratory tests for patients with coronavirus disease 2019 (COVID-19). Methods We evaluated patients with COVID-19 admitted to Wuhan West Union Hospital between 12 January and 25 February 2020. The data of patients were collected, and the illness severity was assessed. Results Among 1,150 enrolled patients, 296 (25.7%) patients developed into critical illness. A baseline nomogram model consists of seven variables including age [odds ratio (OR), 1.028;95% confidence interval (CI), 1.004–1.052], sequential organ failure assessment (SOFA) score (OR, 4.367;95% CI, 3.230–5.903), neutrophil-to-lymphocyte ratio (NLR;OR, 1.094;95% CI, 1.024–1.168), D-dimer (OR, 1.476;95% CI, 1.107–1.968), lactate dehydrogenase (LDH;OR, 1.004;95% CI, 1.001–1.006), international normalised ratio (INR;OR, 1.027;95% CI, 0.999–1.055), and pneumonia area interpreted from computed tomography (CT) images (medium vs. small [OR, 4.358;95% CI, 2.188–8.678], and large vs. small [OR, 9.567;95% CI, 3.982–22.986]) were established to predict the risk for critical illness at admission. The differentiating power of this nomogram scoring system was perfect with an area under the curve (AUC) of 0.960 (95% CI, 0.941–0.972) in the training set and an AUC of 0.958 (95% CI, 0.936–0.980) in the testing set. In addition, a linear mixed model (LMM) based on dynamic change of seven variables consisting of SOFA score (value, 2;increase per day [I/d], +0.49), NLR (value, 10.61;I/d, +2.07), C-reactive protein (CRP;value, 46.9 mg/L;I/d, +4.95), glucose (value, 7.83 mmol/L;I/d, +0.2), D-dimer (value, 6.08 μg/L;I/d, +0.28), LDH (value, 461 U/L;I/d, +13.95), and blood urea nitrogen (BUN value, 6.51 mmol/L;I/d, +0.55) were established to assist in predicting occurrence time of critical illness onset during hospitalization. Conclusion The two-checkpoint system could assist in accurately and dynamically predicting critical illness and timely adjusting the treatment regimen for patients with COVID-19.

2.
Systems ; 10(3):68, 2022.
Article in English | ProQuest Central | ID: covidwho-1911595

ABSTRACT

The COVID-19 outbreak has currently led to serious social and economic consequences. In poor and developing countries, there are more challenges and barriers to tackling the pandemic. The study’s aim is to propose a hybrid approach to multiple-criteria decision-making (MCDM) models for determining the most efficient intervention strategies. The methodology is a combination between the Best-Worst Model (BWM) and Group Best-Worst Model (GBWM) to estimate the efficiency score of intervention. Based on the background of knowledge, five groups of stakeholders including Academicians, Entrepreneurs, Commons Residents, Social Workers, Health Workers are considered decision-makers (DMs). A set of nine potential strategies was evaluated and prioritized by all DMs. The findings have shown that different groups of stakeholders prioritized differently the importance of criteria due to their interests. In the context of Vietnam, however, the Availability of Health Systems is prioritized as the most important intervention. The results and proposed model of this paper contributed to MCDM literature as well as a good reference to apply practically in many different countries.

3.
Chinese Journal of School Health ; 43(3):341-344, 2022.
Article in Chinese | GIM | ID: covidwho-1856431

ABSTRACT

Objective: To understand the online learning-related screen use duration and screen types in school-aged children in Shanghai during the COVID-19 epidemic.

4.
Mathematics ; 10(7):1037, 2022.
Article in English | ProQuest Central | ID: covidwho-1785801

ABSTRACT

Due to the existence and variation of various viruses, an epidemic in which different strains spread at the same time will occur. here, an avian–human epidemic model with two strain viruses are established and analyzed. Both theoretical and simulation results reveal that the mixed infections intensify the epidemic and the dynamics become more complex and sensitive. There are six equilibria. The trivial equilibrium point is a high-order singular point and will undergo the transcritical bifurcations to bifurcate three equilibria. The existence and stability of equilibria mainly depend on five thresholds. A bifurcation portrait for the existence and stability of equilibria is presented. Simulations suggest that the key control measure is to develop the identification technology to eliminate the poultry infected with a high pathogenic virus preferentially, then the infected poultry with a low pathogenic virus in the recruitment and on farms. Controlling contact between human and poultry can effectively restrain the epidemic and controlling contagions in poultry can avoid great infection in humans.

5.
Preprint in English | bioRxiv | ID: ppbiorxiv-486173

ABSTRACT

Large-scale populations in the world have been vaccinated with COVID-19 vaccines, however, breakthrough infections of SARS-CoV-2 are still growing rapidly due to the emergence of immune-evasive variants, especially Omicron. It is urgent to develop effective broad-spectrum vaccines to better control the pandemic of these variants. Here, we present a mosaic-type trimeric form of spike receptor-binding domain (mos-tri-RBD) as a broad-spectrum vaccine candidate, which carries the key mutations from Omicron and other circulating variants. Tests in rats showed that the designed mos-tri-RBD, whether used alone or as a booster shot, elicited potent cross-neutralizing antibodies against not only Omicron but also other immune-evasive variants. Neutralizing antibody titers induced by mos-tri-RBD were substantially higher than those elicited by homo-tri-RBD (containing homologous RBDs from prototype strain) or the inactivated vaccine BBIBP-CorV. Our study indicates that mos-tri-RBD is highly immunogenic, which may serve as a broad-spectrum vaccine candidate in combating SARS-CoV-2 variants including Omicron.

6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330164

ABSTRACT

Objectives: Since the outbreak of coronavirus disease 2019 (COVID-19), it has caused serious casualties worldwide. In recent months, the virus has mutated into an increasingly infectious form (Delta variant) and spread rapidly. Methods In the current study, we analyzed the clinical, epidemiological and viral genetic characteristics of the first four imported Delta cases in Anhui Province, China. Results The four imported Delta cases developed chest inflammation, tissue damage and recovered after admission, the serum high-sensitivity C-reactive protein (hs-CRP) and CRP levels showed a first increasing and then decreasing trend. The changes of hs-CRP /CRP and serum neutralizing antibodies (Nab) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels were associated with the regression of chest lesions. The combination of genetic sequencing and epidemiological analysis suggested that the SARS-CoV-2 delta variant infection of these four patients may originate from Russia. Conclusions Our study found the certain correlations of serum hs-CRP/CRP and Nab levels with the occurrence, development and outcome of COVID-19 delta variant, suggesting that monitoring hs-CRP/CRP and Nab levels of COVID-19 delta variant patients at hospital admission may be useful for understanding the severity of patients’ current conditions.

7.
Preprint in English | medRxiv | ID: ppmedrxiv-22272062

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.

8.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329405

ABSTRACT

Antibody therapeutics for the treatment of COVID-19 has been highly successful while faces a challenge of the recent emergence of the Omicron variant which escapes the majority of existing SARS-CoV-2 neutralizing antibodies (nAbs). Here, we successfully generated a panel of SARS-CoV-2/SARS-CoV cross-neutralizing antibodies by sequential immunization of the two pseudoviruses. Of which, nAbs X01, X10 and X17 showed broadly neutralizing breadths against most variants of concern (VOCs) and X17 was further identified as a Class 5 nAb with undiminished neutralization against the Omicron variant. Cryo-EM structures of three-antibody in complex with the spike proteins of prototyped SARS-CoV-2, Delta, Omicron and SARS-CoV defined three non-overlapping conserved epitopes on the receptor-binding domain (RBD). The triple antibody cocktail exhibited enhanced resistance to viral escape and effective protection against the infection of Beta variant in hamsters. Our finding will aid the development of both antibody therapeutics and broad vaccines against SARS-CoV-2 and emerging variants.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325356

ABSTRACT

Background: In critically ill COVID-19 patients, the crucial turning point before critical illness onset (CIO) remain largely unknown, and the combination of baseline risk factors with the turning point during hospitalization was rarely reported. Methods: In this retrospective cohort study, 1150 consecutively admitted patients with confirmed COVID-19 were enrolled, including 296 critical and 854 non-critical patients. We compared the differences of all the clinically tested indicators and their dynamic changes between critical and non-critical patients. Three prediction models were established and validated based on the risk factors at admission, and an online baseline predictive tool was developed. Linear mixed model (LMM) was applied for longitudinal data analysis in 296 critical patients throughout the hospitalization, to predict the likelihood and possible time of critical illness in COVID-19 patients. A crucial turning point, where several indicators will experience a greater and significantly continuous change before CIO, was defined as “burning point” in our study. This point indicates the deterioration of patient’s condition before CIO. Results: We established a novel two-checkpoint system to predict critical illness for COVID-19 patients in which the first checkpoint happened at patient admission was assessed by a baseline prediction model to project the likelihood of critical illness based on the variables selected from random forest and LASSO regression analysis, including age, SOFA score, neutrophil-to-lymphocyte ratio (NLR), D-dimer, lactate dehydrogenase (LDH), International Normalized Ratio (INR), and pneumonia area derived from CT images, which yields an AUC of 0.960 (95% confidence interval, 0.941-0.972) and 0.958 (0.936-0.980) in the training and testing sets, respectively. This model has been translated into a public web-based risk calculator. Furthermore, the second checkpoint (designated as “burning point” in our study) could be identified as early as 5 days preceding the CIO, and 12 ( IQR , 7-17) days after illness onset. Seven most significant and representative “burning point” indicators were SOFA score, NLR, C-reactive protein (CRP), glucose, D-dimer, LDH, and blood urea nitrogen (BUN). Conclusions: With this two-checkpoint prediction system, the deterioration of COVID-19 patients could be early identified and more intensive treatments could be started in advance to reduce the incidence of critical illness.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324770

ABSTRACT

Given the existing COVID-19 pandemic worldwide, it is critical to systematically study the interactions between hosts and coronaviruses including SARS-Cov, MERS-Cov, and SARS-CoV-2 (cause of COVID-19). We first created four host-pathogen interaction (HPI)-Outcome postulates, and generated a HPI-Outcome model as the basis for understanding host-coronavirus interactions (HCI) and their relations with the disease outcomes. We hypothesized that ontology can be used as an integrative platform to classify and analyze HCI and disease outcomes. Accordingly, we annotated and categorized different coronaviruses, hosts, and phenotypes using ontologies and identified their relations. Various COVID-19 phenotypes are hypothesized to be caused by the backend HCI mechanisms. To further identify the causal HCI-outcome relations, we collected 35 experimentally-verified HCI protein-protein interactions (PPIs), and applied literature mining to identify additional host PPIs in response to coronavirus infections. The results were formulated in a logical ontology representation for integrative HCI-outcome understanding. Using known PPIs as baits, we also developed and applied a domain-inferred prediction method to predict new PPIs and identified their pathological targets on multiple organs. Overall, our proposed ontology-based integrative framework combined with computational predictions can be used to support fundamental understanding of the intricate interactions between human patients and coronaviruses (including SARS-CoV-2) and their association with various disease outcomes.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323745

ABSTRACT

Background: COVID-19 cases with suspected returned-positive SRAS-CoV-2 tests following consecutive negative tests have been reported, but evidence-based explanations for this phenomenon is still lacking. We aimed to describe the clinical and laboratory characteristics of returned-positive COVID-19 patients during treatment in comparison with other patients. Methods: : From January 20 to April 10, 2020, all COVID-19 inpatient with at least three RT-PCR SARS-CoV-2 tests in Renmin Hospital in Wuhan, China were enrolled. Patients with 2 consecutively negative RT-PCR results followed by a positive result were classified as returned-positive patients, and their characteristics and repeatedly measured laboratory results were compared with the rest of the patients. Linear mixed effects models were performed. Results: A total of 789 COVID-19 patients were included and 22.8% patients returned positive in RT-PCR SARS-CoV-2 test. No significant differences were found for general characteristics between the returned-positive and the control groups. The trends of inflammatory and immune factors including the third component of complement (C3), C-reactive protein, procalcitonin (PCT), IL-4, IL-6, the counts of lymphocyte, CD3+, CD8+, white blood cell and immunoglobulin levels during hospitalization were significantly different between the two groups. During the returned-positive period, C3, PCT, serum IgM, anti-SARS-CoV-2 IgM and anti-SARS-CoV-2 IgG were significantly higher in the returned-positive patients at certain time points. Conclusions: : Returned-positive COVID-19 patients appeared to be more sever at admission, and had periodically higher levels in C3, PCT, serum IgM and two specific antibodies during hospitalization. This suggests that positive return of SARS-COV-2 could not be completely explained by false-negative testing and longer observation of these patients is warranted.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323571

ABSTRACT

An unexpected observation among the COVID-19 pandemic is that smokers constituted only 1.4-18.5% of hospitalized adults, calling for an urgent investigation to determine the role of smoking in SARS-CoV-2 infection. Here, we show that cigarette smoke extract (CSE) and carcinogen benzo(a)pyrene (BaP) increase ACE2 mRNA but trigger ACE2 protein catabolism. BaP induces an aryl hydrocarbon receptor (AhR)-dependent upregulation of the ubiquitin E3 ligase Skp2 for ACE2 ubiquitination. ACE2 in lung tissues of non-smokers is higher than in smokers, consistent with the findings that tobacco carcinogens downregulate ACE2 in mice. Tobacco carcinogens inhibit SARS-CoV-2 Spike protein pseudovirions infection of the cells. These data indicate that recommendation of cessation of tobacco smoking remains valid because it is the carcinogens that are responsible for ACE2 degradation.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-317970

ABSTRACT

Background: Angiotensin-converting enzyme 2 (ACE2), a crucial cell entry receptor for severe acute respiratory syndrome coronavirus 2, has been identified as an oncogene in some tumour types. However, its role in colon cancer is poorly understood. Methods: : Integrative bioinformatics analyses were performed to uncover the role of ACE2 in colon cancer-associated immunology. Results: : The results showed that ACE2 was overexpressed in colon cancer tissues and correlated with poor survival. Moreover, ACE2 expression was closely associated with the immune-infiltrating levels of CD4+ T, CD8+ T, and neutrophils. Conclusions: : ACE2 is closely associated with colon cancer and may be involved in tumourigenesis and cancer–immune interactions, and could be a promising prognostic and therapeutic biomarker in colon cancer.

14.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-317969

ABSTRACT

Background: and objective: Angiotensin-converting enzyme 2 (ACE2), a membrane structural glycoprotein that acts as a key receptor in the process of SARS-CoV-2 infection, has been identified as an oncogene in some tumor types. However, few studies have explored the role of the ACE2 gene in head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to investigate the potential relationship between ACE2 and HNSCC and explore early markers and molecular targets for the treatment of HNSCC. Methods: : Integrative bioinformatics analyses were applied to uncover the potential role of ACE2 in HNSCC development and tumor-associated immunology. Results: : The results showed that ACE2 was highly expressed in HNSCC and significantly correlated with clinical features such as sex. In addition, ACE2 may be a potential prognostic marker for HNSCC, as it was correlated with shorter recurrence-free survival (RFS) according to the Kaplan-Meier method. The PPI network revealed that STAT1 is the gene most closely related to ACE2 and that the NOD-like receptor signaling pathway was the most relevant pathway. Moreover, ACE2 expression was closely associated with the immune-infiltrating levels of CD8 + T cells, myeloid dendritic cells, and neutrophils. Conclusions: : The viral entry molecule ACE2 plays an important role in the tumorigenesis and cancer-immune interactions of HNSCC, suggesting that it is a novel molecular target and a new immune checkpoint in the diagnosis and treatment of HNSCC.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315884

ABSTRACT

Background: The Coronavirus Disease 2019 (COVID-19) epidemic has been largely controlled in China, to the point where case fatality rate (CFR) data can be comprehensively evaluated. Methods: Data on confirmed patients, with a final outcome reported as of 29 March 2020, were obtained from official websites and other internet sources. The hospitalized CFR (HCFR) was estimated, epidemiological features described, and risk factors for a fatal outcome identified. Findings: The overall CFR in China was estimated to be 4.6% (95% CI 4.5%-4.8%). It increased with age and was higher in males than females. The highest CFR observed was in male patients ≥70 years old. Although the outcome of infection is generally worse for males, this adverse effect from male sex decreased as people get old. Differential age/sex CFR patterns across geographical regions were found: the age effect on CFR was greater in other provinces outside Hubei than in Wuhan. An effect of longer interval from symptom onset to admission was only observed outside Hubei, not in Wuhan. By performing multivariate analysis and survival analysis, the higher CFR was associated with older age, and male sex. Only in regions outside Hubei, longer interval from symptom onset to admission, were associated with higher CFR. Interpretation: This up-to-date and comprehensive picture of COVID-19 CFR and its drivers will help healthcare givers target limited medical resources to patients with high risk of fatality.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315876

ABSTRACT

Background: Coronavirus 2019 (COVID-19) is a novel infectious disease that was earliest reported in Wuhan, China, but has been later discovered everywhere in the world. On the other hand, Hepatitis B virus (HBV) is ubiquitous in China;having millions of HBV carriers, HBV infection has become a major problem of public health in China. In this study, we aim to describe the clinical features of HBV carriers infected with COVID-19 and to assess factors that may affect the progression and outcome of the disease. Methods: : 72 patients diagnosed as infected with both COVID-19 and HBV at the Jinyintan Hospital of Wuhan have been involved in this study. Epidemiological characteristics, demographic features, clinical manifestations, laboratory test, treatment, management and final outcomes of these patients were collected and analyzed. Results: : Among all 72 patients (40 male and 32 female, with a median age of 58.5 years old), 22 (30.56%) were diagnosed as severe cases and 50 (69.44%) non-severe cases. Fever is the most common symptom, followed by cough, chest tightness and sputum. Significant differences have been observed in the outcomes of laboratory tests including hematologic, biochemical, infection and coagulation parameters, and in indicators like Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Total Bilirubin (TBil), Direct Bilirubin (DBil), Indirect Bilirubin (IBil) and γ-glutamyl Transferase (GGT) at the admission and discharge of these patients. Especially, levels of Prealbumin (PA) and Serum Amyloid A (SAA) showed an obvious trend of decreasing, which is statistically significant. Conclusions: : The clinical features of HBV carriers infected with COVID-19 have obvious systemic symptoms, such as fever, cough, and chest tightness. By comparing their liver functions tested on the dates of admission and discharge, we found that the SARS-CoV-2 virus, which causes COVID-19, does not directly activate the Hepatitis B virus, so that the risk of liver cell damage for HBV carriers infected with COVID-19 does not increase. Both PA and SAA seem to work as sensitive indicators and can be used to evaluate the prognosis and outcome of these patients.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315710

ABSTRACT

Background: Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for the prevention of cognitive decline in elderly population. This study aims to assess cognitive status and longitudinal decline at 6 months post-infection in elderly patients recovered from COVID-19.Methods: This cross-sectional study recruited 1013 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to March 13, 2020. In total, 262 uninfected living spouses of COVID-19 patients were selected as controls. Subjects were examined for their current cognitive status using a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) and longitudinal cognitive decline using an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cognitive assessments were performed 6 months after patient discharge.Findings: COVID-19 patients had significantly lower TICS-40 scores (patients: 29.73±6.13;controls: 30.74±5.95, p=0.016) and higher IQCODE scores (patients: 3.40±0.81;controls: 3.15±0.39, p<0.001) than the controls. Severe COVID-19 patients had lower TICS-40 scores and higher IQCODE scores than non-severe COVID-19 patients (TICS-40: 22.98±7.12 vs. 30.46±5.53, p<0.001;IQCODE: 4.06±1.39 vs. 3.33±0.68, p<0.001) and controls (TICS-40: 22.98±7.12 vs. 30.74±5.95, p<0.001;IQCODE: 4.06±1.39 vs. 3.15±0.39, p<0.001). Severe COVID-19 patients had a higher proportion of cases with a current cognitive impairment and longitudinal cognitive decline than non-severe COVID-19 patients and controls. COVID-19 severity (OR: 8.142, 95% CI: 5.007-13.239) was associated with worse current cognitive function. Older age (OR: 1.024, 95% CI: 1.003 to 1.046), COVID-19 severity (OR: 2.277, 95% CI: 1.308 to 3.964), mechanical ventilation (OR: 5.388, 95% CI: 3.007 to 9.656), and hypertension (OR: 1.866, 95% CI: 1.376 to 2.531) were associated with an increased risk of longitudinal cognitive decline.Interpretation: SARS-CoV-2 infection is associated with delayed cognitive decline in elderly population. COVID-19 patients with risk factors, including severe disease, older age, mechanical ventilation, and hypertension, should be intensively monitored for delayed cognitive decline. Funding: National Natural Science Foundation of China.Conflict of Interest: We declared no conflict of interests.Ethical Approval: The study protocols were approved by the institutional review boards of the hospitals. Verbal informed consent was obtained from all participants prior to the survey.

18.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315379

ABSTRACT

Background: While the immunogenicity of inactivated vaccines against coronavirus disease 2019 (COVID‐19) has been characterized in several well-conducted clinical trials, real-world evidence concerning immune responses against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) raised by such vaccines is currently missing. Here, we comprehensively characterized various parameters of SARS-CoV-2-specific cellular and humoral immune responses induced by inactivated COVID-19 vaccines under real-world conditions. Methods: Venous blood was collected from 126 adults, before and/or after inactivated COVID-19 vaccine inoculation. SARS-CoV-2 neutralizing antibody (NAb) and S-receptor binding domain IgG in the serum were detected. The isolated peripheral blood mononuclear cells were stimulated by three pools of lyophilized peptides covering the spike, nucleocapsid, and membrane protein of SARS-CoV-2 for evaluating antigen-specific T cell responses against the virus. Findings: The seroconversion rate for S-RBD IgG and NAb after two doses of vaccination was 87.06% (74/85) and 78.82% (67/85), respectively. Female participants developed higher concentrations of S-RBD IgG and NAb compared to male vaccinees. Interestingly, a longer dosing interval between the first and second vaccination resulted in a better long-term SARS-CoV-2 S-RBD IgG response. The frequencies of CD4+ T cells that produce effector cytokines (IFN-γ, IL-2, and TNF-α) in response to stimulation with peptide pools corresponding to the SARS-CoV-2 spike (S), nucleocapsid (N) or membrane (M) protein increased significantly after a single vaccination dose, and continued to increase after the second administration. S, N, or M-specific CD4+ and CD8+ T cell responses became detectable in 95.83% (69/72) and 54.16% (39/72) of double-vaccinated individuals, respectively. The longitudinal analysis demonstrated that CD4+ T cell responses recognizing S, N, and M waned quickly after a single vaccine dose, but were boosted and became more sustained following a second dose. Interpretation: Both humoral and cellular SARS-CoV-2-specific immunity are elicited in the majority of individuals after two doses of inactivated COVID-19 vaccines. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2100048837).Funding Fundamental Research Funds for the Central Universities, National Natural Science Foundation of China, National Science and Technology Major Project, Deutsche Forschungsgemeinschaft, Medical Faculty of the University of Duisburg-Essen and Stiftung Universiätsmedizin, University Hospital Essen, Germany, and the Tongji-Rongcheng Center for Biomedicine, Huazhong University of Science and Technology.Declaration of Interest: None to declare. Ethical Approval: The study protocol was approved by the local medical ethics committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (2021-0570)

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312656

ABSTRACT

In a coronavirus disease 2019 (COVID-19) epidemic, management of the emergency department is a difficult task in terms of prevention and control of the disease in general hospitals. On top of meeting urgent needs of patients for medical treatment, the emergency department also has to devote resources into investigation and prevention of COVID-19. At the beginning of the epidemic, with the strategy to intercept the chain of infection, Peking University First Hospital (PKUFH) focused on three important aspects: controlling the source of infection, cutting off the route of transmission, and protecting vulnerable populations, to expeditiously draft scientific and proper management measures for the emergency department, followed by real-time dynamic adjustments based on the development trend of the epidemic. These measures effectively ensured a smooth, orderly and safe operation of the emergency department. As of the writing of this manuscript, there has been no active COVID-19 infection in patients and medical staff in the emergency department, and no infection in patients admitted to PKUFH through the emergency department. This study describes the prevention and control measures in the emergency department of PKUFH during the outbreak of COVID-19, aiming to provide some reference for domestic and international medical institutions.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312501

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression into account. Methods: A single-centered, retrospective study was carried out, which included moderate (n=76) and severe COVID-19 cases (n=22). The difference of laboratory findings from blood routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression was indicated by oxygenation index. Results: Age is a risk factor for disease progression from moderate to severe. Lymphocytopenia, neutrophilia, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients. Conclusions: Lymphocytopenia and neutrophilia, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia in severe COVID-19. Oxygenation index presented potentiality as predictor on the progression of COVID-19.

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