Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 59
Filter
Add filters

Year range
1.
Weishengwuxue Tongbao = Microbiology ; - (10):3895, 2021.
Article in English | ProQuest Central | ID: covidwho-1553107

ABSTRACT

Coronaviruses (CoVs) are the largest single-stranded positive-stranded RNA viruses in the genome. Most of them can spread across species and infect humans. They are currently one of the pathogens that cause major public health incidents and seriously threaten human health. The viral genome is about 25-31 kb in length, encoding multiple non-structural proteins, structural proteins (S, E, M, N) and accessory proteins. For most coronaviruses, although accessory protein is a non-essential protein for virus replication, it often plays an important role in the pathogenic process of the virus and is an important functional protein for coronaviruses. This type of protein is located at the 3′ end of the viral genome, and the transcription of the mRNA is regulated by the transcription regulating sequence (TRS) located at the start position of the gene, and the codon usage preference of the protein coding sequence also produces protein translation. Significant influence. The accessory protein has the properties of a transmembrane protein and a unique protein transport motif. The latter plays a decisive role in the formation of the transmembrane region, the topological structure of the protein, and the intracellular transport process of the protein, which directly affects the function of the accessory protein. . This article first summarizes the latest classification and genome structure of coronaviruses;then systematically summarizes relevant research progress in terms of the types, functions, protein transport motifs, topological structures, and codon usage preferences of accessory proteins, and then provides an overview of the next step The research direction has been prospected, which provides an important reference for a more comprehensive understanding of the biological characteristics of the coronavirus accessory protein.

2.
Nurs Open ; 2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1516793

ABSTRACT

AIM: To evaluate the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the COVID-19 epidemic in Anhui, China. METHODS: A cross-sectional, multic'entre quantitative study was conducted among surgical nurses in Anhui province. SAS, SDS and SSRS scales were used for the investigation. Data were collected between 3 March 2020 to 19 March 2020. RESULTS: A total of 3,492 surgical nurses completed the survey. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm. Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety and depression. Fertility status, participation in care for COVID-19 patients, likelihood of being infected with COVID-19 and social support were significantly influencing surgical nurses' anxiety degree. Similarly, these characteristics were significantly associated with the odds of depression symptoms in surgical nurses. CONCLUSION: These findings suggest that targeted psychological interventions to promote mental health of surgical nurses need to be immediately implemented.

3.
Preprint in English | EuropePMC | ID: ppcovidwho-292242

ABSTRACT

Objective: This study sought to reveale the psychological characteristics of lung cancer patients at different time points of the COVID-19 epidemic. Methods: : This cross-sectional study used data from two different regional medical centers. 128 pairs of lung cancer (LC) patients and non-lung cancer subjects (NLC) were selected through propensity score matching (PSM) analysis. For the longitudinal study, the anxiety and distress state before and during the COVID-19 pandemic were surveyed through a dedicated questionnaire. Results: : A total of 135 LC patients and 165 healthy individuals were included in this cross-sectional study. After PSM analysis, 128 pairs of LC patients and NLC were matched and compared in this analysis. During the uptrend period of COVID-19 epidemic, there were significant differences in anxiety between LC patients and NLC ( P =0.005). For LC patients, the proportions of severe distress differed significantly between the uptrend and the decline period (22.05% vs 11.90%, P =0.032). In two-way repeated ANOVA analysis, no significant main effect for group or group × condition interaction effect has been founded. The distress of LC patients is mainly manifested as worry. Logistic regression showed that gender (OR=41.48, 95% CI: 9.74-17.97), age (OR=0.20, 95% CI: 0.08-0.50), and education level (OR=4.82, 95% CI: 1.98-11.69) were correlated with “worry” and contributed significantly to the model. Conclusions: : This study revealed that lung cancer patients had significant anxiety and distress during the uptrend period of the COVID-19 epidemic. The distress states of LC patients mainly manifested as worry, which was associated with age, gender, and education level.

4.
Front Med (Lausanne) ; 8: 659793, 2021.
Article in English | MEDLINE | ID: covidwho-1497084

ABSTRACT

Background: Extracorporeal membrane oxygenation (ECMO) might benefit critically ill COVID-19 patients. But the considerations besides indications guiding ECMO initiation under extreme pressure during the COVID-19 epidemic was not clear. We aimed to analyze the clinical characteristics and in-hospital mortality of severe critically ill COVID-19 patients supported with ECMO and without ECMO, exploring potential parameters for guiding the initiation during the COVID-19 epidemic. Methods: Observational cohort study of all the critically ill patients indicated for ECMO support from January 1 to May 1, 2020, in all 62 authorized hospitals in Wuhan, China. Results: Among the 168 patients enrolled, 74 patients actually received ECMO support and 94 not were analyzed. The in-hospital mortality of the ECMO supported patients was significantly lower than non-ECMO ones (71.6 vs. 85.1%, P = 0.033), but the role of ECMO was affected by patients' age (Logistic regression OR 0.62, P = 0.24). As for the ECMO patients, the median age was 58 (47-66) years old and 62.2% (46/74) were male. The 28-day, 60-day, and 90-day mortality of these ECMO supported patients were 32.4, 68.9, and 74.3% respectively. Patients survived to discharge were younger (49 vs. 62 years, P = 0.042), demonstrated higher lymphocyte count (886 vs. 638 cells/uL, P = 0.022), and better CO2 removal (PaCO2 immediately after ECMO initiation 39.7 vs. 46.9 mmHg, P = 0.041). Age was an independent risk factor for in-hospital mortality of the ECMO supported patients, and a cutoff age of 51 years enabled prediction of in-hospital mortality with a sensitivity of 84.3% and specificity of 55%. The surviving ECMO supported patients had longer ICU and hospital stays (26 vs. 18 days, P = 0.018; 49 vs. 29 days, P = 0.001 respectively), and ECMO procedure was widely carried out after the supplement of medical resources after February 15 (67.6%, 50/74). Conclusions: ECMO might be a benefit for severe critically ill COVID-19 patients at the early stage of epidemic, although the in-hospital mortality was still high. To initiate ECMO therapy under tremendous pressure, patients' age, lymphocyte count, and adequacy of medical resources should be fully considered.

5.
Preprint in English | EuropePMC | ID: ppcovidwho-291477

ABSTRACT

Objectives: To investigate the medical occupational risk and stress level of workplace violence (WPV) and novel coronavirus 2019 ( 2019-nCoV) pandemic in Chinese healthcare professionals (HPs). Methods: : A national questionnaire survey was created to investigate HPs from 21 provinces of China. Seven questions in environment part and eight questions in stress part were used to assess medical occupation risk and stress respectively. Categorical data were statistically analyzed using chi-square tests. Structural equation model was performed to examine the correlations and differences among experiences of WPV, the 2019-nCoVpandemic, and occupational stress. Results: : Totally, 1241 HPs completed the online survey from March 1st, 2020 to May 25th, 2020. The majority of the participants thought the current Chinese medical occupation was in inferior circumstance (n = 433, 34.89%), at high risk (n = 1082, 81.19%) and was in middle class (n = 717, 57.78%). Work-related stress ranked first of medical occupational risk (n = 786, 63.34%). When being asked the possility for their children to choose medicine, most HPs were uncertain (n = 542, 43.67%) or opposed (n = 547, 44.08%). More HPs thought there was no stress under 2019-nCoV pandemic (n = 303, 24.42%) than that under WPV (n = 48, 3.87%). WPV (Stress index = 3.23) put more pressure on HPs than the 2019-nCoV pandemic did (Stress index = 2.33) with significant difference (P = 0.006). WPV had a positive relationship with increasing doctor-patient conflicts (E=0.5, P 0.000), and a negative correlation with ego-enhancement (E=-0.2, P =0.000) and public concern (E=-0.2, P =0.000). The 2019-nCoV pandemic had a positive correlation with ego-enhancement (E=0.09, P =0.006), the public's concern (E=0.1, P =0.002) and healthcare reform (E=0.1, P =0.000). Conclusions: : Most HPs believe that the current environment for Chinese medical occupation is abominable and at high risk. Compared with WPV, the 2019-nCoV pandemic increases personal risks and reduces psychological stress to HPs. WPV weakens enthusiasm and significantly intensifies doctor-patient conflicts.

6.
Front Med (Lausanne) ; 8: 716086, 2021.
Article in English | MEDLINE | ID: covidwho-1450817

ABSTRACT

Background: Extracorporeal membrane oxygenation (ECMO) is a rapidly evolving therapy for acute lung and/or heart failure. However, the information on the application of ECMO in severe coronavirus disease 2019 (COVID-19) is limited, such as the initiation time. Especially in the period and regions of ECMO instrument shortage, not all the listed patients could be treated with ECMO in time. This study aimed to investigate and clarify the timing of ECMO initiation related to the outcomes of severe patients with COVID-19. The results show that ECMO should be initiated within 24 h after the criteria are met. Methods: In this retrospective, multicenter cohort study, we enrolled all ECMO patients with confirmed COVID-19 at the three hospitals between December 29, 2019 and April 5, 2020. Data on the demographics, clinical presentation, laboratory profile, clinical course, treatments, complications, and outcomes were collected. The primary outcomes were successful ECMO weaning rate and 60-day mortality after ECMO. Successful weaning from ECMO means that the condition of patients improved with adequate oxygenation and gas exchange, as shown by the vital signs, blood gases, and chest X-ray, and the patient was weaned from ECMO for at least 48 h. Results: A total of 31 patients were included in the analysis. The 60-day mortality rate after ECMO was 71%, and the ECMO weaning rate was 26%. Patients were divided into a delayed ECMO group [3 (interquartile range (IQR), 2-5) days] and an early ECMO group [0.5 (IQR, 0-1) days] based on the time between meeting the ECMO criteria and ECMO initiation. In this study, 14 and 17 patients were included in the early and delayed treatment groups, respectively. Early initiation of ECMO was associated with decreased 60-day mortality after ECMO (50 vs. 88%, P = 0.044) and an increased ECMO weaning rate (50 vs. 6%, P = 0.011). Conclusions: In ECMO-supported patients with COVID-19, delayed initiation of ECMO is a risk factor associated with a poorer outcome. Trial Registration: Clinical trial submission: March 19, 2020. Registry name: A medical records-based study for the clinical application of extracorporeal membrane oxygenation in the treatment of severe respiratory failure patients with novel coronavirus pneumonia (COVID-19). Chinese Clinical Trial Registry: https://www.chictr.org.cn/showproj.aspx?proj=51267,identifier:~ChiCTR2000030947.

7.
JMIR Infodemiology ; 1(1): e25636, 2021.
Article in English | MEDLINE | ID: covidwho-1450763

ABSTRACT

Background: During the early stages of the COVID-19 pandemic, developing safe and effective coronavirus vaccines was considered critical to arresting the spread of the disease. News and social media discussions have extensively covered the issue of coronavirus vaccines, with a mixture of vaccine advocacies, concerns, and oppositions. Objective: This study aimed to uncover the emerging themes in Twitter users' perceptions and attitudes toward vaccines during the early stages of the COVID-19 outbreak. Methods: This study employed topic modeling to analyze tweets related to coronavirus vaccines at the start of the COVID-19 outbreak in the United States (February 21 to March 20, 2020). We created a predefined query (eg, "COVID" AND "vaccine") to extract the tweet text and metadata (number of followers of the Twitter account and engagement metrics based on likes, comments, and retweeting) from the Meltwater database. After preprocessing the data, we tested Latent Dirichlet Allocation models to identify topics associated with these tweets. The model specifying 20 topics provided the best overall coherence, and each topic was interpreted based on its top associated terms. Results: In total, we analyzed 100,209 tweets containing keywords related to coronavirus and vaccines. The 20 topics were further collapsed based on shared similarities, thereby generating 7 major themes. Our analysis characterized 26.3% (26,234/100,209) of the tweets as News Related to Coronavirus and Vaccine Development, 25.4% (25,425/100,209) as General Discussion and Seeking of Information on Coronavirus, 12.9% (12,882/100,209) as Financial Concerns, 12.7% (12,696/100,209) as Venting Negative Emotions, 9.9% (9908/100,209) as Prayers and Calls for Positivity, 8.1% (8155/100,209) as Efficacy of Vaccine and Treatment, and 4.9% (4909/100,209) as Conspiracies about Coronavirus and Its Vaccines. Different themes demonstrated some changes over time, mostly in close association with news or events related to vaccine developments. Twitter users who discussed conspiracy theories, the efficacy of vaccines and treatments, and financial concerns had more followers than those focused on other vaccine themes. The engagement level-the extent to which a tweet being retweeted, quoted, liked, or replied by other users-was similar among different themes, but tweets venting negative emotions yielded the lowest engagement. Conclusions: This study enriches our understanding of public concerns over new vaccines or vaccine development at early stages of the outbreak, bearing implications for influencing vaccine attitudes and guiding public health efforts to cope with infectious disease outbreaks in the future. This study concluded that public concerns centered on general policy issues related to coronavirus vaccines and that the discussions were considerably mixed with political views when vaccines were not made available. Only a small proportion of tweets focused on conspiracy theories, but these tweets demonstrated high engagement levels and were often contributed by Twitter users with more influence.

8.
Pediatr Pulmonol ; 57(1): 49-56, 2022 01.
Article in English | MEDLINE | ID: covidwho-1437078

ABSTRACT

OBJECTIVE: Few studies have explored the clinical features in children infected with SARS-CoV-2 and other common respiratory viruses, including respiratory syncytial virus (RSV), Influenza virus (IV), and adenovirus (ADV). Herein, we reported the clinical characteristics and cytokine profiling in children with COVID-19 or other acute respiratory tract infections (ARTI). METHODS: We enrolled 20 hospitalized children confirmed as COVID-19 positive, 58 patients with ARTI, and 20 age and sex-matched healthy children. The clinical information and blood test results were collected. A total of 27 cytokines and chemokines were measured and analyzed. RESULTS: The median age in the COVID-19 positive group was 14.5 years, which was higher than that of the ARTI groups. Around one-third of patients in the COVID-19 group experienced moderate fever, with a peak temperature of 38.27°C. None of the patients displayed wheezing or dyspnea. In addition, patients in the COVID-19 group had lower white blood cells, platelet counts as well as a neutrophil-lymphocyte ratio. Lower serum concentrations of 14 out of 27 cytokines were observed in the COVID-19 group than in healthy individuals. Seven cytokines (IL-1Ra, IL-1ß, IL-9, IL-10, TNF-α, MIP-1α, and VEGF) changed serum concentration in COVID-19 compared with other ARTI groups. CONCLUSION: Patients with COVID-19 were older and showed milder symptoms and a favorable prognosis than ARTI caused by RSV, IV, and ADV. There was a low grade or constrained innate immune reaction in children with mild COVID-19.


Subject(s)
COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Adolescent , China/epidemiology , Humans , Infant , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Tract Infections/diagnosis , SARS-CoV-2
9.
BMJ Case Rep ; 14(9)2021 Sep 20.
Article in English | MEDLINE | ID: covidwho-1430178

ABSTRACT

We describe a patient who developed acute bilateral corneal decompensation following COVID-19 pneumonia and prolonged intensive care unit ventilation. SARS-CoV-2 uses human ACE2 as the receptor for entry with subsequent downregulation of ACE2. ACE2 receptors are found in human ocular surface cells including cornea. Mouse models of ACE2 deficiency result in corneal haze, oedema and ocular surface inflammation due to upregulation of the inflammatory cascades. We therefore hypothesise that the cause of this patient's corneal decompensation was viral endotheliitis due to direct infection by the SARS-CoV-2 virus.


Subject(s)
COVID-19 , Animals , Cornea , Endothelium, Corneal , Humans , Inflammation , Mice , Peptidyl-Dipeptidase A , SARS-CoV-2
11.
Nat Med ; 26(9): 1494, 2020 09.
Article in English | MEDLINE | ID: covidwho-1387438

ABSTRACT

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

12.
Hepatobiliary Surg Nutr ; 10(4): 486-497, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1372186

ABSTRACT

Background: Increased risks have been found for patients undergoing liver transplantation due to the blood supply shortage following the ongoing coronavirus disease 2019 (COVID-19) pandemic. Hence, exploring a method to alleviate this dilemma is urgent. This phase I, nonrandomized, prospective trial aimed to evaluate the safety and feasibility of using donor-specific red blood cell transfusion (DRBCT) as an urgent measurement to alleviate the blood supply shortage in deceased donor liver transplantation (DDLT). Methods: The outcomes of 26 patients who received DRBCT and 37 patients in the control group who only received 3rd party packed red blood cells (pRBCs) transfusion between May 2020 and January 2021 were compared. Results: Patients receiving DRBCT did not develop transfusion-related complications, and the incidence of postoperative infection was similar to that in the control group (23.1% vs. 18.9%, P=0.688). Because the patients received the red blood cells from organ donors, the median volume of intraoperative allogeneic red blood cell transfusion from blood bank was 4.0 U (IQR 1.1-8.0 U) in the DRBCT group, which is significantly lower than that (7.5 U, IQR 4.0-10.0 U) in the control group (P=0.018). The peak aspartate aminotransferase (AST) level was significantly lower in the DRBCT group than in the control group (P=0.008) and so were the AST levels in the first two days after the operation (P=0.006 and P=0.033). Conclusions: DRBCT is a safe and effective procedure to lower the need for blood supply and is associated with a reduction in AST levels after transplantation. DRBCT is beneficial to patients receiving life-saving transplantation without sufficient blood supply during the COVID-19 pandemic.

13.
Ann Palliat Med ; 10(8): 8557-8570, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1353025

ABSTRACT

BACKGROUND: Since 2020 COVID-19 pandemic became an emergent public sanitary incident. The epidemiology data and the impact on prognosis of secondary infection in severe and critical COVID-19 patients in China remained largely unclear. METHODS: We retrospectively reviewed medical records of all adult patients with laboratory-confirmed COVID-19 who were admitted to ICUs from January 18th 2020 to April 26th 2020 at two hospitals in Wuhan, China and one hospital in Guangzhou, China. We measured the frequency of bacteria and fungi cultured from respiratory tract, blood and other body fluid specimens. The risk factors for and impact of secondary infection on clinical outcomes were also assessed. RESULTS: Secondary infections were very common (86.6%) when patients were admitted to ICU for >72 hours. The majority of infections were respiratory, with the most common organisms being Klebsiella pneumoniae (24.5%), Acinetobacter baumannii (21.8%), Stenotrophomonas maltophilia (9.9%), Candida albicans (6.8%), and Pseudomonas spp. (4.8%). Furthermore, the proportions of multidrug resistant (MDR) bacteria and carbapenem resistant Enterobacteriaceae (CRE) were high. We also found that age ≥60 years and mechanical ventilation ≥13 days independently increased the likelihood of secondary infection. Finally, patients with positive cultures had reduced ventilator free days in 28 days and patients with CRE and/or MDR bacteria positivity showed lower 28-day survival rate. CONCLUSIONS: In a retrospective cohort of severe and critical COVID-19 patients admitted to ICUs in China, the prevalence of secondary infection was high, especially with CRE and MDR bacteria, resulting in poor clinical outcomes.


Subject(s)
COVID-19 , Coinfection , Cross Infection , Adult , Anti-Bacterial Agents/therapeutic use , Coinfection/drug therapy , Cross Infection/drug therapy , Cross Infection/epidemiology , Humans , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
14.
Ann Palliat Med ; 10(8): 8536-8546, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1353024

ABSTRACT

BACKGROUND: The characteristics of the coronavirus disease 2019 (COVID-19) patients with hypotension are still limited. We aim to describe the clinical features and outcomes of the patients. METHODS: This was a multicenter retrospective study of critically ill patients with COVID-19 from ICUs in 19 hospitals in China. All patients were followed up to day 28 or death, which came first. Clinical and outcome data were collected and analyzed. Patients were classified as early-onset or late-onset hypotension, and clinical characteristics and outcomes were compared. RESULTS: A total of 649 patients were included in the final analysis, and 240 (37.0%) were hypotension patients. The median age of hypotension patients was 67 years (IQR, 60-73 years), and 159 (66.2%) were male. 172 (71.7%) of the hypotension patients had at least one comorbidity. The 28-day mortality of the patients with hypotension was 85.4%, which was significantly higher than that of patients without hypotension. Compared with late-onset hypotension patients, the 28-day mortality of patients with early-onset hypotension was significantly higher (90.1% vs. 78.6%, P=0.02). CONCLUSIONS: Approximately one third critically ill COVID-19 patients progressed to hypotension. The mortality was significantly higher in hypotension patients than that in patients without hypotension. Compared with patients with late-onset hypotension, the mortality of patients with early-onset hypotension was significantly higher.


Subject(s)
COVID-19 , Hypotension , Aged , Critical Illness , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
15.
BJPsych Open ; 7(5): e146, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1352682

ABSTRACT

Background: Acceptance and willingness to pay for the COVID-19 vaccine are unknown. Aims: We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it. Method: Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale. Results: Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls. Conclusions: To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.

16.
Int J Ophthalmol ; 14(8): 1133-1137, 2021.
Article in English | MEDLINE | ID: covidwho-1342055

ABSTRACT

AIM: To explore the ocular features of corona virus disease (COVID)-19 and severe acute respiratory syndrome coronavirus (SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients. METHODS: This is a multicenter observational clinical study with no intervention conducted from Jan 25th to March 1st, 2020. Clinical data and samples of tears and conjunctival scraping were collected in consecutive laboratory-confirmed, non-severe COVID-19 patients from three hospitals. COVID-19 virus was analyzed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) kits. RESULTS: Totally 255 laboratory-confirmed, non-severe COVID-19 patients were recruited for ocular manifestation investigation. Of them, 54.9% were females, with a mean age of 49.4y. None of the patients has evidence of uveitis; 11 patients (4.3%) complained of mild asthenopia; 2 (0.8%) had mild conjunctival congestion and serous secretion. Twenty-five of them had performed tears and conjunctival scrape for COVID-19 virus detection, with 4 yield possible positive results in the nucleoprotein gene. One of them were asymptomatic with normal chest CT and positive pharyngeal swab result. CONCLUSION: Ocular manifestations are neither common nor specific in non-severe COVID-19 patients. Meanwhile, COVID-19 virus nucleotides can be detected in the tears and conjunctival scrape samples, warranting further research on the transmissibility by the ocular route.

17.
Ann Transl Med ; 9(13): 1054, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1326097

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has caused more than 2 million deaths worldwide. Viral sepsis has been proposed as a description for severe COVID-19, and numerous therapies have been on trials based upon this hypothesis. However, whether the clinical characteristics of severe COVID-19 are similar to those of bacterial sepsis has not been elucidated. Methods: We retrospectively compared the clinical data of non-surviving COVID-19 patients who were admitted to a 30-bed intensive care unit (ICU) in Wuhan Infectious Diseases Hospital (Wuhan, China) from 22 January 2020, to 28 February 2020, with those of non-surviving patients with bacterial sepsis who were admitted to the ICU in Zhongshan Hospital, Fudan University (Shanghai, China) from 3 July 2018, to 30 June 2020. Results: A total of 53 COVID-19 patients and 26 septic patients were included in the analysis. The mean ages were 65.6 [standard deviation (SD): 11.1] and 70.4 (SD: 14.3) years in the COVID-19 cohort and sepsis cohort, respectively. The proportion of participants with hypertension was higher in non-survivors with COVID-19 than in non-survivors with sepsis (41.5% vs. 15.4%, P=0.020). The Sequential Organ Failure Assessment (SOFA) score of non-survivors with COVID-19 was lower than that of non-survivors with sepsis at ICU admission {4.0 [interquartile range (IQR): 3.0-6.0] vs. 7.5 [IQR: 5.8-11.0], P<0.001}. The clinical parameters at ICU admission assessed with principal component analysis and hierarchical cluster analysis showed that COVID-19 patients were distinct from bacterial septic patients. Compared with non-survivors with sepsis, non-survivors with COVID-19 had a higher neutrophil/lymphocyte ratio, total protein, globulin, lactate dehydrogenase (LDH), and D-dimer; a lower eosinophil count, procalcitonin, interleukin-6 (IL-6), total bilirubin, direct bilirubin, myohemoglobin, albumin/globulin ratio, activated partial thromboplastin time (APTT), prothrombin time (PT), and international normalization ratio (INR) at ICU admission. In addition, the levels of total protein, globulin, LDH, D-dimer, and IL-6 were significantly different between the two groups during the ICU stay. Conclusions: Patients with critical COVID-19 have a phenotype distinct from that of patients with bacterial sepsis. Therefore, caution should be used when applying the previous experience of bacterial sepsis to patients with severe COVID-19.

18.
BMC Pulm Med ; 21(1): 203, 2021 Jun 23.
Article in English | MEDLINE | ID: covidwho-1318281

ABSTRACT

BACKGROUND: Invasive and non-invasive mechanical ventilation (MV) have been combined as sequential MV in the treatment of respiratory failure. However, the effectiveness remains unclear. Here, we performed a randomized controlled study to assess the efficacy and safety of sequential MV in the treatment of tuberculosis with respiratory failure. METHODS: Forty-four tuberculosis patients diagnosed with respiratory failure were randomly divided into sequential MV group (n = 24) and conventional MV group (n = 20). Initially, the patients in both groups received invasive positive pressure ventilation. When the patients' conditions were relieved, the ventilation modality in sequential MV group was switched to oronasal face mask continuous positive airway pressure until weaning. RESULTS: After treatment, the patients in sequential MV group had similar respiratory rate, heart rate, oxygenation index, alveolo-arterial oxygen partial pressure difference (A-aDO2), blood pH, PaCO2 to those in conventional MV group (all P value > 0.05). There was no significant difference in ventilation time and ICU stay between the two groups (P > 0.05), but sequential MV group significantly reduced the time of invasive ventilation (mean difference (MD): - 36.2 h, 95% confidence interval (CI) - 53.6, - 18.8 h, P < 0.001). Sequential MV group also reduced the incidence of ventilator-associated pneumonia (VAP; relative risk (RR): 0.44, 95% CI 0.24, 0.83, P = 0.006) and atelectasis (RR:0.49, 95% CI 0.24,1.00, P = 0.040). CONCLUSIONS: Sequential MV was effective in treating tuberculosis with respiratory failure. It showed advantages in reducing invasive ventilation time and ventilator-associated adverse events. REGISTRATION NUMBER FOR CLINICAL TRIAL: Chinese Clinical Trial Registry ChiCTR2000032311, April 21st, 2020.


Subject(s)
Pneumonia, Ventilator-Associated/etiology , Respiration, Artificial/methods , Respiratory Insufficiency/therapy , Tuberculosis/complications , Adult , Aged , Female , Humans , Male , Masks/adverse effects , Middle Aged , Prospective Studies , Respiration, Artificial/adverse effects , Treatment Outcome
19.
Intelligent Medicine ; 2021.
Article in English | ScienceDirect | ID: covidwho-1253040

ABSTRACT

In recent years, noncontact crewless operations have become prominent in the field of environmental disinfection. Robots that automatically disinfect the air and surfaces of hospital environments can help reduce the human resources spent on environmental cleaning and disinfection and minimize the risk of occupational exposure for staff. These robots also facilitate informatized management of environmental disinfection, reduce costs, and increase the efficiency of disinfection efforts.

20.
Energy ; : 120899, 2021.
Article in English | ScienceDirect | ID: covidwho-1225215

ABSTRACT

In order to cope with the impact of current coronavirus disease 2019 (COVID-19), the continued extension of financial subsidy period for new energy vehicles at the national level is a strong measure to support the sustainable development of new energy vehicle (NEV) industry. This paper further explores the promotion impact of government subsidies on NEV diffusion, and establishes a three-stage evolutionary game model. Based on the actual application, the NEV diffusion process is simulated in four kinds of authoritative networks. Results show that: (1) in the scale-free network, the subsidy rate must be high enough to promote full NEV diffusion, and the larger the network scale, the higher the threshold of subsidy rate;(2) in the small-world network, the larger the network scale, the more beneficial it is for full NEV diffusion;(3) for the small-scale network, topological characteristics have little effect on NEV diffusion depth, and only affect the speed when NEV diffusion reaches the stable state;(4) for the large-scale network, NEV diffusion in the scale-free network is more sensitive to the subsidy rate than that in the small-world network;(5) network topologies influencing NEV diffusion can be divided into two priorities. Finally, relevant policy recommendations are presented.

SELECTION OF CITATIONS
SEARCH DETAIL
...