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1.
Frontiers in cardiovascular medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-1837494

ABSTRACT

Background The COVID-19 pandemic has led to concerns around its subsequent impact on global health. Objective To investigate the health-seeking behavior, reflected by ECG utilization patterns, of patients with non-COVID-19 diseases during and after COVID-19 epidemic. Methods Taking advantage of the remote ECG system covering 278 medical institutions throughout Shanghai, the numbers of medical visits with ECG examinations during the lockdown (between January 23 and April 7, 2020), post-lockdown (between April 8 and December 31, 2020) and post-SARS-CoV-2 (between January 23 and April 7, 2021) periods were analyzed and compared against those during the same periods of the preceding years (2018 and 2019). Results Compared with the same period during pre-COVID years, the number of medical visits decreased during the lockdown (a 38% reduction), followed by a rebound post-lockdown (a 17% increase) and a fall to the baseline level in post-SARS-CoV-2 period. The number of new COVID-19 cases announced on a given day significantly correlated negatively with the numbers of medical visits during the following 7 days. Medical visit dynamics differed for various arrhythmias. Whereas medical visits for sinus bradycardia exhibited a typical decrease-rebound-fallback pattern, medical visits for atrial fibrillation did not fall during the lockdown but did exhibit a subsequent increase during the post-lockdown period. By comparison, the volume for ventricular tachycardia remained constant throughout this entire period. Conclusion The ECG utilization patterns of patients with arrhythmias exhibited a decrease-rebound-fallback pattern following the COVID-19 lockdowns. Medical visits for diseases with more severe symptoms were less influenced by the lockdowns, showing a resilient demand for healthcare.

2.
VIEW ; n/a(n/a):20220004, 2022.
Article in English | Wiley | ID: covidwho-1819401

ABSTRACT

Acidosis, such as respiratory acidosis and metabolic acidosis, can be induced by coronavirus disease 2019 (COVID-19) infection and is associated with increased mortality in critically ill COVID-19 patients. It remains unclear whether acidosis further promotes SARS-CoV-2 infection in patients, making virus removal difficult. For antacid therapy, sodium bicarbonate poses great risks caused by sodium overload, bicarbonate side effects, and hypocalcemia. Therefore, new antacid antidote is urgently needed. Our study showed that an acidosis-related pH of 6.8 increases SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) expression on the cell membrane by regulating intracellular microfilament polymerization, promoting SARS-CoV-2 pseudovirus infection. Based on this, we synthesized polyglutamic acid-PEG materials, used complexation of calcium ions and carboxyl groups to form the core, and adopted biomineralization methods to form a calcium carbonate nanoparticles (CaCO3-NPs) nanoantidote to neutralize excess hydrogen ions (H+), and restored the pH from 6.8 to approximately 7.4 (normal blood pH). CaCO3-NPs effectively prevented the heightened SARS-CoV-2 infection efficiency due to pH 6.8. Our study reveals that acidosis-related pH promotes SARS-CoV-2 infection, which suggests the existence of a positive feedback loop in which SARS-CoV-2 infection-induced acidosis enhances SARS-CoV-2 infection. Therefore, antacid therapy for acidosis COVID-19 patients is necessary. CaCO3-NPs may become an effective antacid nanoantidote superior to sodium bicarbonate.

3.
Lancet Reg Health West Pac ; 23: 100470, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1819561

ABSTRACT

Background: Atrial fibrillation(AF) has become a significant public health concern in China, with population aging and urbanization. Methods: Data screening was performed for 30,244,930 subjects with medical insurance in the Shanghai Municipal Health Commission database between 2015 and 2020. Patients diagnosed with AF were identified and further assessed for treatment information and clinical outcomes, as well as sex differences and impact of COVID-19 pandemic on AF managment. Findings: AF prevalence was 0.88% in Shanghai, which increased with age and reached 6.70% at subjects 80 years and over. AF was more prevalent in women compared with men (0.89% vs. 0.88%, p<0.0001), which could be attributed to higher AF burden in women over 80 years. Driven by increased prescription of non-vitamin K antagonist oral anticoagulants, anticoagulant use increased from 19.46% in 2015 to 56.57% in 2020. The number of left atrial appendage closure increased from 0.16% in 2015 to 1.23% in 2020. Rhythm control strategy was increasingly adopted, as the use of antiarrhythmic drugs doubled and ablation increased by 21% in 2020 compared to 2015. Compared with men, women were less prone to receive rhythm control treatments, including antiarrhythmics, ablation and cardioversion, but more likely to adopt rate control drugs. During the 5.5 years follow-up, the incidences of stroke, transient ischemic attack, systemic embolism, bleeding, myocardial infarction, and in-hospital death were 6.09%, 5.74%, 1.44%, 5.11%, 8.41%, and 12.84% in patients with index diagnosis of AF in 2015, respectively. Interpretation: The burdens of AF and AF-related outcomes in Shanghai are high. Management of AF is markedly improved in recent years, and was not or only slightly impeded by the COVID-19 pandemic. There are sex differences in the prevalence, management, and outcomes of AF. Funding: Shanghai Hospital Development Center, National Natural Science Foundation of China and Shanghai Municipal Science and Technology Commission.

4.
Cell ; 185(8): 1389-1401.e18, 2022 Apr 14.
Article in English | MEDLINE | ID: covidwho-1788017

ABSTRACT

The effectiveness of SARS-CoV-2 vaccines and therapeutic antibodies have been limited by the continuous emergence of viral variants and by the restricted diffusion of antibodies from circulation into the sites of respiratory virus infection. Here, we report the identification of two highly conserved regions on the Omicron variant receptor-binding domain recognized by broadly neutralizing antibodies. Furthermore, we generated a bispecific single-domain antibody that was able to simultaneously and synergistically bind these two regions on a single Omicron variant receptor-binding domain as revealed by cryo-EM structures. We demonstrated that this bispecific antibody can be effectively delivered to lung via inhalation administration and exhibits exquisite neutralization breadth and therapeutic efficacy in mouse models of SARS-CoV-2 infections. Importantly, this study also deciphered an uncommon and highly conserved cryptic epitope within the spike trimeric interface that may have implications for the design of broadly protective SARS-CoV-2 vaccines and therapeutics.


Subject(s)
COVID-19 Vaccines , Single-Domain Antibodies , Administration, Inhalation , Animals , Antibodies, Neutralizing , Antibodies, Viral , COVID-19 , COVID-19 Vaccines/administration & dosage , Disease Models, Animal , Humans , Mice , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/chemistry
5.
Huan Jing Ke Xue ; 43(4): 1747-1755, 2022 Apr 08.
Article in Chinese | MEDLINE | ID: covidwho-1776689

ABSTRACT

Volatile organic compounds (VOCs) are the key precursors of the ozone (O3) formation processes in the troposphere and are important control objects for the coordinated governance of O3 and PM2.5. The Spring Festival of 2020 was affected by the novel coronavirus (COVID-19) pneumonia epidemic:companies stopped work and production, and traffic was restricted, providing scientific experimentation opportunities for pollutant emission reduction research. This study analyzed the variety of the composition, chemical reaction activity, and sources of VOCs in the Pearl River Delta during the Spring Festival and the epidemic control period, using real-time online monitoring data of VOCs obtained at four sites(Guangzhou, Dongguan, Zhongshan, and Duanfen)in the Pearl River Delta from January 1, 2020 to February 29, 2020. The results showed that during the Spring Festival and the epidemic control period, the average of φ (VOCs) in the Pearl River Delta was 15.89×10-9, and the maximum hourly average concentration was 45.43×10-9, values that were 44% and 60% lower, respectively, than those before the Spring Festival holiday. Among the VOCs component concentration decreases, the aromatic hydrocarbon component decreased the most, and the decrease in the urban area of the Pearl River Delta (74%) was significantly greater than that in the suburban area (56%). As a result, the contribution rate of aromatic hydrocarbons to the total VOCs was reduced to less than 10%. The analysis of the·OH reaction activity of VOCs(L·OH)and ozone formation potential(OFP)showed that the L·OH and OFP of VOCs decreased significantly in the Pearl River Delta during the Spring Festival and the epidemic control period. Compared with those before the Spring Festival holiday, the total L·OH and total OFP decreased by an average of 60% and 63% in the urban area of the Pearl River Delta, respectively. Additionally, the atmospheric oxidation had also been significantly reduced, which showed a 28% decrease in ρ(Ox). The ratio of toluene/benzene showed that the influence of industrial sources had almost disappeared during the Spring Festival and the epidemic control period, and the total points of the representative components of industrial-related solvent-use sources such as toluene, ethylbenzene, and m/p-xylene dropped by 72% to 91%. The results of this study suggest that solvent-use sources and vehicle exhaust emission sources are the current sources of VOCs that need to be paid attention to in the prevention and control of O3 pollution in the Pearl River Delta region, and the impact of petrochemical sources cannot be ignored in the work of further reducing the background concentration of O3.


Subject(s)
Air Pollutants , COVID-19 , Ozone , Volatile Organic Compounds , Air Pollutants/analysis , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Environmental Monitoring/methods , Holidays , Humans , Ozone/analysis , Solvents/analysis , Toluene/analysis , Vehicle Emissions/analysis , Volatile Organic Compounds/analysis
6.
Front Public Health ; 10: 774984, 2022.
Article in English | MEDLINE | ID: covidwho-1775979

ABSTRACT

Objective: Timely and accurate forecast of infectious diseases is essential for achieving precise prevention and control. A good forecasting method of infectious diseases should have the advantages of interpretability, feasibility, and forecasting performance. Since previous research had illustrated that the spatial transmission network (STN) showed good interpretability and feasibility, this study further explored its forecasting performance for infectious diseases across multiple regions. Meanwhile, this study also showed whether the STN could overcome the challenges of model rationality and practical needs. Methods: The construction of the STN framework involved three major steps: the spatial kluster analysis by tree edge removal (SKATER) algorithm, structure learning by dynamic Bayesian network (DBN), and parameter learning by the vector autoregressive moving average (VARMA) model. Then, we evaluated the forecasting performance of STN by comparing its accuracy with that of the mechanism models like susceptible-exposed-infectious-recovered-susceptible (SEIRS) and machine-learning algorithm like long-short-term memory (LSTM). At the same time, we assessed the robustness of forecasting performance of STN in high and low incidence seasons. The influenza-like illness (ILI) data in the Sichuan Province of China from 2010 to 2017 were used as an example for illustration. Results: The STN model revealed that ILI was likely to spread among multiple cities in Sichuan during the study period. During the whole study period, the forecasting accuracy of the STN (mean absolute percentage error [MAPE] = 31.134) was significantly better than that of the LSTM (MAPE = 41.657) and the SEIRS (MAPE = 62.039). In addition, the forecasting performance of STN was also superior to those of the other two methods in either the high incidence season (MAPE = 24.742) or the low incidence season (MAPE = 26.209), and the superiority was more obvious in the high incidence season. Conclusion: This study applied the STN to the forecast of infectious diseases across multiple regions. The results illustrated that the STN not only had good accuracy in forecasting performance but also indicated the spreading directions of infectious diseases among multiple regions to a certain extent. Therefore, the STN is a promising candidate to improve the surveillance work.


Subject(s)
Communicable Diseases , Forecasting , Bayes Theorem , Communicable Diseases/epidemiology , Humans , Incidence
7.
J Pers Med ; 12(3)2022 Feb 26.
Article in English | MEDLINE | ID: covidwho-1760719

ABSTRACT

Cognitive dysfunction is associated with functional impairment of patients with Major Depressive Disorder (MDD). The goals were to explore the associated factors of cognitive impairment in MDD and to develop and validate a brief and culture-relevant questionnaire, the Taiwan Cognition Questionnaire (TCQ), among patients with MDD. This was a cross-sectional, multi-center observational study of MDD patients in Taiwan. Participants of Group 1 from 10 centers contributed to the validation of the TCQ by their response and sociodemographics. The participants of Group 2 from one center received an objective cognitive assessment for clarification of the relationship between the TCQ score and its associated factors. In Group 1, 493 participants were recruited. As for Group 2, an extra 100 participants were recruited. The global Cronbach's alpha for the TCQ was 0.908. According to the coordinates of the ROC curve, 9/10 was the ideal cut-off point. With the criteria, the sensitivity/specificity of the TCQ was 0.610/0.689. The TCQ score was positively associated with a history of being admitted to acute psychiatric care and the severity of depression and negatively associated with objective cognitive measures. The TCQ provides a reliable, valid, and convenient measure of subjective cognitive dysfunction in patients with MDD.

8.
Annals of Tourism Research ; 94:103384, 2022.
Article in English | ScienceDirect | ID: covidwho-1748287

ABSTRACT

Tourism demand forecasting is a crucial prerequisite for effective and efficient tourism management. This study develops a novel model based on deep learning methods for precise demand forecasting, namely, spatial-temporal fused graph convolutional network (ST-FGCN). ST-FGCN generates forecasts based on spatial effects extracted using graph convolutional network and temporal dependency captured through long short-term memory. A data-driven spatial matrix is used in our model to strengthen forecasting performance further. Two markedly different forecasting experiments verify the effectiveness of our model. Empirical results suggest that incorporating spatial effects can remarkably reduce forecasting errors. Furthermore, our model shows good applicability for data with different time granularity and different periods: before and during the COVID-19 pandemic.

9.
Comput Biol Med ; 144: 105340, 2022 05.
Article in English | MEDLINE | ID: covidwho-1734294

ABSTRACT

The outbreak of COVID-19 has caused a severe shortage of healthcare resources. Ground Glass Opacity (GGO) and consolidation of chest CT scans have been an essential basis for imaging diagnosis since 2020. The similarity of imaging features between COVID-19 and other pneumonia makes it challenging to distinguish between them and affects radiologists' diagnosis. Recently, deep learning in COVID-19 has been mainly divided into disease classification and lesion segmentation, yet little work has focused on the feature correlation between the two tasks. To address these issues, in this study, we propose MultiR-Net, a 3D deep learning model for combined COVID-19 classification and lesion segmentation, to achieve real-time and interpretable COVID-19 chest CT diagnosis. Precisely, the proposed network consists of two subnets: a multi-scale feature fusion UNet-like subnet for lesion segmentation and a classification subnet for disease diagnosis. The features between the two subnets are fused by the reverse attention mechanism and the iterable training strategy. Meanwhile, we proposed a loss function to enhance the interaction between the two subnets. Individual metrics can not wholly reflect network effectiveness. Thus we quantify the segmentation results with various evaluation metrics such as average surface distance, volume Dice, and test on the dataset. We employ a dataset containing 275 3D CT scans for classifying COVID-19, Community-acquired Pneumonia (CAP), and healthy people and segmented lesions in pneumonia patients. We split the dataset into 70% and 30% for training and testing. Extensive experiments showed that our multi-task model framework obtained an average recall of 93.323%, an average precision of 94.005% on the classification test set, and a 69.95% Volume Dice score on the segmentation test set of our dataset.


Subject(s)
COVID-19 , Pneumonia , COVID-19/diagnostic imaging , Humans , Tomography, X-Ray Computed/methods
10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325267

ABSTRACT

Objective: In the battle against COVID-19, most medical resources in China have been directed to infected patients in Wuhan. Thus, patients with hepatobiliary pancreatic tumors who are not suffering from COVID-19 are often not given timely and effective anti-cancer treatments. In this study, we aimed to describe clinical characteristics, treatment, and outcomes of patients with hepatobiliary and pancreatic oncology from our department, which retained normal working during the COVID-19 epidemic. We also sought to formulate a set of standardized hospitalization and treatment processes. Methods: : A retrospective and descriptive study was conducted involving patients hospitalized from February 1, 2020, to February 29, 2020 (Return to work after the Spring Festival), at our Department of Hepatobiliary and Pancreatic Surgical Oncology. Results: : The study included 92 patients from 12 provinces in the north of China who underwent surgical resection at our Department of Hepatobiliary and Pancreatic Surgical Oncology during the COVID-19 epidemic. Robotic surgery was performed on 82% (75/92) of patients, while the rest underwent laparoscopic (2/92) and open surgery (15/92). Eighty-six patients had malignant tumor, and six had emergency benign diseases. Only five patients had severe pancreatic fistula, and three had biliary fistula after operation. Conclusions: : The standardized hospitalization and treatment processes described in this study could prevent cross-infection of patients and still ensure timely treatment of patients with hepatobiliary and pancreatic cancers. These study findings will guide the management of surgical oncology departments and treatment of patients with hepatobiliary and pancreatic oncology during serious epidemics.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315164

ABSTRACT

Background: In this study, we aimed to find out the features of the maintenance hemodialysis (MHD) patients infected with Coronavirus Disease 2019 (COVID-19) in the Blood Purification Center of Wuhan No.1 Hospital, Hubei Province, China, and provide evidences for clinical treatment. Methods: : We collected the data of all the MHD patients in this hemodialysis center by February 20, 2020, including those infected with COVID-19. These patients were divided into three groups: the control group (537 cases), confirmed group (66 cases) and suspected group (24 cases). We compared the relevant data of the three groups and analyzed the factors that may affect the possibility of catching COVID-19. Results: : 1. By February 20, 2020, there were 627 MHD patients in the Hemodialysis Center of Wuhan No.1 Hospital. The prevalence rate of the COVID-19 was 14.35% (90/627, including 66 confirmed cases and 24 suspected cases);the fatality rate 13.33% (12/90, including 12 death cases);the mortality rate 1.91% (12/627). 2. The comparison between the three groups revealed the following results: weekly hemodialysis duration (WHD), ultrafiltration volume (UFV) and ultrafiltration rate (UFR) of the confirmed group were obviously lower than those of the control and suspected groups ( P <0.05);the neutrophil ratio (N%), neutrophil (N#), monocyte (M#) and total carbon dioxide (TCO 2 ) were significantly higher than those of the control group while the lymphocyte ratio (L%) was much lower ( P <0.05). 3. The lung CT scans found three common features: bilateral abnormalities (81.54%), multiple abnormalities (84.62%) and patchy opacity (61.54%). 4. The binary logstic regression analysis showed that diabetes ( OR =5.404,95% CI 1.950~14.976, P =0.001) and hypertension ( OR =3.099,95% CI 1.380~6.963, P =0.006) are independent risk factors for MHD patients to be infected with COVID-19;WHD ( OR =0.846,95% CI 0.737~0.970, P =0.017), UFR ( OR =0.012,95% CI 0.002~0.058, P <0.001) and serum ferritin (SF, OR =0.823,95% CI 0.748~0.906, P <0.001) are independent protective factors. Conclusion: MHD patients with diabetes or hypertension are more likely to be infected with COVID-19. In clinical treatment, hemodialysis duration, UFR and SF levels should be controlled appropriately to reduce the risk of infection.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315163

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) is spreading rapidly worldwide, bringing great challenges to infection control professionals (ICPs). The study aims to understand the status quo and the situation of work and physical and mental health of Chinese infection control professionals (ICPs) during the epidemic of coronavirus disease 2019 (COVID-19), in order to complete hospital infection control work and respond to public health emergencies better.[1] Methods: : The questionnaire was designed to conduct anonymous investigations onChinese ICPs relying on the questionnaire star applet during the epidemic of COVID-19. Results: : A total of 1652 ICPs from 1265 hospitals were surveyed. 84.32% ICPs’ professional background was nursing;33.9% could not be promoted in professional title;62.65% ICPs’ daily income was lower than similar staff at the same level in the hospital;98% thought that the hospital infection control discipline should be set up.During the epidemic, the ICPs did a lot of work, and most heads of the infectioncontrol department believed that the infection control department had a great role in this epidemic. During this epidemic, 90.47% ICPs worked more than 9 hours a day;the highest psychological stress score was 10 points(out of 10), accounting for 32.14%;79.3% had worse sleep than usual. Most ICPs felt tired, frustrated and powerless frequently, but only 20.40% complained frequently or consistently. Conclusions: : Chinese ICPs are facing difficulties in promotion of professional title, poor salary, high work intensity and high psychological pressure currently.They has undertaken a lot of work and played an important role in the prevention and control of COVID-19.

13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315157

ABSTRACT

Background: The COVID-19 pandemic has led to concerns around its subsequent impact on patients with non-COVID-19 diseases, and the health-seeking behavior of such patients must be investigated.Methods: Taking advantage of the remote ECG system covering 278 medical institutions throughout Shanghai, the numbers of hospital visits with ECG examinations during the lockdown (between January 23 and April 7, 2020), post-lockdown (between April 8 and December 31, 2020) and post-epidemic (between January 23 and April 7, 2021) periods were analyzed and compared against those during the same periods of the preceding years (2018 and 2019).Findings: Compared with those of the same period during pre-COVID years, the number of hospital visits decreased during the lockdown (a 38% reduction), followed by a rebound post-lockdown (a 17% increase) and a fall to the baseline level of the post-epidemic period. This decrease-rebound-fallback pattern was largely attributed to the dynamics of visits to community clinics rather than academic hospitals. The number of new COVID-19 cases or deaths announced on a given day correlated negatively with hospital visits during the same day and for the following 42 days, with the correlation at its most prominent at seven days. Hospital visit dynamics differed for various cardiovascular diseases. Whereas hospital visits for sinus bradycardia exhibited a typical decrease-rebound-fallback pattern, hospital visits for ST-segment elevated myocardial infarction did not fall during the lockdown period but did exhibit a subsequent increase during the post-lockdown period. By comparison, the volume for ventricular tachycardia remained constant throughout this entire period.Interpretation: The health-seeking behavior of patients with cardiovascular diseases exhibited a decrease-rebound-fallback pattern following the COVID-19 lockdowns. Hospital visits for diseases with more severe symptoms were less influenced by the lockdowns, showing a resilient demand for healthcare.Funding: Shanghai Hospital Development Center, National Natural Science Foundation of China, Shanghai Municipal Science and Technology Commission, and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Declaration of Interest: All authors declare no conflicts of interest.Ethical Approval: This study was approved by the ethics committee at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315066

ABSTRACT

Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis. Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range;0, none;25, maximum) was determined. Results: We analyzed clinical data from 46 patients (26 males and 20 females;age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively). Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308928

ABSTRACT

Background: To date, coronaviruses have caused three pandemics. Fewer studies concentrated on the prognosis of lung function. Objective: To summarize the lung function of the discharged after coronavirus infection. Methods: : We systematically searched PubMed, Cochrane Library, Web of Science, and EMBASE. Two authors independently screened articles and extracted data. On average, predicted values and damage rates of seven lung function indices were pooled by single-arm meta-analysis. And, in severe/critical vs. non-severe/critical and one-year follow-up, they were pooled by two-arm meta-analysis. The source of high heterogeneity was explored by meta-regression or subgroup analysis. Results: : Of the 7798 articles identified, 34 studies were included. On average, the pooled predicted values of the seven indices were within normal except for DLCO (79.2, 95% CI (76.2-82.2 )). Damage of lung function indices accounted for 6.2-35.2% of the discharged with DLCO most, and 83-100% of the damage was mild. Meta-regression showed that different viruses, countries, disease settings, and measurement times were not the source of high heterogeneities. In severe/critical illness vs. non-severe/critical, predicted values of seven indices were significantly lower (largest gap in DLCO (WMD -11.60, 95% CI -14.23--8.98)). However, damage rates got rises only in DLCO (RR 1.74, 95% CI 1.46-2.07) and TLC, having no differences in the other indices. In one-year follow-up, predicted values were significantly improved in the severe/critical subgroup, while having no change in the non-severe/critical subgroup. Damage rates got no improvement in all indices. Interpretation: A single predicted value or damage rate can't give a clear description of lung function after coronavirus infection, and the trends of the two are sometimes inconsistent. We suggest more prospective cohort or follow-up studies in the future to lessen the influence of differences in lung function measurements across studies. Registration: PROSPERO (CRD42020192843)

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308150

ABSTRACT

Then novel coronavirus disease (COVID-19) epidemic was considered to be the worst and complex virus outbreak, which caused 56,985 deaths as of April 22, 2020 already. The epidemic infectious may cause mental health crisis. Meanwhile, little is known about the specific psychological status of the COVID-19 survivors and healthcare workers. This cross-sectional study surveyed the mental health among 20 COVID-19 survivors, 54 nurses, and 24 hygienists in Wuhan, China and analyze the possible impact factors using the Symptom Check List 90 - Revised (SCL90-R) questionnaire. 3 indices and 9 dimensions were compared among job, education level, gender, age, marriage classification. This study found that mental distress among participants was not very serious in general. The survivors presented a highest score, then the hygienists, and the lowest in nurses. Low-educated and women showed significant increase. No significant difference was noted in age and marriage classification. Our study indicated that the survivors need psychological support immediately. Meanwhile, healthcare workers warrant more attention, especially low-educated and women. Comprehensive emergency response plan was warranted.

17.
IEEE Access ; 8: 194158-194165, 2020.
Article in English | MEDLINE | ID: covidwho-1528297

ABSTRACT

COVID-19 is an emerging disease with transmissibility and severity. So far, there are no effective therapeutic drugs or vaccines for COVID-19. The most serious complication of COVID-19 is a type of pneumonia called 2019 novel coronavirus-infected pneumonia (NCIP) with about 4.3% mortality rate. Comparing to chest Digital Radiography (DR), it is recently reported that chest Computed Tomography (CT) is more useful to serve as the early screening and diagnosis tool for NCIP. In this study, aimed to help physicians make the diagnostic decision, we develop a machine learning (ML) approach for automated diagnosis of NCIP on chest CT. Different from most ML approaches which often require training on thousands or millions of samples, we design a few-shot learning approach, in which we combine few-shot learning with weakly supervised model training, for computerized NCIP diagnosis. A total of 824 patients are retrospectively collected from two Hospitals with IRB approval. We first use 9 patients with clinically confirmed NCIP and 20 patients without known lung diseases for training a location detector which is a multitask deep convolutional neural network (DCNN) designed to output a probability of NCIP and the segmentation of targeted lesion area. An experienced radiologist manually localizes the potential locations of NCIPs on chest CTs of 9 COVID-19 patients and interactively segments the area of the NCIP lesions as the reference standard. Then, the multitask DCNN is furtherly fine-tuned by a weakly supervised learning scheme with 291 case-level labeled samples without lesion labels. A test set of 293 patients is independently collected for evaluation. With our NCIP-Net, the test AUC is 0.91. Our system has potential to serve as the NCIP screening and diagnosis tools for the fight of COVID-19's endemic and pandemic.

18.
Front Public Health ; 9: 716483, 2021.
Article in English | MEDLINE | ID: covidwho-1515550

ABSTRACT

Objectives: To explore and understand the SARS-CoV-2 seroprevalence of convalescents, the association between antibody levels and demographic factors, and the seroepidemiology of convalescents of COVID-19 till March 2021. Methods: We recruited 517 voluntary COVID-19 convalescents in Sichuan Province and collected 1,707 serum samples till March 2021. Then we reported the seroprevalence and analyzed the associated factors. Results: Recent travel history was associated with IgM levels. Convalescents who had recent travel history were less likely to be IgM antibody negative [OR = 0.232, 95% CI: (0.128, 0.420)]. Asymptomatic cases had, approximately, twice the odds of being IgM antibody negative compared with symptomatic cases [OR = 2.583, 95% CI: (1.554, 4.293)]. Participants without symptoms were less likely to be IgG seronegative than those with symptoms [OR = 0.511, 95% CI: (0.293, 0.891)]. Convalescents aged 40-59 were less likely to be IgG seronegative than those aged below 20 [OR = 0.364, 95% CI: (0.138, 0.959)]. The duration of positive IgM antibodies persisted 365 days while the IgG persisted more than 399 days. Conclusions: Our findings suggested that recent travel history might be associated with the antibody levels of IgM, while age could be associated with the antibody levels of IgG. Infection type could be associated with both antibody levels of IgM and IgG that declined quicker in asymptomatic cases.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , China/epidemiology , Humans , Immunoglobulin G , Seroepidemiologic Studies
19.
Front Public Health ; 9: 730611, 2021.
Article in English | MEDLINE | ID: covidwho-1512061

ABSTRACT

Introduction: As of June 7, 2021, the outbreak of Coronavirus Disease 2019 (COVID-19) has spread to more than 200 countries. The global number of reported cases is more than 172.9 million, with more than 3.7 million deaths, and the number of infected individuals is still growing rapidly. Consequently, events and activities around the world were canceled or postponed, and the preparation for sporting events were greatly challenged. Under such circumstances, about 11,000 athletes from ~206 countries are arriving in Tokyo for the 32nd Summer Olympic Games. Therefore, it is urgently necessary to assess the occurrence and spread risk of COVID-19 for the Games. Objectives: To explore effective prevention and control measures for COVID-19 in large international events through simulations of different interventions according to risk assessment. Methods: We used a random model to calculate the number of initial infected patients and used Poisson distribution to determine the number of initial infected patients based on the number of countries involved. Furthermore, to simulate the COVID-19 transmission, the susceptible-exposed-symptomatic-asymptomatic-recovered-hospitalized (SEIARH) model was established based on the susceptible-exposed-infectious-recovered (SEIR) mathematical model of epidemic diseases. According to risk assessment indicators produced by different scenarios of the simulated interventions, the risk of COVID-19 transmission in Tokyo Olympic Games was assessed. Results: The current COVID-19 prevention measures proposed by the Japan Olympic Committee need to be enhanced. And large-scale vaccination will effectively control the spread of COVID-19. When the protective efficacy of vaccines is 78.1% or 89.8%, and if the vaccination rate of athletes reaches 80%, an epidemic prevention barrier can be established.


Subject(s)
COVID-19 , Sports , Humans , Risk Assessment , SARS-CoV-2 , Tokyo/epidemiology
20.
Signal Transduct Target Ther ; 6(1): 378, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1500450

ABSTRACT

The current COVID-19 pandemic has heavily burdened the global public health system and may keep simmering for years. The frequent emergence of immune escape variants have spurred the search for prophylactic vaccines and therapeutic antibodies that confer broad protection against SARS-CoV-2 variants. Here we show that the bivalency of an affinity maturated fully human single-domain antibody (n3113.1-Fc) exhibits exquisite neutralizing potency against SARS-CoV-2 pseudovirus, and confers effective prophylactic and therapeutic protection against authentic SARS-CoV-2 in the host cell receptor angiotensin-converting enzyme 2 (ACE2) humanized mice. The crystal structure of n3113 in complex with the receptor-binding domain (RBD) of SARS-CoV-2, combined with the cryo-EM structures of n3113 and spike ecto-domain, reveals that n3113 binds to the side surface of up-state RBD with no competition with ACE2. The binding of n3113 to this novel epitope stabilizes spike in up-state conformations but inhibits SARS-CoV-2 S mediated membrane fusion, expanding our recognition of neutralization by antibodies against SARS-CoV-2. Binding assay and pseudovirus neutralization assay show no evasion of recently prevalent SARS-CoV-2 lineages, including Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) for n3113.1-Fc with Y58L mutation, demonstrating the potential of n3113.1-Fc (Y58L) as a promising candidate for clinical development to treat COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/chemistry , Antibodies, Neutralizing/chemistry , Antibodies, Viral/chemistry , COVID-19 , SARS-CoV-2/chemistry , Single-Chain Antibodies/chemistry , Angiotensin-Converting Enzyme 2/immunology , Animals , Antibodies, Neutralizing/immunology , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral/immunology , Antibodies, Viral/therapeutic use , Crystallography, X-Ray , Epitopes/chemistry , Epitopes/immunology , Humans , Mice , SARS-CoV-2/immunology , Single-Chain Antibodies/immunology , Single-Chain Antibodies/therapeutic use
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