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1.
Vaccine ; 40(19): 2696-2704, 2022 Apr 26.
Article in English | MEDLINE | ID: covidwho-1764022

ABSTRACT

OBJECTIVES: Little is known about how the coronavirus disease 2019 (COVID-19) pandemic affected influenza vaccine utilization and disparities. We sought to estimate changes in the likelihood of receiving an influenza vaccine across different demographic subgroups during the COVID-19 pandemic. METHODS: In this cohort study, we analyzed influenza vaccine uptake from 2019 to 2020 using Optum commercial insurance claims data. Eligible individuals were aged 18 or above in 2018 and continuously enrolled from 08/01/2018 through 12/31/2020. Multivariable logistic regressions were fitted for the individual-level influenza vaccine uptake. Adjusting for demographic factors and medical histories, we estimated probabilities of receiving influenza vaccines before and after the COVID-19 pandemic across demographic subgroups. RESULTS: From August to December 2019, unadjusted influenza vaccination rate was 42.3%, while in the same period of 2020, the vaccination rate increased to 45.9%. Females had a higher vaccination rate in 2019 (OR: 1.16, 95% CI 1.15-1.16), but the increase was larger for males. Blacks and Hispanics had lower vaccination rates relative to whites in both flu seasons. Hispanics showed a greater increase in vaccination rate, increasing by 7.8 percentage points (p < .001) compared to 4.4 (p < .001) for whites. The vaccination rate for Blacks increased by 5.2 percentage points (p < .001). All income groups experienced vaccination improvements, but poorer individuals had lower vaccination rates in both seasons. The most profound disparities occurred when educational cohort were considered. The vaccination rate increased among college-educated enrollees by 8.8 percentage points (p < .001) during the pandemic compared to an increase of 2.8 percentage points (p < .001) for enrollees with less than a 12th grade education. Past influenza infections or vaccination increased the likelihood of vaccination (p < .001). CONCLUSIONS: The COVID-19 pandemic was associated with increased influenza vaccine utilization. Disparities persisted but narrowed with respect to gender and race but worsened with respect to income and educational attainment.

2.
Vaccine ; 40(14): 2209-2214, 2022 03 25.
Article in English | MEDLINE | ID: covidwho-1757914

ABSTRACT

OBJECTIVES: To evaluate the impact of Facebook's vaccine misinformation policy in March 2019 on user endorsements of vaccine content on its platform. METHODS: We identified 172 anti- and pro-vaccine Facebook Pages and collected posts from these Pages six months before and after the policy. Using interrupted time series regression models, we evaluated the policy impact on user endorsements (i.e., likes) of anti- and pro-vaccine posts on Facebook. RESULTS: The number of likes for posts on anti-vaccine Pages had decreased after the policy implementation (policy = 153.2, p < 0.05; policy*day = -0.838, p < 0.05; marginal effect at the mean = -22.74, p < 0.01; marginal effect at the median = -24.56, p < 0.01). When the number of subscribers was considered, the policy effect on the number of likes for anti-vaccine posts was much smaller, but still statistically significant (policy = 4.849, p < 0.05; policy*day = -0.027, p < 0.05; marginal effect at the mean = -0.742, p < 0.01; marginal effect at the median = -0.800, p < 0.01). There was no policy effect observed for posts on pro-vaccine Pages. CONCLUSIONS: Our analysis suggested that Facebook's March 2019 vaccine misinformation policy moderately impacted the number of endorsements of anti-vaccine content on its platform. Social media companies can take measures to limit the popularity of anti-vaccine content by reducing their reach and visibility. Future research efforts should focus on evaluating additional policies and examining policies across platforms.

3.
Nature ; 2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1751733

ABSTRACT

Coronavirus disease 2019 (COVID-19) is especially severe in aged populations1. SARS-CoV-2 vaccines are highly effective, but vaccine efficacy is partly compromised by the emergence of SARS-CoV-2 variants with enhanced transmissibility2. The emergence of these variants emphasizes the need for further development of anti-SARS-CoV-2 therapies, especially in aged populations. Here, we describe the isolation of highly virulent mouse-adapted viruses and use them to test a novel therapeutic drug in infected aged animals. Many of the mutations observed in SARS-CoV-2 during mouse adaptation (positions 417, 484, 493, 498, 501 of the spike protein) also arise in humans in variants of concern (VOC)2. Their appearance during mouse adaptation indicates that immune pressure is not required for selection. In murine SARS, in which severity is also age-dependent, elevated levels of an eicosanoid, prostaglandin D2 (PGD2) and of a phospholipase, PLA2G2D, contributed to poor outcomes in aged mice3,4. mRNA expression of PLA2G2D and PTGDR, a PGD2 receptor, and production of PGD2 also increase in human PBMC-derived dendritic cells with aging and after SARS-CoV-2 infection. Using our mouse-adapted SARS-CoV-2, we show that middle-aged mice lacking expression of PTGDR, or PLA2G2D are protected from severe disease. Further, treatment with a PTGDR antagonist, asapiprant, protected aged mice from lethal infection. PTGDR antagonism is one of the first interventions in SARS-CoV-2-infected animals that specifically protects aged animals, suggesting that the PLA2G2D-PGD2/PTGDR pathway is a useful target for therapeutic interventions.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325164

ABSTRACT

Background: The novel coronavirus pneumonia (COVID-19) is a highly contagious and highly pathogenic disease caused by a novel coronavirus(SARS-CoV-2)and has become pandemic within a short period of time. The epidemic has brought not only the risk of death from infection but also unbearable psychological pressure. College students as a special group, their mental health status need to be studied during the outbreak of COVID-19.MethodsWe used the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and the compulsive behavior part of the Yale-Brown Obsessive-Compulsive Scale (YBOCS), combined with demographic information, using online questionnaires to research, and the study was conducted between February 21 and 24, 2020. A total of 2270 valid questionnaires were collected, the respondents of these questionnaires included 563 medical students and 1707 non-medical students. We separately analyzed the mental health status of medical and non-medical students during the outbreak of COVID-19.ResultsOf the 563 medical students, 20 (3.55%) students had anxiety symptoms, and 57 (10.12%) students had depressive symptoms. Gender, PMH, compulsive behavior, and regularity of daily life during the epidemic outbreak were correlated with their anxiety symptoms and age, PMH, compulsive behavior, and regularity of daily life during the epidemic outbreak were associated with their depressive symptoms. Of the 1707 non-medical students, 66 (3.87%) students had anxiety symptoms, and 180 (10.54%) students had depressive symptoms. Gender, contact history of similar infectious disease, PMH, compulsive behavior, regularity of daily life and exercise during the epidemic outbreak and concern on COVID-19 were correlated with their anxiety symptoms and contact history of similar infectious disease, PMH, compulsive behavior, regularity of daily life and exercise during the epidemic outbreak and concern on COVID-19 were associated with their depressive symptoms.ConclusionsResults indicated that gender, age, contact history of similar infectious disease, past medical history (PMH), compulsive behavior, regularity of daily life, and exercise during the epidemic outbreak are the key factors making college students anxious or depressed. The results provided a theoretical basis for relevant interventions;it is also essential for medical education and public health epidemic prevention.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324260

ABSTRACT

Corona Virus Disease 2019 (COVID-19) became the outbreak of infectious diseases emergency worldwide. It remains unknown whether the RT-PCR test results was associated with the prognosis of COVID-19 patients or not. In this study, a total number of 495 patients with typical chest CT feature and symptom consistent with COVID-19 were retrospectively included from Jan 23, 2020 to Feb 26, 2020. 186 (37.58%), 32 (6.46%) and 277 (55.96%) COVID-19 patients had initial positive, suspected and negative RT-PCR results, respectively. The mean age was 58.55 years and 254(51.3%) were older than 60 years. 60.00% (297/495), 22.02% (109/495) and 17.98% (89/495) of COVID-19 patients were common, severe and critically type, respectively. There were no significant differences of age, gender, time from onset to hospitalization and severity classification in the patients with initial positive and negative RT-PCR result. The mortality rate of patients with positive and negative were 7.14% and 7.94%. Patients with initial negative or initial positive RT-PCR results had no significant difference of mortality rate (c2=4.079, p=0.130). The number of patients with lymphocyte ratios under the normal level was significantly larger in patients with initial negative RT-PCR results (59/92) compared with the patients with initial positive result (86/167), p=0.033. COVID-19 patients with positive or negative RT-PCR results had no significant difference in severity and mortality. Chest CT may be a more effective tool to screen COVID-19 in preference to RT-PCR.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323785

ABSTRACT

We investigate the effectiveness of different machine learning methodologies in predicting economic cycles. We identify the deep learning methodology of Bi-LSTM with Autoencoder as the most accurate model to forecast the beginning and end of economic recessions in the U.S. We adopt commonly-available macro and market-condition features to compare the ability of different machine learning models to generate good predictions both in-sample and out-of-sample. The proposed model is flexible and dynamic when both predictive variables and model coefficients vary over time. It provided good out-of-sample predictions for the past two recessions and early warning about the COVID-19 recession.

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323668

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) epidemic is still ongoing, but the optimal treatment remains unclear. China adopted a series of measures, including widespread screening, strict quarantine and early treatment, combining western medicine with Chinese medicine, leading to rapid control of its spread. Nevertheless, the effects of ( combined ) Chinese medicine in reducing the toll of COVID-19 lack proof from statistics. Objective We conducted a retrospective data analysis to determine whether ( combined ) Chinese medicine is able to affect patient outcomes and to decrease the risk of death in COVID-19 patients. Methods The data were acquired by outputting the formatting information from the HIS system and then extracting and recording it in the database for complete cases. The demographics, disease onset, treatment, survival/death and all of the clinical classifications, groups and definitions were verified by specialists in the clinic, along with the research methodology and statistics, before conducting the statistical analysis. The characteristics of the cohort and the clinical symptoms and signs, prescriptions and outcomes were described and analyzed by the mean ± SD, median, interquartile range and composition ratio. Analysis of variance was used for comparisons between the measurement data sets;otherwise, the rank sum test was used. Counting data were compared between groups using the chi square test and Fisher’s exact test. Tendency matching was adopted to make the general data balance between groups. A Cox proportional hazard model was used to compare the risk of death among the different groups. Results Four centers were included in our study, and a total of 6,076 patients' clinical records were obtained after combining the data. We included 4567 cases for the descriptive statistics, and the crude case fatality rate was 3.0%. Compared with using only western medicine, (combined) Chinese medicine reduced the risk of death from COVID-19 after adjusting for other prognostic risk factors (HR = 0.135, 95% CI (0.088, 0.208)). Multivariate Cox regression also indicated that when applying the clinical classification of severe/critical, age ≥ 65 years old, coronary heart disease or chronic kidney disease and a time from onset to hospital admission of fewer than 14 days, all of these factors increased the risk of death. Conclusion (Combined) Chinese medicine can significantly reduce the risk of death from COVID-19, but the specific strategy/solution, effects and amount need further exploration in future studies.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323613

ABSTRACT

Objectives: COVID-19 remains a global challenge. Corticosteroids are a group of anti-inflammatory and suppressive immune response drugs that are widely used in the treatment of COVID-19, especially when it presents with viral pneumonia. Comprehensive reviews investigating the comparative proportion and efficacy of corticosteroid use are scarce. Therefore, we conducted a systematic review and meta-analysis of clinical trials to evaluate the proportion and efficacy of corticosteroid use for the treatment of COVID-19. Methods: : We conducted a comprehensive literature review of PubMed, EMBASE, the Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing Database for relevant trials on glucocorticoid therapy in COVID-19 patients. Outcome measures were the proportion of patients administered corticosteroids, viral clearance and mortality. Effect size was reported as weighted mean differences (WMDs) for continuous outcomes and odds ratios (ORs) for dichotomous outcomes with associated 95% confidence intervals (CIs). Results: : Forty-three trials involving 6603 patients were included. The meta-analysis demonstrated that the proportion of COVID-19 patients who received corticosteroids was significantly lower than that of patients who did not receive corticosteroids. In addition, our meta-analysis demonstrated no significant difference in the proportions of severe and nonsevere patients who were administered corticosteroids. We also performed subgroup analyses stratified by severity, indicating that the proportion of patients administered corticosteroids was significantly higher among intensive care unit (ICU) patients than among non-ICU patients. The results of our meta-analysis indicated that corticosteroid treatment significantly delayed the viral clearance time. Finally, our meta-analysis demonstrated no significant difference between the use of corticosteroids for COVID-19 patients who died and those who survived. This result indicated that mortality was not correlated with corticosteroid therapy. Conclusion: The proportion of COVID-19 patients who received corticosteroids was significantly lower than that of patients who did not receive corticosteroids. Corticosteroid use in subjects with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections delayed virus clearance and did not convincingly improve survival;therefore, corticosteroids should be used with caution in the treatment of COVID-19.

9.
Front Med (Lausanne) ; 8: 671667, 2021.
Article in English | MEDLINE | ID: covidwho-1643500

ABSTRACT

Background: In this study, we investigated the relationship between serum lactate dehydrogenase (LDH) level and disease progression and prognosis of patients with COVID-19. Methods: We retrospectively reviewed the information of 1,751 patients with COVID-19 from Leishenshan Hospital in Wuhan, China. Univariate and multivariate Cox regression analyses as well as Logistics regression analyses, and Kaplan-Meier curves were used to determine the association between LDH levels and the prognosis of COVID-19 patients. Results: LDH was an independent risk factor for in-hospital death no matter it was taken as classified variable and continuous variable (all P = 0.001) but not for severe or critical illness status. The Kaplan-Meier curves for LDH level showed that an elevated level of LDH was associated with in-hospital death. Conclusions: In patients with COVID-19, the increased LDH level is associated with a higher risk of negative clinical prognosis and higher mortality. This will provide a reference for clinicians and researchers to understand, diagnose, and treat patients with COVID-19. Further prospective studies with larger sample sizes are needed to verify these findings.

10.
Front Public Health ; 9: 778539, 2021.
Article in English | MEDLINE | ID: covidwho-1538377

ABSTRACT

Several recent studies have reported that a few patients had positive SARS-CoV-2 RNA tests after hospital discharge. The high-risk factors associated with these patients remain to be identified. A total of 463 patients with COVID-19 discharged from Leishenshan Hospital in Wuhan, China, between February 8 and March 8, 2020 were initially enrolled, and 351 patients with at least 2 weeks of follow-up were finally included. Seventeen of the 351 discharged patients had positive tests for SARS-CoV-2 RNA. Based on clinical characteristics and mathematical modeling, patients with shorter hospital stays and less oxygen desaturation were at higher risk of SARS-CoV-2 RNA reoccurrence after discharge. Notably, traditional Chinese medicine treatment offered extensive benefits to reduce risk. Particular attention should be paid to those patients with high risk, and traditional Chinese medicine should be advocated.


Subject(s)
COVID-19 , Patient Discharge , Hospitals , Humans , RNA, Viral/genetics , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2
11.
Nurse Educ Today ; 108: 105183, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1504046

ABSTRACT

BACKGROUND: Due to the rapid spread of coronavirus disease 2019 (COVID-19) around the world, the World Health Organization (WHO) declared it a global pandemic on March 11, 2020. This declaration had an unprecedented impact on health profession education, especially the clinical clerkship of nursing and medical students. The teaching hospitals had to suspend traditional bedside clinical teaching and switch to digital education. OBJECTIVE: To systematically synthesize the available literature on the application of digital education in undergraduate nursing and medical interns during the COVID-19 pandemic. DESIGN: A systematic review informed by PRISMA guidelines. DATA SOURCES: Five electronic databases were systematically searched: PubMed, Embase, MEDLINE (OVID), CINAHL and the Cochrane Library. REVIEW METHODS: The retrieved articles were screened at the title, abstract, and full text stages. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the quality of quantitative and mixed-method studies. Then, two reviewers extracted the quantitative data of the included studies. RESULTS: A total of 4596 studies were identified following a comprehensive search, and 16 studies were included after removing duplicates and screening, which focused on undergraduate nursing students (3 studies) and medical students (13 studies). We found that the standalone digital education modalities were as effective as conventional learning for knowledge and practice. Different educational technologies have different effects on the knowledge and practice of interns. CONCLUSION: Digital education plays a significant role in distance training for nursing and medical interns both now and in the future. The overall risk of bias was high, and the quality of evidence was found to be variable. There is a need for further research designing more quasi-experimental studies to assess the effectiveness of standalone digital education interventions for the remote training of nursing or medical interns to be fully prepared for emergencies.


Subject(s)
COVID-19 , Education, Medical, Undergraduate , Education, Nursing, Baccalaureate , Students, Nursing , Humans , Pandemics , SARS-CoV-2
12.
J Infect Dis ; 224(8): 1357-1361, 2021 10 28.
Article in English | MEDLINE | ID: covidwho-1493824

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 ) initiates entry into airway epithelia by binding its receptor, angiotensin-converting enzyme 2 (ACE2). METHODS: To explore whether interindividual variation in ACE2 abundance contributes to variability in coronavirus disease 2019 (COVID-19) outcomes, we measured ACE2 protein abundance in primary airway epithelial cultures derived from 58 human donor lungs. RESULTS: We found no evidence for sex- or age-dependent differences in ACE2 protein expression. Furthermore, we found that variations in ACE2 abundance had minimal effects on viral replication and induction of the interferon response in airway epithelia infected with SARS-CoV-2. CONCLUSIONS: Our results highlight the relative importance of additional host factors, beyond viral receptor expression, in determining COVID-19 lung disease outcomes.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/pathology , Receptors, Coronavirus/metabolism , SARS-CoV-2/metabolism , Angiotensin-Converting Enzyme 2/analysis , Biological Variation, Population , Bronchi/cytology , Bronchi/pathology , Bronchi/virology , COVID-19/virology , Epithelial Cells , Female , Humans , Male , Primary Cell Culture , Receptors, Coronavirus/analysis , Respiratory Mucosa/cytology , Respiratory Mucosa/metabolism , Respiratory Mucosa/pathology , Respiratory Mucosa/virology , Sex Factors , Virus Internalization
13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-291207

ABSTRACT

Since the emergence of Corona Virus Disease 2019 (COVID-19) in Wuhan city, Hubei Province, China, it has caused thousands of deaths. As the ongoing outbreak of COVID-19 around the world, the number of deaths will definitely continue to increase. We aimed to further describe the clinical characteristics of dead cases with COVID-19 through a large sample and multi-centered study and to find some clinical predictors for the deterioration of COVID-19 during the process. Methods One hundred and seven patients (16 patients from Lei Shen-Shan Hospital, 54 patients from Seventh Hospital of Wuhan and 37 patients from Zhongnan Hospital of Wuhan University) with COVID-19 were enrolled in our research from Jan 22 to Feb 29, 2020. The demographic, clinical, radiological, laboratory and treatment data of all cases were analysed. Results Of the 107 dead patients with COVID-19, 71 (66.4%) were male and 36 (33.6%) were female. The mean age of the patients was 71.2 ± 12.1 years. 82 (76.6%) of patients had chronic diseases. The mean duration from admission to death was 9 (IQR,5-14) days. Respiratory functional damage was the most common one followed by heart and kidney. Hematuria was found in 36(33.6%) patients. 89(83.2%) patients’ albumin levels were decreased. 68(63.6%) patients had anemia. concerning laboratory results, 55 (69.6%) and 56 (70.1%) patients have the elevated white blood cells and elevated Neutrophils during the process;only 43 (54.4%) have the decreased Lymphocytes;The values of platelets and haemoglobin decreased in 64(81.0%) and 58 (73.4%) patients. Alanine aminotransferase and aspartate aminotransferase elevated in near half of patients, while almost 80% of patients have the decreased albumin. The elevated blood urea nitrogen and cystatin C were manifested in about 70% of patients. Procalcitonin was elevated in 38 (71.7%) patients. Conclusions In conclusion, the older men with chronic diseases are more likely to die from COVID-19. Apart from that, more attention should be pay on timely treatment, coinfections, malnutrition, and dysfunction of kidney and coagulation. The rising values (white blood cell, blood urea nitrogen, cystatin C, PCT and PT) and the decreased values (PLT, Hb and albumin) maybe meaningful for predict the poor prognosis.

14.
Adv Physiol Educ ; 45(4): 779-785, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1416731

ABSTRACT

The Coronavirus Disease 2019 pandemic has changed the way most people live and work, including the way in which students undertake study. To protect students during the pandemic, most schools in China adopted a study-at-home model. Under these circumstances, the pathophysiology teaching team at Tongji University considered how to reform teaching methods to minimize the impact of the pandemic on students' curriculum studies. This article describes our teaching reforms in detail, notably a combination of online education resources, online discussion courses, and a WeChat study group. We compared the effects of the reformed and traditional teaching approaches, including student performance and student evaluation of the reformed teaching methods. Analysis showed that although students were generally worried about the impact of the pandemic on their curriculum studies, their overall performance was not affected by the reformed teaching methods. Of interest, compared with traditional teaching, the proportion of students with higher final test scores (≥90 points) actually increased. The revised teaching methods promoted the learning of some students externally and internally and enhanced their enthusiasm for medical study and their academic performance. These approaches could be applied as a reference for future course arrangements after the pandemic.


Subject(s)
COVID-19 , Education, Distance , Curriculum , Humans , Pandemics , SARS-CoV-2
15.
Clin Cosmet Investig Dermatol ; 14: 1119-1124, 2021.
Article in English | MEDLINE | ID: covidwho-1394656

ABSTRACT

PURPOSE: During the COVID-19 pandemic, teledermatology service was increased rapidly. The purpose of our study was to analyze the characteristics of patients and common skin diseases via teledermatology during the COVID-19 pandemic in mainland China. PATIENTS AND METHODS: During weekends between January 21 and April 4, 2020, the data of patients who used teledermatology service via a mobile application were collected, including gender, age, and diagnosis. RESULTS: A total of 698 patients (315 men and 383 women), with a mean age of 26 years, used this service. The top ten common diseases in order of proportion were eczema (22%), acne (9%), atopic dermatitis (9%), urticaria (5%), contact dermatitis (5%), herpes zoster (3%), warts (3%), folliculitis (3%), prurigo (3%), and androgenetic alopecia (2%). When classified according to age groups, atopic dermatitis was the most common condition for patients in the first decade, acne was more prevalent in the second and third decades, and eczema was the most prevalent condition for all other age groups. CONCLUSION: The ten common diseases accounted for the majority of the evaluated cases and varied by age group, allowing individualizing teledermatology services.

16.
Neuropsychiatr Dis Treat ; 17: 2539-2547, 2021.
Article in English | MEDLINE | ID: covidwho-1359123

ABSTRACT

INTRODUCTION: Post-traumatic stress disorder (PTSD) has an adverse impact on the emotional health of prenatal maternal women and their offspring. During the Coronavirus Disease 2019 (COVID-19) pandemic, pregnant women are vulnerable to traumatic events and are prone to PTSD symptoms. The aim of the study was to explore the predictive effects of insomnia and somatization on PTSD in pregnant women by utilizing generalized additive model (GAM). MATERIALS AND METHODS: A total of 1638 pregnant women from three local cities in China underwent online survey on sleep quality, somatization, and PTSD symptoms tested by the Insomnia Severity Index (ISI), the subscale somatization of Symptom Checklist-90 (SCL-90-S) and the Checklist for DSM-5 (PCL-5), respectively. RESULTS: Insomnia was positively correlated with PTSD symptoms in pregnant women (p = 1.79×10-5). Interestingly, insomnia and somatization showed a complex non-primary linear interaction in predicting PTSD (p = 2.00×10-16). CONCLUSION: Our results suggest that insomnia is a prominent predictor of PTSD symptoms in pregnant women in the context of public emergencies. In addition, the effects of insomnia and somatization on PTSD symptoms are characterized by complex non-primary linear relationships.

18.
Infect Drug Resist ; 14: 2953-2956, 2021.
Article in English | MEDLINE | ID: covidwho-1341570

ABSTRACT

At the moment, the SARS-CoV-19 pandemic is still attacking the health of humanity, and vaccines are the primary health strategy to eradicate this global challenge. So, with the exception of the SARS-CoV-2 vaccine, no vaccine for any disease has been brought to clinical use so quickly. Therefore, even with strict management, it can still bring some special adverse effects. One of the most notable is the adverse cardiovascular reactions to SARS-CoV-2 vaccines. No case reports of individuals with irreversible arrhythmia complications following the SARS-CoV-2 vaccine have been found in the available literature. We report the first case of a postoperative man with Marfan syndrome with atrial fibrillation after receiving the SARS-CoV-2 vaccine.

19.
mBio ; 12(4): e0097021, 2021 08 31.
Article in English | MEDLINE | ID: covidwho-1338834

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality on a global scale. The etiologic agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initiates host cell entry when its spike protein (S) binds to its receptor, angiotensin-converting enzyme 2 (ACE2). In airway epithelia, the spike protein is cleaved by the cell surface protease TMPRSS2, facilitating membrane fusion and entry at the cell surface. This dependence on TMPRSS2 and related proteases suggests that protease inhibitors might limit SARS-CoV-2 infection in the respiratory tract. Here, we tested two serine protease inhibitors, camostat mesylate and nafamostat mesylate, for their ability to inhibit entry of SARS-CoV-2 and that of a second pathogenic coronavirus, Middle East respiratory syndrome coronavirus (MERS-CoV). Both camostat and nafamostat reduced infection in primary human airway epithelia and in the Calu-3 2B4 cell line, with nafamostat exhibiting greater potency. We then assessed whether nafamostat was protective against SARS-CoV-2 in vivo using two mouse models. In mice sensitized to SARS-CoV-2 infection by transduction with human ACE2, intranasal nafamostat treatment prior to or shortly after SARS-CoV-2 infection significantly reduced weight loss and lung tissue titers. Similarly, prophylactic intranasal treatment with nafamostat reduced weight loss, viral burden, and mortality in K18-hACE2 transgenic mice. These findings establish nafamostat as a candidate for the prevention or treatment of SARS-CoV-2 infection and disease pathogenesis. IMPORTANCE The causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), requires host cell surface proteases for membrane fusion and entry into airway epithelia. We tested the hypothesis that inhibitors of these proteases, the serine protease inhibitors camostat and nafamostat, block infection by SARS-CoV-2. We found that both camostat and nafamostat reduce infection in human airway epithelia, with nafamostat showing greater potency. We then asked whether nafamostat protects mice against SARS-CoV-2 infection and subsequent COVID-19 lung disease. We performed infections in mice made susceptible to SARS-CoV-2 infection by introducing the human version of ACE2, the SARS-CoV-2 receptor, into their airway epithelia. We observed that pretreating these mice with nafamostat prior to SARS-CoV-2 infection resulted in better outcomes, in the form of less virus-induced weight loss, viral replication, and mortality than that observed in the untreated control mice. These results provide preclinical evidence for the efficacy of nafamostat in treating and/or preventing COVID-19.


Subject(s)
Benzamidines/pharmacology , Esters/pharmacology , Guanidines/pharmacology , SARS-CoV-2/drug effects , Serine Endopeptidases/metabolism , Serine Proteinase Inhibitors/pharmacology , Virus Internalization/drug effects , Angiotensin-Converting Enzyme 2/genetics , Animals , COVID-19/drug therapy , Cells, Cultured , Disease Models, Animal , Drug Evaluation, Preclinical , Humans , Lung/pathology , Mice , Mice, Inbred C57BL , Mice, Transgenic , Middle East Respiratory Syndrome Coronavirus/drug effects , Respiratory Mucosa/pathology , Respiratory Mucosa/virology , Spike Glycoprotein, Coronavirus/metabolism
20.
Risk Manag Healthc Policy ; 14: 2825-2829, 2021.
Article in English | MEDLINE | ID: covidwho-1317169

ABSTRACT

INTRODUCTION: Miliary intrapulmonary carcinomatosis (MIPC) is very rare in the existing literature. We reported a lung adenocarcinoma patient presented with over 200 uniform size pulmonary nodules in all lung lobes at the initial examination. The application of artificial intelligence (AI) in lung cancer has been gradually reported, but not yet reported in MIPC. The application of AI in this rare disease is worth exploring. PATIENT INFORMATION: A 57-year-old woman received chest computed tomography (CT) scan because of dry cough, intermittent chest wall and back pain for 3 weeks. CT imaging found over 200 uniform size pulmonary nodules in an evenly dispersed pattern at bilateral lungs with a 38×45mm new creature at the dorsal segment of the lower lobe of the left lung. However, as a very reliable diagnostic assistant system in CT imaging of lung cancer, AI can only identify 18 nodules in such classic metastatic lung cancer case. CONCLUSION: This case provides classical imaging figures as textbook-like, even though there is no such classic imaging of lung metastases in the existing textbooks. This medical imaging material will impress medical students and help them learn about the disease deeply. This medical imaging material can warn patients to recognize the horror of lung cancer metastasis and has good popularization of science. This medical imaging material presents a new challenge for AI.

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