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1.
Canadian Respiratory Journal ; 2021, 2021.
Article | WHO COVID | ID: covidwho-1093889

ABSTRACT

We aimed to investigate changes in pulmonary function and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) during the recovery period COVID-19 patients underwent symptom assessment, pulmonary function tests, and high-resolution chest CT 6 months after discharge from the hospital Of the 54 patients enrolled, 31 and 23 were in the moderate and severe group, respectively The main symptoms 6 months after discharge were fatigue and exertional dyspnea, experienced by 24 1% and 18 5% of patients, respectively, followed by smell and taste dysfunction (9 3%) and cough (5 6%) One patient dropped out of the pulmonary function tests Of the remaining 54 patients, 41 5% had pulmonary dysfunction Specifically, 7 5% presented with restrictive ventilatory dysfunction (forced vital capacity <80% of the predicted value), 18 9% presented with small airway dysfunction, and 32 1% presented with pulmonary diffusion impairment (diffusing capacity for carbon monoxide <80% of the predicted value) Of the 54 patients enrolled, six patients dropped out of the chest CT tests Eleven of the remaining 48 patients presented with abnormal lung CT findings 6 months after discharge Patients with residual lung lesions were more common in the severe group (52 6%) than in the moderate group (3 4%);a higher proportion of patients had involvement of both lungs (42 1% vs 3 4%) in the severe group The residual lung lesions were mainly ground-glass opacities (20 8%) and linear opacities (14 6%) Semiquantitative visual scoring of the CT findings revealed significantly higher scores in the left, right, and both lungs in the severe group than in the moderate group COVID-19 patients 6 months after discharge mostly presented with fatigue and exertional dyspnea, and their pulmonary dysfunction was mostly characterized by pulmonary diffusion impairment As revealed by chest CT, the severe group had a higher prevalence of residual lesions than the moderate group, and the residual lesions mostly manifested as ground-glass opacities and linear opacities

2.
Protein Sci ; 2021 Feb 16.
Article in English | MEDLINE | ID: covidwho-1086532

ABSTRACT

The pandemic outbreak of coronavirus disease 2019 (COVID-19) across the world has led to millions of infection cases and caused a global public health crisis. Current research suggests that SARS-CoV-2 is a highly contagious coronavirus that spreads rapidly through communities. To understand the mechanisms of viral replication, it is imperative to investigate coronavirus viral replicase, a huge protein complex comprising up to 16 viral nonstructural and associated host proteins, which is the most promising antiviral target for inhibiting viral genome replication and transcription. Recently, several components of the viral replicase complex in SARS-CoV-2 have been solved to provide a basis for the design of new antiviral therapeutics. Here, we report the crystal structure of the SARS-CoV-2 nsp7+8 tetramer, which comprises two copies of each protein representing nsp7's full-length and the C-terminus of nsp8 owing to N-terminus proteolysis during the process of crystallization. We also identified a long helical extension and highly flexible N-terminal domain of nsp8, which is preferred for interacting with single-stranded nucleic acids.

3.
Journal of the American Society of Nephrology ; 32(1):151-160, 2021.
Article | WHO COVID | ID: covidwho-1080996

ABSTRACT

Background: Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes However, AKI among hospitalized patients with COVID-19 in the United States is not well described

4.
Curr Med Sci ; 41(1): 39-45, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1084651

ABSTRACT

Infection-associated hemophagocytic syndrome (IAHS), a severe complication of various infections, is potentially fatal. This study aims to determine whether IAHS occurs in critically ill patients with coronavirus disease 2019 (COVID-19). We conducted a retrospective observational study on 268 critically ill patients with COVID-19 between February 1st, 2020 and February 26th, 2020. Demographics, clinical characteristics, laboratory results, information on concurrent treatments and outcomes were collected. A diagnosis of secondary hemophagocytic lymphohistiocytosis (sHLH) was made when the patients had an HScore greater than 169. Histopathological examinations were performed to confirm the presence of hemophagocytosis. Of 268 critically ill patients with confirmed SARS-CoV-2 infection, 17 (6.3%) patients had an HScore greater than 169. All the 17 patients with sHLH died. The interval from the onset of symptom of COVID-19 to the time of a diagnosis of sHLH made was 19 days and the interval from the diagnosis of sHLH to death was 4 days. Ten (59%) patients were infected with only SARS-CoV-2. Hemophagocytosis in the spleen and the liver, as well as lymphocyte infiltration in the liver on histopathological examinations, was found in 3 sHLH autopsy patients. Mortality in sHLH patients with COVID-19 is high. And SARS-CoV-2 is a potential trigger for sHLH. Prompt recognition of IAHS in critically ill patients with COVID-19 could be beneficial for improving clinical outcomes.


Subject(s)
/complications , Lymphohistiocytosis, Hemophagocytic/mortality , Adult , Aged , Critical Illness , Female , Humans , Lymphohistiocytosis, Hemophagocytic/etiology , Male , Middle Aged , Mortality , Prognosis , Retrospective Studies
5.
Eur J Radiol ; 137: 109602, 2021 Feb 15.
Article in English | MEDLINE | ID: covidwho-1084604

ABSTRACT

PURPOSE: Differentiating COVID-19 from other acute infectious pneumonias rapidly is challenging at present. This study aims to improve the diagnosis of COVID-19 using computed tomography (CT). METHOD: COVID-19 was confirmed mainly by virus nucleic acid testing and epidemiological history according to WHO interim guidance, while other infectious pneumonias were diagnosed by antigen testing. The texture features were extracted from CT images by two radiologists with 5 years of work experience using modified wavelet transform and matrix computation analyses. The random forest (RF) classifier was applied to identify COVID-19 patients and images. RESULTS: We retrospectively analysed the data of 95 individuals (291 images) with COVID-19 and 96 individuals (279 images) with other acute infectious pneumonias, including 50 individuals (160 images) with influenza A/B. In total, 6 texture features showed a positive association with COVID-19, while 4 features were negatively associated. The mean AUROC, accuracy, sensitivity, and specificity values of the 5-fold test sets were 0.800, 0.722, 0.770, and 0.680 for image classification and 0.858, 0.826, 0.809, and 0.842 for individual classification, respectively. The feature 'Correlation' contributed most both at the image level and individual level, even compared with the clinical factors. In addition, the texture features could discriminate COVID-19 from influenza A/B, with an AUROC of 0.883 for images and 0.957 for individuals. CONCLUSIONS: The developed texture feature-based RF classifier could assist in the diagnosis of COVID-19, which could be a rapid screening tool in the era of pandemic.

7.
Aging (Albany NY) ; 13(3): 3176-3189, 2021 02 09.
Article in English | MEDLINE | ID: covidwho-1076957

ABSTRACT

To establish an effective nomogram for predicting in-hospital mortality of COVID-19, a retrospective cohort study was conducted in two hospitals in Wuhan, China, with a total of 4,086 hospitalized COVID-19 cases. All patients have reached therapeutic endpoint (death or discharge). First, a total of 3,022 COVID-19 cases in Wuhan Huoshenshan hospital were divided chronologically into two sets, one (1,780 cases, including 47 died) for nomogram modeling and the other (1,242 cases, including 22 died) for internal validation. We then enrolled 1,064 COVID-19 cases (29 died) in Wuhan Taikang-Tongji hospital for external validation. Independent factors included age (HR for per year increment: 1.05), severity at admission (HR for per rank increment: 2.91), dyspnea (HR: 2.18), cardiovascular disease (HR: 3.25), and levels of lactate dehydrogenase (HR: 4.53), total bilirubin (HR: 2.56), blood glucose (HR: 2.56), and urea (HR: 2.14), which were finally selected into the nomogram. The C-index for the internal resampling (0.97, 95% CI: 0.95-0.98), the internal validation (0.96, 95% CI: 0.94-0.98), and the external validation (0.92, 95% CI: 0.86-0.98) demonstrated the fair discrimination ability. The calibration plots showed optimal agreement between nomogram prediction and actual observation. We established and validated a novel prognostic nomogram that could predict in-hospital mortality of COVID-19 patients.

8.
International Journal of Infectious Diseases ; 103:647-653, 2021.
Article | WHO COVID | ID: covidwho-1065167

ABSTRACT

This is the first report on the detailed characteristics of hospitalized patients with COVID-19 and epileptic seizures This report estimated the proportion of severe/critical patients and mortality in patients with epilepsy Individuals with epilepsy seizures were not likely to have recurrent seizures if antiepileptic drugs treatment continue before and after admission This study aims to present the clinical characteristics of 30 hospitalized cases with epileptic seizures and coronavirus disease 2019(COVID-19) This is a retrospective observational research study Clinical data were extracted from electronic medical records in 1550 patients with a laboratory-confirmed diagnosis of COVID-19, who were hospitalized in Wuhan Central Hospital, China, from 1 January to 31 April 2020 30 COVID-19 patients with the diagnosis of epilepsy were enrolled The clinical characteristics, complications, treatments, and clinical outcomes of 30 cases were collected and analyzed Of 30 patients with a diagnosis of epilepsy and COVID-19, 13 patients (43 4%) had new-onset epileptic seizures without an epilepsy history(new-onset seizure group, NS group), ten patients(33 3%) had an epilepsy history with a recurrent epileptic seizure (recurrent seizure group, RS group) and seven patients(23 3%) had an epilepsy history but no seizure during the course of COVID-19 (epilepsy history group, EH group) Patients in the RS group had a larger number of other-neurological-disease histories than those in the NS and EH groups (7/10[70%] VS 1/13 [7 7%] VS 1/7[14 3%]);the difference between the RS group and NS group is significant (P < 0 05) Patients in the NE and RS groups suffered more severe/critical COVID-19 infection than patients in the EH group (10/13[76 9%] VS 6/10[60%] VS 1/7[14 3%]);the difference between the NS group and EH group is significant (P < 0 05) 36 7% of patients had one to five neurological complications, and 46 4% of patients had 6–10 neurological complications The complications in patients with seizures (in the RS and NS groups) seem to be more than those without seizures (in the EH group), but it did not reach statistical significance The proportion of antiepileptic drugs (AEDs) treatment before admission was higher in the EH group than in the RE group(7/7 [100%] VS 2/10 [20%], P < 0 05) The mortality of 30 patients with epilepsy and COVID-19 was 36 67% The mortality of the NS group(38 5%) and the RS group(50%) were a little higher than in the EH group(14 3%) None of the convalescent patients had a recurrent seizure, and there were no more deaths in the 3-month follow-up after discharge COVID-19 patients with recurrent epileptic seizures had more underlying neurological diseases than patients who had an epilepsy history but without a seizure Patients with new-onset and recurrent epileptic seizures suffered more severe/critical COVID-19, which may lead to a worse prognosis If patients with epilepsy history continue using AEDs during COVID-19 pandemics, the risk of recurrent seizure may be reduced, and a good prognosis for patients with epilepsy history could be expected [ABSTRACT FROM AUTHOR] Copyright of International Journal of Infectious Diseases is the property of Elsevier B V and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

9.
Commun Biol ; 4(1): 35, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1065967

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a global pandemic posing significant health risks. The diagnostic test sensitivity of COVID-19 is limited due to irregularities in specimen handling. We propose a deep learning framework that identifies COVID-19 from medical images as an auxiliary testing method to improve diagnostic sensitivity. We use pseudo-coloring methods and a platform for annotating X-ray and computed tomography images to train the convolutional neural network, which achieves a performance similar to that of experts and provides high scores for multiple statistical indices (F1 scores > 96.72% (0.9307, 0.9890) and specificity >99.33% (0.9792, 1.0000)). Heatmaps are used to visualize the salient features extracted by the neural network. The neural network-based regression provides strong correlations between the lesion areas in the images and five clinical indicators, resulting in high accuracy of the classification framework. The proposed method represents a potential computer-aided diagnosis method for COVID-19 in clinical practice.


Subject(s)
/diagnosis , Deep Learning , Neural Networks, Computer , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Algorithms , /virology , Humans , Reverse Transcriptase Polymerase Chain Reaction , /physiology , Sensitivity and Specificity
10.
MedComm ; n/a(n/a), 2021.
Article | WHO COVID | ID: covidwho-1062116

ABSTRACT

Abstract Novel Coronavirus disease 2019 (COVID-19) has spread rapidly around the world Individuals with immune dysregulation and/or on immunosuppressive therapy, such as rheumatic patients, are considered at greater risk for infections However, the risks of patients with each subcategory of rheumatic diseases have not been reported Here, we identified 100 rheumatic patients from 18,786 COVID-19 patients hospitalized in 23 centers affiliated to Hubei COVID-19 Rheumatology Alliance between January 1 and April 1, 2020 Demographic information, medical history, length of hospital stay, classification of disease severity, symptoms and signs, laboratory tests, disease outcome, computed tomography, and treatments information were collected Compared to gout and ankylosing spondylitis (AS) patients, patients with connective tissue disease (CTD) tend to be more severe after COVID-19 infection (p = 0 081) CTD patients also had lower lymphocyte counts, hemoglobin, and platelet counts (p values were 0 033, < 0 001, and 0 071, respectively) Hydroxychloroquine therapy and low- to medium-dose glucocorticoids before COVID-19 diagnosis reduced the progression of COVID-19 to severe/critical conditions (p = 0 001 for hydroxychloroquine;p = 0 006 for glucocorticoids) Our data suggests that COVID-19 in CTD patients may be more severe compared to patients with AS or gout

11.
Chin J Integr Med ; 2021 Feb 03.
Article in English | MEDLINE | ID: covidwho-1061046

ABSTRACT

OBJECTIVE: To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process. METHODS: This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed. RESULTS: All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026-8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased. CONCLUSIONS: Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430).

12.
Chinese Medical Journal ; 133(12):1470-1472, 2020.
Article | WHO COVID | ID: covidwho-1050188

ABSTRACT

[8] But the study conducted by Aso et al[9] did not find significant difference in mortality during hospitalization between patients with and those without cyclosporine A As for tacrolimus, a study showed that patients who received glucocorticoids and tacrolimus not only had improved survival rate and duration, but also had reduced AE recurrence, in comparison with patients who received glucocorticoids alone [14] It was retrospective, and a RCT (NCT03584802) was sponsored by Assistance Publique-Hôpitaux de Paris to evaluate the efficacy and safety of glucocorticoids combined with plasma exchanges, rituximab, and IVIG vs standard glucocorticoid therapy in patients admitted in intensive care unit with severe AE-IPF Because of the coronavirus disease 2019 epidemics, the study has been suspended [19] Extracorporeal membrane oxygenation (ECMO) is now regarded as a lifesaving option for patients who are candidates for lung transplantation, because it is unable to reverse the progression of interstitial lung disease and acute respiratory failure

13.
Clin Lab ; 67(1)2021 Jan 01.
Article in English | MEDLINE | ID: covidwho-1045292

ABSTRACT

BACKGROUND: The COVID-19 outbreak, which began in late 2019, continues to ravage the globe and has become the greatest threat to human health. As nucleic acid test is the primary means of screening for COVID-19, this makes the laboratory the most important node in the epidemic prevention and control system. METHODS: As a small laboratory in the hospital, we can meet a large number of demands for nucleic acid test by optimizing staff process, strictly disinfecting experimental batches and changing experimental methods. RESULTS: Through the improvement of the above aspects, our daily maximum detection quantity has been increased from 256/day to 1,012/day. Besides, none of the medical staff has been infected. And there have been no nosocomial infections. CONCLUSIONS: Nucleic acid laboratories, especially small laboratories, should promptly adjust their strategies in the face of unexpected outbreaks and conduct risk assessment in accordance with laboratory activities.


Subject(s)
/diagnosis , Health Services Needs and Demand/organization & administration , Mass Screening/organization & administration , Specimen Handling , Workflow , Workload , Humans , Infection Control/organization & administration , Occupational Health , Predictive Value of Tests
14.
J Perinat Med ; 49(2): 237-240, 2021 Feb 23.
Article in English | MEDLINE | ID: covidwho-1038536

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) had become a worldwide pandemic, however, information is limited on the asymptomatic proportion and thromboembolism risk of pregnant women with infection. METHODS: All 32 pregnant women with COVID-19 who were admitted to the hospital in Wuhan during the outbreak from January 20 to March 18, 2020, were retrospectively reviewed for the clinical records, laboratory tests, chest CT scans, and neonatal outcomes. RESULTS: There were 17 of the 32 patients (53%) with no subjective symptoms before admission, and 13 (41%) remained asymptomatic throughout hospitalization. There were 28 patients (88%) showing typical radiographic evidence of pneumonia on chest CT. The patients with COVID-19 were found in an increased risk of thromboembolism with much higher D-dimer levels than uninfected pregnant women. One neonate with asphyxia and positive immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies was reported. CONCLUSIONS: The considerable asymptomatic proportion of pregnant women with COVID-19 indicates symptom-based screening would miss a number of cases. Chest CT could provide a useful screening resource during the COVID-19epidemic outbreak. Anticoagulation therapy for the postpartum patients may be helpful for good prognosis. The findings provide important information for the hospital isolation, control strategies and clinical therapy.

15.
Food Addit Contam Part A Chem Anal Control Expo Risk Assess ; : 1-12, 2020 Nov 09.
Article in English | MEDLINE | ID: covidwho-1024072

ABSTRACT

Coix seed is an important food and traditional Chinese medicine in China and other Asian countries. Notably, coix seed is currently being used as a traditional medicine for the treatment of COVID-19 in China. However, coix seeds are generally contaminated by mycotoxins, and this risk cannot be ignored. In this paper, we developed a method that involves direct extraction and UHPLC-HRMS analysis for the simultaneous detection of 24 mycotoxins in coix seeds. UHPLC-HRMS instrument and data acquisition parameters, and the sample pretreatment were optimised. One-step extraction showed several advantages compared to the three commercial solid-phase extraction clean-up methods, including ease of use, reduced time of sample preparation, low cost, good recovery, and acceptable matrix effect. The method validation results indicate that all mycotoxins have good linearity and sensitivity. Recoveries were between 74.2-101.1%, and RSD ranged from 0.1-5.8%. The LOQs for 24 mycotoxins were in the range of 0.5-100 µg/kg. To survey the contamination levels of these mycotoxins in commercial coix seeds, more than 70 samples were collected from Chinese markets and were analysed using the newly developed method. Zearalenone (positive ratio: 98.7%, range:1.1-1562 µg/kg), deoxynivalenol (positive ratio: 87%, range: 8.4-382.5 µg/kg), nivalenol (positive ratio: 85.7%, range: 26.8-828.2 µg/kg), fumonisin B1 (positive ratio: 84.4%, range:2.5-314.5 µg/kg), fumonisin B2 (positive ratio: 75.3%, range:1.6-72.8 µg/kg), fumonisin B3 (positive ratio: 48%, range:1.0-203.6 µg/kg), aflatoxin B1 (positive ratio: 29.9%, range: 0.39-14.7 µg/kg), sterigmatocystin (positive ratio: 29.9%, range: 1.4-51.6 µg/kg), and tenuazonic acid (positive ratio: 19.5%, range 36.1-105.7 µg/kg) were the most frequent mycotoxin contaminants. These results highlight the importance of routine monitoring and control of mycotoxins in coix seeds.

18.
Preprint | SciFinder | ID: ppcovidwho-5267

ABSTRACT

A review The outbreak of COVID-19 caused by a novel coronavirus known as SARS-CoV-2 has initiated the first-grade national response in China and listed as a public health emergency of international concern (PHEIC) by WHO In this article, the authors summarized their front-line clin experience in fighting against COVID-19 in combination with literature review to illustrate the clin manifestations and diagnostic and therapeutic measures for COVID-19 patients, especially the identification and treatment strategies for severe COVID-19 patients, aiming to provide reference for the front-line clinicians

19.
Preprint | SciFinder | ID: ppcovidwho-5191

ABSTRACT

Guidance for the construction and prevention and control strategies of new coronavirus (SARS-CoV-2) infection in pharmacy

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