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1.
BMJ : British Medical Journal (Online) ; 377, 2022.
Article in English | ProQuest Central | ID: covidwho-1807349

ABSTRACT

ObjectiveTo evaluate sintilimab versus placebo in combination with chemotherapy (cisplatin plus paclitaxel or cisplatin plus 5-fluorouracil) as first line treatment of unresectable locally advanced, recurrent, or metastatic oesophageal squamous cell carcinoma.DesignMulticentre, randomised, double blind, phase 3 trial.Setting66 sites in China and 13 sites outside of China between 14 December 2018 and 9 April 2021.Participants659 adults (aged ≥18 years) with advanced or metastatic oesophageal squamous cell carcinoma who had not received systemic treatment.InterventionParticipants were randomised 1:1 to receive sintilimab or placebo (3 mg/kg in patients weighing <60 kg or 200 mg in patients weighing ≥60 kg) in combination with cisplatin 75 mg/m2 plus paclitaxel 175 mg/m2 every three weeks. The trial was amended to allow investigators to choose the chemotherapy regimen: cisplatin plus paclitaxel or cisplatin plus 5-fluorouracil (800 mg/m2 continuous infusion on days 1-5).Main outcome measuresOverall survival in all patients and in patients with combined positive scores of ≥10 for expression of programmed cell death ligand 1.Results659 patients were randomly assigned to sintilimab (n=327) or placebo (n=332) with chemotherapy. 616 of 659 patients (93%) received sintilimab or placebo in combination with cisplatin plus paclitaxel and 43 of 659 patients (7%) received sintilimab or placebo in combination with cisplatin plus 5-fluorouracil. At the interim analysis, sintilimab with chemotherapy showed better overall survival compared with placebo and chemotherapy in all patients (median 16.7 v 12.5 months, hazard ratio 0.63, 95% confidence interval 0.51 to 0.78, P<0.001) and in patients with combined positive scores of ≥10 (17.2 v 13.6 months, 0.64, 0.48 to 0.85, P=0.002). Sintilimab and chemotherapy significantly improved progression free survival compared with placebo and chemotherapy in all patients (7.2 v 5.7 months, 0.56, 0.46 to 0.68, P<0.001) and in patients with combined positive scores of ≥10 (8.3 v 6.4 months, 0.58, 0.45 to 0.75, P<0.001). Adverse events related to treatment occurred in 321 of 327 patients (98%) in the sintilimab-chemotherapy group versus 326 of 332 (98%) patients in the placebo-chemotherapy group. Rates of adverse events related to treatment, grade ≥3, were 60% (196/327) and 55% (181/332) in the sintilimab-chemotherapy and placebo-chemotherapy groups, respectively.ConclusionsCompared with placebo, sintilimab in combination with cisplatin plus paclitaxel showed significant benefits in overall survival and progression free survival as first line treatment in patients with advanced or metastatic oesophageal squamous cell carcinoma. Similar benefits of sintilimab with cisplatin plus 5-fluorouracil seem promising.Trial registrationClinicalTrials.gov NCT03748134.

2.
IEEE Transactions on Automation Science & Engineering ; 19(2):663-676, 2022.
Article in English | Academic Search Complete | ID: covidwho-1806964

ABSTRACT

During the outbreak of epidemics such as coronavirus disease (COVID-19), the local hospitals often withstand a sharp increase of patient influx, which renders the healthcare system on the verge of collapse. To alleviate the situation, the effective allocation of scarce medical resources during the pandemic plays a vital role. The essence of the healthcare system in time of emergency is to stay functional, and to be able to diagnose and hospitalize as many patients as possible. Fangcang shelter hospital, as a novel way to temporarily increase the capacity of the local healthcare system, is proven to be effective against the COVID-19 pandemic. To improve the performance of the healthcare system with Fangcang, many practical factors need to be taken into account, such as the patient deterioration during waiting to be admitted, the referral mechanism according to the severity of the patients, and the selective admission regulations. To address the high volatility and time-varying feature of the COVID-19, a multistage and multi-type medical service network model is established, and a dynamic allocation strategy of the medical resources at each stage is proposed based on a stochastic optimization problem, which is then solved via the fluid queueing approximation. Combined with the real data collected from Wuhan, it is revealed that the proposed algorithm could help with the allocation of medical resources during the outbreak of epidemics. Even with limited medical resources available, the method could still maintain a guaranteed service level while keeping the healthcare system operational. Furthermore, the simulation analysis validates that our method can effectively allocate medical resources at each stage, so as to stabilize the system performance and fulfill the medical demand for multiple types of patients. Note to Practitioners—To fend off the outbreak of epidemics, the lessons have to be learned from the past. The successful control of the spread of COVID-19 in Wuhan (China) is a classical example of applying modern medical practices and management tools. In the present article, the treating procedure of COVID-19 in Wuhan is modeled as a multistage decision problem, which includes the screening with nucleic acid testing, the further testing, the treatment of patients with mild/severe symptoms, or even critical patients. The introduction of Fangcang shelter hospital is crucial for winning the battle against COVID-19. The current study attempts to determine the timing of introducing the Fangcang shelter hospital during the outbreak of a major epidemic, and helps allocate the medical resources needed to contain the spread of the virus. It is discovered that the actual number of beds in the Fangcang shelter hospital is far more than what is necessary, and it would be better to have built the Fangcang some time in advance. In the meantime, the number of designated hospitals for COVID-19 is in line with the results obtained via the optimal staffing strategy proposed here, but it is also noticeable that these hospitals should be released of duty sooner to fight against not only COVID-19 but also other diseases in reality. [ FROM AUTHOR] Copyright of IEEE Transactions on Automation Science & Engineering is the property of IEEE 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 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 . (Copyright applies to all s.)

3.
Signal Transduct Target Ther ; 6(1): 427, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1795805

ABSTRACT

Abnormal glucose and lipid metabolism in COVID-19 patients were recently reported with unclear mechanism. In this study, we retrospectively investigated a cohort of COVID-19 patients without pre-existing metabolic-related diseases, and found new-onset insulin resistance, hyperglycemia, and decreased HDL-C in these patients. Mechanistically, SARS-CoV-2 infection increased the expression of RE1-silencing transcription factor (REST), which modulated the expression of secreted metabolic factors including myeloperoxidase, apelin, and myostatin at the transcriptional level, resulting in the perturbation of glucose and lipid metabolism. Furthermore, several lipids, including (±)5-HETE, (±)12-HETE, propionic acid, and isobutyric acid were identified as the potential biomarkers of COVID-19-induced metabolic dysregulation, especially in insulin resistance. Taken together, our study revealed insulin resistance as the direct cause of hyperglycemia upon COVID-19, and further illustrated the underlying mechanisms, providing potential therapeutic targets for COVID-19-induced metabolic complications.


Subject(s)
COVID-19/blood , Hyperglycemia/blood , Insulin Resistance , Lipid Metabolism , Lipids/blood , SARS-CoV-2/metabolism , Adult , Aged , Biomarkers/blood , COVID-19/complications , Female , Humans , Hyperglycemia/etiology , Male , Middle Aged , Retrospective Studies
4.
BMC Vet Res ; 18(1): 90, 2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1789121

ABSTRACT

BACKGROUND: Infectious bronchitis virus (IBV) leads to huge economic losses in the poultry industry worldwide. The high levels of mutations of IBV render vaccines partially protective. Therefore, it is urgent to explore an effective antiviral drug or agent. The present study aimed to investigate the in vivo anti-IBV activity of a mixture of plant essential oils (PEO) of cinnamaldehyde (CA) and glycerol monolaurate (GML), designated as Jin-Jing-Zi. RESULTS: The antiviral effects were evaluated by clinical signs, viral loads, immune organ indices, antibody levels, and cytokine levels. The infection rates in the PEO-M (middle dose) and PEO-H (high dose) groups were significantly lower than those in the prevention, positive drug, and PEO-L (low dose) groups. The cure rates in the PEO-M and PEO-H groups were significantly higher than those in the prevention, positive drug, and PEO-L groups, and the PEO-M group had the highest cure rate of 92.31%. The symptom scores and IBV mRNA expression levels were significantly reduced in the PEO-M group. PEO significantly improved the immune organ indices and IBV-specific antibody titers of infected chickens. The anti-inflammatory factor levels of IL-4 and IFN-γ in the PEO-M group maintained high concentrations for a long time. The IL-6 levels in the PEO-M group were lower than those in prevention, positive drug, and PEO-L groups. CONCLUSION: The PEO had remarkable inhibition against IBV and the PEO acts by inhibiting virus multiplication and promoting immune function, suggesting that the PEO has great potential as a novel anti-IBV agent for inhibiting IBV infection.


Subject(s)
Coronavirus Infections , Infectious bronchitis virus , Oils, Volatile , Poultry Diseases , Viral Vaccines , Animals , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Chickens , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Coronavirus Infections/veterinary , Oils, Volatile/pharmacology , Oils, Volatile/therapeutic use , Plant Oils/pharmacology , Plant Oils/therapeutic use , Poultry Diseases/drug therapy , Poultry Diseases/prevention & control , Viral Vaccines/therapeutic use
5.
Pathogens ; 11(4):452, 2022.
Article in English | MDPI | ID: covidwho-1785869

ABSTRACT

During the COVID-19 pandemic, many general hospitals have been transformed into designated infectious disease care facilities, where a large number of patients with COVID-19 infections have been treated and discharged. With declines in the number of hospitalizations, a major question for our healthcare systems, especially for these designated facilities, is how to safely resume hospital function after these patients have been discharged. Here, we take a designated COVID-19-care facility in Wuhan, China, as an example to share our experience in resuming hospital function while ensuring the safety of patients and medical workers. After more than 1200 patients with COVID-19 infections were discharged in late March, 2020, our hospital resumed function by setting up a three-level hospital infection management system with four grades of risk of exposure. Moreover, we also took measures to ensure the safety of medical personnel in different departments including clinics, wards, and operation rooms. After all patients with COVID-19 infections were discharged, during the five months of regular function from April to September in 2020, no positive cases have been found among more than 40,000 people in our hospital, including hospital staff and patients.

6.
Front Public Health ; 9: 700148, 2021.
Article in English | MEDLINE | ID: covidwho-1775816

ABSTRACT

Background: An increasing number of Chinese elderly women stay at home and act as grandchildren sitters. In consequence of the frequent load-bearing, chronic lumbar fatigue probably caused a higher risk of lumbar degeneration, fatigue, and injury which has become one of the most important aging and health problems in China. In this study, a multi-mode lumbar finite element model (FEM) with specific bone mineral density (BMD) were developed and validated for further spine injury prevention and control. Methods: The material properties of lumbar vertebra were modified according to degenerated bone mineral density, and geometry was adjusted based on intervertebral disc height. The motion of lifting children was simulated by a 76 year-old Chinese women's FEM, and the stress distribution was calculated and predicted. Results: The pressure of L5-S intervertebral disc in the bending 3-year-old dummy lifting posture was significantly higher than the same posture without lifting, the maximum effective stress of endplate cartilage in the upright child lifting posture was 1.6 times that of the bending without lifting posture. And the fatigue risk limitation frequency of the upright with dummy posture was predicted with the functional equation of fatigue and stress which was deduced by genetic algorithm, which combined with the effective stress of lumbar vertebrae spongy bone calculated from FEM. Conclusions: The child-lifting motion could increase the risk of lumbar degeneration, fatigue, and injury in elderly women, and they should keep below the frequency limit of the motion of lifting children in their daily life. This study could put forward scientific injury prevention guidance to Chinese elderly women who lift children in daily life frequently.


Subject(s)
Fatigue , Lumbar Vertebrae , Aged , Bone Density , Child, Preschool , Fatigue/etiology , Female , Humans , Risk Assessment
7.
Transbound Emerg Dis ; 2022 Feb 28.
Article in English | MEDLINE | ID: covidwho-1765047

ABSTRACT

Diarrhoea is one of the most important syndromes in neonatal calves. In industrialized nations with intensive animal farming, Cryptosporidium spp. and rotavirus are primary causes of calf diarrhoea, but the role of these and other enteric pathogens is not clear in China. In November and December 2018, a diarrhoea outbreak was identified in over 150 pre-weaned calves on a dairy farm in Heilongjiang Province, northeast China and approximately 60 calves died. To determine the cause of the outbreak, we analyzed 131 faecal samples collected from pre-weaned calves (0-2 months) during (n = 114) and after the outbreak (n = 17). Initially, 10 diarrheic samples during the outbreak and 10 non-diarrheic samples after the outbreak were screened for rotavirus, coronavirus, Escherichia coli K99 and Cryptosporidium parvum by using an enzymatic immunoassay (EIA). In addition, 81 other samples were tested specifically for rotavirus by EIA, and all 131 samples were analyzed for Cryptosporidium spp., Giardia duodenalis and Enterocytozoon bieneusi by PCR. The initial EIA analysis identified C. parvum (8/10) and rotavirus (5/10) as the dominant pathogens in calves during the outbreak, while both pathogens were detected at lower frequency after the outbreak (2/10 and 1/10, respectively). Further PCR analyses indicated that the occurrence of C. parvum infections in calves was significantly higher during the outbreak (75.4%, 86/114) than after the outbreak (11.8%, 2/17; odds ratio [OR] = 23.0), and was significantly associated with the occurrence of watery diarrhoea (OR = 15.7) and high oocyst shedding intensity. All C. parvum isolates were identified as subtype IIdA20G1. Among other pathogens analyzed, the overall prevalence of rotavirus, G. duodenalis and E. bieneusi was 19.8% (20/101), 38.9% (51/131) and 42.0% (55/131) in calves, respectively, without significant differences during and after the outbreak. Among the three pathogens, only the rotavirus infection was associated with diarrhoea in calves. More importantly, coinfections of C. parvum and rotavirus were significantly associated with the occurrence of watery diarrhoea in calves and were seen only during the outbreak. Thus, C. parvum subtype IIdA20G1 and rotavirus appeared to be responsible for this diarrhoea outbreak. Control measures should be implemented to effectively prevent the concurrent transmission of these enteric pathogens in pre-weaned dairy calves in China.

8.
J Med Internet Res ; 24(3): e31449, 2022 03 23.
Article in English | MEDLINE | ID: covidwho-1760105

ABSTRACT

BACKGROUND: The use of mobile health technologies has been necessary to deliver patient education to patients with diabetes during the COVID-19 pandemic. OBJECTIVE: This open-label randomized controlled trial evaluated the effects of a diabetes educational platform-Taipei Medical University-LINE Oriented Video Education-delivered through a social media app. METHODS: Patients with type 2 diabetes were recruited from a clinic through physician referral. The social media-based program included 51 videos: 10 about understanding diabetes, 10 about daily care, 6 about nutrition care, 21 about diabetes drugs, and 4 containing quizzes. The intervention group received two or three videos every week and care messages every 2 weeks through the social media platform for 3 months, in addition to usual care. The control group only received usual care. Outcomes were measured at clinical visits through self-reported face-to-face questionnaires at baseline and at 3 months after the intervention, including the Simplified Diabetes Knowledge Scale (true/false version), the Diabetes Care Profile-Attitudes Toward Diabetes Scales, the Summary of Diabetes Self-Care Activities, and glycated hemoglobin (HbA1c) levels. Health literacy was measured at baseline using the Newest Vital Sign tool. Differences in HbA1c levels and questionnaire scores before and after the intervention were compared between groups. The associations of knowledge, attitudes, and self-care activities with health literacy were assessed. RESULTS: Patients with type 2 diabetes completed the 3-month study, with 91 out of 181 (50.3%) patients in the intervention group and 90 (49.7%) in the control group. The change in HbA1c did not significantly differ between groups (intervention group: mean 6.9%, SD 0.8% to mean 7.0%, SD 0.9%, P=.34; control group: mean 6.7%, SD 0.6% to mean 6.7%, SD 0.7%, P=.91). Both groups showed increased mean knowledge scores at 12 weeks, increasing from 68.3% (SD 16.4%) to 76.7% (SD 11.7%; P<.001) in the intervention group and from 64.8% (SD 18.2%) to 73.2% (SD 12.6%; P<.001) in the control group. Positive improvements in attitudes and self-care activities were only observed in the intervention group (attitudes: mean difference 0.2, SD 0.5, P=.001; self-care activities: mean difference 0.3, SD 1.2, P=.03). A 100% utility rate was achieved for 8 out of 21 (38%) medication-related videos. Low health literacy was a significant risk factor for baseline knowledge scores in the intervention group, with an odds ratio of 2.80 (95% CI 1.28-6.12; P=.01); this became insignificant after 3 months. CONCLUSIONS: The social media-based program was effective at enhancing the knowledge, attitudes, and self-care activities of patients with diabetes. This intervention was also helpful for patients with low health literacy in diabetes knowledge. The program represents a potentially useful tool for delivering diabetes education to patients through social media, especially during the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04876274; https://clinicaltrials.gov/ct2/show/results/NCT04876274.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Self-Management , Social Media , Diabetes Mellitus, Type 2/therapy , Health Knowledge, Attitudes, Practice , Humans , Pandemics , Patient Education as Topic
10.
Front Microbiol ; 12: 803031, 2021.
Article in English | MEDLINE | ID: covidwho-1753384

ABSTRACT

Background: COVID-19 has caused more than 2.6 billion infections and several million deaths since its outbreak 2 years ago. We know very little about the long-term cellular immune responses and the kinetics of neutralizing antibodies (NAbs) to SARS-CoV-2 because it has emerged only recently in the human population. Methods: We collected blood samples from individuals who were from the first wave of the COVID-19 epidemic in Wuhan between December 30, 2019, and February 24, 2020. We analyzed NAbs to SARS-CoV-2 using pseudoviruses and IgG antibodies to SARS-CoV-2 spike (S) and nucleocapsid (N) protein using enzyme-linked immunosorbent assay in patients' sera and determined SARS-CoV-2-specific T-cell responses of patients with ELISpot assays. Results: We found that 91.9% (57/62) and 88.9% (40/45) of COVID-19 patients had NAbs against SARS-CoV-2 in a year (10-11 months) and one and a half years (17-18 months), respectively, after the onset of illness, indicating that NAbs against SARS-CoV-2 waned slowly and possibly persisted over a long period time. Over 80% of patients had IgG antibodies to SARS-CoV-2 S and N protein one and a half years after illness onset. Most patients also had robust memory T-cell responses against SARS-CoV-2 one and a half years after the illness. Among the patients, 95.6% (43/45) had an IFN-γ-secreting T-cell response and 93.8% (15/16) had an IL-2-secreting T-cell response. The T-cell responses to SARS-CoV-2 were positively correlated with antibodies (including neutralizing antibodies and IgG antibodies to S and N protein) in COVID-19 patients. Eighty percent (4/5) of neutralizing antibody-negative patients also had SARS-CoV-2-specific T-cell response. After long-term infection, protective immunity was independent of disease severity, sex, and age. Conclusions: We concluded that SARS-CoV-2 infection elicited a robust and persistent neutralizing antibody and memory T-cell response in COVID-19 patients, indicating that these sustained immune responses, among most SARS-CoV-2-infected people, may play a crucial role in protection against reinfection.

11.
Sustainability ; 14(5):3021, 2022.
Article in English | ProQuest Central | ID: covidwho-1742673

ABSTRACT

Under different carbon regulatory policies, corporate social responsibility (CSR) activities will have different impacts on the environmental benefits of the supply chain and corporate carbon emission reduction decisions. In this study, we examine a dual-channel closed-loop supply chain consisting of a single manufacturer selling re-products generated from waste products and a single retailer selling new products and consider two settings: enforcing a carbon tax policy or enforcing a subsidy policy. Under each setting, we put CSR into account, construct two models for the retailer to implement or not implement CSR activities, and analyze the decisions obtained under optimal solutions. Through numerical simulation and comparative research, we observe that the carbon tax policy applies to the supply chain where CSR activities are implemented, while the subsidy policy applies to the supply chain where CSR activities are not implemented. Reasonable selection of CSR implementation methods with low-cost coefficients by the retailer is conducive to eliminating profit conflicts among supply chain members. The government should fully consider the decision-making thresholds of supply chain members to ensure the maximum effectiveness of the policy.

12.
Security and Communication Networks ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-1731348

ABSTRACT

In the era of the COVID-19 (SARS-CoV-2) virus, it has become imperative to audit the environment surrounding us to prioritize public health and the healthcare system. This study aims to accelerate the reform of the economic development modes and the construction of a resource-friendly society. The environmental protection-oriented ecoenvironmental performance audit system is studied here. Based on the current situation of regional ecological pollution in the Yangtze River Economic Belt, the situation and existing problems are analyzed for the ecoenvironment in the Yangtze River Economic Belt from the perspectives of biodiversity, water ecoenvironment, wetland ecoenvironment, and forest ecoenvironment. Then, the situation is deeply analyzed for the ecoenvironmental performance audit project in the Yangtze River Economic Belt. Afterward, we explore the basic characteristics of the environmental audit and summarize the implementation path of resource and environmental audit. The results show that there are some problems in the control and utilization of funds for environmental protection and the development and protection of resources in the cities along the Yangtze River Economic Belt. Then we analyze the problems in the ecoenvironmental performance audit of the Yangtze River Economic Belt and give some suggestions for improving the ecoenvironmental performance audit work. The objective of this paper is to improve the application effect of ecoenvironmental performance audit and provide references for future environmental protection work which will have great impacts on public health and the development of healthcare services.

13.
Infectious Medicine ; 2022.
Article in English | PMC | ID: covidwho-1720101
14.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329546

ABSTRACT

Purpose: The immunogenicity of SARS-CoV-2 vaccines is poor in kidney transplant recipients (KTRs). The factors related to poor immunogenicity to vaccination in KTRs are not well defined. Methods An observational study was conducted in KTRs and healthy individuals who had received two doses of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor-binding domain found in the S1 subunit of the spike protein, and against nucleocapsid protein were measured using enzyme-linked immunosorbent assay. Receptor-binding domain (RBD)-angiotensin-converting enzyme 2 interaction-blocking antibodies were measured using commercial kits. T cell responses against the spike and nucleocapsid proteins were detected using enzyme-linked immunosorbent spot assay. Results No severe adverse effects were observed in KTRs after first or second dose of SARS-CoV-2 inactivated vaccine. IgG antibodies against the receptor- binding domain, and nucleocapsid protein were not effectively induced in a majority of KTRs after second dose of inactivated vaccine. Specific T cell immunity response was detectable in 32%-40% KTRs after second doses of inactivated vaccine. KTRs who developed specific T cell immunity were more likely to be female, and have lower levels of total bilirubin, unconjugated bilirubin, and blood tacrolimus concentration. Multivariate logistic regression analysis found that blood unconjugated bilirubin was significantly negatively associated with SARS-CoV-2 specific T cell immunity response in k KTRs. Conclusions Specific T cell immunity response could be induced in 32%-40% KTRs after two doses of inactivated vaccine. Blood unconjugated bilirubin was negatively associated with specific cellular immunity response in KTRs following vaccination.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316848

ABSTRACT

Background: The COVID-19 pandemic led to a global atmosphere of anxiety and depression. However, the impact of this disaster on mental health in pregnancy women was not clear. Methods Based on two cohort study, the Novel Coronavirus Disease Influenced Pregnant Cohort Study (NCP) set up during the COVID-19 epidemic and the Healthy Baby Cohort Study (HBC) set up in 2012, we compared the anxiety, depression and stress levels of pregnant women who did not or did go through the COVID-19 pandemic and analyzed the risk factors for mental health in pregnancy women. Results There were 784 and 2448 participants in the CNP and HBC studies involved in the analysis, respectively. We found that there were 23.09% and 4.72% pregnant women suffering for mild and moderate-to-several anxieties for those in the NCP study, and 21.53% and 3.06% in the HBC study. The mild and moderate-to-several depression rate was 25.89% and 11.35% for those in the NCP study, and 19.81% and 0.51% for those in the HBC study, respectively. No significant difference was found for anxiety, depression and stress levels was found at each gestational trimester ( p  > 0.05). The pandemic of COVID-19 was significantly associated with maternal depression and stress ( p  < 0.05), with the co-efficient and 95%CI as 0.37 (0.18, 0.55) and − 0.12 (-0.09, -0.32), respectively. Pregnant women with pre-pregnancy obesity, higher educational level or good sleep quality might have lower risks for anxiety, depression and stress compared with the referenced groups. conclusions The pandemic had a huge impact on depression, especially moderate-to-sever level, in pregnant women at whatever gestational week;and that pre-pregnancy obesity, highly educated and sleep well ones had less anxiety and depression risks. The society, especially the family members, should pay more attention to pregnant ones and give more social support to them.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315212

ABSTRACT

Background: Multiorgan damage by SARS-CoV-2 results in alterations of many clinical measures associated with mortality of COVID-19. This research discussed the pioneering pathogenicity factors that lead to the extensive damage elusive. Objectives: A cohort of COVID-19 patients. Methods: : We conducted a correlational analysis of hospital outcomes with an independent cohort of COVID-19 patients and we also presented a death case to illustrate for time course of immune cell density. Results: : The results showed that dysregulated immune cell densities were correlated with hospitalization duration before death, not before discharge. High neutrophil densities allowed sorting out one third of total death cases while a density of less than 70% of the white blood cells allowed sorting out 70% of surviving cases. Conclusion: Collectively surged neutrophil was a top trigger for mortality in patients with COVID-19.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315211

ABSTRACT

Background: Worldwide spread of the novel coronavirus disease 2019 (COVID-19) has made hundreds of thousands people sick and fortunately many of them have been treated and discharged. However, it remains unclear how well the discharged patients were recovering. Chest CT scan, with demonstrated high sensitivity to COVID-19, was used here to examine clinical manifestations in patients at discharge. Methods: This study registered retrospectively single-center case series of 180 discharged patients, all confirmed with COVID-19 at Wuhan Red Cross Hospital in Wuhan, China. Epidemiological, demographic, clinical, laboratory and treatment data were collected. CT imaging features of absorption vs progressive stage were compared and analyzed. Results: Five pulmonary lobes were affected in 54 (30%) of the 180 patients at the absorption stage, comparing to 66% of them at the progressive stage ( P=1.45×10 -11 ). Forty five (25%) patients had pleural effusion on admission and 13 of them still carried hydrothorax when discharged as per standard discharge criteria( P=4.48×10 -6 ). Besides, compared with those at progressive stage, 97 (54%) discharged patients had interlobular thickening ( P=6.95×10 -3 ) and 43% of them still presented adjacent pleura thickening ( P=5.58×10 -5 ). The median total CT score of discharged patients at absorption stage was lower than progressive stage (3 vs 12.5 ). The median total CT score recovery rate was 67% (range, 0-100%) and 139 (77%) patients showed less than 90% improvement at discharge. Conclusions: A majority (77%) of the discharged patients had not recovered completely. The current discharge criteria may need to include 90% or higher CT score-based recovery rate.Authors Jingwen Li, Xi Long, Fang Fang, and Xuefei Lv contributed equally to this work.Authors Zhicheng Lin and Nian Xiong are joint last coauthors.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311955

ABSTRACT

Background: Since December 2019, acute respiratory disease (ARD) caused by 2019 novel coronavirus (2019-nCoV) rapidly spread throughout China. Children and adults seemed to differ in the clinical course of the disease. The purpose of the current study is to comparatively analyze the clinical characteristics of children and adult patients with 2019-nCoV infection and to explore the possible causes for the discrepant aspects. Methods: : In this retrospective study, the medical records of 32 cases confirmed with 2019-nCoV ARD from Xi'an eighth hospital (Shaanxi, China) from January 31 to February 16, 2020 were reviewed. Results: : In all 32 patients contained 7 children and 25 adults. All children were family cluster. For adult patients, local residents of Wuhan, recently travelled to Wuhan, patient contacted with people from Wuhan were 14 (56%), 10 (40%), 1 (4%), respectively. The median incubation period of children and adult was 5 days (range, 3 to 12) and 4 days (range, 2 to 12), respectively. Altogether 10 (40%) adult patients had underlying conditions significantly, but no children had. Fever (Children 71.4% vs. Adult 96%) and cough (Children 71.4% vs. Adult 76%) were the most common symptoms in both groups. The third symptom observed in children was diarrhea and/or vomiting (57.1%), for adult it was myalgia or fatigue (52%). On admission, 5 (71.4%) children patients showed pneumonia roughly the same as adult patients (20, 80%), and that the two group shared a multitude of common imaging characteristics. 20% of adult with leucopoenia, but leukocytosis was significantly more frequently in children (28.6%, P=0.014). More children had elevated creatine kinase isoenzyme (57.1% vs. 4%, P=0.004). All patients were discharged after symptomatic treatment, including oxygen therapy, antiviral treatment, antibiotic treatment. Only one infant was intravenously injected low-dose glucocorticoids. Conclusions: : Our results multi-dimensionally demonstrate that children with 2019-nCoV infection present a clinical picture which is often distinct from that of adults. Knowledge of these differences will be helpful for the clinical diagnosis of 2019 novel coronavirus diseases (COVID-19) and for a future discussion on age specific infection case definitions.

19.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-305059

ABSTRACT

Epidemics are a serious public health threat, and the resources for mitigating their effects are typically limited. Decision-makers face challenges in forecasting the demand for these resources as prior information about the disease is often not available, the behaviour of the disease can periodically change (either naturally or as a result of public health policies) and can differ by geographical region. In this work, we discuss a model that is suitable for short-term real-time supply and demand forecasting during emerging outbreaks without having to rely on demographic information. We propose a data-driven mixed-integer programming (MIP) resource allocation model that assigns available resources to maximize a notion of fairness among the resource-demanding entities. Numerical results from applying our MIP model to a COVID-19 Convalescent Plasma (CCP) case study suggest that our approach can help balance the supply and demand of limited products such as CCP and minimize the unmet demand ratios of the demand entities.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309028

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 had spread all over the world, causing public health emergency. Although the diagnosis for COVID-19 such as nucleic acid test and antibody detection have been well defined, there is still a big gap of knowledge regarding for COVID-19 patients receiving convalescent plasma transfusion (CPT) therapy, especially patients with comorbidity of diabetes. Method: In this study, out of 3059 COVID-19 patients admitted in Wuhan Huoshenshan Hospital of China, we described the characteristics of 39 diabetes patients receiving the transfusion of ABO-compatible convalescent plasma, and compared the baseline information and clinical outcome with that of 328 diabetes patients receiving traditional treatment. Results: : It was found that the intervention of CPT therapy was effective and beneficial for COVID-19 patients, including severe or critical patients with comorbidity of diabetes, without obvious adverse effects observing during the treatments. The CPT therapy significantly improved the clinical outcome of diabetes patients with COVID-19 infection, especially the duration based on six categories compared to the patients with traditional therapy. Conclusions: : This study not only provided a better understanding of COVID-19 in diabetes people receiving CPT, but also highlighted the CPT therapy was helpful for COVID-19 patients with comorbidity of diabetes.

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