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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-334162

ABSTRACT

The SARS-CoV-2 pandemic poses a great threat to global health, particularly in solid organ transplant recipients (SOTRs). Although a 3-dose mRNA vaccination protocol has been implemented for the majority of SOTRs, its effectiveness was still largely unknown. We analyzed 113 vaccinated SOTRs, and 30 healthy controls (HCs), some of whom had recovered from COVID, for their immune responses against the original vaccine strain and variants of concern (VOC), including the highly mutated-omicron variant. Here, we report that 3 doses of the mRNA vaccine had only a modest effect in eliciting anti-viral responses against all viral strains in the fully vaccinated SOTRs who did not contract the virus. Only 34.0% (16/47) of this group of patients demonstrated both detectable anti-RBD IgG and neutralization activities against alpha, beta, and delta variants, and only 8.5% (4/47) of them showed additional omicron-neutralizing capacities. In contrast, 79.5% (35/44) of the vaccinated recovered-SOTRs demonstrated both higher anti-RBD IgG levels and neutralizing activities against all VOC, including omicron. These findings illustrate a significant impact of previous infection on the development of anti-COVID immune responses in vaccinated SOTRs and highlight the need for alternative strategies to protect a subset of a lesser-vaccine responsive population.

2.
The Lancet Infectious Diseases ; 2022.
Article in English | ScienceDirect | ID: covidwho-1795982

ABSTRACT

Summary Background We previously reported the efficacy of the adjuvanted-protein COVID-19 vaccine candidate S-Trimer (SCB-2019) in adults who showed no evidence of previous exposure to SARS-CoV-2. In this study, we aimed to investigate the extent of protection afforded by previous exposure to SARS-CoV-2 on subsequent COVID-19 infection, as well as the efficacy, safety, and reactogenicity of SCB-2019 in participants who were enrolled in the Study evaluating Protective-Efficacy and safety of Clover's Trimeric Recombinant protein-based and Adjuvanted COVID-19 vaccine (SPECTRA) trial who had already been exposed to SARS-CoV-2 before vaccination. Methods In a phase 2 and 3 multicentre, double-blind, randomised, placebo-controlled trial (SPECTRA) done at 31 sites in five countries, participants were randomly assigned 1:1 using the Cenduit Interactive Response Technology system (IQVIA, Durham, NC, USA), with a block size of six, to receive two doses of either SCB-2019 or placebo 21 days apart. The primary outcomes of the SPECTRA trial were vaccine efficacy, measured by real-time PCR (rtPCR)-confirmed COVID-19 of any severity, with onset from 14 days after the second vaccine dose, as well as the safety and solicited local and systemic adverse events in the phase 2 subset. Here, we present secondary analyses to calculate the protective efficacy due to previous exposure to SARS-CoV-2 against reinfection with COVID-19 according to severity in SPECTRA participants who had evidence of exposure to SARS-CoV-2 at baseline, including efficacy against identified viral variants, as well as efficacy of SCB-2019 vaccination in this population. Findings We enrolled 30 174 participants between March 24, 2021, and Aug 10, 2021. In the 14 670 participants who were randomly assigned to receive placebo, there were 418 (2·8%) confirmed cases of COVID-19;65 (0·9%) of 7339 SARS-CoV-2-exposed participants, and 353 (4·8%) of 7331 SARS-CoV-2-naive participants (attack rates of 5·5 cases per 100 person-years for SARS-CoV-2-exposed participants and 32·4 cases per 100 person-years for SARS-CoV-2-naive participants). Protective efficacy due to previous exposure to SARS-CoV-2 was 83·2% (95% CI 78·0–87·3) against any COVID-19, 92·5% (82·9–97·3) against moderate-to-severe COVID-19, and 100% (59·3–100) against severe COVID-19;no SARS-CoV-2-exposed participants had hospitalisation associated with COVID-19. Protective efficacy against variants were 100% for alpha (B.1.1.7) and lambda (C.37) variants, 88·6% (14·9–99·7) for B.1.623, 93·6% (80·1–98·7) for gamma (P.1), and 92·4% (81·2–97·6) for mu (B.1.621) variants, and lowest against beta (B.1.351;72·2% [33·1–89·9]) and delta (B.1.617.2;77·2% [61·3–87·2]) variants. In addition, one dose of SCB-2019 had 49·9% (1·5–75·6) efficacy against any symptomatic COVID-19, and two doses had 64·2% (26·5–83·8) efficacy. SCB-2019 was well tolerated in SARS-CoV-2-exposed participants, but was associated with higher rates of injection site pain (89 [33·8%] of 263 participants) than placebo (16 [6·7%] of 239 participants). Rates of solicited systemic adverse events, severe adverse events, and serious adverse events were similar between vaccine and placebo groups, and with rates in SARS-CoV-2-naive vaccine recipients. Interpretation Previous exposure to SARS-CoV-2 decreased the risk and severity of subsequent COVID-19 infection, even against newly emerging variants. Protection is further enhanced by one or two doses of SCB-2019. Funding Clover Biopharmaceuticals, The Coalition for Epidemic Preparedness Innovations (CEPI).

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-332766

ABSTRACT

Background: Existing clinical studies supported the potential efficacy of mesenchymal stromal cells as well as derived exosomes in the treatment of COVID-19. We aimed to explore the safety and efficiency of aerosol inhalation of the exosomes derived from human adipose-derived MSCs (haMSC-Exos) in patients with COVID-19. Methods: The MEXCOVID trial is a phase 2a single-arm, open-labelled, interventional trial and patients were enrolled in Jinyintan Hospital, Wuhan, China. Eligible 7 patients were assigned to receive the daily dose of haMSCs-Exos (2.0×10 8 nano vesicles) for consecutively 5 days. The primary outcomes included the incidence of prespecified inhalation-associated events and serious adverse events. We also observed the demographic data, clinical characteristics, laboratory results including lymphocyte count, levels of D-dimer and IL-6 as well as chest imaging. Results: Seven severe COVID-19 related pneumonia patients (4 males and 3 females) were enrolled and received nebulized haMSC-Exos. The median age was 57 year (IQR, 43 year to 70 year). The median time from onset of symptoms to hospital admission and administration of nebulized haMSC-Exos was 30 days (IQR, 15 days to 40 days) and 54 d (IQR, 34 d to 69 d), respectively. All COVID-19 patients tolerated the haMSC-Exos nebulization well, with no evidence of prespecified adverse events or clinical instability during the nebulization or during the immediate post-nebulization period. All patients presented a slight increase of serum lymphocyte counts (median as 1.61×10 9 /L vs. 1.78×10 9 /L). Different degrees of resolution of pulmonary lesions after aerosol inhalation of haMSC-Exos were observed among all patients, more obviously in 4 of 7 patients. Conclusions: Our trial shows that a consecutive 5 days inhalation dose of clinical grade haMSC-Exos up to a total amount of 2.0×10 9 nano vesicles was feasible and well tolerated in seven COVID-19 patients, with no evidence of prespecified adverse events, immediate clinical instability, or dose-relevant toxicity at any of the doses tested. This safety profile is seemingly followed by CT imaging improvement within 7 days. Further trials will have to confirm the long-term safety or efficacy in larger population. Trial Registration MEXCOVID, NCT04276987

4.
Front Psychol ; 12: 795219, 2021.
Article in English | MEDLINE | ID: covidwho-1771087

ABSTRACT

Background and Objectives: Anxiety plays an important role in psychology. An exploration of anxiety and its associated reactions may provide insight into measures for addressing mental health problems caused by the coronavirus disease 2019 (COVID-19) pandemic. Data from this study provide potential correlational responses to anxiety. Methods: A cross-sectional study using data collected via an online self-reported questionnaire was conducted in Japan during the COVID-19 pandemic. Using the State-Trait Anxiety Inventory (STAI-6), we assessed anxiety levels and explored the relationship between anxiety STAI-6 score, sources of COVID-19 information, the influences of COVID-19, social anxiety symptoms, discrimination, and evaluation of the government. Results: A total of 4,127 participants were included in the analysis. The level of anxiety was not equally distributed across the general population with respect to age, gender, educational level, occupation, income, presence of underlying disease, and location (p < 0.05). The number of sources of information on COVID-19 had a positive correlation with the STAI-6 score (Spearman's rho = 0.176, p < 0.001). The influence of the pandemic was correlated with moderate-severe anxiety. A high level of anxiety added to social anxiety (Spearman's rho = 0.04, p < 0.05) and discriminatory behavior (Spearman's rho = 0.11, p < 0.01). Being female (Estimate = 0.926) and from a non-emergency area (Estimate = -0.308) was related to higher STAI scores, and higher education (Estimate = -0.305), and income (Estimate = -0.168) decreased the STAI score. The respondents who had a lower evaluative score of the preventive activities undertaken by the national and local governments had higher STAI-6 scores. Conclusion: Our findings provide statistical evidence for the associated reaction of anxiety and that anxiety reactions may vary in predictable ways. Further studies should focus on the strategic interventions that may decrease the associated responses to anxiety, to address mental health issues due to the pandemic.

5.
Clin Infect Dis ; 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1758700

ABSTRACT

BACKGROUND: To combat the COVID-19 pandemic, nonpharmaceutical interventions (NPI) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARI). METHODS: Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for eight viral pathogens (influenza virus, IFV; respiratory syncytial virus, RSV; human parainfluenza virus, HPIV; human adenovirus; human metapneumovirus; human coronavirus, HCoV; human bocavirus, HBoV, and human rhinovirus, HRV) between 2012 and 2021, were analyzed to assess the changes of respiratory infections in China during the first COVID-19 pandemic year compared to pre-pandemic years. RESULTS: Test positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012-2019, with changes ranging from -17·2% for RSV to -87·6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year round, RSV, HPIV, HCoV, HRV HBov resurged and went beyond historical levels during September, 2020-January, 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children younger than 18 years and in Northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. CONCLUSIONS: Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children.

6.
PLoS One ; 17(3): e0262373, 2022.
Article in English | MEDLINE | ID: covidwho-1753184

ABSTRACT

Human genetics has been proposed to play an essential role in inter-individual differences in respiratory virus infection occurrence and outcomes. To systematically understand human genetic contributions to respiratory virus infection, we developed the database dbGSRV, a manually curated database that integrated the host genetic susceptibility and severity studies of respiratory viruses scattered over literatures in PubMed. At present, dbGSRV contains 1932 records of genetic association studies relating 1010 unique variants and seven respiratory viruses, manually curated from 168 published articles. Users can access the records by quick searching, batch searching, advanced searching and browsing. Reference information, infection status, population information, mutation information and disease relationship are provided for each record, as well as hyperlinks to public databases in convenient of users accessing more information. In addition, a visual overview of the topological network relationship between respiratory viruses and associated genes is provided. Therefore, dbGSRV offers a convenient resource for researchers to browse and retrieve genetic associations with respiratory viruses, which may inspire future studies and provide new insights in our understanding and treatment of respiratory virus infection. Database URL: http://www.ehbio.com/dbGSRV/front/.


Subject(s)
Virus Diseases , Viruses , Databases, Factual , Databases, Genetic , Genetic Association Studies , Genetic Predisposition to Disease , Humans , Virus Diseases/genetics , Viruses/genetics
7.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(12): 1386-1391, 2021 Dec 28.
Article in English, Chinese | MEDLINE | ID: covidwho-1726803

ABSTRACT

The coronavirus disease 2019 (COVID-19) continues to spread around the world, and how to build an immune barrier against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the population is the work we need to do for a long time in the future. The vaccination is an important strategy to construct and improve the herd immunity barrier. Therefore, our country is currently actively and extensively implementing the anti-epidemic policy of SARS-CoV-2 vaccination. However, because of insufficient data on the safety of the SARS-CoV-2 vaccine in the population, especially the lack of clinical research in pregnant and lactating women, China has adopted a conservative approach on whether women in this special physiological period receive SARS-CoV-2 vaccine based on the safe consideration. However, with the widespread application of the SARS-CoV-2 vaccine in the prevention and control of the global epidemic, and the emergence of a large number of clinical research evidences at home and abroad, if we still exclude pregnant and lactating women from the vaccinated population, this part of the population will be fully exposed to the SARS-CoV-2 threat, which will weak the national prevention and control policy. Therefore, it is necessary to reconsider the vaccination of people in this special physiological period based on the experience of vaccination at home and abroad.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , China/epidemiology , Female , Humans , Lactation , Pregnancy , Vaccination
8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324073

ABSTRACT

Purpose: This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic. Methods: An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent Phase 3 and Phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score (HADS-T)) with two subscales, namely anxiety (HADS-A) and depression (HADS-D). Results: From a total of 631 responses received, the proportion of participants with abnormal anxiety and depression was 29.0% and 20.9%, respectively. Distress was reported in 23.0% of the respondents. A total of 16.45% had combined abnormal anxiety and depression. The highest HADS-A (6.10;95% CI 5.64‒6.56), HADS-D (5.61;95% CI 5.14‒6.08), and HADS-T (11.71;95% CI 10.84‒12.58) scores were reported among respondents during Phase 4 of the MCO. Partial least squares-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. Conclusion: Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors’ psychological and emotional needs during the COVID-19 pandemic is essential.Implication for cancer survivors: Cancer survivors or their carers should be made aware of the high psychological risk during infectious disease outbreaks and seek timely support.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324072

ABSTRACT

Background: The objective of this study was to investigate anxiety symptoms and preventive measures being taken against COVID-19. The study also aimed to compare the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak. Methods: : A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan and were aged between 20 and 70 years. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Results: : Of a total of 3,555 completed responses, a total of 52.1% (95% Confidence Interval [CI] 50.4–53.7) of the respondents reported having moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2–50.5) reported that they had had moderate to severe levels of anxiety symptoms at the beginning of the outbreak. The median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [Interquartile Range] 36.7-53.3) and 43.3 (IQR 36.7-53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0–30.0) and 24.0 (IQR 19.0–28.0), respectively, out of a maximum score of 36. In the multivariate analysis, having an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28–8.66) was a strongly significant determinant of having an increased preventive measures score in the past week compared with score at the beginning of the outbreak. Conclusions: : The study reveals the need to reduce levels of public anxiety and to maintain appropriate levels of infection prevention against COVID-19. The psychological effects and psychobehavioural responses to the outbreak found in this study provide important information about developing and implementing effective preventive and emotional regulation control strategies.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324071

ABSTRACT

Monitoring public psychological and behavioural responses during the early phase of the coronavirus disease 2019 (COVID-19) outbreak is important for the management of infection prevention and control. This study aims to investigate the temporal trend in preventive measures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, fear, socio-economic impact, perception of susceptibility/severity and anxiety levels during the early phase of the COVID-19 pandemic. Between 25 January and 3 April 2020 a total of 962 survey responses were received. The majority of respondents had good levels of avoidance and protective behaviour. A high perception of severity (76.5%;95%CI = 73.7–79.2) of SARS-CoV-2 infection was reported but perception of susceptibility was relatively low (30.6%;95%CI = 27.7–33.6). A sizeable proportion of study participants were greatly impacted by the COVID-19 outbreak, with a total impact score of 9.1 (standard deviation 4.7) from a possible total score of 15, and 72.1% (95%CI = 69.2–75.0) reported moderate to severe anxiety as measured by the State-Trait Anxiety Inventory. Overall, the psychological and behavioural responses were found to increase with progression of the outbreak, however a slightly higher increase was observed for the socio-economic impact. These temporal trends during the early phase of the COVID-19 pandemic provide valuable insights for mitigation strategies to contain the current rapidly escalating outbreak.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323551

ABSTRACT

This paper studies the dynamic change of volatility spillovers between several major international financial markets during the global COVID-19 pandemic using Diebold and Yilmaz’s connectedness index. We found that the total volatility spillover in this March reached its highest level of recent ten years, while the pandemic developed to its worst stage in this April. Results of total directional spillover show that American and British stock markets are main spillover transmitters during the pandemic, while Chinese and Japanese stock markets, as well as GBP/USD exchange rate are spillover recipients. The pairwise directional spillover between American and British stock markets is larger than other pairs. GBP/USD exchange rate and WTI crude oil futures market mainly receive spillovers from American stock market. Results show that the COVID-19 pandemic has caused huge shocks to international financial markets, especially of those countries with severe pandemics, and the pandemic led to increased spillovers between financial markets.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322464

ABSTRACT

Objective: this study aimed to explore the impacts of myocardial injury on the clinical severity and outcomes in patients with Coronavirus Disease 2019 (COVID-19). Methods: : we analyzed the electronic medical records of 1646 COVID-19 inpatients in Wuhan Huoshenshan Hospital. Results: : 327 (19.9%) developed into severe cases, 23 (1.4%) died. In comparison to common cases, severe cases showed older age, more comorbidities, abnormal immune responses, as well as liver, renal, cardiac and coagulation disorders. Multivariable logistic regression identified that older age , combining with arrhythmia, abnormal lymphocyte percentage, elevated hypersensitive C reactive protein (hs-CRP) and myocardial injury were the independent risk factors for the incidence of severe cases. Moreover, Kaplan-Meier survival analysis showed that patients with myocardial injury had increasing risks of mortality, incidence of severe cases, acute respiratory distress syndrome (ARDS), and intensive care unit (ICU) admission. Particularly, myocardial injury patients co-existed with any other risk factor further deteriorated the clinical outcomes. Conclusion: The presence of myocardial injury and its co-existing with older age, arrhythmia, abnormal lymphocyte percentage, or elevated hs-CRP were greatly associated with the incidence of severe patients and poor clinical outcomes.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315629

ABSTRACT

Background: Novel coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-caused emerging infectious disease, firstly identified in Wuhan (Hubei, China), is pandemic. However, data concerning presymptomatic SARS-CoV-2 transmission and disease diversity among family members are limited. Objectives To investigate the epidemiological and clinical characteristics of presymptomatic transmission-caused familial clustering cases of SARS-CoV-2 infection in Zhoushan island, China. Methods All family members were tested for SARS-CoV-2 genomic RNA by quantitative reverse transcription PCR in 3 different samples and serum antibody immunoglobin M (IgM) and IgG against SARS-CoV-2. Exposure identification, laboratory test, and imaging were performed according to the national guideline of COVID-19 (7th edition, China). Results Of the 6 cases, index case who ever met his relative with COVID-19 from Xianning, Hubei on January 26–31, 2020, transmitted SARS-CoV-2 to his family members in Zhoushan via visiting family during January 31 and February 3, 2020. The index was identified as common-type COVID-19 on February 6, 2020. All 5 family members were infected with SARS-CoV-2. Of those, a 7-year-old girl was an asymptomatic carrier whereas her grandparents, especially her grandfather, were very sick. Case 6 (grandfather) remained positive for SARS-CoV-2 RNA in his sputum specimen in subsequent 2 months. Case 2 (mother) tested negative for SARS-CoV-2 RNA in all samples but positive for IgM and IgG to SARS-CoV-2 since February 9, 2020. Conclusions Presymptomatic transmission of SARS-CoV-2 causes familial cluster of COVID-19. Exposed to the same source of infection, family members present their differences in disease severity and viral clearance.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315193

ABSTRACT

Objective: To evaluate the role of high-resolution computed tomography (HRCT) in the diagnosis of 2019 novel coronavirus (2019-nCoV) pneumonia and to provide experience in the early detection and diagnosis of 2019-nCoV pneumonia. Methods: : 72 patients confirmed to be infected with 2019-nCoV from multiple medical centers in western China were retrospectively analyzed, including epidemiologic characteristics, clinical manifestations, laboratory findings and HRCT chest features. Results: : All patients had lung parenchymal abnormalities on HRCT scans, which were mostly multifocal in both lungs and asymmetric in all patients, and were mostly in the peripheral or subpleural lung regions in 52 patients (72.22%), in the central lung regions in sixteen (22.22%), and in both lungs, with "white lung "manifestations in four (5.56%). Subpleural multifocal consolidation was predominant abnormality in 38 patients (52.78%). Ground-glass opacity was seen in 34 patients (47.22%). Interlobular septal thickening was found in 18patients, of which eight had only generally mild thickening with no zonal predominance. Reticulation was seen in 8 patients (11.11%), in all of whom it was mild and randomly distributed. In addition, both lungs of 28 patients had two or three CT imaging features. Out of these 72 patients, 36 were diagnosed as early stage, 32 patients as progressive stage and 4 patient as severe stage pneumonia. Moreover, the diagnostic accuracy of HRCT features combined with epidemiological history was not significantly different from the detection of viral nucleic acid (all P >0.05). Conclusion: The HRCT features of 2019-nCoV pneumonia are characteristic to a certain degree, which when combined with epidemiological history yield high clinical value in the early detection and diagnosis of 2019-nCoV pneumonia.Authors Hong-Wei Li, Li-Hua Zhuo, Gao-Wu Yan contributed equally to this work.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312180

ABSTRACT

Background: The aim of the study was to establish and validate nomograms to predict the mortality risk of patients with COVID-19 using routine clinical indicators. Method: This retrospective study included a development cohort enrolled 2119 hospitalized COVID-19 patients and a validation cohort included 1504 COVID-19 patients. The demographics, clinical manifestations, vital signs and laboratory test results of the patients at admission and outcome of in-hospital death were recorded. The independent factors associated with death were identified by a forward stepwise multivariate logistic regression analysis and used to construct two prognostic nomograms. The models were then tested in an external dataset. Results: Nomogram 1 is a full model included nine factors identified in the multivariate logistic regression and nomogram 2 is built by selecting four factors from nine to perform as a reduced model. Nomogram 1 and nomogram 2 established showed better performance in discrimination and calibration than the MuLBSTA score in training. In validation, Nomogram 1 performed better than nomogram 2 for calibration. Conclusion: Nomograms we established performed better than the MuLBSTA score. We recommend the application of nomogram 1 in general hospital which provide robust prognostic performance but more cumbersome;nomogram 2 in mobile cabin hospitals which depend on less laboratory examinations and more convenient. Both nomograms can help clinicians in identifying patients at risk of death with routine clinical indicators at admission, which may reduce the overall mortality of COVID-19.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311953

ABSTRACT

The green bond market has been growing rapidly worldwide in recent years. This paper investigates the role of green bonds in asset allocation considering Chinese financial markets. We use CoVaR to examine the risk spillovers between green bonds and stock-bond markets, finding that green bonds and bonds are strongly dependent as expected. We find no risk spillovers between green bonds and stocks, suggesting that green bonds have diversification benefits for stock investors. We analyze the in-sample and out-of-sample diversification effects of green bonds on a stock-bond portfolio using various asset allocation strategies. The main results show that for most asset allocation strategies, green bonds improve the Sharpe ratio of a stock-bond portfolio in different market environments and can provide downside risk protection during the COVID-19 pandemic.

17.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311007

ABSTRACT

Background: Nationwide nonpharmaceutical interventions (NPI) were used to combat the novel coronavirus disease (COVID-19) during 2020 in the mainland of China. These NPIs have proven effective on mitigating the spread of COVID-19, but their broad impact on other diseases remains under-investigated. In this study, we aim to assess whether such broad impact exists on notifiable diseases in China.Methods: Weekly incidence and mortality data for 31 major notifiable infectious diseases at the province level were extracted from the China Information System for Disease Control and Prevention from 2014 to 2020. We assessed the impact of NPIs by contrasting the incidences of each infectious disease in predefined COVID-19 phases during 2020 to the average incidences in the corresponding time intervals during 2014-2019.Findings: We observed decreased incidences of most diseases during the phases after the lockdown of Wuhan. In general, respiratory diseases and gastrointestinal or enteroviral diseases were more affected than sexually transmitted or bloodborne diseases and vector-borne or zoonotic diseases. Seasonal flu and rubella were the most sensitive to the NPIs, with reductions of 67-99% in incidence rates throughout the NPI-implemented phases in China (Jan 27-Dec 31, 2020). Among gastrointestinal or enteroviral diseases, the hand, foot and mouth disease (HFMD) was subject to the largest declines during Jan 27-Aug 31, 2020, with >90% reduction in incidence rate. Phases with more stringent NPIs were associated with more reductions. Non-respiratory diseases, particularly HFMD, gonorrhea and brucellosis, rebounded towards the end of the year as the NPIs were relaxed.Interpretation: NPIs are broadly effective in containing infectious diseases. Less disruptive NPIs such as wearing face masks are still effective in mitigating respiratory diseases but are not adequate for containing non-respiratory diseases.Funding Statement: This work was supported by grants from the National Natural Science Funds [91846302, 81825019], the China Mega-Project on Infectious Disease Prevention [2018ZX10713001, 2018ZX10713002, 2018ZX10201001 and 2017ZX10103004], and the US National Institutes of Health [R56 AI148284].Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: Missing.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310722

ABSTRACT

Background: In December 2019, Wuhan witnessed the outbreak of an “unexplained pneumonia” caused by a novel coronavirus strain infection and was dubbed the COVID-19 by the WHO. The disease quickly spread to China. This study aimed to investigate the disease’s evolving epidemiological history, as well as analyze the clinical and CT imaging characteristics, treatment regimens, and patients’ prognosis. Methods: : This was a retrospective study whose cases were 64 patients with a confirmed diagnosis of COVID-19. The clinical data were obtained from patients who were admitted to the isolation ward from 21 January 2020 to 19 February 2020. Results: : 60 out of 64 patients had a definitive history of exposure to people who had traveled from Wuhan City. The median time from onset of symptoms to first hospital admission was 3.9±1.9 days. The initial symptoms included fever (46/64), dry cough (38/64), fatigue or myalgia (23/64), sore throat (10/64), diarrhea (3/64) along with late-onset symptoms like chest pains (2/64) and headaches (2/64). The majority of the patients (43/64) had normal white blood cell counts while 29.7 % (19/64) had leukopenia. Only two patients (3.1 %) presented with leukocytosis. 58 of the 64patients had abnormal radiological findings on chest CTs. The first chest CTs (within 2 days) was more sensitive in detecting COVID-19 infection (85.9 %) compared to the initial RT-PCR (56.3 %;p<0.01). The CTs showed lesions in multiple lung lobes in three-quarters of the patients while 15.6 % had lesions localized to one lobe. Most of the lesions were typically dense with ground-glass opacity co-existing with consolidation or cord-like shadows. Most of these patients (50/64) have recovered and got discharged giving a mean length of hospital stay of 13.5±4.8 days. Our hospital unit has not reported any COVID-19 related death so far. Conclusions: : Early intervention in COVID-19 disease improves patients’ prognosis. Our data demonstrate the superiority of early radiological tests ahead of RT-PCR. The initial and dynamic CT changes in COVID-19 patients along with other clinical data shared above can better guide clinical decision making.

19.
IEEE Trans Biomed Eng ; PP2022 Feb 11.
Article in English | MEDLINE | ID: covidwho-1685149

ABSTRACT

OBJECTIVE: The m6A modification is the most common ribonucleic acid (RNA) modification, playing a role in prompting the viruss gene mutation and protein structure changes in the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Nanopore single-molecule direct RNA sequencing (DRS) provides data support for RNA modification detection, which can preserve the potential m6A signature compared to second-generation sequencing. However, due to insufficient DRS data, there is a lack of methods to find m6A RNA modifications in DRS. Our purpose is to identify m6A modifications in DRS precisely. METHODS: We present a methodology for identifying m6A modifications that incorporated mapping and extracted features from DRS data. To detect m6A modifications, we introduce an ensemble method called mixed-weight neural bagging (MWNB), trained with 5-base RNA synthetic DRS containing modified and unmodified m6A. RESULTS: Our MWNB model achieved the highest classification accuracy of 97.85% and AUC of 0.9968. Additionally, we applied the MWNB model to the COVID-19 dataset; the experiment results reveal a strong association with biomedical experiments. CONCLUSION: Our strategy enables the prediction of m6A modifications using DRS data and completes the identification of m6A modifications on the SARS-CoV-2. SIGNIFICANCE: The Corona Virus Disease 2019 (COVID-19) outbreak has significantly influence, caused by the SARS-CoV-2. An RNA modification called m6A is connected with viral infections. The appearance of m6A modifications related to several essential proteins affects proteins' structure and function. Therefore, finding the location and number of m6A RNA modifications is crucial for subsequent analysis of the protein expression profile.

20.
J Clin Hypertens (Greenwich) ; 24(3): 224-233, 2022 03.
Article in English | MEDLINE | ID: covidwho-1673151

ABSTRACT

Hypertension is the most common comorbidity in patients with coronavirus disease 2019 (COVID-19) and increases in-hospital mortality. Day-by-day blood pressure (BP) variability (BPV) is associated with clinical outcomes in hypertensive patients. However, little information is available on the association of BPV with the outcomes of COVID-19 patients with hypertension. This study aimed to demonstrate whether day-by-day in-hospital BPV had prognostic significance in these patients. The authors included 702 COVID-19 patients with hypertension from Huoshenshan Hospital (Wuhan, China), who underwent valid in-hospital BP measurements on at least seven consecutive days. Day-by-day BPV was assessed by standard deviation (SD), coefficient of variation (CV), and variation independent of mean (VIM). Overall, patients with severe COVID-19 and non-survivors had higher BPV than moderate cases and survivors, respectively. Additionally, higher BPV was correlated with greater age and higher levels of C-reactive protein, procalcitonin, high-sensitive cardiac troponin I, and B-type natriuretic peptide. In multivariable Cox regression, SD of systolic BP (SBP) was predictive of mortality [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.05-1.30] as well as acute respiratory distress syndrome (ARDS) (HR 1.09, 95% CI 1.01-1.16). Similar trends were observed for CV and VIM of SBP, but not indices of diastolic BP variability. The authors demonstrated that day-by-day in-hospital SBP variability can independently predict mortality and ARDS in COVID-19 patients with hypertension. And high BPV might be correlated with severe inflammation and myocardial injury. Further studies are needed to clarify whether early reduction of BPV will improve the prognosis of these patients.


Subject(s)
COVID-19 , Hypertension , Blood Pressure/physiology , COVID-19/complications , COVID-19/epidemiology , Hospitals , Humans , Hypertension/complications , Hypertension/epidemiology , Prognosis
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