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1.
Front Vet Sci ; 9: 850510, 2022.
Article in English | MEDLINE | ID: covidwho-1785463

ABSTRACT

Central nervous system (CNS) inflammation is a common cause of neurological dysfunction in dogs. Most dogs with CNS inflammation are diagnosed with presumptive autoimmune disease. A smaller number are diagnosed with an infectious etiology. Additionally, at necropsy, a subset of dogs with CNS inflammation do not fit previously described patterns of autoimmune disease and an infectious cause is not readily identifiable. Because viral infection is a common cause of meningoencephalitis in people, we hypothesize that a subset of dogs presented with CNS inflammation have an occult viral infection either as a direct cause of CNS inflammation or a trigger for autoimmunity. The goal of this research was to screen cerebrospinal fluid from a large number dogs with CNS inflammation for occult viral infection. One hundred seventy-two dogs with neurological dysfunction and cerebrospinal fluid (CSF) pleocytosis were identified. Of these, 42 had meningoencephalitis of unknown origin, six had steroid-responsive meningitis-arteritis, one had eosinophilic meningoencephalitis, five had documented infection, 21 had and undetermined diagnosis, and 97 had a diagnosis not consistent with primary inflammatory disease of the CNS (e.g., neoplasia). CSF samples were subsequently screened with broadly reactive PCR for eight viral groups: adenovirus, bunyavirus, coronavirus, enterovirus, flavivirus, herpesvirus, paramyxovirus, and parechovirus. No viral nucleic acids were detected from 168 cases screened for eight viral groups, which does not support occult viral infection as a cause of CNS inflammation in dogs. La Crosse virus (LACV) nucleic acids were detected from four cases in Georgia. Subclinical infection was supported in two of these cases but LACV could not be ruled-out as a cause of infection in the other two cases, suggesting further research is warranted to determine if LACV is an occult cause of CNS inflammation in dogs.

2.
Biomed J ; 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1767931

ABSTRACT

BACKGROUND: The impact of COVID-19 on public health has mandated an 'all hands on deck' scientific response. The current clinical study and basic research on COVID-19 are mainly based on existing publications or our knowledge of coronavirus. However, efficiently retrieval of accurate, relevant knowledge on COVID-19 can pose significant challenges for researchers. MATERIAL AND METHODS: To improve quality in accessing important literature findings, we developed a novel natural language processing (NLP) method to automatically recognize the associations among potential targeted host organ systems, associated clinical manifestations, and pathways. We further validated these associations through clinician experts' evaluations and prioritize candidate drug targets through bioinformatics network analysis. RESULTS: We found that the angiotensin-converting enzyme 2 (ACE2), a receptor that SARS-CoV-2 required for cell entry, is associated with cardiovascular and endocrine organ system and diseases. Furthermore, we found SARS-CoV-2 is associated with some important pathways such as IL-6, TNF-alpha, and IL-1 beta-induced dyslipidemia, which are related to inflammation, lipogenesis, and oxidative stress mechanisms, suggesting potential drug candidates. CONCLUSIONS: We prioritized the list of therapeutic targets involved in antiviral and immune modulating drugs for experimental validation, rendering it valuable during public health crises marked by stresses on clinical and research capacity. Our automatic intelligence pipeline also contributes to other novel and emerging disease management and treatments in the future.

3.
Preprint in English | bioRxiv | ID: ppbiorxiv-483948

ABSTRACT

Severe injuries following viral infection cause lung epithelial destruction with the presence of ectopic basal progenitor cells (EBCs), although the exact function of EBCs remains controversial. We and others previously showed the presence of ectopic tuft cells in the disrupted alveolar region following severe influenza infection. Here, we further revealed that the ectopic tuft cells are derived from EBCs. This process is amplified by Wnt signaling inhibition but suppressed by Notch inhibition. Further analysis revealed that p63-CreER labeled population de novo arising during regeneration includes alveolar epithelial cells when Tamoxifen was administrated after viral infection. The generation of the p63-CreER labeled alveolar cells is independent of tuft cells, demonstrating segregated differentiation paths of EBCs in lung repair. EBCs and ectopic tuft cells can also be found in the lung parenchyma post SARS-CoV-2 infection, suggesting a similar response to severe injuries in humans.

4.
N Engl J Med ; 386(9): 815-826, 2022 03 03.
Article in English | MEDLINE | ID: covidwho-1721751

ABSTRACT

BACKGROUND: Whether the use of balanced multielectrolyte solution (BMES) in preference to 0.9% sodium chloride solution (saline) in critically ill patients reduces the risk of acute kidney injury or death is uncertain. METHODS: In a double-blind, randomized, controlled trial, we assigned critically ill patients to receive BMES (Plasma-Lyte 148) or saline as fluid therapy in the intensive care unit (ICU) for 90 days. The primary outcome was death from any cause within 90 days after randomization. Secondary outcomes were receipt of new renal-replacement therapy and the maximum increase in the creatinine level during ICU stay. RESULTS: A total of 5037 patients were recruited from 53 ICUs in Australia and New Zealand - 2515 patients were assigned to the BMES group and 2522 to the saline group. Death within 90 days after randomization occurred in 530 of 2433 patients (21.8%) in the BMES group and in 530 of 2413 patients (22.0%) in the saline group, for a difference of -0.15 percentage points (95% confidence interval [CI], -3.60 to 3.30; P = 0.90). New renal-replacement therapy was initiated in 306 of 2403 patients (12.7%) in the BMES group and in 310 of 2394 patients (12.9%) in the saline group, for a difference of -0.20 percentage points (95% CI, -2.96 to 2.56). The mean (±SD) maximum increase in serum creatinine level was 0.41±1.06 mg per deciliter (36.6±94.0 µmol per liter) in the BMES group and 0.41±1.02 mg per deciliter (36.1±90.0 µmol per liter) in the saline group, for a difference of 0.01 mg per deciliter (95% CI, -0.05 to 0.06) (0.5 µmol per liter [95% CI, -4.7 to 5.7]). The number of adverse and serious adverse events did not differ meaningfully between the groups. CONCLUSIONS: We found no evidence that the risk of death or acute kidney injury among critically ill adults in the ICU was lower with the use of BMES than with saline. (Funded by the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand; PLUS ClinicalTrials.gov number, NCT02721654.).


Subject(s)
Acute Kidney Injury/prevention & control , Critical Illness/therapy , Saline Solution/therapeutic use , Acute Kidney Injury/etiology , Adult , Aged , Critical Care/methods , Critical Illness/mortality , Double-Blind Method , Female , Fluid Therapy , Gluconates/adverse effects , Gluconates/therapeutic use , Humans , Intensive Care Units , Magnesium Chloride/adverse effects , Magnesium Chloride/therapeutic use , Male , Middle Aged , Potassium Chloride/adverse effects , Potassium Chloride/therapeutic use , Saline Solution/adverse effects , Sodium Acetate/adverse effects , Sodium Acetate/therapeutic use , Sodium Chloride/adverse effects , Sodium Chloride/therapeutic use , Treatment Outcome
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-313341

ABSTRACT

Paper based flexible pressure sensors have received extensive attention due to their recoverability and accessibility. In this paper, we proposed graphical pressure sensors array with multilayered structure. A simple writing method was adopted to achieve the adsorption of sensitive materials on the fiber structure of cellulose paper. Pressure sensors with 1, 3, 5 and 7 stacked layers were fabricated and compared, respectively. The results show that the 7layers sensor combined high sensitivity (44 kPa-1) and fast time response (150 ms). The highly sensitive stacked paper-based sensor array realizes the pressure detection of objects and special-shaped surfaces. A pressure sensor base on commercial corrugated box was also fabricated to compare. The corrugated carton array was made to switch reminder devices for its convenience and accessibility. Since there are many scenarios that require a safe distance, especially under the influence of the COVID-19, the writable paper-based sensor array was used to realize graphical distance perception and warning.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312185

ABSTRACT

Background: This study aims to identify some biomarkers for monitoring the recovery of lung injury in severe COVID-19 patients from stabilized stage toward convalescence. Methods: : We enrolled participants who diagnosed with severe COVID-19 (n = 28) and health volunteers (n = 25) from Taikang Tongji (Wuhan) Hospital. The patients were in a stabilized stage and had a course of 48.1±12.8 days. We followed these patients for 90 days. The blood routine, cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-17A, TNF-α, IFN-α, IFN-γ), type II alveolar epithelium injury indicators (Surfactant protein A (SP-A), Krebs von den Lungen-6 (KL-6)) and chest CT were tested on the 1, 30, 60, and 90 days after enrollment. Results: : In stabilized stage, the parameters of blood routine and some cytokines (IL-1β, IL-2, IL-4, IL-12p70, TNF-α) had bounced back to normal (p>0.05). Some cytokines (IL-5, IL-6, IL-10, IL-17A, IFN-α, IFN-γ) and type II alveolar epithelium injury indicators (SP-A and KL-6) were still higher than normal (p<0.05). During the stabilized stage to convalescence, in spite of the variation of monocyte count, monocyte/lymphocyte ratio, IL-5, IL-10, IL-12p70, IL-17A, IFN-γ, IFN-α, SP-A and KL-6 were downward trend (p<0.05), only KL-6 level (p<0.05) could simultaneously reflect the lung injury volume which be measured by CT. Conclusions: : Our preliminary data indicated that KL-6 could be an effective prognostic biomarker for monitoring the recovery of lung function in patients with severe COVID-19 from stabilized stage toward convalescence.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310879

ABSTRACT

Objective: We aimed to describe the features of 220 nonemergency (mild or common type) COVID-19 patients from a shelter hospital, as well as evaluate the efficiency of antiviral drug, Arbidol in their disease progressions. Methods: . Basic clinical characteristics were described and the efficacy of Arbidol was evaluated based on gender, age, maximum body temperature of the patients. Results: . Basically, males had a higher risk of fever and more onset symptoms than females. Arbidol could accelerate fever recovery and viral clearance in respiratory specimens, particularly in males. Arbidol also contributed to shorter hospital stay without obvious adverse reactions. Conclusions: . In the retrospective COVID-19 cohort, gender was one of the important factors affecting patient's conditions. Arbidol showed several beneficial effects in these patients, especially in males. This study brought more researches enlightenment in understanding the emerging infectious disease.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309729

ABSTRACT

Aims: & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment. Methods: : Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared. Results: : Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74). Conclusions: : The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325501

ABSTRACT

Background: Many COVID-19 patients have been discharged, but lung injury, including pulmonary fibrosis, might lead to long-term impairment. This study aimed to evaluate predictors and monitors of pulmonary fibrosis in patients with COVID-19. Methods Thirty-five convalescent patients with severe COVID-19, after appropriate medical treatments, were recruited. According to evidence of fibrosis on initial computed tomography (CT), the patients were divided into mild-to-moderate and severe groups. Levels of transforming growth factor beta (TGF-β), chemokine ligand 18 (CCL18), type III procollagen peptide (PⅢP), hyaluronic acid (HA), laminin (LN), and type IV collagen (CⅣ) were determined. Laboratory tests, clinical data, and CT features at different stages were collected and analyzed, and the prognostic performance of these parameters was evaluated. Results Severe fibrosis was found in 76.29% (26/35) of patients. However, most baseline laboratory characteristics were normal. Fibrosis indicators (TGF-β: 66.67 ± 158.57 vs 55.84 ± 126.43 pg/mL, P = 0.006;CCL18: 364.27 ± 167.70 vs 84.47 ± 60.67 ng/mL, P = 0.000;PⅢP: 54.12 ± 55.34 vs 17.15 ± 2.48 ng/mL, P = 0.000;HA: 122.47 ± 78.84 vs 59.74 ± 18.01 ng/mL, p = 0.000;LN: 55.43 ± 46.44 vs 24.25 ± 7.79 ng/mL, P = 0.000;CⅣ: 24.77 ± 14.97 vs 15.32 ± 1.15 ng/mL, P = 0.001) were elevated in patients compared with controls. Over 90 days’ follow-up, HRCT scores gradually decreased from 22.48 ± 16.13 to 10.33 ± 11.11 (P < 0.001), and mMRC scores decreased from 3.27 ± 0.32 to 1.48 ± 0.33, and all fibrosis indicators, except for PⅢP, gradually declined with the improvement of pulmonary fibrosis. Moreover, TGF-β and CCL18 levels were lower in the mild-to-moderate than severe fibrosis group (88.16 ± 97.45 vs 205.93 ± 170.57 pg/mL, P = 0.024;241.84 ± 125.37 vs 366.64 ± 161.06 ng/mL, P = 0.038), and patients with elevated baseline levels of serum TGF-β and CCL18 had longer rehabilitation times. Conclusions TGF-β and CCL18 may be promising biomarkers for predicting and monitoring the development of pulmonary fibrosis in patients with COVID-19.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322241

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) remains underdiagnosed globally. The coronavirus disease 2019 pandemic has also severely restricted spirometry, the primary tool used for COPD diagnosis and severity evaluation, due to concerns of virus transmission. Computed tomography (CT)-based deep learning (DL) approaches have been suggested as a cost-effective alternative for COPD identification within smokers. The present study aims to develop weakly supervised DL models that utilize CT image data for the automated detection and staging of spirometry-defined COPD among natural population. Methods: A large, highly heterogenous dataset was established comprising 1393 participants recruited from outpatient, inpatient and physical examination center settings of 4 large public hospitals in China. CT scans, spirometry data, demographic data, and clinical information of each participant were collected for the purpose of model development and evaluation. An attention-based multi-instance learning (MIL) model for COPD detection was trained using CT scans from 837 participants and evaluated using a test set comprised of data from 278 non-overlapping participants. External validation of the COPD detection was performed with 620 low-dose CT (LDCT) scans acquired from the National Lung Screening Trial (NLST) cohort. A multi-channel 3D residual network was further developed to categorize GOLD stages among confirmed COPD patients and evaluated using 5-fold cross validation. Spirometry tests were used to diagnose COPD, with stages defined according to the GOLD criteria. Results: The attention-based MIL model used for COPD detection achieved an area under the receiver operating characteristic curve (AUC) of 0.934 on the test set and 0.866 on the LDCT subset acquired from NLST. The model exhibited high generalizability across distinct scanning devices and slice thicknesses, with an AUC above 0.90. The multi-channel 3D residual network was able to correctly grade 76.4% of COPD patients in the test set (423/553) using the GOLD scale, with a Cohen’s weighted Kappa of 0.619 for the assessment of GOLD categorization . Conclusion: The proposed chest CT-DL approach can automatically identify spirometry-defined COPD and categorize patients according to the GOLD scale, with clinically acceptable performance. As such, this approach may be a powerful novel tool for COPD diagnosis and staging at the population level.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315876

ABSTRACT

Background: Coronavirus 2019 (COVID-19) is a novel infectious disease that was earliest reported in Wuhan, China, but has been later discovered everywhere in the world. On the other hand, Hepatitis B virus (HBV) is ubiquitous in China;having millions of HBV carriers, HBV infection has become a major problem of public health in China. In this study, we aim to describe the clinical features of HBV carriers infected with COVID-19 and to assess factors that may affect the progression and outcome of the disease. Methods: : 72 patients diagnosed as infected with both COVID-19 and HBV at the Jinyintan Hospital of Wuhan have been involved in this study. Epidemiological characteristics, demographic features, clinical manifestations, laboratory test, treatment, management and final outcomes of these patients were collected and analyzed. Results: : Among all 72 patients (40 male and 32 female, with a median age of 58.5 years old), 22 (30.56%) were diagnosed as severe cases and 50 (69.44%) non-severe cases. Fever is the most common symptom, followed by cough, chest tightness and sputum. Significant differences have been observed in the outcomes of laboratory tests including hematologic, biochemical, infection and coagulation parameters, and in indicators like Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Total Bilirubin (TBil), Direct Bilirubin (DBil), Indirect Bilirubin (IBil) and γ-glutamyl Transferase (GGT) at the admission and discharge of these patients. Especially, levels of Prealbumin (PA) and Serum Amyloid A (SAA) showed an obvious trend of decreasing, which is statistically significant. Conclusions: : The clinical features of HBV carriers infected with COVID-19 have obvious systemic symptoms, such as fever, cough, and chest tightness. By comparing their liver functions tested on the dates of admission and discharge, we found that the SARS-CoV-2 virus, which causes COVID-19, does not directly activate the Hepatitis B virus, so that the risk of liver cell damage for HBV carriers infected with COVID-19 does not increase. Both PA and SAA seem to work as sensitive indicators and can be used to evaluate the prognosis and outcome of these patients.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315634

ABSTRACT

Objectives: To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods: This retrospective study included 50 confirmed patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical and CT characteristics of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results: There were no differences in the occurrence rate of CT characteristics between the moderate group (n=34) and the severe and critical group (n=16) in the initial CT (all p >0.05). There were differences in the CT score of right lung and total CT score at the initial CT between the two groups (all p <0.05). There was a quadratic relationship between total CT score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT score and CT follow-up time in the moderate group (p >0.05). The total CT score of the severe and critical group was different between the initial and first follow-up, the second and third follow-ups, the third and fourth follow-ups, and the fourth and fifth follow-ups CT (all p<0.05). The total CT score of the moderate group was different between the second and third follow-ups CT (p<0.05). Conclusions: COVID-19 pneumonia with the severe and critical types progressed rapidly with the greatest severity at the second follow-up CT, and the moderate type was relatively stable.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315283

ABSTRACT

Objectives: We aimed to develop a simple algorithm helps early identification of SARS-CoV-2 infection patients with severe progression tendency. Methods: 322 SARS-COV-2 infection patients were respectively enrolled. The univariable and multivariable analysis were computed to identify the independent predictors of severe progression, and the prediction model was established based on independent predictors. The areas under the ROC curves (AUROCs) were used to evaluate the diagnostic performances. Results: Of 322 confirmed SARS-COV-2 infection patients, 11 were diagnosed as severe cases on admission, 15 developed to severe cases after admission, and 296 were non-severe cases. The multivariable analysis identified age (OR=1.061, p =0.028), lactate dehydrogenase (LDH) (OR=1.006, p =0.037), and CD4 count (OR=0.993, p =0.006) as the independent predictors of severe progression. Consequently, the age-LDH-CD4 algorithm was derived as (age×LDH)/CD4. The AUROC of the age-LDH-CD4 model was significantly higher than that of single CD4 count, LDH, or age (0.92, 0.85, 0.80, and 0.75, respectively). The age-LDH-CD4 model ≥ 82 has high sensitive (81%) and specific (93%) for the early identification of patients with severe progression tendency following SARS-CoV-2 infection. Conclusions: The age-LDH-CD4 model is a simple algorithm for early identifying cases with severe progression tendency in SARS-CoV-2 infection patients, and warrants further validation.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315281

ABSTRACT

Objective: Recently, the CALL score based on comorbidity, age, lymphocyte and lactate dehydrogenase was reported to predict COVID-19 progression in two studies, which had relatively small samples (208 and 210 patients) and come to the opposite conclusion. We aimed to optimize and validate the CALL score in a large sample cohort. Methods: In this retrospective study, 651 patients with COVID-19 were divided into stable group (n=633) and progressive group (n=18) based on whether they progressed to severe cases. D-Dimer, CD4+ T cell count, and CRP was separately added to the CALL score to form the CALL-DD score, CALL-CD4 score, and CALL-CRP score, respectively. Results: For predicting COVID-19 progression, the CALL-DD score yielded a significantly higher AUROC compared with CALL-CD4, CALL-CRP, and CALL score (0.90, 0.84, 0.83, and 0.81, respectively). Using a cutoff of 7 points, the sensitivity and negative predictive value (NPV) of the CALL-DD score was 94% and 99%, respectively. Using a cutoff of 11 points, the specificity and NPV was 91% and 99%, respectively. Conclusion: Adding D-Dimer might further improve the performance of CALL score for the prediction of COVID-19 progression. The CALL-DD score had worth of applying in regulating the large flow of patients with COVID-19 between primary health care and tertiary centers.Funding Statement: This study was supported by grant NO.17411969700 from Shanghai Association for Science and Technology and grant NO.19YF1441200 from Shanghai Sailing Plan Program.Declaration of Interests: None.Ethics Approval Statement: The verbal informed consents were obtained from all participants. The ethics committee of Shanghai Public Health Clinical Center approved this study (JY-2020-S097-02). This study was performed in accordance with the declaration of Helsinki.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315280

ABSTRACT

Objective: We aimed to compare the dynamic differences of immunological parameters between severe and non-severe COVID-19 patients. Methods: The cytokine profiles and lymphocyte subsets of 664 patients with COVID-19 (31 severe cases and 633 non-severe cases) were longitudinally analyzed. Results: Compared with non-severe cases, severe cases had higher age (64 vs 40 years, p < 0.001), more common comorbidities (74.2% vs 20.5%, p < 0.001) and lymphopenia (0.7 vs 1.4×109 /L, p < 0.001). Severe cases had markedly higher levels of IL-6, IL-8, and IL-10 than non-severe cases from baseline to 35 days after admission (p < 0.001). No significant differences were observed in the dynamic levels of IL-1β, IL-2, IL-4, IL-5, IL-12, IL-17, TNF-α, IFN-α, and IFN-γ between the two groups (p > 0.05). The absolute counts of lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD45+ T cells were markedly lower in severe COVID-19 patients compared with that in non-severe cases from baseline to 35 days after admission (p < 0.001). No significant differences were observed in the dynamic levels of white cells count, CD19+ B cells count, and NK cells count between the two groups (p > 0.05). The decrease of T lymphocyte subsets reached its peak at day 1 to 3 after admission, and gradually increased during the follow-up period in the non-severe group;however, always sustained at low levels in the severe group. Conclusion: The dynamic changes of cytokine profiles and T lymphocyte subsets are related with COVID-19 progression.Funding Statement: This study was supported by grant NO.17411969700 from Shanghai Association for Science and Technology and grant NO.19YF1441200 from Shanghai Sailing Plan Program.Declaration of Interests: None.Ethics Approval Statement: The verbal informed consents were obtained from all participants. The ethics committee of Shanghai Public Health Clinical Center approved this study. This study was performed in accordance with the declaration of Helsinki.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315277

ABSTRACT

Background: /Objective To date, the clinical features of SARS-CoV-2 infections were reported mainly based on cases in Wuhan. We aimed to report the clinical features of SARS-CoV-2 infections outside Wuhan. Methods We analyzed 325 SARS-COV-2 infection patients hospitalized in Shanghai Public Health Clinical Center. The epidemiological, demographic, and clinical data were compared between severe and non-severe cases. Results Of 325 patients, the median age was 51 years, 167 (51.4%) were men, and 107 (32.9%) had underlying diseases. 159 (48.9%) visited Wuhan or had contacted with people from Wuhan, but 57 (17.5%) had no clear epidemiological history. Compared with non-severe patients (n=299, 92%), severe patients (n=26, 8%) were older, had more common underlying disorder, more common lymphopenia, and higher D-dimer, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, total bilirubin, blood urea nitrogen, creatinine, procalcitonin, C-reactive-protein, and troponin I level. The common complications included secondary infection (12.3%), acute cardiac injury (9.2%), ARDS (5.5%), acute kidney injury (5.8%), and shock (4.9%). To Mar 12, 311 (95.7%) patients were discharged, 3 (0.9%) died, and 11 (3.4%) still hospitalized. Conclusions The severity rate and fatality rate were low if the measures (early isolation, early diagnosis and early management) were undertaken at the early time of the outbreak.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315276

ABSTRACT

By using the public data from Jan. 20 to Feb. 11, 2020, we perform data-driven analysis and forecasting on the COVID-19 epidemic in mainland China, especially Hubei province. Our results show that the turning points of the daily infections are predicted to be Feb. 6 and Feb. 1, 2020, for Hubei and China other than Hubei, respectively. The epidemic in China is predicted to end up after Mar. 10, 2020, and the number of the total infections are predicted to be 51600. The data trends reveal that quick and active strategies taken by China to reduce human exposure have already had a good impact on the control of the epidemic.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315275

ABSTRACT

Background: The effect of corticosteroids on COVID-19 remains controversial. This study aims to clarify the potential roles of corticosteroids in severe COVID-19 patients. Methods In the current retrospective single-center study, we collected data of 214 severe patients with confirmed COVID-19 in Wuhan Union Hospital from Feb 20th to Mar 1st, 2020. Epidemiological, clinical and treatment were analyzed between patients treated with corticosteroids or not. Results Corticosteroids used patients have higher levels of lactate dehydrogenase (LDH), interleukin-6 (IL-6), CD4 + /CD8 + cells, C-reactive protein (CRP) and procalcitonin (PCT). Virus clearance time and hospital length of stay in corticosteroids group were also significantly higher. The antiviral treatment and antibiotics treatment in patients given corticosteroids were both significantly higher. Antibiotics treatment duration was significantly longer in corticosteroids group. And the usage of multiple antibiotics in corticosteroid group was also significantly higher. And patients who treated by corticosteroids beyond 5 days showed a significantly longer antibiotics duration. Whereas there were no differences on virus clearance time and multiple antibiotics between the patients treated with corticosteroids beyond 5 days and less than 5 days. Multivariate analysis showed that patients with sputum production and higher IL-6 at admission, or treated with corticosteroid therapy were associated with prolonged virus clearance time and lianhua qingwen capsule may contributed to shorten virus clearance time. Conclusions The use of corticosteroids could prolong the virus clearance. The benefits and harms should be carefully weighed in the COVID-19 patients who intend to use corticosteroids. The dosage should be low-to-moderate (≤ 0.5-1 mg/kg per day methylprednisolone or equivalent) and the duration should be short (≤ 5 days) to avoid secondary infections.

19.
Emerg Microbes Infect ; 11(1): 452-464, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1672032

ABSTRACT

Breakthrough infection of SARS-CoV-2 is a serious challenge, as increased infections were documented in fully-vaccinated individuals. Recipients with poor antibody response are highly vulnerable to reinfection, whereas those with strong antibody responses achieve sterilizing immunity. Thus far, biomarkers associated with levels of vaccine-elicited antibody response are still lacking. Here, we studied the antibody response of age- and gender-controlled healthy cohort, who received inactivated SARS-CoV-2 vaccines and profiled the B cell receptor repertoires in longitudinally consecutive samples. Upon vaccination, all vaccinated individuals displayed a convergent antibody response with shared common antibody clones and public neutralizing antibodies. Strikingly, poor vaccine-responders are distinguishable from strong vaccine-responders by a biased V-usage before vaccination and IgG to IgM mRNA ratio. These findings reveal molecular signatures associated with the different levels of vaccine-induced antibody response, which could be further developed into biomarkers for the design of vaccination strategies.


Subject(s)
COVID-19 Vaccines , COVID-19 , Antibodies, Neutralizing , Antibodies, Viral , Humans , Receptors, Antigen, B-Cell , SARS-CoV-2 , Vaccination
20.
Front Public Health ; 9: 767617, 2021.
Article in English | MEDLINE | ID: covidwho-1595348

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has greatly disrupted the normal treatment of patients with liver cancer and increased their risk of death. The weight of therapeutic safety was significantly amplified for decision-making to minimize the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Herein, the safety and effectiveness of carbon ion radiotherapy (CIRT) for unresectable liver cancer (ULC) were evaluated, and Chinese experiences were shared to solve the predicament of ULC treatment caused by SARS-CoV-2. Worldwide studies were collected to evaluate CIRT for ULC as the world has become a community due to the COVID-19 pandemic. We not only searched five international databases including the Cochrane Library, Web of Science, PubMed, Embase, and Scopus but also performed supplementary retrieval with other sources. Chinese experiences of fighting against COVID-19 were introduced based on the advancements of CIRT in China and a prospective clinical trial of CIRT for treating ULC. A total of 19 studies involving 813 patients with ULC were included in the systematic review. The qualitative synthetic evaluation showed that compared with transarterial chemoembolization (TACE), CIRT could achieve superior overall survival, local control, and relative hepatic protection. The systematic results indicated that non-invasive CIRT could significantly minimize harms to patients with ULC and concurrently obtain superior anti-cancer effectiveness. According to the Chinese experience, CIRT allows telemedicine within the hospital (TMIH) to keep a sufficient person-to-person physical distance in the whole process of treatment for ULC, which is significant for cutting off the transmission route of SARS-CoV-2. Additionally, CIRT could maximize the utilization rate of hospitalization and outpatient care (UHO). Collectively, CIRT for ULC patients not only allows TMIH and the maximized UHO but also has the compatible advantages of safety and effectiveness. Therefore, CIRT should be identified as the optimal strategy for treating appropriate ULC when we need to minimize the risk of SARS-CoV-2 infection and to improve the capacity of medical service in the context of the unprecedented COVID-19 crisis.


Subject(s)
COVID-19 , Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Heavy Ion Radiotherapy , Liver Neoplasms , Carcinoma, Hepatocellular/radiotherapy , Humans , Liver Neoplasms/radiotherapy , Pandemics , Prospective Studies , SARS-CoV-2
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