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1.
Artificial Organs ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1819876

ABSTRACT

Objective Myocardial damage occurs in up to 25% of coronavirus disease 2019 (COVID-19) cases. While veno-venous extracorporeal life support (V-V ECLS) is used as respiratory support, mechanical circulatory support (MCS) may be required for severe cardiac dysfunction. This systematic review summarizes the available literature regarding MCS use rates, disease drivers for MCS initiation, and MCS outcomes in COVID-19 patients. Methods PubMed/EMBASE were searched until October 14, 2021. Articles including adults receiving ECLS for COVID-19 were included. The primary outcome was the rate of MCS use. Secondary outcomes included mortality at follow-up, ECLS conversion rate, intubation-to-cannulation time, time on ECLS, cardiac diseases, use of inotropes, and vasopressors. Results Twenty-eight observational studies (comprising both ECLS-only populations and ECLS patients as part of larger populations) included 4218 COVID-19 patients (females: 28.8%;median age: 54.3?years, 95%CI: 50.7?57.8) of whom 2774 (65.8%) required ECLS with the majority (92.7%) on V-V ECLS, 4.7% on veno-arterial ECLS and/or Impella, and 2.6% on other ECLS. Acute heart failure, cardiogenic shock, and cardiac arrest were reported in 7.8%, 9.7%, and 6.6% of patients, respectively. Vasopressors were used in 37.2%. Overall, 3.1% of patients required an ECLS change from V-V ECLS to MCS for heart failure, myocarditis, or myocardial infarction. The median ECLS duration was 15.9?days (95%CI: 13.9?16.3), with an overall survival of 54.6% and 28.1% in V-V ECLS and MCS patients. One study reported 61.1% survival with oxy-right ventricular assist device. Conclusion MCS use for cardiocirculatory compromise has been reported in 7.3% of COVID-19 patients requiring ECLS, which is a lower percentage compared to the incidence of any severe cardiocirculatory complication. Based on the poor survival rates, further investigations are warranted to establish the most appropriated indications and timing for MCS in COVID-19.

2.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-334382

ABSTRACT

Device-to-device relative positioning systems such as COVID-19 contact tracing, seamless access systems, mobile interactive gaming, directional interaction, etc. have been promoted recently. The legacy absolute object positioning technologies are not suitable for device-to-device positioning because of the mobility and heterogeneity of devices. In this paper, we focus on the heterogeneity problem and propose Capo, the first calibration algorithm that enables the interaction among devices with different communication modes for relative positioning in heterogeneous systems. In particular, Capo optimizes the ranging results of low-precision devices in a collaborative network based on the ranging data collected from high-precision devices. Evaluation results show that Capo can significantly improve up to 26.56% of the positioning accuracy of the heterogeneous systems. Real use case study on COVID-19 contact tracing further shows that Capo significantly improves the accuracy of exposure notifications.

3.
iScience ; 2022.
Article in English | EuropePMC | ID: covidwho-1755857

ABSTRACT

The global pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection confers great threat to the public health. Human breastmilk is a complex with nutritional composition to nourish infants and protect them from different kinds of infectious diseases including COVID-19. Here, we identified lactoferrin (LF), mucin1 (MUC1) and α-lactalbumin (α-LA) from human breastmilk inhibit SARS-CoV-2 infection using a SARS-CoV-2 pseudovirus system and transcription and replication-competent SARS-CoV-2 virus-like-particles (trVLP). Additionally, LF and MUC1 inhibited multiple steps including viral attachment, entry and post-entry replication, while α-LA inhibited viral attachment and entry. Importantly, LF, MUC1 and α-LA possessed potent antiviral activities towards variants such as B.1.1.7 (alpha), B.1.351 (beta), P.1 (gamma) and B.1.617.1 (kappa). Taken together, our study provides evidence that human breastmilk components (LF, MUC1 and α-LA) are promising antiviral and potential therapeutic candidates warranting further development or treating COVID-19. Graphical

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308180

ABSTRACT

Background: A few patients with coronavirus disease 2019 (COVID-19) may progress into irreparable outcomes. Early identification of patients with serious symptoms who may develop critical illness and even death is of considerable importance for personalizing treatment and balancing medical resources. Methods: : In this retrospective study, demographic, clinical characteristics and laboratory tests from 726 patients with serious COVID-19 from Tongji Hospital (Wuhan, China) were analyzed. The standards for the serious type are guided by the Chinese management guideline for COVID-19. Patients were classified into critical group (174 cases) and severe group (552 cases) based on whether the composite endpoint was reached, and the former group was divided into the survivors (47 cases) and non-survivors (127 cases). Univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to investigate the risk factors associated with poor prognosis and mortality outcomes. Results: : Male patients accounted for 62.1% and 51.6% in the critical group and severe group, with a median age of 68 and 65 years, respectively. Among critical cases there was a higher prevalence of chronic obstructive lung disease (p = 0.029) and chest distress (p = 0.040) than in severe cases. In the multivariable analysis, the risk factors associated with poor prognosis in severe cases were advanced age (p = 0.002), high respiratory rate (RR) (p < 0.0001), high lactate dehydrogenase (LDH) level (p = 0.021), high hypersensitive cardiac troponin I (hs-cTnI) level (p < 0.0001), and low platelet counts (p = 0.005) at admission. In the adjusted models, higher mortality outcomes in critical patients were associated with high hs-cTnI level (p = 0.037). By plotting ROC curves of different indices, hs-cTnI and LDH were found to be predictive factors for poor prognosis in patients with severe COVID-19. Conclusions: : For the risk assessment of serious COVID-19 patients on admission, advanced age, high level of RR, LDH, hs-cTnI, and low platelet counts, constitute important risk factors for poor prognosis in severe cases, and the hs-cTnI level can be helpful in predicting fatal outcomes in critically ill patients.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307646

ABSTRACT

National and local governments have implemented a large number of policies, particularly non-pharmaceutical interventions, in response to the Covid-19 pandemic. Evaluating the effects of these policies, both on the number of Covid-19 cases as well on other economic outcomes is a key ingredient for policymakers to be able to determine which policies are most effective as well as the relative costs and benefits of particular policies. In this paper, we consider the relative merits of common identification strategies exploiting variation in policy choices made across different locations by checking whether the identification strategies are compatible with leading epidemic models in the epidemiology literature. We argue that unconfoundedness type approaches are likely to be more useful for evaluating policies than difference in differences type approaches due to the highly nonlinear spread of cases during a pandemic. For difference in differences, we further show that a version of this problem continues to exist even when one is interested in understanding the effect of a policy on other economic outcomes when those outcomes also depend on the number of Covid-19 cases. We propose alternative approaches that are able to circumvent these issues. We apply our proposed approach to study the effect of state level shelter-in-place orders early in the pandemic.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307645

ABSTRACT

During the early stages of the Covid-19 pandemic, national and local governments introduced a large number of policies, particularly non-pharmaceutical interventions, to combat the spread of Covid-19. Understanding the effects that these policies had (both on Covid-19 cases and on other outcomes) is particularly challenging though because (i) Covid-19 testing was not widely available, (ii) the availability of tests varied across locations, and (iii) the tests that were available were generally targeted towards individuals meeting certain eligibility criteria. In this paper, we propose a new approach to evaluate the effect of policies early in the pandemic that accommodates limited and nonrandom testing. Our approach results in (generally informative) bounds on the effect of the policy on actual cases and in point identification of the effect of the policy on other outcomes. We apply our approach to study the effect of Tennessee's open-testing policy during the early stage of the pandemic. For this policy, we find suggestive evidence that the policy decreased the number of Covid-19 cases in the state relative to what they would have been if the policy had not been implemented.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325358

ABSTRACT

This study mainly uses simulation technology to simulate the COVID-19 epidemic in Changsha, Hunan Province, China, and analyze the impact of different prevention and control measures on the epidemic. we Collect the information of all COVID-19 patients in Changsha from January 21, 2020 to March 14, 2020 and relevant policies during the COVID-19 epidemic in Changsha. Established the SEIAR infectious disease dynamics model under natural conditions, and added isolation measures on this basis. Using Anylogic8.5, the COVID-19 epidemic in Changsha City was simulated under various conditions based on the established model.In this study we find that There were 242 COVID-19 patients in Changsha. including 121 males (50%) and 121 females (50%).Most cases occurred between February 6 and February 16. Through the calculation of the R t during the epidemic in Changsha, it is found that it is reasonable to resume work on February 8, because the R t value of Changsha dropped below 1 at this time.The simulation results show that reducing the contact rate of residents and reducing the success rate of virus transmission (wearing masks, disinfection, etc.) can effectively prevent the spread of COVID-19 and significantly reduce the number of peak patients.We believe that the disease is mainly spread by the respiratory tract. Therefore, the simulation results show that whether in the early or mid-stage of the epidemic, quarantining the names of residents or reducing the contact rate of residents is very effective in controlling the COVID-19 epidemic.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325057

ABSTRACT

Background: Retroperitoneal hemorrhage is a rare and severe complication in patients undergoing extracorporeal membrane oxygenation (ECMO). Retroperitoneal hematoma after the operation of multiple ECMO in a single center at the same time is extremely rare. The causes and treatment options can provide clinical experience and bring some inspiration. Case presentation: Three cases of retroperitoneal hemorrhage patients with Corona Virus Disease-19 (COVID-19) are introduced;they had respiratory failure and were treated with veno-venous ECMO or veno-arterial-venous ECMO. Retroperitoneal hemorrhage occurred during ECMO treatment. Among the three cases, 2 cases were found due to abdominal pain, and 1 case was found because of a decrease in ECMO circuit flow rate and hemoglobin level. 2 cases were treated with transcatheter arterial embolization, and 1 case was treated conservatively. The hemorrhage in each of the 3 cases did not deteriorate. Through early diagnosis and treatment, satisfactory treatment results were achieved for these 3 patients. Conclusions: : During the period of ECMO treatment, there is a low incidence of retroperitoneal hematoma, yet it comes with a high risk. This is due to anticoagulant use and some local mechanical injuries. If a decline in blood flow velocity and hemoglobin is detected, retroperitoneal hematoma should be taken into consideration, and early aggressive therapy should be started.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325056

ABSTRACT

Background: COVID-19 broke out all over the world, and the mortality rate is extremely high. We report the successful experience of a critically ill COVID-19 patient who underwent long-term extracorporeal membrane oxygenation (ECMO) and multiple prone position ventilation (PPV) treatments. Case presentation: A 53-year-old male patient was sent to our hospital after 11 days of cough and 9 days of fever. According to his CT scan and real-time reverse transcription–polymerase chain reaction assay to throat swap, his nucleic acid was positive, confirming that he was infected with COVID-19. Subsequently, he was sent to ICU for respiratory failure. Afterwards, the patient received antiviral drug, tiny amount of glucocorticoid, and respiratory support, including mechanical ventilation, but the affect was poor. In the 28th day of his admission, veno-venous ECMO and PPV were used, combining with awake ECMO and other comprehensive rehabilitation. In the 17th day of ECMO, the patient started getting better and his chest CT and lung compliance improved. The ECMO was removed in the 27th days, after which the mechanical ventilation was gotten rid of in the 9th day. Then he was transferred to rehabilitation department. Conclusions: : COVID-19 can damage lung tissues and cause evident inflammatory exudation, affecting oxygenation function. It is effective to use PPV, awake ECMO, and comprehensive rehabilitation to cure patients with critical COVID-19 and respiratory failure. Our experience hopes to be promoted to play a positive role.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324990

ABSTRACT

Background: A new infectious disease, Coronavirus disease 2019 (COVID-19) has been first reported during December 2019 in Wuhan, China, cases have been exported to other cities and abroad rapidly. Hunan is the neighboring province of Wuhan, a series of preventive and control measures were taken to control the outbreak of COVID-19. It is critical to assess these measures on the epidemic progression for the benefit of global expectation. Method: A Susceptible-exposed-infections/asymptomatic-removed (SEIAR) model was established to evaluate the effect of preventive measures. Berkeley Madonna 8.3.18 was employed for the model simulation and prediction, and the curve-fitting problem was solved by Runge-Kutta fourth-order method.Results In this study, we found that R t was 2.71 from January 21 to 27 and reduced to 0.21 after January 27, 2020. If measures have not been fully launched, patients in Hunan would reach the maximum (8.96 million) on March 25, 2020, and end in about 208 days;when measures have been fully launched, patients in Hunan would just reach the maximum (699) on February 9, 2020, and end in about 56 days, which was very closed to the actual situation.Conclusion The outbreak of COVID-19 in Hunan, China has been well controlled under current measures, full implementation of measures could reduce the peak value, short the time to peak and duration of the outbreak effectively, which could provide a reference for controlling of COVID-19 for other countries.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324989

ABSTRACT

Background: A new human coronavirus named SARS-CoV-2 emerged during December 2019 in Wuhan, China. Cases have been exported to other Chinese cities and abroad, which may cause the global outbreak. Chang Sha is the nearest provincial capital city to Wuhan, the first case of COVID-19 in Changsha was diagnosed on January 21, 2020. Estimating the transmissibility and forecasting the trend of the outbreak of SARS-CoV-2 under the prevention and control measures in Changsha could inform evidence based decisions to policy makers. Methods: : Data were collected from the Health Commission of Changsha and Hunan Center for Disease Control and Prevention. A Susceptible-exposed-infections/ asymptomatic- removed (SEIAR) model was established to simulate the transmission of SARS-CoV-2 in Changsha. Berkeley Madonna 8.3.18 were employed for the model simulation and prediction, while the curve fitting problem was solved by the Runge-Kutta fourth-order method, with a tolerance of 0.001. Results: : In this study, we found that Rt was 2.05 from January 21 to 27 and reduced to 0.2 after January 27, 2020 in Changsha. The prediction results showed that when no obvious prevention and control measures were applied, the total number of patients in Changsha would reach the maximum (2.27 million) on the 79th day after the outbreak, and end in about 240 days;When measures have not been fully launched, the total number of patients would reach the maximum (1.60 million) on the 28th day after the outbreak, and end in about 110 days;When measures have been fully launched, the total number of patients would reach the maximum (234) on the 23rd day after the outbreak, and end in about 60 days. Conclusions: : Outbreak of SARS-CoV-2 in Changsha is in a controllable stage under current prevention and control measures, it is predicted that the cumulative patients would reach the maximum of 234 on February 12, and the outbreak would be over on 20 March in Changsha. With the fully implementation of prevention and control measures, it could effectively reduce the peak value, short the time to peak and duration of the outbreak.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321330

ABSTRACT

Large-scale COVID-19 infections have occurred worldwide, which has caused tremendous impact on the economy and people's lives. The traditional method for tracing contagious virus, for example, determining the infection chain according to the memory of infected people, has many drawbacks. With the continuous spread of the pandemic, many countries or organizations have started to study how to use mobile devices to trace COVID-19, aiming to help people automatically record information about incidents with infected people through technologies, reducing the manpower required to determine the infection chain and alerting people at risk of infection. This article gives an overview on various Bluetooth-based COVID-19 proximity tracing proposals including centralized and decentralized proposals. We discussed the basic workflow and the differences between them before providing a survey of five typical proposals with explanations of their design features and benefits. Then, we summarized eight security and privacy design goals for Bluetooth-based COVID-19 proximity tracing proposals and applied them to analyze the five proposals. Finally, open problems and future directions are discussed.

13.
Chem Biodivers ; 19(1): e202100668, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1611203

ABSTRACT

Forsyqinlingines C (1) and D (2), two C9 -monoterpenoid alkaloids bearing a rare skeleton, were isolated from the ripe fruits of Forsythia suspensa. Their structures, including absolute configurations, were fully elucidated by extensive spectroscopic data and ECD experiments. The plausible biogenetic pathway for compounds 1 and 2 was also proposed. In vitro, two C9 -monoterpenoid alkaloids showed anti-inflammatory activity performed by the inhibitory effect on the release of ß-glucuronidase in rat polymorphonuclear leukocytes (PMNs), as well as antiviral activity against influenza A (H1N1) virus and respiratory syncytial virus (RSV).


Subject(s)
Alkaloids/chemistry , Anti-Inflammatory Agents/chemistry , Antiviral Agents/chemistry , Forsythia/chemistry , Monoterpenes/chemistry , Alkaloids/isolation & purification , Alkaloids/pharmacology , Animals , Anti-Inflammatory Agents/isolation & purification , Anti-Inflammatory Agents/pharmacology , Antiviral Agents/isolation & purification , Antiviral Agents/pharmacology , Forsythia/metabolism , Fruit/chemistry , Fruit/metabolism , Glucuronidase/metabolism , Influenza A Virus, H1N1 Subtype/drug effects , Magnetic Resonance Spectroscopy , Molecular Conformation , Neutrophils/cytology , Neutrophils/drug effects , Neutrophils/metabolism , Platelet Activating Factor/pharmacology , Rats , Respiratory Syncytial Viruses/drug effects
14.
J Adv Res ; 36: 201-210, 2022 02.
Article in English | MEDLINE | ID: covidwho-1536631

ABSTRACT

Introduction: The COVID-19 global epidemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a great public health emergency. Discovering antiviral drug candidates is urgent for the prevention and treatment of COVID-19. Objectives: This work aims to discover natural SARS-CoV-2 inhibitors from the traditional Chinese herbal medicine licorice. Methods: We screened 125 small molecules from Glycyrrhiza uralensis Fisch. (licorice, Gan-Cao) by virtual ligand screening targeting the receptor-binding domain (RBD) of SARS-CoV-2 spike protein. Potential hit compounds were further evaluated by ELISA, SPR, luciferase assay, antiviral assay and pharmacokinetic study. Results: The triterpenoids licorice-saponin A3 (A3) and glycyrrhetinic acid (GA) could potently inhibit SARS-CoV-2 infection, with EC50 of 75 nM and 3.17 µM, respectively. Moreover, we reveal that A3 mainly targets the nsp7 protein, and GA binds to the spike protein RBD of SARS-CoV-2. Conclusion: In this work, we found GA and A3 from licorice potently inhibit SARS-CoV-2 infection by affecting entry and replication of the virus. Our findings indicate that these triterpenoids may contribute to the clinical efficacy of licorice for COVID-19 and could be promising candidates for antiviral drug development.


Subject(s)
COVID-19 , Glycyrrhiza , Triterpenes , Humans , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Triterpenes/pharmacology
15.
IEEE Internet of Things Journal ; 8(23):16723-16733, 2021.
Article in English | ProQuest Central | ID: covidwho-1526325

ABSTRACT

The outbreak of Covid-19 changed the world as well as human behavior. In this article, we study the impact of Covid-19 on smartphone usage. We gather smartphone usage records from a global data collection platform called Carat, including the usage of mobile users in North America from November 2019 to April 2020. We then conduct the first study on the differences in smartphone usage across the outbreak of Covid-19. We discover that Covid-19 leads to a decrease in users’ smartphone engagement and network switches, but an increase in WiFi usage. Also, its outbreak causes new typical diurnal patterns of both memory usage and WiFi usage. Additionally, we investigate the correlations between smartphone usage and daily confirmed cases of Covid-19. The results reveal that memory usage, WiFi usage, and network switches of smartphones have significant correlations, whose absolute values of Pearson coefficients are greater than 0.8. Moreover, smartphone usage behavior has the strongest correlation with the Covid-19 cases occurring after it, which exhibits the potential of inferring outbreak status. By conducting extensive experiments, we demonstrate that for the inference of outbreak stages, both Macro-F1 and Micro-F1 can achieve over 0.8. Our findings explore the values of smartphone usage data for fighting against the epidemic.

16.
ASAIO J ; 67(9): 973-981, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1494076

ABSTRACT

Coronavirus disease 2019 (COVID-19) radically modified the organization of healthcare systems with shutdown of routine activities and outpatient clinics. Herein, we report our institutional experience with a Telemonitoring and Care Program (TC-Program) to monitor and support left ventricular assist device (LVAD) patients during COVID-19 outbreak. This single-arm cohort study analyzed 156 patients who entered the TC-Program at our institution between April and August 2020. The TC-Program was based on routine phone calls to patients and a 24/7 emergency line. In November 2020, patients were asked for feedback on the TC-Program and checked for survival, transplant, or explant. The primary endpoint was the rate of TC-Program-driven interventions. Patients (males: 82.8%) were 61 years old (interquartile range [IQR]: 53.0-67.5) and on LVAD support for 1,266 days (IQR: 475-2,211). Patients were included in the TC-Program for a median time of 99 days (min:15, max:120) and received a median number of six phone calls (min:1, max:14). Twenty-three patients (14.7%) were referred for clinical evaluation after phone contact. Two patients (1.27%) were diagnosed with COVID-19: one of them died after intensive care, and one remained paucisymptomatic and recovered. Three patients asked to exit the program considering it not useful while the others gave high rates in terms of usefulness (median: 9, IQR: 8-10), information (median: 9, IQR: 8-10), good medical care (median: 9, IQR: 8-10), and psychologic support (median: 8, IQR: 7-10). A TC-Program based on the four ICSA principles (Inform, Care, Support, and Adapt) is feasible in LVAD patients and can be rapidly implemented during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Heart Failure/therapy , Heart-Assist Devices/statistics & numerical data , Infection Control/organization & administration , Telemedicine , COVID-19/epidemiology , Cohort Studies , Disease Outbreaks , Female , Heart Failure/epidemiology , Heart-Assist Devices/adverse effects , Humans , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2
17.
World J Gastroenterol ; 27(32): 5404-5423, 2021 Aug 28.
Article in English | MEDLINE | ID: covidwho-1379993

ABSTRACT

BACKGROUND: Intestinal barrier breakdown, a frequent complication of intestinal ischemia-reperfusion (I/R) including dysfunction and the structure changes of the intestine, is characterized by a loss of tight junction and enhanced permeability of the intestinal barrier and increased mortality. To develop effective and novel therapeutics is important for the improvement of outcome of patients with intestinal barrier deterioration. Recombinant human angiopoietin-like protein 4 (rhANGPTL4) is reported to protect the blood-brain barrier when administered exogenously, and endogenous ANGPTL4 deficiency deteriorates radiation-induced intestinal injury. AIM: To identify whether rhANGPTL4 may protect intestinal barrier breakdown induced by I/R. METHODS: Intestinal I/R injury was elicited through clamping the superior mesenteric artery for 60 min followed by 240 min reperfusion. Intestinal epithelial (Caco-2) cells and human umbilical vein endothelial cells were challenged by hypoxia/ reoxygenation to mimic I/R in vitro. RESULTS: Indicators including fluorescein isothiocyanate-conjugated dextran (4 kilodaltons; FD-4) clearance, ratio of phosphorylated myosin light chain/total myosin light chain, myosin light chain kinase and loss of zonula occludens-1, claudin-2 and VE-cadherin were significantly increased after intestinal I/R or cell hypoxia/reoxygenation. rhANGPTL4 treatment significantly reversed these indicators, which were associated with inhibiting the inflammatory and oxidative cascade, excessive activation of cellular autophagy and apoptosis and improvement of survival rate. Similar results were observed in vitro when cells were challenged by hypoxia/reoxygenation, whereas rhANGPTL4 reversed the indicators close to normal level in Caco-2 cells and human umbilical vein endothelial cells significantly. CONCLUSION: rhANGPTL4 can function as a protective agent against intestinal injury induced by intestinal I/R and improve survival via maintenance of intestinal barrier structure and functions.


Subject(s)
/pharmacology , Intestines , Reperfusion Injury , Caco-2 Cells , Human Umbilical Vein Endothelial Cells , Humans , Intestinal Mucosa , Recombinant Proteins/pharmacology , Reperfusion Injury/prevention & control
18.
World J Clin Cases ; 9(21): 5963-5971, 2021 Jul 26.
Article in English | MEDLINE | ID: covidwho-1335440

ABSTRACT

BACKGROUND: A critically ill coronavirus disease 2019 (COVID-19) patient complicated by acute respiratory distress syndrome is reported. The patient survived following treatment with awake veno-venous extracorporeal membrane oxygenation (ECMO). CASE SUMMARY: A 53-year-old male patient attended our hospital following a cough for 11 d and fever for 9 d. According to his computed tomography (CT) scan and real-time reverse transcription-polymerase chain reaction assay of a throat swab, nucleic acid was positive, confirming that he had COVID-19. He was subsequently transferred to the intensive care unit due to respiratory failure. The patient received antiviral drugs, a small dose of glucocorticoid, and respiratory support, including mechanical ventilation, but the treatment effect was poor. On the 28th day after admission, veno-venous ECMO and prone position ventilation (PPV) were performed, combined with awake ECMO and other comprehensive rehabilitation measures. On the 17th day of ECMO, the patient started to improve and his chest CT and lung compliance improved. ECMO was discontinued after 27 days, and mechanical ventilation was also discontinued after 9 days. The patient was then transferred to the rehabilitation department. CONCLUSION: COVID-19 can damage lung tissues and cause evident inflammatory exudation, thus affecting oxygenation function. Awake ECMO, PPV, and comprehensive rehabilitation are effective in patients with critical COVID-19 and respiratory failure.

19.
World J Clin Cases ; 9(19): 5203-5210, 2021 Jul 06.
Article in English | MEDLINE | ID: covidwho-1314995

ABSTRACT

BACKGROUND: Retroperitoneal hemorrhage (RPH) is a rare and severe complication in patients undergoing extracorporeal membrane oxygenation (ECMO). Clinical diagnosis is difficult. CASE SUMMARY: Three cases of RPH patients with corona virus disease-19 (COVID-19) were included in this study. All three suffered from respiratory failure, were treated with veno-venous or veno-arterial-venous ECMO, and experienced RPH during ECMO treatment. Two of the COVID-19 cases were diagnosed after the patients experienced abdominal pain. The other patient exhibited decreases in the ECMO circuit flow rate and hemoglobin level. Two cases were treated by transcatheter arterial embolization, and one was treated conservatively. The hemorrhage in each of the three cases did not deteriorate. Satisfactory treatment results were achieved for the three patients because of prompt diagnosis and treatment. CONCLUSION: Although the incidence of RPH during ECMO treatment is low, the risk is increased by anticoagulant use and local mechanical injury. If declines in blood flow velocity and hemoglobin are detected, RPH should be considered, and prompt aggressive therapy should be started.

20.
BMJ Open ; 11(6): e046350, 2021 06 24.
Article in English | MEDLINE | ID: covidwho-1282098

ABSTRACT

OBJECTIVES: To survey anxiety and depression symptoms to COVID-19 outbreak in the public, medical staff and patients during the initial phase of the pandemic. DESIGN: Cross-sectional online survey administered through WeChat Mini Program using Chinese versions of Zung Self-rating Depression Scale and Zung Self-rating Anxiety Scale. SETTING: Guangzhou, China. PARTICIPANTS: 47 378 public, 1512 medical staff and 125 patients with COVID-19. RESULTS: Higher rates of depression (47.8%) and anxiety symptoms (48.7%) were shown by patients who were screened positive compared with those of the public (35.6%, 25.7%) or medical staff (15.4%, 13.3%). The professional identity of a nurse, conditions of 'with an infected family member' and 'working at the frontline' were risk factors to depression or anxiety symptoms for the medical staff. Younger age, lower educational level, female and not having adequate masks were the risk factors for the public. CONCLUSION: The COVID-19 outbreak increased people's depression or anxiety emotion responses, which varied extensively among the patients, public and medical staff.


Subject(s)
Anxiety , COVID-19 , Depression , Medical Staff/psychology , Pandemics , Anxiety/epidemiology , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Prevalence , Surveys and Questionnaires
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