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1.
Vaccines ; 10(5):706, 2022.
Article in English | MDPI | ID: covidwho-1820443

ABSTRACT

The administration of COVID-19 vaccines has become increasingly essential to curb the pandemic. However, adverse events of acute kidney injury (AKI) emerge rapidly as the COVID-19 vaccination promotes. To investigate the intervenable risk factors of AKI, we searched the Vaccine Adverse Event Reporting System database and recorded adverse effects after COVID-19 vaccines from Dec 2020 to Jun 2021. We included 1149 AKI cases, of which 627 (54.6%) cases were reported following the Pfizer-BNT COVID-19 vaccine, and 433 (37.7%) were reported after the Moderna vaccine. A univariate analysis revealed that coexisting active illnesses (infections, uncontrolled hypertension, heart failure, etc.) have an unfavorable prognosis, with an increased risk of death (OR 2.35, 95% CI 1.70–3.25, p < 0.001). The other risk factors included older age and past disease histories. An adjusted regression analysis proved that coexisting active illnesses worsen AKI prognosis after COVID-19 vaccination, with a higher mortality risk (OR 2.19, 95% CI 1.48–3.25, p < 0.001). In subgroup analysis, we stratified different variables, and none revealed a significant effect modification on the association between coexisting active illnesses and AKI-associated death after vaccination (p-interaction >0.05). We found that coexisting active illnesses could complicate AKI after vaccines, but the potential causal relationship needed further investigation.

2.
Journal of Cleaner Production ; 332:130019, 2022.
Article in English | ScienceDirect | ID: covidwho-1559186

ABSTRACT

Ten years after the Fukushima nuclear accident, on April 13, 2021, the Japanese government announced the discharge of nuclear wastewater into the Pacific Ocean starting from the late 2022 or early 2023. The implementation of this decision would harm the local and global marine ecology because of the radioactive substances in the nuclear wastewater, which has also triggered strong opposition from the Japanese people and neighboring countries. The discharge of nuclear wastewater is a complicated process. In the context of the COVID-19, options of decision makers (DMs) must take into consideration existing global uncertainty, potentially leading to a slew of uncertain outcomes. A novel grey and unknown preference framework of the graph model for conflict resolution (GMCR) was proposed in this study to resolve the conflict of discharging nuclear wastewater in the ocean. Four forms of unknown preferences were defined for different grey stability definitions fully considering consider the possibility of choosing unknown results by DMs and increasing the diversity of equilibrium results. The equilibrium results the other alternative methods to discharge or continue to store nuclear waste are more conducive to the development of various DMs, and the consultation and cooperation of all DMs would ensure effective conflict resolution.

3.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-296272

ABSTRACT

New SARS-CoV-2 variants continue to emerge from the current global pandemic, some of which can replicate faster and with greater transmissibility and pathogenicity. In particular, UK501Y.V1 identified in UK, SA501Y.V2 in South Africa, and BR501Y.V3 in Brazil are raising serious concerns as they spread quickly and contain spike protein mutations that may facilitate escape from current antibody therapies and vaccine protection. Here, we constructed a panel of 28 SARS-CoV-2 pseudoviruses bearing single or combined mutations found in the spike protein of these three variants, as well as additional nine mutations that within or close by the major antigenic sites in the spike protein identified in the GISAID database. These pseudoviruses were tested against a panel of monoclonal antibodies (mAbs), including some approved for emergency use to treat SARS-CoV-2 infection, and convalescent patient plasma collected early in the pandemic. SA501Y.V2 pseudovirus was the most resistant, in magnitude and breadth, against mAbs and convalescent plasma, followed by BR501Y.V3, and then UK501Y.V1. This resistance hierarchy corresponds with Y144del and 242-244del mutations in the N-terminal domain as well as K417N/T, E484K and N501Y mutations in the receptor binding domain (RBD). Crystal structural analysis of RBD carrying triple K417N-E484K-N501Y mutations found in SA501Y.V2 bound with mAb P2C-1F11 revealed a molecular basis for antibody neutralization and escape. SA501Y.V2 and BR501Y.V3 also acquired substantial ability to use mouse and mink ACE2 for entry. Taken together, our results clearly demonstrate major antigenic shifts and potentially broadening the host range of SA501Y.V2 and BR501Y.V3, which pose serious challenges to our current antibody therapies and vaccine protection.

5.
Int J Clin Pract ; 75(10): e14640, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1325002

ABSTRACT

BACKGROUND: Clinical symptoms of adults and paediatric inpatients with COVID-19 disease are conflicting. This meta-analysis was conducted to assess the effect of age of COVID-19 inpatient on the severity of the disease. METHODS: A systematic literature search up to January 2021 was performed and 5 studies included 910 inpatients with COVID-19 disease at the baseline of the study; 773 of them were adult inpatients, and 137 of them were paediatric inpatients. They reported a comparison between adults and children with COVID-19 in the level of symptomatic severity, clinical features, computed tomography (CT) results and laboratory results. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effect of age of COVID-19 inpatient on the severity of the disease using the dichotomous method with a random or fixed-effect model. RESULTS: Adults with COVID-19 disease had significantly lower number of mild cases (OR, 0.18; 95% CI, 0.04-0.77, P = .02); higher number severe cases (OR, 4.90; 95% CI, 2.03-11.83, P < .001); higher number of cases with fever (OR, 4.14; 95% CI, 2.31-7.43, P < .001); and higher number of cases with CT positive COVID-19 disease (OR, 2.04; 95% CI, 1.17-3.55, P = .001) compared with children. However, no significant difference was found between adults and children in number of cases with shortness of breath (OR, 1.44; 95% CI, 0.41-5.04, P = .57); dry cough (OR, 1.77; 95% CI, 0.64-4.93, P = .27); leukopenia (OR, 0.89; 95% CI, 0.47-1.66, P = .71); lymphopenia (OR, 0.96; 95% CI, 0.49-1.88, P = .91); high platelets (OR, 0.41; 95% CI, 0.17-1.02, P = .05); and high D-dimer (OR, 0.82; 95% CI, 0.43-1.56, P = .54). CONCLUSIONS: Adults with COVID-19 disease have a much higher level of symptomatic severity, fever and CT-positive COVID-19 disease than children. However, as shown in our results, the laboratory data were similar in both groups.


Subject(s)
COVID-19 , Inpatients , Adult , Child , Cough , Fever , Humans , SARS-CoV-2
6.
Ann Palliat Med ; 10(7): 7270-7279, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1311481

ABSTRACT

BACKGROUND: We aim to investigate the clinical characteristics and survival rate of coronavirus disease 2019 (COVID-19) patients. METHODS: Ninety-seven COVID-19 patients were enrolled. The laboratory results, lung imaging and medical treatment were compared. Patients were followed up after 1 year, and the Kaplan-Meier test was used for survival analysis. RESULTS: Compared with the non-severe group, the age of the severe group was older, and the proportion of concomitant diseases were higher. As fever was the primary clinical manifestation, dyspnea and anorexia were more common in severe patients. Lung imaging manifestations and laboratory indicators were worse in the severe group. Accordingly, the treatment of glucocorticoid, antibiotics, and advanced life support were in high proportion. Of the 97 patients with COVID-19, 4 severe patients died within one month during the 1-year follow-up, with the median survival time of 47.0 weeks (95% CI: 45.1-48.9). CONCLUSIONS: Severe cases of COVID-19 are characterized by advanced age, more concomitant diseases and complications, which lead to a decreased short-term survival rate. However, there were no deaths after one month, which implied a good prognosis if the risk period were passed smoothly.


Subject(s)
COVID-19 , Humans , Lung , Retrospective Studies , SARS-CoV-2 , Survival Analysis
7.
Ren Fail ; 43(1): 1104-1114, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1303829

ABSTRACT

BACKGROUND: The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study. METHODS: This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored. RESULTS: A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m2) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m2) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m2 while 25% showed eGFRcr < 60 ml/min/1.73 m2 (χ2 = 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m2) was associated with death (HR = 1.939, 95%CI 1.078-3.489, p = 0.027). CONCLUSIONS: The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.


Subject(s)
COVID-19/physiopathology , Creatine/blood , Cystatin C/blood , Glomerular Filtration Rate , Renal Insufficiency, Chronic/diagnosis , Aged , Biomarkers/blood , COVID-19/complications , COVID-19/mortality , China/epidemiology , Critical Illness/therapy , Female , Hospital Mortality , Humans , Kidney Function Tests , Male , Middle Aged , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/etiology , Retrospective Studies , Survival Analysis
8.
Exp Ther Med ; 21(1): 3, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1261371

ABSTRACT

SARS-CoV-2 is the seventh member of the family of coronaviruses that can cause infections in humans, termed as COVID-19, which is now a global pandemic. Because it is a novel virus, considerable efforts and extensive studies are needed to fully understand its characteristics. Its symptoms and severity range from mild to critical, depending on several factors, such as host susceptibility to the virus and their immune system, with the most common symptoms being fever, fatigue, sore throat and runny nose. There is no clear treatment available yet, though several options are being explored, with research for vaccines being at the forefront. Traditional Chinese Medicine may also be used as a treatment option. Since this virus is similar to the SARS-CoV and MERS viruses, considerable insight can be gained from previous studies. Although many patients recover completely, there are several factors that lead to poor prognosis. This review summarizes the research carried out so far in terms of treatment options and prognosis factors associated with COVID-19.

9.
Immunity ; 54(7): 1611-1621.e5, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1260761

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to emerge during the global pandemic and may facilitate escape from current antibody therapies and vaccine protection. Here we showed that the South African variant B.1.351 was the most resistant to current monoclonal antibodies and convalescent plasma from coronavirus disease 2019 (COVID-19)-infected individuals, followed by the Brazilian variant P.1 and the United Kingdom variant B.1.1.7. This resistance hierarchy corresponded with Y144del and 242-244del mutations in the N-terminal domain and K417N/T, E484K, and N501Y mutations in the receptor-binding domain (RBD) of SARS-CoV-2. Crystal structure analysis of the B.1.351 triple mutant (417N-484K-501Y) RBD complexed with the monoclonal antibody P2C-1F11 revealed the molecular basis for antibody neutralization and escape. B.1.351 and P.1 also acquired the ability to use mouse and mink ACE2 receptors for entry. Our results demonstrate major antigenic shifts and potential broadening of the host range for B.1.351 and P.1 variants, which poses serious challenges to current antibody therapies and vaccine protection.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , Antibodies, Neutralizing/immunology , Immune Evasion , SARS-CoV-2/immunology , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/chemistry , Antigenic Variation/genetics , COVID-19/immunology , COVID-19/virology , Host Specificity , Humans , Immune Evasion/genetics , Mice , Mink , Mutation , Protein Binding , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Spike Glycoprotein, Coronavirus/metabolism , Virus Internalization
10.
Front Immunol ; 12: 669010, 2021.
Article in English | MEDLINE | ID: covidwho-1259345

ABSTRACT

Background: The prophylactic vaccination of COVID-19 mRNA vaccines is the first large-scale application of this kind in the human world. Over 1.8 million doses of the COVID-19 vaccine had been administered in the US until December 2020, and around 0.2% submitted AE reports to the Vaccine Adverse Event Reporting System (VAERS). This study aimed to evaluate the AEs following immunization (AEFIs) and analyze the potential associations based on the information from the VAERS database. Methods: We searched the VAERS database recorded AEFIs after COVID-19 vaccines in December 2020. After data mapping, we summarized demographic and clinical features of reported cases. Fisher exact test was used to comparing the clinical characteristics among AE groups with an anaphylactic response, concerning neurological disorders and death. Results: VAERS reported 3,908 AEFIs of COVID-19 vaccines in December 2020. Most (79.68%) were reported after the first dose of the vaccine. Among the reported cases, we found that general disorders (48.80%), nervous system disorders (46.39%), and gastrointestinal disorders (25.54%) were the most common AEFIs. The allergy history was more frequent in vaccine recipients with anaphylactic reactions than those without (64.91% vs. 49.62%, OR = 1.88, P <0.017). History of anxiety or depression was more common in subjects reporting severe neurological AEFIs than those reporting other AEFIs (18.37% vs. 7.85%, OR = 2.64, P <0.017). Cases reporting death were significantly older (79.36 ± 10.41-year-old vs. 42.64 ± 12.55-year-old, P <0.01, 95% CI 29.30-44.15) and more likely experienced hypertension (50.00% vs. 11.42%, OR = 7.76, P <0.01) and neurological disorders (50.00% vs. 5.36%, OR = 17.65, P <0.01) than other vaccine recipients. The outpatient and emergency room visit rates were 11.92 and 22.42% for AEFIs, and 2.53% of cases needed hospitalization. Conclusion: AEFIs of COVID-19 mRNA vaccines were generally non-severe local or systemic reactions. A prior allergy history is the risk factor for anaphylaxis, while a history of anxiety may link with severe neurological AEs. Such vaccine recipients need further evaluation and monitor.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , SARS-CoV-2 , Vaccines, Synthetic/adverse effects , Adolescent , Adult , Adverse Drug Reaction Reporting Systems , Aged , Female , Humans , Male , Middle Aged , United States , Vaccination/adverse effects , Young Adult
11.
Cell Res ; 31(7): 732-741, 2021 07.
Article in English | MEDLINE | ID: covidwho-1237995

ABSTRACT

SARS-CoV-2 variants could induce immune escape by mutations on the receptor-binding domain (RBD) and N-terminal domain (NTD). Here we report the humoral immune response to circulating SARS-CoV-2 variants, such as 501Y.V2 (B.1.351), of the plasma and neutralizing antibodies (NAbs) elicited by CoronaVac (inactivated vaccine), ZF2001 (RBD-subunit vaccine) and natural infection. Among 86 potent NAbs identified by high-throughput single-cell VDJ sequencing of peripheral blood mononuclear cells from vaccinees and convalescents, near half anti-RBD NAbs showed major neutralization reductions against the K417N/E484K/N501Y mutation combination, with E484K being the dominant cause. VH3-53/VH3-66 recurrent antibodies respond differently to RBD variants, and K417N compromises the majority of neutralizing activity through reduced polar contacts with complementarity determining regions. In contrast, the 242-244 deletion (242-244Δ) would abolish most neutralization activity of anti-NTD NAbs by interrupting the conformation of NTD antigenic supersite, indicating a much less diversity of anti-NTD NAbs than anti-RBD NAbs. Plasma of convalescents and CoronaVac vaccinees displayed comparable neutralization reductions against pseudo- and authentic 501Y.V2 variants, mainly caused by E484K/N501Y and 242-244Δ, with the effects being additive. Importantly, RBD-subunit vaccinees exhibit markedly higher tolerance to 501Y.V2 than convalescents, since the elicited anti-RBD NAbs display a high diversity and are unaffected by NTD mutations. Moreover, an extended gap between the third and second doses of ZF2001 leads to better neutralizing activity and tolerance to 501Y.V2 than the standard three-dose administration. Together, these results suggest that the deployment of RBD-vaccines, through a third-dose boost, may be ideal for combating SARS-CoV-2 variants when necessary, especially for those carrying mutations that disrupt the NTD supersite.


Subject(s)
Antibodies, Neutralizing/immunology , COVID-19 Vaccines/pharmacology , COVID-19/immunology , COVID-19/prevention & control , Immunity, Humoral , SARS-CoV-2/immunology , Vaccines, Inactivated/pharmacology , Animals , Antibodies, Neutralizing/blood , COVID-19/blood , COVID-19 Vaccines/immunology , Cell Line , HEK293 Cells , Humans , Models, Molecular , Mutation , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Vaccines, Inactivated/immunology , Vaccines, Subunit/immunology , Vaccines, Subunit/pharmacology
12.
Front Immunol ; 12: 614436, 2021.
Article in English | MEDLINE | ID: covidwho-1167338

ABSTRACT

The novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic of the coronavirus disease 2019 (COVID-19), which elicits a wide variety of symptoms, ranging from mild to severe, with the potential to lead to death. Although used as the standard method to screen patients for SARS-CoV-2 infection, real-time PCR has challenges in dealing with asymptomatic patients and those with an undetectable viral load. Serological tests are therefore considered potent diagnostic tools to complement real-time PCR-based diagnosis and are used for surveillance of seroprevalence in populations. However, the dynamics of the antibody response against SARS-CoV-2 currently remain to be investigated. Here, through analysis of plasma samples from 84 patients with COVID-19, we observed that the response of virus-specific antibodies against three important antigens, RBD, N and S, dynamically changed over time and reached a peak 5-8 weeks after the onset of symptoms. The antibody responses were irrespective of sex. Severe cases were found to have higher levels of antibody response, larger numbers of inflammatory cells and C-reactive protein levels. Within the mild/moderate cases, pairwise comparison indicated moderate association between anti-RBD vs. anti-N, anti-RBD vs. anti-S1S2, and anti-N vs. anti-S1S2. Furthermore, the majority of cases could achieve IgM and IgG seroconversion at 2 weeks since the disease onset. Analysis of neutralizing antibodies indicated that these responses were able to last for more than 112 days but decline significantly after the peak. In summary, our findings demonstrate the longitudinally dynamic changes in antibody responses against SARS-CoV-2, which can contribute to the knowledge of humoral immune response after SARS-CoV-2 infection and are informative for future development of vaccine and antibody-based therapies.


Subject(s)
Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/immunology , Coronavirus Nucleocapsid Proteins/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Adult , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Beijing , COVID-19/pathology , China , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Phosphoproteins/immunology , Protein Domains/immunology , Seroconversion , Severity of Illness Index , Tertiary Care Centers
13.
Front Pediatr ; 9: 619738, 2021.
Article in English | MEDLINE | ID: covidwho-1145575

ABSTRACT

SARS-CoV-2, a member of the family coronaviridae, has triggered a lethal pandemic termed coronavirus disease 2019 (COVID-19). Pediatric patients, mainly from families with a cluster of infection or a history of exposure to epidemic areas, get infected via direct contacts or air-borne droplets. Children (aged below 18 years) are susceptible to COVID-19, with an average incubation period of about 6.5 days. Most cases present asymptomatic or common cold symptoms such as fever, cough, and myalgia or fatigue, which is milder than adult patients. Besides, most abnormal laboratory and radiologic findings in children with COVID-19 are non-specific. Since no specific chemotherapeutic agents have been approved for children, timely preventive methods could effectively forestall the transmission of SARS-CoV-2. To date, mostly studied cases have been adults with COVID-19, whereas data on pediatrics patients remain poorly defined. We herein conducted a literature review for papers published in PubMed and medRxiv (preprints) between December 2019 and December 2020 that reported on pediatrics patients (aged below 18 years) with a confirmed COVID-19 diagnosis. In this review, we summarized and discussed the pathogenesis, epidemiology, and clinical management of COVID-19 in pediatrics patients to improve our understanding of this new disease in children.

14.
Clin Respir J ; 15(5): 499-505, 2021 May.
Article in English | MEDLINE | ID: covidwho-1066647

ABSTRACT

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly to 185 regions and countries around the world with more than 2.8 million confirmed infections and 203,044 deaths. Respiratory diseases caused by SARS-CoV-2 are serious threats to human health. OBJECTIVES: To develop a rapid detection kit for new coronavirus antibodies and use it to study the dynamic changes in antibodies in clinically confirmed SARS-CoV-2-infected patients. METHODS: The SARS-CoV-2 IgM/IgG antibody test kit (colloidal gold method) was developed. Serum SARS-CoV-2 IgM and IgG antibodies were tested in SARS-CoV-2- and non-SARS-CoV-2-infected persons, respectively. RESULTS AND CONCLUSION: The sensitivities of the SARS-CoV-2 IgM/IgG antibody test kit (colloidal gold method) were 50%, 70%, 92.5% and 97.5% after 1-3 days, 4-6 days, 7-9 days and >9 days of admission, respectively, and the specificities of the IgM, IgG and IgM + IgG antibodies were all 100%. Using the SARS-CoV-2 IgM/IgG antibody test kit (colloidal gold method), the positive rates of SARS-CoV-2 IgM and IgG antibodies increased from 50% to 92.5% after 1-3 days, 4-6 days and 7-9 days of admission, which showed an increasing trend. The titers of the SARS-CoV-2 IgM and IgG antibodies in the positive specimens increased with the length of admission.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , Immunoglobulin G/blood , Immunoglobulin M/immunology , SARS-CoV-2/immunology , Adult , COVID-19/epidemiology , Female , Humans , Immunoglobulin M/blood , Male , Pandemics
15.
Chin J Integr Med ; 27(4): 245-251, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1061046

ABSTRACT

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


Subject(s)
COVID-19/drug therapy , Medicine, Chinese Traditional , Pneumonia/drug therapy , SARS-CoV-2 , Adult , Aged , Case-Control Studies , Convalescence , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Discharge , Pneumonia/diagnostic imaging , Prospective Studies
16.
Psychiatry Res ; 296: 113654, 2021 02.
Article in English | MEDLINE | ID: covidwho-997443

ABSTRACT

The COVID-19 pandemic put global medical systems under massive pressure for its uncertainty, severity, and persistence. For detecting the prevalence of suicidal and self-harm ideation (SSI) and its related risk factors among hospital staff during the COVID-19 pandemic, this cross-sectional study collected the sociodemographic data, epidemic-related information, the psychological status and need, and perceived stress and support from 11507 staff in 46 hospitals by an online survey from February 14 to March 2, 2020. The prevalence of SSI was 6.47%. Hospital staff with SSI had high family members or relatives infected number and the self-rated probability of infection. Additionally, they had more perceived stress, psychological need, and psychological impact. On the contrary, hospital staff without SSI reported high self-rated health, willingness to work in a COVID-19 ward, confidence in defeating COVID-19, and perceived support. Furthermore, they reported better marital or family relationship, longer sleep hours, and shorter work hours. The infection of family members or relatives, poor marital status, poor self-rated health, the current need for psychological intervention, perceived high stress, perceived low support, depression, and anxiety were independent factors to SSI. A systematic psychological intervention strategy during a public health crisis was needed for the hospital staff's mental well-being.


Subject(s)
Anxiety Disorders/epidemiology , COVID-19/epidemiology , Depressive Disorder/epidemiology , Personnel, Hospital/statistics & numerical data , Self-Injurious Behavior/epidemiology , Suicidal Ideation , Adult , Anxiety Disorders/psychology , COVID-19/psychology , China , Cross-Sectional Studies , Depressive Disorder/psychology , Female , Humans , Incidence , Male , Personnel, Hospital/psychology , Self-Injurious Behavior/psychology , Uncertainty , Young Adult
17.
Front Med (Lausanne) ; 7: 588301, 2020.
Article in English | MEDLINE | ID: covidwho-940193

ABSTRACT

Renal involvement has been implicated in coronavirus disease 2019 (COVID-19), but the related prevalence and prognosis were largely unknown. In this meta-analysis, we searched the literature from PubMed, Embase, through bioRxiv, and medRxiv until April 26, 2020. Studies reporting chronic kidney diseases (CKDs) and/or acute kidney injury (AKI) were included. Demographics, relevant data of disease severity, and patient's prognosis were extracted and aggregated. Twenty-one thousand one hundred sixty-four patients from 52 peer-reviewed studies were included. Thirty-seven studies (n = 16,922) reported CKD in COVID-19 patients at diagnosis, and the pooled prevalence was 3.52% (95% CI, 1.98-5.48%; I 2 = 93%). Subgroup analysis showed that CKD prevalence was higher in severe cases [odds ratio (OR), 3.42; 95% CI 2.05-5.61; I 2 = 0%] compared to those with non-severe disease and deceased cases (6.46, 3.40-12.29; I 2 = 1%) compared with survivors. Pooled prevalence of CKD was lower in Chinese patients (2.56%; 95% CI, 1.79-3.47%; I 2 = 80%) compared to those outside of China (6.32%; 95% CI, 0.9-16.12%; I 2 = 93%) (p = 0.08). The summary estimates for AKI prevalence was 11.46% (95% CI, 6.93-16.94%). Patients with AKI had a higher prevalence of developing into severe cases (OR, 6.97; 95% CI, 3.53-13.75; I 2 = 0%) and mortality risk (45.79, 36.88-56.85; I 2 = 17%). The prevalence estimates of CKD or AKI were not significantly different from preprint publications (p > 0.05). Our study indicates that renal condition, either in CKD or AKI, is associated with COVID-19 prognosis, and taking care of such patients needs further awareness and investigations.

18.
Psychol Health Med ; 26(1): 114-118, 2021 01.
Article in English | MEDLINE | ID: covidwho-925735

ABSTRACT

With the outbreak and spread of the novel coronavirus (SARS-CoV-2), there has been a significant increase in the number of children infected, and some severe infection cases and neonatal cases have been reported. The parents or other family members who come to our paediatric clinic inevitably experience panic, tension and anxiety. The generation of these emotions has seriously affected the normal order of outpatient treatment and has led to many children not receiving an accurate diagnosis or proper treatment. This situation is not conducive to the control of the epidemic or the children's physical and mental health. Through summarizing parents' behaviours and emotional characteristics during the epidemic period, we hope to develop relevant coping and nursing strategies to ensure better control of the epidemic and to protect the physical and mental health of children.


Subject(s)
Adaptation, Psychological , Anxiety/psychology , COVID-19 , Hospitals, Pediatric , Outpatient Clinics, Hospital , Parents/psychology , Adult , Child , Female , Humans , Male
20.
Front Cell Infect Microbiol ; 10: 470, 2020.
Article in English | MEDLINE | ID: covidwho-797396

ABSTRACT

Objective: To explore the diagnostic value of serum severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) protein assay in the early stages of SARS-COV-2 infection. Methods: Serum N protein level in SARS-COV-2 infected patients and non-SARS-COV-2 infected population was measured by enzyme-linked immunosorbent assay (ELISA) double antibody sandwich assay. Colloidal gold immunochromatography assay was used to detect serum N protein antibodies in the above populations. Results: Fifty cases of SARS-CoV-2 nucleic acid-positive and SARS-CoV-2 antibody-negative patients had a serum N protein positivity rate of 76%. Thirty-seven patients who were positive for serum SARS-CoV-2 antibody after infection had a serum SARS-CoV-2 N protein positivity rate of 2.7%. Serum N protein test results of 633 non-SARS-COV-2 infected patients, including pregnant women, patients with other respiratory infections, and individuals with increased rheumatoid factor were all negative, with serum N protein concentration <10.00 pg/mL at 100% specificity. Using SPSS 19.0 to calculate the receiver operating characteristic curve, the area under the curve was determined to be 0.9756 (95% confidence interval 0.9485-1.000, p < 0.0001), and sensitivity and specificity were 92% (95% confidence interval 81.16-96.85%) and 96.84% (95% confidence interval 95.17-97.15%), respectively. The best CUT-OFF value was 1.850 pg/mL. Conclusion: The measurement of serum SARS-COV-2 N protein has a high diagnostic value for infected patients before the antibody appears and shortens the window period of serological diagnosis. It is recommended that the manufacturer establish two different CUT-OFF values according to the purpose of the application. One CUT-OFF value is used for the diagnosis of clinical SARS-COV-2 infection, and the other is used to screen out as many suspected cases as possible.


Subject(s)
Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Nucleocapsid Proteins/blood , Pneumonia, Viral/diagnosis , Antibodies, Viral/blood , Betacoronavirus/isolation & purification , Biomarkers/blood , COVID-19 , COVID-19 Testing , Coronavirus Infections/blood , Coronavirus Nucleocapsid Proteins , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Male , Pandemics , Phosphoproteins , Pneumonia, Viral/blood , Pregnancy , SARS-CoV-2 , Sensitivity and Specificity
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