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1.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases ; 2022.
Article in English | EuropePMC | ID: covidwho-1615443

ABSTRACT

Objective: The mortality rate for critically ill coronavirus disease 2019 (COVID-19) cases was more than 80%. Nonetheless, research about the effect of common respiratory diseases on critically ill COVID-19 expression and outcomes is scarce. Design: We performed proteomic analyses on airway mucus obtained by bronchoscopy from severe COVID-19 patients, or induced sputum from patients with chronic obstructive pulmonary disease (COPD), asthma, and healthy controls. Results: Out of the total identified and quantified proteins, 445 differentially expressed proteins (DEPs) were found in different comparison groups. In comparison to COPD, asthma, and controls, 11 proteins were uniquely present in COVID-19 patients. Apart from DEPs associated with COPD vs controls and asthma vs controls, there were a total of 59 DEPs specific to COVID-19 patients. Finally, the findings revealed that there were 8 overlapping proteins in COVID-19 patients, including C9, FGB, FGG, PRTN3, HBB, HBA1, IGLV3-19, and COTL1. Functional analyses revealed that the majority of them were associated with complement and coagulation cascades, platelet activation, or iron metabolism, and anemia-related pathways. Conclusions: This study provides fundamental data for identifying COVID-19-specific proteomic changes in comparison to COPD and asthma, which may suggest molecular targets for specialized therapy. Graphical Image, graphical

2.
EBioMedicine ; 75: 103789, 2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1587925

ABSTRACT

BACKGROUND: The long-term consequences of human umbilical cord-derived mesenchymal stem cell (UC-MSC) treatment for COVID-19 patients are yet to be reported. This study assessed the 1-year outcomes in patients with severe COVID-19, who were recruited in our previous UC-MSC clinical trial. METHODS: In this prospective, longitudinal, cohort study, 100 patients enrolled in our phase 2 trial were prospectively followed up at 3-month intervals for 1 year to evaluate the long-term safety and effectiveness of UC-MSC treatment. The primary endpoint was an altered proportion of whole-lung lesion volumes measured by high-resolution CT. Other imaging outcomes, 6 min walking distance (6-MWD), lung function, plasma biomarkers, and adverse events were also recorded and analyzed. This trial was registered with ClinicalTrials.gov (NCT04288102). FINDINGS: MSC administration improved in whole-lung lesion volume compared with the placebo with a difference of -10.8% (95% CI: -20.7%, -1.5%, p = 0.030) on day 10. MSC also reduced the proportion of solid component lesion volume compared with the placebo at each follow-up point. More interestingly, 17.9% (10/56) of patients in the MSC group had normal CT images at month 12, but none in the placebo group (p = 0.013). The incidence of symptoms was lower in the MSC group than in the placebo group at each follow-up time. Neutralizing antibodies were all positive, with a similar median inhibition rate (61.6% vs. 67.6%) in both groups at month 12. No difference in adverse events at the 1-year follow-up and tumor markers at month 12 were observed between the two groups. INTERPRETATION: UC-MSC administration achieves a long-term benefit in the recovery of lung lesions and symptoms in COVID-19 patients. FUNDING: The National Key R&D Program of China, the Innovation Groups of the National Natural Science Foundation of China, and the National Science and Technology Major Project.

3.
Chinese Journal of School Health ; 42(1):87-91, 2021.
Article in Chinese | CAB Abstracts | ID: covidwho-1498069

ABSTRACT

Objective: To understand physical exercises and associated factors among college students COVID-19 pandemic, and to provide a reference for promoting physical exercise of college students at home.

4.
Biotechnol Bioeng ; 119(1): 48-58, 2022 01.
Article in English | MEDLINE | ID: covidwho-1441944

ABSTRACT

Manufacturing has been the key factor limiting rollout of vaccination during the COVID-19 pandemic, requiring rapid development and large-scale implementation of novel manufacturing technologies. ChAdOx1 nCoV-19 (AZD1222, Vaxzevria) is an efficacious vaccine against SARS-CoV-2, based upon an adenovirus vector. We describe the development of a process for the production of this vaccine and others based upon the same platform, including novel features to facilitate very large-scale production. We discuss the process economics and the "distributed manufacturing" approach we have taken to provide the vaccine at globally-relevant scale and with international security of supply. Together, these approaches have enabled the largest viral vector manufacturing campaign to date, providing a substantial proportion of global COVID-19 vaccine supply at low cost.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Drug Industry/methods , Animals , Escherichia coli , Geography , HEK293 Cells , Humans , Pan troglodytes , SARS-CoV-2 , Technology, Pharmaceutical , Vaccination/instrumentation
5.
Environ Pollut ; 289: 117887, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1330804

ABSTRACT

The Chinese government issued an unprecedentedly strict lockdown policy to control the spread of the novel coronavirus disease 2019 (COVID-19), significantly mitigating air pollution because of the dramatic reduction of industrial and traffic emissions. To explore the impact of COVID-19 lockdown (LCD) on organic aerosols, the mixing states and evolution processes of amine-containing particles were studied using a single particle aerosol mass spectrometer from January to March 2020 in Liaocheng, which is a seriously polluted city in North China. The counts and percentages of amine-containing particles in total obtained particles during the pre-LCD (547832, 29.8 %) were higher than those during the LCD (283983, 20.7 %) and post-LCD (102026, 18.4 %), mainly due to the reduced emission strength of amines and suppressed gas-to-particle partitioning of amines during the LCD and post-LCD. 74(C2H5)2NH2+ was the most abundant amine marker, which accounted for 98.2 %, 98.4 %, and 96.7 % of all amine-containing particles during the pre-LCD, LCD, and post-LCD, respectively. Correlation analysis and temporal variations indicated that the gas-to-particle partitioning of amines was facilitated by the stronger acidic environment and lower temperature, while the effect of RH and aerosol liquid water content was minor. The A-OC particles were the most abundant type (accounting for ~40 %) throughout the observation period. The temporal profiles and correlation analysis suggested that the impact of the increased O3 on the amines and their oxidation products (e.g., trimethylamine oxide) was minor. The identified particle types, correlation analysis, and the potential source contribution function results implied that the amine-containing particles were mainly derived from local and surrounding sources during the LCD, while those were mainly affected by long-range transport during the pre-LCD and post-LCD. Our results could deepen the comprehension of the sources and atmospheric processing of amines in the urban area of North China during the COVID-19 outbreak.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Aerosols/analysis , Air Pollutants/analysis , Air Pollution/analysis , Amines , Atmosphere , China , Communicable Disease Control , Disease Outbreaks , Environmental Monitoring , Humans , Particulate Matter/analysis , SARS-CoV-2
6.
Pharmacol Res ; 161: 105290, 2020 11.
Article in English | MEDLINE | ID: covidwho-1318948

ABSTRACT

The coronavirus disease 2019 (COVID-19) epidemic has been almost controlled in China under a series of policies, including "early diagnosis and early treatment". This study aimed to explore the association between early treatment with Qingfei Paidu decoction (QFPDD) and favorable clinical outcomes. In this retrospective multicenter study, we included 782 patients (males, 56 %; median age 46) with confirmed COVID-19 from 54 hospitals in nine provinces of China, who were divided into four groups according to the treatment initiation time from the first date of onset of symptoms to the date of starting treatment with QFPDD. The primary outcome was time to recovery; days of viral shedding, duration of hospital stay, and course of the disease were also analyzed. Compared with treatment initiated after 3 weeks, early treatment with QFPDD after less than 1 week, 1-2 weeks, or 2-3 weeks had a higher likelihood of recovery, with adjusted hazard ratio (HR) (95 % confidence interval [CI]) of 3.81 (2.65-5.48), 2.63 (1.86-3.73), and 1.92 (1.34-2.75), respectively. The median course of the disease decreased from 34 days to 24 days, 21 days, and 18 days when treatment was administered early by a week (P < 0.0001). Treatment within a week was related to a decrease by 1-4 days in the median duration of hospital stay compared with late treatment (P<0.0001). In conclusion, early treatment with QFPDD may serve as an effective strategy in controlling the epidemic, as early treatment with QFPDD was associated with favorable outcomes, including faster recovery, shorter time to viral shedding, and a shorter duration of hospital stay. However, further multicenter, prospective studies with a larger sample size should be conducted to confirm the benefits of early treatment with QFPDD.


Subject(s)
COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Adult , Aged , Aged, 80 and over , China , Cohort Studies , Female , Follow-Up Studies , Humans , Length of Stay , Male , Middle Aged , Time-to-Treatment , Treatment Outcome , Young Adult
7.
Journal of Jianghan University ; 48(6):33-37, 2020.
Article in Chinese | GIM | ID: covidwho-1279219

ABSTRACT

Objective: To explore the assessment value of neutrophil-to-lymphocyte ratio(NLR) for prognosis in coronavirus disease 2019(COVID-19).

8.
Transfusion ; 60(9): 2038-2046, 2020 09.
Article in English | MEDLINE | ID: covidwho-1263879

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA could be detected in the blood of infected cases. From February 9, all blood establishments in Hubei province, China, implemented nucleic acid testing (NAT) for SARS-CoV-2 RNA among blood donors to ensure blood safety. STUDY DESIGN AND METHODS: Nucleic acid test screening individually (ID) or by minipool (MP) testing was performed according to the manufacturer's instructions. Inactivated culture supernatant of SARS-CoV-2-infected Vero cells was quantified by droplet digital polymerase chain reaction (ddPCR) and series diluted with negative plasma to evaluate the assay's performance. RESULTS: The limit of detection of the kit for MP testing was 62.94 and 33.14 copies/mL for N and ORF1ab region, respectively. ID testing could achieve 3.87 and 4.85 copies/mL for two regions using 1600 µL of plasma. Coefficients of variations of two different concentrations of reference samples were all less than 5% in MP testing. As of April 30, 2020, a total of 98,342 blood donations including 87,095 whole blood donations and 11,247 platelet donations were tested by ID or MP testing, and no RNAemia was found. In addition, Hubei province suffered precipitously decreased blood supply, especially in February: 86% reduction compared with the same period of 2019. CONCLUSION: Nucleic acid test screening of SARS-CoV-2 on blood donations is suitable in blood establishments using the commercial real-time PCR detection kit based on available instruments. The negative result indicated that SARS-CoV-2 appears to be no direct threat to blood safety but raises some serious issues for general blood supply.


Subject(s)
Blood Donors , COVID-19 Nucleic Acid Testing , COVID-19/epidemiology , RNA, Viral/blood , SARS-CoV-2/isolation & purification , Viremia/diagnosis , Animals , Blood Banks , Blood Donors/supply & distribution , COVID-19/diagnosis , China/epidemiology , Chlorocebus aethiops , Humans , Limit of Detection , RNA, Viral/isolation & purification , Real-Time Polymerase Chain Reaction/methods , SARS-CoV-2/physiology , Vero Cells , Viral Load , Virus Cultivation
9.
Front Psychiatry ; 12: 611223, 2021.
Article in English | MEDLINE | ID: covidwho-1231402

ABSTRACT

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has caused public panic and psychological health problems, especially in medical staff. We aimed to investigate the psychological effect of the COVID-19 outbreak on medical staff. Methods: A cross-sectional study was conducted to examine the psychological impact of medical staff working in COVID-19 designated hospitals from February to March 2020 in China. We assessed psychological health problems using the Symptom Check List 90 (SCL-90). Results: Among 656 medical staff, 244 were frontline medical staff and 412 general medical staff. The prevalence of psychological health problems was 19.7%. The SCL-90 scores in frontline medical staff were significantly higher than that in general medical staff (mean: 141.22 vs. 129.54, P < 0.05). Furthermore, gender [odds ratio (OR) = 1.53, 95% CI = (1.02, 2.30), P = 0.042 for female vs. male] and the burden of current work [OR = 7.55, 95% CI = (3.75, 15.21), P < 0.001 for high burden; OR = 2.76, 95% CI = (1.80, 4.24), P < 0.001 for moderate burden vs. low burden] were associated with increased risk of poor psychological status. Conclusions: Medical staff experienced a high risk of psychological health problems during the outbreak of COVID-19, especially for frontline medical staff. Psychological health services are expected to arrange for medical staff in future unexpected infectious disease outbreaks.

10.
Signal Transduct Target Ther ; 6(1): 58, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1078577

ABSTRACT

Treatment of severe Coronavirus Disease 2019 (COVID-19) is challenging. We performed a phase 2 trial to assess the efficacy and safety of human umbilical cord-mesenchymal stem cells (UC-MSCs) to treat severe COVID-19 patients with lung damage, based on our phase 1 data. In this randomized, double-blind, and placebo-controlled trial, we recruited 101 severe COVID-19 patients with lung damage. They were randomly assigned at a 2:1 ratio to receive either UC-MSCs (4 × 107 cells per infusion) or placebo on day 0, 3, and 6. The primary endpoint was an altered proportion of whole lung lesion volumes from baseline to day 28. Other imaging outcomes, 6-minute walk test (6-MWT), maximum vital capacity, diffusing capacity, and adverse events were recorded and analyzed. In all, 100 COVID-19 patients were finally received either UC-MSCs (n = 65) or placebo (n = 35). UC-MSCs administration exerted numerical improvement in whole lung lesion volume from baseline to day 28 compared with the placebo (the median difference was -13.31%, 95% CI -29.14%, 2.13%, P = 0.080). UC-MSCs significantly reduced the proportions of solid component lesion volume compared with the placebo (median difference: -15.45%; 95% CI -30.82%, -0.39%; P = 0.043). The 6-MWT showed an increased distance in patients treated with UC-MSCs (difference: 27.00 m; 95% CI 0.00, 57.00; P = 0.057). The incidence of adverse events was similar in the two groups. These results suggest that UC-MSCs treatment is a safe and potentially effective therapeutic approach for COVID-19 patients with lung damage. A phase 3 trial is required to evaluate effects on reducing mortality and preventing long-term pulmonary disability. (Funded by The National Key R&D Program of China and others. ClinicalTrials.gov number, NCT04288102.


Subject(s)
COVID-19/therapy , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , SARS-CoV-2 , Umbilical Cord , Aged , Allografts , COVID-19/mortality , COVID-19/physiopathology , Double-Blind Method , Female , Humans , Male , Middle Aged , Treatment Outcome
11.
Int J Infect Dis ; 103: 647-653, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1065167

ABSTRACT

OBJECTIVE: This study aims to present the clinical characteristics of 30 hospitalized cases with epileptic seizures and coronavirus disease 2019(COVID-19). METHODS: This is a retrospective observational research study. Clinical data were extracted from electronic medical records in 1550 patients with a laboratory-confirmed diagnosis of COVID-19, who were hospitalized in Wuhan Central Hospital, China, from 1 January to 31 April 2020. 30 COVID-19 patients with the diagnosis of epilepsy were enrolled. The clinical characteristics, complications, treatments, and clinical outcomes of 30 cases were collected and analyzed. RESULT: Of 30 patients with a diagnosis of epilepsy and COVID-19, 13 patients (43.4%) had new-onset epileptic seizures without an epilepsy history(new-onset seizure group, NS group), ten patients(33.3%) had an epilepsy history with a recurrent epileptic seizure (recurrent seizure group, RS group) and seven patients(23.3%) had an epilepsy history but no seizure during the course of COVID-19 (epilepsy history group, EH group). Patients in the RS group had a larger number of other-neurological-disease histories than those in the NS and EH groups (7/10[70%] VS 1/13 [7.7%] VS 1/7[14.3%]); the difference between the RS group and NS group is significant (P < 0.05). Patients in the NE and RS groups suffered more severe/critical COVID-19 infection than patients in the EH group (10/13[76.9%] VS 6/10[60%] VS 1/7[14.3%]); the difference between the NS group and EH group is significant (P < 0.05). 36.7% of patients had one to five neurological complications, and 46.4% of patients had 6-10 neurological complications. The complications in patients with seizures (in the RS and NS groups) seem to be more than those without seizures (in the EH group), but it did not reach statistical significance. The proportion of antiepileptic drugs (AEDs) treatment before admission was higher in the EH group than in the RE group(7/7 [100%] VS 2/10 [20%], P < 0.05). The mortality of 30 patients with epilepsy and COVID-19 was 36.67%. The mortality of the NS group(38.5%) and the RS group(50%) were a little higher than in the EH group(14.3%). None of the convalescent patients had a recurrent seizure, and there were no more deaths in the 3-month follow-up after discharge. CONCLUSIONS: COVID-19 patients with recurrent epileptic seizures had more underlying neurological diseases than patients who had an epilepsy history but without a seizure. Patients with new-onset and recurrent epileptic seizures suffered more severe/critical COVID-19, which may lead to a worse prognosis. If patients with epilepsy history continue using AEDs during COVID-19 pandemics, the risk of recurrent seizure may be reduced, and a good prognosis for patients with epilepsy history could be expected.


Subject(s)
COVID-19/complications , Epilepsy/drug therapy , SARS-CoV-2 , Adult , Aged , Anticonvulsants/therapeutic use , Female , Humans , Male , Middle Aged , Retrospective Studies
12.
Life Sci ; 269: 119046, 2021 Mar 15.
Article in English | MEDLINE | ID: covidwho-1030918

ABSTRACT

BACKGROUND: The pandemic of the coronavirus disease 2019 (COVID-19) has brought a global public health crisis. However, the pathogenesis underlying COVID-19 are barely understood. METHODS: In this study, we performed proteomic analyses of airway mucus obtained by bronchoscopy from severe COVID-19 patients. In total, 2351 and 2073 proteins were identified and quantified in COVID-19 patients and healthy controls, respectively. RESULTS: Among them, 92 differentiated expressed proteins (DEPs) (46 up-regulated and 46 down-regulated) were found with a fold change >1.5 or <0.67 and a p-value <0.05, and 375 proteins were uniquely present in airway mucus from COVID-19 patients. Pathway and network enrichment analyses revealed that the 92 DEPs were mostly associated with metabolic, complement and coagulation cascades, lysosome, and cholesterol metabolism pathways, and the 375 COVID-19 only proteins were mainly enriched in amino acid degradation (Valine, Leucine and Isoleucine degradation), amino acid metabolism (beta-Alanine, Tryptophan, Cysteine and Methionine metabolism), oxidative phosphorylation, phagosome, and cholesterol metabolism pathways. CONCLUSIONS: This study aims to provide fundamental data for elucidating proteomic changes of COVID-19, which may implicate further investigation of molecular targets directing at specific therapy.


Subject(s)
Amino Acids/metabolism , COVID-19/physiopathology , Mucus/virology , Proteins/metabolism , Aged , Bronchoscopy , Case-Control Studies , Cholesterol/metabolism , Critical Illness , Female , Humans , Male , Middle Aged , Proteomics , Severity of Illness Index
13.
J Affect Disord ; 281: 597-604, 2021 02 15.
Article in English | MEDLINE | ID: covidwho-952061

ABSTRACT

BACKGROUND: Growing evidence supports a clear association between COVID-19 pandemic and mental health. However, little is known about the longitudinal course of psychopathology in young adults at different stages of the pandemic. METHODS: This large-scale, longitudinal, population-based survey was conducted among college students in China. The rates of three mental health problems (acute stress, anxiety, and depressive symptoms), and their change patterns at two phases of the pandemic (early vs under-control) were measured. Predictors of changes in mental health symptoms were examined utilizing multivariate regression. RESULTS: Among the 164,101 college students who participated in the first wave survey (T1=during onset of outbreak), 68,685 (41.9%) completed a follow-up survey (T2=during remission). In the follow-up survey, the prevalence of probable acute stress (T1: 34.6%; T2: 16.4%) decreased, while the rates of depressive (T1: 21.6%; T2: 26.3%) and anxiety symptoms (T1: 11.4%; T2: 14.7%) increased. Senior students, with suspected or conformed cases in their community and COVID-19 related worries (all AORs > 1.20, ps < 0.001) were found to have a higher risk of developing mental health problems in at least one wave. Less physical exercise, low perceived social support, and a dysfunctional family were found to negatively impact psychological symptoms. CONCLUSIONS: Acute stress, anxiety, and depressive symptoms have been prevalent among college students during the COVID-19 epidemic, and showed a significant increase after the initial stage of the outbreak. Some college students, especially those with the risk factors noted above, exhibited persistent or delayed symptoms.


Subject(s)
COVID-19/psychology , Mental Health , Pandemics , Students/psychology , Anxiety/epidemiology , China/epidemiology , Depression/epidemiology , Humans , Longitudinal Studies , Young Adult
14.
Sci Total Environ ; 758: 143709, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-922133

ABSTRACT

To eliminate the spread of a novel coronavirus breaking out in the end of 2019 (COVID-19), the Chinese government has implemented a nationwide lockdown policy after the Chinese lunar New Year of 2020, resulting in a sharp reduction in air pollutant emissions. To investigate the impact of the lockdown on aerosol chemistry, the number fraction, size distribution and formation process of oxalic acid (C2) containing particles and its precursors were studied using a single particle aerosol mass spectrometer (SPAMS) at the urban site of Liaocheng in the North China Plain (NCP). Our results showed that five air pollutants (i.e., PM2.5, PM10, SO2, NO2, and CO) decreased by 30.0-59.8% during the lockdown compared to those before the lockdown, while O3 increased by 63.9% during the lockdown mainly due to the inefficient titration effect of O3 via NO reduction. The increased O3 concentration can boost the atmospheric oxidizing capacity and further enhance the formation of secondary organic aerosols, thereby significantly enhancing the C2 particles and its precursors as observed during the lockdown. Before the lockdown, C2 particles were significantly originated from biomass burning emissions and their subsequent aqueous-phase oxidation. The hourly variation patterns and correlation analysis before the lockdown suggested that relative humidity (RH) and aerosol liquid water content (ALWC) played a key role in the formation of C2 particles and the increased aerosol acidity can promote the conversion of precursors such as glyoxal (Gly) and methyglyoxal (mGly) into C2 particles in the aqueous phase. RH and ALWC decreased sharply but O3 concentration and solar radiation increased remarkably during the lockdown, the O3-dominated photochemical pathways played an important role in the formation of C2 particles in which aerosol acidity was ineffective. Our study indicated that air pollution treatment sponges on a joint-control and balanced strategy for controlling numerous pollutants.


Subject(s)
Air Pollutants , COVID-19 , Aerosols/analysis , Air Pollutants/analysis , China , Communicable Disease Control , Environmental Monitoring , Humans , Particulate Matter/analysis , Photochemical Processes , SARS-CoV-2
15.
Infect Dis Ther ; 9(4): 1003-1015, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-917172

ABSTRACT

BACKGROUND: Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) has the potential to improve the pathogen identification in severe community-acquired pneumonia (SCAP). METHODS: In this 1.5-year, multicenter, prospective study, we investigated the usefulness of mNGS of BALF for identifying pathogens of SCAP in hospitalized adults, comparing it with other laboratory methods. RESULTS: Of 329 SCAP adults, a microbial etiology was established in 304 cases (92.4%). The overall microbial yield was 90.3% for mNGS versus 39.5% for other methods (P < 0.05). The most frequently detected pathogens in immunocompetent patients were Streptococcus pneumoniae (14.8%), rhinovirus (9.8%), Haemophilus influenzae (9.1%), Staphylococcus aureus (8.7%), and Chlamydia psittaci (8.0%), while in immunocompromised patients they were Pneumocystis jirovecii (44.6%), Klebsiella pneumoniae (18.5%), Streptococcus pneumoniae (15.4%), Haemophilus influenzae (13.8%), and Pseudomonas aeruginosa (13.8%). Notably, novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified from two patients solely by mNGS in January 2020; uncommon pathogens including Orientia tsutsugamushi and Nocardia otitidiscaviarum were identified from one patient, respectively. Furthermore, mixed infections were detected in 56.8% of the patients. CONCLUSIONS: A high microbial detection rate was achieved in SCAP adults using mNGS testing of BALF. The most frequently detected pathogens of SCAP differed between immunocompetent and immunocompromised patients. mNGS testing may be an powerful tool for early identification of potential pathogens for SCAP to initiate a precise antimicrobial therapy.

16.
Zhongguo Fei Ai Za Zhi ; 23(10): 858-865, 2020 Oct 20.
Article in English | MEDLINE | ID: covidwho-914583

ABSTRACT

BACKGROUND: Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase (RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula (BF) during the treatment of lung cancer patients and summarize the possible causes. METHODS: We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and PubMed for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula." RESULTS: Our literature search produced two case reports (three patients) which, in addition to our three patients. We collated the patients' clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus (DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophago-tracheobronchial fistula. Six patients all died within 6 months. CONCLUSIONS: Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.


Subject(s)
Antineoplastic Agents/adverse effects , Bronchial Fistula/etiology , Indoles/adverse effects , Lung Neoplasms/drug therapy , Quinolines/adverse effects , Aged , Antineoplastic Agents/therapeutic use , Bronchial Fistula/diagnostic imaging , China , Humans , Indoles/therapeutic use , Male , Middle Aged , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/therapeutic use , Quinolines/therapeutic use
17.
Syst Rev ; 9(1): 258, 2020 11 06.
Article in English | MEDLINE | ID: covidwho-914109

ABSTRACT

BACKGROUND: Previous studies on the impact of corona virus disease 2019 (COVID-19) on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) among COVID-19 patients. METHODS: We will perform a comprehensive search of the following databases: Cochrane Library, PubMed, Web of Science, EMBASE, and Chinese Biomedicine Literature to identify relevant studies. We will include peer-reviewed cross-sectional studies published in English and Chinese. Two reviewers will independently assess the methodological quality of included studies using the Joanna Briggs Institute Prevalence Critical Appraisal tool and perform data extraction. In the absence of clinical heterogeneity, the prevalence estimates with a 95% confidence interval (CI) of delirium, depression, anxiety, and post-traumatic stress disorder (PTSD) will be calculated by using random-effects model to minimize the effect of between-study heterogeneity separately. The literature searches will be updated every 3 months. We will perform meta-analysis if any new eligible studies or data are obtained. We will resubmit an updated review when there were relevant changes in the results, i.e., when outcomes became statistically significant (or not statistically significant anymore) or when heterogeneity became substantial (or not substantial anymore). DISCUSSION: This LSR will provide an in-depth and up-to-date summary of whether the common neuropsychiatric conditions observed in patients hospitalized for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS) are also prevalent in a different stage of COVID-19 patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196610.


Subject(s)
Anxiety Disorders , Anxiety , COVID-19/psychology , Delirium , Depression , Depressive Disorder , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , Anxiety/etiology , Anxiety Disorders/epidemiology , Anxiety Disorders/etiology , COVID-19/virology , Delirium/epidemiology , Delirium/etiology , Depression/epidemiology , Depression/etiology , Depressive Disorder/epidemiology , Depressive Disorder/etiology , Humans , Mental Health , Prevalence , Research Design , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Systematic Reviews as Topic
18.
PLoS One ; 15(10): e0241329, 2020.
Article in English | MEDLINE | ID: covidwho-895073

ABSTRACT

OBJECTIVE: To investigate the blood coagulation function in COVID-19 patients, and the correlation between coagulopathy and disease severity. METHODS: We retrospectively collected 147 clinically diagnosed COVID-19 patients at Wuhan Leishenshan Hospital of Hubei, China. We analyzed the coagulation function in COVID-19 patients through the data including thrombin-antithrombin complex (TAT), α2-plasmininhibitor-plasmin Complex (PIC), thrombomodulin (TM), t-PA/PAI-1 Complex (t-PAIC), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-Dimer (DD), and platelet (PLT). RESULT: The levels of TAT, PIC, TM, t-PAIC, PT, INR, FIB, and DD in COVID-19 patients were higher than health controls (p<0.05), and also higher in the patients with thrombotic disease than without thrombotic disease (p<0.05). What's more, the patients with thrombotic disease had a higher case-fatality (p<0.05). TAT, PIC, TM, t-PAIC, PT, INR, APTT, FIB, DD, and PLT were also found correlated with disease severity. Meanwhile, we found that there were significant difference in TAT, TM, t-PAIC, PT, INR, APTT, DD, and PLT in the death and survival group. Further using univariate and multivariate logistic regression analysis also found that t-PAIC and DD were independent risk factors for death in patients and are excellent predicting the mortality risk of COVID-19. CONCLUSION: Most COVID-19 patients with inordinate coagulation systems, dynamic monitoring of coagulation parameters might be a key in the control of COVID-19 death.


Subject(s)
Blood Coagulation , Coronavirus Infections/blood , Pneumonia, Viral/blood , Adult , Aged , Betacoronavirus , Blood Coagulation Disorders/virology , Blood Coagulation Tests , COVID-19 , Case-Control Studies , China , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2
20.
Infect Drug Resist ; 13: 3401-3408, 2020.
Article in English | MEDLINE | ID: covidwho-844444

ABSTRACT

Background: The pandemic of coronavirus disease 2019 (COVID-19) has become a global public health problem. It is important for clinical physicians to differentiate COVID-19 from other respiratory infectious diseases caused by viruses, such as human adenovirus. Subjects and Methods: This was a retrospective observational study. We analyzed and compared the clinical manifestations, laboratory findings and radiological features of two independent cohorts of patients diagnosed with either COVID-19 (n=36) or adenovirus pneumonia (n=18). Results: COVID-19 did not show a preference in males or females, whereas 94.4% of patients with adenovirus pneumonia were males. Fever and cough were common in both COVID-19 and adenovirus pneumonia. But the median maximal body temperature of the adenovirus pneumonia cohort was significantly higher than in COVID-19 (P<0.001). Furthermore, 77.8% of patients with adenovirus pneumonia had a productive cough versus only 13.9% of COVID-19 patients (P<0.001). Compared with adenovirus pneumonia, constitutional symptoms were less common in COVID-19, including headache (16.7% vs 38.9%, P=0.072), sore throat (8.3% vs 27.8%, P=0.058), myalgia (8.3% vs 61.1%, P<0.001) and diarrhea (8.3% vs 44.4%, P=0.002). Furthermore, patients with COVID-19 were less likely to develop respiratory failure (8.3% vs 83.3%, P<0.001) and showed less prominent laboratory abnormalities, including lymphocytopenia (61.1% vs 88.9%, P=0.035), thrombocytopenia (2.8% vs 61.1%, P<0.001), elevated procalcitonin (2.8% vs 77.8%, P<0.001) and elevated C-reactive protein (36.1% vs 100%, P<0.001). Besides, a higher percentage of patients with adenovirus pneumonia showed elevated transaminase, myocardial enzymes, creatinine and D-dimer compared with COVID-19 patients. On chest CT, the COVID-19 cohort was characterized by peripherally distributed ground-glass opacity and patchy shadowing, while the adenovirus pneumonia cohort frequently presented with consolidation and pleural effusion. Conclusion: There were many differences between patients diagnosed with COVID-19 and those with adenovirus pneumonia in their clinical, laboratory and radiological characteristics. Compared with adenovirus pneumonia, COVID-19 patients tended to show a lower severity of illness.

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