In the context of the COVID-19 pandemic, can the development of coastal ecological resources create a safe leisure and tourism environment, maintain ecology, and promote economic development in villages?

Context and aims. The purpose of the study was to examine the impact of environmental development in the seashore waters of Maluan Bay on the current situation of sustainable development of coastal villages. Methods. We used SPSS statistical software (ver. 26.0) to analyse the data with statistical verification, Student's t-test and ANOVA, the used the inverview method to solicit opinions on the questionnarie results, and, finally, conducted multivariate inspection and analysis to explore the results. Key results. The development of seashore waters can effectively enhance people's positive perceptions of the current economic, social, environmental and coastal ecological development, and increase their willingness to revisit and purchase property. Also, the insufficient number of security guards in villages can be improved, the environmental awareness of residents and their willingness to participate in decision-making can be enhanced. Conclusions and implications. Providing tourists with better tourism facilities, transportation, hotel and restaurant management and planning will increase leisure opportunities and solve environmental and waste problems such as in this scenic location. It will help achieve the goal of sustainable circular economy of water.

Tourists' Hotel Booking Preferences Changed by the COVID-19 Outbreak

This study aims to identify the characteristics and behaviors of Thai tourists during the pandemic, to investigate the marketing factors in tourism affecting their hotel reservations during the pandemic, and to analyze which marketing factors in tourism have affected their decisions on hotel reservations during the pandemic. Online questionnaires were used to collect data from 385 people. The data was analyzed by descriptive statistics and a confirmatory factor analysis (CFA), while the hypotheses were tested by inferential statistics. The results indicated that Thai tourists considered significant factors in tourism marketing. It included hotel products, room rates, reservation channels, promotions, personnel, features, and services. Furthermore, the hypothesis test indicated that Thai tourists had different hotel reservation behaviors during the pandemic. Gender, age, region, occupation, monthly income, travel goal, accommodation type, length of stay, travel companion, and reservation channel played a statistically significant role at 0.05. Therefore, this study will support hoteliers in planning their strategy to handle situations during the pandemic and prepare for another health crisis in the future. Furthermore, it will benefit the hotel industry by showing ways to develop and improve their products and services to meet tourist demand during a pandemic. © 2023, ASERS Publishing House. All rights reserved.

Dynamical linkages between the Brent oil price and stock markets in BRICS using quantile connectedness approach

The Quantile connectedness approach, which allows for a detailed scrutinization of the connectedness, to analysis the connectedness for oil price and BRICS stock markets. Russia and South Africa plays the net transmitting roles, and similar evidence is obtained in Brazil after 2010. Brent oil, India, and Shanghai are net recipients for most time. The extent of the connectedness is further stronger when facing up the market slump such as the global financial crisis, European debt crisis, and Covid-19 periods. For investors, practitioners, and financial institutions, periodically changing the assets allocating can follow noted above evidence. © 2023 Elsevier Inc.

Nirmatrelvir increases blood tacrolimus concentration in COVID-19 patients as determined by UHPLC-MS/MS method.

OBJECTIVE: Transplant recipients have a higher risk of SARS-CoV-2 infection owing to the use of immunosuppressive drugs like tacrolimus (FK506). FK506 and nirmatrelvir (NMV) (an anti-SARS-CoV-2 drug) are metabolized by cytochrome P450 3A4 and may have potential drug-drug interactions. It is important to determine the effect of NMV on FK506 concentrations. PATIENTS AND METHODS: Following protein precipitation from blood, FK506 and its internal standard (FK506-13C,2d4) were detected by ultra-high performance liquid chromatography/tandem mass spectrometry (UHPLC-MS/MS). Total 22 blood samples (valley concentrations) from two coronavirus disease 2019 (COVID-19) patients were collected and analyzed for FK506 concentrations. RESULTS: Blood levels of FK506 (0.5-100 ng/mL) showed good linearity. The UHPLC-MS/MS method was validated with intra- and inter-batch accuracies of 104.55-107.85%, and 99.52-108.01%, respectively, and precisions of < 15%. Mean blood FK506 concentration was 12.01 ng/mL (range, 3.15-33.1 ng/mL). Five-day co-administration with NMV increased the FK506 concentrations from 3.15 ng/mL to 33.1 ng/mL, returning to 3.36 ng/mL after a 9-day-washout. CONCLUSIONS: We developed a simple quantification method for therapeutic drug monitoring of FK506 in patients with COVID-19 using UHPLC-MS/MS with protein precipitation. We found that NMV increased FK506 blood concentration 10-fold. Therefore, it is necessary to re-consider co-administration of FK506 with NMV.

Experimental test on the performance of a −80 °C cascade refrigeration unit using refrigerants R290-R170 for COVID-19 vaccines storage

With the urgent demand for ultralow-temperature refrigerators worldwide, the operation reliability and stability of the refrigeration system becomes greatly crucial. In this study, a -80 oC ultralow-temperature cascade refrigeration system (CRS) is developed. From aspects of global warming potential (GWP) and ozone depletion potential (ODP), the environmentally friendly refrigerants R290 and R170 are utilized in the high-temperature cycle and low-temperature cycle of CRS. The experimental measurement is conducted in a Type-laboratory with a dry bulb temperature of 25.0 °C and a wet bulb temperature of 20.2 °C. The pull-down and stable operation performance of the CRS freezer are experimentally investigated. Both the inlet and outlet temperature and pressure of two compressors are monitored, and the operation characteristic of the CRS is analyzed. With some temperature test points arranged in the freezer, the temperature drop and temperature fluctuation variation of air are assessed. The operation power consumption of the CRS is also measured during the whole process. It shows that the −80 °C temperature can be generated and realized by the developed ultralow-temperature freezer. © 2022 Elsevier Ltd

Role of pyroptosis in severe COVID-19

Corona virus disease 2019 (COVID-19) is an infectious disease endangering the respirator)' traet and multiple organs of the whole body caused by severe aeute respirator)' syndrome coronavirus 2 ( SARS-CoV-2).More than 200 million people in the world have been infected with the disease, which is an unprecedented global plague.Most patients with C0VID-19 only show mild symptoms with a good prognosis, but about 20% of them may develop into severe cases and eause serious compli-cations, including acute respirator)' distress syndrome ( ARDS) , systemic inflammatory response syndrome (SIRS) , cytokine release syndrome (CRS) , etc.Pyroptosis is a kind of programmed cell death characterized by significant inflammatory response.It is often mediated by inflammatory caspase and the gasdermin family of membrane perforating proteins is the final effector molecules, resulting in cell membrane swelling and rupture to death, accompanied by the release of a large number of pro-inflammatory cytokines (such as IL-lp and IL-18, etc).Pyropto- sis affects the occurrence, progression and treatment of many diseases due to its inflammatory and morphological characteristics, and also plays an important role in severe COVID-19.Therefore, drugs that target key molecules in the pyroapoptotic pathway could he a promising breakthrough for treating severe COVID-19.This article reviews the role of pyroptosis in severe COVID-19 complications ARDS and CHS. Copyright © 2022 Publication Centre of Anhui Medical University. All rights reserved.

Modeling the Impact of Social Determinants of Health on COVID Behaviors in Older Adults using the All of Us Dataset

Non-pharmaceutical interventions such as hand-washing hygiene, avoiding large gatherings, and avoiding visiting nursing homes remain important in mitigating risks of COVID infection among at-risk populations such as older adults. The NIH's All of Us Research Program offers a unique dataset which contains detailed survey data that medical records often lack. Leveraging this dataset and impact scores, we were able to compare deep neural network (DNN) models to more conventional logistic regression and XGBoost models in the task of examining the relationships between social determinants of health and COVID-related behaviors in older adults. LR and DNN models found that African American participants were more likely than White participants to report adherence to guidelines regarding attending large social gatherings, abiding by stay-at-home recommendations and practicing pandemic-related hygiene. Both models also showed that respondents who were employed were less likely than their unemployed/retired counterparts to avoid large social gatherings or participate in activities outside their homes but were more likely to report practice pandemic-related hygiene. DNN models combined with impact scores to explain their output present an alternate approach to modeling outcomes in large, multi-variate cohorts which can outperform conventional statistical modeling. © 2022 IEEE.

[Analysis of liver function injury associated with 2019-nCoV Omicron mutant strains].

Objective: To investigate the clinical features and influencing factors of liver function injury in patients with 2019-nCoV/SARS-CoV-2 Omicron mutant strains. Methods: 1 183 confirmed imported cases of SARS-CoV-2 who were admitted at Shanghai Public Health Clinical Center (affiliated to Fudan University) from July 1, 2021 to January 15, 2022 were collected. Clinical data, viral genotyping and laboratory test results were collected to retrospectively analyze the basic condition and clinical characteristics of liver function injury. Statistical analysis was performed using t-test or Wilcoxon rank-sum test, χ2 test or Fisher's exact test, Pearson correlation test and logistic regression analysis. Results: 125 (10.6%) cases had raised baseline ALT level and 60 (5.1%) cases had abnormal baseline AST level. Among them, 33 cases (2.8%) had received hepatoprotective drugs. Liver function injury was generally mild in SARS-CoV-2 infection and minimal in Omicron mutant strains. Leukocyte count was increased in patients with raised alanine aminotransferase (ALT) [(6.96±1.78)×109/L vs. (6.41±1.96)×109/L, P=0.005 2], CT scan showed the proportion of liver hypodensity was significantly increased (2.4% vs. 0.3%, P=0.018 0). High-sensitivity C-reactive protein [(7.83±22.36) mg/L vs. (2.68±6.21) mg/L, P=0.007 8] and D-dimer [(0.34±0.39) µg/ml vs. (0.31±0.75) µg/ml, P=0.047 5] levels were higher in patients with raised AST than normal group. 26 cases had normal liver function at hospital admission; however, abnormal liver function was occurred during the course of the disease. Another 8 patients had abnormal liver function at hospital admission, and reduced liver function further during the course of treatment. Recovery time and length of hospital stay was significantly affected in patients with worsened liver function. Baseline body mass index value [odds ratio (OR)]=1.80, P=0.047), non-Omicron strains (OR=12.63, P=0.046), D-dimer (OR=2.36, P=0.047) and interleukin-6 levels (OR=1.03, P=0.009), and those who used glucocorticoids and/or ulinastatin after hospital admission (OR=6.89, P=0.034) had a higher risk of worsening liver function. Conclusions: Liver dysfunction could be observed among COVID-19 patients. Patients infected with omicron variant generally showed mild liver injury. Dynamic monitoring of liver function is necessary, especially among those with baseline elevated IL-6, D-Dimer level and use of antiinflammation medication during treatment.

Impact of the COVID-19 pandemic on primary care access for patients with gastrointestinal malignancies

Background: Primary care physicians (PCPs) provide essential support for cancer patients. Both primary and cancer care have been affected by the COVID-19 pandemic. In the US, cancer related encounters and screening decreased over 40% and 80% respectively in January to April 2020 compared to 2019 (London et al JCO Clin Cancer Inform 2020). However, the impact of the pandemic on primary care access for cancer patients remains unclear. Methods: This was a population-based, retrospective cohort study using administrative healthcare databases held at ICES in Ontario, Canada. Patients with a new gastrointestinal (GI) malignancy diagnosed within the year prior to the pandemic, between July 1 and Sept 30, 2019 (COVID-19 cohort), were compared to patients diagnosed in years unaffected by the pandemic, between July 1 - Sept 30, 2018 and July 1 - Sept 30, 2017 (pre-pandemic cohort). Both groups were followed for 12 months after initial cancer diagnosis. In the COVID-19 cohort, this allowed for at least 4 months of follow-up data occurring during the pandemic. The primary outcome was number of in-person and telemedicine visits with a PCP. Secondary outcomes were number of in-person and telemedicine visits with a medical oncologist, number of emergency department (ED) visits, and number of unplanned hospitalizations. Outcomes, reported as number of visits per person-year, were compared between the COVID-19 and pre-pandemic cohorts. Results: 2833 individuals diagnosed with a new GI malignancy in the COVID-19 cohort were compared to 5698 individuals in the pre-pandemic cohort. The number of in-person visits to PCPs per person-year significantly decreased from 7.13 [95% CI 7.05 - 7.20] in the pre-pandemic cohort to 4.75 [4.66 - 4.83] in the COVID-19 cohort. Telemedicine visits to PCPs increased from 0.06 [0.05 - 0.07] to 2.07 [2.01 - 2.12]. Combined in-person and telemedicine visits to PCPs decreased from 7.19 [7.11 - 7.26] to 6.82 [6.71 - 6.92]. In-person visits to medical oncologists decreased from 3.73 [3.68 - 3.79] to 2.87 [2.80 - 2.94], and telemedicine visits increased from 0.10 [0.10 - 0.11] to 0.95 [0.91 - 0.99]. Combined in-person and telemedicine visits to medical oncologists remained stable (3.84 [3.78 - 3.89] vs. 3.82 [3.74 - 3.90]). The number of ED visits per person-year decreased from 1.04 [1.01 - 1.07] in the pre-pandemic cohort to 0.93 [0.89 - 0.97] in the COVID-19 cohort. Unplanned hospitalizations did not show a significant change (0.56 [0.54 - 0.58] vs. 0.53 [0.50 - 0.56]). Conclusions: PCP visits for patients with newly diagnosed GI malignancies overall decreased during the pandemic, with a dramatic shift from in-person to telemedicine visits. Visits to medical oncologists also shifted from in-person to telemedicine, but the overall combined visits remained the same. While the number of ED visits decreased, the shift in ambulatory practices did not seem to impact the number of unplanned hospitalizations.

Impact of the COVID-19 Pandemic on Primary Care Access for Patients with Hematologic Malignancies

Introduction: Primary care physicians are essential to cancer care. They frequently identify signs and symptoms leading to a diagnosis of cancer, and provide ongoing support and management of non-cancer health conditions during cancer treatment. Both primary care and cancer care have been greatly affected by the COVID-19 pandemic. In the United States, cancer-related patient encounters and cancer screening decreased over 40% and 80% respectively in January to April 2020 compared to 2019 (London et al. JCO Clin Cancer Inform 2020). However, the impact of the COVID-19 pandemic on primary care access for cancer patients remain unclear. Methods: We undertook a population-based, retrospective cohort study using healthcare databases held at ICES in Ontario, Canada. Patients with a new lymphoid or myeloid malignancy diagnosed within the year prior to the COVID-19 pandemic, between July 1, 2019 and September 30, 2019 (COVID-19 cohort) were compared to patients diagnosed in years unaffected by the COVID-19 pandemic, between July 1, 2018 - September 30, 2018 and July 1, 2017 - September 30, 2017 (pre-pandemic cohort). Both groups were followed for 12 months after initial cancer diagnosis. In the COVID-19 cohort, this allowed for at least 4 months of follow-up data occurring during the COVID-19 pandemic. The primary outcome was number of in-person and virtual visits with a primary care physician. Secondary outcomes of interest included number of in-person and virtual visits with a hematologist, number of visits to the emergency department (ED), and number of unplanned hospitalizations. Outcomes, reported as crude rates per 1000 person-months, were compared between the COVID-19 and pre-pandemic cohorts using Poisson regression modelling. Results: We identified 2882 individuals diagnosed with a new lymphoid or myeloid malignancy during the defined COVID-19 timeframe and compared them to 5997 individuals diagnosed during the defined pre-pandemic timeframe. The crude rate of in-person primary care visits per 1000 person-months significantly decreased from 574.4 [95% CI 568.5 - 580.4] in the pre-pandemic cohort to 402.5 [395.3 - 409.7] in the COVID-19 cohort (p < 0.0001). Telemedicine visits to primary care significantly increased from 5.3 [4.8 - 5.9] to 173.0 [168.4 - 177.8] (p < 0.0001). The rate of combined in-person and telemedicine visits to primary care did not change from 579.8 [573.8 - 585.8] in the pre-pandemic cohort to 575.5 [566.9 - 584.2] in the COVID-19 cohort (p = 0.43). In-person visits to hematologists decreased from 504.1 [498.5 - 509.7] to 432.8 [425.3 - 440.3] (p < 0.0001), and telemedicine visits to hematologists increased from 6.6 [6.0 - 7.3] to 75.9 [72.8 - 79.1] (p < 0.0001). The rate of combined visits to hematologists did not change from 510.7 [505.1 - 516.4] to 508.7 [500.6 - 516.8] (p = 0.68). The rate of ED visits significantly decreased from 95.1 [92.7 - 97.6] in the pre-pandemic cohort to 84.7 [81.4 - 88.0] in the COVID-19 cohort (p < 0.0001). The rate of unplanned hospitalizations did not change from 64.8 [62.8 - 66.8] to 65.7 [62.9 - 68.7] (p = 0.60). Conclusions: Primary care visits for patients with hematologic malignancies did not significantly change during the pandemic, but there was a sizeable shift from in-person to telemedicine visits. Similar findings were seen for visits to hematologists. While the rate of visits to the ED decreased, potentially due to concern of being exposed to the COVID-19 virus, the shift in ambulatory practices did not seem to impact the rate of unplanned hospitalizations. Disclosures: No relevant conflicts of interest to declare.

Driver eye location and state estimation based on a robust model and data augmentation

Eye state evaluation is crucial for vision-based driver fatigue detection. With the outbreak of COVID-19, many proposed models for eye location and state evaluation based on facial landmarks are unreliable due to mask coverings. In this paper, we proposed a robust facial landmark location model for eye location and state evaluation. First, we develop an existing lightweight face alignment model for eye key point locations that is robust in large poses. Then, to develop the performance of our model in a complex driving environment such as an environment with mask coverings, changing illumination, etc., we design a method to augment the training data set based on the original landmark data set without any extra cost. Finally, some facial landmarks around the eyes are extracted, and the eye aspect ratio (EAR) is introduced to evaluate the eye state based on eye key points. The experiment shows that our model achieves significantly improved landmark location performance on a driving simulation data set due to data augmentation. We tested our model on the BioID data set to measure the eye state evaluation performance, and the results showed that our model obtained satisfactory performance with an accuracy of approximately 97.7%. Further testing on the driving simulation data set shows that our model is robust in different driving scenarios with an average accuracy of approximately 93.9%. CCBY

Blood molecular markers associated with COVID-19 immunopathology and multi-organ damage

COVID-19 is characterized by dysregulated immune responses, metabolic dysfunction and adverse effects on the function of multiple organs. To understand host responses to COVID-19 pathophysiology, we combined transcriptomics, proteomics, and metabolomics to identify molecular markers in peripheral blood and plasma samples of 66 COVID-19-infected patients experiencing a range of disease severities and 17 healthy controls. A large number of expressed genes, proteins, metabolites, and extracellular RNAs (exRNAs) exhibit strong associations with various clinical parameters. Multiple sets of tissue-specific proteins and exRNAs varied significantly in both mild and severe patients suggesting a potential impact on tissue function. Chronic activation of neutrophils, IFN-I signaling, and a high level of inflammatory cytokines were observed in patients with severe disease progression. In contrast, COVID-19-infected patients experiencing milder disease symptoms showed robust T-cell responses. Finally, we identified genes, proteins, and exRNAs as potential biomarkers that might assist in predicting the prognosis of SARS-CoV-2 infection. These data refine our understanding of the pathophysiology and clinical progress of COVID-19. SYNOPSIS image Proteomics, metabolomics and RNAseq data map immune responses in COVID-19 patients with different disease severity, revealing molecular makers associated with disease progression and alterations of tissue-specific proteins. A multi-omics profiling of the host response to SARS-CoV2 infection in 66 clinically diagnosed and laboratory confirmed COVID-19 patients and 17 uninfected controls. Significant correlations between multi-omics data and key clinical parameters. Alteration of tissue-specific proteins and exRNAs. Enhanced activation of immune responses is associated with COVID-19 pathogenesis. Biomarkers to predict COVID-19 clinical outcomes pending clinical validation as prospective marker.

Comparing effects of brain training and roleplaying games on problem-solving speed

Problem-solving skills are increasingly becoming a desired skill in the workplace today. Although formal education will be the best way to develop one's own problem-solving skills, the problems addressed are often clearly defined and structured. However, problems in the real world are often ill-structured and requires complex problem-solving. Many researches indicate that video games can be an alternative to developing problem-solving skills given that the problem and environment are ill-structured. Based on prior comparative findings on strategy-fast-paced video games and role-playing-brain training games, this study investigates whether participants will evidence greater learning gains in problem-solving speed within a sandwich Tower of Hanoi-a fastpaced-brain-training or a strategy role-playing video game-Tower of Hanoi methodology. There is closer similarity between the fast-paced video game to the Tower of Hanoi. Hence, we hypothesize that this closer similarity may result in improved problem-solving speed since the development of rules may be analogically similar. In our study, findings indicate that participants who play Idle Supermarket Tycoon (strategy role-playing video game) evidence more pre-post-test learning gains (problem-solving speed) compared to Mario Kart Tour (fast-paced-brain-training video game). This finding confirms prior research that strategy and role-playing video games are more effective than fast-paced and brain training games in developing problem-solving skills. It also hints that increased cognitive load due to multivariate complexity may be traded off by motivation to form or activate rules when the problem is personally relevant or simulates real-life challenges. However, there are several limitations to the experiment in terms of specificity due to the small sample size. This is due to the research being carried out during the country's COVID-19 movement control order/lockdown and the need for more data to be conclusive. Nevertheless, we hope it can serve as a catalyst for more research and studies in the field. Copyright © 2020 Asia-Pacific Society for Computers in Education.

The Course of Mild and Moderate COVID-19 Infections-The Unexpected Long-Lasting Challenge

Background. The course of disease in mild and moderate COVID-19 has many implications for mobile patients, such as the risk of spread of the infection, precautions taken, and investigations targeted at preventing transmission. Methods. Three hundred thirty-one adults were hospitalized from January 21 to February 22, 2020, and classified as severe (10%) or critical (4.8%) cases;1.5% died. Two hundred eighty-two (85.2%) mild or moderate cases were admitted to regular wards. Epidemiological, demographic, clinical, chest computed tomography (CT) scan, laboratory, treatment, and outcome data from patient records were analyzed retrospectively. Results. Patients were symptomatic for 9.82 +/- 5.75 (1-37) days. Pulmonary involvement was demonstrated on a chest CT scan in 97.9% of cases. It took 16.81 +/- 8.54 (3-49) days from the appearance of the first symptom until 274 patients tested virus-negative in naso- and oropharyngeal (NP) swabs, blood, urine, and stool, and 234 (83%) patients were asymptomatic for 9.09 +/- 7.82 (1-44) days. Subsequently, 131 patients were discharged. One hundred sixty-nine remained in the hospital;these patients tested virus-free and were clinically asymptomatic because of widespread persisting or increasing pulmonary infiltrates. Hospitalization took 16.24 +/- 7.57 (2-47) days;the time interval from the first symptom to discharge was 21.37 +/- 7.85 (3-52) days. Conclusions. With an asymptomatic phase, disease courses are unexpectedly long until the stage of virus negativity. NP swabs are not reliable in the later stages of COVID-19. Pneumonia outlasts virus-positive tests if sputum is not acquired. Imminent pulmonary fibrosis in high-risk groups demands follow-up examinations. Investigation of promising antiviral agents should heed the specific needs of mild and moderate COVID-19 patients.

[Effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker on clinical characteristics of coronavirus disease 2019 patients with hypertension].

Objective: To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients. Methods: Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group. Results: Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) µmol/L vs. 71.29 (50.98, 76.98) µmol/L, P=0.007] was higher significantly in ACEI/ARB group. Conclusions: ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs.

[Risks factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes].

OBJECTIVE: The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown,evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study. METHODS: This was a single-centered, retrospective, observational study. Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan. 29, 2020 to Mar. 20, 2020 were included. The positive nucleic acid of COVID-19 virus and combination with hypertension, coronary heart disease or diabetes were in the standard. We collected the clinical data and laboratory examination results of the eligible patients to evaluate the related factors of death. RESULTS: In the study, 94 COVID-19 patients enrolled were divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66.7 years. Compared with the survival group, the death group had faster basal heart rate(103.2 beats/min vs. 88.4 beats /min, P=0.004), shortness of breath(29.0 beats /min vs. 20.0 beats /min, P<0.001), higher neutrophil count(9.2×109/L vs. 3.8×109/L, P<0.001), lower lymphocyte count(0.5×109/L vs. 1.1×109/L, P<0.001), creatine kinase MB(CK-MB, 3.2 µg/L vs. 0.8 µg/L, P<0.001), high sensitivity cardiac troponin Ⅰ(hs-cTnⅠ, 217.2 ng/L vs. 4.9 ng/L, P<0.001), N-terminal pro brain natriuretic peptide(NT-proBNP; 945.0 µg/L vs. 154.0 µg/L, P<0.001), inflammatory factor ferritin(770.2 µg/L vs. 622.8 µg/L , P=0.050), interleukin-2 recepter(IL-2R, 1 586.0 U/mL vs. 694.0 U/mL, P<0.001), interleukin-6(IL-6, 82.3 ng/L vs. 13.0 ng/L, P<0.001), interleukin-10(IL-10, 9.8 ng/L vs. 5.0 ng/L, P<0.001)were higher than those in the survival group. Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2R, IL-6, and IL-10. Multivariate regression showed that old age (OR=1.11, 95%CI=1.03-1.19, P=0.026), low non oxygen saturation(OR=0.85, 95%CI=0.72-0.99, P=0.041), and abnormal increase of IL-10(＞9.1 ng/L, OR=101.93, 95%CI=4.74-2190.71, P=0.003)were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes. CONCLUSION: In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, and abnormal increase of IL-2R, IL-6, and IL-10. Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors.

[Analysis of baseline liver biochemical parameters in 324 cases with novel coronavirus pneumonia in Shanghai area].

Objective: To summarize the clinical characteristics and liver biochemical parameters of 324 cases admitted with novel coronavirus pneumonia in Shanghai area. Methods: Clinical data and baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia admitted to the Shanghai Public Health Clinical Center from January 20, 2020 to February 24, 2020 were retrospectively analyzed. Patients were divided into two groups based on the status of illness: mild type (mild and typical) and severe type (severe and critical).The differences in clinical data and baseline liver biochemical parameters of the two groups were described and compared. The t-test and Wilcoxon rank-sum test were used for measurement data. The enumeration data were expressed by frequency and rate, and chi-square test was used. Results: Of the 324 cases with novel coronavirus pneumonia, 26 were severe cases (8%), with median onset of 5 days, 20 cases were HBsAg positive (6.2%), and 70 cases (21.6%) with fatty liver, diagnosed with X-ray computed tomography. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), total bilirubin (TBil), albumin(ALB) and international normalized ratio (INR) of 324 cases at baseline were 27.86 ± 20.02 U/L, 29.33 ± 21.02 U/L, 59.93 ± 18.96 U / L, 39.00 ± 54.44 U/L, 9.46 ± 4.58 µmol / L, 40.64 ± 4.13 g / L and 1.02 ± 0.10. Of which, ALT was > than the upper limit of normal (> ULN), accounting for 15.7% (51/324). ALT and AST > ULN, accounting for 10.5% (34/324). ALP > ULN, accounting for 1.2% (4/324). ALP and GGT > ULN, accounting for 0.9% (3/324). INR > ULN was lowest, accounting for 0.6% (2/324). There were no statistically significant differences (P > 0.05) in ALT [(21.5 vs. 26) U / L, P = 0.093], ALP [(57 vs.59) U/L, P = 0.674], and GGT [(24 vs.28) U/L, P = 0.101] between the severe group and the mild group. There were statistically significant differences in AST (23 U/L vs. 34 U/L, P < 0.01), TBil (10.75 vs. 8.05 µmol / L, P < 0.01), ALB (35.79 ± 4.75 vs. 41.07 ± 3.80 g/L, P < 0.01), and INR (1.00 vs. 1.04, P < 0.01). Conclusion: The baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia in Shanghai area was comparatively lower and the liverinjury degree was mild, and the bile duct cell damage was rare.