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1.
International Journal of Biological Sciences ; 16(13):2382-2391, 2020.
Article | WHO COVID | ID: covidwho-689142

ABSTRACT

COVID-19 is a public health emergency that has rapidly spread to over 200 countries and regions, and no effective treatment has been established to date Severe and critical cases have been associated with higher mortality due to acute respiratory distress syndrome (ARDS) and cytokine storm Based on the novelty and recent emergence of COVID-19, no effective treatment regimen has been identified, thus prompting clinicians to engage in drug repurposing to address the immediate therapeutic need This study focused on the molecular target angiotensin-converting enzyme 2 (ACE2) of SARS-CoV-2 and screened a group of ACE2 agonists by bioinformatics Glucocorticoids are a type of ACE2 activator We verified the efficacy of nine chemicals on regulating ACE2 expression in human GES-1, an upper digestive tract epithelial cell line, and THP-1, a human monocyte cell line, and found that several glucocorticoids imparted activating effects on ACE2 in both cell lines The drugs triciribine and kinetin riboside activate ACE2 expression or inhibit IL-6 production in macrophages to some extent In addition, we compared the efficacies of several glucocorticoids Hydrocortisone showed the strongest effect on ACE2 activation, followed by prednisolone, dexamethasone, and methylprednisolone We retrospectively analyzed the therapeutic efficacy of nine severe or critical patients from a cohort of 90 COVID-19 cases, who received medium to small doses of glucocorticoids from our integrated medical team in Wuhan Seven out of nine patients revealed significant improvement in clinical parameters and chest CT images This study provides experimental and clinical evidence that medium-to-low-dose glucocorticoids may play a protective role in the respiratory and digestive systems by activating ACE2 and suppressing cytokine storm

2.
Eur J Clin Invest ; : e13364, 2020 Jul 29.
Article in English | MEDLINE | ID: covidwho-684466

ABSTRACT

BACKGROUND: COVID-19 is currently the most urgent threat to public health in the world. The aim of this study is to provide an overview of the first cases of COVID-19 to make further improvements in health policies and prevention measurements in response to the outbreak of COVID-19. METHODS: We performed a search in PubMed, the CNKI (China National Knowledge Infrastructure), Web of Science, and the WHO database of publications on COVID-19 for peer-reviewed papers from December 1, 2019 to July 9, 2020. We analyzed the demographics, epidemiological characteristics, clinical features, signs, and symptoms of the disease at the onset. RESULTS: We identified the first cases of COVID-19 in 16 different countries/regions from Asia, Europe, North America, and South America. Of these 16 cases, 8 (50.0%) were male, with a mean of age 43.38±15.19 years. All the cases had a history of travel or exposure. 12 cases (75.0%) occurred in January, eight patients were Chinese, two patients were international students in Wuhan, one patient had a history of traveling in Wuhan, and one patient was in contact with Chinese patient. The longest hospital stay was 24 days (1 patient), and the shortest was 5 days (1 patient). The usual hospital stay was 9 days (4 patients). CONCLUSION: Understanding the epidemiological characteristics, clinical characteristics, and diagnosis and treatment of the first patients in various countries are of great significance for the identification, prevention, and control of COVID-19.

3.
Front. Public Health ; (8)20200519.
Article in English | ELSEVIER | ID: covidwho-609566

ABSTRACT

The COVID-19 outbreak spread rapidly throughout the globe, with worldwide infections and deaths continuing to increase dramatically. To control disease spread and protect healthcare workers, accurate information is necessary. We searched PubMed and Google Scholar for studies published from December 2019 to March 31, 2020 with the terms “COVID-19,” “2019-nCoV,” “SARS-CoV-2,” or “Novel Coronavirus Pneumonia.” The main symptoms of COVID-19 are fever (83–98.6%), cough (59.4–82%), and fatigue (38.1–69.6%). However, only 43.8% of patients have fever early in the disease course, despite still being infectious. These patients may present to clinics lacking proper precautions, leading to nosocomial transmission, and infection of workers. Potential COVID-19 cases must be identified early to initiate proper triage and distinguish them quickly from similar infections. Early identification, accurate triage, and standardized personal protection protocols can reduce the risk of cross infection. Containing disease spread will require protecting healthcare workers.

4.
J Med Virol ; 2020 May 13.
Article in English | MEDLINE | ID: covidwho-245681

ABSTRACT

This study aims to observe the clinical characteristics of recovered patients from Coronavirus Disease 2019 (COVID-19) with positive in reverse transcription-polymerase chain reaction (RT-PCR) or serum antibody. The profile, clinical symptoms, laboratory outcomes, and radiologic assessments were extracted on 11 patients, who tested positive for COVID-19 with RT-PCR or serum antibody after discharged and was admitted to Hubei No. 3 People's Hospital of Jianghan University for a second treatment in March 2020. The average interval time between the first discharge and the second admission measured 16.00 ± 7.14 days, ranging from 6 to 27 days. In the second hospitalization, one patient was positive for RT-PCR and serum antibody immunoglobulin M (IgM)-immunoglobulin G (IgG), five patients were positive for both IgM and IgG but negative for RT-PCR. Three patients were positive for both RT-PCR and IgG but negative for IgM. The main symptoms were cough (54.55%), fever (27.27%), and feeble (27.27%) in the second hospitalization. Compared with the first hospitalization, there were significant decreases in gastrointestinal symptoms (5 vs 0, P = .035), elevated levels of both white blood cell count (P = .036) and lymphocyte count (P = .002), remarkedly decreases in C-reactive protein and serum amyloid A (P < .05) in the second hospitalization. Additionally, six patients' chest computed tomography (CT) exhibited notable improvements in acute exudative lesions. There could be positive results for RT-PCR analysis or serum IgM-IgG in discharged patients, even with mild clinical symptoms, however, their laboratory outcomes and chest CT images would not indicate the on-going development in those patients.

5.
J Med Virol ; 2020 May 05.
Article in English | MEDLINE | ID: covidwho-175874

ABSTRACT

In December 2019, a novel coronavirus causing severe acute respiratory disease occurred in Wuhan, China. It is an emerging infectious disease with widespread and rapid infectiousness. The World Health Organization declared the coronavirus outbreak to be a public health emergency of international concern on 31 January 2020. Severe COVID-19 patients should be managed and treated in a critical care unit. Performing a chest X-ray/CT can judge the severity of the disease. The management of COVID-19 patients includes epidemiological risk and patient isolation; treatment entails general supportive care, respiratory support, symptomatic treatment, nutritional support, psychological intervention, etc. The prognosis of the patients depends upon the severity of the disease, the patient's age, the underlying diseases of the patients, and the patient's overall medical condition. The management of COVID-19 should focus on early diagnosis, immediate isolation, general and optimized supportive care, and infection prevention and control.

6.
Otolaryngol Head Neck Surg ; 162(6): 809-810, 2020 06.
Article in English | MEDLINE | ID: covidwho-52516

ABSTRACT

More than half of COVID-19 patients are afebrile early in the disease course, yet mildly ill or asymptomatic patients can still spread SARS-CoV-2 with high efficiency. Atypically presenting patients may be seen in noninfectious disease settings such as otolaryngology, which is a specialty prone to occupational exposure. Otolaryngologists have been infected with COVID-19 at higher rates than other specialties in China and other countries. Otolaryngology providers should maintain high clinical suspicion for mild and asymptomatic COVID-19 patients. Protective strategies should be implemented including preappointment screening, triaging, restriction of nonurgent visits and surgeries, telemedicine, and appropriate personal protective equipment use.


Subject(s)
Asymptomatic Diseases/therapy , Coronavirus Infections/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Otolaryngology/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Asymptomatic Diseases/epidemiology , Communicable Disease Control/organization & administration , Disease Management , Female , Global Health , Health Personnel/statistics & numerical data , Humans , Male , Otolaryngologists/statistics & numerical data , Pandemics/statistics & numerical data , Universal Precautions/methods
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