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1.
BMJ Open ; 12(6): e062294, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-1886767

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates. METHODS AND ANALYSIS: We will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and (3) determine the role of social contextual factors on racial/ethnic disparities in pregnancy-related morbidities using machine learning algorithms. We will leverage an existing South Carolina COVID-19 Cohort by creating a pregnancy cohort that links COVID-19 testing data, electronic health records (EHRs), vital records data, healthcare utilisation data and billing data for all births in South Carolina (SC) between 2018 and 2021 (>200 000 births). We will also conduct similar analyses using EHR data from the National COVID-19 Cohort Collaborative including >270 000 women who had a childbirth between 2018 and 2021 in the USA. We will use a convergent parallel design which includes a quantitative analysis of data from the 2018-2021 SC Pregnancy Risk Assessment and Monitoring System (unweighted n>2000) and in-depth interviews of 40 postpartum women and 10 maternal care providers to identify distinct mediating pathways. ETHICS AND DISSEMINATION: The study was approved by institutional review boards at the University of SC (Pro00115169) and the SC Department of Health and Environmental Control (DHEC IRB.21-030). Informed consent will be provided by the participants in the in-depth interviews. Study findings will be disseminated with key stakeholders including patients, presented at academic conferences and published in peer-reviewed journals.


Subject(s)
COVID-19 , Maternal Health Services , COVID-19/epidemiology , COVID-19 Testing , Female , Humans , Morbidity , Pandemics , Parturition , Pregnancy , SARS-CoV-2 , United States/epidemiology
2.
Transl Androl Urol ; 11(2): 159-167, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1727124

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) has spread worldwide with alarming levels of spread and severity. The distribution of angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) from bioinformatics evidence, the autopsy report for COVID-19 and the published study on sperm quality indicated COVID-19 could have a negative impact on male fertility. However, whether the negative impact of COVID-19 on male fertility is persistent remains unknown, which requires long-term follow-up investigation. Methods: Semen samples were collected from 36 male COVID-19 patients with a median recovery time of 177.5 days and 45 control subjects. Then, analysis of sperm quality and alterations of total sperm number with recovery time were performed. Results: There was no significant difference in semen parameters between male recovered patients and control subjects. And the comparisons of semen parameters between first follow-up and second follow-up revealed no significant difference. In addition, we explored the alterations of sperm count with recovery time. It showed that the group with recovery time of ≥120 and <150 days had a significantly lower total sperm number than controls while the other two groups with recovery time of ≥150 days displayed no significance with controls, and total sperm number showed a significant decline after a recovery time of 90 days and an improving trend after a recovery time of about 150 days. Conclusions: The sperm quality of COVID-19 recovered patients improved after a recovery time of nearly half a year, while the total sperm number showed an improvement after a recovery time of about 150 days. COVID-19 patients should pay close attention to the quality of semen, and might be considered to be given medical interventions if necessary within about two months after recovery, in order to improve the fertility of male patients as soon as possible.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324554

ABSTRACT

Objective: To explore the clinical characteristics and prognosis of COVID-19 patients with cerebral stroke. Methods: : In this retrospective study, 2474 patients with COVID-19 were admitted and treated in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan from February 10, 2020, to March 24, 2020. Data on the clinical characteristics, laboratory parameters and prognosis of COVID-19 patients with or without cerebral stroke were collected and comparatively analyzed. Results: : Of 2474 COVID-19 patients (61.0±15.7 years;1235 males [49.9%]), 113 (4.7%) patients had cerebral stroke, and 25 (1.0%) patients had a new onset of stroke. Eighty-eight (77.9%) patients in the previous stroke group had cerebral ischemia, while 25 (22.1%) patients in the new-onset stroke group had cerebral ischemia. Most COVID-19 patients with stroke were elderly with more complicated disorders, such as hypertension, diabetes and heart diseases. Laboratory examinations showed a hypercoagulation status and elevated serum parameters such as IL-6, cTnI, NT pro-BNP and BUN. Of note, stroke patients revealed a nearly double mortality (12.4% vs 6.9%) to that of patients without stroke. Additionally, age (≥60 years), fingertip oxygen saturation (<93%) and consciousness disorder were independent predictors for new cerebral stroke in COVID-19 patients. Interpretation: The high risk of new-onset stroke in COVID-19 patients was older age combined with fingertip oxygen saturation (<93%) and consciousness disorder. These patients are more vulnerable to multiple organ dysfunction and an overactivated inflammatory response, in turn leading to a deteriorated outcome and mortality.

4.
Micromachines (Basel) ; 13(2)2022 Jan 26.
Article in English | MEDLINE | ID: covidwho-1648327

ABSTRACT

With the research and the development of graphene-based materials, new sensors based on graphene compound materials are of great significance to scientific research and the consumer market. However, in the past ten years, due to the requirements of sensor accuracy, reliability, and durability, the development of new graphene sensors still faces many challenges in the future. Due to the special structure of graphene, the obtained characteristics can meet the requirements of high-performance sensors. Therefore, graphene materials have been applied in many innovative sensor materials in recent years. This paper introduces the important role and specific examples of sensors based on graphene and its base materials in biomedicine, photoelectrochemistry, flexible pressure, and other fields in recent years, and it puts forward the difficulties encountered in the application of graphene materials in sensors. Finally, the development direction of graphene sensors has been prospected. For the past two years of the COVID-19 epidemic, the detection of the virus sensor has been investigated. These new graphene sensors can complete signal detection based on accuracy and reliability, which provides a reference for researchers to select and manufacture sensor materials.

5.
BMC Pregnancy Childbirth ; 21(1): 745, 2021 Nov 03.
Article in English | MEDLINE | ID: covidwho-1501992

ABSTRACT

BACKGROUND: Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. We aimed to evaluate the acceptance of influenza vaccination and associated factors among pregnant women during COVID-19 pandemic, provide evidence to improve influenza vaccination among pregnant women, help reduce the risk of infection and alleviate the burden of healthcare system for co-infected patients. METHODS: We conducted a multi-center cross-sectional study among pregnant women in China. Sociodemographic characteristics, health status, knowledge on influenza, attitude towards vaccination, and health beliefs were collected. Locally weighted scatterplot smoothing regression analysis was used to evaluate the trends in the acceptance of influenza vaccine. Logistic regression was applied to identify factors associated with vaccination acceptance. RESULTS: The total acceptance rate was 76.5% (95%CI: 74.8-78.1%) among 2568 pregnant women enrolled. Only 8.3% of the participants had a history of seasonal influenza vaccination. In the logistic regression model, factors associated with the acceptance of influenza vaccine were western region, history of influenza vaccination, high knowledge of influenza infection and vaccination, high level of perceived susceptibility, perceived benefit, cues to action and low level of perceived barriers. Among 23.5% of the participants who had vaccine hesitancy, 48.0% of them were worried about side effect, 35.6% of them lacked confidence of vaccine safety. CONCLUSIONS: Our findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women's concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system.


Subject(s)
COVID-19/epidemiology , Influenza A virus/immunology , Influenza Vaccines/pharmacology , Influenza, Human/prevention & control , Pandemics , Pregnancy Complications, Infectious/prevention & control , Vaccination/methods , Adult , China/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Health Belief Model , Health Knowledge, Attitudes, Practice , Humans , Influenza, Human/epidemiology , Patient Acceptance of Health Care , Pregnancy , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2 , Seasons , Surveys and Questionnaires
6.
J Sex Med ; 18(11): 1863-1871, 2021 11.
Article in English | MEDLINE | ID: covidwho-1446910

ABSTRACT

BACKGROUND: The psychological and sexual health of different populations are negatively affected during the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about psychological distress and erectile function of male recovered patients with COVID-19 in the long term. AIM: We aimed to evaluate psychological distress and erectile function of male recovered patients with COVID-19 in the mid-to-long terms. METHODS: We recruited 67 eligible male recovered patients with COVID-19 and followed them up twice within approximately 6 months of recovery time. The psychological distress and erectile function were assessed by validated Chinese version of paper questionnaires. OUTCOMES: The primary outcomes were Symptom Checklist 90 questionnaire for psychological distress and International Index of Erectile Function-5 for erectile function. RESULTS: In the first visit, COVID-19 patients with a median recovery time of 80 days mainly presented the following positive symptoms: Obsessive-Compulsive, additional items (ADD), Hostility, Interpersonal Sensitivity, Depression, and Somatization; while the dimension scores in Somatization, Anxiety, ADD, and Phobia were higher than Chinese male norms. Besides, the prevalence of erectile dysfunction (ED) in the first-visit patients was significantly higher than Chinese controls. In the second visit, the primary psychological symptoms of COVID-19 patients with a median recovery time of 174 days were Obsessive-Compulsive, ADD, Interpersonal Sensitivity, and Hostility, while all dimensions scores of Symptom Checklist 90 were lower than Chinese male norms. Moreover, second-visit patients had no significant difference with Chinese controls in ED prevalence. In addition, it suggested that GSI was the independent risk factor for ED in the regression analysis for the first-visit patients. CLINICAL IMPLICATIONS: The study showed the changes of psychological symptoms and erectile function in COVID-19 recovered patients, and provided reference on whether psychological and sexual supports are needed after a period of recovery. STRENGTHS AND LIMITATIONS: To our knowledge, it is the first study to comprehensively evaluate the psychological distress and erectile function of COVID-19 recovered patients in the mid-to-long terms. The main limitations were the low number of analyzed participants, and the psychological distress and erectile function of healthy Chinese men over the same period were not evaluated, and the psychological and sexual related data of participants prior to COVID-19 were not available. Additionally, there was a selection bias in comparing COVID-19 patients with healthy controls. CONCLUSION: With less impact of COVID-19 event, the impaired erectile function and psychological distress improved in COVID-19 recovered patients with a recovery time of nearly half a year. Hu B, Ruan Y, Liu K, et al. A Mid-to-Long Term Comprehensive Evaluation of Psychological Distress and Erectile Function in COVID-19 Recovered Patients. J Sex Med 2021;18:1863-1871.


Subject(s)
COVID-19 , Erectile Dysfunction , Psychological Distress , Erectile Dysfunction/epidemiology , Humans , Male , Penile Erection , SARS-CoV-2 , Surveys and Questionnaires
7.
Health Services Research ; 56(S2):30-31, 2021.
Article in English | ProQuest Central | ID: covidwho-1409262

ABSTRACT

Research ObjectiveThe Centers for Disease Control and Prevention called for telehealth uptakes to avoid disruption of routine prenatal care (PNC) during the COVID‐19 pandemic. Yet, lack of technology capacity may hinder telehealth access and disrupt PNC. Social support could serve as a protective factor against technology barriers and moderate the association between technology capacity and attending PNC. To date, little data are available regarding the associations between technology capacity, social support, and PNC. This study assessed the associations of technology capacity with PNC provider continuity and overall PNC experience and to examine whether social support modifies such associations.Study DesignA nationwide survey was completed from 5/4/2020–5/6/2020 by 668 U.S. pregnant women, 18–44 years of age and being at least 8‐week gestation. Two aspects of PNC were studies: 1) pregnant women's overall rating of PNC experience, ranging from very poor (1) to outstanding (5), and 2) PNC provider continuity, defined as whether a woman stayed with the same PNC provider during the pandemic. Technology capacity was measured as the total scores of participants' confidence and necessary skills for telehealth use (range: 2–10). Social support was assessed using the modified Medical Outcomes Study Social Support Survey and categorized to three levels (low, medium and high) with mean +/− one standard deviation. Multivariable linear regressions and logistic regression were used to examine the associations between technology capacity and PNC outcomes and the modifying roles of social support.Population Studied668 women who were > 8 weeks pregnant, aged 18–44 years, living and planning to give birth in the United States, and having initiated PNC were included in the analysis.Principal FindingsA total of 668 pregnant women have initiated PNC by 5/6/2020. They were mostly aged 25–34 years (91.8%), diverse (44.3% non‐Hispanic Black, 8.5% Hispanic, 44.3% non‐Hispanic White and 6.6% other non‐Hispanic race), urban residents (86.4%), and full‐time employed (63.9%). Technology capacity and social support were positively associated with PNC experience and provider continuity (Ps < 0.01). However, technology capacity was positively related to PNC experience (β = 0.31, 95% CI 0.16 to 0.45;P < 0.001) and PNC provider continuity (OR = 1.80, 95% CI 1.52 to 2.14;P < 0.001) only among women with low social support, but not among women with high social support.ConclusionsTechnology capacity had positive associations with overall rating of PNC experience and provider continuity. These relationships were stronger among women with lower social support.Implications for Policy or PracticeThere is a need to improve technology capacity and/or promote and incentivize social support structures for pregnant women, especially those who lack technology capacity and social support. Clinical healthcare providers may consider providing technology support in the meantime of deploying telehealth resources, in collaboration with communities that can reach out to pregnant women in need. Policymakers and insurers should develop complementary policies to ensure both the supply and demand sides benefit from wide‐spread telehealth use for prenatal care.Primary Funding SourceUniversity of South Carolina vice president for research.

8.
Health Services Research ; 56(S2):18-19, 2021.
Article in English | Wiley | ID: covidwho-1409225

ABSTRACT

Research Objective Before the COVID-19 pandemic, about one in ten childbirths were elective deliveries ? labor induction and cesarean deliveries without medical indications ? which evidently increased adverse maternal and neonatal outcomes. Anecdotal evidence shows that during COVID-19, providers are increasingly recommending these deliveries, but little is known regarding the extent and the patterns of such recommendations across pregnant women in the United States (U.S.). Study Design We conducted a nationwide cross-sectional survey of 740 racial-diverse U.S. pregnant women with >8-week pregnancy, and aged 18?44?years during 5/4/2020?5/6/2020 to evaluate maternal and provider characteristics associated with birth plan changes due to the COVID-19 pandemic. To understand the birth plan changes, we asked each participant, ?has a health care professional recommended a change to your birth plan as a result of COVID-19?? Options include 1) No, there have been no recommended changes to my original birth plan as a result of COVID-19. 2) Yes, my provider recommended inducing labor as a result of COVID-19. 3) Yes, my provider recommended a planned cesarean (c-section) delivery as a result of COVID-19. 4) I don't know yet. Women who responded, ?I don't know yet? were excluded, yielding a total of 678 sample pregnant women in the analysis. Multivariable regressions were used to assess rural?urban differences in the likelihoods of provider recommendations for birth plan changes to labor induction or planned c-section, controlling for race/ethnicity, age, insurance-type, education, employment, household income, pregnancy condition, pre-pregnancy Body Mass Index, parity, trimester, provider specialty, delayed prenatal care initiation, positive-tested family member, state positivity rates as of 5/6/2020, and census region. Population Studied 740 racial-diverse U.S. pregnant women with >8-week pregnancy, and aged 18?44?years in 2020. Principal Findings Of 678 eligible pregnant women, the majority lived in urban communities (87.0%). Rural women reported lower household income, were less likely to initiate prenatal care at the first trimester, visit obstetricians for prenatal care, be privately insured, be employed full-time than urban women participants. They were similar in age, race/ethnicity, education, pregnancy condition, pre-pregnancy BMI, and state COVID-19 positivity rates. Overall, 22.6% were recommended to change delivery plans to either labor induction or planned c-section due to the pandemic, with a higher rate in rural women (34.5%) than urban women (20.9%). Controlling for other maternal, provider, and state COVID-19 characteristics, these recommendations were disproportionately prevalent among rural women (Odds ratios [OR]: 1.6), primiparous women (OR: 7.7), women delaying prenatal care initiation (OR: 5.2), those visiting family physicians but no obstetricians for prenatal care (OR: 4.3), Medicaid insured (OR: 3.2), and those with family members tested positive for COVID-19 (OR: 5.4). Conclusions In May 2020, women living in rural areas, Medicaid insured, having delayed prenatal care initiation, and visiting only family physicians for prenatal care were more likely to be recommended for elective procedures. Implications for Policy or Practice There is an urgent need for health system and policymakers to establish safe and effective protocols to ensure pregnant women obtain evidence-based care as needed during the pandemic and beyond to avoid long-term detrimental effects. Primary Funding Source University of South Carolina Vice Office of the Vice President for Research.

9.
Birth ; 48(4): 470-479, 2021 12.
Article in English | MEDLINE | ID: covidwho-1234217

ABSTRACT

BACKGROUND: Few studies have evaluated whether pandemic-related stressors, worries, and social distancing have affected the mental health of pregnant women during the COVID-19 pandemic. METHODS: Data came from an online survey of United States pregnant women (n = 715), conducted in May 2020. The Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder Scale were used to assess depressive symptoms, thoughts of self-harm, and moderate or severe anxiety. Multiple logistic regressions were used to examine the associations of COVID-19 experiences with mental health outcomes. RESULTS: Participants were racially diverse. The prevalence of adverse mental health outcomes was 36% for probable depression, 20% for thoughts of self-harm, and 22% for anxiety. Women who reported family members dying from COVID-19 had four times higher odds of having thoughts of self-harm than women who did not experience family death. Depression was more prevalent among women who canceled or reduced medical appointments. Women were more likely to have worse mental health outcomes if they expressed worry about getting financial or emotional/social support, about their pregnancy, or about family or friends. Strict social distancing was positively associated with depression. A higher proportion of adults working from home was inversely associated with depression and thoughts of self-harm. CONCLUSION: High percentages of pregnant women had symptoms of depression or anxiety, suggesting an urgent need to screen and treat mental health conditions among pregnant women during the pandemic. Pandemic-related risks and protective factors are relevant to developing tailored interventions to address the mental health of pregnant women during pandemic circumstances.


Subject(s)
COVID-19 , Mental Health , Adult , Anxiety/epidemiology , Depression/epidemiology , Female , Humans , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2 , United States/epidemiology
10.
Hum Vaccin Immunother ; 17(8): 2378-2388, 2021 08 03.
Article in English | MEDLINE | ID: covidwho-1228401

ABSTRACT

Background: Vaccine hesitancy has been recognized as an urgent public health issue. We aimed to explore the acceptance of a COVID-19 vaccine and related factors among pregnant women, a vulnerable population for vaccine-preventable diseases.Methods: A multi-center cross-sectional study among pregnant women was conducted in five provinces of mainland China from November 13 to 27, 2020. We collected sociodemographic characteristics, attitude, knowledge, and health beliefs on COVID-19 vaccination. Locally weighted scatterplot smoothing regression analysis was used to assess the trends of vaccination acceptance. Multivariable logistic regression was performed to identify factors related to vaccination acceptance.Results: Among the 1392 pregnant women, the acceptance rate of a COVID-19 vaccine were 77.4% (95%CI 75.1-79.5%). In the multivariable regression model, the acceptance rate was associated with young age (aOR = 1.87, 95% CI: 1.20-2.93), western region (aOR = 2.73, 95% CI: 1.72-4.32), low level of education (aOR = 2.49, 95% CI: 1.13-5.51), late pregnancy (aOR = 1.49, 95% CI: 1.03-2.16), high knowledge score on COVID-19 (aOR = 1.05, 95% CI: 1.01-1.10), high level of perceived susceptibility (aOR = 2.18, 95% CI: 1.36-3.49), low level of perceived barriers (aOR = 4.76, 95% CI: 2.23-10.18), high level of perceived benefit (aOR = 2.18, 95% CI: 1.36-3.49), and high level of perceived cues to action (aOR = 15.70, 95% CI: 8.28-29.80).Conclusions: About one quarters of pregnant women have vaccine hesitancy. Our findings highlight that targeted and multipronged efforts are needed to build vaccine literacy and confidence to increase the acceptance of a COVID-19 vaccine during the COVID-19 pandemic, especially for vulnerable populations.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , China , Cross-Sectional Studies , Female , Health Belief Model , Humans , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2 , Vaccination
11.
Int J Med Sci ; 18(11): 2366-2371, 2021.
Article in English | MEDLINE | ID: covidwho-1222282

ABSTRACT

Coronavirus Disease 2019 (COVID-19) emerges as a global pandemic and there is a lack of evidence about the clinical course and outcome of patients on maintenance hemodialysis (MHD). Here we conducted a retrospective longitudinal study aimed to analyze the clinical features and outcome of MHD patients hospitalized with COVID-19. Of 3126 inpatients with COVID-19 at 3 Branches of Wuhan Tongji Hospital from Jan 18th to Mar 9th, 2020, 19 patients were undergoing maintenance hemodialysis. Among the 19 MHD patients with COVID-19, 6 patients (31.6%) died, and 13 patients (68.4%) were able to be discharged. Baseline characteristics, clinical courses, laboratory findings, and dynamic trajectories of major laboratory markers were compared between survivors and nonsurvivors. According to our findings, MHD patients with COVID-19 who experienced non-surviving outcome had more elevated CRP, IL6 and procalcitonin as well as fibrinogen levels at various points compared to survivors. Thus the dysregulation of immune response as well as coagulation abnormalities might be highly involved in the pathological process of COVID-19, contributing to the poor prognosis in MHD patients.


Subject(s)
COVID-19/etiology , Kidney Failure, Chronic/complications , Renal Dialysis , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , C-Reactive Protein/analysis , COVID-19/drug therapy , COVID-19/immunology , Female , Hospitalization , Humans , Longitudinal Studies , Male , Middle Aged , Retrospective Studies
12.
Front Cell Infect Microbiol ; 11: 641920, 2021.
Article in English | MEDLINE | ID: covidwho-1170079

ABSTRACT

Pseudomonas aeruginosa is a biofilm-forming opportunistic pathogen which causes chronic infections in immunocompromised patients and leads to high mortality rate. It is identified as a common coinfecting pathogen in COVID-19 patients causing exacerbation of illness. In our hospital, P. aeruginosa is one of the top coinfecting bacteria identified among COVID-19 patients. We collected a strong biofilm-forming P. aeruginosa strain displaying small colony variant morphology from a severe COVID-19 patient. Genomic and transcriptomic sequencing analyses were performed with phenotypic validation to investigate its adaptation in SARS-CoV-2 infected environment. Genomic characterization predicted specific genomic islands highly associated with virulence, transcriptional regulation, and DNA restriction-modification systems. Epigenetic analysis revealed a specific N6-methyl adenine (m6A) methylating pattern including methylation of alginate, flagellar and quorum sensing associated genes. Differential gene expression analysis indicated that this isolate formed excessive biofilm by reducing flagellar formation (7.4 to 1,624.1 folds) and overproducing extracellular matrix components including CdrA (4.4 folds), alginate (5.2 to 29.1 folds) and Pel (4.8-5.5 folds). In summary, we demonstrated that P. aeuginosa clinical isolates with novel epigenetic markers could form excessive biofilm, which might enhance its antibiotic resistance and in vivo colonization in COVID-19 patients.


Subject(s)
Adaptation, Physiological/physiology , COVID-19/complications , Coinfection/complications , Pseudomonas Infections/complications , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/metabolism , Adhesins, Bacterial/genetics , Adhesins, Bacterial/metabolism , Alginates , Bacteria , Biofilms/growth & development , DNA Methylation , Epigenomics , Gene Expression Profiling , Gene Expression Regulation, Bacterial , Genome, Bacterial , Humans , Pseudomonas Infections/immunology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/classification , Quorum Sensing/genetics , SARS-CoV-2 , Transcriptome , Virulence
13.
Front Med (Lausanne) ; 8: 582764, 2021.
Article in English | MEDLINE | ID: covidwho-1154222

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) has swept through the world at a tremendous speed, and there is still limited data available on the treatment for COVID-19. The mortality of severely and critically ill COVID-19 patients in the Optical Valley Branch of Tongji Hospital was low. We aimed to analyze the available treatment strategies to reduce mortality. Methods: In this retrospective, single-center study, we included 1,106 COVID-19 patients admitted to the Optical Valley Branch of Tongji Hospital from February 9 to March 9, 2020. Cases were analyzed for demographic and clinical features, laboratory data, and treatment methods. Outcomes were followed up until March 29, 2020. Results: Inflammation-related indices (hs-CRP, ESR, serum ferritin, and procalcitonin) were significantly higher in severe and critically ill patients than those in moderate patients. The levels of cytokines, including IL-6, IL2R, IL-8, and TNF-α, were also higher in the critical patients. Incidence of acute respiratory distress syndrome (ARDS) in the severely and critically ill group was 23.0% (99/431). Sixty-one patients underwent invasive mechanical ventilation. The correlation between SpO2/FiO2 and PaO2/FiO2 was confirmed, and the cut-off value of SpO2/FiO2 related to survival was 134.43. The mortality of patients with low SpO2/FiO2 (<134.43) at intubation was higher than that of patients with high SpO2/FiO2 (>134.43) (72.7 vs. 33.3%). Among critical patients, the application rates of glucocorticoid therapy, continuous renal replacement therapy (CRRT), and anticoagulation treatment reached 55.2% (238/431), 7.2% (31/431), and 37.1% (160/431), respectively. Among the intubated patients, the application rates of glucocorticoid therapy, CRRT, and anticoagulation treatment were respectively 77.0% (47/61), 54.1% (33/61), and 98.4% (60/61). Conclusion: No vaccines or specific antiviral drugs for COVID-19 have been shown to be sufficiently safe and effective to date. Comprehensive treatment including ventilatory support, multiple organ function preservation, glucocorticoid use, renal replacement therapy, anticoagulation, and restrictive fluid management was the main treatment strategy. Early recognition and intervention, multidisciplinary collaboration, multi-organ function support, and personalized treatment might be the key for reducing mortality.

14.
Journal of Robotics ; 2021, 2021.
Article in English | ProQuest Central | ID: covidwho-1109681

ABSTRACT

Delivery robots face the problem of storage and computational stress when performing immediate tasks, exceeding the limits of on-board computing power. Based on cloud computing, robots can offload intensive tasks to the cloud and acquire massive data resources. With its distributed cluster architecture, the platform can help offload computing and improve the computing power of the control center, which can be considered the external “brain” of the robot. Although it expands the capabilities of the robot, cloud service deployment remains complex because most current cloud robot applications are based on monolithic architectures. Some scholars have proposed developing robot applications through the microservice development paradigm, but there is currently no unified microservice-based robot cloud platform. This paper proposes a delivery robot cloud platform based on microservice, providing dedicated services for autonomous driving of delivery robot. The microservice architecture is adopted to split the monomer robot application into multiple services and then implement automatic orchestration and deployment of services on the cloud platform based on components such as Kubernetes, Docker, and Jenkins. This enables containerized CI/CD (continuous integration, continuous deployment, and continuous delivery) for the cloud platform service, and the whole process can be visualized, repeatable, and traceable. The platform is prebuilt with development tools, and robot application developers can use these tools to develop in the cloud, without the need for any customization in the background, to achieve the rapid deployment and launch of robot cloud service. Through the cloud migration of traditional robot applications and the development of new APPs, the platform service capabilities are continuously improved. This paper verifies the feasibility of the platform architecture through the delivery scene experiment.

15.
Transl Androl Urol ; 10(1): 466-474, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1079883

ABSTRACT

BACKGROUND: To introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19). METHODS: All emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study's COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods. RESULTS: The total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period. CONCLUSIONS: Urological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.

16.
Midwifery ; 95: 102929, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1049852

ABSTRACT

PURPOSE: To examine changes in lifestyle behaviors early in the COVID-19 pandemic among pregnant women. MATERIALS AND METHODS: A cross-sectional internet-based survey was completed by 706 pregnant women (mean age 29.6 years ± 3.2) residing in the United States in May 2020 to assess self-reported changes in diet, physical activity, and sleep during the COVID-19 pandemic. Logistic regression analyses examined whether sociodemographic, clinical, and pandemic-related characteristics were associated with health behavior changes. RESULTS: Approximately 17% of women reported their diets worsened during the COVID-19 pandemic, 42% reported improvements, and 41% reported no change. For physical activity, 22% reported they stopped being active, 2% reported they became active, and 76% reported no change. Nearly one-third of participants reported getting less sleep. The factors consistently associated with adverse lifestyle changes (worse diet, stopped being active, and reduced sleep) were experiences of pregnancy complications, loss of income due to COVID-19, and changes in social connections due to COVID-19. CONCLUSIONS: A substantial proportion of pregnant women reported adverse lifestyle changes during the COVID-19 pandemic. Interventions during the pandemic to optimize health behaviors in pregnant women, especially among those with pregnancy complications, should address economic disadvantages and social support.


Subject(s)
COVID-19/psychology , Health Behavior , Life Style , Pregnant Women/psychology , Adult , Cross-Sectional Studies , Diet/standards , Exercise , Female , Humans , Pregnancy , Sleep , Surveys and Questionnaires , United States/epidemiology
17.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-5588

ABSTRACT

Background: The outbreak of COVID-19 is a global concern. Positive 2019-nCoV nucleic acid results were reported in discharged patients, arousing the question of

18.
Eur J Neurosci ; 53(4): 1350-1361, 2021 02.
Article in English | MEDLINE | ID: covidwho-991349

ABSTRACT

To explore the clinical characteristics and prognosis of COVID-19 patients with cerebral stroke. A total of 2,474 COVID-19 patients from February 10th to March 24th, 2020 were admitted and treated in two branches (Optic Valley and Sino-French New City branch) of the Tongji Hospital. Data on the clinical characteristics, laboratory parameters and prognosis of COVID-19 patients with or without cerebral stroke were collected and comparatively analysed. Of the 2,474 COVID-19 patients, 113 (4.7%) patients had cerebral stroke and 25 (1.0%) patients had new-onset stroke. Eighty-eight (77.9%) patients in the previous-stroke group had cerebral ischaemia, while 25 (22.1%) patients in the new-onset stroke group had cerebral ischaemia. Most COVID-19 patients with stroke were elderly with more comorbidities such as hypertension, diabetes and heart diseases than patients without stroke. Laboratory examinations showed hypercoagulation and elevated serum parameters such as IL-6, cTnI, NT pro-BNP and BUN. Consciousness disorders, a long disease course and poor prognosis were also more commonly observed in stroke patients. The mortality rate of stroke patients was almost double (12.4% vs. 6.9%) that of patients without stroke. In addition, age, male sex and hypertension were independent predictors for new cerebral stroke in COVID-19 patients. In conclusion, the high risk of new-onset stroke must be taken into consideration when treating COVID-19 patients with an elderly age combined with a history of hypertension. These patients are more vulnerable to multiorgan dysfunction and an overactivated inflammatory response, in turn leading to an unfavourable outcome and higher mortality rate.


Subject(s)
COVID-19/complications , Stroke/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/mortality , Comorbidity , Female , Humans , Hypertension/epidemiology , Incidence , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Stroke/complications
19.
J Hepatol ; 74(6): 1295-1302, 2021 06.
Article in English | MEDLINE | ID: covidwho-988355

ABSTRACT

BACKGROUND & AIMS: The evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues. METHODS: This large retrospective cohort study included 2,073 patients with coronavirus disease 2019 (COVID-19) and definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted, with associated factors and risk of death determined by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19, with and without hepatitis B, were compared after 1:3 propensity score matching. RESULTS: Of the 2,073 patients, 1,282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of aspartate aminotransferase (AST) and direct bilirubin (D-Bil) increased early after symptom onset in deceased patients and showed disparity compared to levels in discharged patients throughout the clinical course of the disease. Abnormal AST (adjusted hazard ratio [HR] 1.39; 95% CI 1.04-1.86, p = 0.027) and D-Bil (adjusted HR 1.66; 95% CI 1.22-2.26; p = 0.001) levels at admission were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes. CONCLUSIONS: Abnormal AST and D-Bil levels at admission were independent predictors of COVID-19-related mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, is necessary in hospitalized patients with COVID-19. LAY SUMMARY: Liver test abnormalities (in particular elevations in the levels of aspartate aminotransferase [AST] and direct bilirubin [D-Bil]) were observed after symptom onset in patients who went on to die of coronavirus disease 2019 (COVID-19). Abnormal levels of AST and D-Bil at admission were independent predictors of COVID-19-related mortality. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes.


Subject(s)
Aspartate Aminotransferases/blood , Bilirubin/blood , COVID-19/mortality , Hospital Mortality , Liver Diseases/complications , SARS-CoV-2 , Aged , Female , Hepatitis B/complications , Humans , Male , Middle Aged , Propensity Score , Retrospective Studies
20.
Andrology ; 9(1): 99-106, 2021 01.
Article in English | MEDLINE | ID: covidwho-910378

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. OBJECTIVES: To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. MATERIALS AND METHODS: Men aged between 20 years and 50 years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. RESULTS: Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80 days (IQR, 64-93). The median age was 31 years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. DISCUSSION AND CONCLUSIONS: To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90 days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.


Subject(s)
COVID-19/virology , Prostate/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification , Semen/virology , Adult , COVID-19/diagnosis , COVID-19/therapy , COVID-19 Nucleic Acid Testing , Humans , Male , Middle Aged , RNA, Viral/genetics , RNA, Viral/urine , Remission Induction , SARS-CoV-2/genetics , Semen Analysis , Time Factors , Urine/virology , Young Adult
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