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1.
Methods Mol Biol ; 2452: 213-224, 2022.
Article in English | MEDLINE | ID: covidwho-1844269

ABSTRACT

The nasal epithelium lining the human upper airway is the primary portal of entry for several respiratory pathogens, including the recently emerged SARS-CoV-2 virus responsible for the ongoing COVID-19 pandemic. Here, we describe in detail methods for in vitro ALI differentiation of primary cells collected from human donors, to obtain differentiated hNECs. This can serve as a physiologically relevant model to investigate various aspects of host-pathogen responses to SARS-CoV-2 and other emerging respiratory viruses.


Subject(s)
COVID-19 , SARS-CoV-2 , Epithelial Cells , Humans , Models, Biological , Pandemics
2.
Frontiers in public health ; 10, 2022.
Article in English | EuropePMC | ID: covidwho-1824575

ABSTRACT

Background Virtual simulation has been widely used in nursing education and nursing training. This study aims to characterize the publications in terms of countries, institutions, journals, authors, collaboration relationships, and analyze the trends of virtual simulation in nursing research. Methods Publications regarding virtual simulation in nursing were retrieved from Web of Science core collection. Microsoft Excel 2010, VOSviewer were used to characterize the contributions of the authors, journals, institutions, and countries. The trends, hot-spots and knowledge network were analyzed by Citespace and VOSviewer. Results We identified 677 papers between 1999 and 2021. The number of publications grew slowly until 2019, after that, it got a sharp increase in 2020 and 2021. The USA, Canada and Australia were three key contributors to this field. Centennial College and University of San Paulo, University of Ottawa and Ryerson University were top major institutions with a larger number of publications. Verkuyl M was the most productive and highest cited author. Clinical Simulation in Nursing, Nurse Education Today, Journal of Nursing Education were the three productive journals. The foundational themes of virtual simulation research in nursing are “virtual learning during COVID-19, clinical nursing care, education in nurse practitioners, education technology”. Conclusion Virtual simulation in nursing field has attracted considerable attention during COVID-19 pandemic. The research hotspot is gradually shifting from clinical nursing care to studies of nursing education using different virtual simulation technologies

3.
Front Microbiol ; 13: 792532, 2022.
Article in English | MEDLINE | ID: covidwho-1809433

ABSTRACT

A recent study showed that patients with coronavirus disease 2019 (COVID-19) have gastrointestinal symptoms and intestinal flora dysbiosis. Yeast probiotics shape the gut microbiome and improve immune homeostasis. In this study, an oral candidate of yeast-derived spike protein receptor-binding domain (RBD) and fusion peptide displayed on the surface of the yeast cell wall was generated. The toxicity and immune efficacy of oral administration were further performed in Institute of Cancer Research (ICR) mice. No significant difference in body weights, viscera index, and other side effects were detected in the oral-treated group. The detectable RBD-specific immunoglobulin G (IgG) and immunoglobulin A (IgA) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and more complex microbiota were detected from oral administration mice compared with those of the control group. Interestingly, the recombinant yeast was identified in female fetal of the high-dose group. These results revealed that the displaying yeast could fulfill the agent-driven immunoregulation and gut microbiome reconstitution. The findings will shed light on new dimensions against SARS-CoV-2 infection with the synergistic oral agents as promising non-invasive immunization and restoring gut flora.

4.
Desalination ; 534: 115798, 2022 Jul 15.
Article in English | MEDLINE | ID: covidwho-1800115

ABSTRACT

The ongoing coronavirus pandemic (COVID-19) throughout the world has severely threatened the global economy and public health. Due to receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a wide variety of sources (e.g., households, hospitals, slaughterhouses), urban sewage treatment systems are regarded as an important path for the transmission of waterborne viruses. This review presents a quantitative profile of the concentration distribution of typical viruses within wastewater collection systems and evaluates the influence of different characteristics of sewer systems on virus species and concentration. Then, the efficiencies and mechanisms of virus removal in the units of wastewater treatment plants (WWTPs) are summarized and compared, among which the inactivation efficiencies of typical viruses by typical disinfection approaches under varied operational conditions are elucidated. Subsequently, the occurrence and removal of viruses in treated effluent reuse and desalination, as well as that in sewage sludge treatment, are discussed. Potential dissemination of viruses is emphasized by occurrence via aerosolization from toilets, the collection system and WWTP aeration, which might have a vital role in the transmission and spread of viruses. Finally, the frequency and concentration of viruses in reclaimed water, the probability of infection are also reviewed for discussing the potential health risks.

5.
Front Immunol ; 13: 833418, 2022.
Article in English | MEDLINE | ID: covidwho-1771038

ABSTRACT

As TLR2 agonists, several lipopeptides had been proved to be candidate vaccine adjuvants. In our previous study, lipopeptides mimicking N-terminal structures of the bacterial lipoproteins were also able to promote antigen-specific immune response. However, the structure-activity relationship of lipopeptides as TLR2 agonists is still unclear. Here, 23 synthetic lipopeptides with the same lipid moiety but different peptide sequences were synthesized, and their TLR2 activities in vitro and mucosal adjuvant effects to OVA were evaluated. LP1-14, LP1-30, LP1-34 and LP2-2 exhibited significantly lower cytotoxicity and stronger TLR2 activity compared with Pam2CSK4, the latter being one of the most potent TLR2 agonists. LP1-34 and LP2-2 assisted OVA to induce more profound specific IgG in sera or sIgA in BALF than Pam2CSK4. Furthermore, the possibility of LP1-34, LP2-2 and Pam2CSK4 as the mucosal adjuvant for the SARS-CoV-2 recombinant RBD (rRBD) was investigated. Intranasally immunized with rRBD plus either the novel lipopeptide or Pam2CSK4 significantly increased the levels of specific serum and respiratory mucosal IgG and IgA, while rRBD alone failed to induce specific immune response due to its low immunogenicity. The novel lipopeptides, especially LP2-2, significantly increased levels of rRBD-induced SARS-CoV-2 neutralizing antibody in sera, BALF and nasal wash. Finally, Support vector machine (SVM) results suggested that charged residues in lipopeptides might be beneficial to the agonist activity, while lipophilic residues might adversely affect the agonistic activity. Figuring out the relationship between peptide sequence in the lipopeptide and its TLR2 activity may lay the foundation for the rational design of novel lipopeptide adjuvant for COVID-19 vaccine.


Subject(s)
COVID-19 , Lipopeptides , Adjuvants, Immunologic/pharmacology , Adjuvants, Pharmaceutic , COVID-19 Vaccines , Humans , Immunity , Immunoglobulin G , Lipopeptides/pharmacology , SARS-CoV-2 , Toll-Like Receptor 2
8.
Journal of Shandong University ; 59(4):6-16, 2021.
Article in Chinese | CAB Abstracts | ID: covidwho-1744694

ABSTRACT

Objective: To explore the potential molecular mechanism of Astragalus membranaceus in the treatment of coronavirus disease 2019(COVID-19)based on the network pharmacology and molecular docking. Methods The traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP)and the related literature were searched to obtain the active ingredients and predictive targets of Astragalus membranaceus. The herbal targets were selected based on STRING database for PPI network construction and the results were displayed by Cytoscape software. The key targets were screened through the algorithm of network topology and the network modules were analyzed. Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were carried out on key target genes using Gene Ontology Enrichment Analysis Software Toolkit(GOEAST)and The Database for Annotation, Visualization and Integrated Discovery(DAVID)online tools. Combined with relevant literature, the mechanism of Astragalus membranaceus in the treatment of COVID-19 was analyzed. Results A total of 19 candidate active components and 889 predictive targets of Astragalus membranaceus were selected by oral bioavailability(OB)and drug-likeness(DL)values. The preventive mechanism of Astragalus membranaceus might be closely related to the signal pathways involved in the body's living nerve ligand receptor interaction, calcium signal, T cell receptor, cAMP signal pathway and chemokines. Conclusion Astragalus membranaceus mainly plays roles in many kinds of targets through multi-approach and multi-signaling pathways.

9.
Transpl Infect Dis ; : e13823, 2022 Mar 12.
Article in English | MEDLINE | ID: covidwho-1741506

ABSTRACT

BACKGROUND: Previous reports of coronavirus disease 2019 (COVID-19) following lung transplantation generally described a grim prognosis, but these were anecdotal case series of symptomatic patients. A systematic study of the outcomes and pathology of SARS-CoV-2 infection in a large cohort of lung transplant patients is lacking. METHODS: To determine the histopathologic evolution of COVID-19 in lung transplant recipients, we identified all patients who underwent surveillance transbronchial biopsies at our institution, tested positive for SARS-CoV-2, and had multiple pathology specimens available for evaluation. Histology was reviewed and immunofluorescence for SARS-CoV-2 nucleocapsid protein was performed. RESULTS: Ten patients met inclusion criteria. Half (5/10) had incidental diagnosis on routine respiratory pathogen testing at the time of transbronchial biopsy. Six patients were hospitalized, with three requiring intensive care unit (ICU) admission. One patient died. Two specimens showed new onset International Society for Heart and Lung Transplantation (ISHLT) Grade A2 rejection at or following diagnosis. One patient developed bronchiolitis obliterans 111 days following diagnosis and 1 year post transplant. Two patients had organizing pneumonia at diagnosis and three patients showed evolving lung injury following diagnosis. The SARS-CoV-2 nucleocapsid protein was detected in a subset of samples at diagnosis and up to 111 days following diagnosis. CONCLUSIONS: Overall, the pathology of SARS-CoV-2 infection in lung transplant patients is varied, ranging from no pathologic alterations to organizing pneumonia and lung injury. The pathology findings did not necessarily correlate with clinical acuity, as one patient admitted to the ICU had normal pathology. These findings may be generalizable to non-transplant patients and require more follow-up regarding long-term outcomes.

10.
Antimicrobial Agents and Chemotherapy ; 64(6), 2020.
Article in English | GIM | ID: covidwho-1723508

ABSTRACT

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lies behind the ongoing outbreak of coronavirus disease 2019 (COVID-19). There is a growing understanding of SARS-CoV-2 in virology, epidemiology, and clinical management strategies. However, no anti-SARS-CoV-2 drug or vaccine has been officially approved due to the absence of adequate evidence. Scientists are racing to develop a treatment for COVID-19. Recent studies have revealed many attractive therapeutic options, even if some of them remain to be further confirmed in rigorous preclinical models and clinical trials. In this minireview, we aim to summarize the updated potential approaches against SARS-CoV-2. We emphasize that further efforts are warranted to develop the safest and most effective approach.

11.
Front Physiol ; 12: 786255, 2021.
Article in English | MEDLINE | ID: covidwho-1725424

ABSTRACT

Acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome that leads to acute respiratory failure and accounts for over 70,000 deaths per year in the United States alone, even prior to the COVID-19 pandemic. While its molecular details have been teased apart and its pathophysiology largely established over the past 30 years, relatively few pharmacological advances in treatment have been made based on this knowledge. Indeed, mortality remains very close to what it was 30 years ago. As an alternative to traditional pharmacological approaches, gene therapy offers a highly controlled and targeted strategy to treat the disease at the molecular level. Although there is no single gene or combination of genes responsible for ARDS, there are a number of genes that can be targeted for upregulation or downregulation that could alleviate many of the symptoms and address the underlying mechanisms of this syndrome. This review will focus on the pathophysiology of ARDS and how gene therapy has been used for prevention and treatment. Strategies for gene delivery to the lung, such as barriers encountered during gene transfer, specific classes of genes that have been targeted, and the outcomes of these approaches on ARDS pathogenesis and resolution will be discussed.

12.
Brain Behav Immun ; 87: 144-146, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719347

ABSTRACT

This study reports the physical health, mental health, anxiety, depression, distress, and job satisfaction of healthcare staff in Iran when the country faced its highest number of total active COVID-19 cases. In a sample of 304 healthcare staff (doctors, nurses, radiologists, technicians, etc.), we found a sizable portion reached the cutoff levels of disorders in anxiety (28.0%), depression (30.6%), and distress (20.1%). Age, gender, education, access to PPE (personal protective equipment), healthcare institutions (public vs. private), and individual status of COVID-19 infection each predicted some but not all the outcome variables of SF-12, PHQ-4, K6, and job satisfaction. The healthcare workers varied greatly in their access to PPE and in their status of COVID-19 infection: negative (69.7%), unsure (28.0%), and positive (2.3%). The predictors were also different from those identified in previous studies of healthcare staff during the COVID-19 crisis in China. This study helps to identify the healthcare staff in need to enable more targeted help as healthcare staff in many countries are facing peaks in their COVID-19 cases.


Subject(s)
Coronavirus Infections/psychology , Health Personnel/psychology , Pneumonia, Viral/psychology , Adult , Anxiety/psychology , Betacoronavirus/pathogenicity , COVID-19 , Female , Humans , Iran , Job Satisfaction , Male , Mental Health/trends , Middle Aged , Pandemics , Personal Protective Equipment/trends , Risk Factors , SARS-CoV-2
13.
Sustainability ; 14(4):2452, 2022.
Article in English | ProQuest Central | ID: covidwho-1715704

ABSTRACT

Preventive behavior, such as hand hygiene, facemask wearing, and social distancing, plays a vital role in containing the spread of viruses during pandemics. However, people in many parts of the world usually encounter difficulties adhering to this behavior due to various causes. Thus, this article aims to develop a research framework and propose design strategies to prompt individuals’ behavior change during pandemics. Initially, we integrated a literature review and a structured interview (n = 22) to ascertain the core factors impacting behavior change during pandemics. These factors were categorized into four aspects: perceptional factors (attitudes, subjective norms and perceived behavior control, risk perceptions);social factors (knowledge and information dissemination, governmental regulations);physical factors (tools and facilities and surveillance);and sociocultural factor (cultural contexts). Then, a theoretical framework with antecedents was developed to reveal behavior intention and formation process. After that, an empirical study was carried out to test the research framework through a questionnaire survey (n = 549). The research findings indicated that all derived factors could directly or indirectly affect individuals’ preventive behavior during pandemics. This article strives to provide valuable insights for different stakeholders when coping with pandemic situations.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325175

ABSTRACT

Objective: To describe the clinical characteristics and outcomes of ordinary COVID-19 when admitted, to describe how these patients were treated and risk factors for in-hospital progression. Methods: : In this retrospective study, we included 291 adult patients diagnosed as ordinary COVID-19 on admission who had been discharged or had died between Jan 20, 2020 and Mar 16, 2020 from General Hospital of Central Theatre Command (Wuhan, China). Results: : Of the 291 patients diagnosed as ordinary COVID-19 when admitted, 65 (22.34%) had been recorded COVID-19 progressing at least once, and 226 (77.66%) had been recorded COVID-19 improving during hospitalization. The median time from admission to disease progressed was 5.0 days (2.0-7.0). Multivariable regression showed increasing odds of in-hospital progression associated with male (odds ratio 2.333, 95% CI 1.135-4.395;P=0.020), preexisting cardiovascular diseases (2.433, 1.044-5.671;P=0.039), and lymphopenia (3.482, 1.783-6.799;P<0.001), elevated IL-6 (2.669, 1.084-6.574;P=0.033), d-dimer (2.829, 1.420-5.636;P=0.003) and lactate dehydrogenase (2.855, 1.458-5.591;P= 0.002) on admission. Conclusions: : The potential risk factors of male, preexisting cardiovascular disease, lymphopenia, elevated IL-6, and lactate dehydrogenase, d-dimer could help clinicians to identify in-hospital progression among ordinary COVID-19 at early stage to optimize medical treatment.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324322

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19) outbroke in Wuhan and spread to the world recently. But there were little studies on how long it took to recover from treatment beginning and resolve from chest computed tomography (CT) imaging so far. Case presentation: A patient diagnosed with severe type of COVID-19 was reported in this study. He was the first patient recovered and discharged from our hospital located in Guangzhou city. Initial chest computed tomography (CT) images of him showed bilateral multiple lobular peripheral ground-glass opacities without consolidation. Features and changes of his chest CT images from admission to discharge and follow-up were demonstrated. It took more than six weeks for lesion resolution in CT manifestations although the symptoms improved for a period of time after proper treatment. Conclusions: : Repeated chest CT imaging for a period of more than six weeks in patients of COVID-19 is necessary to ascertain the lesion resolution and completely recovery. The result could be supplementary data to COVID-19 and help health care providers manage the COVID-19 patients.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323879

ABSTRACT

Background: The COVID-19 pandemic is a significant worldwide health crisis. Patients with malignancy are considered at substantially increased risk of infection and poor outcomes. Breast cancer patients with COVID-19 represent an urgent clinical need. This study aimed to identify clinical characteristics of breast cancer patients with COVID-19 and risks associated with anti-cancer treatment. Methods: : This multicenter retrospective cohort study included 45 breast cancer patients with laboratory-confirmed COVID-19 at seven designated hospitals in Hubei, China. The medical records of breast cancer patients were collected from the records of 9559 COVID-19 patients from 13 th January, 2020 to 18 th March, 2020. Univariate and multivariate analyses were performed to assess risk factors for COVID-19 severity. Results: : Of 45 breast cancer patients with COVID-19, 33 (73.3%) developed non-severe COVID-19, while 12 (26.7%) developed severe COVID-19, of which 3 (6.7%) patients died. The median age was 62 years, and 3 (6.7%) patients had stage IV breast cancer. Most patients developed fever (37, 82.2%), and most had bilateral lung involvement on chest CT (36, 80.0%). Univariate analysis showed the age over 75 and Eastern Cooperative Oncology Group (ECOG) score were associated with COVID-19 disease severity ( P <0.05). Multivariate analysis showed patients received chemotherapy within 7 days had a significantly higher risk for severe COVID-19 (logistic regression model: RR=13.886, 95% CI 1.014-190.243, P =0.049;Cox proportional hazards model: HR=13.909, 95% CI 1.086-178.150, P =0.043), with more pronounced neutropenia and higher LDH, CRP and procalcitonin levels than patients else ( P <0.05). Conclusions: The severity of COVID-19 in breast cancer patients was associated with baseline factors of the age over 75 and ECOG score, but not with tumor characteristics. Chemotherapy within 7 days before symptom onset was a risk factor for severe COVID-19, reflected by neutropenia and elevated LDH, CRP and procalcitonin levels.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322986

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a worldwide public health pandemic with a high mortality rate, among severe cases. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. It is important to ensure early detection of the virus to curb disease progression to severe COVID-19. This study aimed to establish a clinical-nomogram model to predict the progression to severe COVID-19 in a timely, efficient manner. Methods This retrospective study included 202 patients with COVID-19 who were admitted to the Fifth Affiliated Hospital of Sun Yat-sen University and Shiyan Taihe Hospital from January 17 to April 30, 2020. The patients were randomly assigned to the training dataset (n = 163, with 43 progressing to severe COVID-19) or the validation dataset (n = 39, with 10 progressing to severe COVID-19) at a ratio of 8:2. The optimal subset algorithm was applied to filter for the clinical factors most relevant to the disease progression. Based on these factors, the logistic regression model was fit to distinguish severe (including severe and critical cases) from non-severe (including mild and moderate cases) COVID-19. Sensitivity, specificity, and area under the curve (AUC) were calculated using the R software package to evaluate prediction performance. A clinical nomogram was established and performance assessed with the discrimination curve. Results Risk factors, including demographics data, symptoms, laboratory and image findings were recorded for the 202 patients. Eight of the 52 variables that were entered into the selection process were selected via the best subset algorithm to establish the predictive model;they included gender, age, BMI, CRP, D-dimer, TP, ALB, and involved-lobe. Sensitivity, specificity and AUC were 0.91, 0.84 and 0.86 for the training dataset, and 0.87, 0.66, and 0.80 for the validation dataset. Conclusions We established an efficient and reliable clinical nomogram model which showed that gender, age, and initial indexes including BMI, CRP, D-dimer, involved-lobe, TP, and ALB could predict the risk of progression to severe COVID-19.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322985

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is the leading cause of a public health emergency in the world, accompanying with high mortality in severe corona virus disease 2019(COVID-19 ), thereby early detection and stopping the progress to severe COVID-19 is important. Our aim is to establish a clinical nomogram model to calculate and predict the progress to severe COVID-19 timely and efficiently. Methods: In this study, 65 patients with COVID-19 had been included retrospectively in the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, to February 11, 2020. Patients were randomly assigned to train dataset (n=51 with 15 progressing to severe COVID-19) and test dataset (n=14 with 4 progressing to severe COVID-19). Lasso algorithm was applied to filter the most classification relevant clinical factors. Based on selected factors, logistic regression model was fit to predict the severe from mild/common. Meanwhile in nomogram sensitivity, specificity, AUC (Area under Curve), and calibration curve were depicted and calculated by R language, to evaluate the prediction performance to severe COVID-19. Results: High ratio of sever COVID-19 patients (26.5%) had been found in our retrospective study, and 84% of these cases progress to severe or critical after 5 days from their first clinical examination. In these 65 patients with COVID-19, 77 clinical characteristics in first examination were collected and analyzed, and 37 ones had been found different between non-severe and severe COVID-19. But when all these factors were analyzed in establishment of prediction model, six factors are crucial for predicting progress of severe COVID-19 via Lasso algorithm. Based on these six factors, including increased fibrinogen, hyponatremia, decreased PaO2,multiple lung lobes involved, down-regulated CD3(+)T-lymphocyte and fever, a logistic regression model was fit to discriminate severe and common COVID-19 patients. The sensitivity, specificity and AUC were 0.93, 0.86, 0.96 in the train dataset and 0.9, 1.0, 1.0 in test dataset respectively. Nomogram-predicted probability was more consistent with actual probability by R language. Conclusions: In summary, an efficient and reliable clinical nomogram model had been established, which indicate increased fibrinogen, hyponatremia, decreased PaO2, multiple lung lobes involved, down-regulated CD3(+)T-lymphocyte and fever at the first clinical examination, could predict progress of patients to severe COVID-19.

20.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322455

ABSTRACT

Deaths attributed to Coronavirus Disease 2019 (COVID-19) are mainly due to severe hypoxemic respiratory failure. Although the inflammatory storm has been considered main pathogenesis of severe COVID-19, hypersensitivity may be another important mechanism involved in severe cases, which have perfect response to corticosteroids (CS). We detected the presence of anti-SARS-CoV-2–spike S1 protein specific IgE (SP- IgE)and SARS-CoV-2 nucleocapsid protein specific IgE (NP- IgE)in all COVID-19 patients’ serum, while it was rarely detected in healthy controls. Additionally, the levels of serum SP- IgE and NP- IgE were significantly higher in severe cases, and which were correlations with the total lung severity scores (TLSS) and the PaO 2 /PAO 2 ratio. In both airway and intestinal tissues obtained from severe COVID-patients via endoscopy, NP could be stained and detected in activated mast cells, which binded with IgE. After application of CS in severe COVID-19, SP- IgE and NP- IgE decreased, but maintained at high level in early convalescence, which were maybe reason of airway hyperresponsiveness (AHR) in these patients partly. Overall, our study revealed that the chief mechanism of severe COVID-19–related hypoxemic respiratory failure is likely hypersensitivity reactions directly involving SARS-CoV-2 antigens, anti-SARS-CoV-2–specific IgE, and mast cells. Moreover, in our cohort of COVID-19 patients, severe COVID-19 patients with increased SP- IgE and NP-IgE and hypoxemic respiratory failure were treated with pulse methylprednisolone and achieved an excellent response. In conclusion, hypersensitivity may be involved in severe COVID-19.Funding Information: Guangdong Basic and Applied Basic Research Foundation (2020A1515011147) Zhuhai Science and Technology Project (ZH22036302200021PWC).Declaration of Interests: The authors of this manuscript declare no relationships with any companies whose products or services might be related to the subject matter of the article.Ethics Approval Statement: Our study was approved by the Research Ethics Committee of the Fifth Affiliated Hospital of Sun Yat-sen University. Written informed consent was obtained from all participants.

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