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1.
Ann Hematol ; 2020 Sep 06.
Article in English | MEDLINE | ID: covidwho-746148

ABSTRACT

The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients' preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1-20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based frontline therapy was highly effective with acceptable toxicity in routine practice and the ixazomib oral regimens could be good alternative options for NDMM patients.

2.
Engineering ; 2020.
Article | WHO COVID | ID: covidwho-743961

ABSTRACT

Fast and accurate diagnosis and the immediate isolation of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are regarded as the most effective measures to restrain the coronavirus disease 2019 (COVID-19) pandemic Here, we present a high-throughput, multi-index nucleic acid isothermal amplification analyzer (RTisochipTM-W) employing a centrifugal microfluidic chip to detect 19 common respiratory viruses, including SARS-CoV-2, from 16 samples in a single run within 90 min The limits of detection of all the viruses analyzed by the RTisochipTM-W system were equal to or less than 50 copies per microliter, which is comparable to those of conventional reverse-transcription polymerase chain reaction We also demonstrate that the RTisochipTM-W system possesses the advantages of good repeatability, strong robustness, and high specificity Finally, we analyzed 201 cases of preclinical samples, 14 cases of COVID-19-positive samples, 25 cases of clinically diagnosed samples, and 614 cases of clinical samples from patients or suspected patients with respiratory tract infections using the RTisochipTM-W system The test results matched the referenced results well and reflected the epidemic characteristics of the respiratory infectious diseases The coincidence rate of the RTisochipTM-W with the referenced kits was 98 15% for the detection of SARS-CoV-2 Based on these extensive trials, we believe that the RTisochipTM-W system provides a powerful platform for fighting the COVID-19 pandemic

3.
J Xray Sci Technol ; 2020 Aug 06.
Article in English | MEDLINE | ID: covidwho-721454

ABSTRACT

OBJECTIVE: To retrospectively analyze and stratify the initial clinical features and CT imaging findings of patients with COVID-19 by gender and age. METHODS: Data of 50 COVID-19 patients were collected in two hospitals. The clinical manifestations, laboratory examination and chest CT imaging features were analyzed, and a stratification analysis was performed according to gender and age [younger group: <50 years old, elderly group ≥50 years old]. RESULTS: Most patients had a history of epidemic exposure within 2 weeks (96%). The main clinical complaints are fever (54%) and cough (46%). In chest CT images, ground-glass opacity (GGO) is the most common feature (37/38, 97%) in abnormal CT findings, with the remaining 12 patients (12/50, 24%) presenting normal CT images. Other concomitant abnormalities include dilatation of vessels in lesion (76%), interlobular thickening (47%), adjacent pleural thickening (37%), focal consolidation (26%), nodules (16%) and honeycomb pattern (13%). The lesions were distributed in the periphery (50%) or mixed (50%). Subgroup analysis showed that there was no difference in the gender distribution of all the clinical and imaging features. Laboratory findings, interlobular thickening, honeycomb pattern and nodules demonstrated remarkable difference between younger group and elderly group. The average CT score for pulmonary involvement degree was 5.0±4.7. Correlation analysis revealed that CT score was significantly correlated with age, body temperature and days from illness onset (p < 0.05). CONCLUSIONS: COVID-19 has various clinical and imaging appearances. However, it has certain characteristics that can be stratified. CT plays an important role in disease diagnosis and early intervention.

4.
Future Microbiol ; 2020 Aug 14.
Article in English | MEDLINE | ID: covidwho-717658

ABSTRACT

Since December 2019, an outbreak of SARS coronavirus 2 (SARS-CoV-2) began in Wuhan, and has rapidly spread worldwide. Previously, discharged patients with coronavirus disease 2019 (COVID-19) patients met the criteria of China's pneumonia diagnosis and treatment program of novel coronavirus infection (trial version 7) for cure of viral infection. Nevertheless, positive detection of SARS-CoV-2 has been found again in several cured COVID-19 patients, leading to conflicts with current criteria. Here, we report clinically cured cases with positive results only in anal swabs, and investigate the clinical value of anal swabs for SARS-CoV-2 detection.

5.
Chin. J. Microbiol. Immunol. ; 6(40): 405-409, 20200630.
Article in Chinese | ELSEVIER | ID: covidwho-708573

ABSTRACT

Objective: To retrospectively analyze the test results of novel coronavirus (2019-nCoV) in different samples (throat swab, sputum and feces) collected from recovered COVID-19 patients in order to provide a more reliable basis for discharge and reduce the risk of recurrence after discharge. Methods: Throat swabs and sputum were sampled in pairs from 78 patients before discharge and sampled in pairs twice from 54 cases with an interval of 1-5 d. Real-time fluorescence quantitative RT-PCR was used to detect the virus in the two types of samples. Throat swab, sputum and fecal samples of six patients were tested for 2019-nCoV during follow-up. Results: The detection rate of viral nucleic acid was 46.15% in throat swabs and 50.00% in sputum samples. Test results of the second paired samples showed that the detection rate of viral nucleic acid was 25.93% in throat swabs and 46.30% in sputum samples, and the difference between the two types of samples was statistically significant (P<0.05). During follow-up, 2019-nCoV nucleic acid could be detected in the fecal samples of the six patients, but not in their throat swab and sputum samples. Their fecal samples remained positive up to 52 d. Conclusions: In the late convalescence, the respiratory symptoms of COVID-19 patients gradually disappeared with the improvement of clinical symptoms. Moreover, the virus might enter the gastrointestinal tract from respiratory tract, and could long-term exist in recovered patients and be excreted in feces. In order to reduce the rate of missed detection and avoid false negative results, it was suggested to test the viral nucleic acid in different types of samples before a COVID-19 patient was discharged.

6.
OncoImmunology ; 1(9)20200101.
Article in English | ELSEVIER | ID: covidwho-706088

ABSTRACT

Amid controversial reports that COVID-19 can be treated with a combination of the antimalarial drug hydroxychloroquine (HCQ) and the antibiotic azithromycin (AZI), a clinical trial (ONCOCOVID, NCT04341207) was launched at Gustave Roussy Cancer Campus to investigate the utility of this combination therapy in cancer patients. In this preclinical study, we investigated whether the combination of HCQ+AZI would be compatible with the therapeutic induction of anticancer immune responses. For this, we used doses of HCQ and AZI that affect whole-body physiology (as indicated by a partial blockade in cardiac and hepatic autophagic flux for HCQ and a reduction in body weight for AZI), showing that their combined administration did not interfere with tumor growth control induced by the immunogenic cell death inducer oxaliplatin. Moreover, the HCQ+AZI combination did not affect the capacity of a curative regimen (cisplatin + crizotinib + PD-1 blockade) to eradicate established orthotopic lung cancers in mice. In conclusion, it appears that HCQ+AZI does not interfere with the therapeutic induction of therapeutic anticancer immune responses.

7.
Aging Med. ; 2(3): 82-94, 20200601.
Article in English | ELSEVIER | ID: covidwho-648186

ABSTRACT

Coronavirus disease 2019 (COVID-19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO-FICs) framework to form an expert consensus on the COVID-19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO-FICs.

8.
BMJ Open ; 10(7): e040517, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-639976

ABSTRACT

INTRODUCTION: COVID-19 has spread rapidly in China and around the world. Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. However, the results were inconsistent and the analysis of epidemiological data stratified by the severity of COVID-19 was not available in previous meta-analyses. Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury. METHODS AND ANALYSIS: We have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model. The I² test will be used to identify the extent of heterogeneity. Publication bias will be assessed by funnel plot and performing the Begg's and Egger's test if adequate studies are available. We will perform a risk of bias assessment using the Joanna Briggs Institute's critical appraisal checklist. ETHICS AND DISSEMINATION: Since this study will be based on the published data, it does not require ethical approval. The final results of this study will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020179462.


Subject(s)
Coronavirus Infections/epidemiology , Liver Diseases/epidemiology , Pneumonia, Viral/epidemiology , Acute Disease , Alanine Transaminase/blood , Alkaline Phosphatase/blood , Aspartate Aminotransferases/blood , Betacoronavirus , Bilirubin/blood , Humans , Incidence , Liver Diseases/blood , Pandemics , Prevalence
12.
J. Chinese Gov. ; 2(5): 198-212, 20200402.
Article in English | ELSEVIER | ID: covidwho-116515

ABSTRACT

The outbreak of the COVID-19 epidemic in China is, essentially, a public health emergency. Therefore, it becomes a critical issue to make policies by using scientific knowledge in a highly uncertain and unpredictable context. The key issue of risk-based decision-making (RBDM) is how to strike a balance between science and politics. After reviewing existing literature and practice, three main approaches to risk-based decision-making (RBDM) can be summarized: politics-based, science-led, and the integration and negotiation of science and politics. On the basis of public reports from current mass media, this article focuses on the time period from the releasing of the first COVID-19 case in Wuhan to the lockdown policy made by Wuhan municipal government, and we divide important stakeholders in early stage into two groups:scientist group and politician group. It finds that the RBDM process of Wuhan municipal government against COVID-19 demonstrated that politics intertwined tightly with science. Its RBDM process could be categorized into three phases: politics-based, science-involved, and science-led. We conclude six main characteristics of RBDM mechanisms in contemporary China. Finally, we argue that Chinese governments should establish institutionalized mechanisms for the negotiation and cooperation of science and politics in its RBDM process like COVID-19 epidemic. Five policy recommendations have been discussed to improve its RBDM quality in China’s context.

13.
Thromb Haemost ; 120(6): 937-948, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-101973

ABSTRACT

Coronavirus disease 2019 (COVID-19) has caused a global pandemic in just a few months, causing millions infected. Nearly 20% of COVID-19 patients present severe coagulation abnormalities, which may occur in almost all of the severe and critical ill COVID-19 cases. Concomitant venous thromboembolism (VTE), a potential cause of unexplained deaths, has been frequently reported in COVID-19 cases, but its management is still challenging due to the complexity between antithrombotic therapy and coagulation disorders. Based on frontline practical experience and comprehensive literature review, here a panel of experts and physicians from China and Europe developed an evidence and opinion-based consensus on the prophylaxis and management of VTE associated with COVID-19. This statement aims for clinicians treating COVID-19 and provides practical recommendations in detailed situations, for example, how to choose thromboprophylactic measures for patients with diverse severity of disease and bleeding risk, or which kind of anticoagulant should be prescribed. With limited experience on COVID19-associated VTE, this expert consensus statement should be helpful for clinicians worldwide with specific suggestions.


Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Venous Thromboembolism/prevention & control , Venous Thromboembolism/therapy , Anticoagulants/therapeutic use , Betacoronavirus , Blood Coagulation Disorders/drug therapy , China/epidemiology , Consensus , Coronavirus Infections/blood , Coronavirus Infections/therapy , Critical Illness , Europe/epidemiology , Fibrin Fibrinogen Degradation Products/analysis , Hemorrhage/prevention & control , Humans , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/therapy , Pulmonary Embolism/complications , Pulmonary Embolism/prevention & control , Registries , Risk Assessment , Risk Factors , Treatment Outcome , Venous Thromboembolism/complications , Venous Thrombosis/complications , Venous Thrombosis/prevention & control
14.
Z Gesundh Wiss ; : 1-4, 2020 Apr 21.
Article in English | MEDLINE | ID: covidwho-96668

ABSTRACT

Background: The objectives of this study were to analyze the clinical features of coronavirus disease 2019 (COVID-19) and evaluate the diagnosis and treatment. Methods: A retrospective analysis of the clinical manifestation and auxiliary examination of 19 patients with COVID-19 from the Liyuan Hospital intensive care unit (ICU) between January 16, 2020 and February 20, 2020 was undertaken. Results: There were 11 male and 8 female cases among the patients. The median (range) age was 73 (38-91) years. Of these patients, 8 (42.1%) had died and the median duration from ICU admission to death was 2 (interquartile range (IQR): 1-10.75) days. Seven of these 8 patients had underlying diseases. The auxiliary examination showed fever (68.4%), dry cough (15.8%), dyspnea (10.5%), and diarrhea (5.3%). All 19 cases showed ground-glass changes on chest computed tomography. Serum hypersensitive C-reactive protein (hs-CRP) and serum amylase A (SAA) were clearly increased in all of the cases. Among the 19 cases, there were 16 (84.2%) cases in which the total number of lymphocytes decreased, 12 cases (63%) had reduced liver function, and 11 cases (58%) had deviant results for fibrinogen (FIB) and D-dimer, in particular, the D-dimer level was significantly higher in the non-survivors compared with the survivors. Conclusion: There were more men than women among critically ill patients. All of the cases showed ground-glass changes on chest computed tomography and the vast majority of patients displayed fever and dry cough. The clinical laboratory indices change significantly, especially the D-dimer level among non-survivors.

15.
J. Thorac. Dis. ; 3(12): 165-174, 20200301.
Article in English | ELSEVIER | ID: covidwho-48351

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak originating in Wuhan, Hubei province, China, coincided with chunyun, the period of mass migration for the annual Spring Festival. To contain its spread, China adopted unprecedented nationwide interventions on January 23 2020. These policies included large-scale quarantine, strict controls on travel and extensive monitoring of suspected cases. However, it is unknown whether these policies have had an impact on the epidemic. We sought to show how these control measures impacted the containment of the epidemic. Methods: We integrated population migration data before and after January 23 and most updated COVID-19 epidemiological data into the Susceptible-Exposed-Infectious-Removed (SEIR) model to derive the epidemic curve. We also used an artificial intelligence (AI) approach, trained on the 2003 SARS data, to predict the epidemic. Results: We found that the epidemic of China should peak by late February, showing gradual decline by end of April. A five-day delay in implementation would have increased epidemic size in mainland China three-fold. Lifting the Hubei quarantine would lead to a second epidemic peak in Hubei province in mid-March and extend the epidemic to late April, a result corroborated by the machine learning prediction. Conclusions: Our dynamic SEIR model was effective in predicting the COVID-19 epidemic peaks and sizes. The implementation of control measures on January 23 2020 was indispensable in reducing the eventual COVID-19 epidemic size.

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