Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Huan Jing Ke Xue ; 44(1): 48-57, 2023 Jan 08.
Article in Chinese | MEDLINE | ID: covidwho-2242797

ABSTRACT

The multi-scale variation trend of PM2.5-O3 compound pollution events was analyzed based on air quality data, meteorological data, and COVID-19 data in Beijing from 2015 to 2020. For the threshold of compound pollution, a compound pollution index was proposed, and the numerical response trend was evaluated based on the generalized additive model. A distributed lag nonlinear model was introduced to analyze the risk response relationship between compound pollution and influencing factors. The results showed that the events of PM2.5-O3 compound pollution in Beijing decreased annually. At the same time, due to the influence of pollutant emissions and meteorological conditions, there were obvious seasonal effects, week effects, holiday effects, and epidemic effects. The composite pollution index had no correlation with rainfall but had a linear positive correlation with O3 and air temperature and a nonlinear correlation with other explanatory variables. Air pollutants and meteorological conditions had obvious lag effects on the composite pollution index, and the lag effects were mainly concentrated in 1-3 d. PM2.5, PM10, O3, SO2, and air temperature in high-value areas significantly increased the risk of compound pollution. The CO (1-6 mg·m-3), NO2 (38-118 µg·m-3), and relative humidity (54%-87%) in the median section would also increase the risk of compound pollution, as would low wind speed. The compound pollution events showed a trend of multi-day continuous pollution in the numerical response. Compared with PM2.5 and PM10, compound pollution events were more dependent on O3, and the compound pollution rate in high-value areas was 30.7%-47.5%. CO and relative humidity had little effect on compound pollution events. The air temperature had the greatest impact, and 84.7% of the composite pollution incidents occurred at 20-30℃.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Humans , Beijing/epidemiology , Environmental Monitoring/methods , COVID-19/epidemiology , Air Pollutants/analysis , Particulate Matter/analysis , China/epidemiology
2.
Disease Surveillance ; 37(9):1211-1215, 2022.
Article in Chinese | GIM | ID: covidwho-2143862

ABSTRACT

Objective: Taking the COVID-19 data of the United States as an example, using software R to calculate of the serial interval (SI), basic reproduction number (R0), effective reproduction number (Re), doubling time and the number of COVID-19 using software R to provide a reference for the future epidemic response.

3.
World J Gastrointest Surg ; 14(9): 1072-1081, 2022 Sep 27.
Article in English | MEDLINE | ID: covidwho-2055790

ABSTRACT

BACKGROUND: Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail. As a congenital disease, caudal cysts are very rare, and their canceration is even rarer, which makes the disease prone to misdiagnosis and delayed treatment. We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990. CASE SUMMARY: A 35-year-old woman found a mass in her lower abdomen 2 mo ago. She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic. Two weeks ago, the patient developed abdominal distension and right waist discomfort and came to our hospital. Except for the high level of serum carcinoembryonic antigen, the medical history and laboratory tests were not remarkable. Magnetic resonance imaging showed a well-defined, slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm × 9 cm in the presacral space, slightly high signal intensity on T2-weighted imaging, and moderate signal intensity on T1-weighted imaging. The mass was completely removed by laparoscopic surgery. Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma, and the multidisciplinary team decided to implement postoperative chemotherapy. The patient recovered well, the tumor marker levels returned to normal, and tumor-free survival has been achieved thus far. CONCLUSION: The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.

4.
Disease Surveillance ; 37(6):802-806, 2022.
Article in Chinese | GIM | ID: covidwho-2055475

ABSTRACT

Objective: To introduce the principle and method ofa-Sutte model, establish a a-Sutte model by using software R, compare the fitting and prediction effects of thea-Sutte model and multiple seasonal autoregressive integrated moving average model, SARIMA model and provides reference for the application of thea-Sutte model in epidemic prediction.

5.
PLoS Pathog ; 18(7): e1010583, 2022 07.
Article in English | MEDLINE | ID: covidwho-1974332

ABSTRACT

The spike (S) protein of SARS-CoV-2 has been observed in three distinct pre-fusion conformations: locked, closed and open. Of these, the function of the locked conformation remains poorly understood. Here we engineered a SARS-CoV-2 S protein construct "S-R/x3" to arrest SARS-CoV-2 spikes in the locked conformation by a disulfide bond. Using this construct we determined high-resolution structures confirming that the x3 disulfide bond has the ability to stabilize the otherwise transient locked conformations. Structural analyses reveal that wild-type SARS-CoV-2 spike can adopt two distinct locked-1 and locked-2 conformations. For the D614G spike, based on which all variants of concern were evolved, only the locked-2 conformation was observed. Analysis of the structures suggests that rigidified domain D in the locked conformations interacts with the hinge to domain C and thereby restrains RBD movement. Structural change in domain D correlates with spike conformational change. We propose that the locked-1 and locked-2 conformations of S are present in the acidic high-lipid cellular compartments during virus assembly and egress. In this model, release of the virion into the neutral pH extracellular space would favour transition to the closed or open conformations. The dynamics of this transition can be altered by mutations that modulate domain D structure, as is the case for the D614G mutation, leading to changes in viral fitness. The S-R/x3 construct provides a tool for the further structural and functional characterization of the locked conformations of S, as well as how sequence changes might alter S assembly and regulation of receptor binding domain dynamics.


Subject(s)
COVID-19 , SARS-CoV-2 , Disulfides , Humans , Protein Binding , Protein Conformation , Spike Glycoprotein, Coronavirus/metabolism
6.
Rheumatology & Autoimmunity ; 2022.
Article in English | EuropePMC | ID: covidwho-1863866

ABSTRACT

Background We examined attitudes toward the COVID‐19 vaccine, potential factors underlying these attitudes, and ways to increase vaccination willingness in autoimmune inflammatory rheumatic diseases (AIIRD) patients. Methods A multicenter, web‐based, observational survey using an online questionnaire was conducted among AIIRD patients aged ≥18 years from May 24, 2021, to June 3, 2021. Participants were 3104 AIIRD patients (2921 unvaccinated and 183 vaccinated). Results Of the unvaccinated patients, 32.9% were willing to receive the COVID‐19 vaccine, 45.0% were uncertain, and 14.8% were unwilling. When vaccination was recommended by physicians, patients' willingness increased to 93.8%. Participants' main concerns were that the vaccine may aggravate AIIRD disease (63.0%) and may cause vaccine‐related adverse events (19.9%). Female patients were less likely to be vaccinated. However, patients who had children aged ≤18 years were more willing to be vaccinated. In addition, vaccination willingness was higher in patients with trust in the safety and efficacy of the COVID‐19 vaccine. Notably, 183 (5.9%) patients were vaccinated. The major vaccination side effects were injection reaction, myalgia, and fatigue. At a median follow‐up of 88 (38, 131) days, patients' disease activities were stable. Conclusions The findings show that AIIRD patients were unwilling to receive the COVID‐19 vaccine because of fears of potential disease exacerbation and additional adverse events. Sociodemographic characteristics and concerns about COVID‐19 disease and vaccines had a significant effect on vaccination willingness. Key points The percentage of patients willing to receive the COVID‐19 vaccine greatly increased when vaccination was recommended by a physician. Gender, marital status, age of the patients' children, smoking, trust in the safety and efficacy of the vaccine, and previous vaccinations had significant effects on the willingness of patients with AIIRDs to receive the COVID‐19 vaccine. The data from vaccinated patients indicated no aggravation of AIIRD or additional adverse events. The population characteristics of AIIRD patients with different attitudes towards COVID‐19 vaccine.

7.
Front Microbiol ; 13: 856757, 2022.
Article in English | MEDLINE | ID: covidwho-1817983

ABSTRACT

Background: The delta variant (B.1.617.2) of SARS-CoV-2 was the dominant viral strain causing COVID-19 in China, 2021. We reported a SARS-CoV-2 delta variant outbreak in Jingmen City, Hubei Province, China. Methods: The data of epidemiological, clinical, laboratorial, and vaccination of COVID-19 cases were collected through field investigation and analyzed. Results: During the outbreak from 4 to 20 August 2021, 58 cases of the SARS-CoV-2 delta variant (B.1.617.2) were identified with 15 (25.9%) asymptomatic and 43 (74.1%) symptomatic (mild and moderate) patients. The mean serial interval was 2.6 days (standard deviation: 2.0, 95% CI: 1.9-3.6). The median age of the patients was 39 years (ranging from 1 to 60 years) with the high proportion in children (19.0%). The secondary attack rate was 9.8% higher from parents to their children (<18 years) (46.2%, 95% CI: 14.8-77.5%) than that between spouses (36.4%, 95% CI: 14.5-58.2%), but no significant difference was observed (p > 0.05). Approximately half (27; 46.6%) of cases were vaccine breakthrough infections. In vaccine breakthrough cases (fully vaccinated), viral loads decreased 1.9-3.4-folds (p < 0.05), duration of viral shedding shortened 5 days (p < 0.05), and the risk of becoming symptomatic from asymptomatic decreased 33% (95% CI: 5-53%) (aged ≥12 years) than those in unvaccinated infections. Conclusions: Children are highly susceptible to the SARS-CoV-2 delta variant in the COVID-19 outbreak in Jingmen City in 2021. Inactivated vaccine derived from wide-type strain can effectively reduce the viral load, duration of viral shedding, and clinical severity in vaccine breakthrough cases. Our study indicates that protective measures that include full vaccination against COVID-19, especially in children, should be strengthened.

8.
J Imaging ; 8(3)2022 Mar 05.
Article in English | MEDLINE | ID: covidwho-1732094

ABSTRACT

Ultrasound imaging of the lung has played an important role in managing patients with COVID-19-associated pneumonia and acute respiratory distress syndrome (ARDS). During the COVID-19 pandemic, lung ultrasound (LUS) or point-of-care ultrasound (POCUS) has been a popular diagnostic tool due to its unique imaging capability and logistical advantages over chest X-ray and CT. Pneumonia/ARDS is associated with the sonographic appearances of pleural line irregularities and B-line artefacts, which are caused by interstitial thickening and inflammation, and increase in number with severity. Artificial intelligence (AI), particularly machine learning, is increasingly used as a critical tool that assists clinicians in LUS image reading and COVID-19 decision making. We conducted a systematic review from academic databases (PubMed and Google Scholar) and preprints on arXiv or TechRxiv of the state-of-the-art machine learning technologies for LUS images in COVID-19 diagnosis. Openly accessible LUS datasets are listed. Various machine learning architectures have been employed to evaluate LUS and showed high performance. This paper will summarize the current development of AI for COVID-19 management and the outlook for emerging trends of combining AI-based LUS with robotics, telehealth, and other techniques.

9.
Rheumatol Autoimmun ; 2(2): 82-91, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1680540

ABSTRACT

Background: We examined attitudes toward the COVID-19 vaccine, potential factors underlying these attitudes, and ways to increase vaccination willingness in autoimmune inflammatory rheumatic diseases (AIIRD) patients. Methods: A multicenter, web-based, observational survey using an online questionnaire was conducted among AIIRD patients aged ≥18 years from May 24, 2021, to June 3, 2021. Participants were 3104 AIIRD patients (2921 unvaccinated and 183 vaccinated). Results: Of the unvaccinated patients, 32.9% were willing to receive the COVID-19 vaccine, 45.0% were uncertain, and 14.8% were unwilling. When vaccination was recommended by physicians, patients' willingness increased to 93.8%. Participants' main concerns were that the vaccine may aggravate AIIRD disease (63.0%) and may cause vaccine-related adverse events (19.9%). Female patients were less likely to be vaccinated. However, patients who had children aged ≤18 years were more willing to be vaccinated. In addition, vaccination willingness was higher in patients with trust in the safety and efficacy of the COVID-19 vaccine. Notably, 183 (5.9%) patients were vaccinated. The major vaccination side effects were injection reaction, myalgia, and fatigue. At a median follow-up of 88 (38, 131) days, patients' disease activities were stable. Conclusions: The findings show that AIIRD patients were unwilling to receive the COVID-19 vaccine because of fears of potential disease exacerbation and additional adverse events. Sociodemographic characteristics and concerns about COVID-19 disease and vaccines had a significant effect on vaccination willingness.

10.
BMC Infect Dis ; 22(1): 56, 2022 Jan 15.
Article in English | MEDLINE | ID: covidwho-1631087

ABSTRACT

BACKGROUND: Previous reports have described hypogonadism associated with virus infection such as hantavirus, human immunodeficiency virus (HIV) or severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). However, to our best knowledge there has been no case report of secondary hypogonadism following hand, foot, and mouth disease (HFMD). CASE PRESENTATION: A previously healthy 28-year-old man with no history of major physical and psychological trauma, presented with bilateral gynecomastia and erectile dysfunction 2 weeks after HFMD. Laboratory testament showed the level of gonadotropin hormones declined. Imaging examination demonstrated no major abnormal change in pituitary or reproductive system. The diagnosis of hypogonadism was established. Then the patient was ordered to maintain mental health outward of hospital without drug intervention. One month after presentation, his gonadotropin hormone level and sexual desire had recovered, while bilateral gynecomastia and erectile dysfunction symptoms disappeared. CONCLUSIONS: Physicians should notice the possibility for hypogonadism in adult patients with a recent history of HFMD.


Subject(s)
COVID-19 , Erectile Dysfunction , Hand, Foot and Mouth Disease , Hypogonadism , Adult , Erectile Dysfunction/etiology , Hand, Foot and Mouth Disease/complications , Hand, Foot and Mouth Disease/diagnosis , Humans , Male , SARS-CoV-2
11.
Front Cell Infect Microbiol ; 11: 715143, 2021.
Article in English | MEDLINE | ID: covidwho-1551489

ABSTRACT

Background: Recently, more patients who recovered from the novel coronavirus disease 2019 (COVID-19) may later test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) again using reverse transcription-polymerase chain reaction (RT-PCR) testing. Even though it is still controversial about the possible explanation for clinical cases of long-term viral shedding, it remains unclear whether the persistent viral shedding means re-infection or recurrence. Methods: Specimens were collected from three COVID-19-confirmed patients, and whole-genome sequencing was performed on these clinical specimens during their first hospital admission with a high viral load of SARS-CoV-2. Laboratory tests were examined and analyzed throughout the whole course of the disease. Phylogenetic analysis was carried out for SARS-CoV-2 haplotypes. Results: We found haplotypes of SARS-CoV-2 co-infection in two COVID-19 patients (YW01 and YW03) with a long period of hospitalization. However, only one haplotype was observed in the other patient with chronic lymphocytic leukemia (YW02), which was verified as one kind of viral haplotype. Patients YW01 and YW02 were admitted to the hospital after being infected with COVID-19 as members of a family cluster, but they had different haplotype characteristics in the early stage of infection; YW01 and YW03 were from different infection sources; however, similar haplotypes were found together. Conclusion: These findings show that haplotype diversity of SARS-CoV-2 may result in viral adaptation for persistent shedding in multiple recurrences of COVID-19 patients, who met the discharge requirement. However, the correlation between haplotype diversity of SARS-CoV-2 virus and immune status is not absolute. It showed important implications for the clinical management strategies for COVID-19 patients with long-term hospitalization or cases of recurrence.


Subject(s)
COVID-19 , Haplotypes , Humans , Phylogeny , RNA, Viral/genetics , SARS-CoV-2 , Virus Shedding
12.
China CDC Wkly ; 2(27): 491-495, 2020 Jul 03.
Article in English | MEDLINE | ID: covidwho-1449642

ABSTRACT

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: The key epidemiological parameters including serial interval, basic reproductive number (R 0), and effective reproductive number (R t) are crucial for coronavirus disease 2019 (COVID-19) control and prevention. Previous studies provided different estimations but were often flawed by some limitations such as insufficient sample size and selection bias. WHAT IS ADDED BY THIS REPORT?: In this study, a total of 116 infector-infectee pairs meeting strict inclusion criteria were selected for analysis. The mean serial interval of COVID-19 was 5.81 days (standard deviation: 3.24). The estimated mean with 95% confidence interval of R 0 was 3.39 (3.07-3.75) and 2.98 (2.62-3.38) using exponential growth (EG) and maximum likelihood (ML) methods, respectively. The R t in the early phase of the epidemic was above 1 with the peak of 4.43 occurring on January 8, and then showing subsequent declines and approaching 1 on January 24. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICES?: This study supports previous findings that COVID-19 has high transmissibility and that implementing comprehensive measures is effective in controlling the COVID-19 outbreak.

13.
International Journal of Disaster Risk Science ; 2021.
Article in English | PMC | ID: covidwho-1330428

ABSTRACT

More than a year after its appearance and still rampant around the world, the COVID-19 pandemic has highlighted tragically how poorly the world is prepared to handle systemic risks in an increasingly hyper-connected global social-ecological system. The absence or clear inadequacy of global governance arrangements and mechanisms is painfully distinct and obvious. In this short article, we summarize a set of COVID-19 pandemic-related analyses and lessons that are inspired by Chinese practice. First, strong government response is one of the most important methods to control a pandemic. Second, countries should be concerned about human-to-frozen goods-to-human transmission. Third, sharing resources and experiences through cooperation is crucial to ensure an adequate health response. Based on these insights, we stress the critical importance of coordination and cooperation, and call for a global network to enhance integrated human health risk resilience.

14.
Ann Hum Genet ; 85(6): 221-234, 2021 11.
Article in English | MEDLINE | ID: covidwho-1286650

ABSTRACT

In the early 2000s, emerging SARS-CoV-2, which is highly pathogenic, posed a great threat to public health. During COVID-19, epigenetic regulation is deemed to be an important part of the pathophysiology and illness severity. Using the Illumina Infinium Methylation EPIC BeadChip (850 K), we investigated genome-wide differences in DNA methylation between healthy subjects and COVID-19 patients with different disease severities. We conducted a combined analysis and selected 35 "marker" genes that could indicate a SARS-CoV-2 infection, including 12 (ATHL1, CHN2, CHST15, CPLX2, CRHR2, DCAKD, GNAI2, HECW1, HYAL1, MIR510, PDE11A, and SMG6) situated in the promoter region. The functions and pathways of differentially methylated genes were enriched in biological processes, signal transduction, and the immune system. In the "Severe versus Mild" group, differentially methylated genes, after eliminating duplicates, were used for PPI analyses. The four hub genes (GNG7, GNAS, PRKCZ, and PRKAG2) that had the highest degree of nodes were identified and among them, GNG7 and GNAS genes expressions were also downregulated in the severe group in sequencing results. Above all, the results suggest that GNG7 and GNAS may play a non-ignorable role in the progression of COVID-19. In conclusion, the identified key genes and related pathways in the current study can be used to study the molecular mechanisms of COVID-19 and may provide possibilities for specific treatments.


Subject(s)
COVID-19/genetics , COVID-19/pathology , DNA Methylation/genetics , Epigenesis, Genetic/genetics , Severity of Illness Index , Adult , Chromogranins/genetics , CpG Islands/genetics , Epigenome/genetics , Female , GTP-Binding Protein alpha Subunits, Gs/genetics , GTP-Binding Protein gamma Subunits/genetics , Genetic Markers/genetics , Humans , Inflammation/pathology , Male , Middle Aged , SARS-CoV-2
15.
Disease Surveillance ; 36(2):120-126, 2021.
Article in Chinese | GIM | ID: covidwho-1229331

ABSTRACT

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases in Jingzhou, Hubei, and provide scientific basis for the prevention and control of similar epidemic in future.

16.
J Med Imaging Radiat Sci ; 52(2): 186-190, 2021 06.
Article in English | MEDLINE | ID: covidwho-1171127

ABSTRACT

INTRODUCTION: Portable chest radiography through glass (TG-CXR) is a novel technique, particularly useful during the COVID-19 (Coronavirus disease 2019) pandemic. The purpose of this study was to understand the cost and benefit of adopting TG-CXR in quantifiable terms. METHODS: Portable or bedside radiographs are typically performed by a team of two technologists. The TG-CXR method has the benefit of allowing one technologist to stay outside of the patient room while operating the portable radiography machine, reducing PPE use, decreasing the frequency of radiography machine sanitization and decreasing technologists' exposures to potentially infectious patients. The cost of implementing this technique during the current COVID-19 pandemic was obtained from our department's operational database. The direct cost of routinely used PPE and sanitization materials and the cost of the time taken by the technologists to clean the machine was used to form a quantitative picture of the benefit associated with TG-CXR technique. RESULTS: Technologists were trained on the TG-CXR method during a 15 min shift change briefing. This translated to a one-time cost of $424.88 USD. There was an average reduction of portable radiography machine downtime of 4 min and 48 s per study. The benefit of adopting the TG-CXR technique was $9.87 USD per patient imaged. This will result in a projected net cost savings of $51,451.84 USD per annum. CONCLUSION: Adoption of the TG-CXR technique during the COVID-19 pandemic involved minimal one-time cost, but is projected to result in a net-benefit of over $51,000 USD per annum in our emergency department.


Subject(s)
COVID-19 , Cost-Benefit Analysis , Radiography, Thoracic/economics , Glass , Humans , Point-of-Care Testing/economics , Radiography, Thoracic/instrumentation , Tertiary Care Centers
17.
Int J Infect Dis ; 104: 685-692, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1056706

ABSTRACT

BACKGROUND: Almost a year after the outbreak of coronavirus disease 2019 (COVID-19), many hospitalized COVID-19 patients have recovered. However, little is known about the long-term follow-up (> 2 months) of discharged patients. METHODS: This study enrolled 527 discharged COVID-19 patients from 05 February to 11 March 2020. Basic characteristics, imaging features, nucleic acid detection results, and antibody levels of these patients were retrospectively reviewed. RESULTS: Of the 527 discharged patients, 32 (6.1%) had re-detectable positive (RP) nucleic acid results for SARS-CoV-2 during follow-up examinations, with 11 and four detections entailing stool samples and anal swabs, respectively, rather than respiratory samples. Juveniles were more susceptible to "infection recurrence" than other age groups, with shorter time spans for re-detectable positive (RP) RNA tests (an average of 8.8 days [6.0-9.0 days]), while the reverse was true for the middle-aged group (17.5 days on average [14.0-17.5 days]). Similar improvements in the imaging features of both RP and no RP (NRP) groups were observed. Negative antibody detections in patients at 3 and 6 months after discharge were 14.2% and 25.0%, respectively. Cases evidencing negative antibodies were more common among juvenile patients (40% vs. 15.6%, P=0.03) 6 months post-discharge. CONCLUSIONS: A total of 6.1% of 527 discharged patients showed RP status, which may be easier to be identified from stool samples than from other samples. Given the dropping rate of SARS-CoV-2 antibodies, reinfection may happen, especially in juvenile patients (aged<18 years). These findings have implications for the long-term management of recovered COVID-19 patients.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/immunology , COVID-19/virology , COVID-19 Nucleic Acid Testing , COVID-19 Serological Testing , Child , Child, Preschool , China/epidemiology , Female , Follow-Up Studies , Humans , Infant , Male , Middle Aged , Patient Discharge , Retrospective Studies , Young Adult
18.
Ther Clin Risk Manag ; 17: 9-21, 2021.
Article in English | MEDLINE | ID: covidwho-1030561

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel pathogen, has caused an outbreak of coronavirus disease 2019 (COVID-19) that has spread rapidly around the world. Determining the risk factors for death and the differences in clinical features between severely ill and critically ill patients with SARS-CoV-2 pneumonia has become increasingly important. AIM: This study was intended to provide insight into the difference between severely ill and critically ill patients with SARS-CoV-2 pneumonia. METHODS: In this retrospective, multicenter cohort study, we enrolled 62 seriously ill patients with SARS-CoV-2 pneumonia who had been diagnosed by March 12, 2020. Clinical data, laboratory indexes, chest images, and treatment strategies collected from routine medical records were compared between severely ill and critically ill patients. Univariate and multivariate logistic regression analyses were also conducted to identify the risk factors associated with the progression of patients with severe COVID-19. RESULTS: Of the 62 patients with severe or critical illness, including 7 who died, 30 (48%) patients had underlying diseases, of which the most common was cardiovascular disease (hypertension, 34%, and coronary heart disease, 5%). Compared to patients with severe disease, those with critical disease had distinctly higher white blood cell counts, procalcitonin levels, and D-dimer levels, and lower hemoglobin levels and lymphocyte counts. Multivariate regression showed that a lymphocyte count less than 109/L (odds ratio 20.92, 95% CI 1.76-248.18; p=0.02) at admission increased the risk of developing a critical illness. CONCLUSION: Based on multivariate regression analysis, a lower lymphocyte count (<109/L) on admission is the most critical independent factor that is closely associated with an increased risk of progression to critical illness. Age, underlying diseases, especially hypertension and coronary heart disease, elevated D-dimer, decreased hemoglobin, and SOFA score, and APACH score also need to be taken into account for predicting disease progression. Blood cell counts and procalcitonin levels for the later secondary bacterial infection have a certain reference values.

19.
Braz. j. infect. dis ; 24(3):247-249, 2020.
Article in English | LILACS (Americas) | ID: grc-742469

ABSTRACT

ABSTRACT Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China and has spread rapidly worldwide. We present a mild SARS-CoV-2 infection in a baby with non-productive cough and normal chest computed tomography, in whom only anal swabs tested positive by real-time PCR testing for SARS-CoV-2. She was given atomization inhalation therapy with recombinant human interferon alfa-1b for 10 days. Her anal swabs remained positive for eight days, whereas her throat swabs were persistently negative by real-time PCR testing. Mild and asymptomatic cases, especially in children, might present with PCR negative pharyngeal/nasal swabs and PCR positive anal swabs. Those patients are potential sources of infection via fecal-oral transmission for COVID-19.

20.
World J Clin Cases ; 8(20): 4908-4916, 2020 Oct 26.
Article in English | MEDLINE | ID: covidwho-918545

ABSTRACT

BACKGROUND: The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases. Elderly patients are a high-risk group for surgical treatment. If the incarceration of gallstones cannot be relieved, emergency surgery is unavoidable. CASE SUMMARY: We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis. He had several coexisting, high-risk underlying diseases, had a history of radical gastrectomy for gastric cancer, and was taking aspirin before the operation. Nevertheless, he underwent emergency laparoscopic cholecystectomy, with maintenance of postoperative heart and lung function, successfully recovered, and was discharged on day 8 after the operation. CONCLUSION: Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic, the key is to abide strictly by the hospital's epidemic prevention regulations, fully implement the epidemic prevention procedure for emergency surgery, fully prepare before the operation, accurately perform the operation, and carefully manage the patient postoperatively.

SELECTION OF CITATIONS
SEARCH DETAIL