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1.
Chinese Journal of Laboratory Medicine ; 43(4):358-363, 2020.
Article | WHO COVID | ID: covidwho-769448

ABSTRACT

Objective: To investigate the effect of virus inactivation on weak positive result of 2019 novel coronavirus(2019-nCoV) nucleic acid test Methods: A retrospective study was conducted on the nasopharyngeal swabs of three patients with positive PCR nucleic acid test for 2019-nCoV at different concentrations in the Second affiliated Hospital of Zhejiang University Medical College from January to February 2020 The virus in nasopharyngeal swab specimens were inactivated by water bath at 56 ℃ for 30 min, dry bath at 56 ℃ for 60 min and dry bath at 60 ℃ for 30 min respectively After treatment, these samples RNA were extracted and then detected by three new commercial quantitative real-time polymerase chain reaction reagent kits for 2019-nCoV Cycle threshold (Ct) value was used to evaluate the effect of virus inactivation on nucleic acid detection of 2019-nCoV Results: There was no significant difference between the groups before and after inactivation Ct values of ORF1ab gene before inactivation were 23 28±0 28, 25 25±0 25, 28 93±0 44, 32 06±0 47, 35 20±0 38, 32 89±0 38, 36 24±0 23, 33 30±0 46, and those after inactivation were, group 1:23 60±0 20, 27 29±0 30, 31 83±0 51, 37 41±0 46, group 2: 24 25±0 34, 27 18±0 42, 31 84±0 61, 34 99±1 01, 34 89±0 45,group 3: 23 37±0 17, 26 89±0 52, 32 05±0 50 Ct value of N gene before inactivation were 24 38±0 09, 26 64±0 11, 30 35±0 12, 33 29±0 33, 36 93±0 11, 34 50±0 12, 35 63±0 12, those after inactivation were, group 1: 24 66±0 11, 28 52±0 14, 32 71±0 14, 37 00±0 13;group 2: 25 41±0 10, 28 79±0 15, 33 29±0 28;group 3: 23 37±0 11, 28 68±0 11, 33 54±0 13, 37 18±0 23(ORF1ab gene: t=-1 416;N gene: t=-1 379, P>0 05) There was no significant difference among the three inactivation groups, the specific Ct values are shown above(ORF1ab gene: t=-0 460;N gene: t=-0 132, P>0 05) However, the Ct values of the inactivated groups (1,2,3) and the non-inactivated group at different dilution times were different (10 ×:Ct value of ORF1ab was 25 25±0 25 in the non-inactivated group, and 27 29±0 30, 27 18±0 42 and 26 89±0 52 in the inactivated group1,2 and 3,t(ORF1ab)=-7 327, P0 05) and among the three reagents(reagent 1:7/11, 4/11, 3/11, 3/11, reagent 2:8/11, 4/11, 3/11, 3/11, reagent 3:5/11, 3/11, 3/11, 2/11)(χ2=1 199, P>0 05) Conclusion: The virus inactivation can degrade the nucleic acid of the 2019-nCoV, resulting in the decrease of the Ct value and the false negative results of the low-concentration specimens

2.
Journal of Traditional Chinese Medicine ; 40(3):497-508, 2020.
Article | WHO COVID | ID: covidwho-707200

ABSTRACT

The TCM protocol in the Diagnosis and Treatment Protocol for corona virus disease 2019 (COVID-19) (Trial Version 7) has been updated from previous versions The protocol was formulated under the direct leadership of the National Administration of Traditional Chinese Medicine, based on the experience of a panel of experts, supported by evidence from fever clinics and from the outcomes of emergency (EM) observation rooms and inpatients throughout China (especially in Wuhan, Hubei Province) in combination with the latest scientific research results and data The present interpretation of the TCM protocol is based on an overall understanding of the revised content, and aims to guide and standardize its clinical application to provide a reference for clinicians

3.
Eur Rev Med Pharmacol Sci ; 24(14): 7826-7833, 2020 07.
Article in English | MEDLINE | ID: covidwho-693444

ABSTRACT

OBJECTIVE: The outbreak of the 2019 Novel Coronavirus Disease (COVID-19) is seriously threatening the health of people all over China and the world. This study aims to investigate the clinical characteristics and outcomes of COVID-19 patients admitted at different time periods. PATIENTS AND METHODS: A total of 132 discharged cases and 10 deaths of laboratory or clinically confirmed cases were retrospectively collected from The First People's Hospital of Jingzhou, Hubei. All cases were divided into two groups according to different admission times (group 1 from 2020-1-23 to 2020-2-3 and group 2 from 2020-2-4 to 2020-2-15). Individual data, clinical data, laboratory indices and prognosis were collected for the two groups, and statistical analysis was performed using the t-test or chi-square test to assess differences between the groups. RESULTS: Among the 142 cases, there were 67 in the first group and 75 in the second group. According to the individual data and clinical manifestations of the two groups, the hospital stay in the first group was significantly longer than that of the second group (26 [9-39] compared with 20 [6-30], p=0.000). There were more clinical symptoms upon admission in group 1 than in group 2; although 66.2% of all patients had fever, the proportion of patients with fever on admission in the first group was significantly higher than that in the second group (79.1% compared with 54.7%, p=0.002). The proportion of patients with chills in the first group was higher than that in the second group (16.4% compared with 5.3%, p=0.032), and the proportion of patients with dyspnea was also higher than that in the second group (17.9% compared with 4%, p=0.007). Four of the 67 patients in the first group had symptoms of ocular discomfort, but none in the second group had this symptom (6.0% compared with 0, p=0.032). Based on laboratory examination, the inflammatory index of patients in the first group was higher than that in the second group, and the proportion of patients with a C-reactive protein (CRP) increase was also significantly higher (60% compared with 38.7%, p=0.020). The main difference in routine blood tests involved white blood cell and lymphocyte counts and the lymphocyte percentage. The proportion of patients with reduced white blood cell counts in the first group was higher than that in the second group (23.9% compared with 10.7% p=0.036). Moreover, more patients in the first group had a reduced lymphocyte count and percentage (71.6% compared with 30.7% p=0.000; 49.3% compared with 29.7% p=0.015, respectively), and the former was significantly lower than that in the second group (0.94 [0.24-2.42] compared with 1.365 [0.22-3.62], p=0.000). Regarding prognosis, the proportion of severe cases and mortality in the first group were slightly higher than in the second group (p>0.05). CONCLUSIONS: The clinical manifestations, blood changes and outcomes differed in patients admitted at different time periods. In the second group of patients, clinical symptoms were less common than in the first group, routine blood changes and inflammatory indices were milder, and the clinical prognosis was better.


Subject(s)
Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/isolation & purification , C-Reactive Protein/analysis , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/virology , Dyspnea/diagnosis , Dyspnea/etiology , Female , Humans , Length of Stay , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Prognosis , Retrospective Studies , Severity of Illness Index , Survival Rate , Time Factors , Young Adult
5.
Clin Exp Immunol ; 201(1): 76-84, 2020 07.
Article in English | MEDLINE | ID: covidwho-628822

ABSTRACT

Effective laboratory markers for the estimation of disease severity and predicting the clinical progression of coronavirus disease-2019 (COVID-19) is urgently needed. Laboratory tests, including blood routine, cytokine profiles and infection markers, were collected from 389 confirmed COVID-19 patients. The included patients were classified into mild (n = 168), severe (n = 169) and critical groups (n = 52). The leukocytes, neutrophils, infection biomarkers [such as C-reactive protein (CRP), procalcitonin (PCT) and ferritin] and the concentrations of cytokines [interleukin (IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] were significantly increased, while lymphocytes were significantly decreased with increased severity of illness. The amount of IL-2R was positively correlated with the other cytokines and negatively correlated with lymphocyte number. The ratio of IL-2R to lymphocytes was found to be remarkably increased in severe and critical patients. IL-2R/lymphocytes were superior compared with other markers for the identification of COVID-19 with critical illness, not only from mild but also from severe illness. Moreover, the cytokine profiles and IL-2R/lymphocytes were significantly decreased in recovered patients, but further increased in disease-deteriorated patients, which might be correlated with the outcome of COVID-19. Lymphopenia and increased levels of cytokines were closely associated with disease severity. The IL-2R/lymphocyte was a prominent biomarker for early identification of severe COVID-19 and predicting the clinical progression of the disease.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Interleukin-2 Receptor alpha Subunit/blood , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , T-Lymphocytes/virology , Aged , Aged, 80 and over , Betacoronavirus/immunology , Biomarkers/blood , C-Reactive Protein/immunology , C-Reactive Protein/metabolism , China/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Disease Progression , Female , Ferritins/blood , Ferritins/immunology , Humans , Interleukin-10/blood , Interleukin-10/immunology , Interleukin-2 Receptor alpha Subunit/immunology , Interleukin-6/blood , Interleukin-6/immunology , Interleukin-8/blood , Interleukin-8/immunology , Leukocyte Count , Male , Middle Aged , Neutrophils/immunology , Neutrophils/virology , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Procalcitonin/blood , Procalcitonin/immunology , Prognosis , Severity of Illness Index , T-Lymphocytes/immunology , Tumor Necrosis Factor-alpha/blood , Tumor Necrosis Factor-alpha/immunology
6.
Clin Microbiol Infect ; 2020 Jun 12.
Article in English | MEDLINE | ID: covidwho-597596

ABSTRACT

OBJECTIVES: The epidemiology of respiratory co-infection pairings is poorly understood. Here we assess the dynamics of respiratory viral co-infections in children and adults and determine predisposition for or against specific viral pairings. METHODS: Over five respiratory seasons from 30 November 2013 through 6 June 2018, the mono-infection and co-infection prevalence of 13 viral pathogens was tabulated at The Cleveland Clinic. Employing a model to proportionally distribute viral pairs using individual virus co-infection rate with prevalence patterns of concurrent co-circulating viruses, we compared predicted occurrence with observed occurrence of 132 viral pairing permutations using binomial analysis. RESULTS: Of 30 535 respiratory samples, 9843 (32.2%) were positive for at least one virus and 1018 (10.8%) of these were co-infected. Co-infected samples predominantly originated from children. Co-infection rate in paediatric population was 35.0% (2068/5906), compared with only 5.8% (270/4591) in adults. Adenovirus C (ADVC) had the highest co-infection rate (426/623, 68.3%) while influenza virus B had the lowest (55/546, 10.0%). ADVC-rhinovirus (HRV), respiratory syncytial virus A (RSVA)-HRV and RSVB-HRV pairings occurred at significantly higher frequencies than predicted by the proportional distribution model (p < 0.05). Additionally, several viral pairings had fewer co-infections than predicted by our model: notably metapneumovirus (hMPV)-parainfluenza virus 3, hMPV-RSVA and RSVA-RSVB. CONCLUSIONS: This is one of the largest studies on respiratory viral co-infections in children and adults. Co-infections are substantially more common in children, especially under 5 years of age, and the most frequent pairings occurred at a higher frequency than would be expected by random. Specific pairings occur at altered rates compared with those predicted by proportional distribution, suggesting either direct or indirect interactions result between specific viral pathogens.

8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 461-465, 2020 Apr 10.
Article in Chinese | MEDLINE | ID: covidwho-324698

ABSTRACT

Objective: To study the early dynamics of the epidemic of coronavirus disease (COVID-19) in China from 15 to 31 January, 2020, and estimate the corresponding epidemiological parameters (incubation period, generation interval and basic reproduction number) of the epidemic. Methods: By means of Weibull, Gamma and Lognormal distributions methods, we estimated the probability distribution of the incubation period and generation interval data obtained from the reported COVID-19 cases. Moreover, the AIC criterion was used to determine the optimal distribution. Considering the epidemic is ongoing, the exponential growth model was used to fit the incidence data of COVID-19 from 10 to 31 January, 2020, and exponential growth method, maximum likelihood method and SEIR model were used to estimate the basic reproduction number. Results: Early COVID-19 cases kept an increase in exponential growth manner before 26 January, 2020, then the increase trend became slower. The average incubation period was 5.01 (95%CI: 4.31-5.69) days; the average generation interval was 6.03 (95%CI: 5.20-6.91) days. The basic reproduction number was estimated to be 3.74 (95%CI: 3.63-3.87), 3.16 (95%CI: 2.90-3.43), and 3.91 (95%CI: 3.71-4.11) by three methods, respectively. Conclusions: The Gamma distribution fits both the generation interval and incubation period best, and the mean value of generation interval is 1.02 day longer than that of incubation period. The relatively high basic reproduction number indicates that the epidemic is still serious; Based on our analysis, the turning point of the epidemic would be seen on 26 January, the growth rate would be lower afterwards.


Subject(s)
Basic Reproduction Number , Coronavirus Infections/epidemiology , Infectious Disease Incubation Period , Pneumonia, Viral/epidemiology , Betacoronavirus , China/epidemiology , Humans , Models, Statistical , Pandemics
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 485-488, 2020 03 05.
Article in Chinese | MEDLINE | ID: covidwho-20913

ABSTRACT

Editor office's response for Ahead of Print article withdrawn The article "Potential false-positive rate among the 'asymptomatic infected individuals' in close contacts of COVID-19 patients" was under strong discussion after pre-published. Questions from the readers mainly focused on the article's results and conclusions were depended on theoretical deduction, but not the field epidemiology data and further researches were needed to prove the current theory. Based on previous discussions, the article was decided to be offline by the editorial board from the pre-publish lists. Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention. Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings. Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%. Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives.

10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 485-488, 2020 03 05.
Article in Chinese | MEDLINE | ID: covidwho-5539

ABSTRACT

Editor office's response for Ahead of Print article withdrawn The article "Potential false-positive rate among the 'asymptomatic infected individuals' in close contacts of COVID-19 patients" was under strong discussion after pre-published. Questions from the readers mainly focused on the article's results and conclusions were depended on theoretical deduction, but not the field epidemiology data and further researches were needed to prove the current theory. Based on previous discussions, the article was decided to be offline by the editorial board from the pre-publish lists. Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention. Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings. Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%. Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives.

11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 461-465, 2020 Apr 10.
Article in Chinese | MEDLINE | ID: covidwho-3053

ABSTRACT

Objective: To study the early dynamics of the epidemic of coronavirus disease (COVID-19) in China from 15 to 31 January, 2020, and estimate the corresponding epidemiological parameters (incubation period, generation interval and basic reproduction number) of the epidemic. Methods: By means of Weibull, Gamma and Lognormal distributions methods, we estimated the probability distribution of the incubation period and generation interval data obtained from the reported COVID-19 cases. Moreover, the AIC criterion was used to determine the optimal distribution. Considering the epidemic is ongoing, the exponential growth model was used to fit the incidence data of COVID-19 from 10 to 31 January, 2020, and exponential growth method, maximum likelihood method and SEIR model were used to estimate the basic reproduction number. Results: Early COVID-19 cases kept an increase in exponential growth manner before 26 January, 2020, then the increase trend became slower. The average incubation period was 5.01 (95%CI: 4.31-5.69) days; the average generation interval was 6.03 (95%CI: 5.20-6.91) days. The basic reproduction number was estimated to be 3.74 (95%CI: 3.63-3.87), 3.16 (95%CI: 2.90-3.43), and 3.91 (95%CI: 3.71-4.11) by three methods, respectively. Conclusions: The Gamma distribution fits both the generation interval and incubation period best, and the mean value of generation interval is 1.02 day longer than that of incubation period. The relatively high basic reproduction number indicates that the epidemic is still serious; Based on our analysis, the turning point of the epidemic would be seen on 26 January, the growth rate would be lower afterwards.


Subject(s)
Basic Reproduction Number , Coronavirus Infections/epidemiology , Infectious Disease Incubation Period , Pneumonia, Viral/epidemiology , Betacoronavirus , China/epidemiology , Humans , Models, Statistical , Pandemics
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(6): 630-633, 2020 Jun 06.
Article in Chinese | MEDLINE | ID: covidwho-2886

ABSTRACT

We used the epidemic data of COVID-19 published on the official website of the municipal health commissions in Anhui province to map the spatiotemporal changes of confirmed cases, fit the epidemic situation by the population growth curve at different stages and analyze the epidemic situation in Anhui Province. It was found that the cumulative incidence of COVID-19 was 156/100 000 by February 18, 2020 and the trend of COVID-19 epidemic declined after February 7 with a change from J-shaped curve to S-shaped curve. As the reporting time of cases might be 3-5 days later than the actual onset time, the number of new cases in Anhui province actually began to decline around February 2 to February 4, 2020.


Subject(s)
Coronavirus Infections/epidemiology , Epidemics , Pneumonia, Viral/epidemiology , China/epidemiology , Humans , Pandemics , Spatio-Temporal Analysis
13.
Zhonghua Zhong Liu Za Zhi ; 42(4): 296-300, 2020 Apr 23.
Article in Chinese | MEDLINE | ID: covidwho-2876

ABSTRACT

Since December 2019, unexplained pneumonia has appeared in Wuhan City, Hubei Province, and a new type of coronavirus infection was confirmed as COVID-19. COVID-19 spread rapidly nationwide and abroad. The COVID-19 has brought huge impacts to all the people and walks of life, especially to the medical and health systems. It has also brought great challenges to the treatment of patients with cancer. Esophageal cancer is a common malignant tumor in China and most of the patients are in the middle and advanced stage when diagnosed, with immunosuppressive and poor prognosis. The selection of surgical procedures and perioperative managements of esophageal cancer require all thoracic surgeons work together to figure out a reasonable system of surgical treatment and emergency response.


Subject(s)
Coronavirus Infections , Coronavirus , Cross Infection/prevention & control , Disease Outbreaks/prevention & control , Esophageal Neoplasms , Pandemics/prevention & control , Pneumonia, Viral , Betacoronavirus , China , Communicable Disease Control/methods , Coronavirus/pathogenicity , Coronavirus Infections/epidemiology , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/therapy , Humans , Immunocompromised Host , Patient Care Planning , Pneumonia, Viral/epidemiology , Risk
14.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(0): E005, 2020 Feb 06.
Article in Chinese | MEDLINE | ID: covidwho-473

ABSTRACT

Objective: To analyze the clinical characteristics of 2019 novel coronavirus (2019-nCoV) pneumonia and to investigate the correlation between serum inflammatory cytokines and severity of the disease. Methods: 29 patients with 2019-ncov admitted to the isolation ward of Tongji hospital affiliated to Tongji medical college of Huazhong University of Science and Technology in January 2020 were selected as the study subjects. Clinical data were collected and the general information, clinical symptoms, blood test and CT imaging characteristics were analyzed. According to the relevant diagnostic criteria, the patients were divided into three groups: mild (15 cases), severe (9 cases) and critical (5 cases). The expression levels of inflammatory cytokines and other markers in the serum of each group were detected, and the changes of these indicators of the three groups were compared and analyzed, as well as their relationship with the clinical classification of the disease. Results: (1) The main symptoms of 2019-nCoV pneumonia was fever (28/29) with or without respiratory and other systemic symptoms. Two patients died with underlying disease and co-bacterial infection, respectively. (2) The blood test of the patients showed normal or decreased white blood cell count (23/29), decreased lymphocyte count (20/29), increased hypersensitive C reactive protein (hs-CRP) (27/29), and normal procalcitonin. In most patients,serum lactate dehydrogenase (LDH) was significantly increased (20/29), while albumin was decreased(15/29). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil), serum creatinine (Scr) and other items showed no significant changes. (3) CT findings of typical cases were single or multiple patchy ground glass shadows accompanied by septal thickening. When the disease progresses, the lesion increases and the scope expands, and the ground glass shadow coexists with the solid shadow or the stripe shadow. (4) There were statistically significant differences in the expression levels of interleukin-2 receptor (IL-2R) and IL-6 in the serum of the three groups (P<0.05), among which the critical group was higher than the severe group and the severe group was higher than the mildgroup. However, there were no statistically significant differences in serum levels of tumor necrosis factor-alpha (TNF-α), IL-1, IL-8, IL-10, hs-CRP, lymphocyte count and LDH among the three groups (P>0.05). Conclusion: The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. High resolution CT is of great value in the differential diagnosis of this disease. The increased expression of IL-2R and IL-6 in serum is expected to predict the severity of the 2019-nCoV pneumonia and the prognosis of patients.

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