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1.
Res Int Bus Finance ; 61: 101666, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1799740

ABSTRACT

Combining the spillover index approach and LASSO-VAR method, we construct the spillover network of 19 specific countries' economic policy uncertainty (EPU). Then we deconstruct the constructed network into four blocks by the block models, the impacts of COVID-19 on EPU spillover effects between each country and blocks is analyzed gradually. The results reveal that: (1) The transnational contagion of EPU is significant, and the spillover network of policy uncertainty is time-varying. (2) EPU networks can be divided into four different blocks by block models. The role of blocks and the spatial spillover transmission path between blocks are different in different periods. (3) The new infection cases and deaths of COVID-19 have a significant effect on reception and transmission directional EPU spillovers, while there is no significant impact on net spillovers. The international movement restrictions during the period of COVID-19 significantly increase the directional and net EPU spillovers. Our findings have some implications for policy-makers and market regulators in the context of the COVID-19 pandemic.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323544

ABSTRACT

The coronavirus disease-19 (COVID-19) caused by SARS-CoV-2 infection can lead to a series of clinical settings from non-symptomatic viral carriers/spreaders to severe illness characterized by acute respiratory distress syndrome (ARDS)1,2. A sizable part of patients with COVID-19 have mild clinical symptoms at the early stage of infection, but the disease progression may become quite rapid in the later stage with ARDS as the common manifestation and followed by critical multiple organ failure, causing a high mortality rate of 7-10% in the elderly population with underlying chronic disease1-3. The pathological investigation in the lungs and other organs of fatal cases is fundamental for the mechanistic understanding of severe COVID-19 and the development of specific therapy in these cases. Gross anatomy and molecular markers allowed us to identify, in two fatal patients subject to necropsy, the main pathological features such as exudation and hemorrhage, epithelium injuries, infiltration of macrophages and fibrosis in the lungs. The mucous plug with fibrinous exudate in the alveoli and the activation of alveolar macrophages were characteristic abnormalities. These findings shed new insights into the pathogenesis of COVID-19 and justify the use of interleukin 6 (IL6) receptor antagonists and convalescent plasma with neutralizing antibodies against SARS-CoV-2 for severe patients.Authors Chaofu Wang, Jing Xie, Lei Zhao, Xiaochun Fei, Heng Zhang, and Yun Tan contributed equally to this work. Authors Chaofu Wang, Jun Cai, Rong Chen, Zhengli Shi, and Xiuwu Bian jointly supervised this work.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315347

ABSTRACT

The coronavirus disease (COVID-19) is an infectious disease caused by the most recently discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to investigate associations between sunlight and vitamin D, using latitude as an indicator, with COVID-19 cases and related deaths in the United States. General regression and Chi-square test were used to examine the associations between latitude and COVID-19 cases and deaths. The analyses indicated that latitudes were marginally associated with cases (p = 0.0792) and deaths (p = 0.0599), with an increase of 2491 cases and 189 deaths of the total numbers in the mainland of US for every unit of increase of the latitude. When the states were classified into high latitude (>N 370) and low latitude (<N 370) groups, both the cases (702 vs 255 cases/100k population) and deaths (43 vs 11 deaths/100k population) were significantly different (p < 0.001) between the two categories. The results suggested that sunlight and vitamin D, with latitude as an indicator, might be associated with decreased risks for both COVID-19 cases and deaths. These findings warranted urgent needs of large cohort, clinical and pre-clinical studies to assess the impact of VD on the prevention of COVID-19.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312676

ABSTRACT

Background: Lung ultrasound (LUS) can be an important imaging tool for the diagnosis and assessment of lung involvement. In this study, we determined the ultrasound manifestations of the lung associated with COVID-19 pneumonia, and obtained the ultrasound image changes of the patients from the initial diagnosis to rehabilitation. Methods: : The purpose of this study is to establish a lung involvement assessment model based on deep learning. A channel attention classification method based on squeeze-and-excitation network combining with ResNeXt (SE_ResNeXt) is proposed, which can automatically learn the importance of different channel features, so as to achieve selective learning of channels and further achieve more accurate classification results. Results: and conclusion: Among 104 patients' data from multicenter and multi-mode ultrasound, the diagnostic model can achieve 97.11% accuracy. The lung involvement severity of COVID-19 pneumonia and the trend of lesion were evaluated quantitatively.

5.
Nat Commun ; 13(1): 269, 2022 01 12.
Article in English | MEDLINE | ID: covidwho-1621240

ABSTRACT

A complete diagnostic autopsy is the gold-standard to gain insight into Coronavirus disease 2019 (COVID-19) pathogenesis. To delineate the in situ immune responses to SARS-CoV-2 viral infection, here we perform comprehensive high-dimensional transcriptional and spatial immune profiling in 22 COVID-19 decedents from Wuhan, China. We find TIM-3-mediated and PD-1-mediated immunosuppression as a hallmark of severe COVID-19, particularly in men, with PD-1+ cells being proximal rather than distal to TIM-3+ cells. Concurrently, lymphocytes are distal, while activated myeloid cells are proximal, to SARS-CoV-2 viral antigens, consistent with prevalent SARS-CoV-2 infection of myeloid cells in multiple organs. Finally, viral load positively correlates with specific immunosuppression and dendritic cell markers. In summary, our data show that SARS-CoV-2 viral infection induces lymphocyte suppression yet myeloid activation in severe COVID-19, so these two cell types likely have distinct functions in severe COVID-19 disease progression, and should be targeted differently for therapy.


Subject(s)
COVID-19/immunology , SARS-CoV-2/physiology , Aged , Autopsy , COVID-19/diagnosis , COVID-19/genetics , COVID-19/virology , China , Diagnosis , Female , Hepatitis A Virus Cellular Receptor 2/genetics , Hepatitis A Virus Cellular Receptor 2/immunology , Humans , Lymphocyte Activation , Lymphocytes/immunology , Male , Middle Aged , Myeloid Cells/immunology , Programmed Cell Death 1 Receptor/genetics , Programmed Cell Death 1 Receptor/immunology , SARS-CoV-2/immunology , Viral Load
6.
Nat Cell Biol ; 23(12): 1314-1328, 2021 12.
Article in English | MEDLINE | ID: covidwho-1559292

ABSTRACT

The lung is the primary organ targeted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), making respiratory failure a leading coronavirus disease 2019 (COVID-19)-related mortality. However, our cellular and molecular understanding of how SARS-CoV-2 infection drives lung pathology is limited. Here we constructed multi-omics and single-nucleus transcriptomic atlases of the lungs of patients with COVID-19, which integrate histological, transcriptomic and proteomic analyses. Our work reveals the molecular basis of pathological hallmarks associated with SARS-CoV-2 infection in different lung and infiltrating immune cell populations. We report molecular fingerprints of hyperinflammation, alveolar epithelial cell exhaustion, vascular changes and fibrosis, and identify parenchymal lung senescence as a molecular state of COVID-19 pathology. Moreover, our data suggest that FOXO3A suppression is a potential mechanism underlying the fibroblast-to-myofibroblast transition associated with COVID-19 pulmonary fibrosis. Our work depicts a comprehensive cellular and molecular atlas of the lungs of patients with COVID-19 and provides insights into SARS-CoV-2-related pulmonary injury, facilitating the identification of biomarkers and development of symptomatic treatments.


Subject(s)
COVID-19/genetics , Lung/metabolism , Transcriptome/genetics , Alveolar Epithelial Cells/metabolism , Alveolar Epithelial Cells/pathology , Alveolar Epithelial Cells/virology , COVID-19/metabolism , Fibrosis/metabolism , Fibrosis/pathology , Fibrosis/virology , Humans , Lung/pathology , Lung/virology , Proteomics/methods , SARS-CoV-2/pathogenicity
7.
Cell Res ; 31(8): 836-846, 2021 08.
Article in English | MEDLINE | ID: covidwho-1275907

ABSTRACT

Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs. However, the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown. We profiled 26 COVID-19 autopsy cases from four cohorts in Wuhan, China, and determined the systemic distribution of SARS-CoV-2. SARS-CoV-2 was detected in the lungs and multiple extrapulmonary organs of critically ill COVID-19 patients up to 67 days after symptom onset. Based on organotropism and pathological features of the patients, COVID-19 was divided into viral intrapulmonary and systemic subtypes. In patients with systemic viral distribution, SARS-CoV-2 was detected in monocytes, macrophages, and vascular endothelia at blood-air barrier, blood-testis barrier, and filtration barrier. Critically ill patients with long disease duration showed decreased pulmonary cell proliferation, reduced viral RNA, and marked fibrosis in the lungs. Permanent SARS-CoV-2 presence and tissue injuries in the lungs and extrapulmonary organs suggest direct viral invasion as a mechanism of pathogenicity in critically ill patients. SARS-CoV-2 may hijack monocytes, macrophages, and vascular endothelia at physiological barriers as the ports of entry for systemic dissemination. Our study thus delineates systemic pathological features of SARS-CoV-2 infection, which sheds light on the development of novel COVID-19 treatment.


Subject(s)
COVID-19/pathology , Lung/virology , SARS-CoV-2/isolation & purification , Aged , Aged, 80 and over , Autopsy , COVID-19/virology , China , Cohort Studies , Critical Illness , Female , Fibrosis , Hospitalization , Humans , Kidney/pathology , Kidney/virology , Leukocytes, Mononuclear/pathology , Leukocytes, Mononuclear/virology , Lung/pathology , Male , Middle Aged , RNA, Viral/metabolism , SARS-CoV-2/genetics , Spleen/pathology , Spleen/virology , Trachea/pathology , Trachea/virology
8.
Med Sci Monit ; 27: e928837, 2021 Feb 13.
Article in English | MEDLINE | ID: covidwho-1161104

ABSTRACT

BACKGROUND Coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) in March 2020. To further reveal the pathologic associations between coronavirus and hypoxemia, we report the findings of 4 complete systematic autopsies of severe acute respiratory syndrome coronavirus 2-positive individuals who died of multiple organ failure caused by severe hypoxemia. MATERIAL AND METHODS We examined the donated corpses of 4 deceased patients who had been diagnosed with severe acute respiratory syndrome coronavirus 2. A complete post-mortem examination was carried out on each corpse, and multiple organs were macroscopically examined. RESULTS The 4 corpses were 2 males and 2 females, with an average age of 69 years. Bilateral lungs showed various degrees of atrophy and consolidation, with diffusely tough and solid texture in the sections. A thromboembolism was found in the main pulmonary artery extending into the atrium in 1 corpse, and significant atherosclerotic plaques tagged in the inner wall of the aortic arch were found in 2 corpses. Two corpses were found to have slightly atrophied bilateral renal parenchyma. Atrophic changes in the spleen were found in 2 corpses. Notably, there were significantly expanded alveolar septa and prominent fibroblastic proliferation. CONCLUSIONS The laboratory data of these corpses showed a progressive decrease in blood oxygen saturation, followed by refractory and irreversible hypoxemia. Clinical and laboratory information and autopsy and histologic presentations of multiple organs showed insufficient air exchange due to abnormalities in the respiratory system, and reduced erythropoiesis in bone marrow may play a role.


Subject(s)
Autopsy , COVID-19/pathology , COVID-19/virology , Hypoxia/complications , Hypoxia/pathology , Pneumonia/pathology , Pneumonia/virology , SARS-CoV-2/physiology , Aged , Aged, 80 and over , Alveolar Epithelial Cells/metabolism , Alveolar Epithelial Cells/pathology , COVID-19/complications , Cell Aggregation , Female , Humans , Lung/pathology , Macrophages/pathology , Male , Middle Aged , Mucus/metabolism , Myocardium/pathology , Necrosis , Pneumonia/complications , Thoracic Cavity/pathology
9.
Med Sci Monit ; 27: e932092, 2021 Mar 17.
Article in English | MEDLINE | ID: covidwho-1148747

ABSTRACT

This manuscript has been retracted due to the identification of undeclared duplication of content, including Figure images, from a -previous publication by some of the authors: Wang C, Xie J, Zhao L, Fei X, Zhang H, Tan Y, Nie X, Zhou L, Liu Z, Ren Y, Yuan L, Zhang Y, Zhang J, Liang L, Chen X, Liu X, Wang P, Han X, Weng X, Chen Y, Yu T, Zhang X, Cai J, Chen R, Shi ZL, Bian XW. Alveolar macrophage dysfunction and cytokine storm in the pathogenesis of two severe COVID-19 patients. EBioMedicine. 2020; 57: 102833. All authors are requested to declare that manuscripts submitted to this journal are original. This journal makes clear that research fraud of any kind will not be tolerated and will result in immediate retraction.

10.
Biomed Eng Online ; 20(1): 27, 2021 Mar 20.
Article in English | MEDLINE | ID: covidwho-1143220

ABSTRACT

BACKGROUND: Lung ultrasound (LUS) can be an important imaging tool for the diagnosis and assessment of lung involvement. Ultrasound sonograms have been confirmed to illustrate damage to a person's lungs, which means that the correct classification and scoring of a patient's sonogram can be used to assess lung involvement. METHODS: The purpose of this study was to establish a lung involvement assessment model based on deep learning. A novel multimodal channel and receptive field attention network combined with ResNeXt (MCRFNet) was proposed to classify sonograms, and the network can automatically fuse shallow features and determine the importance of different channels and respective fields. Finally, sonogram classes were transformed into scores to evaluate lung involvement from the initial diagnosis to rehabilitation. RESULTS AND CONCLUSION: Using multicenter and multimodal ultrasound data from 104 patients, the diagnostic model achieved 94.39% accuracy, 82.28% precision, 76.27% sensitivity, and 96.44% specificity. The lung involvement severity and the trend of COVID-19 pneumonia were evaluated quantitatively.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Pneumonia/diagnostic imaging , Ultrasonography , Algorithms , Databases, Factual , False Positive Reactions , Humans , Image Processing, Computer-Assisted/methods , Models, Statistical , Neural Networks, Computer , Programming Languages , Reproducibility of Results , Sensitivity and Specificity , Software
11.
Med Sci Monit ; 27: e932092, 2021 Mar 17.
Article in English | MEDLINE | ID: covidwho-1138933

ABSTRACT

This manuscript has been retracted due to the identification of undeclared duplication of content, including Figure images, from a -previous publication by some of the authors: Wang C, Xie J, Zhao L, Fei X, Zhang H, Tan Y, Nie X, Zhou L, Liu Z, Ren Y, Yuan L, Zhang Y, Zhang J, Liang L, Chen X, Liu X, Wang P, Han X, Weng X, Chen Y, Yu T, Zhang X, Cai J, Chen R, Shi ZL, Bian XW. Alveolar macrophage dysfunction and cytokine storm in the pathogenesis of two severe COVID-19 patients. EBioMedicine. 2020; 57: 102833. All authors are requested to declare that manuscripts submitted to this journal are original. This journal makes clear that research fraud of any kind will not be tolerated and will result in immediate retraction.

12.
Soc Psychiatry Psychiatr Epidemiol ; 56(12): 2275-2286, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1092643

ABSTRACT

PURPOSE: To evaluate the prevalence of and risk factors associated with anxiety, depression, and insomnia symptoms during the return-to-work period of coronavirus disease 2019 in China. METHODS: The authors conducted a large-scale, nationwide, multicenter, cross-sectional study in China. A population-based quota and snowball sampling were designed to recruit a representative sample. Online questionnaires and telephone reviews were used to collect characteristics and assess psychological and sleep problems. Anxiety, depression, and insomnia symptoms were measured by the generalized anxiety disorder-7, patient health questionnaire-9, and insomnia severity index tools. RESULTS: A total of 42,000 participants were recruited from 15 centers, and 36,795 valid questionnaires were received. Generally, 18.3, 14.9, and 17.9% of the participants had anxiety, depression, and insomnia symptoms, respectively, and 2.2-2.7% had severe symptoms. Engaging in outside activity once in ≥ 30 days (OR = 2.719, OR = 2.074, OR = 2.225) and age 50-64 years (OR = 2.431, OR = 1.936, OR = 2.036) were common risk factors for anxiety, depression and insomnia symptoms. Living in Hubei Province (OR = 1.304, OR = 1.242) was a common risk factor for anxiety and insomnia symptoms. Working as frontline medical staff (OR = 2.150) was another risk factor for anxiety symptoms. The health education rate of the samples reached 98.9%. However, the psychological intervention rate was only 16.2%, and 2.5% received targeted interventions. CONCLUSIONS: An increasing number of people might have psychological and sleep problems. However, the current psychological interventions are not sufficient. Efforts should be made to strengthen interventions for high-risk populations.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Anxiety/epidemiology , Anxiety Disorders/epidemiology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Humans , Middle Aged , Prevalence , Return to Work , Risk Factors , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology
13.
Natl Sci Rev ; 7(12): 1868-1878, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1087785

ABSTRACT

Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of 12 COVID-19 decedents-findings that evaluated histopathological changes, immune cell signature and inflammatory factor expression in the lungs, spleen and lymph nodes. Here we show that the major pulmonary alterations included diffuse alveolar damage, interstitial fibrosis and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration and abundant production of inflammatory factors (IL-6, IP-10, TNFα and IL-1ß). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.

14.
Urologia ; 88(3): 232-236, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-999439

ABSTRACT

BACKGROUND: The COVID-19 is a challenge for both patients and physicians in emergency department (ED). This study was aimed to report the impacts of the COVID-19 outbreak on visits and treatments for patients with ureteral stones in a general hospital ED. METHODS: The patients with ureteral stones were collected from 24 January to 24 March 2020 during the COVID-19 outbreak in Beijing. Two periods were divided for study: 24 January to 24 February (Period 1) and 25 February to 24 March (Period 2). Data on patients' characteristics, attendance, visual analog scale (VAS) scores, stone features, and final treatment choices were retrieved from the computer and compared with the data in the same periods in 2019. RESULTS: The study included 376 patients with ureteral stones during the COVID-19 outbreak periods in 2020 and 343 patients during the same periods in 2019. Compared with the same periods in 2019, the number of patients with ureteral stones was less in Period 1 (137 vs 163) but had a rebound phenomenon in Period 2 (239 vs 180). The visit frequency was significantly reduced (2.6 ± 0.4 vs 3.6 ± 0.8, p < 0.01) and the VAS scores and the onset time increased (7.7 ± 1.3 vs 5.5 ± 1.6, p < 0.01; 7.4 ± 1.8 vs 8.2 ± 1.5, p < 0.01, respectively) in Period 1. More patients chose oral analgesics medication to release from renal colic in the COVID-19 outbreak period instead of ESWL and intravenous analgesics medication (Period 1, 54.0% vs 20.2%, p < 0.01; Period 2, 20.9% vs 13.3%, p = 0.044; respectively). However, the percentage of patients underwent endoscopy surgery in outbreak period showed no significant difference compared with that in 2019. CONCLUSION: These results showed that the COVID-19 outbreak can directly affect the visits and final treatment choices for patients with ureteral stones.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Hospitals, General/statistics & numerical data , Hospitals, Urban/statistics & numerical data , Patient Acceptance of Health Care , SARS-CoV-2 , Ureteral Calculi/epidemiology , Administration, Oral , Adult , Analgesics/administration & dosage , Analgesics/therapeutic use , China/epidemiology , Cross-Sectional Studies , Decision Making, Shared , Female , Humans , Injections, Intravenous , Lithotripsy/statistics & numerical data , Male , Middle Aged , Procedures and Techniques Utilization , Renal Colic/drug therapy , Renal Colic/etiology , Ureteral Calculi/complications , Ureteral Calculi/therapy , Ureteroscopy/statistics & numerical data , Young Adult
15.
Eur Psychiatry ; 63(1): e77, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-992607

ABSTRACT

BACKGROUND.: During the outbreak of coronavirus disease 2019 (COVID-19), people are under the dual pressure of interpersonal isolation and concerns about infection. An evaluation of people's psychological status and risk factors is needed to conduct target interventions. METHODS.: This was a nationwide, multicenter, cross-sectional study using quota and snowball sampling methods during the COVID-19 epidemic in China. Participants' characteristics and experiences were obtained by an online questionnaire and telephone review. Psychological distress and sleep problems were measured by the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Insomnia Severity Index. RESULTS.: A total of 23,500 participants were recruited, and 19,372 valid questionnaires were received from 11 centers. Overall, 11.0-13.3% of the participants had anxiety, depression, or insomnia symptoms, and 1.9-2.7% had severe symptoms. The prevalence of psychological and sleep problems has increased. Working as frontline medical staff (Odds Ratio OR = 3.406), living in Hubei Province (OR = 2.237), close contacts with COVID-19 (OR = 1.808), and age 35-49 years (OR = 1.310) were risk factors for anxiety symptoms; no outside activity for 2 weeks (OR = 2.167) and age 35-49 years (OR = 1.198) were risk factors for depression symptoms; and living in Hubei Province (OR = 2.376), no outside activity for 2 weeks (OR = 1.927), and age 35-49 years (OR = 1.262) were risk factors for insomnia symptoms. Only 1.9% of participants received counseling during the epidemic. CONCLUSIONS.: Psychological and sleep problems increased during interpersonal isolation due to COVID-19. Current psychological interventions are far from sufficient.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Mental Health/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Sleep Initiation and Maintenance Disorders/epidemiology , Social Isolation/psychology , Stress, Psychological/epidemiology , Adolescent , Adult , Aged , Anxiety/epidemiology , COVID-19 , Child , Coronavirus Infections/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Middle Aged , Pneumonia, Viral/psychology , Prevalence , Surveys and Questionnaires , Young Adult
16.
J Psychosom Res ; 138: 110253, 2020 11.
Article in English | MEDLINE | ID: covidwho-779327

ABSTRACT

OBJECTIVE: In this study, the authors analyzed the status of anxiety depression and insomnia symptoms and influential factors in the work resumption period of Coronavirus disease 2019 (COVID-19). METHODS: A multicenter cross-sectional survey was conducted from March 2, 2020 to March 8, 2020 in Shandong Province, China, using quota sampling combined with snowball sampling. The Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index (ISI) were used to assess the anxiety, depression, and insomnia symptoms. The multivariate logistic regression analysis was used to explore the influential factors. RESULTS: A total of 4000 invitations were sent from three centers, 3237 valid questionnaires were received. Based on GAD-7, PHQ-9, and ISI scales, 19.5%-21.7% of the participants had anxiety, depression, or insomnia symptoms; 2.9%-5.6% had severe symptoms. Besides, 2.4%, 4.8%, and 4.5% of the participants had anxiety-depression, anxiety-insomnia, or depression-insomnia combined symptoms. The scores of anxiety and insomnia symptoms, along with scores of depression and insomnia symptoms were positively correlated in these samples. Aged 50-64 years and outside activities once in ≥30 days were risk factors of anxiety, depression, and insomnia symptoms in common. During the epidemic, 17.4% of the participants had received psychological interventions, and only 5.2% had received individual interventions. CONCLUSIONS: The incidence of psychological distress increased during the outbreak of COVID-19 in the work resumption period than the normal period. Current psychological interventions were insufficient; target psychological interventions should be conducted in time.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/psychology , Depression/epidemiology , Epidemics , Pneumonia, Viral/psychology , Sleep Initiation and Maintenance Disorders/epidemiology , Work/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , China/epidemiology , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Risk Factors , Surveys and Questionnaires , Young Adult
17.
EBioMedicine ; 57: 102833, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-613483

ABSTRACT

BACKGROUND: The novel coronavirus pneumonia COVID-19 caused by SARS-CoV-2 infection could lead to a series of clinical symptoms and severe illnesses, including acute respiratory distress syndrome (ARDS) and fatal organ failure. We report the fundamental pathological investigation in the lungs and other organs of fatal cases for the mechanistic understanding of severe COVID-19 and the development of specific therapy in these cases. METHODS: The autopsy and pathological investigations of specimens were performed on bodies of two deceased cases with COVID-19. Gross anatomy and histological investigation by Hematoxylin and eosin (HE) stained were reviewed on each patient. Alcian blue/periodic acid-Schiff (AB-PAS) staining and Masson staining were performed for the examinations of mucus, fibrin and collagen fiber in lung tissues. Immunohistochemical staining was performed on the slides of lung tissues from two patients. Real-time PCR was performed to detect the infection of SARS-CoV-2. Flow cytometry analyses were performed to detect the direct binding of S protein and the expression of ACE2 on the cell surface of macrophages. FINDINGS: The main pathological features in lungs included extensive impairment of type I alveolar epithelial cells and atypical hyperplasia of type II alveolar cells, with formation of hyaline membrane, focal hemorrhage, exudation and pulmonary edema, and pulmonary consolidation. The mucous plug with fibrinous exudate in the alveoli and the dysfunction of alveolar macrophages were characteristic abnormalities. The type II alveolar epithelial cells and macrophages in alveoli and pulmonary hilum lymphoid tissue were infected by SARS-CoV-2. S protein of SARS-CoV-2 directly bound to the macrophage via the S-protein-ACE2 interaction. INTERPRETATION: Infection of alveolar macrophage by SARS-CoV-2 might be drivers of the "cytokine storm", which might result in damages in pulmonary tissues, heart and lung, and lead to the failure of multiple organs . FUNDING: Shanghai Guangci Translational Medical Research Development Foundation, Shanghai, China.


Subject(s)
Alveolar Epithelial Cells/pathology , Coronavirus Infections/pathology , Cytokine Release Syndrome/pathology , Lung/pathology , Macrophages, Alveolar/pathology , Pneumonia, Viral/pathology , Angiotensin-Converting Enzyme 2 , Autopsy , Betacoronavirus , COVID-19 , China , Coronavirus Infections/mortality , Cytokine Release Syndrome/mortality , Cytokines/blood , Cytokines/metabolism , Female , Humans , Hyperplasia/pathology , Male , Middle Aged , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/mortality , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/metabolism
18.
Crit Care ; 24(1): 334, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-594759

ABSTRACT

The handheld ultrasound demonstrates clinical and economic value in combating COVID-19 based on interviews with frontline ultrasound physician and cardiologist as well as a national expert in medical ultrasound.


Subject(s)
Betacoronavirus , Computers, Handheld/standards , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Ultrasonography, Interventional/instrumentation , Attitude of Health Personnel , COVID-19 , Coronavirus Infections/therapy , Diagnosis, Computer-Assisted/instrumentation , Humans , Pandemics , Pneumonia, Viral/therapy , Point-of-Care Systems , SARS-CoV-2 , Ultrasonography, Interventional/methods
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