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1.
Front Psychol ; 13: 809520, 2022.
Article in English | MEDLINE | ID: covidwho-1879476

ABSTRACT

The unprecedented public panic caused by COVID-19 will affect the recovery of tourism, especially the theme parks, which are generally crowded due to high visitor volume. The purpose of this study is to discuss the effect of the COVID-19 on the theme park industry. This study aims to predict recommendation intentions of theme park visitors by exploring the complicated mechanism derived from the fear of COVID-19. This study uses a quantitative research method, and SPSS 20.0 and AMOS 22.0 were used for data analysis. An online survey was conducted with 420 Chinese respondents who visited Shanghai Disneyland after its reopening. The study explored the relationship between Fear of COVID-19, perceived risk, participation, service experience, and revisit intention. Results indicated the perceived risk of theme park visitors will not directly ruin their recommendation intention. Visitors' fear of COVID-19 enhanced their perceived risk, reduced their desire for active participation and impaired their service experience, which consequently affected their recommendation intention. We provide theoretical and managerial implications.

3.
Frontiers in psychology ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1738331

ABSTRACT

The unprecedented public panic caused by COVID-19 will affect the recovery of tourism, especially the theme parks, which are generally crowded due to high visitor volume. The purpose of this study is to discuss the effect of the COVID-19 on the theme park industry. This study aims to predict recommendation intentions of theme park visitors by exploring the complicated mechanism derived from the fear of COVID-19. This study uses a quantitative research method, and SPSS 20.0 and AMOS 22.0 were used for data analysis. An online survey was conducted with 420 Chinese respondents who visited Shanghai Disneyland after its reopening. The study explored the relationship between Fear of COVID-19, perceived risk, participation, service experience, and revisit intention. Results indicated the perceived risk of theme park visitors will not directly ruin their recommendation intention. Visitors’ fear of COVID-19 enhanced their perceived risk, reduced their desire for active participation and impaired their service experience, which consequently affected their recommendation intention. We provide theoretical and managerial implications.

4.
Lancet Respir Med ; 10(6): 573-583, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1740330

ABSTRACT

BACKGROUND: Awake prone positioning has been broadly utilised for non-intubated patients with COVID-19-related acute hypoxaemic respiratory failure, but the results from published randomised controlled trials (RCTs) in the past year are contradictory. We aimed to systematically synthesise the outcomes associated with awake prone positioning, and evaluate these outcomes in relevant subpopulations. METHODS: In this systematic review and meta-analysis, two independent groups of researchers searched MEDLINE, Embase, PubMed, Web of Science, Scopus, MedRxiv, BioRxiv, and ClinicalTrials.gov for RCTs and observational studies (with a control group) of awake prone positioning in patients with COVID-19-related acute hypoxaemic respiratory failure published in English from Jan 1, 2020, to Nov 8, 2021. We excluded trials that included patients intubated before or at enrolment, paediatric patients (ie, younger than 18 years), or trials that did not include the supine position in the control group. The same two independent groups screened studies, extracted the summary data from published reports, and assessed the risk of bias. We used a random-effects meta-analysis to pool individual studies. We used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty and quality of the evidence. The primary outcome was the reported cumulative intubation risk across RCTs, and effect estimates were calculated as risk ratios (RR;95% CI). The analysis was primarily conducted on RCTs, and observational studies were used for sensitivity analyses. No serious adverse events associated with awake prone positioning were reported. The study protocol was prospectively registered with PROSPERO, CRD42021271285. FINDINGS: A total of 1243 studies were identified, we assessed 138 full-text articles and received the aggregated results of three unpublished RCTs; therefore, after exclusions, 29 studies were included in the study. Ten were RCTs (1985 patients) and 19 were observational studies (2669 patients). In ten RCTs, awake prone positioning compared with the supine position significantly reduced the need for intubation in the overall population (RR 0·84 [95% CI 0·72-0·97]). A reduced need for intubation was shown among patients who received advanced respiratory support (ie, high-flow nasal cannula or non-invasive ventilation) at enrolment (RR 0·83 [0·71-0·97]) and in intensive care unit (ICU) settings (RR 0·83 [0·71-0·97]) but not in patients receiving conventional oxygen therapy (RR 0·87 [0·45-1·69]) or in non-ICU settings (RR 0·88 [0·44-1·76]). No obvious risk of bias and publication bias was found among the included RCTs for the primary outcome. INTERPRETATION: In patients with COVID-19-related acute hypoxaemic respiratory failure, awake prone positioning reduced the need for intubation, particularly among those requiring advanced respiratory support and those in ICU settings. Awake prone positioning should be used in patients who have acute hypoxaemic respiratory failure due to COVID-19 and require advanced respiratory support or are treated in the ICU. FUNDING: OpenAI, Rice Foundation, National Institute for Health Research, and Oxford Biomedical Research Centre.


Subject(s)
COVID-19 , Respiratory Insufficiency , COVID-19/complications , Child , Humans , Patient Positioning/methods , Prone Position , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Wakefulness
5.
Allergy Asthma Clin Immunol ; 17(1): 67, 2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1690881

ABSTRACT

BACKGROUND: A significant portion of COVID-19 sufferers have asthma. The impacts of asthma on COVID-19 progression are still unclear but a modifying effect is plausible as respiratory viruses are acknowledged to be an important trigger for asthma exacerbations and a different, potentially type-2 biased, immune response might occur. In this study, we compared the blood circulating cytokine response to COVID-19 infection in patients with and without asthma. METHODS: Plasma samples and clinical information were collected from 80 patients with mild (25), severe (36) or critical (19) COVID-19 and 29 healthy subjects at the John Radcliffe Hospital, Oxford, UK. The concentrations of 51 circulating proteins in the plasma samples were measured with Luminex and compared between groups. RESULTS: Total 16 pre-existing asthma patients were found (3 in mild, 10 in severe, and 3 in critical COVID-19). The prevalence of asthma in COVID-19 severity groups did not suggest a clear correlation between asthma and COVID-19 severity. Within the same COVID-19 severity group, no differences were observed between patients with or without asthma on oxygen saturation, CRP, neutrophil counts, and length of hospital stay. The mortality in the COVID-19 patients with asthma (12.5%) was not higher than that in patients without asthma (17.2%). No significant difference was found between asthmatic and non-asthmatic in circulating cytokine response in different COVID-19 severity groups, including the cytokines strongly implicated in COVID-19 such as CXCL10, IL-6, CCL2, and IL-8. CONCLUSIONS: Pre-existing asthma was not associated with an enhanced cytokine response after COVID-19 infection, disease severity or mortality.

6.
Int J Environ Res Public Health ; 19(4)2022 02 14.
Article in English | MEDLINE | ID: covidwho-1690236

ABSTRACT

The recovery of the tourism industry is an important issue that has attracted much attention during the COVID-19 pandemic. Sustainable and safe festival tourism is considered an effective way of aiding in the recovery of the industry. A face-to-face survey of participants in the Guangzhou Hanfu Festival was conducted to examine the relationship between fears of COVID-19, perceived risks, perceptual evaluations, festival attitudes, behavioral intentions, and crowding during this difficult time. Results clarified how fear affects behavioral intentions in festival research, and the mediation role of perceived risk and the moderation role of crowding was confirmed. A timely set of recommendations was provided to festival operators and local governments.


Subject(s)
COVID-19 , COVID-19/epidemiology , Fear , Holidays , Humans , Intention , Pandemics , SARS-CoV-2
7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323568

ABSTRACT

Background: There is limited information on the difference in epidemiology, clinical characteristics and outcomes of the initial outbreak of the coronavirus disease (COVID-19) in Wuhan (the epicenter) and Sichuan (the peripheral area) in the early phase of the COVID-19 pandemic. This study was conducted to investigate the differences in the epidemiological and clinical characteristics of patients with COVID-19 between the epicenter and peripheral areas of pandemic and thereby generate information that would be potentially helpful in formulating clinical practice recommendations to tackle the COVID-19 pandemic. Methods: The Sichuan & Wuhan Collaboration Research Group for COVID-19 established two retrospective cohorts that separately reflect the epicenter and peripheral area during the early pandemic. The epidemiology, clinical characteristics and outcomes of patients in the two groups were compared. Multivariate regression analyses were used to estimate the adjusted odds ratios (aOR) with regard to the outcomes. Results: The Wuhan (epicenter) cohort included 710 randomly selected patients, and the peripheral (Sichuan) cohort included 474 consecutive patients. A higher proportion of patients from the periphery had upper airway symptoms, whereas a lower proportion of patients in the epicenter had lower airway symptoms and comorbidities. Patients in the epicenter had a higher risk of death (aOR=7.64), intensive care unit (ICU) admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03, respectively), and prolonged duration of viral shedding (aOR=1.64). Conclusions: The worse outcomes in the epicenter could be explained by the prolonged time from illness onset to hospital and ICU admission. This could potentially have been associated with elevated systemic inflammation secondary to organ dysfunction and prolonged duration of virus shedding independent of age and comorbidities. Thus, early supportive care could achieve better clinical outcomes.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322987

ABSTRACT

Background: Border malaria remain as one of the greatest challenges facing elimination in China. Malaria control interventions among migrant population across border relies on personal protection from mosquito bites. Understanding the knowledge of the link between mosquitoes and malaria will inform malaria control and elimination programmes on those targeted risk population.MethodsFrom March 2018 to September 2019, 108 migrant workers from Vietnam were enrolled conducted in Ning Ming County in Guangxi. Each people were interviewed using the structured questionnaires. Blood samples were collected and sent to the PCR detection and sequenced.ResultsMalaria knowledge was poor with 19.4% on transmission, 23.2% on clinical symptoms, 7.4% on awareness of the risk of death, and 14.8% on awareness of prevention methods. No significant difference was found among occupations except for migrant workers, whose knowledge rate were higher than other occupations. Most of the participants (80.6%) had mosquito nets and 73.2% of them had 2 persons who were under the bed net at night. The usage rate of bed-nets accounted for over 49.1%. For parasitological study, 5.6% (n = 6) of all participants infected tested positive for malaria, and no statistically significant differences in the positive rate among different age, sex, family size, nationality, occupation and different behaviors.ConclusionThe health education focus on the high risk population such as migrant workers and forest goers should be strengthened. Therefore, health education based on verbal communication such as web, radio, and mobile phone may be required under the COVID-19 pandemic situation. Further risk assessment of importation and proactive case detection should also be carried out, not only in Ningming County, but also in other border counties in Guangxi, which aimed to timely detect the patients, as well as the asymptomatic infections that could cause the re-establishment of malaria.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325195

ABSTRACT

Background: COVID-19 is a globally emerging infectious disease. As the global epidemic continues to spread, the risk of COVID-19 transmission and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia from Wuhan. Methods: : Patients with COVID-19 pneumonia admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models. Results: : 106 (61.3%) of the patients were female. The mean age of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension (24.9%). The most common symptoms on admission were fever (67.6%) and cough (60.1%), digestive symptoms (22.0%) was also very common. Older age (OR: 3.420;95%Cl: 1.415-8.266;P=0.006), diarrhea (OR: 0.143;95%Cl: 0.033-0.611;P=0.009) and lymphopenia (OR: 4.769;95%Cl: 2.019-11.266;P=0.000) were associated with severe illness on admission;the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918;P=0.000). Older age (OR: 0.309;95%Cl: 0.142-0.674;P=0.003), leucopenia (OR: 0.165;95%Cl: 0.034-0.793;P=0.025), increased lactic dehydrogenase (OR: 0.257;95%Cl: 0.100-0.659;P=0.005) and interleukins-6 levels (OR: 0.294;95%Cl: 0.099-0.872;P=0.027) were associated with poor in-hospital outcome;AUC of predictive model were 0.752 (95%CI: 0.681-0.824;P=0.000). Conclusion: Older patients with diarrhea and lymphopenia need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome. Trial registration: ChiCTR2000029549

10.
Wireless Communications & Mobile Computing (Online) ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-1642942

ABSTRACT

The implementation of immunity passport has been hampered by the controversies over vaccines in various countries, the privacy of vaccinators, and the forgery of passports. While some existing schemes have been devoted to accelerating this effort, the problems above are not well solved in existing schemes. In this paper, we present an immunity passport scheme based on the dual-blockchain architecture, which frees people from the cumbersome epidemic prevention process while traveling abroad. Specially, the dual-blockchain architecture is established to fit with the scenarios of immunity passport. Searchable encryption and anonymous authentication are utilized to ensure users’ privacy. In addition, the performance and security evaluations show that our scheme achieves the proposed security goals and surpasses other authentication schemes in communicational and computational overheads.

11.
PLoS Pathog ; 17(9): e1009804, 2021 09.
Article in English | MEDLINE | ID: covidwho-1416909

ABSTRACT

Prior studies have demonstrated that immunologic dysfunction underpins severe illness in COVID-19 patients, but have lacked an in-depth analysis of the immunologic drivers of death in the most critically ill patients. We performed immunophenotyping of viral antigen-specific and unconventional T cell responses, neutralizing antibodies, and serum proteins in critically ill patients with SARS-CoV-2 infection, using influenza infection, SARS-CoV-2-convalescent health care workers, and healthy adults as controls. We identify mucosal-associated invariant T (MAIT) cell activation as an independent and significant predictor of death in COVID-19 (HR = 5.92, 95% CI = 2.49-14.1). MAIT cell activation correlates with several other mortality-associated immunologic measures including broad activation of CD8+ T cells and non-Vδ2 γδT cells, and elevated levels of cytokines and chemokines, including GM-CSF, CXCL10, CCL2, and IL-6. MAIT cell activation is also a predictor of disease severity in influenza (ECMO/death HR = 4.43, 95% CI = 1.08-18.2). Single-cell RNA-sequencing reveals a shift from focused IFNα-driven signals in COVID-19 ICU patients who survive to broad pro-inflammatory responses in fatal COVID-19 -a feature not observed in severe influenza. We conclude that fatal COVID-19 infection is driven by uncoordinated inflammatory responses that drive a hierarchy of T cell activation, elements of which can serve as prognostic indicators and potential targets for immune intervention.


Subject(s)
COVID-19/immunology , COVID-19/mortality , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Antigens, CD/immunology , Antigens, Differentiation, T-Lymphocyte/immunology , B-Lymphocytes/immunology , Biomarkers/blood , Blood Proteins/metabolism , Cohort Studies , Critical Illness/mortality , Female , Humans , Immunophenotyping , Influenza, Human/immunology , Lectins, C-Type/immunology , Lymphocyte Activation , Male , Middle Aged , Mucosal-Associated Invariant T Cells/immunology , Patient Acuity
12.
Psychol Res Behav Manag ; 14: 1371-1378, 2021.
Article in English | MEDLINE | ID: covidwho-1405368

ABSTRACT

PURPOSE: The COVID-19 pandemic may increase the development of psychiatric disorders, such as posttraumatic stress disorder (PTSD) among medical staff. A brief validated screening tool is essential for the early diagnosis of PTSD. The purpose of the present study was to evaluate the validation of a Chinese version of the Primary Care-PTSD-5 (C-PC-PTSD-5) and determine an appropriate cutoff score with optimal sensitivity and specificity for medical staff in China during the COVID-19 pandemic. PARTICIPANTS AND METHODS: An online cross-sectional survey was conducted on medical staff (n = 1104) from 17 medical institutions in Shanghai. Questionnaires comprising general information, medical-related traumatic event experiences, the PTSD Checklist (PCL-5), and C-PC-PTSD-5 were distributed to participants using the online Questionnaire Star electronic system. Internal consistency, convergent validity, and test-retest reliability were calculated. Receiver operating characteristic (ROC) analysis was performed to determine diagnostic accuracy and the optimal cutoff score of the C-PC-PTSD-5 for medical staff. RESULTS: We included 1062 valid questionnaires for the analysis. Data of 838 traumatic experiences were analyzed. Internal consistency of the C-PC-PTSD-5 was satisfied (Cronbach's α = 0.756). The total score of the C-PC-PTSD-5 showed good test-retest reliability (r = 0.746). We found a strong correlation between the C-PC-PTSD-5 score and PCL-5 total score (r = 0.669, p < 0.001), which indicated good convergent validity. The ROC analysis showed an area under the curve of 0.81 ± 0.016. A cutoff score of 2 provided optimal sensitivity and specificity for the C-PC-PTSD-5 (sensitivity = 0.632, specificity = 0.871, Youden index = 0.503, and overall efficiency = 0.768). CONCLUSION: Our results indicated that the C-PC-PTSD-5 can be employed as a brief and efficient screening instrument for medical staff exposed to the COVID-19 pandemic. A score of 2 was identified as the optimal threshold for probable clinical PTSD symptoms.

13.
Nat Prod Res ; 34(16): 2249-2254, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1343564

ABSTRACT

The enhanced osteoblast differentiation is beneficial to the prevention of osteoporosis. In this study, a homogeneous polysaccharide (LRP-S2A) with the potential of promoting osteoblast differentiation was obtained from the fruits of Lycium ruthenicum, a traditional herb for treatment of postmenopausal metabolic disorders. Structural identification indicated that LRP-S2A, with a relative molecular weight of 2.65 × 106 Da and an uronic acid content of 41.8%, contained Rha, Ara, Gal, Glc and GlcA in a molar ratio of 1.00 : 2.07 : 0.57 : 2.59 : 4.33 and was composed of a backbone consisting of 6-O-Me-α-(1→4)-D-GlcpA, 2-O-acetyl-α-(1→4)-D-Glcp, α-(1→2,4)-L-Rhap, ß-(1→3)-D-Galp andα-(1→3,5)-L-Araf, and some branches consisting of 6-O-Me-α-(1→4)-D-GlcpA and terminal α-L-Araf. These results suggested that LRP-S2A with the potential of promoting osteoblast differentiation was a new acidic polysaccharide.


Subject(s)
Cell Differentiation/drug effects , Lycium/chemistry , Osteoblasts/cytology , Polysaccharides/chemistry , Animals , Cells, Cultured , Fruit/chemistry , Humans , Molecular Weight , Polysaccharides/pharmacology , Uronic Acids/analysis
14.
Allergy Asthma Clin Immunol ; 17(1): 67, 2021 Jul 08.
Article in English | MEDLINE | ID: covidwho-1301885

ABSTRACT

BACKGROUND: A significant portion of COVID-19 sufferers have asthma. The impacts of asthma on COVID-19 progression are still unclear but a modifying effect is plausible as respiratory viruses are acknowledged to be an important trigger for asthma exacerbations and a different, potentially type-2 biased, immune response might occur. In this study, we compared the blood circulating cytokine response to COVID-19 infection in patients with and without asthma. METHODS: Plasma samples and clinical information were collected from 80 patients with mild (25), severe (36) or critical (19) COVID-19 and 29 healthy subjects at the John Radcliffe Hospital, Oxford, UK. The concentrations of 51 circulating proteins in the plasma samples were measured with Luminex and compared between groups. RESULTS: Total 16 pre-existing asthma patients were found (3 in mild, 10 in severe, and 3 in critical COVID-19). The prevalence of asthma in COVID-19 severity groups did not suggest a clear correlation between asthma and COVID-19 severity. Within the same COVID-19 severity group, no differences were observed between patients with or without asthma on oxygen saturation, CRP, neutrophil counts, and length of hospital stay. The mortality in the COVID-19 patients with asthma (12.5%) was not higher than that in patients without asthma (17.2%). No significant difference was found between asthmatic and non-asthmatic in circulating cytokine response in different COVID-19 severity groups, including the cytokines strongly implicated in COVID-19 such as CXCL10, IL-6, CCL2, and IL-8. CONCLUSIONS: Pre-existing asthma was not associated with an enhanced cytokine response after COVID-19 infection, disease severity or mortality.

15.
BMC Infect Dis ; 21(1): 206, 2021 Feb 24.
Article in English | MEDLINE | ID: covidwho-1102331

ABSTRACT

BACKGROUND: There is limited information on the difference in epidemiology, clinical characteristics and outcomes of the initial outbreak of the coronavirus disease (COVID-19) in Wuhan (the epicenter) and Sichuan (the peripheral area) in the early phase of the COVID-19 pandemic. This study was conducted to investigate the differences in the epidemiological and clinical characteristics of patients with COVID-19 between the epicenter and peripheral areas of pandemic and thereby generate information that would be potentially helpful in formulating clinical practice recommendations to tackle the COVID-19 pandemic. METHODS: The Sichuan & Wuhan Collaboration Research Group for COVID-19 established two retrospective cohorts that separately reflect the epicenter and peripheral area during the early pandemic. The epidemiology, clinical characteristics and outcomes of patients in the two groups were compared. Multivariate regression analyses were used to estimate the adjusted odds ratios (aOR) with regard to the outcomes. RESULTS: The Wuhan (epicenter) cohort included 710 randomly selected patients, and the peripheral (Sichuan) cohort included 474 consecutive patients. A higher proportion of patients from the periphery had upper airway symptoms, whereas a lower proportion of patients in the epicenter had lower airway symptoms and comorbidities. Patients in the epicenter had a higher risk of death (aOR=7.64), intensive care unit (ICU) admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03, respectively), and prolonged duration of viral shedding (aOR=1.64). CONCLUSIONS: The worse outcomes in the epicenter could be explained by the prolonged time from illness onset to hospital and ICU admission. This could potentially have been associated with elevated systemic inflammation secondary to organ dysfunction and prolonged duration of virus shedding independent of age and comorbidities. Thus, early supportive care could achieve better clinical outcomes.


Subject(s)
COVID-19/complications , SARS-CoV-2 , Adult , Aged , COVID-19/virology , China/epidemiology , Comorbidity , Female , Humans , Intensive Care Units , Male , Middle Aged , Retrospective Studies , Virus Shedding
17.
Int J Environ Res Public Health ; 17(21)2020 10 27.
Article in English | MEDLINE | ID: covidwho-895362

ABSTRACT

The impacts of COVID-19 are massive. Global tourism is one of the industries that is heavily affected. "Travel bubble", a recent term initiated by travel operators, is a programme that allows tourists to travel to countries nearby without quarantine requirements. This study investigates the relationship amongst fear of COVID-19, travel anxiety, risk attitude and travel intention towards "travel bubble" destinations. Results show that fear of COVID-19, travel anxiety and risk attitude negatively impact travel intention. Furthermore, travel anxiety and risk attitude moderate the indirect impacts between fear of COVID-19 and travel intention. Future research and implications of practices are presented.


Subject(s)
Anxiety/psychology , Coronavirus Infections/psychology , Fear , Intention , Pneumonia, Viral/psychology , Travel/psychology , Adolescent , Adult , Attitude , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Quarantine , SARS-CoV-2 , Young Adult
18.
Medicine (Baltimore) ; 99(39): e22316, 2020 Sep 25.
Article in English | MEDLINE | ID: covidwho-811172

ABSTRACT

BACKGROUND: There is a worldwide outbreak of COVID-19, as the number of patients increases. External treatment of traditional Chinese medicine includes acupuncture, massage, fire needle, cupping, and other alternative therapies. Currently, there are no relevant articles for systematic review. METHODS: We will search the randomized controlled trials related to the external treatment of traditional Chinese medicine (such as, acupuncture, massage, etc) and COVID-19 from inception to June 2020. The following database is our focus area: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-Fang Database. All published randomized controlled trials in English or Chinese related to massage for COVID-19 will be included. Primary outcomes include the influence of external treatment of traditional Chinese medicine on the patients with COVID-19. Secondary outcomes include accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), average hospitalization time, Clinical curative effect, and improved quality of life. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide evidence to judge whether external treatment of traditional Chinese medicine is an effective intervention on the patients with COVID-19. PROSPERO REGISTRATION NUMBER: CRD42020181336.


Subject(s)
Coronavirus Infections/therapy , Medicine, Chinese Traditional/methods , Pneumonia, Viral/therapy , Age Factors , Betacoronavirus , Body Weights and Measures , COVID-19 , Humans , Pandemics , Quality of Life , Randomized Controlled Trials as Topic , Research Design , SARS-CoV-2 , Sex Factors
20.
Medicine (Baltimore) ; 99(35): e21700, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-740200

ABSTRACT

The coronavirus disease 2019 (COVID-19) outbreak has become a global health threat and will likely be one of the greatest global challenges in the near future. The battle between clinicians and the COVID-19 outbreak may be a "protracted war."The objective of this study was to investigate the risk factors for in-hospital mortality in patients with COVID-19, so as to provide a reference for the early diagnosis and treatment.This study retrospectively enrolled 118 patients diagnosed with COVID-19, who were admitted to Eastern District of Renmin Hospital of Wuhan University from February 04, 2020 to March 04, 2020. The demographics and laboratory data were collected and compared between survivors and nonsurvivors. The risk factors of in-hospital mortality were explored by univariable and multivariable logistic regression to construct a clinical prediction model, the prediction efficiency of which was verified by receiver-operating characteristic (ROC) curve.A total of 118 patients (49 males and 69 females) were included in this study; the results revealed that the following factors associated with in-hospital mortality: older age (odds ratio [OR] 1.175, 95% confidence interval [CI] 1.073-1.287, P = .001), neutrophil count greater than 6.3 × 10 cells/L (OR 7.174, (95% CI 2.295-22.432, P = .001), lymphocytopenia (OR 0.069, 95% CI 0.007-0.722, P = .026), prothrombin time >13 seconds (OR 11.869, 95% CI 1.433-98.278, P = .022), D-dimer >1 mg/L (OR 22.811, 95% CI 2.224-233.910, P = .008) and procalcitonin (PCT) >0.1 ng/mL (OR 23.022, 95% CI 3.108-170.532, P = .002). The area under the ROC curve (AUC) of the above indicators for predicting in-hospital mortality were 0.808 (95% CI 0.715-0.901), 0.809 (95% CI 0.710-0.907), 0.811 (95% CI 0.724-0.898), 0.745 (95% CI 0.643-0.847), 0.872 (95% CI 0.804-0.940), 0.881 (95% CI 0.809-0.953), respectively. The AUC of combined diagnosis of these aforementioned factors were 0.992 (95% CI 0.981-1.000).In conclusion, older age, increased neutrophil count, prothrombin time, D-dimer, PCT, and decreased lymphocyte count at admission were risk factors associated with in-hospital mortality of COVID-19. The prediction model combined of these factors could improve the early identification of mortality risk in COVID-19 patients.


Subject(s)
Coronavirus Infections , Fibrin Fibrinogen Degradation Products/analysis , Leukocyte Count , Pandemics , Pneumonia, Viral , Procalcitonin/analysis , Prothrombin Time , Adult , Aged , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/immunology , Coronavirus Infections/mortality , Female , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Leukocyte Count/methods , Leukocyte Count/statistics & numerical data , Male , Pneumonia, Viral/blood , Pneumonia, Viral/immunology , Pneumonia, Viral/mortality , Predictive Value of Tests , Prognosis , Prothrombin Time/methods , Prothrombin Time/statistics & numerical data , Retrospective Studies , Risk Assessment/methods , Risk Factors , SARS-CoV-2
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