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1.
Int J Mol Sci ; 23(18)2022 Sep 18.
Article in English | MEDLINE | ID: covidwho-2039875

ABSTRACT

The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein is the major target for antibody therapeutics. Shark-derived variable domains of new antigen receptors (VNARs) are the smallest antibody fragments with flexible paratopes that can recognize protein motifs inaccessible to classical antibodies. This study reported four VNARs binders (JM-2, JM-5, JM-17, and JM-18) isolated from Chiloscyllium plagiosum immunized with SARS-CoV-2 RBD. Biolayer interferometry showed that the VNARs bound to the RBD with an affinity KD ranging from 38.5 to 2720 nM, and their Fc fusions had over ten times improved affinity. Gel filtration chromatography revealed that JM-2-Fc, JM-5-Fc, and JM-18-Fc could form stable complexes with RBD in solution. In addition, five bi-paratopic VNARs, named JM-2-5, JM-2-17, JM-2-18, JM-5-18, and JM-17-18, were constructed by fusing two VNARs targeting distinct RBD epitopes based on epitope grouping results. All these bi-paratopic VNARs except for JM-5-18 showed higher RBD binding affinities than its component VNARs, and their Fc fusions exhibited further enhanced binding affinities, with JM-2-5-Fc, JM-2-17-Fc, JM-2-18-Fc, and JM-5-18-Fc having KD values lower than 1 pM. Among these Fc fusions of bi-paratopic VNARs, JM-2-5-Fc, JM-2-17-Fc, and JM-2-18-Fc could block the angiotensin-converting enzyme 2 (ACE2) binding to the RBD of SARS-CoV-2 wildtype, Delta, Omicron, and SARS-CoV, with inhibition rates of 48.9~84.3%. Therefore, these high-affinity VNAR binders showed promise as detectors and therapeutics of COVID-19.


Subject(s)
COVID-19 , Sharks , Angiotensin-Converting Enzyme 2 , Animals , COVID-19/drug therapy , Epitopes , Humans , Immunoglobulin Fragments/metabolism , Peptidyl-Dipeptidase A/metabolism , Protein Binding , Receptors, Virus/metabolism , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
2.
Cell Res ; 32(9): 831-842, 2022 09.
Article in English | MEDLINE | ID: covidwho-1967595

ABSTRACT

SARS-CoV-2 variants with adaptive mutations have continued to emerge, causing fresh waves of infection even amongst vaccinated population. The development of broad-spectrum antivirals is thus urgently needed. We previously developed two hetero-bivalent nanobodies (Nbs), aRBD-2-5 and aRBD-2-7, with potent neutralization activity against the wild-type (WT) Wuhan isolated SARS-CoV-2, by fusing aRBD-2 with aRBD-5 and aRBD-7, respectively. Here, we resolved the crystal structures of these Nbs in complex with the receptor-binding domain (RBD) of the spike protein, and found that aRBD-2 contacts with highly-conserved RBD residues and retains binding to the RBD of the Alpha, Beta, Gamma, Delta, Delta plus, Kappa, Lambda, Omicron BA.1, and BA.2 variants. In contrast, aRBD-5 and aRBD-7 bind to less-conserved RBD epitopes non-overlapping with the epitope of aRBD-2, and do not show apparent binding to the RBD of some variants. However, when fused with aRBD-2, they effectively enhance the overall binding affinity. Consistently, aRBD-2-5-Fc and aRBD-2-7-Fc potently neutralized all of the tested authentic or pseudotyped viruses, including WT, Alpha, Beta, Gamma, Delta, and Omicron BA.1, BA.1.1 and BA.2. Furthermore, aRBD-2-5-Fc provided prophylactic protection against the WT and mouse-adapted SARS-CoV-2 in mice, and conferred protection against the Omicron BA.1 variant in hamsters prophylactically and therapeutically, indicating that aRBD-2-5-Fc could potentially benefit the prevention and treatment of COVID-19 caused by the emerging variants of concern. Our strategy provides new solutions in the development of broad-spectrum therapeutic antibodies for COVID-19.


Subject(s)
COVID-19 , Single-Domain Antibodies , Animals , Antibodies, Neutralizing , Antibodies, Viral/therapeutic use , Epitopes , Mice , Mice, Inbred BALB C , SARS-CoV-2 , Single-Domain Antibodies/pharmacology , Spike Glycoprotein, Coronavirus/genetics
3.
Nurse Educ Pract ; 62: 103385, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1921280

ABSTRACT

AIM: The aim of this study was to examine the levels of stress, coping style and burnout among Chinese nursing students in late-stage clinical practice and to identify their relationships. BACKGROUND: High stress, passive coping and burnout among nursing students in late-stage clinical practice may contribute to severe psychological consequences. DESIGN: A descriptive and cross-sectional study was conducted in November and December 2020. METHODS: Participants completed the Perceived Stress Scale, Simplified Coping Style Questionnaire and Maslach Burnout Inventory-Human Service Survey to examine their stress levels, coping style and burnout. Intention to leave the profession was also assessed. RESULTS: Approximately 36.1 % of nursing students experienced emotional exhaustion and 85.3 % of nursing students perceived themselves to have moderate to high stress levels. A positive coping style can protect nursing students from depersonalization and reduced personal accomplishment. High stress and passive coping style predicted emotional exhaustion. Passive coping style and high stress were significant factors leading to intention to quit nursing education before graduation. CONCLUSIONS: Lowering the level of stress and using positive coping behaviors may help students during late internship to mitigate burnout and avoid leaving nursing education. Therefore, nurse educators and clinical nursing mentors need to consider developing strategies and interventions to reduce the decline in nursing students entering nursing education and prevent burnout.


Subject(s)
Students, Nursing , Adaptation, Psychological , Burnout, Psychological , China , Cross-Sectional Studies , Humans
5.
Epidemiol Infect ; 150: e117, 2022 05 25.
Article in English | MEDLINE | ID: covidwho-1900386

ABSTRACT

In the past 10-15 years, the government of China has made various efforts in tackling excessive antibiotics use. Yet, little is known about their effects at rural primary care settings. This study aimed to determine the impact of government policies and the COVID-19 pandemic on antibiotic prescribing practices at such settings utilizing data from separate studies carried out pre- and during the pandemic, in 2016 and 2021 in Anhui province, China, using identical sampling and survey approaches. Data on antibiotics prescribed, diagnosis, socio-demographic, etc., were obtained through non-participative observation and a structured exit survey. Data analysis comprised mainly descriptive comparisons of 1153 and 762 patients with respiratory infections recruited in 2016 and 2021, respectively. The overall antibiotics prescription rate decreased from 89.6% in 2016 to 69.1% in 2021, and the proportion of prescriptions for two or more classes of antibiotics was estimated as 35.9% in 2016 and 11.0% in 2021. There was a statistically significant decrease in the number of days from symptom onset to clinic visits between the year groups. In conclusion, measures to constrain excessive prescription of antibiotics have led to some improvements at the rural primary care level, and the COVID-19 pandemic has had varying effects on antibiotic use.


Subject(s)
COVID-19 , Respiratory Tract Infections , Anti-Bacterial Agents/therapeutic use , COVID-19/drug therapy , COVID-19/epidemiology , China/epidemiology , Humans , Pandemics , Practice Patterns, Physicians' , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/epidemiology
6.
BMJ Open ; 12(4), 2022.
Article in English | ProQuest Central | ID: covidwho-1848930

ABSTRACT

ObjectivesEmergency department physicians and nurses are at high risk of compassion fatigue, burnout and depression. The purpose of this study was to examine the inter-relationship between compassion fatigue, burnout, compassion satisfaction and depression in emergency department physicians and nurses.DesignA cross-sectional study.SettingThis study was conducted in five tertiary hospitals in five different cities across the province of Sichuan, China, in 2021.ParticipantsA total of 342 emergency department physicians and nurses participated in the study.Main outcome measuresCompassion fatigue, burnout, compassion satisfaction and depression scores.ResultsAmong the study participants, 100% were found to have depressive symptoms, 27.8% had low compassion satisfaction, 2.3% had high burnout and 3.8% had compassion fatigue. In the final multiple linear regression model, marital status (p=0.008;95% CI –5.205 to –0.789), history of chronic disease (p=0.003;95% CI –6.461 to –1.386), compassion satisfaction (p<0.001;95% CI 0.593 to 1.274), burnout (p=0.019;95% CI 0.084 to 0.930) and compassion fatigue (p<0.001;95% CI –1.527 to –1.053) among emergency department physicians and nurses were considered to be significant predictors of depression.ConclusionsThe prevalence of depression among emergency department physicians and nurses is high in the province of Sichuan, China. Compassion fatigue, burnout and compassion satisfaction were significantly associated with depression in emergency department physicians and nurses. Hospital administrations should consider these findings to develop appropriate psychological interventions and strategies, to prevent, alleviate or treat severe depression among emergency department physicians and nurses in the province of Sichuan.

7.
COVID ; 2(4):450-463, 2022.
Article in English | MDPI | ID: covidwho-1762176

ABSTRACT

Since 2019, COVID-19 began spreading globally and has significantly affected peoples' daily lifestyles. The public was asked to stay at home for constant quarantine and community containment starting on 23 January 2020. To assess the circadian rhythms and sleep changes and their influential factors during the COVID-19 outbreak, a questionnaire was administered to 451 Chinese participants during 20–31 January 2020. The changes in circadian rhythm, sleep–wake cycle, dining, and exercise of the participants and their correlation with negative emotions were analyzed. Furthermore, the effects of three factors (holiday, quarantine, and concerns regarding the pandemic situation) on these changes were assessed. We found that 34.6% of the participants reported circadian rhythm disturbance. Moreover, 67.2% presented negative emotions (worry, fear, downheartedness, anxiety, depression, and stupefaction) regarding the pandemic situation, among which worry was the most prevalent. Gender and age were significant factors for changes in the circadian phases and emotions. There was a correlation between circadian rhythm alterations and negative emotions. In addition, holiday, quarantine, and concerns regarding the pandemic situation had significant effects on circadian rhythms and sleep in a substantial part of the population. Regression analysis demonstrated reciprocal influences between many of these variables. Our findings suggest that circadian rhythms, sleep, and negative emotions in the normal population need to be considered during the pandemic period and that the adjustment of circadian rhythms could help promote sleep, restore emotions and improve public health.

8.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329660

ABSTRACT

Following Delta, Omicron variant triggered a new wave of SARS-CoV-2 infection globally, adaptive evolution of the virus may not stop, the development of broad-spectrum antivirals is still urgent. We previously developed two hetero-bivalent nanobodies with potent neutralization against original WT SARS-CoV-2, termed aRBD-2-5 and aRBD-2-7, by fusing aRBD-2 with aRBD-5 or aRBD-7, respectively. Here, we resolved crystal structures of these nanobodies in complex with RBD, and found the epitope of aRBD-2 differs from that of aRBD-5, aRBD-7. aRBD-2 binds to a conserved epitope which renders its binding activity to all variants of concern (VOCs) including Omicron. Interestingly, although monovalent aRBD-5 and aRBD-7 lost binding to some variants, they effectively improved the overall affinity when transformed into the hetero-bivalent form after being fused with aRBD-2. Consistent with the high binding affinities, aRBD-2-5-Fc and aRBD-2-7-Fc exhibited ultra-potent neutralization to all five VOCs;particularly, aRBD-2-5-Fc neutralized authentic virus of Beta, Delta and Omicron with the IC50 of 5.98~9.65 ng/mL or 54.3~87.6 pM. Importantly, aRBD-2-5-Fc provided in vivo prophylactic protection for mice against WT and mouse-adapted SARS-CoV-2, and provided full protection against Omicron in hamster model when administrated either prophylactically or therapeutically. Taken together, we found a conserved epitope on RBD, and hetero-bivalent nanobodies had increased affinity for VOCs over its monovalent form, and provided potent and broad-spectrum protection both in vitro and in vivo against all tested major variants, and potentially future emerging variants. Our strategy provides a new solution in the development of therapeutic antibodies for COVID-19 caused by newly emergent VOCs.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321868

ABSTRACT

Background: Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between nutritional risk at admission and in-hospital mortality. Methods: : A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. Nutritional risk was assessed using the Geriatric Nutritional Risk Index (GNRI), the Prognostic Nutritional Index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. Results: : 295 patients were enrolled, including 66 severe patients and 41 critically ill patients. 25 deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI score, as well as higher CONUT, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. Conclusions: : Despite variant assessment tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-291858

ABSTRACT

Background: Highly pathogenic coronavirus disease-2019 (COVID-19) initiated by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has swiftly expanded throughout the world, and the fatality rate is still expanding due to the second wave in 2020 winters. This ongoing epidemic threatens public health with its new strain that emerged in some countries and might cause devastating deaths. Therefore, the host transcriptomic profile from patients during recovery is important for understanding this disease. MethodsWe performed transcriptome profiling of the RNAs isolated from the peripheral blood mononuclear cells (PBMCs) of recovered COVID-19 patients at hospital discharge of three months and five months respectively.ResultsOur results exposed diverse inflammatory genes and cytokine profiles to infection in recovered patients, and emphasize the highly expressed genes in COVID-19 patients like CCL4, CCL3, CXCL9, CXCL16, IL10, CSF2, VEGFA showed a decreasing trend in recovered patients. Furthermore, the integrated analysis predicted that JUN, CTSL, DDIT4, RRAS, BIRC5, CTSZ, CCNB2, CDK1, OAS1/2, IFIT3, RSAD2, and TP53I3 genes may be valuable for the recovery of COVID-19 patients. ConclusionsOur analysis confirms the presence of some inflammatory genes in recovered patients, suggesting COVID-19 patients did not return to their normal expression even after 5-months of discharge. Identification of transcriptome profiling of recovered patients provides useful information regarding its pathogenesis and might help for the development of better treatment for COVID-19.

11.
Front Immunol ; 12: 715464, 2021.
Article in English | MEDLINE | ID: covidwho-1430698

ABSTRACT

The mutants resulted from the ongoing SARS-CoV-2 epidemic have showed resistance to antibody neutralization and vaccine-induced immune response. The present study isolated and identified two novel SARS-CoV-2 neutralizing antibodies (nAbs) from convalescent COVID-19 patients. These two nAbs (XG81 and XG83) were then systemically compared with nine nAbs that were reconstructed by using published data, and revealed that, even though these two nAbs shared targeting epitopes on spike protein, they were different from any of the nine nAbs. Compared with XG81, XG83 exhibited a higher RBD binding affinity and neutralization potency against wild-typed pseudovirus, variant pseudoviruses with mutated spike proteins, such as D614G, E484Q, and A475V, as well as the authentic SARS-CoV-2 virus. To explore potential broadly neutralizing antibodies, heavy and light chains from all 18 nAbs (16 published nAbs, XG81 and XG83) were cross-recombined, and some of the functional antibodies were screened and studied for RBD binding affinity, and neutralizing activity against pseudovirus and the authentic SARS-CoV-2 virus. The results demonstrated that several recombined antibodies had a more potent neutralization activity against variant pseudoviruses compared with the originally paired Abs. Taken together, the novel neutralizing antibodies identified in this study are a likely valuable addition to candidate antibody drugs for the development of clinical therapeutic agents against SARS-CoV-2 to minimize mutational escape.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Broadly Neutralizing Antibodies/immunology , Broadly Neutralizing Antibodies/therapeutic use , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Antibodies, Neutralizing/genetics , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral/genetics , Antibodies, Viral/therapeutic use , Antibody Affinity/immunology , B-Lymphocytes/immunology , Broadly Neutralizing Antibodies/genetics , COVID-19/immunology , COVID-19/therapy , Cell Line , Epitopes/immunology , Humans , Immunotherapy/methods , Neutralization Tests , SARS-CoV-2/drug effects
12.
ACS Sens ; 6(7): 2709-2719, 2021 07 23.
Article in English | MEDLINE | ID: covidwho-1310777

ABSTRACT

The spread of Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), resulting in a global pandemic with around four million deaths. Although there are a variety of nucleic acid-based tests for detecting SARS-CoV-2, these methods have a relatively high cost and require expensive supporting equipment. To overcome these limitations and improve the efficiency of SARS-CoV-2 diagnosis, we developed a microfluidic platform that collected serum by a pulling-force spinning top and paper-based microfluidic enzyme-linked immunosorbent assay (ELISA) for quantitative IgA/IgM/IgG measurements in an instrument-free way. We further validated the paper-based microfluidic ELISA analysis of SARS-CoV-2 receptor-binding domain (RBD)-specific IgA/IgM/IgG antibodies from human blood samples as a good measurement with higher sensitivity compared with traditional IgM/IgG detection (99.7% vs 95.6%) for early illness onset patients. In conclusion, we provide an alternative solution for the diagnosis of SARS-CoV-2 in a portable manner by this smart integration of pulling-force spinning top and paper-based microfluidic immunoassay.


Subject(s)
COVID-19 Testing , COVID-19 , Enzyme-Linked Immunosorbent Assay , Lab-On-A-Chip Devices , Antibodies, Viral/blood , COVID-19/diagnosis , Humans , SARS-CoV-2 , Sensitivity and Specificity
13.
Nutr J ; 20(1): 46, 2021 05 25.
Article in English | MEDLINE | ID: covidwho-1243811

ABSTRACT

BACKGROUND: Could nutritional status serve as prognostic factors for coronavirus disease 2019 (COVID-19)? The present study evaluated the clinical and nutritional characteristics of COVID-19 patients and explored the relationship between risk for malnutrition at admission and in-hospital mortality. METHODS: A retrospective, observational study was conducted in two hospitals in Hubei, China. Confirmed cases of COVID-19 were typed as mild/moderate, severe, or critically ill. Clinical data and in-hospital death were collected. The risk for malnutrition was assessed using the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT) via objective parameters at admission. RESULTS: Two hundred ninety-five patients were enrolled, including 66 severe patients and 41 critically ill patients. Twenty-five deaths were observed, making 8.47% in the whole population and 37.88% in the critically ill subgroup. Patients had significant differences in nutrition-related parameters and inflammatory biomarkers among three types of disease severity. Patients with lower GNRI and PNI, as well as higher CONUT scores, had a higher risk of in-hospital mortality. The receiver operating characteristic curves demonstrated the good prognostic implication of GNRI and CONUT score. The multivariate logistic regression showed that baseline nutritional status, assessed by GNRI, PNI, or CONUT score, was a prognostic indicator for in-hospital mortality. CONCLUSIONS: Despite variant screening tools, poor nutritional status was associated with in-hospital death in patients infected with COVID-19. This study highlighted the importance of nutritional screening at admission and the new insight of nutritional monitoring or therapy.


Subject(s)
COVID-19/epidemiology , Hospital Mortality , Malnutrition/epidemiology , Nutrition Assessment , Nutritional Status , SARS-CoV-2 , Adult , Aged , China/epidemiology , Comorbidity , Critical Illness/mortality , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Severity of Illness Index , Thorax/diagnostic imaging , Tomography, X-Ray Computed
14.
J Virol ; 2021 Mar 03.
Article in English | MEDLINE | ID: covidwho-1117219

ABSTRACT

Cell entry by SARS-CoV-2 requires the binding between the receptor-binding domain (RBD) of the viral Spike protein and the cellular angiotensin-converting enzyme 2 (ACE2). As such, RBD has become the major target for vaccine development, while RBD-specific antibodies are pursued as therapeutics. Here, we report the development and characterization of SARS-CoV-2 RBD-specific VHH/nanobody (Nb) from immunized alpacas. Seven RBD-specific Nbs with high stability were identified using phage display. They bind to SARS-CoV-2 RBD with affinity KD ranging from 2.6 to 113 nM, and six of them can block RBD-ACE2 interaction. The fusion of the Nbs with IgG1 Fc resulted in homodimers with greatly improved RBD-binding affinities (KD ranging from 72.7 pM to 4.5 nM) and nanomolar RBD-ACE2 blocking abilities. Furthermore, the fusion of two Nbs with non-overlapping epitopes resulted in hetero-bivalent Nbs, namely aRBD-2-5 and aRBD-2-7, with significantly higher RBD binding affinities (KD of 59.2 pM and 0.25 nM) and greatly enhanced SARS-CoV-2 neutralizing potency. The 50% neutralization dose (ND50) of aRBD-2-5 and aRBD-2-7 was 1.22 ng/mL (∼0.043 nM) and 3.18 ng/mL (∼0.111 nM), respectively. These high-affinity SARS-CoV-2 blocking Nbs could be further developed into therapeutics as well as diagnostic reagents for COVID-19.ImportanceTo date, SARS-CoV-2 has caused tremendous loss of human life and economic output worldwide. Although a few COVID-19 vaccines have been approved in several countries, the development of effective therapeutics, including SARS-CoV-2 targeting antibodies, remains critical. Due to their small size (13-15 kDa), high solubility, and stability, Nbs are particularly well suited for pulmonary delivery and more amenable to engineer into multivalent formats than the conventional antibody. Here, we report a series of new anti-SARS-CoV-2 Nbs isolated from immunized alpaca and two engineered hetero-bivalent Nbs. These potent neutralizing Nbs showed promise as potential therapeutics against COVID-19.

18.
Nat Commun ; 11(1): 3924, 2020 08 06.
Article in English | MEDLINE | ID: covidwho-695765

ABSTRACT

Several studies show that the immunosuppressive drugs targeting the interleukin-6 (IL-6) receptor, including tocilizumab, ameliorate lethal inflammatory responses in COVID-19 patients infected with SARS-CoV-2. Here, by employing single-cell analysis of the immune cell composition of two severe-stage COVID-19 patients prior to and following tocilizumab-induced remission, we identify a monocyte subpopulation that contributes to the inflammatory cytokine storms. Furthermore, although tocilizumab treatment attenuates the inflammation, immune cells, including plasma B cells and CD8+ T cells, still exhibit robust humoral and cellular antiviral immune responses. Thus, in addition to providing a high-dimensional dataset on the immune cell distribution at multiple stages of the COVID-19, our work also provides insights into the therapeutic effects of tocilizumab, and identifies potential target cell populations for treating COVID-19-related cytokine storms.


Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Betacoronavirus/immunology , Coronavirus Infections/immunology , Cytokines/immunology , Monocytes/immunology , Pneumonia, Viral/immunology , Antibodies, Monoclonal, Humanized/administration & dosage , B-Lymphocytes/drug effects , B-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/immunology , COVID-19 , Computational Biology , Coronavirus Infections/blood , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Cytokines/blood , Humans , Inflammation/drug therapy , Macrophages/drug effects , Macrophages/immunology , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , Receptors, Interleukin-6/immunology , SARS-CoV-2 , Single-Cell Analysis/methods
19.
Front Public Health ; 8: 339, 2020.
Article in English | MEDLINE | ID: covidwho-646611

ABSTRACT

SARS-CoV-2 outbreak has attracted global attention. Verifying the presence of viral RNA is the gold standard for the diagnosis of COVID-19. However, RT-qPCR diagnosis often fails to catch infected patients, because of inconsistent swab sample collection. Here we report a case that showed 5 consecutive negative and 1 low-viral- dose RT-qPCR results during illness spanning over 20 days. Clinical symptoms suggest SARS-CoV-2 infection with typical ground glass like a lung in computed tomography. SARS-CoV-2 infection was serologically confirmed by the presence of anti-SARS-CoV-2 specific antibodies in patients' serum. Finally, a high level of protective IgG was produced after the patient recovered. Surprisingly, as a barber and a housewife staying at home for the first 2 weeks after the onset of illness, none of the close contacts were infected, showing a case of low viral load and low infectivity in this patient.


Subject(s)
COVID-19 , Humans , RNA, Viral/genetics , SARS-CoV-2 , Serologic Tests , Viral Load
20.
Psychol Med ; 52(5): 884-892, 2022 04.
Article in English | MEDLINE | ID: covidwho-633713

ABSTRACT

BACKGROUND: During previous pandemic outbreaks, medical staff have reported high levels of psychological distress. The aim of the current study was to report a snapshot of the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic and its correlated factors on medical staff in Guangdong, China. METHODS: On the 2nd and 3rd February 2020, soon after the start of the COVID-19 pandemic, we surveyed medical staff at four hospitals in Guangdong, China, to collect demographic characteristics, Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-14), and Insomnia Severity Index (ISI) scores. RESULTS: Complete responses were received from 1045 medical staff. Respondents were divided into high- and low-risk groups according to their working environment of contacting with potential or confirmed COVID-19 cases. The proportion of staff with anxiety (55.4% v. 43.0%, p < 0.001) or depression (43.6% v. 36.8%, p = 0.028) was significantly higher in the high-risk group than the low-risk group. The percentage of staff with severe anxiety was similar in the two groups. Doctors were more susceptible to moderate-to-severe depressive symptoms. The high-risk group had higher levels of clinical insomnia (13.5% v. 8.5%, p = 0.011) and were more likely to be in the upper quartile for stress symptoms (24.7% v. 19.3%, p = 0.037) than the low-risk group. Additionally, work experience negatively correlated with insomnia symptoms. CONCLUSIONS: It is important for hospitals and authorities to protect both the physical and psychological health of medical staff during times of pandemic, even those with a low exposure risk.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Anxiety/epidemiology , Anxiety/psychology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Humans , Medical Staff/psychology , Pandemics , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/psychology
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