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1.
Curr Med Sci ; 42(3): 561-568, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1942807

ABSTRACT

OBJECTIVE: To evaluate the impact of hypertension on the clinical outcome of COVID-19 patients aged 60 years old and older. METHODS: This single-center retrospective cohort study enrolled consecutive COVID-19 patients aged 60 years old and older, who were admitted to Liyuan Hospital from January 1, 2020 to April 25, 2020. All included patients were divided into two groups: hypertension and nonhypertension group. The baseline demographic characteristics, laboratory test results, chest computed tomography (CT) images and clinical outcomes were collected and analyzed. The prognostic value of hypertension was determined using binary logistic regression. RESULTS: Among the 232 patients included in the analysis, 105 (45.3%) patients had comorbid hypertension. Compared to the nonhypertension group, patients in the hypertension group had higher neutrophil-to-lymphocyte ratios, red cell distribution widths, lactate dehydrogenase, high-sensitivity C-reactive protein, D-dimer and severity of lung lesion, and lower lymphocyte counts (all P<0.05). Furthermore, the hypertension group had a higher proportion of intensive care unit admissions [24 (22.9%) vs. 14 (11.0%), P=0.02) and deaths [16 (15.2%) vs. 3 (2.4%), P<0.001] and a significantly lower probability of survival (P<0.001) than the nonhypertension group. Hypertension (OR: 4.540, 95% CI: 1.203-17.129, P=0.026) was independently correlated with all-cause in-hospital death in elderly patients with COVID-19. CONCLUSION: The elderly COVID-19 patients with hypertension tend to have worse conditions at baseline than those without hypertension. Hypertension may be an independent prognostic factor of poor clinical outcome in elderly COVID-19 patients.


Subject(s)
COVID-19 , Hypertension , Aged , COVID-19/complications , Hospital Mortality , Humans , Hypertension/complications , Hypertension/epidemiology , Middle Aged , Retrospective Studies , SARS-CoV-2
2.
Expert Rev Vaccines ; : 1-9, 2022 Jul 29.
Article in English | MEDLINE | ID: covidwho-1937581

ABSTRACT

BACKGROUND: As of 2022, inactivated SARS-CoV-2 vaccines had been used in more than 91 countries. However, limited real world information was available on the immune responses of the inactivated SARS-CoV-2 vaccine. METHODS: We used SARS-CoV-2 pseudovirues to determine the neutralizing antibodies (NAbs) to wild type and several global variants and utilized enzyme-linked immunosorbent assay to investigate IFN-γ-secreting T-cell responses to SARS-CoV-2 among 240 vaccinated individuals after two doses of inactivated vaccine in China. RESULTS: A majority of the vaccinated (>90%) developed robust NAbs and T-cell responses to SARS-CoV-2 in the first two months after the second dose. After six months, only 37.0% and 44.0% of vaccinees had NAbs and T-cell immunity to SARS-CoV-2, respectively. Immune serum retained most of its neutralizing potency against the Alpha and Iota variants, but lost significant neutralizing potency against the Beta, Kappa, Delta, and Omicron variants. Only 40% of vaccine-sera retained low-level neutralization activities to Omicron, with a 14.7-fold decrease compared to the wild type. CONCLUSION: The inactivated SARS-CoV-2 vaccine stimulated robust NAbs and T-cell immune responses in the first two months after the second dose but the immune effect dropped rapidly, highlighing that a third dose or additional booster immunizations may be required to boost immunity against SARS-CoV-2.

3.
Chin Med J (Engl) ; 134(17): 2017-2024, 2021 Aug 25.
Article in English | MEDLINE | ID: covidwho-1769432

ABSTRACT

ABSTRACT: Acute respiratory distress syndrome (ARDS) is one of the most common severe diseases seen in the clinical setting. With the continuous exploration of ARDS in recent decades, the understanding of ARDS has improved. ARDS is not a simple lung disease but a clinical syndrome with various etiologies and pathophysiological changes. However, in the intensive care unit, ARDS often occurs a few days after primary lung injury or after a few days of treatment for other severe extrapulmonary diseases. Under such conditions, ARDS often progresses rapidly to severe ARDS and is difficult to treat. The occurrence and development of ARDS in these circumstances are thus not related to primary lung injury; the real cause of ARDS may be the "second hit" caused by inappropriate treatment. In view of the limited effective treatments for ARDS, the strategic focus has shifted to identifying potential or high-risk ARDS patients during the early stages of the disease and implementing treatment strategies aimed at reducing ARDS and related organ failure. Future research should focus on the prevention of ARDS.


Subject(s)
Respiratory Distress Syndrome , Humans , Intensive Care Units , Respiratory Distress Syndrome/etiology , Treatment Outcome
4.
Front Microbiol ; 12: 803031, 2021.
Article in English | MEDLINE | ID: covidwho-1753384

ABSTRACT

Background: COVID-19 has caused more than 2.6 billion infections and several million deaths since its outbreak 2 years ago. We know very little about the long-term cellular immune responses and the kinetics of neutralizing antibodies (NAbs) to SARS-CoV-2 because it has emerged only recently in the human population. Methods: We collected blood samples from individuals who were from the first wave of the COVID-19 epidemic in Wuhan between December 30, 2019, and February 24, 2020. We analyzed NAbs to SARS-CoV-2 using pseudoviruses and IgG antibodies to SARS-CoV-2 spike (S) and nucleocapsid (N) protein using enzyme-linked immunosorbent assay in patients' sera and determined SARS-CoV-2-specific T-cell responses of patients with ELISpot assays. Results: We found that 91.9% (57/62) and 88.9% (40/45) of COVID-19 patients had NAbs against SARS-CoV-2 in a year (10-11 months) and one and a half years (17-18 months), respectively, after the onset of illness, indicating that NAbs against SARS-CoV-2 waned slowly and possibly persisted over a long period time. Over 80% of patients had IgG antibodies to SARS-CoV-2 S and N protein one and a half years after illness onset. Most patients also had robust memory T-cell responses against SARS-CoV-2 one and a half years after the illness. Among the patients, 95.6% (43/45) had an IFN-γ-secreting T-cell response and 93.8% (15/16) had an IL-2-secreting T-cell response. The T-cell responses to SARS-CoV-2 were positively correlated with antibodies (including neutralizing antibodies and IgG antibodies to S and N protein) in COVID-19 patients. Eighty percent (4/5) of neutralizing antibody-negative patients also had SARS-CoV-2-specific T-cell response. After long-term infection, protective immunity was independent of disease severity, sex, and age. Conclusions: We concluded that SARS-CoV-2 infection elicited a robust and persistent neutralizing antibody and memory T-cell response in COVID-19 patients, indicating that these sustained immune responses, among most SARS-CoV-2-infected people, may play a crucial role in protection against reinfection.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-318614

ABSTRACT

Excessive inflammatory responses induced upon SARS-CoV-2 infection interlocks with severe symptoms and acute lung injury in patients with Severe Coronavirus Disease 2019 (COVID-19). Revealing the mechanism underlying the control of SARS-CoV-2-triggered immune-inflammatory responses would help us to understand the pathological process and guide clinical treatment. However, the effect of the NLRP3 inflammasome on regulating SARS-CoV-2-induced inflammatory responses has not been reported. Here, we revealed a distinct mechanism by which SARS-CoV-2 nucleocapsid (N) protein promotes the NLRP3 inflammasome activation to induce hyperinflammation. We demonstrated that N protein facilitates the maturation of proinflammatory cytokines IL-1β and IL-6 and induces proinflammatory responses in cultured cells and mice tissues. In team of molecular mechanism, N protein interacts directly with NLRP3 protein, promotes the binding of NLRP3 with ASC, and facilitates the assemble of the inflammasome complex. More importantly, N protein aggravates lung injury, accelerated death in sepsis and acute inflammation mouse models, and promotes IL-1β and IL-6 activation in mice. Notably, N-induced lung injury and cytokine production were blocked by Ac-YVAD-cmk, an inhibitor of the NLRP3 inflammasome. Therefore, this study revealed a distinct mechanism by which SARS-CoV-2 N protein promotes the NLRP3 inflammasome activation and induces excessive inflammatory responses.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310363

ABSTRACT

Objective: to analyze the epidemic situation of COVID-19 in northeast China, Liaoning and Jilin. To study the prevalence of COVID-19 virus in areas other than Hubei province. To understand the spread of COVID-19 in Liaoning and Jilin provinces by means of communication network. More in-depth understanding of COVID-19 epidemic, and put forward effective prevention and control recommendations. Methods: We collected the demographic characteristics, exposure history and course of action of patients with laboratory-confirmed infection with COVID-19 published by Liaoning Provincial Health Commission and Jilin Provincial Health Commission as of February 15, 2020. We describe the demographic characteristics, case characteristics, spatial distribution characteristics and related interpersonal network of these patients. To analyze the transmission of COVID-19 in two provinces. Results: : By February 15, 2020, the cumulative number of infected people in Liaoning province was 119.The largest number was 27(22.7%) in Shenyang and the smallest in Fushun, with no reported cases of infection. Among them, 55(46.2%) have a history of sojourning in Hubei province. The mainly clinical symptoms of the infected patients were fever, and 67(56.3%) of them developed fever at the time of diagnosis. Cough, sneezing and other respiratory symptoms are less. The cumulative number of infected people in Jilin province was 89, with the highest number in Changchun city at 39(43.8%) and the lowest in Baishan city, with no reported infections. 21(23.6%) people with a history of sojourning in Hubei province. Most of those infected in the two provinces were related to Hubei province, and most of those infected in the second generation or more were infected by close contact with relatives. Conclusion: The COVID-19 outbreaks in Liaoning and Jilin provinces are gradually stabilizing, but have not yet reached the time required to lower the prevention and control level. The fatality rate of the two provinces is relatively low. There is no evidence of super-spreader in either province.

7.
Adv Sci (Weinh) ; 9(3): e2103248, 2022 01.
Article in English | MEDLINE | ID: covidwho-1527412

ABSTRACT

COVID-19 is infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can cause severe multiple organ injury and death. Kidney is one of major target organs of COVID-19 and acute kidney injury (AKI) is common in critically ill COVID-19 patients. However, mechanisms through which COVID-19 causes AKI remain largely unknown and treatment remains unspecific and ineffective. Here, the authors report that normal kidney-specifically overexpressing SARS-CoV-2 N develops AKI, which worsens in mice under ischemic condition. Mechanistically, it is uncovered that SARS-CoV-2 N-induced AKI is Smad3-dependent as SARS-CoV-2 N protein can interact with Smad3 and enhance TGF-ß/Smad3 signaling to cause tubular epithelial cell death and AKI via the G1 cell cycle arrest mechanism. This is further confirmed in Smad3 knockout mice and cells in which deletion of Smad3 protects against SARS-CoV-2 N protein-induced cell death and AKI in vivo and in vitro. Most significantly, it is also found that targeting Smad3 with a Smad3 pharmacological inhibitor is able to inhibit SARS-CoV-2 N-induced AKI. In conclusion, the authors identify that SARS-CoV-2 N protein is a key mediator for AKI and induces AKI via the Smad3-dependent G1 cell cycle arrest mechanism. Targeting Smad3 may represent as a novel therapy for COVID-19-asscoaited AKI.


Subject(s)
Acute Kidney Injury , COVID-19 , Coronavirus Nucleocapsid Proteins , G1 Phase Cell Cycle Checkpoints , SARS-CoV-2 , Smad3 Protein , Acute Kidney Injury/genetics , Acute Kidney Injury/metabolism , Acute Kidney Injury/virology , Animals , COVID-19/genetics , COVID-19/metabolism , Cell Line , Coronavirus Nucleocapsid Proteins/genetics , Coronavirus Nucleocapsid Proteins/metabolism , Disease Models, Animal , HEK293 Cells , Humans , Mice , Mice, Knockout , Phosphoproteins/genetics , Phosphoproteins/metabolism , SARS-CoV-2/genetics , SARS-CoV-2/metabolism , Smad3 Protein/genetics , Smad3 Protein/metabolism
8.
Front Med (Lausanne) ; 8: 690523, 2021.
Article in English | MEDLINE | ID: covidwho-1438418

ABSTRACT

Objectives: The longitudinal characterization and risk of poor outcomes related to cytokine overproduction in critical coronavirus disease 2019 (COVID-19) patients with hyperinflammation in bronchoalveolar lavage requires further investigation. Methods: We enrolled two critically ill patients with comorbidities diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detected by RT-PCR during hospitalization. Clinical characteristics, longitudinal immunological, and biochemical parameters of each critical COVID-19 case were collected. Main Results: The clinical characteristics and laboratory results of each case demonstrated critical symptoms of COVID-19 with poor outcomes. Both nasopharyngeal swabs and bronchoalveolar lavage fluid (BALF) samples tested positive for SARS-CoV-2. Two patients received targeted treatments against pathogen infection and inflammation in addition to interventional therapies, except for Patient 2, who received an additional artificial liver system treatment. Hyperinflammation with a dominantly high level of IL-6 was observed in BALF samples from both critical cases with decreased T cell populations. High levels of cytokines and pathological parameters were successively maintained in Patient 1, but rapidly reduced at the late treatment stage in Patient 2. The outcome of Patient 1 is death, whereas the outcome of Patient 2 is recovery. Conclusions: This case report suggests that a high risk of poor outcomes was related to a heavily hyperinflammatory milieu in both the blood and lungs of critical COVID-19 patients. The artificial liver intervention on cytokines overproduction might be beneficial for the recovery of critical COVID-19 patients as a reliable therapy that can be coordinated with targeted treatments, which ought to be further tested in adequately designed and powered clinical trials.

10.
Medicine ; 100:26, 2021.
Article in English | CAB Abstracts | ID: covidwho-1410298

ABSTRACT

In this study, corona virus disease 2019 (COVID-19) transmission networks were built to analyze the epidemic situation of COVID-19 in Liaoning and Jilin provinces in early 2020. We explore the characteristics of the spread of COVID-19, and put forward effective recommendations for epidemic prevention and control. We collected demographic characteristics, exposure history, and course of action of COVID-19 cases. We described the demographic and case characteristics of these cases to show the basic characteristics of COVID-19 cases in both provinces. Combined with the spatial analysis of confirmed cases, the distribution law of the number of confirmed cases in different regions was analyzed. We exhibit the relationship among COVID-19 cases with a transmission network. The transmission characteristics of COVID-19 were analyzed through the transmission network. Mainly cases in Liaoning and Jilin provinces were imported cases from other provinces and the vast majority of these cases were related to Hubei province. The number of confirmed cases in different regions was positively correlated with their GDP and population. The main clinical symptoms of the cases were fever. Judge from the transmission network relationship between the 2 provinces, the transmission chain in Liaoning province contains fewer cases than that in Jilin province. The main transmission routes of the local cases in the 2 provinces were the family members, and the infection of the imported cases were mainly occurred in public places. It was estimated that the unidentified asymptomatic infected cases in the 2 provinces account for approximately 7.3% of the total number of infected cases. The length of the transmission chain suggests that the spread of COVID-19 can be effectively controlled with effective prevention measures.

11.
Preprint in English | medRxiv | ID: ppmedrxiv-21263213

ABSTRACT

BackgroundUnderstanding risk factors for short- and long-term COVID-19 outcomes have implications for current guidelines and practice. We study whether early identified risk factors for COVID-19 persist one year later and through varying disease progression trajectories. MethodsThis was a retrospective study of 6,731 COVID-19 patients presenting to Michigan Medicine between March 10, 2020 and March 10, 2021. We describe disease progression trajectories from diagnosis to potential hospital admission, discharge, readmission, or death. Outcomes pertained to all patients: rate of medical encounters, hospitalization-free survival, and overall survival, and hospitalized patients: discharge versus in-hospital death and readmission. Risk factors included patient age, sex, race, body mass index, and 29 comorbidity conditions. ResultsYounger, non-Black patients utilized healthcare resources at higher rates, while older, male, and Black patients had higher rates of hospitalization and mortality. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss anemia were risk factors for these outcomes. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss were associated with lower discharge and higher inpatient mortality rates. ConclusionsThis study found differences in healthcare utilization and adverse COVID-19 outcomes, as well as differing risk factors for short- and long-term outcomes throughout disease progression. These findings may inform providers in emergency departments or critical care settings of treatment priorities, empower healthcare stakeholders with effective disease management strategies, and aid health policy makers in optimizing allocations of medical resources.

12.
Viruses ; 13(1)2020 12 30.
Article in English | MEDLINE | ID: covidwho-1389523

ABSTRACT

SARS-CoV-2 is highly pathogenic in humans and poses a great threat to public health worldwide. Clinical data shows a disturbed type I interferon (IFN) response during the virus infection. In this study, we discovered that the nucleocapsid (N) protein of SARS-CoV-2 plays an important role in the inhibition of interferon beta (IFN-ß) production. N protein repressed IFN-ß production induced by poly(I:C) or upon Sendai virus (SeV) infection. We noted that N protein also suppressed IFN-ß production, induced by several signaling molecules downstream of the retinoic acid-inducible gene I (RIG-I) pathway, which is the crucial pattern recognition receptor (PRR) responsible for identifying RNA viruses. Moreover, our data demonstrated that N protein interacted with the RIG-I protein through the DExD/H domain, which has ATPase activity and plays an important role in the binding of immunostimulatory RNAs. These results suggested that SARS-CoV-2 N protein suppresses the IFN-ß response through targeting the initial step, potentially the cellular PRR-RNA-recognition step in the innate immune pathway. Therefore, we propose that the SARS-CoV-2 N protein represses IFN-ß production by interfering with RIG-I.


Subject(s)
COVID-19/immunology , DEAD Box Protein 58/metabolism , Interferon-beta/metabolism , Nucleocapsid Proteins/metabolism , SARS-CoV-2/metabolism , A549 Cells , Animals , DEAD Box Protein 58/genetics , HEK293 Cells , HeLa Cells , Host-Pathogen Interactions/immunology , Humans , Protein Interaction Domains and Motifs , Receptors, Immunologic , Signal Transduction
14.
Signal Transduct Target Ther ; 6(1): 308, 2021 08 18.
Article in English | MEDLINE | ID: covidwho-1364579

ABSTRACT

Cytokine storm induced by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a major pathological feature of Coronavirus Disease 2019 (COVID-19) and a crucial determinant in COVID-19 prognosis. Understanding the mechanism underlying the SARS-CoV-2-induced cytokine storm is critical for COVID-19 control. Here, we identify that SARS-CoV-2 ORF3a and host hypoxia-inducible factor-1α (HIF-1α) play key roles in the virus infection and pro-inflammatory responses. RNA sequencing shows that HIF-1α signaling, immune response, and metabolism pathways are dysregulated in COVID-19 patients. Clinical analyses indicate that HIF-1α production, inflammatory responses, and high mortalities occurr in elderly patients. HIF-1α and pro-inflammatory cytokines are elicited in patients and infected cells. Interestingly, SARS-CoV-2 ORF3a induces mitochondrial damage and Mito-ROS production to promote HIF-1α expression, which subsequently facilitates SARS-CoV-2 infection and cytokines production. Notably, HIF-1α also broadly promotes the infection of other viruses. Collectively, during SARS-CoV-2 infection, ORF3a induces HIF-1α, which in turn aggravates viral infection and inflammatory responses. Therefore, HIF-1α plays an important role in promoting SARS-CoV-2 infection and inducing pro-inflammatory responses to COVID-19.


Subject(s)
COVID-19/metabolism , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Mitochondria/metabolism , SARS-CoV-2/metabolism , Signal Transduction , Viroporin Proteins/metabolism , A549 Cells , Animals , Chlorocebus aethiops , HEK293 Cells , HeLa Cells , Humans , Mitochondria/pathology , RNA-Seq , THP-1 Cells , Vero Cells
15.
Nat Commun ; 12(1): 4664, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1338538

ABSTRACT

Excessive inflammatory responses induced upon SARS-CoV-2 infection are associated with severe symptoms of COVID-19. Inflammasomes activated in response to SARS-CoV-2 infection are also associated with COVID-19 severity. Here, we show a distinct mechanism by which SARS-CoV-2 N protein promotes NLRP3 inflammasome activation to induce hyperinflammation. N protein facilitates maturation of proinflammatory cytokines and induces proinflammatory responses in cultured cells and mice. Mechanistically, N protein interacts directly with NLRP3 protein, promotes the binding of NLRP3 with ASC, and facilitates NLRP3 inflammasome assembly. More importantly, N protein aggravates lung injury, accelerates death in sepsis and acute inflammation mouse models, and promotes IL-1ß and IL-6 activation in mice. Notably, N-induced lung injury and cytokine production are blocked by MCC950 (a specific inhibitor of NLRP3) and Ac-YVAD-cmk (an inhibitor of caspase-1). Therefore, this study reveals a distinct mechanism by which SARS-CoV-2 N protein promotes NLRP3 inflammasome activation and induces excessive inflammatory responses.


Subject(s)
COVID-19/metabolism , Coronavirus Nucleocapsid Proteins/metabolism , Inflammasomes/metabolism , Inflammation/metabolism , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , SARS-CoV-2/metabolism , Animals , COVID-19/virology , Cells, Cultured , Cytokines/metabolism , HEK293 Cells , Humans , Inflammasomes/genetics , Lung Injury/genetics , Lung Injury/metabolism , Male , Mice, Inbred C57BL , Mice, Knockout , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Phosphoproteins/metabolism , Protein Binding , SARS-CoV-2/physiology , THP-1 Cells
16.
Medicine (Baltimore) ; 100(26): e26298, 2021 Jul 02.
Article in English | MEDLINE | ID: covidwho-1288188

ABSTRACT

ABSTRACT: In this study, corona virus disease 2019 (COVID-19) transmission networks were built to analyze the epidemic situation of COVID-19 in Liaoning and Jilin provinces in early 2020. We explore the characteristics of the spread of COVID-19, and put forward effective recommendations for epidemic prevention and control. We collected demographic characteristics, exposure history, and course of action of COVID-19 cases. We described the demographic and case characteristics of these cases to show the basic characteristics of COVID-19 cases in both provinces. Combined with the spatial analysis of confirmed cases, the distribution law of the number of confirmed cases in different regions was analyzed. We exhibit the relationship among COVID-19 cases with a transmission network. The transmission characteristics of COVID-19 were analyzed through the transmission network. Mainly cases in Liaoning and Jilin provinces were imported cases from other provinces and the vast majority of these cases were related to Hubei province. The number of confirmed cases in different regions was positively correlated with their GDP and population. The main clinical symptoms of the cases were fever. Judge from the transmission network relationship between the 2 provinces, the transmission chain in Liaoning province contains fewer cases than that in Jilin province. The main transmission routes of the local cases in the 2 provinces were the family members, and the infection of the imported cases were mainly occurred in public places. It was estimated that the unidentified asymptomatic infected cases in the 2 provinces account for approximately 7.3% of the total number of infected cases. The length of the transmission chain suggests that the spread of COVID-19 can be effectively controlled with effective prevention measures.


Subject(s)
COVID-19/transmission , Adolescent , Adult , Age Distribution , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Child , China/epidemiology , Epidemiologic Studies , Female , Humans , Infectious Disease Transmission, Patient-to-Professional , Male , Middle Aged , Pandemics , SARS-CoV-2 , Spatio-Temporal Analysis , Travel-Related Illness , Young Adult
17.
ACS Omega ; 6(14): 9667-9671, 2021 Apr 13.
Article in English | MEDLINE | ID: covidwho-1191080

ABSTRACT

SARS-CoV-2 is the etiologic agent of COVID-19, which has led to a dramatic loss of human life and presents an unprecedented challenge to public health worldwide. The gold standard assay for SARS-CoV-2 identification is real-time polymerase chain reaction; however, this assay depends on highly trained personnel and sophisticated equipment and may suffer from false results. Thus, a serological antibody test is a supplement to the diagnosis or screening of SARS-CoV-2. Here, we develop and evaluate the diagnostic performance of an IgM/IgG indirect ELISA method for antibodies against SARS-CoV-2 in COVID-19. The ELISA was constructed by coating with a recombinant nucleocapsid protein of SARS-CoV-2 on an enzyme immunoassay plate, and its sensitivity and specificity for clinical diagnosis of SARS-CoV-2 infection was assessed by detecting the SARS-CoV-2-specific IgM and IgG antibodies in COVID-19 patient's sera or healthy person's sera. The SARS-CoV-2 positive serum samples (n = 168) were collected from confirmed COVID-19 patients. A commercial nucleocapsid protein-based chemiluminescent immunoassay (CLIA) kit and a colloidal gold immunochromatography kit were compared with those of the ELISA assay. The specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of IgM were 100, 95.24, 100, and 91.84%, whereas those of IgG were 100, 97.02, 100, and 94.74%, respectively. We developed a highly sensitive and specific SARS-CoV-2 nucleocapsid protein-based ELISA method for the diagnosis and epidemiologic investigation of COVID-19 by SARS-CoV-2 IgM and IgG antibody detection.

18.
Occup Environ Med ; 78(2): 129-135, 2021 02.
Article in English | MEDLINE | ID: covidwho-1060160

ABSTRACT

OBJECTIVE: To explore the level and influencing factors of frontline nurses' post-traumatic growth (PTG) during COVID-19 epidemic. METHODS: A cross-sectional survey was conducted in February 2020 in three hospitals in China. The Post-traumatic Growth Inventory (PTGI) was used to investigate the PTG of frontline nurses. Data on related factors, including demographic characteristics and subjective variables, were collected. The Event-Related Rumination Inventory was used to assess rumination. Pearson's or Spearman's correlation was calculated for bivariate analysis. Independent sample t-tests or one-way analysis of variance and multiple linear regression analysis were used to examine the related factors. RESULTS: A total of 179 frontline nurses were recruited, and 167 were included in the analyses. The mean PTG score was 70.53±17.26. The bivariate analyses showed that deliberate rumination was modestly positively correlated with PTG (r=0.557, p<0.01), while intrusive rumination had a modest negative correlation with PTG (r=-0.413, p<0.01). Multiple linear regression demonstrated that working years, self-confidence in frontline work, awareness of risk, psychological intervention or training during the epidemic and deliberate rumination were the main influencing factors of PTG among frontline nurses and accounted for 42.5% of the variance (F=31.626, p<0.001). CONCLUSIONS: The PTG of frontline nurses was at a medium to high level and was influenced by working years, self-confidence in frontline work, awareness of risk, psychological intervention or training and deliberate rumination. It is necessary to strengthen psychological guidance and training for frontline nurses and promote their deliberate rumination on epidemic events to improve their PTG.


Subject(s)
Adaptation, Psychological , COVID-19 , Nurses/psychology , Occupational Stress , Posttraumatic Growth, Psychological , Psychological Trauma , Adult , Awareness , China , Cross-Sectional Studies , Epidemics , Female , Humans , Male , Regression Analysis , SARS-CoV-2 , Self Concept , Thinking
19.
2020.
Preprint | CAplus | ID: ppcovidwho-5037

ABSTRACT

A review. During the Coronavirus Disease (COVID-19) epidemic prevention period, if patients with COVID-19 have sudden acute myocardial infarction, cardiac interventional surgery must be performed. But in the absence of neg. pressure Digital Subtraction Angiog. (DSA) interventional surgery rooms, how to control environmental infection in the catheterization room to prevent the spread of iatrogenic infection, cut off the transmission route and protect the medical staff involved in the operation is a problem that needs immediate attention and urgent solution In this paper, combined with the relevant literature published at home and abroad and the relevant national notices or norms, how to carry out preoperative preparation, intraoperative treatment and postoperative treatment in the catheterization room during the implementation of cardiac intervention operation is reviewed.

20.
J Med Internet Res ; 22(11): e23128, 2020 11 11.
Article in English | MEDLINE | ID: covidwho-976118

ABSTRACT

BACKGROUND: Patients with COVID-19 in the intensive care unit (ICU) have a high mortality rate, and methods to assess patients' prognosis early and administer precise treatment are of great significance. OBJECTIVE: The aim of this study was to use machine learning to construct a model for the analysis of risk factors and prediction of mortality among ICU patients with COVID-19. METHODS: In this study, 123 patients with COVID-19 in the ICU of Vulcan Hill Hospital were retrospectively selected from the database, and the data were randomly divided into a training data set (n=98) and test data set (n=25) with a 4:1 ratio. Significance tests, correlation analysis, and factor analysis were used to screen 100 potential risk factors individually. Conventional logistic regression methods and four machine learning algorithms were used to construct the risk prediction model for the prognosis of patients with COVID-19 in the ICU. The performance of these machine learning models was measured by the area under the receiver operating characteristic curve (AUC). Interpretation and evaluation of the risk prediction model were performed using calibration curves, SHapley Additive exPlanations (SHAP), Local Interpretable Model-Agnostic Explanations (LIME), etc, to ensure its stability and reliability. The outcome was based on the ICU deaths recorded from the database. RESULTS: Layer-by-layer screening of 100 potential risk factors finally revealed 8 important risk factors that were included in the risk prediction model: lymphocyte percentage, prothrombin time, lactate dehydrogenase, total bilirubin, eosinophil percentage, creatinine, neutrophil percentage, and albumin level. Finally, an eXtreme Gradient Boosting (XGBoost) model established with the 8 important risk factors showed the best recognition ability in the training set of 5-fold cross validation (AUC=0.86) and the verification queue (AUC=0.92). The calibration curve showed that the risk predicted by the model was in good agreement with the actual risk. In addition, using the SHAP and LIME algorithms, feature interpretation and sample prediction interpretation algorithms of the XGBoost black box model were implemented. Additionally, the model was translated into a web-based risk calculator that is freely available for public usage. CONCLUSIONS: The 8-factor XGBoost model predicts risk of death in ICU patients with COVID-19 well; it initially demonstrates stability and can be used effectively to predict COVID-19 prognosis in ICU patients.


Subject(s)
COVID-19/epidemiology , Machine Learning/standards , Algorithms , Female , Humans , Intensive Care Units , Male , Prognosis , Reproducibility of Results , Retrospective Studies , Risk Factors
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