Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
Add filters

Year range
2.
The American Journal of Gastroenterology ; 116, 2021.
Article in English | ProQuest Central | ID: covidwho-1478679
3.
The American Journal of Gastroenterology ; 116, 2021.
Article in English | ProQuest Central | ID: covidwho-1478628
4.
Front Artif Intell ; 4: 672050, 2021.
Article in English | MEDLINE | ID: covidwho-1430749

ABSTRACT

Cohort-independent robust mortality prediction model in patients with COVID-19 infection is not yet established. To build up a reliable, interpretable mortality prediction model with strong foresight, we have performed an international, bi-institutional study from China (Wuhan cohort, collected from January to March) and Germany (Würzburg cohort, collected from March to September). A Random Forest-based machine learning approach was applied to 1,352 patients from the Wuhan cohort, generating a mortality prediction model based on their clinical features. The results showed that five clinical features at admission, including lymphocyte (%), neutrophil count, C-reactive protein, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase, could be used for mortality prediction of COVID-19 patients with more than 91% accuracy and 99% AUC. Additionally, the time-series analysis revealed that the predictive model based on these clinical features is very robust over time when patients are in the hospital, indicating the strong association of these five clinical features with the progression of treatment as well. Moreover, for different preexisting diseases, this model also demonstrated high predictive power. Finally, the mortality prediction model has been applied to the independent Würzburg cohort, resulting in high prediction accuracy (with above 90% accuracy and 85% AUC) as well, indicating the robustness of the model in different cohorts. In summary, this study has established the mortality prediction model that allowed early classification of COVID-19 patients, not only at admission but also along the treatment timeline, not only cohort-independent but also highly interpretable. This model represents a valuable tool for triaging and optimizing the resources in COVID-19 patients.

5.
Annals of Hematology ; 100(3):843-846, 2021.
Article in English | CAB Abstracts | ID: covidwho-1408352

ABSTRACT

In total, we identified five Caucasian patients from Wurzburg (Nos. 1-5) and three Asian patients from Wuhan (Nos. 6-8). The majority of the patients were male (n = 5, 63%), and the median age at COVID-19 diagnosis was 57 (range 39-83 years). The three patients from Wuhan were infected by COVID-19 in January or February 2020, while the Wurzburg patients were diagnosed in March or April 2020. Due to COVID-19 infection, anti-MM treatment was discontinued in all the patients. Notably, two patients (Nos. 3-4) in Wurzburg showed no COVID-19 symptoms, and the other three patients (Nos. 1, 2, and 5) exhibited only mild symptoms such as fever, cough, and nausea, which did not require an intensive care unit (ICU) admission. Interestingly, approximately 3 weeks after diagnosis, as the patient No. 6 was discharged and the swab was also negative for COVID-19, both COVID-19 IgM and IgG were tested negative in this patient. In four patients from Wurzburg, we also performed COVID-19 antibody test after recovery, and three of them (Nos. 1, 2, and 5) showed positive IgG, while one patient (No. 3) did not develop IgG or IgM against COVID-19. This finding suggested inadequate humoral immune response in MM patients, probably due to secondary immune deficiency caused by the treatments or the disease itself. This observation suggested that it might be a nosocomial infection in this patient. After recovery, two patients from Wurzburg received MM therapy, i.e., lenalidomide maintenance in one patient and DARA-VRCD (daratumumab, bortezomib, lenalidomide, cyclophosphamide, and dexamethasone) in another patient with NDMM.

6.
Infect Dis (Lond) ; 53(11): 865-875, 2021 11.
Article in English | MEDLINE | ID: covidwho-1327306

ABSTRACT

BACKGROUND: The COVID-19 pandemic has become a new challenge to the medical system in various countries. The patients with ST-segment elevated myocardial infarction (STEMI) were also affected. METHODS: We used a random-effects mode to analyze the differences of the baseline characteristics and therapeutic features between STEMI patients admitted before and after the start of the COVID-19 pandemic. RESULTS: Thirty eight studies involving 79,753 patients were included in this analysis. The number of hospitalized STEMI patients decreased by 26% after the start of the COVID-19 pandemic. There were no differences in age, sex, prevalence of diabetes, hypertension, dyslipidemia or percutaneous coronary intervention rate between the STEMI patients before and after the start of the COVID-19 pandemic. However, the STEMI patients admitted after the start of the COVID-19 pandemic had a significantly increased time from symptom onset to first medical contact (standard mean difference: 0.51, 95% confidence interval: 0.24-0.78, p < .001) and an increased in-hospital mortality (odds ratio: 1.70, 95% confidence interval:1.14-2.56, p < .001); The in-hospital mortality of the STEMI patients with COVID-19 was 24% (95% confidence interval: 0.15-0.33); The in-hospital mortality of the STEMI patients with COVID-19 was significantly higher than that of the STEMI patients without COVID-19 at the initial stage of the COVID-19 pandemic (odds ratio: 7.28, 95% confidence interval: 2.75-19.28, p < .001). CONCLUSION: The number of admitted STEMI patients was reduced while the in-hospital mortality and the time from symptom onset to first medical contact were increased during the COVID-19 pandemic.


Subject(s)
COVID-19 , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Hospital Mortality , Humans , Pandemics , SARS-CoV-2 , ST Elevation Myocardial Infarction/epidemiology
7.
World J. Pediatric Surg. ; 1(3)20200423.
Article in English | ELSEVIER | ID: covidwho-1318222

ABSTRACT

The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged and spread rapidly throughout the world. As of February 29, 2020, 79 389 cases of COVID-19 have been reported, and the outbreak is linked to 2838 deaths. The population is generally susceptible to the disease, and differences in incubation periods after infection exist among individuals. These two aspects of COVID-19 pose significant challenges to pediatric orthopedic diagnosis and treatment. As a dedicated center for managing pediatric cases of SARS-CoV-2 in Shanghai, our hospital has mobilized all branches and departments to undertake joint actions for scientific prevention and control, precise countermeasure and comprehensive anti-epidemic efforts. Combined with our experience, we have consulted the relevant national regulations and the latest research advances and have formulated the prevention and control measures of SARS-CoV-2 infection, including outpatient, emergency, inpatient and surgical cares, for clinical practices of pediatric orthopedics according to the physicochemical properties of SARS-CoV-2. It may serve as practical references and recommendations for managing SARS-CoV-2 infection in other pediatric specialties and in other hospitals.

8.
Sustainability ; 13(14):7626, 2021.
Article in English | MDPI | ID: covidwho-1302453

ABSTRACT

Under the background of COVID-19, the conditions and environment of international cooperation in Arctic sustainable fisheries have changed. Accurately predicting the impact of environmental changes on the evolution of Arctic fishery cooperation, identifying its key influencing elements, and formulating appropriate corresponding measures have practical value for the sustainable development of Arctic fisheries. Based on the collection of fisheries trade data in Arctic sustainable fisheries trade cooperation countries, this paper builds a trade cooperation network, identifies key influencing factors, establishes a network game model, and uses simulation methods to verify the variables. The results show that the reward value given by neighboring countries has a positive effect on such cooperation. The higher the reward value is, the more countries choose to cooperate. The cooperation cost has the opposite effect, the lower the cost, the more countries choose to cooperate. The impact of cost on cooperation is greater than the incentives. The game structure also affects the outcome of cooperation, and the number of countries participating in cooperation based on the Stag Hunt Model is the largest. The change of network structure will have an impact on cooperation, and the COVID-19 pandemic has influenced cooperation on Arctic sustainable fisheries trade cooperation in the short term.

9.
Virulence ; 12(1): 1199-1208, 2021 12.
Article in English | MEDLINE | ID: covidwho-1192789

ABSTRACT

Background: COVID-19 has rapidly become a major health emergency worldwide. The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear.Methods: Medical records were collected from 23 Chinese hospitals. Patients with decompensated cirrhosis and age- and sex-matched non-liver disease patients were enrolled with 1:4 ratio using stratified sampling.Results: There were more comorbidities with higher Chalson Complication Index (p < 0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p < 0.05) and in decompensated cirrhosis patients. Mortality (p < 0.05) and the proportion of severe ill (p < 0.001) were significantly high among those patients. Patients in severe ill subgroup had higher mortality (p < 0.001), MELD, and CRUB65 score but lower lymphocytes count. Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p < 0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance. Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome. Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores.Conclusions: COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality. MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.


Subject(s)
COVID-19/mortality , Liver Cirrhosis/complications , SARS-CoV-2 , Severity of Illness Index , Adult , Aged , COVID-19/etiology , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors
10.
Medicine (Baltimore) ; 100(14): e25467, 2021 Apr 09.
Article in English | MEDLINE | ID: covidwho-1174983

ABSTRACT

RATIONALE: Coronavirus disease 2019 (COVID-19) is a disease caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which commonly presents with symptoms including fever, cough, and dyspnea. More recently, however, some patients have tested positive for COVID-19 after developing gastrointestinal (GI) symptoms either solely or in conjunction with respiratory symptoms. This may be due to SARS-CoV-2 infection of the GI tract. In patients with chronic GI illnesses, COVID-19 may initially present as a flare of their underlying GI conditions as viruses have historically been implicated in exacerbations of GI disorders, including gastroparesis. PATIENT CONCERNS: We report a case of a 37-year-old female with a history of diabetic gastroparesis who presented to the Emergency Department (ED) with nausea and vomiting similar to her gastroparesis flares. DIAGNOSES: Her symptoms in the ED failed to improve with fluids and anti-emetic medications. After developing a fever, she was tested and found to be positive for COVID-19. INTERVENTIONS: She was started on antibiotic, steroid, and antiviral medications. OUTCOMES: Her symptoms improved, her fever defervesced on day 4 of hospitalization, and she was discharged on day 5 of hospitalization. The patient reported symptom improvement at a follow-up outpatient gastroenterology visit 2 months after hospitalization. LESSONS: To the best of our knowledge, at the present time, this is the first report of a patient with COVID-19 presenting with signs and symptoms of a gastroparesis flare. This case illustrates that COVID-19 may present in an exacerbation of symptoms of an underlying disorder, such as a severe gastroparesis flare, in a patient with underlying gastroparesis. Initial presentation of these patients manifesting as a flare of their chronic GI disease, more severe than usual, should prompt an index of suspicion for COVID-19.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Diabetes Complications/complications , Diabetes Complications/physiopathology , Gastroparesis/physiopathology , Adult , Female , Humans , SARS-CoV-2
11.
Front Psychiatry ; 11: 563781, 2020.
Article in English | MEDLINE | ID: covidwho-1000146

ABSTRACT

Background: The outbreak of COVID-19 in China was a sudden bio-disaster, which may bring a negative impact on the job burnout of health care professionals (HCPs). Objective: We aim to find out the association factors, especially those closely related to this outbreak, of job burnout in Chinese HCPs. Method: The cross-sectional survey about HCPs' job burnout based on a network platform was conducted in high and low infection regions during the COVID-19 outbreak in China. The demographic characteristics, medical-work-related factors, risk of getting infected due to occupational exposure, and family factors were collected by the self-reported questionnaire. The Chinese version of the Maslach Burnout Inventory (CMBI) and the Trait Coping Style Questionnaire (TCSQ) were employed in this study to evaluate the job burnout and coping style, respectively. Furthermore, statistical analysis was done to find out the associated factors of job burnout. Results: We collected 880 complete questionnaires from doctors and nurses from February 9, 2020 to February 11, 2020. In this study, the positive rates of three dimensions of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and overall burnout were 9.09, 50.57, 56.59, and 73.98%, respectively. After the statistical analysis, we found that several factors can independently affect the dimensions. Working in the high infection region and negative coping styles can affect all three dimensions at once. More night shift quantity and having symptoms could increase emotional exhaustion and depersonalization, while higher work intensity and senior title could increase emotional exhaustion and reduce personal accomplishment, respectively. Conclusion: The rate of moderate and severe burnout had increased due to the outbreak. More attention should be paid to burnout in HCPs, especially those with negative coping. There were some potential ways to reduce burnout, such as reducing their workload and providing better protection from the virus.

12.
Gastroenterol Res Pract ; 2020: 8853922, 2020.
Article in English | MEDLINE | ID: covidwho-999336

ABSTRACT

The incidence of digestive symptoms may vary depending on doctors' professional backgrounds when they inquired suspected COVID-19 patients in a fever clinic. We sought to understand the characteristics of inquiries about digestive symptoms by doctors in different specialties; therefore, inquiry records of 2 gastroenterologists and 6 nongastroenterologists were reviewed. We compared the difference in inquiry of digestive symptoms (diarrhea, vomit, distension, anorexia, and abdominal pain) between these two groups among identified COVID-19 patients. And we further compared the difference of digestive symptoms between confirmed patients and suspected cases who excluded from COVID-19. Among 495 confirmed COVID-19 cases (254 cases by gastroenterologists and 241 cases by nongastroenterologists), 22.83% patients experienced various digestive symptoms in the gastroenterologists' group, while only 4.47% reported digestive symptoms by nongastroenterologists (p < 0.0001). Additionally, among initially suspected 611 patients who presented with similar respiratory symptoms inquired by gastroenterologists, confirmed cases presented far more frequency of digestive symptoms than excluded cases (22.8% vs. 3.64%, p < 0.0001). Furthermore, confirmed patients reported more percentage of watery diarrhea (56% vs. 36%, p < 0.0001) and higher frequent vomit (2.77 ± 0.97 vs. 1.80 ± 0.45 per day, p = 0.041) than excluded cases. We concluded that gastroenterologists could detect a greater proportion of gastrointestinal symptoms in COVID-19 patients during fever clinic inquiries. Moreover, confirmed COVID-19 patients are more likely to have higher severity in digestive symptoms than excluded cases. Therefore, physicians in fever clinic should pay more attention to the triage of gastrointestinal symptoms.

13.
J Control Release ; 330: 529-539, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-988295

ABSTRACT

The current health crisis of corona virus disease 2019 (COVID-19) highlights the urgent need for vaccine systems that can generate potent and protective immune responses. Protein vaccines are safe, but conventional approaches for protein-based vaccines often fail to elicit potent and long-lasting immune responses. Nanoparticle vaccines designed to co-deliver protein antigens and adjuvants can promote their delivery to antigen-presenting cells and improve immunogenicity. However, it remains challenging to develop vaccine nanoparticles that can preserve and present conformational epitopes of protein antigens for induction of neutralizing antibody responses. Here, we have designed a new lipid-based nanoparticle vaccine platform (NVP) that presents viral proteins (HIV-1 and SARS-CoV-2 antigens) in a conformational manner for induction of antigen-specific antibody responses. We show that NVP was readily taken up by dendritic cells (DCs) and promoted DC maturation and antigen presentation. NVP loaded with BG505.SOSIP.664 (SOSIP) or SARS-CoV-2 receptor-binding domain (RBD) was readily recognized by neutralizing antibodies, indicating the conformational display of antigens on the surfaces of NVP. Rabbits immunized with SOSIP-NVP elicited strong neutralizing antibody responses against HIV-1. Furthermore, mice immunized with RBD-NVP induced robust and long-lasting antibody responses against RBD from SARS-CoV-2. These results suggest that NVP is a promising platform technology for vaccination against infectious pathogens.


Subject(s)
AIDS Vaccines/chemistry , COVID-19 Vaccines/chemistry , Immunity, Humoral/drug effects , Lipids/chemistry , Nanoparticles , Viral Vaccines/chemistry , AIDS Vaccines/administration & dosage , Adjuvants, Immunologic , Animals , Antigen Presentation , Antigen-Antibody Reactions , COVID-19 Vaccines/administration & dosage , Dendritic Cells/immunology , Dendritic Cells/metabolism , HIV-1 , Humans , Lymph Nodes/immunology , Mice , Mice, Inbred BALB C , Rabbits , SARS-CoV-2 , Viral Vaccines/administration & dosage
15.
BMC Infect Dis ; 20(1): 818, 2020 Nov 10.
Article in English | MEDLINE | ID: covidwho-917921

ABSTRACT

BACKGROUND: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19. METHODS: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. RESULTS: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. CONCLUSIONS: All COVID-19 patients in this study were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , Clinical Laboratory Techniques , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/immunology , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/immunology , Adolescent , Adult , Aged , Betacoronavirus/genetics , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Child , China/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Coronavirus Nucleocapsid Proteins , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Nucleocapsid Proteins/immunology , Pandemics , Phosphoproteins , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Sputum/virology , Tomography, X-Ray Computed , Young Adult
16.
Preprint | SSRN | ID: ppcovidwho-808

ABSTRACT

Background: Coronavirus disease 2019(COVID-19)is an emerged infection raised wide concerns for the pneumonia and respiratory manifestations. Also, diarrhea and

17.
Preprint | SSRN | ID: ppcovidwho-762

ABSTRACT

Background: Coronavirus disease 2019(COVID-19)is an emerged infection raised wide concerns for the pneumonia and respiratory manifestations. Also, digestive com

18.
Preprint | SSRN | ID: ppcovidwho-574

ABSTRACT

BACKGROUND: Corona virus infective disease 2019(COVID-19) is an emerging infectious disease that first outbreak in humans in China in December 2020 and has subs

19.
Soc Psychiatry Psychiatr Epidemiol ; 56(1): 47-55, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-754675

ABSTRACT

PURPOSE: This study was conducted to evaluate the status of depression and anxiety of healthcare workers and to explore the risk factors during the outbreak of COVID-19 in China. METHODS: A cross-sectional study was designed using convenience sampling to obtain a sample of healthcare workers. A structured questionnaire was designed to collect the information of the basic characteristics, workload, and the health condition. Burnout, coping style, anxiety, and depression were measured by specific scales. Multiple logistic regression model was performed to explore the risk factors of anxiety or depression. RESULTS: There were 902 questionnaires received between February 9, 2020 and February 11, 2020. The proportion of healthcare workers with symptoms of moderate/severe anxiety and moderate/severe depression were 16.63% and 18.29%, respectively. There were 24.50% healthcare workers experiencing moderate/severe anxiety and depression at the same time. The increased workload, respiratory symptoms, digestive symptoms, having done specific test(s) related to COVID-19, having family member needs to be taken care of, negative coping style, and job burnout were the independent risk factors of anxiety. Furthermore, the increased workload, respiratory symptoms, digestive symptoms, having done specific test(s) related to COVID-19, negative coping style, and job burnout were the independent risk factors of depression. CONCLUSION: More attention should be paid to the mental health of frontline healthcare workers at the outbreak of COVID-19 in China. Taking steps to reduce the intensity of the work and burnout will be effective to stabilize the mental state of them.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Disease Outbreaks , Female , Health Personnel , Humans , Male , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
20.
J Neurogastroenterol Motil ; 26(3): 397-409, 2020 07 30.
Article in English | MEDLINE | ID: covidwho-722244

ABSTRACT

Background/Aims: Lipopolysaccharide (LPS) is the key factor inducing mucosal and systemic inflammation in various intestinal and parenteral diseases, which could initially disrupt the epithelial barrier function. EphrinA1/ephA2 is speculated to increase the epithelial permeability for its "repulsive interaction" between adjacent cells. This study aim to investigate the role of ephrinA1/ephA2 in LPS-induced epithelial hyperpermeability. Methods: In vivo model challenged with oral LPS in C57BL/6 mice and in vitro model exposed to LPS in Caco2 monolayer were established. The barrier function was assessed including expression of tight junction proteins (occludin and claudin-1), transepithelial electrical resistance, and permeability to macromolecules (fluorescein isothiocyanate-labeled fluorescent dextran 4 kDa [FD4]). Moreover, the expression and phosphorylation of ephrinA1/ephA2 were quantified, and its roles in the process of epithelial barrier disruption were confirmed via stimulating ephA2 with ephrinA1-Fc chimera (ephrinA1-Fc) and inactivating ephA2 with ephA2-Fc chimera (ephA2-Fc), or ephA2 monoclonal antibody (ephA2-mab), as well as inhibiting extracellular signal-regulated kinase 1/2 (ERK1/2) with PD98059. Results: LPS induced significant barrier dysfunction with dismissed occludin and claudin-1 expression, reduced transepithelial electrical resistance and increased FD4 permeability, accompanied by upregulated ephrinA1/ephA2 pathway and phosphorylation of ephA2 receptor. Furthermore, ephA2-Fc, and ephA2-mab ameliorated LPS-induced epithelial hyperpermeability, which was also inhibited by PD98059. Additionally, ephrinA1-Fc led to apparent epithelial leakage in Caco2 monolayer by promoting the phosphorylation of ERK1/2, which could be obviously blocked by ephA2-mab and PD98059. Conclusion: EphrinA1/ephA2 promotes epithelial hyperpermeability with an ERK1/2-dependent pathway, which involves in LPS-induced intestinal barrier dysfunction.

SELECTION OF CITATIONS
SEARCH DETAIL
...