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1.
EMBO J ; 40(5): e107651, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1082516

ABSTRACT

Defining the pulmonary cell types infected by SARS-CoV-2 and finding ways to prevent subsequent tissue damage are key goals for controlling COVID-19. Recent work establishing a human lung organoid-derived air-liquid interface model permissive to SARS-CoV-2 infection identifies alveolar type II cells as the primary cell type infected, reports an infection-induced interferon response and demonstrates the effectiveness of interferon lambda 1 treatment in dampening lung infection.


Subject(s)
Alveolar Epithelial Cells/metabolism , Models, Biological , Organoids/metabolism , Virus Replication , Alveolar Epithelial Cells/pathology , Alveolar Epithelial Cells/virology , /pathology , Humans , Organoids/pathology , Organoids/virology
2.
BMC Infect Dis ; 21(1): 155, 2021 Feb 08.
Article in English | MEDLINE | ID: covidwho-1069544

ABSTRACT

BACKGROUND: The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients. METHODS: Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared. RESULTS: Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P <  0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046). CONCLUSIONS: The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.


Subject(s)
/physiopathology , Adult , Aged , Child, Preschool , China , Comorbidity , Cough , Disease Outbreaks , Female , Fever , Hospitalization , Humans , Infant , Lung/diagnostic imaging , Lymphopenia , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Tomography, X-Ray Computed
3.
Preprint | SciFinder | ID: ppcovidwho-4394

ABSTRACT

A review Since Dec 2019, the new 1919 coronavirus (2019-novelcoronavirus, 2019-nCov) pneumonia epidemic has spread from Wuhan City, Hubei Province to the whole country There are many cases of child infections reported at present, the youngest age is 30h born newborns Therefore, in view of the different clin characteristics, diagnosis and treatment of children′s cases and adults, in order to better deal with the new type of coronavirus pneumonia in pediatrics, the Pediatric Branch of the Guangdong Medical Association, the Guangdong Pediatric Quality Control Center, the Pediatric Branch of the Guangzhou Medical Association and the Guangzhou City The Pediatric Quality Control Center organized a panel of experts in the clin diagnosis and treatment of new coronaviruses in Guangdong and Guangzhou according to the "Suspected New Coronavirus Infection Program (Trial Version 5)" issued by the National Health and Health Commission and the "Suspected New Coronavirus Infection" issued by the WHO "Guidelines for clin management of severe acute respiratory infections", with reference to the existing experience in the diagnosis and treatment of children′s cases in the country, combined with the experience of the doctors in our province, form a consensus of experts in the diagnosis and treatment of new coronavirus pneumonia in pediatrics in Guangdong Province This consensus covers children of all ages The characteristics of the system are explained from the aspects of clin diagnosis, treatment, prevention and control, etc , for the reference of clinicians

4.
Med Sci Monit ; 26: e928835, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-994262

ABSTRACT

BACKGROUND This study summarizes the characteristics of children screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reports the case of 1 child who was diagnosed with SARS-CoV-2 infection in Guangzhou Women and Children's Medical Center and the cases of his family members. MATERIAL AND METHODS The medical records of 159 children who were admitted to our hospital from January 23 to March 20, 2020, were retrospectively analyzed. Samples from pharyngeal or/and anal swabs were subjected to reverse-transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 within 12 h of patient admission; a second RT-PCR test was done 24 h after the first test. RESULTS Of the 159 patients, 151 patients had epidemiological histories, 14 patients had cluster onset, and 8 patients had no epidemiological history but had symptoms similar to coronavirus disease 2019 (COVID-19). The most common symptom was fever (n=125), followed by respiratory and gastrointestinal symptoms. A 7-year-old boy in a cluster family from Wuhan was confirmed with asymptomatic SARS-CoV-2 infection with ground-glass opacity shadows on his lung computed tomography scan, and his swab RT-PCR test had not turned negative until day 19 of his hospitalization. In patients who did not test positive for SARS-CoV-2, influenza, respiratory syncytial virus, and adenovirus were observed. A total of 158 patients recovered, were discharged, and experienced no abnormalities during follow-up. CONCLUSIONS For SARS-CoV-2 nosocomial infections, taking a "standard prevention & contact isolation & droplet isolation & air isolation" strategy can prevent infection effectively. Children with clustered disease need close monitoring.


Subject(s)
/diagnosis , /epidemiology , /methods , Child , Child, Preschool , China/epidemiology , Coronavirus/metabolism , Coronavirus/pathogenicity , Cross Infection/epidemiology , Female , Fever , Hospitalization , Hospitals , Humans , Male , Medical Records , Patient Discharge , Retrospective Studies , /pathogenicity
5.
Elife ; 92020 11 09.
Article in English | MEDLINE | ID: covidwho-969888

ABSTRACT

Respiratory failure associated with COVID-19 has placed focus on the lungs. Here, we present single-nucleus accessible chromatin profiles of 90,980 nuclei and matched single-nucleus transcriptomes of 46,500 nuclei in non-diseased lungs from donors of ~30 weeks gestation,~3 years and ~30 years. We mapped candidate cis-regulatory elements (cCREs) and linked them to putative target genes. We identified distal cCREs with age-increased activity linked to SARS-CoV-2 host entry gene TMPRSS2 in alveolar type 2 cells, which had immune regulatory signatures and harbored variants associated with respiratory traits. At the 3p21.31 COVID-19 risk locus, a candidate variant overlapped a distal cCRE linked to SLC6A20, a gene expressed in alveolar cells and with known functional association with the SARS-CoV-2 receptor ACE2. Our findings provide insight into regulatory logic underlying genes implicated in COVID-19 in individual lung cell types across age. More broadly, these datasets will facilitate interpretation of risk loci for lung diseases.

7.
Stem Cells International ; 2020:8, 2020.
Article in English | WHO COVID | ID: covidwho-827747

ABSTRACT

Insults to the alveoli usually lead to inefficient gas exchange or even respiratory failure, which is difficult to model in animal studies Over the past decade, stem cell-derived self-organizing three-dimensional organoids have emerged as a new avenue to recapitulate respiratory diseases in a dish Alveolar organoids have improved our understanding of the mechanisms underlying tissue homeostasis and pathological alterations in alveoli From this perspective, we review the state-of-the-art technology on establishing alveolar organoids from endogenous lung epithelial stem/progenitor cells or pluripotent stem cells, as well as the use of alveolar organoids for the study of respiratory diseases, including idiopathic pulmonary fibrosis, tuberculosis infection, and respiratory virus infection We also discuss challenges that need to be overcome for future application of alveolar organoids in individualized medicine

8.
Am J Kidney Dis ; 76(4): 490-499.e1, 2020 10.
Article in English | MEDLINE | ID: covidwho-730121

ABSTRACT

RATIONALE & OBJECTIVE: Patients receiving maintenance hemodialysis (MHD) are highly vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The current study was designed to evaluate the prevalence of SARS-CoV-2 infection based on both nucleic acid testing (NAT) and antibody testing in Chinese patients receiving MHD. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: From December 1, 2019, to March 31, 2020, a total of 1,027 MHD patients in 5 large hemodialysis centers in Wuhan, China, were enrolled. Patients were screened for SARS-CoV-2 infection by symptoms and initial computed tomography (CT) of the chest. If patients developed symptoms after the initial screening was negative, repeat CT was performed. Patients suspected of being infected with SARS-CoV-2 were tested with 2 consecutive throat swabs for viral RNA. In mid-March 2020, antibody testing for SARS-CoV-2 was obtained for all MHD patients. EXPOSURE: NAT and antibody testing results for SARS-CoV-2. OUTCOMES: Morbidity, clinical features, and laboratory and radiologic findings. ANALYTICAL APPROACH: Differences between groups were examined using t test or Mann-Whitney U test, comparing those not infected with those infected and comparing those with infection detected using NAT with those with infection detected by positive serology test results. RESULTS: Among 1,027 patients receiving MHD, 99 were identified as having SARS-CoV-2 infection, for a prevalence of 9.6%. Among the 99 cases, 52 (53%) were initially diagnosed with SARS-CoV-2 infection by positive NAT; 47 (47%) were identified later by positive immunoglobulin G (IgG) or IgM antibodies against SARS-CoV-2. There was a spectrum of antibody profiles in these 47 patients: IgM antibodies in 5 (11%), IgG antibodies in 35 (74%), and both IgM and IgG antibodies in 7 (15%). Of the 99 cases, 51% were asymptomatic during the epidemic; 61% had ground-glass or patchy opacities on CT of the chest compared with 11.6% among uninfected patients (P<0.001). Patients with hypertensive kidney disease were more often found to have SARS-CoV-2 infection and were more likely to be symptomatic than patients with another primary cause of kidney failure. LIMITATIONS: Possible false-positive and false-negative results for both NAT and antibody testing; possible lack of generalizability to other dialysis populations. CONCLUSIONS: Half the SARS-CoV-2 infections in patients receiving MHD were subclinical and were not identified by universal CT of the chest and selective NAT. Serologic testing may help evaluate the overall prevalence and understand the diversity of clinical courses among patients receiving MHD who are infected with SARS-CoV-2.


Subject(s)
Antibodies, Viral/analysis , Betacoronavirus/immunology , Coronavirus Infections/diagnosis , Kidney Failure, Chronic/therapy , Pneumonia, Viral/diagnosis , Renal Dialysis , China/epidemiology , Comorbidity , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Kidney Failure, Chronic/epidemiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Prevalence , Retrospective Studies , Serologic Tests/methods , Tomography, X-Ray Computed
9.
Infect Dis Poverty ; 9(1): 115, 2020 Aug 19.
Article in English | MEDLINE | ID: covidwho-721344

ABSTRACT

BACKGROUND: The emerging infectious disease, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a serious threat in China and worldwide. Challenged by this serious situation, China has taken many measures to contain its transmission. This study aims to systematically review and record these special and effective practices, in hope of benefiting for fighting against the ongoing worldwide pandemic. METHODS: The measures taken by the governments was tracked and sorted on a daily basis from the websites of governmental authorities (e.g. National Health Commission of the People's Republic of China). And the measures were reviewed and summarized by categorizations, figures and tables, showing an ever-changing process of combating with an emerging infectious disease. The population shift levels, daily local new diagnosed cases, daily mortality and daily local new cured cases were used for measuring the effect of the measures. RESULTS: The practices could be categorized into active case surveillance, rapid case diagnosis and management, strict follow-up and quarantine of persons with close contacts, and issuance of guidance to help the public understand and adhere to control measures, plus prompt and effective high-level policy decision, complete activation of the public health system, and full involvement of the society. Along with the measures, the population shift levels, daily local new diagnosed cases, and mortality were decreased, and the daily local new cured cases were increased in China. CONCLUSIONS: China's practices are effective in controlling transmission of SARS-CoV-2. Considering newly occurred situations (e.g. imported cases, work resumption), the control measures may be adjusted.


Subject(s)
Communicable Diseases, Emerging/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Population Surveillance , China/epidemiology , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Health Policy , Humans , Masks , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Time Factors , Travel
10.
J Med Internet Res ; 22(4): e18948, 2020 04 22.
Article in English | MEDLINE | ID: covidwho-62910

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) has been an unprecedented challenge to the global health care system. Tools that can improve the focus of surveillance efforts and clinical decision support are of paramount importance. OBJECTIVE: The aim of this study was to illustrate how new medical informatics technologies may enable effective control of the pandemic through the development and successful 72-hour deployment of the Honghu Hybrid System (HHS) for COVID-19 in the city of Honghu in Hubei, China. METHODS: The HHS was designed for the collection, integration, standardization, and analysis of COVID-19-related data from multiple sources, which includes a case reporting system, diagnostic labs, electronic medical records, and social media on mobile devices. RESULTS: HHS supports four main features: syndromic surveillance on mobile devices, policy-making decision support, clinical decision support and prioritization of resources, and follow-up of discharged patients. The syndromic surveillance component in HHS covered over 95% of the population of over 900,000 people and provided near real time evidence for the control of epidemic emergencies. The clinical decision support component in HHS was also provided to improve patient care and prioritize the limited medical resources. However, the statistical methods still require further evaluations to confirm clinical effectiveness and appropriateness of disposition assigned in this study, which warrants further investigation. CONCLUSIONS: The facilitating factors and challenges are discussed to provide useful insights to other cities to build suitable solutions based on cloud technologies. The HHS for COVID-19 was shown to be feasible and effective in this real-world field study, and has the potential to be migrated.


Subject(s)
Cloud Computing , Coronavirus Infections/epidemiology , Decision Support Systems, Clinical , Pneumonia, Viral/epidemiology , Sentinel Surveillance , Betacoronavirus , China/epidemiology , Coronavirus , Delivery of Health Care , Humans , Mobile Applications , Pandemics , Patient Discharge , Public Health
11.
Nat Med ; 26(4): 502-505, 2020 04.
Article in English | MEDLINE | ID: covidwho-10221

ABSTRACT

We report epidemiological and clinical investigations on ten pediatric SARS-CoV-2 infection cases confirmed by real-time reverse transcription PCR assay of SARS-CoV-2 RNA. Symptoms in these cases were nonspecific and no children required respiratory support or intensive care. Chest X-rays lacked definite signs of pneumonia, a defining feature of the infection in adult cases. Notably, eight children persistently tested positive on rectal swabs even after nasopharyngeal testing was negative, raising the possibility of fecal-oral transmission.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/virology , Feces/virology , Pneumonia, Viral/virology , Virus Shedding , Betacoronavirus/genetics , Child , Child, Preschool , Clinical Laboratory Techniques , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Female , Humans , Infant , Male , Nasopharynx/virology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Radiography, Thoracic , Real-Time Polymerase Chain Reaction , Rectum/virology
12.
Chin. J. Evid.-Based Med. ; 2(20): 125-133, 2020.
Article in Chinese | ELSEVIER | ID: covidwho-3359

ABSTRACT

China is facing the serious situation of 2019-novel coronavirus (2019-nCoV) infection. The health care institutions have actively participated in the prevention, diagnosis, and treatment of the disease. Proper regulation of in-hospital policy may help control virus spreading. We developed seven key clinical questions about the prevention and control of 2019-novel coronavirus infection in a hospital, and provided recommendations based on the best available evidence and expert experience. We interpret the recommendations for better feasibility in Chinese hospital. We hope to provide evidence and reference for the domestic medical institutions to reasonably adjust the hospital workflow during 2019-nCoV infection period.

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