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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308211

ABSTRACT

Background: Global healthcare systems have been under huge pressure since Coronavirus Disease 2019 (COVID-19) was declared a pandemic. It is critical to prevent further spread of COVID-19 and to protect health workers from infection. This study aims to figure out short-term physiological impact on health workers induced by working in isolation wards for hours with personal protective equipment (PPE), so as to provide insights on reducing physiological impact and infection risk of health workers. Methods: : Health workers who had worked in COVID-19 isolation wards for at least five weeks in Wuhan, China were recruited. Parameters including lung function, heart rate, oxygen saturation and weight were respectively measured before and after they worked in isolation wards. Comparison and regression analyses were conducted. Correlations between changing levels of measured parameters (lung function and heart rate) and baseline characteristics (body mass index, age, and working duration) were also analyzed. Results: : After working in isolation wards for four to nine hours, the forced vital capacity (FVC) of health workers (74.32±17.59 versus 81.28±16.35, P <0.001) as well as weight (54.79 (48.50, 61.00) versus 55.50 (48.90, 61.00) P <0.01) showed significant decrease, while HR showed significant increase (110.31±14.65 versus 103.94±16.38, P =0.04). Correlation between BMI and the decline levels of FEV 1 /FVC (β=2.87, P =0.02) and correlation between BMI and the decline levels of FEF 25-75 % predicted (β=1.80, P <0.05) were reported. Conclusions: : After working in COVID-19 isolation wards with PPE for four to nine hours, the lung function of health workers declined. The decline levels were associated with BMI. HR increase and weight loss were reported. In order to reduce the potential infection risk of health workers, the balance between working duration and physiological changes should be considered when making shifting schedule.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315270

ABSTRACT

Background: Coronavirus disease (COVID-19) has resulted in high mortality worldwide. However, information regarding cardiac markers for precise risk-stratification is limited. We aimed to discover a sensitive and reliable early-warning biomarker for optimizing management and improving COVID-19 patients’ prognosis. Methods: : This single-center case series was conducted between February 4 and April 10, 2020. In total, 2,954 consecutive COVID-19 patients who were receiving treatment at Wuhan Huoshenshan Hospital in China were included in the retrospectively selected cohort. All patients were diagnosed with COVID-19 and treated at the study site. Data of serum levels of cardiac markers, coronary artery disease (CAD) diagnosis, and survival were collected after admission. Single-cell RNA-sequencing was performed to analyze severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor expression. Results: : Median patient age was 60 years (range, 50-68 years);1,461 (49.5%) were female, and 1,515 (51.3%) patients were in a severe/critical condition. Compared to mild/moderate patients (1,439, 48.7%), severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. Among severe/critical COVID-19 patients, those with abnormal serum levels of brain natriuretic peptide had a significantly higher mortality rate than patients with normal levels. Severe/critical COVID-19 patients with pre-existing CAD (165/1,155 [10.9%]) had more cases of abnormal brain natriuretic peptide levels than those without CAD. Enhanced SARS-CoV-2 receptor expression was observed in patients with CAD. Regression analysis revealed that patients with elevated brain natriuretic peptide levels were at a higher risk of death (hazards ratio, 1.001 [95% confidence interval, 1.0003-1.002]). Conclusions: : Brain natriuretic peptide is an effective biomarker for early risk assessment in COVID-19 patients with or without pre-existing CAD. Monitoring BNP status will improve the risk-stratification management and prognosis of patients within one week after admission.

4.
Int J Psychol ; 57(1): 73-86, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1332978

ABSTRACT

When the COVID-19 pandemic struck, research teams in the United States and Finland were collaborating on a study to improve adolescent academic engagement in chemistry and physics and the impact remote teaching on academic, social, and emotional learning. The ongoing "Crafting Engaging Science Environments" (CESE) intervention afforded a rare data collection opportunity. In the United States, students were surveyed at the beginning of the school year and again in May, providing information for the same 751 students from before and during the pandemic. In Finland, 203 students were surveyed during remote learning. Findings from both countries during this period of remote learning revealed that students' academic engagement was positively correlated with participation in hands-on, project-based lessons. In Finland, results showed that situational engagement occurred in only 4.7% of sampled cases. In the United States, students show that academic engagement, primarily the aspect of challenge, was enhanced during remote learning. Engagement was in turn correlated with positive socioemotional constructs related to science learning. The study's findings emphasise the importance of finding ways to ensure equitable opportunities for students to participate in project-based activities when learning remotely.


Subject(s)
COVID-19 , Pandemics , Adolescent , Finland , Humans , SARS-CoV-2 , Schools , United States
5.
Crit Care ; 25(1): 158, 2021 04 26.
Article in English | MEDLINE | ID: covidwho-1204102

ABSTRACT

BACKGROUND: COVID-19 has resulted in high mortality worldwide. Information regarding cardiac markers for precise risk-stratification is limited. We aim to discover sensitive and reliable early-warning biomarkers for optimizing management and improving the prognosis of COVID-19 patients. METHODS: A total of 2954 consecutive COVID-19 patients who were receiving treatment from the Wuhan Huoshenshan Hospital in China from February 4 to April 10 were included in this retrospective cohort. Serum levels of cardiac markers were collected after admission. Coronary artery disease diagnosis and survival status were recorded. Single-cell RNA-sequencing and bulk RNA-sequencing from different cohorts of non-COVID-19 were performed to analyze SARS-CoV-2 receptor expression. RESULTS: Among 2954 COVID-19 patients in the analysis, the median age was 60 years (50-68 years), 1461 (49.5%) were female, and 1515 (51.3%) were severe/critical. Compared to mild/moderate (1439, 48.7%) patients, severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. In severe/critical COVID-19 patients, those with abnormal serum levels of BNP (42 [24.6%] vs 7 [1.1%]), hs-TNI (38 [48.1%] vs 6 [1.0%]), α- HBDH (55 [10.4%] vs 2 [0.2%]), CK-MB (45 [36.3%] vs 12 [0.9%]), and LDH (56 [12.5%] vs 1 [0.1%]) had a significantly higher mortality rate compared to patients with normal levels. The same trend was observed in the ICU admission rate. Severe/critical COVID-19 patients with pre-existing coronary artery disease (165/1,155 [10.9%]) had more cases of BNP (52 [46.5%] vs 119 [16.5%]), hs-TNI (24 [26.7%] vs 9.6 [%], α- HBDH (86 [55.5%] vs 443 [34.4%]), CK-MB (27 [17.4%] vs 97 [7.5%]), and LDH (65 [41.9%] vs 382 [29.7%]), when compared with those without coronary artery disease. There was enhanced SARS-CoV-2 receptor expression in coronary artery disease compared with healthy controls. From regression analysis, patients with five elevated cardiac markers were at a higher risk of death (hazards ratio 3.4 [95% CI 2.4-4.8]). CONCLUSIONS: COVID-19 patients with pre-existing coronary artery disease represented a higher abnormal percentage of cardiac markers, accompanied by high mortality and ICU admission rate. BNP together with hs-TNI, α- HBDH, CK-MB and LDH act as a prognostic biomarker in COVID-19 patients with or without pre-existing coronary artery disease.


Subject(s)
Biomarkers/blood , COVID-19/blood , COVID-19/therapy , Coronary Artery Disease/blood , Aged , COVID-19/epidemiology , China/epidemiology , Coronary Artery Disease/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment/methods
6.
J Psychiatr Res ; 136: 595-602, 2021 04.
Article in English | MEDLINE | ID: covidwho-894074

ABSTRACT

The major Corona Virus Disease 2019 (COVID-19) outbreak caused tens of thousands of diagnosed patients quarantined and treated in designated hospitals in Wuhan, the epicenter of the disease in China. Evidence for the psychological problems of COVID-19 patients was limited. Here we report a cross-sectional study of the mental distress and sleep quality of patients in a single center in Wuhan. The study was based on a combined questionnaire of basic questions designed by the study group, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI). On Feb 17th and Mar 14th, two groups of patients were recruited respectively in a designated hospital for COVID-19. Univariate analysis and regression models were used to identify predictors for patients' psychological distress and sleep quality. In total, there were 202 participants in our combined sample. The average SAS, SDS, and PSQI score of participants were 44.2, 51.7, and 9.3 respectively. Factors associated with SAS score include gender, subjective evaluation of disease symptoms, and evaluation of medical staffs' attitude. Gender, age, education level, frequency of contacting with family, subjective knowledge level of COVID 19, and evaluation of medical staffs' attitude are associated with participants SDS score. Factors associated with PSQI score are age and subjective evaluation of disease symptoms.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Psychological Distress , Sleep , Adult , COVID-19/epidemiology , China/epidemiology , Cities/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged
8.
Lancet ; 395(10236): 1569-1578, 2020 05 16.
Article in English | MEDLINE | ID: covidwho-824547

ABSTRACT

BACKGROUND: No specific antiviral drug has been proven effective for treatment of patients with severe coronavirus disease 2019 (COVID-19). Remdesivir (GS-5734), a nucleoside analogue prodrug, has inhibitory effects on pathogenic animal and human coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro, and inhibits Middle East respiratory syndrome coronavirus, SARS-CoV-1, and SARS-CoV-2 replication in animal models. METHODS: We did a randomised, double-blind, placebo-controlled, multicentre trial at ten hospitals in Hubei, China. Eligible patients were adults (aged ≥18 years) admitted to hospital with laboratory-confirmed SARS-CoV-2 infection, with an interval from symptom onset to enrolment of 12 days or less, oxygen saturation of 94% or less on room air or a ratio of arterial oxygen partial pressure to fractional inspired oxygen of 300 mm Hg or less, and radiologically confirmed pneumonia. Patients were randomly assigned in a 2:1 ratio to intravenous remdesivir (200 mg on day 1 followed by 100 mg on days 2-10 in single daily infusions) or the same volume of placebo infusions for 10 days. Patients were permitted concomitant use of lopinavir-ritonavir, interferons, and corticosteroids. The primary endpoint was time to clinical improvement up to day 28, defined as the time (in days) from randomisation to the point of a decline of two levels on a six-point ordinal scale of clinical status (from 1=discharged to 6=death) or discharged alive from hospital, whichever came first. Primary analysis was done in the intention-to-treat (ITT) population and safety analysis was done in all patients who started their assigned treatment. This trial is registered with ClinicalTrials.gov, NCT04257656. FINDINGS: Between Feb 6, 2020, and March 12, 2020, 237 patients were enrolled and randomly assigned to a treatment group (158 to remdesivir and 79 to placebo); one patient in the placebo group who withdrew after randomisation was not included in the ITT population. Remdesivir use was not associated with a difference in time to clinical improvement (hazard ratio 1·23 [95% CI 0·87-1·75]). Although not statistically significant, patients receiving remdesivir had a numerically faster time to clinical improvement than those receiving placebo among patients with symptom duration of 10 days or less (hazard ratio 1·52 [0·95-2·43]). Adverse events were reported in 102 (66%) of 155 remdesivir recipients versus 50 (64%) of 78 placebo recipients. Remdesivir was stopped early because of adverse events in 18 (12%) patients versus four (5%) patients who stopped placebo early. INTERPRETATION: In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies. FUNDING: Chinese Academy of Medical Sciences Emergency Project of COVID-19, National Key Research and Development Program of China, the Beijing Science and Technology Project.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/therapeutic use , Aged , Alanine/adverse effects , Alanine/therapeutic use , Antiviral Agents/adverse effects , Betacoronavirus , COVID-19 , China , Double-Blind Method , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Negative Results , Pandemics , SARS-CoV-2
12.
Front Neurol ; 11: 659, 2020.
Article in English | MEDLINE | ID: covidwho-634494

ABSTRACT

SARS-CoV-2 is a novel coronavirus leading to serious respiratory disease and is spreading around the world at a raging speed. Recently there is emerging speculations that the central nervous system (CNS) may be involved during SARS-CoV-2 infection, contributing to the respiratory failure. However, the existence of viral replication in CNS has not been confirmed due to the lack of evidence from autopsy specimens. Considering the tropism of SARS-CoV-2, ACE2, is prevailing in CNS, and the neuro-invasive property of human coronavirus was widely reported, there is a need to identified the possible complications during COVID-19 for CNS. In this review, we conduct a detailed summary for the potential of SARS-CoV-2 to infect central nervous system from latest biological fundamental of SARS-CoV-2 to the clinical experience of other human coronaviruses. To confirm the neuro-invasive property of SARS-CoV-2 and the subsequent influence on patients will require further exploration by both virologist and neurologist.

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