Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 32
Filter
Add filters

Year range
1.
Zhongguo Anquan Shengchan Kexue Jishu = Journal of Safety Science and Technology ; - (10):11, 2021.
Article in English | ProQuest Central | ID: covidwho-1519232

ABSTRACT

In order to comprehensively and systematically prevent and control the major infectious diseases and break the deadlock of local security, a model of the prevention and control of major infectious diseases was established from the perspective of macro security.By expatiating the transformation from local security to comprehensive security, a new perspective of macro security was put forward to understand the spread of major infectious diseases.Combined with the characteristics of security events, the causative path of major infectious diseases was deeply analyzed, then the four key nodes and three time states in the transmission process were obtained, and the evolution, development and characteristics of major infectious disease security events in the perspective of macro security were defined.The internal and external factors influencing the prevention and control of major infectious diseases were determined from the prevention perspective of accident causes, and two prevention and control strategies of emergency management and response mechanism were proposed, so as to construct the model of the prevention and control of major infectious diseases in the perspective of macro security.The results showed that the model had good practicability in the prevention and control process of COVID-19,and the model has important theoretical and practical significance for discussing the security perspective and logic of epidemic prevention and control.

2.
Clin Pediatr (Phila) ; : 99228211058601, 2021 Nov 09.
Article in English | MEDLINE | ID: covidwho-1511594

ABSTRACT

Background. This case-control study aims to investigate the clinical characteristics in pediatric patients with pneumonia infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A, and human adenoviruses (HAdVs). Methods. Hospitalized pediatric patients with pneumonia infected with SARS-CoV-2 at Wuhan Children's Hospital and pneumonia infected with influenza A, and HAdVs at Qilu Children's Hospital were compared. Clinical manifestations, laboratory examinations, and imaging characteristics were analyzed. Results. The proportions of hyperpyrexia (54.3%, 33.9%), cough (100%, 99.2%), wheezing (45.7%, 53.7%), diarrhea (31.4%, 14.9%), and fever (100%, 75.2%) in patients with influenza A and HAdVs were higher than those of patients with SARS-CoV-2 (9.4%, P < .001; 48.5%, P < .001; 0%, P < .001; 8.8%, P = .002; 41.5%, P < .001; respectively). Laboratory examinations revealed the proportions of leukocytosis (37.1%, 52.9%), abnormal rates of neutrophils (40%, 40.5%), and lymphocytosis (42.9%, 65.3%) in influenza A and HAdV pneumonia groups were significantly higher than coronavirus disease 2019 (COVID-19) group (0%, P < .001; 0%, P < .001; 0%, P < .001; respectively). The proportion of elevated procalcitonin (5.7%, 14%) in patients with influenza A and HAdVs was significantly lower than those in patients with SARS-CoV-2 (64%, P < .001). In chest computed tomography, ground-glass opacities near the pleura were more common in patients with COVID-19 than those in patients with influenza A and HAdVs (32.7% vs 0% vs 0%, P < .001). Conclusion. Fever, cough, and wheezing are more common in the influenza A and HAdVs groups, whereas procalcitonin and computed tomography findings are likely to be pronounced in COVID-19 pneumonia. It provides a variety of methods except polymerase chain reaction for differentiating COVID-19 pneumonia from influenza A and HAdVs pneumonia.

4.
Phys Rev E ; 104(4-1): 044307, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1481983

ABSTRACT

Changes in individual behavior often entangle with the dynamic interaction of individuals, which complicates the epidemic process and brings great challenges for the understanding and control of the epidemic. In this work, we consider three kinds of typical behavioral changes in epidemic process, that is, self-quarantine of infected individuals, self-protection of susceptible individuals, and social distancing between them. We connect the behavioral changes with individual's social attributes by the activity-driven network with attractiveness. A mean-field theory is established to derive an analytical estimate of epidemic threshold for susceptible-infected-susceptible models with individual behavioral changes, which depends on the correlations between activity, attractiveness, and the number of generative links in the susceptible and infected states. We find that individual behaviors play different roles in suppressing the epidemic. Although all the behavioral changes could delay the epidemic by increasing the epidemic threshold, self-quarantine and social distancing of infected individuals could effectively decrease the epidemic outbreak size. In addition, simultaneous changes in these behaviors and the timing of implement of them also play a key role in suppressing the epidemic. These results provide helpful significance for understanding the interaction of individual behaviors in the epidemic process.

5.
Front Med (Lausanne) ; 8: 696976, 2021.
Article in English | MEDLINE | ID: covidwho-1450816

ABSTRACT

Background: Previous research suggested that Chinese Medicine (CM) Formula Huashibaidu granule might shorten the disease course in coronavirus disease 2019 (COVID-19) patients. This research aimed to investigate the early treatment effect of Huashibaidu granule in well-managed patients with mild COVID-19. Methods: An unblinded cluster-randomized clinical trial was conducted at the Dongxihu FangCang hospital. Two cabins were randomly allocated to a CM or control group, with 204 mild COVID-19 participants in each cabin. All participants received conventional treatment over a 7 day period, while the ones in CM group were additionally given Huashibaidu granule 10 g twice daily. Participants were followed up to their clinical endpoint. The primary outcome was worsening symptoms before the clinical endpoint. The secondary outcomes were cure and discharge before the clinical endpoint and alleviation of composite symptoms after the 7 days of treatment. Results: All 408 participants were followed up to their clinical endpoint and included in statistical analysis. Baseline characteristics were comparable between the two groups (P > 0.05). The number of worsening patients in the CM group was 5 (2.5%), and that in the control group was 16 (7.8%) with a significant difference between groups (P = 0.014). Eight foreseeable mild adverse events occurred without statistical difference between groups (P = 0.151). Conclusion: Seven days of early treatment with Huashibaidu granule reduced the likelihood of worsening symptoms in patients with mild COVID-19. Our study supports Huashibaidu granule as an active option for early treatment of mild COVID-19 in similar well-managed medical environments. Clinical Trial Registration:www.chictr.org.cn/showproj.aspx?proj=49408, identifier: ChiCTR2000029763.

6.
Chinese Journal of Integrated Traditional and Western Medicine ; 30(3):269-271, 2020.
Article in Chinese | CAB Abstracts | ID: covidwho-1408647

ABSTRACT

Since December 2019, a lot of unknowns have been discovered successively in Wuhan City, Hubei Province regarding the cause of pneumonia. COVID-19 has successively appeared infected cases all over the country. At the end of January 2015, this article supports Wuhan to participate in the treatment of COVID-19 patients. This article presents realisations regarding the treatment of COVID-19 patients with severe pneumonia.

7.
Front Med (Lausanne) ; 7: 611460, 2020.
Article in English | MEDLINE | ID: covidwho-1389196

ABSTRACT

Background: The data on long-term outcomes of patients infected by SARS-CoV-2 and treated with extracorporeal membrane oxygenation (ECMO) in China are merely available. Methods: A retrospective study included 73 patients infected by SARS-CoV-2 and treated with ECMO in 21 intensive care units in Hubei, China. Data on demographic information, clinical features, laboratory tests, ECMO durations, complications, and living status were collected. Results: The 73 ECMO-treated patients had a median age of 62 (range 33-78) years and 42 (63.6%) were males. Before ECMO initiation, patients had severe respiratory failure on mechanical ventilation with a median PO2/FiO2 of 71.9 [interquartile range (IQR), 58.6-87.0] mmHg and a median PCO2 of 62 [IQR, 43-84] mmHg on arterial blood analyses. The median duration from symptom onset to invasive mechanical ventilation, and to ECMO initiation was19 [IQR, 15-25] days, and 23 [IQR, 19-31] days. Before and after ECMO initiation, the proportions of patients receiving prone position ventilation were 58.9 and 69.9%, respectively. The median duration of ECMO support was 18.5 [IQR 12-30] days. During the treatments with ECMO, major hemorrhages occurred in 31 (42.5%) patients, and oxygenators were replaced in 21 (28.8%) patients. Since ECMO initiation, the 30-day mortality and 60-day mortality were 63.0 and 80.8%, respectively. Conclusions: In Hubei, China, the ECMO-treated patients infected by SARS-CoV-2 were of a broad age range and with severe hypoxemia. The durations of ECMO support, accompanied with increased complications, were relatively long. The long-term mortality in these patients was considerably high.

9.
Nucleic Acids Res ; 49(15): 8822-8835, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1343703

ABSTRACT

The catalytic subunit of SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) contains two active sites that catalyze nucleotidyl-monophosphate transfer (NMPylation). Mechanistic studies and drug discovery have focused on RNA synthesis by the highly conserved RdRp. The second active site, which resides in a Nidovirus RdRp-Associated Nucleotidyl transferase (NiRAN) domain, is poorly characterized, but both catalytic reactions are essential for viral replication. One study showed that NiRAN transfers NMP to the first residue of RNA-binding protein nsp9; another reported a structure of nsp9 containing two additional N-terminal residues bound to the NiRAN active site but observed NMP transfer to RNA instead. We show that SARS-CoV-2 RdRp NMPylates the native but not the extended nsp9. Substitutions of the invariant NiRAN residues abolish NMPylation, whereas substitution of a catalytic RdRp Asp residue does not. NMPylation can utilize diverse nucleotide triphosphates, including remdesivir triphosphate, is reversible in the presence of pyrophosphate, and is inhibited by nucleotide analogs and bisphosphonates, suggesting a path for rational design of NiRAN inhibitors. We reconcile these and existing findings using a new model in which nsp9 remodels both active sites to alternately support initiation of RNA synthesis by RdRp or subsequent capping of the product RNA by the NiRAN domain.


Subject(s)
Nidovirales/enzymology , Nucleotides/metabolism , Protein Domains , RNA-Binding Proteins/chemistry , RNA-Binding Proteins/metabolism , RNA-Dependent RNA Polymerase/chemistry , RNA-Dependent RNA Polymerase/metabolism , SARS-CoV-2/enzymology , Viral Nonstructural Proteins/chemistry , Viral Nonstructural Proteins/metabolism , Amino Acid Sequence , Catalytic Domain , Coenzymes/metabolism , Coronavirus RNA-Dependent RNA Polymerase/metabolism , Diphosphates/pharmacology , Diphosphonates/pharmacology , Guanosine Triphosphate/metabolism , Manganese , Models, Molecular , Nidovirales/chemistry , RNA-Dependent RNA Polymerase/antagonists & inhibitors , Uridine Triphosphate/metabolism
10.
Asian Politics & Policy ; 13(3):426-441, 2021.
Article in English | Academic Search Complete | ID: covidwho-1334429

ABSTRACT

The COVID‐19 pandemic is fundamentally affecting the world by challenging governments. Although most countries are still combating the virus, China, as the first plagued country, has basically contained the pandemic. This review article aims to analyze and explain how the Chinese government has achieved this task. By tracing the detailed timeline of the pandemic, it dissects the political meritocracy and policy integration of the Chinese government, which are the main reasons for its policy efficiency and effectiveness. Meritocracy requires the government and politicians to respect science, knowledge, evidence, rationality, and professionalism, particularly within the background of populism and anti‐intellectualism. In a pandemic, the Chinese experience of political meritocracy and policy integration may balance conflicting public values better than liberal democratic nations. Global solidarity and cooperation during this pandemic can be better achieved if Chinese politics and policies are deeply understood. [ABSTRACT FROM AUTHOR] Copyright of Asian Politics & Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

11.
Phytomedicine ; 91: 153671, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1313371

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of Hua Shi Bai Du Granule (Q-14) plus standard care compared with standard care alone in adults with coronavirus disease (COVID-19). STUDY DESIGN: A single-center, open-label, randomized controlled trial. SETTING: Wuhan Jinyintan Hospital, Wuhan, China, February 27 to March 27, 2020. PARTICIPANTS: A total of 204 patients with laboratory-confirmed COVID-19 were randomized into the treatment group and control group, consisting of 102 patients in each group. INTERVENTIONS: In the treatment group, Q-14 was administered at 10 g (granules) twice daily for 14 days, plus standard care. In the control group, patients were provided standard care alone for 14 days. MAIN OUTCOME MEASURE: The primary outcome was the conversion time for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral assay. Adverse events were analyzed in the safety population. RESULTS: Among the 204 patients, 195 were analyzed according to the intention-to-treat principle. A total of 149 patients (71 vs. 78 in the treatment and control groups, respectively) tested negative via the SARS-CoV-2 viral assay. There was no statistical significance in the conversion time between the treatment group and control group (Full analysis set: Median [interquartile range]: 10.00 [9.00-11.00] vs. 10.00 [9.00-11.00]; Mean rank: 67.92 vs. 81.44; P = 0.051). The recovery time for fever was shorter in the treatment group than in the control group. The disappearance rate of symptoms like cough, fatigue, and chest discomfort was significantly higher in the treatment group. In chest computed tomography (CT) examinations, the overall evaluation of chest CT examination after treatment compared with baseline showed that more patients improved in the treatment group. There were no significant differences in the other outcomes. CONCLUSION: The combination of Q-14 and standard care for COVID-19 was useful for the improvement of symptoms (such as fever, cough, fatigue, and chest discomfort), but did not result in a significantly higher probability of negative conversion in the SARS-CoV-2 viral assay. No serious adverse events were observed. TRIAL REGISTRATION: ChiCTR2000030288.


Subject(s)
COVID-19 , Drugs, Chinese Herbal/therapeutic use , COVID-19/therapy , China , Female , Humans , Male , Middle Aged , Treatment Outcome
12.
J Air Transp Manag ; 95: 102106, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1293896

ABSTRACT

COVID-19 pandemic starting in early 2020 has greatly impacted human and industrial activities. Air transport in China shrank abruptly in February 2020, following a year-long gradual recovery. The airline companies reacted to this unprecedented event by dramatically reducing the flight volume and rearranging the aircraft types. As the first major economy that successfully controls the spread of COVID-19, China can provide a unique opportunity to quantify the medium-long impacts on the air transport industry. To quantify the corresponding changes and to elucidate the effects of COVID-19 in the wake of two major outbreaks centered in Wuhan and Beijing, we analyze twelve flight routes formed by four selected airports, using the Automatic Dependent Surveillance-Broadcast (ADS-B) data in 2019 and 2020. Our results show that the total flight volume in 2020 reduced to 67.8% of 2019 in China. The recovering time of flight volume was about 2-6 months, dependent on the severity. In order to unwind the severe challenge, airlines mainly relied on aircraft B738 and A321 between February and June in 2020 because the fuel consumption per seat of these two aircraft types is the lowest. Besides, fuel consumption and aircraft emissions are calculated according to the Base of Aircraft Data (BADA) and the International Civil Aviation Organization's Engine Emissions Databank (ICAO's EEDB). At the end of 2020, the ratios of daily fuel consumption and aircraft emissions of 2020 to 2019 rebounded to about 0.875, suggesting the domestic commercial flights were nearly fully recovered. Our results may provide practical guidance and meaningful expectation for commercial aircraft management for other countries.

13.
mBio ; 12(3): e0142321, 2021 06 29.
Article in English | MEDLINE | ID: covidwho-1280400

ABSTRACT

The catalytic subunit of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA-dependent RNA polymerase (RdRp) Nsp12 has a unique nidovirus RdRp-associated nucleotidyltransferase (NiRAN) domain that transfers nucleoside monophosphates to the Nsp9 protein and the nascent RNA. The NiRAN and RdRp modules form a dynamic interface distant from their catalytic sites, and both activities are essential for viral replication. We report that codon-optimized (for the pause-free translation in bacterial cells) Nsp12 exists in an inactive state in which NiRAN-RdRp interactions are broken, whereas translation by slow ribosomes and incubation with accessory Nsp7/8 subunits or nucleoside triphosphates (NTPs) partially rescue RdRp activity. Our data show that adenosine and remdesivir triphosphates promote the synthesis of A-less RNAs, as does ppGpp, while amino acid substitutions at the NiRAN-RdRp interface augment activation, suggesting that ligand binding to the NiRAN catalytic site modulates RdRp activity. The existence of allosterically linked nucleotidyl transferase sites that utilize the same substrates has important implications for understanding the mechanism of SARS-CoV-2 replication and the design of its inhibitors. IMPORTANCE In vitro interrogations of the central replicative complex of SARS-CoV-2, RNA-dependent RNA polymerase (RdRp), by structural, biochemical, and biophysical methods yielded an unprecedented windfall of information that, in turn, instructs drug development and administration, genomic surveillance, and other aspects of the evolving pandemic response. They also illuminated the vast disparity in the methods used to produce RdRp for experimental work and the hidden impact that this has on enzyme activity and research outcomes. In this report, we elucidate the positive and negative effects of codon optimization on the activity and folding of the recombinant RdRp and detail the design of a highly sensitive in vitro assay of RdRp-dependent RNA synthesis. Using this assay, we demonstrate that RdRp is allosterically activated by nontemplating phosphorylated nucleotides, including naturally occurring alarmone ppGpp and synthetic remdesivir triphosphate.


Subject(s)
Adenosine Triphosphate/analogs & derivatives , Antiviral Agents/pharmacology , Coronavirus RNA-Dependent RNA Polymerase/metabolism , Guanosine Tetraphosphate/pharmacology , SARS-CoV-2/drug effects , Adenosine Triphosphate/pharmacology , COVID-19/drug therapy , Catalytic Domain/physiology , Coronavirus RNA-Dependent RNA Polymerase/genetics , Humans , Ribosomes/metabolism
14.
Medicine (Baltimore) ; 100(19): e25497, 2021 May 14.
Article in English | MEDLINE | ID: covidwho-1262269

ABSTRACT

ABSTRACT: Coronavirus disease (COVID-19) patients frequently develop liver biochemical abnormality. However, liver biochemical abnormality in COVID-19 patients with liver cirrhosis is under-recognized.Patients hospitalized during COVID-19 pandemic in China (ie, from February to April 2020) were screened. All of 17 COVID-19 patients with liver cirrhosis consecutively admitted to the Wuhan Huoshenshan Hospital were identified. Meanwhile, 17 age-, sex-, and severity-matched COVID-19 patients without liver cirrhosis admitted to this hospital were selected as a control group; all of 14 cirrhotic patients without COVID-19 consecutively admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command were selected as another control group. Incidence of liver biochemical abnormality and decompensated events were primarily compared.Among the COVID-19 patients with liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 76.50% and 84.60%, respectively; 7 (41.20%) had decompensated events at admission; 1 was transferred to intensive care unit due to gastrointestinal bleeding. Among the COVID-19 patients without liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 58.80% (P = .271) and 60.00% (P = .150), respectively. Among the cirrhotic patients without COVID-19, the incidence of liver biochemical abnormality at admission and during hospitalization were 69.20% (P = .657) and 81.80% (P = .855), respectively; 11 (78.60%) had decompensated events at admission (P = .036). None died during hospitalization among the three groups.Liver biochemical abnormality is common in COVID-19 patients with liver cirrhosis. Management of decompensated events in cirrhotic patients without COVID-19 should not be neglected during COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Liver Cirrhosis/epidemiology , Liver Cirrhosis/physiopathology , Liver Function Tests , Adult , Aged , Aged, 80 and over , Case-Control Studies , China , Female , Humans , Intensive Care Units , Male , Middle Aged , Pandemics , Risk Factors , SARS-CoV-2 , Severity of Illness Index
17.
BMC Public Health ; 21(1): 723, 2021 04 14.
Article in English | MEDLINE | ID: covidwho-1183520

ABSTRACT

BACKGROUND: The global spread of the COVID-19 pandemic has become the most fundamental threat to human health. In the absence of vaccines and effective therapeutical solutions, non-pharmaceutic intervention has become a major way for controlling the epidemic. Gentle mitigation interventions are able to slow down the epidemic but not to halt it well. While strict suppression interventions are efficient for controlling the epidemic, long-term measures are likely to have negative impacts on economics and people's daily live. Hence, dynamically balancing suppression and mitigation interventions plays a fundamental role in manipulating the epidemic curve. METHODS: We collected data of the number of infections for several countries during the COVID-19 pandemics and found a clear phenomenon of periodic waves of infection. Based on the observation, by connecting the infection level with the medical resources and a tolerance parameter, we propose a mathematical model to understand impacts of combining intervention measures on the epidemic dynamics. RESULTS: Depending on the parameters of the medical resources, tolerance level, and the starting time of interventions, the combined intervention measure dynamically changes with the infection level, resulting in a periodic wave of infections controlled below an accepted level. The study reveals that, (a) with an immediate, strict suppression, the numbers of infections and deaths are well controlled with a significant reduction in a very short time period; (b) an appropriate, dynamical combination of suppression and mitigation may find a feasible way in reducing the impacts of epidemic on people's live and economics. CONCLUSIONS: While the assumption of interventions deployed with a cycle of period in the model is limited and unrealistic, the phenomenon of periodic waves of infections in reality is captured by our model. These results provide helpful insights for policy-makers to dynamically deploy an appropriate intervention strategy to effectively battle against the COVID-19.


Subject(s)
COVID-19/prevention & control , Models, Theoretical , Pandemics/prevention & control , Communicable Disease Control , Humans
18.
Medicine (Baltimore) ; 100(12): e25083, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1150005

ABSTRACT

ABSTRACT: The purpose of this study was to investigate the predictive value of combined clinical and imaging features, compared with the clinical or radiological risk factors only. Moreover, the expected results aimed to improve the identification of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) patients who may have critical outcomes.This retrospective study included laboratory-confirmed SARS-COV-2 cases between January 18, 2020, and February 16, 2020. The patients were divided into 2 groups with noncritical illness and critical illness regarding severity status within the hospitalization. Univariable and multivariable logistic regression models were used to explore the risk factors associated with clinical and radiological outcomes in patients with SARS-COV-2. The ROC curves were performed to compare the prediction performance of different factors.A total of 180 adult patients in this study included 20 critical patients and 160 noncritical patients. In univariate logistic regression analysis, 15 risk factors were significantly associated with critical outcomes. Of importance, C-reactive protein (1.051, 95% confidence interval 1.024-1.078), D-dimer (1.911, 95% CI, 1.050-3.478), and CT score (1.29, 95% CI, 1.053-1.529) on admission were independent risk factors in multivariate analysis. The combined model achieved a better performance in disease severity prediction (P = .05).CRP, D-dimer, and CT score on admission were independent risk factors for critical illness in adults with SARS-COV-2. The combined clinical and radiological model achieved better predictive performance than clinical or radiological factors alone.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Diagnostic Techniques and Procedures/statistics & numerical data , Adult , Aged , C-Reactive Protein/analysis , Female , Fibrin Fibrinogen Degradation Products/analysis , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , ROC Curve , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed
19.
Curr Opin Cardiol ; 36(3): 367-373, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1132617

ABSTRACT

PURPOSE OF REVIEW: Preventive cardiology has an important role to play in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The SARS-CoV-2 pandemic has been observed to have a greater mortality impact on subgroups of people in the population who are deemed to be at higher medical disease risk. Individuals with cardiovascular disorders are one such COVID-19-associated high-mortality risk group. RECENT FINDINGS: Evidence is accumulating that COVID-19 infection may worsen an individual's future cardiovascular health, and, preinfection/postinfection cardiovascular evaluation may be warranted to determine if progressive cardiovascular damage has occurred because of COVID-19 infection. In this study, we conducted a systematic review and meta-analysis, focusing on the association between COVID-19 severity and cardiac-specific biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin T (TnT)/troponin I (TnI), lactate dehydrogenase (LDH), creatine kinase, and creatine kinase isoenzyme (CK-MB). TnT had the highest odds ratio or OR (11.83) indicating the greatest association with COVID-19 severity, followed by NT-proBNP (7.57), TnI (6.32), LDH (4.79), D-dimer (4.10), creatine kinase (3.43), and CK-MB (3.35). All of the biomarkers studied were significantly correlated with COVID-19 severity including severe symptoms, ICU care, and mortality (P < 0.0001, except P < 0.01 for CK-MB). SUMMARY: COVID-19 infection results in short-term and long-term disease risk that may involve adverse cardiovascular health issues including heart failure. Cardiac-specific biomarkers appear to identify a subset of COVID-19 patients who have the highest risk of an adverse medical outcome. Preventive cardiology has an important role to play in the COVID-19 pandemic.The risk/benefit analysis of maintaining or eliminating the use of the angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitor (ACE-I) medications deserves further investigation.


Subject(s)
COVID-19 , Pandemics , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Biomarkers , Humans , SARS-CoV-2
20.
China Tropical Medicine ; 20(12):1223-1226, 2020.
Article in Chinese | GIM | ID: covidwho-1116450

ABSTRACT

To investigate the early diagnosis and treatment of secondary tuberculosis complicated with COVID-19. The clinical manifestation, auxiliary examination, diagnosis and treatment of one case of secondary tuberculosis complicated with COVID-19 admitted to Wuhan Pulmonary Hospital were analyzed retrospectively. The patient had a clear history of COVID-19 exposure. The clinical manifestations were cough, expectoration, fever and gasp. Chest CT showed multiple patch, nodule, spot, strip and cavity shadow in two lungs. COVID-19 was diagnosed as early as possible by detection of SARS-CoV-2 nucleic acid in respiratory specimens. After reasonable anti-tuberculosis combined with antiviral treatment, the detection of SARS-CoV-2 nucleic acid in respiratory specimens and acid-fast bacilli smear of sputum specimens turned negative, the symptoms were relieved and discharged. In the epidemic period of COVID-19, we should pay attention to the identification of secondary pulmonary tuberculosis with COVID-19, the formulation of drug programs for the treatment of two diseases, and avoid the use of rifampicin, a liver drug enzyme inducer, so as to avoid missed treatment due to the weakened efficacy of lopinavir/ritonavir and abidol, etc.

SELECTION OF CITATIONS
SEARCH DETAIL
...