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1.
International Journal of E-Collaboration ; 18(1):1-17, 2022.
Article in English | ProQuest Central | ID: covidwho-1879527

ABSTRACT

Massive open online courses (MOOCs)-based education has gained a great popularity especially during this special COVID-19 pandemic time. This study, aiming to summarize the effectiveness of MOOCs, seems meaningful and necessary. Through a meta-analysis using Stata/MP 14.0, this study concludes that MOOCs-based education could significantly improve academic achievements and motivation rather than self-regulation and engagement compared with the non-MOOCs-based approach. Blended, independent, and gamified instead of interactive MOOCs could significantly improve academic achievements compared with their counterparts. Different approaches to MOOCs could not predict academic achievements. Future research into MOOCs-based education could focus on how to blend elements of gamification and interaction, as well as instructional methods, with MOOCs-based education.

2.
J Clin Invest ; 132(10)2022 May 16.
Article in English | MEDLINE | ID: covidwho-1846632

ABSTRACT

BackgroundThe Delta and Omicron variants of SARS-CoV-2 are currently responsible for breakthrough infections due to waning immunity. We report phase I/II trial results of UB-612, a multitope subunit vaccine containing S1-RBD-sFc protein and rationally designed promiscuous peptides representing sarbecovirus conserved helper T cell and cytotoxic T lymphocyte epitopes on the nucleocapsid (N), membrane (M), and spike (S2) proteins.MethodWe conducted a phase I primary 2-dose (28 days apart) trial of 10, 30, or 100 µg UB-612 in 60 healthy young adults 20 to 55 years old, and 50 of them were boosted with 100 µg of UB-612 approximately 7 to 9 months after the second dose. A separate placebo-controlled and randomized phase II study was conducted with 2 doses of 100 µg of UB-612 (n = 3,875, 18-85 years old). We evaluated interim safety and immunogenicity of phase I until 14 days after the third (booster) dose and of phase II until 28 days after the second dose.ResultsNo vaccine-related serious adverse events were recorded. The most common solicited adverse events were injection site pain and fatigue, mostly mild and transient. In both trials, UB-612 elicited respective neutralizing antibody titers similar to a panel of human convalescent sera. The most striking findings were long-lasting virus-neutralizing antibodies and broad T cell immunity against SARS-CoV-2 variants of concern (VoCs), including Delta and Omicron, and a strong booster-recalled memory immunity with high cross-reactive neutralizing titers against the Delta and Omicron VoCs.ConclusionUB-612 has presented a favorable safety profile, potent booster effect against VoCs, and long-lasting B and broad T cell immunity that warrants further development for both primary immunization and heterologous boosting of other COVID-19 vaccines.Trial RegistrationClinicalTrials.gov: NCT04545749, NCT04773067, and NCT04967742.FundingUBI Asia, Vaxxinity Inc., and Taiwan Centers for Disease Control, Ministry of Health and Welfare.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , COVID-19/therapy , Humans , Immunization, Passive , Middle Aged , SARS-CoV-2 , T-Lymphocytes , Young Adult
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335168

ABSTRACT

ABSTRACT Importance The SARS-CoV-2 non-spike structural proteins of nucleocapsid (N), membrane (M) and envelope (E) are critical in the host cell interferon response and memory T-cell immunity and have been grossly overlooked in the development of COVID vaccines. Objective To determine the safety and immunogenicity of UB-612, a multitope vaccine containing S1-RBD-sFc protein and rationally-designed promiscuous peptides representing sequence-conserved Th and CTL epitopes on the Sarbecovirus nucleocapsid (N), membrane (M) and spike (S2) proteins. Design, setting and participants UB-612 booster vaccination was conducted in Taiwan. A UB-612 booster dose was administered 6-8 months post-2 nd dose in 1,478 vaccinees from 3,844 healthy participants (aged 18-85 years) who completed a prior placebo (saline)-controlled, randomized, observer-blind, multi-center Phase-2 primary 2-dose series (100-μg per dose;28-day apart) of UB-612. The interim safety and immunogenicity were evaluated until 14 days post-booster. Exposure Vaccination with a booster 3 rd -dose (100-μg) of UB-612 vaccine. Main outcomes and measures Solicited local and systemic AEs were recorded for seven days in the e-diaries of study participants, while skin allergic reactions were recorded for fourteen days. The primary immunogenicity endpoints included viral-neutralizing antibodies against live SARS-CoV-2 wild-type (WT, Wuhan strain) and live Delta variant (VNT 50 ), and against pseudovirus WT and Omicron variant (pVNT 50 ). The secondary immunogenicity endpoints included anti-S1-RBD IgG antibody, S1-RBD:ACE2 binding inhibition, and T-cell responses by ELISpot and Intracellular Staining. Results No post-booster vaccine-related serious adverse events were recorded. The most common solicited adverse events were injection site pain and fatigue, mostly mild and transient. The UB-612 booster prompted a striking upsurge of neutralizing antibodies against live WT Wuhan strain (VNT 50 , 1,711) associated with unusually high cross-neutralization against Delta variant (VNT 50 , 1,282);and similarly with a strong effect against pseudovirus WT (pVNT 50, 6,245) and Omicron variant (pVNT 50 , 1,196). Upon boosting, the lower VNT 50 and pVNT 50 titers of the elderly in the primary series were uplifted to the same levels as those of the young adults. The UB-612 also induced robust, durable VoC antigen-specific Th1-oriented (IFN-γ + -) responses along with CD8 + T-cell (CD107a + -Granzyme B + ) cytotoxicity. Conclusions and relevance With a pronounced cross-reactive booster effect on B- and T-cell immunity, UB-612 may serve as a universal vaccine booster for comprehensive immunity enhancement against emergent VoCs. Trial registration [ClinicalTrials.gov: NCT04773067 ] KEY POINTS Question Facing ever-emergent SARS-CoV-2 variants and long-haul COVID, can composition-updated new vaccines be constructed capable of inducing striking, durable booster-recalled B/T-immunity to prevent infection by VoCs? Findings In a Phase-2 extension study, a booster dose of UB-612 multitope protein-peptide vaccine prompted high viral-neutralizing titers against live wild-type virus (VNT 50 , 1,711), Delta variant (VNT 50 , 1,282);pseudovirus wild-type (pVNT 50 , 6,245) and Omicron variant (pVNT 50 , 1,196). Robust, durable Th1-IFNγ + responses and CD8 + T cell-(CD107a + -Granzyme B + ) cytotoxic activity were both observed. Meaning UB-612 RBD-sFc vaccine armed with T cell immunity-promoting conserved N, M and S2 Th/CTL epitope peptides may serve as a universal vaccine to fend off new VoCs.

4.
Commun Biol ; 5(1): 262, 2022 03 24.
Article in English | MEDLINE | ID: covidwho-1799550

ABSTRACT

Understanding the underlying molecular mechanisms behind ADE of SARS-CoV-2 is critical for development of safe and effective therapies. Here, we report that two neutralizing mAbs, MW01 and MW05, could enhance the infection of SARS-CoV-2 pseudovirus on FcγRIIB-expressing B cells. X-ray crystal structure determination and S trimer-binding modeling showed that MW01 and MW05 could bind to RBDs in S trimer with both "up" and "down" states. While, the neutralizing mAb MW07, which has no ADE activity only binds to RBD in S trimer with "up" state. Monovalent MW01 and MW05 completely diminished the ADE activity compared with their bivalent counterparts. Moreover, both macropinocytosis and endocytosis are confirmed involving in ADE of SARS-CoV-2 pseudoviral infection. Blocking endosome transportation and lysosome acidification could inhibit the ADE activity mediated by MW05. Together, our results identified a novel ADE mechanism of SARS-CoV-2 pseudovirus in vitro, FcγRIIB-mediated uptake of SARS-CoV-2/mAb complex with bivalent interaction.


Subject(s)
Antibody-Dependent Enhancement , COVID-19 , Antibodies, Viral , Humans , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
5.
Chemistry ; 28(18): e202104054, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1767322

ABSTRACT

The ongoing outbreak of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has spread globally and poses a threat to public health and National economic development. Rapid and high-throughput SARS-CoV-2 RNA detection without the need of RNA extraction and amplification remain a key challenge. In this study, a new SARS-CoV-2 RNA detection strategy using a microfluidic biochip for the rapid and ultrasensitive detection of SARS-CoV-2 without RNA extraction and amplification was developed. This new strategy takes advantage of the specific SARS-CoV-2 RNA and probe DNA reaction in the microfluidic channel, fluorescence signal regulation by nanomaterials, and accurate sample control by the microfluidic chip. It presents an ultralow limit of detection of 600 copies mL-1 in a large linear detection regime from 1 aM to 100 fM. Fifteen samples were simultaneously detected in 40 min without the need for RNA purification and amplification. The detection accuracy of the strategy was validated through quantitative reverse transcription polymerase chain reaction (qRT-PCR), with a recovery of 99-113 %. Therefore, the SARS-CoV-2 RNA detection strategy proposed in this study can potentially be used for the quantitative diagnosis of viral infectious diseases.


Subject(s)
COVID-19 Testing , COVID-19 , Microfluidics , SARS-CoV-2 , COVID-19/diagnosis , COVID-19 Testing/methods , Humans , Nucleic Acid Amplification Techniques , RNA, Viral/genetics , SARS-CoV-2/genetics , Sensitivity and Specificity
6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331070

ABSTRACT

Background: An ongoing outbreak of coronavirus disease 2019 (COVID-19) is spreading, there are few reports on exploring individualized nutritional therapy for critical coronavirus disease 2019 (COVID-19) patients. Case presentation: To explore individualized nutritional therapy for critical coronavirus disease 2019 (COVID-19) patients.A nutritional treatment plan was created through nutritional risk screening and nutritional assessment, and an individualized nutritional treatment was implemented through multidisciplinary collaboration. The patient’s gastrointestinal symptoms were corrected, and her nutrition-related indicators such as albumin and body weight were improved. She was cured and discharged. Conclusion: Nutritional therapy is beneficial to improve the nutritional status and clinical outcome of critical COVID- 19 patients.

7.
Frontiers in medicine ; 9, 2022.
Article in English | EuropePMC | ID: covidwho-1710509

ABSTRACT

Diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during border screening among returning residents and prioritized travelers during the early phase of a pandemic can reduce the risk of importation and transmission in the community. This study aimed to compare the accuracy of various SARS-CoV-2 diagnostics and assess their potential utility as border screening for infection and immunity. Systematic literature searches were conducted in six electronic databases for studies reporting SARS-CoV-2 diagnostics (up to April 30, 2020). Meta-analysis and methodological assessment were conducted for all included studies. The performance of the diagnostic tests was evaluated with pooled sensitivity, specificity, and their respective 95% confidence intervals. A total of 5,416 unique studies were identified and 95 studies (at least 29,785 patients/samples) were included. Nucleic acid amplification tests (NAAT) consistently outperformed all other diagnostic methods regardless of the selected viral genes with a pooled sensitivity of 98% and a pooled specificity of 99%. Point-of-care (POC) serology tests had moderately high pooled sensitivity (69%), albeit lower than laboratory-based serology tests (89%), but both had high pooled specificity (96–98%). Serology tests were more sensitive for sampling collected at ≥ 7 days than ≤ 7 days from the disease symptoms onset. POC NAAT and POC serology tests are suitable for detecting infection and immunity against the virus, respectively as border screening. Independent validation in each country is highly encouraged with the preferred choice of diagnostic tool/s.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311801

ABSTRACT

Introduction: Since January 2020, the COVID-19 pandemic has elicited imposition of some form of travel restrictions by almost all countries in the world. Most of which persist to this day even as some restrictions have been gradually eased. It remains unclear if the trade-off from the unprecedented disruption to air travel was well worth in the course of pandemic containment. Methods: : A comparative analysis was conducted on Singapore, Taiwan, Hong Kong and South Korea’s COVID-19 response. Data on COVID-19 cases, travel-related and community interventions, socio-economic profile were consolidated. Trends on imported and local cases were analyzed using computations of moving averages, rate of change, particularly in response to distinct waves of travel-related interventions due to the outbreak in China, South Korea, Iran & Italy, and Europe. Findings: South Korea’s travel restrictions consistently lagged in terms of timeliness and magnitude. The first wave of travel restrictions against China was implemented 34 days after the outbreak in Wuhan, compared to 22-26 days taken by Singapore, Taiwan and Hong Kong. Restrictions against all countries came after 91 days, compared to 78-80 days for the other three countries. Taiwan and Hong Kong were the most efficient in adopting travel restrictions. Singapore’s belated measures and higher importation risk as compared to the other three Asian countries manifested in its deteriorating local transmission. The rate of change of imported cases fell by 1.08-1.43 across all four countries following the first wave of intervention against China, and by 0.22-0.52 in all countries except South Korea in the fifth wave against all international travellers. Conclusion: Travel restriction was effective in preventing COVID-19 case importation in early outbreak phase. However, evidence of its effect on local transmission was lacking. The impact of travel restrictions in containing epidemics cannot be disentangled from local non-pharmaceutical interventions concurrently implemented. Overall, measures should be complementary, with more emphasis on the latter to contain the outbreak effectively.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308533

ABSTRACT

Background: Diagnosis of SARS-CoV-2 plays an essential role for border screening to deter importation and transmission in the community. This study aims to compare the accuracy of various SARS-CoV-2 diagnostics in the general population and assess their potential utility as border screening for SARS-CoV-2 infection and immunity against SARS-CoV-2.Methods: Systematic literature searches were conducted in six electronic databases for studies reporting SARS-CoV-2 diagnostics. Meta-analysis and methodological assessment were conducted for all included studies. Performance of diagnostic tests was evaluated with pooled sensitivity, specificity and their respective 95% confidence intervals.Results: 5,416 unique studies were identified and 95 studies (at least 30,660 patients/samples) were included. Nuclei acid amplification tests (NAAT) consistently outperformed all other diagnostic methods regardless of geographical regions and selected viral genes with pooled sensitivity of 98% and pooled specificity of 99%. Point-of-care serology tests had reasonably high pooled sensitivity (69%), albeit lower than laboratory-based serology tests (89%), but both had high pooled specificity (96-98%). Diagnostic tests were consistently more sensitive among symptomatic patients than asymptomatic patients, while serology tests were more sensitive for later (≥7 days) than early stages (≤7 days) of the disease. Serology tests was less sensitive in American studies (64%, 95% CI 57%-70%) as compared to Chinese (98%, 95% CI: 95%-99%) and European studies (93%, 95% CI: 78%-99%).Conclusion: Point-of-care NAAT and serology tests are suitable for detecting SARS-CoV-2 infection and immunity against SARS-CoV-2, respectively as border screening.Funding Statement: Ministry of Defence (N-608-000-065-001)Declaration of Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325047

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic poses serious threats to the global public health and leads to an unprecedented worldwide crisis. Unfortunately, no effective drugs or vaccines are available till now. Since the RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 is a promising therapeutic target, a deep learning and molecular simulation based hybrid drug screening procedure was proposed and applied to identify potential drug candidates targeting RdRp from 1906 approved drugs. Among the four selected FDA-approved drug candidates, Pralatrexate and Azithromycin were confirmed to effectively inhibit SARS-CoV-2 replication in vitro with EC 50 values of 0.008µM and 9.453 µM, respectively. For the first time, our study discovered that Pralatrexate is able to potently inhibit SARS-CoV-2 replication with a stronger inhibitory activity than Remdesivir within the same experimental conditions. The paper demonstrates the feasibility of accurate virtual drug screening for inhibitors of SARS-CoV-2 and provides potential therapeutic agents against COVID-19.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324689

ABSTRACT

The outbreak of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a worldwide public health crisis. When the SARS-CoV-2 enters the biological fluids in the human body, different types of biomolecules (in particular proteins) may adsorb on its surface and alter its infection ability. Although great efforts have recently been devoted to the interaction of the specific antibodies with the SARS-CoV-2, it still remains largely unknown how the other serum proteins affect the infection of the SARS-CoV-2. In this work, we systematically investigate the interaction of serum proteins with the SARS-CoV-2 RBD by the molecular docking and the all-atom molecular dynamics simulations. It is found that the non-specific immunoglobulin (Ig) indeed cannot effectively bind to the SARS-CoV-2 RBD while the human serum albumin (HSA) may have some potential of blocking its infection (to ACE2). More importantly, we find that the RBD can cause the significant structural change of the Apolipoprotein E (ApoE), by which SARS-CoV-2 may hijack the metabolic pathway of the ApoE to facilitate its cell entry. The present study enhances the understanding of the role of protein corona in the bio-behaviors of SARS-CoV-2, which may aid the more precise and personalized treatment for COVID-19 infection in the clinic.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324682

ABSTRACT

Objectives: During the COVID-19 pandemic, clinicians and public health decision-makers especially focus on fever patients. Other common pathogens that may cause fever are easily overlooked. We aimed to describe the pathogen infection and epidemic trend of non-SARS-CoV-2 occurring in hospitalized patients. Methods: : An observational cohort study of 733 consecutive patients admitted to Hospital Clinic of the Second Xiangya Hospital for COVID-19. All samples of a pharyngeal swab from patients with fever have been tested for nucleic acid and immune antigens of SARS-CoV-2 and Influenza A/B virus . 649 fever patients have been tested for nucleic acid in ten respiratory pathogens. Macrotranscriptome sequencing was performed on 26 samples. Results: : Of a total of 733 patients with fever, 2.05% patients had confirmed SARS-CoV-2 infections. Fever patients with common respiratory pathogens in fever patients was 8.78%. There is no integration phenomenon between SARS-Cov-2 and the human genome. SARS-CoV-2 positive samples will also be infected with other viruses, especially adenovirus. Macrotranscript analysis showed that there was no significant difference in the species and genus levels of pathogens between Covid-19 patients and other fever patients. The main pathways that affect human metabolism after SARS-Cov-2 infection are the Calvin-Benson-Bassham cycle, pyrimidine deoxyribonucleotides de novo biosynthesis I and D-galactose degradation V. Conclusions: : Most patients have a fever caused by common respiratory pathogens. Clinicians still need to pay more attention to infections of common respiratory pathogens in addition to SARS-CoV-2. China's public health measures to stop the spread of the epidemic have proven effective.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324511

ABSTRACT

Background: Corona Virus Disease 2019 (COVID-19) is a recently emerged life-threatening disease caused by SARS-CoV-2. It has the characteristics of rapid transmission, difficult treatment, rapid deterioration, and high mortality rate. Reliable and rapid diagnosis of SARS-CoV-2 infection is critical to treat patients and control transmission in time. Methods To detect SARS-CoV-2 nucleic acid faster and more convenient, RT-LAMP method (reverse transcription loop-mediated isothermal amplification) was developed. ORF1ab gene, E gene and N gene were selected as the target genes, because ORF1ab gene is the most specific and N gene is the most sensitive, while E gene has both sensitivity and specificity. Over thirty primer sets for them were designed, then the primer sets with rapid response and high specificity were screened out and their loop primers were designed and selected in order to improve the reaction speed further. Using these primers, RNA reverse transcription and nucleic acid amplification were performed in one step at 63 ℃ isothermal conditions, and the results can be judged by naked eyes through color change within 30 minutes. Finally, the optimal primer set for each gene was verified with over 208 clinical samples. Results ORF1ab gene, E gene and N gene were detected simultaneously by this method. ORF1ab gene has high specificity and the same sensitivity as RT-PCR currently used in clinic. Although N gene is less specific than ORF1ab, it is 80 times more sensitive than ORF1ab. The sensitivity and specificity of E gene are between them. Simultaneous detection of these three genes can neither cause false positives nor miss samples with low virus concentration, ensuring the sensitivity and specificity of SARS-CoV-2 detection. BLAST comparing results showed the primers for the three genes were highly specific for SARS-CoV-2. And the sequencing results of RT-LAMP products showed that the amplified fragments were unique to SARS-CoV-2. The accuracy of RT-LAMP assay was 99% as detecting 208 clinical specimens. Conclusions The RT-LAMP assay reported here has the advantages of rapid amplification, simple operation, and easy detection, which is useful for the rapid and reliable clinical diagnosis of SARS-CoV-2.

14.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323659

ABSTRACT

Background: Micronutrients has roles in strengthening and maintaining immune function, but its supplementation and/or deficiency effects on respiratory tract infections are inconclusive. This review aims to systematically assess the associations between micronutrient supplementation or deficiency, with novel coronavirus incidence and disease severity. Methods: Systematic literature searches conducted in 5 electronic databases identified 751 unique studies, of which 33 studies (5 supplementation studies, 1 supplementation and deficiency study, and 27 deficiency studies) were eventually included in this review. Proportions of incidence and severity outcomes in each group, and adjusted summary statistics with their relevant 95% confidence intervaIs (CI) were extracted. Data from 19 studies were pooled in meta-analysis using the generic inverse variance method. Findings: A total of 360,346 patients across 16 countries, with a mean age between 32 and 87.7 years, were involved across 33 studies. All studies were on COVID-19 infections. In individuals without micronutrient deficiency, there was a significant reduction on odds of COVID-19 incidence (pooled OR: 0.37, 95% CI: 0.18, 0.78), and ICU admissions or severe/critical disease onset (pooled OR: 0.26, 95% CI: 0.08, 0.89). Insignificant protective effects were observed on other outcome measures –mortality, ICU admission, progression to respiratory-related complications, severe/critical disease onset or requiring respiratory support and hospitalization rate. Conclusion: The absence of micronutrient deficiency significantly reduced COVID-19 incidence and clinical deterioration in hospitalized patients. Usage of micronutrients as prophylaxis and complementary supplement in therapeutic management of COVID-19 patients may be a promising and cost-effective approach warranting in-depth investigation.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323657

ABSTRACT

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously designated as 2019-nCoV) outbreak has caused global concern1. Currently, there are no clinically approved specific drugs or vaccines available for this virus. The viral polymerase is a promising target for developing broad- spectrum antiviral drugs. Here, based on the highly similar structure of SARS- CoV non-structural protein 12 (nsp12) polymerase subunit2, we applied virtual screen for the available compounds, including both the FDA-approved and under- clinic drugs, to identify potential antiviral molecules against SARS-CoV-2. We found two drugs, the clinically approved anti-fungi drug Caspofungin Acetate (Cancidas) and the oncolytic peptide LTX-315, can bind SARS-CoV-2 nsp12 protein to block the polymerase activity in vitro . Further live virus assay revealed that both Caspofungin Acetate and LTX-315 can effectively inhibit SARS-CoV-2 replication in vero cells. These findings present promising drug candidates for treatment of related diseases and would also stimulate the development of pan- coronavirus antiviral agents.Authors Min Wang, Fei Ye, Jiaqi Su, Jingru Zhao, and Bin Yuan contributed equally to this work.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323626

ABSTRACT

Background: Coronavirus disease 2019(COVID-19) is a worldwide pandemic.In this study, we aimed to evaluate the risk factors of death from severe and critical COVID-19 patients. Method: A retrospective study of patients diagnosed with severe and critical COVID-19 from four hospitals in Wuhan, China, describing the clinical characteristics and laboratory results, and using Cox regression to study the risk factors was conducted. Results: Four hundred and forty-six patients with COVID-19 showed a high case fatality rate(CFR)(20.2%). All patients required oxygen therapy, and 52(12%) patients required invasive mechanical ventilation,of which 50(96%) patients died.The univariate Cox proportional hazard model showed a white blood cell count of more than 10 × 10⁹/L(HR3.903,95%CI 2.413 to 6.313),patients’ risk of death significantly increased.The multivariate Cox proportional hazard model demonstrated that older age (HR 1.074, 95% CI 1.050 to 1.098) was an independent risk factor and high white blood cell count(HR 1.119, 95% CI 1.056 to 1.186)was a predictive factor for COVID-19 on admission. Conclusions: COVID-19 is a new disease entity that carries significant risk of morbidity and CFR.Older age was an independent risk factor and high white blood cell was a predictive factor for COVID-19.

18.
Health Expect ; 25(3): 959-970, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1639175

ABSTRACT

OBJECTIVES: The global coronavirus disease 2019 (COVID-19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID-19 vaccine attributes, especially the influence of ANA on the estimated results. METHODS: A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL-EC) was used to analyse the heterogeneity of respondents' preferences for COVID-19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC-homogeneity model considered only ANA and the ECLC-heterogeneity model considered both ANA and preference heterogeneity. RESULTS: Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC-heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC-heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL-EC model, the ECLC-homogeneity model obtained lower WTPs for COVID-19 vaccine attributes, and the ECLC-heterogeneity model obtained mixed WTP results. In the ECLC-heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs. CONCLUSIONS: The RPL-EC, ECLC-homogeneity and ECLC-heterogeneity models obtained inconsistent WTPs for COVID-19 vaccine attributes. The study found that the results of the ECLC-heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC-homogeneity model and the RPL-EC model. The results showed that the probability of ANA was still high in the ECLC-heterogeneity model, although it was lower than that in the ECLC-homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue. PUBLIC CONTRIBUTION: Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID-19 vaccine choice questions generated through the DCE design.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , COVID-19/prevention & control , Choice Behavior , Humans , Patient Preference , Surveys and Questionnaires , Vaccination
19.
Appl Health Econ Health Policy ; 20(3): 417-429, 2022 05.
Article in English | MEDLINE | ID: covidwho-1616286

ABSTRACT

BACKGROUND: Assessing the public's willingness to pay (WTP) for the coronavirus disease 2019 (COVID-19) vaccine by the contingent valuation (CV) method can provide a relevant basis for government pricing. However, the scope issue of the CV method can seriously affect the validity and reliability of the estimation results. AIM: To examine whether there are scope issues in respondents' WTP for the COVID-19 vaccine and to further verify the validity and reliability of the CV estimate results. METHOD: In this study, nine different CV double-bounded dichotomous choices (DBDC) hypothetical COVID-19 vaccine scenarios were designed using an orthogonal experimental design based on the vaccine's attributes. A total of 2450 samples from 31 provinces in Mainland China were collected to independently estimate the public's WTP in these nine scenarios with logistic, normal, log-logistic and log-normal parameter models. Based on this estimation, several external scope tests were designed to verify the validity and reliability of the CV estimate results. RESULTS: In the 20 pairs of COVID-19 vaccine scenarios, 6 pairs of scenarios were classified as negative scope issues, therefore not passing the external scope test. Of the remaining 14 pairs of scenarios, only four pairs of scenarios completely passed the external scope test, and one pair of scenarios partially passed the external scope test. Significant negative scope and scope insensitivity issues were revealed. CONCLUSION: In the context of a dynamic pandemic environment, the findings of this study reveal that the CV method may face difficulty in effectively estimating respondents' WTP for the COVID-19 vaccine. We suggest that future studies be cautious in applying the CV method to estimate the public's WTP for the COVID-19 vaccine.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , China , Humans , Pandemics/prevention & control , Reproducibility of Results , Research Design , Surveys and Questionnaires
20.
Archives of Disease in Childhood ; 106(Suppl 3):A8, 2021.
Article in English | ProQuest Central | ID: covidwho-1574184

ABSTRACT

IntroductionImagine entering an operating theatre or developing clinical skills in empathy and communication through Virtual Reality. To enhance the experience of learning, novel methods using VR have been researched and simulated for clinicians. This is because some aspects of clinical training, like conducting procedures and effective team communication focus on ‘learning by doing’ which is difficult to recreate remotely. Here we present a proof-of-concept prototype of a 360°-video editor that augments 360° videos with media to create a mixed reality learning experience.MethodAn editor was built inside Unity to augment 360°-videos of real-world scenarios in healthcare with interactive data. Unity is a cross-platform games engine used to create two-dimension, three-dimension, virtual reality, and augmented reality games, as well as video players to play panoramic 360°-videos. The video player is attached to a Render Texture and a Skybox material that provides the spherical surface for the 360°-video achieving an immersive experience.ResultsThe editor comprises two software packages, one for the trainer, another for the learner. As a unique feature, we introduce clickable Hotspots. This enables users to annotate the 360° film by tagging specific artefacts in the environment and create a place-based interaction. These Hotspots are anchored to a position and can display text and images, and form part of a novel branched timeline of nested data. The intention being the trainer would create the film and annotate the environment with interactive media. This would then be available to the learner, who would use the player to view a bespoke teaching package.ConclusionSituated Cognition 360 Editor 2021 envisages trainers creating interactive 360°-video learning experiences using real life scenarios in healthcare. Future steps involve user experience evaluations, co-design and development of new learner interactions that deliver low cost, remote and easily deployed healthcare education through immersive learning environments.

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