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1.
International Journal of Environmental Research and Public Health ; 19(9):5464, 2022.
Article in English | MDPI | ID: covidwho-1820256

ABSTRACT

The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89;scores ranged from 7–35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13–15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3–9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19–20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4–13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines.

2.
Science of The Total Environment ; 835:155411, 2022.
Article in English | ScienceDirect | ID: covidwho-1815154

ABSTRACT

This work aimed to reflect the advancements in water-related science, technology, and policy and shed light on future research opportunities related to water through a systematic overview of Water Research articles published in the first 21.5 years of the 21st century. Specific bibliometric analyses were performed to i) reveal the temporal and spatial trends of water-related research themes and ii) identify the underlying connections between research topics. The results showed that while top topics including wastewater (treatment), drinking water, adsorption, model, biofilm, and bioremediation remained constantly researched, there were clear shifts in topics over the years, leading to the identification of trending-up and emerging research topics. Compared to the first decade of the 21st century, the second decade not only experienced significant uptrends of disinfection by-products, anaerobic digestion, membrane bioreactor, advanced oxidation processes, and pharmaceuticals but also witnessed the emerging popularity of PFAS, anammox, micropollutants, emerging contaminants, desalination, waste activated sludge, microbial community, forward osmosis, antibiotic resistance genes, resource recovery, and transformation products. On top of the temporal evolution, distinct spatial evolution existed in water-related research topics. Microplastics and Covid-19 causing global concerns were hot topics detected, while metagenomics and machine learning were two technical approaches emerging in recent years. These consistently popular, trending-up and emerging research topics would most likely attract continuous/increasing research input and therefore constitute a major part of the prospective water-related research publications.

3.
Land ; 11(3):448, 2022.
Article in English | ProQuest Central | ID: covidwho-1760741

ABSTRACT

The importance of pro-environmental behavior in tourism has been established, but explaining its sub-dimensions, especially in the private and public dimensions, is under-researched. Existing literature on tourism research mainly uses SEM to analyze tourist pro-environmental behavior, while fsQCA is scarcely implemented. In this study, SEM is applied to reveal the links among destination image, relationship quality, and pro-environmental behavior, while fsQCA is utilized to investigate configurations predicting pro-environmental behavior. Responses of 285 tourists were collected and analyzed to test the proposed hypotheses. The SEM results showed that (1) destination image directly and positively affected relationship quality (including satisfaction and destination trust);(2) relationship quality was found to positively and directly influence private and public pro-environmental behaviors;(3) relationship quality did mediate the influence of destination image on private pro-environmental behavior partially, while it played a full mediating role in the effect of destination image on public pro-environmental behavior. The findings from fsQCA indicated that (1) three sufficient configurations consistently lead to a high level of private pro-environmental behavior: (a) high destination image and satisfaction, (b) high destination image and trust, (c) high relationship quality;(2) there was only one sufficient causal configuration for a high level of public pro-environmental behavior: high relationship quality. The results provide tenable evidence that relationship quality can be a vital factor enhancing the sub-dimensions of pro-environmental behavior. The integration of these two methods helps to open the black box of tourist pro-environmental behavior in rural tourism contexts in a more systematic and holistic way.

4.
Int J Environ Res Public Health ; 19(6)2022 Mar 08.
Article in English | MEDLINE | ID: covidwho-1760573

ABSTRACT

Climate change and environmental issues caused by carbon emissions have attracted the attention of governments around the world. Drawing on the experience of the EU, China is actively developing a national carbon emissions trading market, trying to encourage emission entities to incorporate carbon emissions reduction into production and consumption decisions through carbon pricing. Is this scheme an effective market-incentivized environmental regulatory policy? Since China successively launched ETS pilots in 2013, the effectiveness of reducing carbon emissions has become one of the current focus issues. This study uses the difference-in-differences (DID) method to evaluate the impact of ETS implementation on emissions reduction and employs the Super-SBM model in data envelopment analysis (DEA) to evaluate the emission-reduction efficiency of eight ETS pilots in China. We find that the carbon trading policy has achieved emission-reduction effects in the implementation stage, and the greenness of economic growth has a significant positive impact on regional GDP. The establishment of China's unified carbon market should be coordinated with regional development. Some supporting measures for regional ecological compensation and the mitigation of regional development are yet to be adopted.

5.
Atmospheric environment (Oxford, England : 1994) ; 2022.
Article in English | EuropePMC | ID: covidwho-1756150

ABSTRACT

Air pollution during the COVID-19 epidemic in Beijing and its surrounding regions has received substantial attention. We collected observational data, including air pollutant concentrations and meteorological parameters, during January and February from 2018 to 2021. A statistical and a numerical model were applied to identify the formation of air pollution and the impact of emission reduction on air quality. Relative humidity, wind speed, SO2, NO2, and O3 had nonlinear effects on the PM2.5 concentration in Beijing, among which the effects of relative humidity, NO2, and O3 were prominent. During the 2020 epidemic period, high pollution concentrations were closely related to adverse meteorological conditions, with different parameters having different effects on the three pollution processes. In general, the unexpected reduction of anthropogenic emissions reduced the PM2.5 concentration, but led to an increase in the O3 concentration. Multi-scenario simulation results showed that anthropogenic emission reduction could reduce the average PM2.5 concentration after the Chinese Spring Festival, but improvement during days with heavy pollution was limited. Considering that O3 enhances the PM2.5 levels, to achieve the collaborative improvement of PM2.5 and O3 concentrations, further research should explore the collaborative emission reduction scheme with VOCs and NOx to achieve the collaborative improvement of PM2.5 and O3 concentrations. The conclusions of this study provide a basis for designing a plan that guarantees improved air quality for the 2022 Winter Olympics and other international major events in Beijing.

6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330164

ABSTRACT

Objectives: Since the outbreak of coronavirus disease 2019 (COVID-19), it has caused serious casualties worldwide. In recent months, the virus has mutated into an increasingly infectious form (Delta variant) and spread rapidly. Methods In the current study, we analyzed the clinical, epidemiological and viral genetic characteristics of the first four imported Delta cases in Anhui Province, China. Results The four imported Delta cases developed chest inflammation, tissue damage and recovered after admission, the serum high-sensitivity C-reactive protein (hs-CRP) and CRP levels showed a first increasing and then decreasing trend. The changes of hs-CRP /CRP and serum neutralizing antibodies (Nab) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels were associated with the regression of chest lesions. The combination of genetic sequencing and epidemiological analysis suggested that the SARS-CoV-2 delta variant infection of these four patients may originate from Russia. Conclusions Our study found the certain correlations of serum hs-CRP/CRP and Nab levels with the occurrence, development and outcome of COVID-19 delta variant, suggesting that monitoring hs-CRP/CRP and Nab levels of COVID-19 delta variant patients at hospital admission may be useful for understanding the severity of patients’ current conditions.

7.
World J Emerg Med ; 13(2): 91-97, 2022.
Article in English | MEDLINE | ID: covidwho-1732431

ABSTRACT

BACKGROUND: Computed tomography (CT) is a noninvasive imaging approach to assist the early diagnosis of pneumonia. However, coronavirus disease 2019 (COVID-19) shares similar imaging features with other types of pneumonia, which makes differential diagnosis problematic. Artificial intelligence (AI) has been proven successful in the medical imaging field, which has helped disease identification. However, whether AI can be used to identify the severity of COVID-19 is still underdetermined. METHODS: Data were extracted from 140 patients with confirmed COVID-19. The severity of COVID-19 patients (severe vs. non-severe) was defined at admission, according to American Thoracic Society (ATS) guidelines for community-acquired pneumonia (CAP). The AI-CT rating system constructed by Hangzhou YITU Healthcare Technology Co., Ltd. was used as the analysis tool to analyze chest CT images. RESULTS: A total of 117 diagnosed cases were enrolled, with 40 severe cases and 77 non-severe cases. Severe patients had more dyspnea symptoms on admission (12 vs. 3), higher acute physiology and chronic health evaluation (APACHE) II (9 vs. 4) and sequential organ failure assessment (SOFA) (3 vs. 1) scores, as well as higher CT semiquantitative rating scores (4 vs. 1) and AI-CT rating scores than non-severe patients (P<0.001). The AI-CT score was more predictive of the severity of COVID-19 (AUC=0.929), and ground-glass opacity (GGO) was more predictive of further intubation and mechanical ventilation (AUC=0.836). Furthermore, the CT semiquantitative score was linearly associated with the AI-CT rating system (Adj R 2=75.5%, P<0.001). CONCLUSIONS: AI technology could be used to evaluate disease severity in COVID-19 patients. Although it could not be considered an independent factor, there was no doubt that GGOs displayed more predictive value for further mechanical ventilation.

8.
J Affect Disord ; 299: 196-204, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1720201

ABSTRACT

OBJECTIVE: To investigate Chinese guardians' willingness to vaccinate teenagers (WVT) against COVID-19, we conducted a national wide survey in 31 provinces in mainland China. METHODS: We involved 16133 guardians from 31 provinces in Chinese Mainland from August 6th to 9th, 2021. The question "Are you willing to vaccinate teenagers of COVID-19 vaccine?" was designed to capture WVT. Odds ratios (OR) with 95% Confidence Intervals (CI) for potential factors of WVT were estimated using multiple logistic regression models. RESULTS: In total, 13327 (82.61%) of the respondents expressed positive WVT, 12.90% of the respondents were uncertain but inclined to vaccinate their teenagers. Meanwhile, 3.89% of the respondents were uncertain and inclined to reject, and 0.60% of the respondents rejected the vaccines. After adjusting for potential confounders, the married, total family income last year, reject to Categoly1 vaccines, access information about the COVID-19 vaccines from community workers, low COVID-19 vaccine conspiracy, guardian's vaccination behavior, and the importance of vaccinating teenagers were all independent factors that affected the guardians' likely to accept. Further, the current study found that lower trust in doctors and vaccine developers was associated with negative WVT. The reasons for negative WVT included teenagers' young age and guardians' worries on the safety and effectiveness of COVID-19 vaccines. CONCLUSION: This large-scale study assessed Chinese guardians' WVT against COVID-19, as well as its potential influencing factors, which is useful for international and national decision-makers.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , China , Cross-Sectional Studies , Humans , SARS-CoV-2 , Vaccination
9.
Front Med (Lausanne) ; 9: 829273, 2022.
Article in English | MEDLINE | ID: covidwho-1715010

ABSTRACT

Detection of serum-specific SARS-CoV-2 antibody has become a complementary means for the identification of coronavirus disease 2019 (COVID-19). As we already know, the neutralizing antibody titers in patients with COVID-19 decrease during the course of time after convalescence, whereas the duration of antibody responses in the convalescent patients has not been defined clearly. In the current study, we collected 148 serum samples from 37 confirmed COVID-19 cases with different disease severities. The neutralizing antibodies (Nabs), IgM and IgG against COVID-19 were determined by CLIA Microparticle and microneutralization assay, respectively. The time duration of serum titers of SARS-CoV-2 antibodies were recorded. Our results indicate that IgG (94.44%) and Nabs (89.19%) can be detected at low levels within 190-266 days of disease onset. The findings can advance knowledge regarding the antibody detection results for COVID-19 patients and provide a method for evaluating the immune response after vaccination.

10.
Adv Drug Deliv Rev ; 183: 114170, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1697560
11.
Frontiers in public health ; 10, 2022.
Article in English | EuropePMC | ID: covidwho-1695136

ABSTRACT

Objective To examine the COVID-19 vaccination rate among a representative sample of adults from 31 provinces on the Chinese mainland and identify its influencing factors. Methods We gathered sociodemographic information, data on people's awareness and behavior regarding COVID-19 and the COVID-19 vaccine, the accessibility of COVID-19 vaccination services, community environmental factors influencing people's awareness and behavior regarding the vaccination, information about people's skepticism on COVID-19 vaccine, and information about people's trust in doctors as well as vaccine developers through an online nationwide cross-sectional survey among Chinese adults (18 years and older). The odds ratios (OR) and 95% confidence intervals (CI) for the statistical associations were estimated using logistic regression models. Results A total of 29,925 participants (51.4% females and 48.6% males) responded. 89.4% of the participants had already received a COVID-19 vaccination. After adjusting for demographic characteristics, awareness of COVID-19 pandemic/ COVID-19 vaccine, community environmental factors, awareness and behavior of general vaccinations, we discovered that having no religious affiliation, having the same occupational status as a result of coronavirus epidemic, being a non-smoker, always engaging in physical activity, having a lower social status, perceiving COVID-19 to be easily curable, and having easier access to vaccination are all associated with high vaccination rate (all P <0.05). Conclusions 31 provinces in mainland China currently have a relatively high rate of COVID-19 vaccination. To further increase the rate of COVID-19 vaccination, we must remove barriers associated with the community context and improve access to COVID-19 vaccine services. In addition, taking proactive and effective measures to address the reasons for non-vaccination with COVID-19 will aid in epidemic prevention and control.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325196

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic radically impacts our lives, while the transmission/infection and recovery dynamics of COVID-19 remain obscure. A time-dependent Susceptible, Exposed, Infectious, and Recovered (SEIR) model was proposed and applied to fit and then predict the time series of COVID-19 evolution observed in the last three months (till 3/22/2020) in various provinces and metropolises in China. The model results revealed the space dependent transmission/infection rate and the significant spatiotemporal variation in the recovery rate, likely due to the continuous improvement of screening techniques and public hospital systems, as well as full city lockdowns in China. The validated SEIR model was then applied to predict COVID-19 evolution in United States, Italy, Japan, and South Korea which have responded differently to monitoring and mitigating COVID-19 so far, although these predictions contain high uncertainty due to the intrinsic change of the maximum infected population and the infection/recovery rates within the different countries. In addition, a stochastic model based on the random walk particle tracking scheme, analogous to a mixing-limited bimolecular reaction model, was developed to evaluate non-pharmaceutical strategies to mitigate COVID-19 spread. Preliminary tests using the stochastic model showed that self-quarantine may not be as efficient as strict social distancing in slowing COVID-19 spread, if not all of the infected people can be promptly diagnosed and quarantined.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324206

ABSTRACT

COVID -19 has rapidly spread from Wuhan to worldwide, and now has become a global health concern. Hypertension is the most common chronic illness in COVID-19, while the influence on those patients have not been well described. In this retrospective study, 82 confirmed patients with COVID-19 were enrolled, with epidemiological, demographic, clinical, laboratory, radiological, and therapies data analyzed and compared between COVID-19 patients with (29 cases) or without (53 cases) hypertension. Of all 82 patients with COVID-19, the median age of all patients was 60.5 years, including 49 females (59.8%) and 33 (40.2%) males. Hypertension (31[28.2%]) was the most chronic illness, followed by diabetes (16 [19.5%]) and cardiovascular disease (15 [18.3%]). Common symptoms included fatigue (55[67.1%]), dry cough (46 [56.1%]) and fever (≥37.3℃ (46 [56.1%]). The median time from illness onset to positive outcomes of RT-PCR analysis were 13.0 days, ranging from 3-25 days. In hypertension group, 6 (20.7%) patients died compared to 5 (9.4%) died in non-hypertension group. More hypertension patients with COVID-19 (8 [27.6%]) had at least one coexisting disease than those of non-hypertension patients (2 [3.8%]) ( P =0.002). Compared with non-hypertension patients, higher levels of neutrophil counts, serum amyloid A, C-reactive protein, and NT-proBNP were observed in hypertension group, whereas levels of lymphocyte count and eGFR were decreased. Dynamic observations displayed more significant and worsened outcomes in hypertension group after hospital admission. COVID-19 patients with hypertension take more risks of severe inflammatory reactions, worsened internal organ injuries, and deteriorated progress.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323882

ABSTRACT

Objectives: This study explored the features of coronavirus disease-2019 (COVID-19) with the aim of improving clinical diagnosis. Methods: : We retrospectively analyzed the clinical and CT data of 85 patients with COVID-19 who were diagnosed between January 20, 2020 and February 20, 2020. The imaging findings, clinical and laboratory data were evaluated. Results: : Of the 85 patients, five had mild symptoms, 60 had moderate symptoms, and 20 had severe symptoms. Sixty-nine patients had direct or indirect contact history, while 16 patients (19%) had no obvious epidemiological history. Eighty-five patients had prominent respiratory symptoms, while 70 patients (82%) had moderate to low fever. There were no obvious lung abnormalities in CT images of patients with mild symptoms. Common chest CT manifestations in patients with moderate or severe symptoms were ground glass opacity (GGO) (16%);GGO combined with grid (39%) or consolidation (32%);and air bronchogram sign (13%). In these patients, lesions were mostly distributed in the lower lobes of the lungs, and most were located in the periphery;pleural effusion was rare. Within 3 days after onset, GGO (23%) and GGO combined with grid (45%) were the most common manifestations in CT images;GGO combined with grid (35%) and/or consolidation (41%) were the main manifestations in CT images at 5–10 days after onset. Conclusions: : Common CT manifestations of COVID-19 were GGO alone and GGO combined with grid and/or consolidation. Short-term increases in ranges of lesions or consolidation areas may indicate disease aggravation.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323705

ABSTRACT

Background: To investigate the effects of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blockers (ARBs) administration to hypertension patients with the coronavirus disease 2019 (COVID-19) induced pneumonia. Methods: : We recorded the recovery status of 67 inpatients with hypertension and COVID-19 induced pneumonia in the Raytheon Mountain Hospital in Wuhan during February 12, 2020 and March 30, 2020. Patients treated with ACEI or ARBs were categorized in group A (n = 22), while patients who were not administered either ACEI or ARBs were categorized into group B (n = 45). We did a comparative analysis of various parameters such as the pneumonia progression, length-of-stay in the hospital, and the level of alanine aminotransferase (ALT), serum creatinine (Cr), and creatine kinase (CK) between the day when these patients were admitted to the hospital and the day when the treatment ended. Results: : These 67 hypertension cases counted for 33.17% of the total COVID-19 patients. There was no significant difference in the usage of drug treatment of COVID-19 between groups A and B (p > 0.05). During the treatment, 1 case in group A and 3 cases in group B progressed from mild pneumonia into severe pneumonia. Eventually, all patients were cured and discharged after treatment, and no recurrence of COVID-2019 induced pneumonia occurred after the discharge. The length of stays was shorter in group A as compared with group B, but there was no significant difference (p > 0.05). There was also no significant difference in other general parameters between the patients of the groups A and B on the day of admission to the hospital (p > 0.05). The ALT, CK, and Cr levels did not significantly differ between groups A and B on the day of admission and the day of discharge (p > 0.05). Conclusions: : To treat the hypertension patients with COVID-19 caused pneumonia, anti-hypertensive drugs (ACEs and ARBs) may be used according to the relative guidelines. The treatment regimen with these drugs does not need to be altered for the COVID-19 patients.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322578

ABSTRACT

Background: COVID-19 is a novel pandemic affecting almost all countries leading to lockdowns worldwide. In Singapore, locally-acquired cases emerged after the first wave of imported cases, and these two groups may have different health-seeking behaviour affecting disease transmission. Objective: We investigated differences in health-seeking behaviour between locally-acquired cases and imported cases, and within the locally-acquired cases, those who saw single versus multiple healthcare providers. Methods: We conducted a retrospective study of 258 patients who were diagnosed with COVID-19 from 23 January to 17 March 2020. Variables related to health-seeking behaviour included number of visits prior to hospitalisation, timing of the first visit, duration from symptom onset to admission, and places where the cases had at least one visit. Results: Locally-acquired cases had longer duration from symptoms onset to hospital admission (median 6 days, range 1-30) than imported cases (median 4 days, range 1-13) (p<0.0005). Singapore residents were more likely to have at least one visit to private clinics and/or government-subsidised public clinics than non-residents (84.0% vs. 58.7%, p<0.0005). Among locally-acquired cases, those who sought care from a single provider had fewer visits before their hospital admissions compared with those who went to multiple care providers (median 2 vs. 3, p=0.001). Conclusion: Our study indicates the need to encourage individuals to seek medical attention early on in their patient journey, particularly from their family physician or the same doctor. This in turn, would facilitate early detection and isolation, hence limiting local transmission and enabling better control of the pandemic.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321465

ABSTRACT

Background: Previous studies showed that the effect of antivirals for COVID-19 was promising but varied across patient population, and was modest among severe cases. Chinese Medicine (CM) was extensively used and reported effective in China, awaiting further evidence support. We aimed to evaluate the real-world effectiveness of add-on semi-individualized.Methods: A retrospective total sampling cohort of 1788 adult confirmed COVID-19 patients were recruited from all 2235 consecutive records retrieved from 5 hospitals in Wuhan during15 January to 13 March 2020. Consultation notes, laboratory/imaging investigations, pharmacy and prognosis records were linked by an electronic medical record system and verified by at least 2 researchers independently. The mortality of add-on semi-individualized CM users and non-users was compared by weighted hazard ratios of multivariable Cox regression and by propensity score matching. Change of biomarkers was compared between groups and the frequency of CMs used was analysed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. Sensitivity analyses were conducted to test the robustness.Findings: The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a significant mortality reduction of 58% (HR=0.42, 95%CI: 0.23 to 0.77, p=0.005) and 66% (HR=0.34, 95%CI: 0.15 to 0.76, p=0.009) among all and severe/critical COVID-19 cases with dose-dependent response, after inversely weighted with propensity score calculated by age, gender, history of hypertension, diabetes, coronary artery disease and disease severity. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission compared to baseline.Interpretation: Add-on semi-individualized CM was associated with reduced mortality demonstrating dose-dependent response, especially among severe/critical COVID-19 patients. Chinese medicine could be considered as an add-on regimen for trial use.Funding Statement: This work is partially supported by the National Key Research and Development Program (2017YFC1703506 and 2020YFC0841600). Declaration of Interests: No financial relationships with any organisations that might have an interest in the submitted work in the previous three years;no other relationships or activities that could appear to have influenced the submitted work.Ethics Approval Statement: This study was approved by the ethics review board of Hubei Provincial Hospital of Traditional Chinese Medicine (HBZY2020-C01-01). Written consent was waived due to the retrospective nature.

18.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321365

ABSTRACT

The ongoing global pandemic of Coronavirus Disease 2019 (COVID-19) poses a serious threat to public health and the economy. Rapid and accurate diagnosis of COVID-19 is crucial to prevent the further spread of the disease and reduce its mortality. Chest Computed tomography (CT) is an effective tool for the early diagnosis of lung diseases including pneumonia. However, detecting COVID-19 from CT is demanding and prone to human errors as some early-stage patients may have negative findings on images. Recently, many deep learning methods have achieved impressive performance in this regard. Despite their effectiveness, most of these methods underestimate the rich spatial information preserved in the 3D structure or suffer from the propagation of errors. To address this problem, we propose a Dual-Attention Residual Network (DARNet) to automatically identify COVID-19 from other common pneumonia (CP) and healthy people using 3D chest CT images. Specifically, we design a dual-attention module consisting of channel-wise attention and depth-wise attention mechanisms. The former is utilized to enhance channel independence, while the latter is developed to recalibrate the depth-level features. Then, we integrate them in a unified manner to extract and refine the features at different levels to further improve the diagnostic performance. We evaluate DARNet on a large public CT dataset and obtain superior performance. Besides, the ablation study and visualization analysis prove the effectiveness and interpretability of the proposed method.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315618

ABSTRACT

Objective: Coronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients. Methods: The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity. Results : The typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7% and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0% and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age. Conclusions : Age, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60 years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312496

ABSTRACT

This study aims to propose decontamination methods that are suitable for use by members of the public to cope with the shortage of surgical masks during the current COVID-19 pandemic. 3-ply surgical masks were subjected to different decontamination protocols (heat, chemical, ultraviolet irradiation) to assess their abilities to achieve at least 4-log reduction of two common respiratory pathogens, H1N1 Influenza A virus, a single-stranded RNA enveloped virus similar to SARS-CoV-2 and Staphylococcus aureus, a Gram-positive bacterium that is more resistant to decontamination than single stranded RNA enveloped virus. Decontaminated surgical masks were assessed for differences in breathability, particle filtration efficiency and bacteria filtration efficiency as compared with non-decontaminated masks. The number of decontamination cycles that the 3-ply surgical masks could undergo without significant changes in breathability and filtration efficiencies were also determined. It was found that surgical masks decontaminated by either soaking for 60 min in 0.5% (v/v) aqueous hydrogen peroxide solution, or 30 min of soaking in 0.05% - 0.5% (v/v) aqueous sodium hypochlorite diluted from household bleach or ultraviolet irradiation by a surface dose of 13.5 kJ/m 2 were able to achieve at least a 4-log reduction of both Staphylococcus aureus and H1N1 Influenza A virus spiked on surgical mask test swatches. No significant changes in breathability and filtration efficiencies of the surgical masks were observed after ten decontamination cycles of hydrogen peroxide or diluted bleach treatment or 30 cycles of ultraviolet irradiation.

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