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1.
BMJ : British Medical Journal (Online) ; 368, 2020.
Article in English | ProQuest Central | ID: covidwho-1837197

ABSTRACT

ObjectiveTo delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died.DesignRetrospective case series.SettingTongji Hospital in Wuhan, China.ParticipantsAmong a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020.Main outcome measuresClinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms.ResultsThe median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83;73%) than in recovered patients (88;55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113;100%), type I respiratory failure (18/35;51%), sepsis (113;100%), acute cardiac injury (72/94;77%), heart failure (41/83;49%), alkalosis (14/35;40%), hyperkalaemia (42;37%), acute kidney injury (28;25%), and hypoxic encephalopathy (23;20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients.ConclusionSevere acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.

2.
Expert Rev Mol Med ; 24: e19, 2022 Apr 12.
Article in English | MEDLINE | ID: covidwho-1815390

ABSTRACT

The pandemic caused by severe acute respiratory syndrome coronavirus 2 is sweeping the world, threatening millions of lives and drastically altering our ways of living. According to current studies, failure to either activate or eliminate inflammatory responses timely and properly at certain stages could result in the progression of the disease. In other words, robust immune responses to coronavirus disease 2019 (COVID-19) are critical. However, they do not theoretically present in some special groups of people, including the young, the aged, patients with autoimmunity or cancer. Differences also do occur between men and women. Our immune system evolves to ensure delicate coordination at different stages of life. The innate immune cells mainly consisted of myeloid lineage cells, including neutrophils, basophils, eosinophils, dendritic cells and mast cells; they possess phagocytic capacity to different degrees at different stages of life. They are firstly recruited upon infection and may activate the adaptive immunity when needed. The adaptive immune cells, on the other way, are comprised mainly of lymphoid lineages. As one grows up, the adaptive immunity matures and expands its memory repertoire, accompanied by an adjustment in quantity and quality. In this review, we would summarise and analyse the immunological characteristics of these groups from the perspective of the immune system 'evolution' as well as 'revolution' that has been studied and speculated so far, which would aid the comprehensive understanding of COVID-19 and personalised-treatment strategy.


Subject(s)
COVID-19 , Adaptive Immunity , Aged , Female , Humans , Immune System , Immunity, Innate , SARS-CoV-2
3.
J Endod ; 2022 Mar 17.
Article in English | MEDLINE | ID: covidwho-1804604

ABSTRACT

INTRODUCTION: The aims of this observational study were to determine if endodontists' practices in early 2021 experienced changes in patient characteristics compared with a comparable prepandemic period and to determine whether the changes reported during the initial outbreak of coronavirus disease 2019 (COVID-19) in 2020 were reversed 1 year later. METHODS: Demographic, diagnostic, and procedural data of 2657 patient visits from 2 endodontist private offices from March 16 to May 31 in 2019, 2020, and 2021 were included. Bivariate analyses and multiple logistic regression models were used to examine the impact of ongoing COVID-19 pandemic on patient data. RESULTS: Bivariate analyses showed that patients' self-reported pain levels and the number of visits with irreversible pulpitis in 2021 were higher than 2019 (P < .05). Patients' self-reported pain, percussion pain, and palpation pain levels in 2021 were less than 2020 (P < .05). Multiple logistic regression analyses showed that endodontists' practices in 2021 had an increase in the number of nonsurgical root canal treatments (odds ratio [OR] = 1.482; 95% confidence interval [CI], 1.102-1.992), and apicoectomies (OR = 2.662; 95% CI, 1.416-5.004) compared with 2019. Compared with the initial outbreak in 2020, endodontists' practices in 2021 had visits with older patients (OR = 1.288; 95% CI, 1.045-1.588), less females (OR = 0.781; 95% CI, 0.635-.960), more molars (OR = 1.389; 95% CI, 1.065-1.811), and less pain on percussion (OR = 0.438; 95% CI, 0.339-0.566). CONCLUSIONS: The ongoing COVID-19 pandemic was associated with an increase in the number of nonsurgical root canal treatments. Some of the changes observed during the initial outbreak in 2020, including objective pain parameters, returned to normal levels 1 year later.

4.
Food Chem ; 386: 132738, 2022 Aug 30.
Article in English | MEDLINE | ID: covidwho-1748003

ABSTRACT

The COVID-19 pandemic has impacted the food industry and consumers, with production gaps, shipping delays, and changes in supply and demand leading to an increased risk of food fraud. Rice has a high probability for adulteration by food fraudsters, being a staple commodity for more than half the global population, making the assessment of geographical origins of rice for authenticity important in terms of protecting businesses and consumers. In this study, we describe ICP-MS elemental profiling coupled with elementomic modelling to identify the geographical indications of Indian, Chinese, and Vietnamese rice. A PLS-DA model exhibited good discrimination (R2 = 0.8393, Q2 = 0.7673, accuracy = 1.0). Data-driven soft independent modelling of class analogy (dd-SIMCA) and K-nearest neighbours (K-NN) models have good sensitivity (98%) and specificity (100%).


Subject(s)
COVID-19 , Oryza , China , Geography , Humans , Pandemics , Vietnam
5.
Vaccines (Basel) ; 10(2)2022 Feb 18.
Article in English | MEDLINE | ID: covidwho-1708201

ABSTRACT

(1) Background: Although there are extensive data on admission co-variates and outcomes of persons with coronavirus infectious disease-2019 (COVID-19) at diverse geographic sites, there are few, if any, subject-level comparisons between sites in regions and countries. We investigated differences in hospital admission co-variates and outcomes of hospitalized people with COVID-19 between Wuhan City, China and the New York City region, USA. (2) Methods: We retrospectively analyzed clinical data on 1859 hospitalized subjects with COVID-19 in Wuhan City, China, from 20 January to 4 April 2020. Data on 5700 hospitalized subjects with COVID-19 in the New York City region, USA, from 1 March to 4 April 2020 were extracted from an article by Richardson et al. Hospital admission co-variates (epidemiological, demographic, and laboratory co-variates) and outcomes (rate of intensive care unit [ICU] admission, invasive mechanical ventilation [IMV], major organ failure and death, and length of hospital stay) were compared between the cohorts. (3) Results: Wuhan subjects were younger, more likely female, less likely to have co-morbidities and fever, more likely to have a blood lymphocyte concentration > 1 × 109/L, and less likely to have abnormal liver and cardiac function tests compared with New York subjects. There were outcomes data on all Wuhan subjects and 2634 New York subjects. Wuhan subjects had higher blood nadir median lymphocyte concentrations and longer hospitalizations, and were less likely to receive IMV, ICU hospitalization, and interventions for kidney failure. Amongst subjects not receiving IMV, those in Wuhan were less likely to die compared with New York subjects. In contrast, risk of death was similar in subjects receiving IMV at both sites. (4) Conclusions: We found different hospital admission co-variates and outcomes between hospitalized persons with COVID-19 between Wuhan City and the New York region, which should be useful developing a comprehensive global understanding of the SARS-CoV-2 pandemic and COVID-19.

6.
Clin Infect Dis ; 2021 Aug 14.
Article in English | MEDLINE | ID: covidwho-1704207

ABSTRACT

BACKGROUND: Follow-up study of Coronavirus disease 2019 (COVID-19) survivors has rarely been reported. We aimed to investigate longitudinal changes in the characteristics of COVID-19 survivors after discharge. METHODS AND FINDINGS: A total of 594 COVID-19 survivors discharged from Tongji Hospital in Wuhan from February 10 to April 30, 2020 were included and followed up until May 17, 2021. Laboratory and radiological findings, pulmonary function tests, electrocardiogram, symptoms and signs were analyzed. 257 (51.2%) patients had at least one symptom at 3 months post-discharge, which decreased to 169 (40.0%) and 138 (28.4%) at 6-month and 12-month visit respectively. During follow-up period, insomnia, chest tightness, and fatigue were the most prevalent symptoms. Most laboratory parameters returned to normal, whereas increased incidence of abnormal liver and renal function and cardiovascular injury was evidenced after discharge. Fibrous stripes (213; 42.4%), pleural thickening and adhesions (188; 37.5%) and enlarged lymph nodes (120; 23.9%) were the most common radiographical findings at 3 months post-discharge. The abnormalities of pulmonary function included obstructive, restrictive, and mixed, which were 5.5%, 4.0%, 0.9% at 6 months post, and 1.9%, 4.7%, 0.2% at 12 months. Electrocardiogram abnormalities occurred in 256 (51.0%) patients at 3 months post-discharge, including arrhythmia, ST-T change and conduction block, which increased to 258 (61.1%) cases at 6-month visit and were maintained at high frequency (242;49.8%) at 12-month visit. CONCLUSIONS: Physiological, laboratory, radiological or electrocardiogram abnormalities, particularly those related to renal, cardiovascular, liver functions are common in patients who recovered from COVID-19 up to 12months post-discharge.

7.
Signal Transduct Target Ther ; 7(1): 57, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1702971

ABSTRACT

The coronavirus disease 2019 (COVID-19) is a highly transmissible disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that poses a major threat to global public health. Although COVID-19 primarily affects the respiratory system, causing severe pneumonia and acute respiratory distress syndrome in severe cases, it can also result in multiple extrapulmonary complications. The pathogenesis of extrapulmonary damage in patients with COVID-19 is probably multifactorial, involving both the direct effects of SARS-CoV-2 and the indirect mechanisms associated with the host inflammatory response. Recognition of features and pathogenesis of extrapulmonary complications has clinical implications for identifying disease progression and designing therapeutic strategies. This review provides an overview of the extrapulmonary complications of COVID-19 from immunological and pathophysiologic perspectives and focuses on the pathogenesis and potential therapeutic targets for the management of COVID-19.


Subject(s)
Acute Kidney Injury/complications , COVID-19/complications , Cytokine Release Syndrome/complications , Disseminated Intravascular Coagulation/complications , Lymphopenia/complications , Myocarditis/complications , Pulmonary Embolism/complications , Acute Kidney Injury/drug therapy , Acute Kidney Injury/immunology , Acute Kidney Injury/virology , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/immunology , COVID-19/virology , Clinical Trials as Topic , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/immunology , Cytokine Release Syndrome/virology , Disseminated Intravascular Coagulation/drug therapy , Disseminated Intravascular Coagulation/immunology , Disseminated Intravascular Coagulation/virology , Endothelial Cells/drug effects , Endothelial Cells/immunology , Endothelial Cells/virology , Humans , Immunity, Innate/drug effects , Immunologic Factors/therapeutic use , Lymphopenia/drug therapy , Lymphopenia/immunology , Lymphopenia/virology , Myocarditis/drug therapy , Myocarditis/immunology , Myocarditis/virology , Pulmonary Embolism/drug therapy , Pulmonary Embolism/immunology , Pulmonary Embolism/virology , Renin-Angiotensin System/drug effects , Renin-Angiotensin System/immunology , SARS-CoV-2/drug effects , SARS-CoV-2/growth & development , SARS-CoV-2/pathogenicity
8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324121

ABSTRACT

Background: Up to now, there is no specific treatment for coronavirus disease 2019 (COVID-19) yet except for general supportive care. Hence, it will be critical to find a new strategy for COVID-19. The study is to explore whether convalescent plasma transfusion may be beneficial in the treatment of severe patients with COVID-19. Methods: This is a retrospective analysis of three severe patients with laboratory-confirmed COVID-19 and admitted in Fuzhou pulmonary hospital of Fujian province from February 18th, to May 15th,who met the following criteria: (1) within 3 weeks of symptom onset;laboratory confirmed cases or who had viremia conformed by clinical experts;(2)Severe patients with rapidly progress or the early stage of critically ill patients or who required plasma therapy were comprehensively evaluated by clinical experts. The data of clinical manifestations and the progresses of disease monitored by blood-gas analysis, biochemical tests, routine examine, radiological exam were abstracted and then analysis the changes before and after convalescent plasma transfusion. Results: All three patients (one male and two females;age range, 57-65years) were treated with convalescent plasma during the study. Two patients had underlying chronic diseases, including diabetes and hypertension. The most common symptoms were fever (three cases, 3/3) and cough (two cases, 2/3). All patients were treated with a combination of two antiviral drugs (lopinaviritonavir or arbidol combined with IFN-ɑ), whereas none of the patients were given glucocorticoids. Following plasma transfusion, the symptoms of the whole group improved to some degree, mainly manifested as reducing in coughing and body temperature normalized. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.97 × 10 9 /L vs. 1.08 × 10 9 /L) and decreased IL-6 (41.34 pg/ml vs. 13.83 pg/ml). The density of bilateral infiltration on CT imaging showed varying degrees of absorption within 7days. Throat swab nucleic acid test of most patients became negative for the novel coronavirus within 3 days after the transfusion. No adverse effects and severe complications were observed. Conclusions: In this preliminary uncontrolled case series of 3severe patients with COVID-19, convalescent plasma could be as a promising therapy for COVID-19 without corticosteroids and no serious adverse reactions associated with the transfusion of convalescent plasma were observed, which would improve the clinical outcomes following by improvement in their clinical status. Using the convalescent plasma at the early stage(less than 10 days) of disease could be more effective. Anticoagulation is necessary for severe patients with COVID-19 given the state of hypercoagulability. However, given the small sample size and limited study design, naturally these results should be taken with a grain of salt until replicated by other further investigation in larger well-controlled trials.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322257

ABSTRACT

In response to the present coronavirus disease 2019 (COVID-19) pandemic, it is important to understand the infection pathogenesis of SARS-CoV-2. Sputum samples from 20 COVID-19 patients and healthy controls were collected, respectively. During the isolation of infectious SARS-CoV-2 virus, exosome-like vesicles were found associated with virions under transmission electron microscope. Next, the expression of IL6 and TGF-β increased in exosomes derived from the sputum of patients, and these were highly correlated with the expression of the SARS-CoV-2 N protein. Further, proximity barcoding assay (PBA) was used to investigate the immune related proteins in the exosomes, as well as the relationship between exosomes and SARS-CoV-2 N protein in COVID-19 patients’ samples. Particularly, to investigate the differential contribution of the specific exosome subsets, the protein expression of a single exosome was detected and analyzed for the first time. Among the 40 exosome subpopulations, 18 were found to have significant differences. The exosome subpopulation regulated by CD81 were most likely to correlate with the changes in the pulmonary microenvironment after SARS-CoV-2 infection. This study provides evidence on the association between exosomes and SARS-CoV-2 virus and promotes our understanding on possible pathogenesis of SARS-CoV-2 infection.Funding Statement: This work is supported by the emergency grants for prevention and control of SARS-CoV-2 of Ministry of Guangdong province (2020B111133001), the China Postdoctoral Science Project (2020T130025ZX and 2019M652860), the National Key Research and Development Program of China (2016YFC1304101), the Independent project of the State Key Laboratory of Respiratory Diseases (SKLRD-QN-201913), and the Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program (2017BT01S155).Declaration of Interests: The authors have declared that no conflict of interest exists.Ethics Approval Statement: The present study obtained the approval of the Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, China).

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-319519

ABSTRACT

Multiorgan injuries are a major complication of severe COVID-19;however, its pathogenesis is barely understood. Herein, we profiled the host responses to SARS-CoV-2 infection by performing quantitative proteomics of COVID-19 postmortem samples, and provided a comprehensive proteome map covering the protein alterations in eight different organs/tissues. Our results revealed that lung underwent the most abundant protein alterations mainly enriched in immune-/inflammation-related or morphology-related processes, while surprisingly, other organs/tissues exhibited significant protein alterations mainly enriched in processes related with organ movement, respiration, and metabolism. These results indicate that the major cause of lung injury was excessive inflammatory response, and subsequent intravascular thrombosis and pulmonary architecture/function destruction, while other organs/tissues were mainly injured by hypoxia and functional impairment. Therefore, our findings demonstrate the significant pathophysiological alternations of host proteins/pathways associated with multiorgan injuries of COVID-19, which provides invaluable knowledge about COVID-19-associated host responses and sheds light on the pathogenesis of COVID-19.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315232

ABSTRACT

Background: At the end of 2019, the outbreak of the coronavirus disease 2019 (COVID-19) had severely damaging people’s life. China’s public health emergency management system had played an essential role in the handling and response of it, which had been appreciated by the World Health Organization and some countries. Hence it is necessary to make an overall analysis of the development of China’s health emergency management system. It can provide a reference for scholars to understand the current situation and look for new research points. Methods: : We collected 2247 international from the Web of Science database, 959 Chinese articles from China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domains analysis methods were used in this study for temporal distribution analysis, cooperation network, co-word network analysis. Results: : The first international article in this field was published in 1991, while Chinese in 2005. Research institutions mainly come from universities and health institutions. Developed countries and European countries published more articles, while east of China published more. There are 52 burst words for international articles from 1999–2018, while 18 burst words for Chinese articles from 2003–2018. International top-ranked articles by citation appeared in 2005, 2007, 2009, 2014, 2015, 2016, while Chinese appeared in 2003, 2004, 2009, 2011. Conclusions: : There are differences in the regional or economic distribution of international and Chinese cooperation networks. International research often relates to hot issues, mainly focus on the emergency preparedness and monitoring for public health events, while China’s focus on the public health emergency and their disposal. International begins the research with terrorism and bioterrorism, followed by disaster planning and emergency preparedness, epidemics and infectious diseases. China takes severe acute respiratory syndrome as the research background and legal system construction as the research starting point, followed by mechanism, structure, system, and learning from abroad of public health emergency management.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312506

ABSTRACT

Background: An outbreak of pneumonia associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan city and then to other city. It is very urgent to delineate the epidemiological and clinical characteristics of these affected patients. Methods: : To investigate the epidemiological characteristics of the COVID-19, we describe a case series of 459 patients with confirmed COVID-19 in WZ of China from January 27 to February 12, 2020. Results: : The median age of all patients was 48.0 years, and 46.8% were females. 37.5% of patients had a history of residence in Wuhan. Fever (72.1%) and cough (43.6%) were the most frequent symptoms. In addition, three kinds of unconventional cases were observed, in which included 4.4% confirmed virus carrier who were asymptomatic, 7.8% confirmed patients who had no link to Wuhan city but contact with individuals from Wuhan without any symptoms at the time of contact, and 10.7% confirmed patients who had no link to Wuhan city nor a history of intimate contact with patients or individuals from Wuhan without any symptoms, respectively. Conclusion: Our findings presented the possibility of asymptomatic carriers affected with SARS-CoV-2, and this phenomenon suggested that chances of uncontrollable transmission in the larger population might be higher than formerly estimated, and transmission by these three kinds of unconventional patients in WZ may be one of the characteristics of infection in other Chinese cities outside the Wuhan epidemic area.

13.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327535

ABSTRACT

Worldwide SARS-CoV-2 sequencing efforts track emerging mutations in its spike protein, as well as characteristic mutations in other viral proteins. Besides their epidemiological importance, the observed SARS-CoV-2 sequences present an ensemble of viable protein variants, and thereby a source of information on viral protein structure and function. Charting the mutational landscape of the nucleocapsid (N) protein that facilitates viral assembly, we observe variability exceeding that of the spike protein, with more than 86% of residues that can be substituted, on average by 3-4 different amino acids. However, mutations exhibit an uneven distribution that tracks known structural features but also reveals highly protected stretches of unknown function. One of these conserved regions is in the central disordered linker proximal to the N-G215C mutation that has become dominant in the Delta variant, outcompeting G215 variants without further spike or N-protein substitutions. Structural models suggest that the G215C mutation stabilizes conserved transient helices in the disordered linker serving as protein-protein interaction interfaces. Comparing Delta variant N-protein to its ancestral version in biophysical experiments, we find a significantly more compact and less disordered structure. N-G215C exhibits substantially stronger self-association, shifting the unliganded protein from a dimeric to a tetrameric oligomeric state, which leads to enhanced co-assembly with nucleic acids. This suggests that the sequence variability of N-protein is mirrored by high plasticity of N-protein biophysical properties, which we hypothesize can be exploited by SARS-CoV-2 to achieve greater efficiency of viral assembly, and thereby enhanced infectivity.

14.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327122

ABSTRACT

At present, COVID-19 poses a serious threat to global human health, and the cumulative confirmed cases in America, Brazil and India continue to grow rapidly. Therefore, the prediction models of cumulative confirmed cases in America, Brazil and India from August 1, 2021 to December 31, 2021 were established. In this study, the prevalence data of COVID-19 from 1 August 2021 to 31 December 2021 were collected from the World Health Organization website. Several ARIMA models were formulated with different ARIMA parameters. ARIMA (7,2,0), ARIMA (3,2,1), and ARIMA (10,2,4) models with the lowest MAPE values (0.00132, 0.00048, and 0.00021) were selected as the best models for America, Brazil, and India, respectively. Initial combinations of model parameters were selected using the automated ARIMA model, and the optimized model parameters were then found based on Bayesian information criterion (BIC). The analytical tools autocorrelation function (ACF), and partial autocorrelation function (PACF) were used to evaluate the reliability of the model. The performance of different models in predicting confirmed cases from January 1, 2022 to January 5, 2022 was compared by using root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE). This study shows that ARIMA models are suitable for predicting the prevalence of COVID-19 in the future. The results of the analysis can shed light on understanding the trends of the outbreak and give an idea of the epidemiological stage of these regions. Besides, the prediction of COVID-19 prevalence trends of America, Brazil, and India can help take precautions and policy formulation for this epidemic in other countries.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294373

ABSTRACT

Background: Although there are extensive data on admission co-variates and outcomes of persons with coronavirus infectious disease-2019 (COVID-19) at diverse geographic sites there are few if any subject-level comparisons between sites in regions and countries. We aim to comparatively investigate differences in hospital admission co-variates and outcomes of hospitalized people with COVID-19 between Wuhan City, China and the New York City region, USA. Methods We retrospectively collected clinical data on 1859 Hospitalized subjects with COVID-19 in Wuhan City, China 20 January to 4 April, 2020. Data on those 5700 hospitalized subjects with COVID-19 in the New York City region, USA 1 March to 4 April, 2020 was drawn from a published article by Richardson et al . Hospital admission co-variates (epidemiological, demographic and laboratory co-variates) and outcomes (rate of intensive care unit(ICU) admission, invasive mechanical ventilation(IMV), major organ failure and death and length of hospital stay) were compared between the two cohorts. Results Wuhan subjects were younger, more likely female, less likely to have co-morbidities and fever, more likely to have a blood lymphocyte concentration > 1×10E+9/L and less likely to have abnormal liver and cardiac function tests compared with the New York subjects. There were outcomes data on all Wuhan subjects and 2,634 New York subjects. Wuhan subjects had higher blood nadir median lymphocyte concentrations and longer hospitalizations, were less likely to receive IMV, ICU hospitalization and kidney replacement therapy. Amongst subjects not receiving IMV those in Wuhan were less likely to die compared with New York subjects. In contrast, risk of death was similar in subjects receiving IMV at both sites. Conclusions We found different hospital admission co-variates and outcomes between hospitalized persons with COVID-19 between Wuhan City and the New York region, which should be useful developing a comprehensive global understanding of the SARS-CoV-2 pandemic and COVID-19.

17.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-292885

ABSTRACT

Soluble Angiotensin-Converting Enzyme 2 (ACE2) constitutes an attractive antiviral receptor decoy that targets the vulnerable site on SARS-CoV-2 spike (S). Here, using structure-guided approaches, we developed divalent ACE2 molecules by grafting the extracellular ACE2-domain onto a human IgG1 or IgG3 (ACE2-Fc). These ACE2-Fcs harbored structurally validated mutations that enhance S binding and remove enzymatic activity. The lead variant bound tightly to S, mediated in vitro neutralization of SARS-CoV-2 variants of concern (VOCs) with sub-nanomolar IC50 and was capable of robust Fc-effector functions, including antibody-dependent cellular cytotoxicity, phagocytosis and complement deposition. When tested in a stringent K18-hACE2 mouse model, the lead variant prevented or delayed lethal SARS-CoV-2 infection in a prophylactic or therapeutic setting utilizing the combined effect of neutralization and Fc-effector functions. These data confirm the utility of ACE2-Fcs as valuable agents in preventing and eliminating SARS-CoV-2 infection and demonstrate that ACE2-Fc therapeutic activity require Fc-effector functions.

18.
Infect Dis Ther ; 10(4): 2431-2446, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1505773

ABSTRACT

INTRODUCTION: As a homologue of the angiotensin-converting enzyme (ACE), angiotensin-converting enzyme 2 (ACE2) has been identified as the main receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion. We aimed to investigate the role of serum ACE in predicting the coronavirus disease 2019 (COVID-19) disease progression and the underlying mechanisms. METHODS: We retrospectively enrolled 120 patients with confirmed COVID-19 who underwent serum ACE detection on admission. The clinical characteristics and laboratory findings during hospitalization were evaluated dynamically to identify the potential risk factors for disease progression. RESULTS: ACE level was demonstrated as one of the independent risk factors. Patients with ACE level ≤ 33.5 U/L showed a higher cumulative virus RNA detection rate, elevated pro-inflammatory mediators levels, declined lymphocyte count, and decreased SARS-CoV-2-specific antibodies than those with ACE level > 33.5 U/L. CONCLUSION: Lower serum ACE levels in relation to delayed virus elimination, hyperinflammatory condition, and impaired host antiviral immune responses contribute to disease progression of COVID-19.

19.
J Endod ; 48(1): 102-108, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1504474

ABSTRACT

INTRODUCTION: The first outbreak of coronavirus disease 2019 (COVID-19) in the United States resulted in a nationwide closure of dental offices that created an oral health crisis. The aim of this observational study was to analyze and compare the characteristics of patients who visited 2 private endodontics offices from March 16 to May 31, 2020, compared with the same period in 2019. METHODS: Demographic, diagnostic, and procedural data of 1520 (693 in 2020 and 827 in 2019) patient visits were collected. Bivariate and multiple logistic regression analyses were used to assess the impact of the COVID-19 outbreak on patient-related variables. RESULTS: Bivariate analyses showed that the number of patient visits decreased in April and May 2020 (P < .0001). In 2020, patients' self-reported pain level was higher, they were more frequently diagnosed with pulp necrosis and acute apical abscess, and they received more incisions for drainage (P < .05). Multiple logistic regression analyses showed that the COVID-19 outbreak was associated with less visits for older patients (>49.5 years) (odds ratio [OR] = 0.720; 95% confidence interval [CI], 0.573-0.906), more patients with kidney diseases (OR = 2.690; 95% CI, 1.143-6.331), higher levels of pain on percussion (OR = 2.277; 95% CI, 1.718-3.016), less cases with previously initiated treatment (OR = 0.242; 95% CI, 0.080-0.731), less periapical diagnoses of asymptomatic apical periodontitis (OR = 0.510; 95% CI, 0.306-0.849), and a higher number of nonsurgical root canal treatments (OR = 2.073; 95% CI, 1.397-3.074) and apicoectomies (OR = 2.799; 95% CI, 1.367-5.729). CONCLUSIONS: These findings show that the public health burden of endodontic infections was more intense during the initial outbreak of COVID-19.


Subject(s)
COVID-19 , Endodontics , Periapical Periodontitis , Disease Outbreaks , Humans , Periapical Periodontitis/epidemiology , SARS-CoV-2
20.
Asian J Pharm Sci ; 16(6): 772-783, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1474287

ABSTRACT

Strong infectivity enables coronavirus disease 2019 (COVID-19) to rage throughout the world. Moreover, the lack of drugs with definite therapeutic effects further aggravates the spread of the pandemic. Remdesivir is one of the most promising anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) drugs. However, the limited clinical effects make its therapeutic effect controversial, which may result from the poor accumulation and activation of remdesivir in the lung. Therefore, we developed lyophilized remdesivir liposomes (Rdv-lips) which can be reconstituted as liposomal aerosol for pulmonary delivery to improve the in vivo behavior of existing remdesivir cyclodextrin conclusion compound (Rdv-cyc) injections. Liposome encapsulation endowed remdesivir with much higher solubility and better biocompatibility. The in vitro liposomal aerosol characterization demonstrated that Rdv-lips possessed a mass median aerodynamic diameter of 4.118 µm and fine particle fraction (<5 µm) higher than 50%, indicating good pulmonary delivery properties. Compared to the Rdv-cyc intravenous injection group, the Rdv-lips inhalation group displayed a nearly 100-fold increase in the remdesivir-active metabolite nucleotide triphosphate (NTP) concentration and better NTP accumulation in the lung than the Rdv-cyc inhalation group. A faster transition from remdesivir to NTP of Rdv-lips (inhalation) could also be observed due to better cell uptake. Compared to other preparations, the superiority of Rdv-lips was further evidenced by the results of an in vivo safety study, with little possibility of inducing inflammation. In conclusion, Rdv-lips for pulmonary delivery will be a potent formulation to improve the in vivo behavior of remdesivir and exert better therapeutic effects in COVID-19 treatment.

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