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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311009

ABSTRACT

Purpose: To evaluate the clinical features and outcomes of rhabdomyolysis (RM) in patients with COVID-19. Method: A single center retrospective cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan hospital in Wuhan, China, between February 17 and April 12, 2020. Results: : The overall incidence of RM was 2.2%. Comparing with patients without RM, patients with RM tended to have a higher risk of deterioration, representing by higher ratio to be admitted to the intensive care unit (ICU) (90.9 % vs 5.3%, P <0.001), and to undergo mechanical ventilation (86.4 % vs 2.7% P <0.001). Compared with patients without RM, patients with RM had laboratory test abnormalities, including indicators of inflammation, coagulation activation and kidney injury. Patients with RM had a higher risk of hospital death ( P < 0.001). Cox proportional hazard regression model confirmed that RM indicators, including peak creatine kinase (CK) >1000 IU/L (HR=6.46, 95% CI: 3.02-13.86), peak serum myoglobin (MYO) >1000 ng/mL (HR=9.85, 95% CI: 5.04-19.28) were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have a delayed virus clearance. Conclusion: RM might be an important factor contributing to adverse outcomes of patients with COVID-19. Early detection and effective intervention of RM may help reduce deaths of patients with COVID-19.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308211

ABSTRACT

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

3.
Comput Ind Eng ; 162: 107749, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1471919

ABSTRACT

COVID-19 has caused massive disruption on the global economy and presents a considerable risk to human lives. Some countries have successfully controlled the pandemic by adopting strict measures, such as lockdown and travel restriction, but such methods are difficult to be applied widely due to their huge costs. To explore available and low-cost solutions, this study proposes an adaptive transmission model on the basis of a complex network, and gives control simulation method of COVID-19. The suggested model considers adaptive changes such as travel network and people's travel intention to form a three-level adaptive network transmission model among cities, communities, and people. The improved susceptible-exposed-infectious-recovered-dead transmission process is integrated into the network. Simulation experiments under high-, low-, and conventional-cost controls are performed. In these experiments, the travel restriction and closing cities are considered, and sensitivity analyses of the parameters are conducted to explore low-cost measures. Meanwhile, time duration and application conditions of different controls are discussed. Results show that lockdown is the most effective way, and the contact and infection rates are the two most important factors to control the pandemic. Low-cost combined control measures are feasible and effective for most countries. Finally, several suggestions are given for national and urban preventions and controls of COVID-19 and other infectious diseases in the future.

4.
Signal Transduct Target Ther ; 6(1): 368, 2021 10 13.
Article in English | MEDLINE | ID: covidwho-1467093

ABSTRACT

The long-term immunity and functional recovery after SARS-CoV-2 infection have implications in preventive measures and patient quality of life. Here we analyzed a prospective cohort of 121 recovered COVID-19 patients from Xiangyang, China at 1-year after diagnosis. Among them, chemiluminescence immunoassay-based screening showed 99% (95% CI, 98-100%) seroprevalence 10-12 months after infection, comparing to 0.8% (95% CI, 0.7-0.9%) in the general population. Total anti-receptor-binding domain (RBD) antibodies remained stable since discharge, while anti-RBD IgG and neutralization levels decreased over time. A predictive model estimates 17% (95% CI, 11-24%) and 87% (95% CI, 80-92%) participants were still 50% protected against detectable and severe re-infection of WT SARS-CoV-2, respectively, while neutralization levels against B.1.1.7 and B.1.351 variants were significantly reduced. All non-severe patients showed normal chest CT and 21% reported COVID-19-related symptoms. In contrast, 53% severe patients had abnormal chest CT, decreased pulmonary function or cardiac involvement and 79% were still symptomatic. Our findings suggest long-lasting immune protection after SARS-CoV-2 infection, while also highlight the risk of immune evasive variants and long-term consequences for COVID-19 survivors.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , Immunologic Memory , Models, Immunological , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Adult , COVID-19/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Tomography, X-Ray Computed
5.
EXCLI J ; 20: 894-906, 2021.
Article in English | MEDLINE | ID: covidwho-1261489

ABSTRACT

Sleep is believed to benefit the host defense against pathogens. We aimed to investigate the association of sleep quality with clinical outcomes among hospitalized patients with COVID-19. We conducted a prospective cohort study in 205 adult hospitalized patients with diagnosed moderate COVID-19, with follow-up until hospital discharge or death. Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality before and after infection. The primary outcome was the incidence of severe or critical pneumonia, and the secondary outcomes were duration of hospital stay and laboratory measurements during the follow up. Among the 205 included hospitalized patients, 185 (90.2 %) experienced poorer sleep quality after infection than before according to the PSQI score, and 25 (12.2 %) developed severe or critical pneumonia during follow-up. In Cox regression models, the adjusted hazard ratio of developing severe or critical pneumonia associated with each 1 score increment in the PSQI score before and after infection was 1.23 (95% CI: 1.09, 1.39) and 1.35 (95 % CI: 1.08, 1.67), respectively. Poorer sleep quality was also significantly associated with a prolonged hospital stay and more serious dysregulations in immune system indicated by several laboratory markers. Poorer sleep quality, either in the daily time or after infection with SARS-CoV-2, was associated with worse clinical outcomes. These findings highlight the importance of good sleep in confronting the emerging pandemic of COVID-19.

6.
Int Heart J ; 62(2): 337-343, 2021 Mar 30.
Article in English | MEDLINE | ID: covidwho-1190190

ABSTRACT

It is unclear whether patients with hypertension are more likely to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and whether there is a difference in the severity of coronavirus disease (COVID-19) pneumonia in patients who have taken ACEI/ARB drugs compared with those who have not.This observational study included data from all patients with clinically confirmed COVID-19 admitted to Hankou Hospital, Wuhan, China, between January 5 and March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was cut off on March 8, 2020.A total of 274 patients, 75 with hypertension and 199 without hypertension, were included in the analysis. Compared with patients without hypertension, patients with hypertension were older and were more likely to have preexisting comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. Moreover, patients with hypertension tended to have higher positive rate for SARS-CoV-2 PCR detection. Multivariate logistic regression analysis showed that age (P = 0.005) and gender (P = 0.019) were independent risk factors associated with the severity of pneumonia in patients on admission, whereas ACEI/ARB treatment (P = 0.184) was not.Patients with COVID-19 with hypertension were significantly older and were more likely to have underlying comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. ACEI/ARB drugs did not influence the severity of pneumonia in patients with SARS-CoV-2. In future studies, a larger sample size and multi-center clinical data would be needed to support these conclusions.


Subject(s)
COVID-19/epidemiology , Hospitalization , Hypertension/complications , Hypertension/drug therapy , Adult , Age Factors , Aged , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/therapeutic use , COVID-19/complications , COVID-19/diagnosis , China , Female , Humans , Logistic Models , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Factors
7.
Journal of Geographical Sciences ; 31(4):565-583, 2021.
Article in English | ProQuest Central | ID: covidwho-1182289

ABSTRACT

Scientifically assessing the economic impact of major public health emergencies, containing their negative effects, and enhancing the resilience of an economy are important national strategic needs. The new coronavirus disease (COVID-19) has, to date, been effectively contained in China, but the threat of imported cases and local risks still exist. The systematic identification of the virus’s path of influence and intensity is significant for economic recovery. This study is based on a refined multi-regional general equilibrium analysis model, which measures the economic and industrial impacts at different epidemic risk levels in China and simulates development trends and the degree of damage to industries and the economy under changes to supplies of production materials and product demand. The results show that, at the macroeconomic level, China’s GDP will decline about 0.4% to 0.8% compared to normal in 2020, with an average drop of about 2% in short-term consumption, an average drop in employment of about 0.7%, and an average increase in prices of about 0.9%. At the industry level, the epidemic will have the greatest short-term impact on consumer and laborintensive industries. For example, the output value of the service industry will fall 6.3% compared to normal. Looking at the impact of the epidemic on the industrial system, the province most affected by the epidemic is Hubei, which is the only province in China in the level-1 risk category. As the disease spread outward from Hubei, there were clear differences in the main industries that were impacted in different regions. In addition, simulation results of recovery intensity of regional economies under the two epidemic response scenarios of resumption of work and production and active fiscal stimulus policies show that an increase in fiscal stimulus policies produces a 0.3% higher rate of gross regional product growth but it causes commodity prices to rise by about 1.8%. Measures to resume work and production offer a wider scope for industrial recovery.

8.
Med Sci Monit ; 27: e930853, 2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1181794

ABSTRACT

BACKGROUND COVID-19 has become a worldwide epidemic disease and is a public health crisis. We aim to provide evidence for clinical diagnosis and assessment of severity by analyzing patients' clinical data and early laboratory results and exploring the correlation between laboratory results and clinical classification. MATERIAL AND METHODS We enrolled 283 cases of suspected and diagnosed COVID-19 from 16 hospitals in Jiangsu Province from January to April 2020. The routine laboratory blood examinations, T lymphocyte subsets, and biochemical and coagulation function among different populations were contrasted by t test and chi-square (χ²) test. RESULTS Cough, fever, and dyspnea could be helpful to diagnose COVID-19 infection (P<0.05). Patients who were older or had comorbidities tended to become severe and critical cases. Among all the patients, the most obvious abnormal laboratory results were higher neutrophil count, CRP, total bilirubin, BUN, CRE, APTT, PT, and D-dimer, and lower blood platelet and lymphocyte count. CD3⁺ T cell, CD4⁺ T cell, and CD8⁺ T cell counts gradually decreased with exacerbation of the disease (P<0.05). CONCLUSIONS Cough and fever were the most common symptom. Patients with comorbidities were in more serious condition. The detection of inflammatory indexes, coagulation function, lymphocyte subsets, and renal function can help diagnose and assess the severity of COVID-19.


Subject(s)
COVID-19/diagnosis , Cough/epidemiology , Fever/epidemiology , SARS-CoV-2/immunology , Severity of Illness Index , Adult , Aged , Aged, 80 and over , Blood Coagulation/immunology , COVID-19/blood , COVID-19/complications , COVID-19/epidemiology , China/epidemiology , Comorbidity , Cough/blood , Cough/immunology , Cough/virology , Female , Fever/blood , Fever/immunology , Fever/virology , Humans , Inflammation/blood , Inflammation/diagnosis , Inflammation/immunology , Inflammation/virology , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , T-Lymphocyte Subsets/immunology , Young Adult
9.
J Affect Disord ; 287: 255-260, 2021 05 15.
Article in English | MEDLINE | ID: covidwho-1163958

ABSTRACT

OBJECTIVE: To compare the differences of depressive symptoms and perceived family cohesion and adaptability between adolescents and parents during the pandemic; to explore the association between depressive symptoms and family cohesion and adaptability. METHODS: A total of 8,940 adolescents (45.77% males; Mean age=15.31±0.018 years old) and their parents (24.34% males; Mean age=40.78±0.60 years old) from Shenyang, Liaoning Province, China, participated in the survey and completed several questionnaires online. We used the Patient Health Questionnaire-9 (PHQ-9) and the Family Adaptability Cohesion Scale, Second Edition, Chinese version (FACES II-CV) to evaluate depressive symptoms and family cohesion and family adaptability from the perception of parents and adolescents. RESULTS: Results indicated significant differences between adolescents' and parents' perspectives of family functions. Significant negative correlations exist between depressive symptoms and family cohesion and family adaptability from the perspectives of both adolescents and parents. In addition, regression models with demographic characteristics adjusted showed that the perceived family cohesion and adaptability of parents and adolescents and the agreements between them could be predicted by their depressive symptoms. LIMITATION: Cross-sectional study and limited population-wide are limitations. CONCLUSION: Detecting the depressive symptoms of adolescents and parents earlier and promptly providing family intervention are of great significance to promote their perceptions of family cohesion and adaptability, which contribute to the mental health development of adolescents and parents during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Parents , SARS-CoV-2
10.
J Aerosol Med Pulm Drug Deliv ; 34(2): 108-114, 2021 04.
Article in English | MEDLINE | ID: covidwho-1127303

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 infection is associated with strong infectiousness and has no effective therapy. We aimed to explore the efficacy and safety of Mycobacterium vaccae nebulization in the treatment of Coronavirus Disease 2019 (COVID-19). Methods: In this randomized, double-blind, placebo-controlled clinical trial, we included 31 adult patients with moderate COVID-19 who were admitted to the Fourth People's Hospital of Nanning (Nanning, China) between January 22, 2020 and February 17, 2020. Patients were randomly divided into two groups: group A (standard care group) and group B (M. vaccae in combination with standard care group). The primary outcome was the time interval from admission to viral RNA negative conversion (oropharyngeal swabs were used in this study). Secondary outcomes included chest computed tomography (CT), mortality, length of hospital stay, complications during treatment, and so on. Patients were followed up to 4 weeks after discharge (reexamination of viral RNA, chest CT, etc.). Results: Nucleic acid test negative conversion time in group B was shorter than that in group A (2.9 days [2.7-8.7] vs. 6.8 days [3.3-13.8]; p = 0.045). No death and no conversion to severe or critical cases were observed in both groups. Two weeks after discharge, neither "relapse" nor "return to positive" cases were found. Four weeks after discharge, it was found that there was no case of " relapse " or "return to positive" in group B, and 1 patient in group A showed "return to positive", but there was no clinical manifestation and imaging progression. No adverse reactions related to M. vaccae were found during observation period. Conclusion: M. vaccae treatment might shorten the time interval from admission to viral RNA negative conversion, which might be beneficial to the prevention and treatment of COVID-19. Clinical Trial Registration: ChiCTR2000030016.


Subject(s)
COVID-19/therapy , Length of Stay , Mycobacteriaceae/immunology , Tomography, X-Ray Computed , Administration, Inhalation , Adolescent , Adult , Aged , COVID-19/immunology , COVID-19/mortality , Double-Blind Method , Female , Humans , Male , Middle Aged , Time Factors , Treatment Outcome , Young Adult
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(2): 157-163, 2021 Feb 25.
Article in Chinese | MEDLINE | ID: covidwho-1100442

ABSTRACT

OBJECTIVE: To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19). OBJECTIVE: This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis. OBJECTIVE: Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI. OBJECTIVE: AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.


Subject(s)
Acute Kidney Injury , COVID-19 , Acute Kidney Injury/epidemiology , Aged , China/epidemiology , Humans , Male , Retrospective Studies , SARS-CoV-2
12.
Sci Bull (Beijing) ; 66(22): 2297-2311, 2021 Nov 30.
Article in English | MEDLINE | ID: covidwho-1065574

ABSTRACT

The pandemic due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), has caused immense global disruption. With the rapid accumulation of SARS-CoV-2 genome sequences, however, thousands of genomic variants of SARS-CoV-2 are now publicly available. To improve the tracing of the viral genomes' evolution during the development of the pandemic, we analyzed single nucleotide variants (SNVs) in 121,618 high-quality SARS-CoV-2 genomes. We divided these viral genomes into two major lineages (L and S) based on variants at sites 8782 and 28144, and further divided the L lineage into two major sublineages (L1 and L2) using SNVs at sites 3037, 14408, and 23403. Subsequently, we categorized them into 130 sublineages (37 in S, 35 in L1, and 58 in L2) based on marker SNVs at 201 additional genomic sites. This lineage/sublineage designation system has a hierarchical structure and reflects the relatedness among the subclades of the major lineages. We also provide a companion website (www.covid19evolution.net) that allows users to visualize sublineage information and upload their own SARS-CoV-2 genomes for sublineage classification. Finally, we discussed the possible roles of compensatory mutations and natural selection during SARS-CoV-2's evolution. These efforts will improve our understanding of the temporal and spatial dynamics of SARS-CoV-2's genome evolution.

13.
Front Genet ; 11: 591833, 2020.
Article in English | MEDLINE | ID: covidwho-1052490

ABSTRACT

SARS-CoV-2 has caused a worldwide pandemic. Existing research on coronavirus mutations is based on small data sets, and multiple sequence alignment using a global-scale data set has yet to be conducted. Statistical analysis of integral mutations and global spread are necessary and could help improve primer design for nucleic acid diagnosis and vaccine development. Here, we optimized multiple sequence alignment using a conserved sequence search algorithm to align 24,768 sequences from the GISAID data set. A phylogenetic tree was constructed using the maximum likelihood (ML) method. Coronavirus subtypes were analyzed via t-SNE clustering. We performed haplotype network analysis and t-SNE clustering to analyze the coronavirus origin and spread. Overall, we identified 33 sense, 17 nonsense, 79 amino acid loss, and 4 amino acid insertion mutations in full-length open reading frames. Phylogenetic trees were successfully constructed and samples clustered into subtypes. The COVID-19 pandemic differed among countries and continents. Samples from the United States and western Europe were more diverse, and those from China and Asia mainly contained specific subtypes. Clades G/GH/GR are more likely to be the origin clades of SARS-CoV-2 compared with clades S/L/V. Conserved sequence searches can be used to segment long sequences, making large-scale multisequence alignment possible, facilitating more comprehensive gene mutation analysis. Mutation analysis of the SARS-CoV-2 can inform primer design for nucleic acid diagnosis to improve virus detection efficiency. In addition, research into the characteristics of viral spread and relationships among geographic regions can help formulate health policies and reduce the increase of imported cases.

14.
Biosci Rep ; 41(1)2021 01 29.
Article in English | MEDLINE | ID: covidwho-1043444

ABSTRACT

OBJECTIVE: ´Three formulas and three medicines,' namely, Jinhua Qinggan Granule, Lianhua Qingwen Capsule, Xuebijing Injection, Qingfei Paidu Decoction, HuaShi BaiDu Formula, and XuanFei BaiDu Granule, were proven to be effective for coronavirus disease 2019 (COVID-19) treatment. The present study aimed to identify the active chemical constituents of this traditional Chinese medicine (TCM) and investigate their mechanisms through interleukin-6 (IL-6) integrating network pharmacological approaches. METHODS: We collected the compounds from all herbal ingredients of the previously mentioned TCM, but those that could down-regulate IL-6 were screened through the network pharmacology approach. Then, we modeled molecular docking to evaluate the binding affinity between compounds and IL-6. Furthermore, we analyzed the biological processes and pathways of compounds. Finally, we screened out the core genes of compounds through the construction of the protein-protein interaction network and the excavation of gene clusters of compounds. RESULTS: The network pharmacology research showed that TCM could decrease IL-6 using several compounds, such as quercetin, ursolic acid, luteolin, and rutin. Molecular docking results showed that the molecular binding affinity with IL-6 of all compounds except γ-aminobutyric acid was < -5.0 kJ/mol, indicating the potential of numerous active compounds in TCM to directly interact with IL-6, leading to an anti-inflammation effect. Finally, Cytoscape 3.7.2 was used to topologize the biological processes and pathways of compounds, revealing potential mechanisms for COVID-19 treatment. CONCLUSION: These results indicated the positive effect of TCM on the prevention and rehabilitation of COVID-19 in at-risk people. Quercetin, ursolic acid, luteolin, and rutin could inhibit COVID-19 by down-regulating IL-6.


Subject(s)
Anti-Inflammatory Agents/pharmacology , COVID-19/drug therapy , Drugs, Chinese Herbal/pharmacology , Interleukin-6/immunology , Anti-Inflammatory Agents/chemistry , COVID-19/immunology , Drug Discovery , Drugs, Chinese Herbal/chemistry , Humans , Interleukin-6/antagonists & inhibitors , Luteolin/analysis , Luteolin/pharmacology , Medicine, Chinese Traditional , Molecular Docking Simulation , Protein Interaction Maps/drug effects , Quercetin/analysis , Quercetin/pharmacology , Rutin/analysis , Rutin/pharmacology , Triterpenes/analysis , Triterpenes/pharmacology
15.
Shock ; 56(3): 360-367, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1028641

ABSTRACT

PURPOSE: Rhabdomyolysis (RM) has been associated with many viral infectious diseases, and associated with poor outcomes. We aim to evaluate the clinical features and outcomes of RM in patients with coronavirus disease 2019 (COVID-19). METHOD: This was a single-center, retrospective, cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan Hospital in Wuhan, China, between February 17 and April 12, 2020. RESULTS: The overall incidence of RM was 2.2%. Compared with patients without RM, those with RM tended to have a higher risk of deterioration. Patients with RM also constituted a greater percentage of patients admitted to the intensive care unit (90.9% vs. 5.3%, P < 0.001) and a greater percentage of patients undergoing mechanical ventilation (86.4% vs. 2.7% P < 0.001). Moreover, patients with RM had laboratory test abnormalities, including the presence of markers of inflammation, activation of coagulation, and kidney injury. Patients with RM also had a higher risk of in-hospital death (P < 0.001). Cox's proportional hazard regression model analysis confirmed that RM indicators, including peak creatine kinase levels > 1,000 IU/L (HR = 6.46, 95% CI: 3.02-13.86) and peak serum myoglobin concentrations > 1,000 ng/mL (HR = 9.85, 95% CI: 5.04-19.28), were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have delayed viral clearance. CONCLUSION: RM might be an important contributing factor to adverse outcomes in COVID-19 patients. The early detection and effective intervention of RM may help reduce mortality among COVID-19 patients.


Subject(s)
COVID-19/complications , COVID-19/mortality , Hospital Mortality , Rhabdomyolysis/complications , Rhabdomyolysis/mortality , Adolescent , Adult , Aged , Aged, 80 and over , China/epidemiology , Female , Hospitalization , Humans , Incidence , Intensive Care Units , Male , Middle Aged , Muscle, Skeletal/physiopathology , Proportional Hazards Models , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Treatment Outcome , Young Adult
16.
Mol Immunol ; 131: 6-12, 2021 03.
Article in English | MEDLINE | ID: covidwho-1014722

ABSTRACT

The SARS-CoV-2 virus responsible for coronavirus 2019 (COVID-19) poses a significant challenge to healthcare systems worldwide. According to the World Health Organization (WHO), the outbreak of COVID-19 has been a pandemic that infected more than 25.32 million people and caused more than 848.25 thousand deaths worldwide at the time of 1st September 2020. Despite governmental initiatives aimed to contain the spread of the disease, several countries are experiencing unmanageable increases in medical equipment and larger testing capacity. The current diagnosis based on nuclear acid requires specialized instruments, time-consuming, and laborious, the low-cost and convenient technologies were still urgently needed. Both spike and nucleocapsid are key structural proteins of COVID-19 with good immunogenicity, can serve as primary targets for immunoassay. After comparative research, we certified nucleocapsid antigen-monoclonal antibody (mAbs) system was more suitable for the COVID-19 immunodetection. Subsequently, we designed a rapid test strip based on it that can be used in large-scale screening of COVID-19 in population and more suitable for some remote and special needs areas were restricted by a medical condition or for quick and large quantities of screenings.


Subject(s)
Antibodies, Monoclonal, Murine-Derived/chemistry , COVID-19 Serological Testing , COVID-19/immunology , Coronavirus Nucleocapsid Proteins/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Monoclonal, Murine-Derived/immunology , Immunoassay , Mice , Mice, Inbred BALB C
17.
Brief Bioinform ; 22(5)2021 09 02.
Article in English | MEDLINE | ID: covidwho-1012820

ABSTRACT

Protein-nucleic acid interactions play essential roles in many biological processes, such as transcription, replication and translation. In protein-nucleic acid interfaces, hotspot residues contribute the majority of binding affinity toward molecular recognition. Hotspot residues are commonly regarded as potential binding sites for compound molecules in drug design projects. The dynamic property is a considerable factor that affects the binding of ligands. Computational approaches have been developed to expedite the prediction of hotspot residues on protein-nucleic acid interfaces. However, existing approaches overlook hotspot dynamics, despite their essential role in protein function. Here, we report a web server named Hotspots In silico Scanning on Nucleic Acid and Protein Interface (HISNAPI) to analyze hotspot residue dynamics by integrating molecular dynamics simulation and one-step free energy perturbation. HISNAPI is capable of not only predicting the hotspot residues in protein-nucleic acid interfaces but also providing insights into their intensity and correlation of dynamic motion. Protein dynamics have been recognized as a vital factor that has an effect on the interaction specificity and affinity of the binding partners. We applied HISNAPI to the case of SARS-CoV-2 RNA-dependent RNA polymerase, a vital target of the antiviral drug for the treatment of coronavirus disease 2019. We identified the hotspot residues and characterized their dynamic behaviors, which might provide insight into the target site for antiviral drug design. The web server is freely available via a user-friendly web interface at http://chemyang.ccnu.edu.cn/ccb/server/HISNAPI/ and http://agroda.gzu.edu.cn:9999/ccb/server/HISNAPI/.


Subject(s)
Computational Biology/methods , Nucleic Acids/metabolism , Proteins/metabolism , Computational Biology/instrumentation , Internet , Protein Binding , User-Computer Interface
18.
J Zhejiang Univ Sci B ; 21(12): 940-947, 2020.
Article in English | MEDLINE | ID: covidwho-999887

ABSTRACT

BACKGROUND: The proportion of recurrences after discharge among patients with coronavirus disease 2019 (COVID-19) was reported to be between 9.1% and 31.0%. Little is known about this issue, however, so we performed a meta-analysis to summarize the demographical, clinical, and laboratorial characteristics of non-recurrence and recurrence groups. METHODS: Comprehensive searches were conducted using eight electronic databases. Data regarding the demographic, clinical, and laboratorial characteristics of both recurrence and non-recurrence groups were extracted, and quantitative and qualitative analyses were conducted. RESULTS: Ten studies involving 2071 COVID-19 cases were included in this analysis. The proportion of recurrence cases involving patients with COVID-19 was 17.65% (between 12.38% and 25.16%) while older patients were more likely to experience recurrence (weighted mean difference (WMD)=1.67, range between 0.08 and 3.26). The time from discharge to recurrence was 13.38 d (between 12.08 and 14.69 d). Patients were categorized as having moderate severity (odds ratio (OR)=2.69, range between 1.30 and 5.58), while those with clinical symptoms including cough (OR=5.52, range between 3.18 and 9.60), sputum production (OR=5.10, range between 2.60 and 9.97), headache (OR=3.57, range between 1.36 and 9.35), and dizziness (OR=3.17, range between 1.12 and 8.96) were more likely to be associated with recurrence. Patients presenting with bilateral pulmonary infiltration and decreased leucocyte, platelet, and CD4+ T counts were at risk of COVID-19 recurrence (OR=1.71, range between 1.07 and 2.75; WMD=-1.06, range between -1.55 and -0.57, WMD=-40.39, range between -80.20 and -0.48, and WMD=-55.26, range between -105.92 and -4.60, respectively). CONCLUSIONS: The main factors associated with the recurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after hospital discharge were older age, moderate severity, bilateral pulmonary infiltration, laboratory findings including decreased leucocytes, platelets, and CD4+ T counts, and clinical symptoms including cough, sputum production, headache, and dizziness. These factors can be considered warning indicators for the recurrence of SARS-CoV-2 and might help the development of specific management strategies.


Subject(s)
COVID-19/diagnosis , Recurrence , Age Factors , Blood Cell Count , CD4 Lymphocyte Count , COVID-19/pathology , Cough , Dizziness , Headache , Humans , Patient Discharge , Risk Factors
19.
J Med Internet Res ; 22(11): e23853, 2020 11 11.
Article in English | MEDLINE | ID: covidwho-976121

ABSTRACT

BACKGROUND: The novel COVID-19 disease has spread worldwide, resulting in a new pandemic. The Chinese government implemented strong intervention measures in the early stage of the epidemic, including strict travel bans and social distancing policies. Prioritizing the analysis of different contributing factors to outbreak outcomes is important for the precise prevention and control of infectious diseases. We proposed a novel framework for resolving this issue and applied it to data from China. OBJECTIVE: This study aimed to systematically identify national-level and city-level contributing factors to the control of COVID-19 in China. METHODS: Daily COVID-19 case data and related multidimensional data, including travel-related, medical, socioeconomic, environmental, and influenza-like illness factors, from 343 cities in China were collected. A correlation analysis and interpretable machine learning algorithm were used to evaluate the quantitative contribution of factors to new cases and COVID-19 growth rates during the epidemic period (ie, January 17 to February 29, 2020). RESULTS: Many factors correlated with the spread of COVID-19 in China. Travel-related population movement was the main contributing factor for new cases and COVID-19 growth rates in China, and its contributions were as high as 77% and 41%, respectively. There was a clear lag effect for travel-related factors (previous vs current week: new cases, 45% vs 32%; COVID-19 growth rates, 21% vs 20%). Travel from non-Wuhan regions was the single factor with the most significant impact on COVID-19 growth rates (contribution: new cases, 12%; COVID-19 growth rate, 26%), and its contribution could not be ignored. City flow, a measure of outbreak control strength, contributed 16% and 7% to new cases and COVID-19 growth rates, respectively. Socioeconomic factors also played important roles in COVID-19 growth rates in China (contribution, 28%). Other factors, including medical, environmental, and influenza-like illness factors, also contributed to new cases and COVID-19 growth rates in China. Based on our analysis of individual cities, compared to Beijing, population flow from Wuhan and internal flow within Wenzhou were driving factors for increasing the number of new cases in Wenzhou. For Chongqing, the main contributing factor for new cases was population flow from Hubei, beyond Wuhan. The high COVID-19 growth rates in Wenzhou were driven by population-related factors. CONCLUSIONS: Many factors contributed to the COVID-19 outbreak outcomes in China. The differential effects of various factors, including specific city-level factors, emphasize the importance of precise, targeted strategies for controlling the COVID-19 outbreak and future infectious disease outbreaks.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks/statistics & numerical data , China/epidemiology , Factor Analysis, Statistical , Humans
20.
Evid Based Complement Alternat Med ; 2020: 7493281, 2020.
Article in English | MEDLINE | ID: covidwho-913872

ABSTRACT

"Three formulas and three medicines," which include Jinhua Qinggan granule, Lianhua Qingwen capsule/granule, Xuebijing injection, Qingfei Paidu decoction, HuaShiBaiDu formula, and XuanFeiBaiDu granule, have been proven to be effective in curbing coronavirus disease 2019 (COVID-19), according to the State Administration of Traditional Chinese Medicine. The aims of this study were to identify the active components of "Three formulas and three medicines" that can be used to treat COVID-19, determine their mechanism of action via angiotensin-converting enzyme 2 (ACE2) by integrating network pharmacological approaches, and confirm the most effective components for COVID-19 treatment or prevention. We investigated all the compounds present in the aforementioned herbal ingredients. Compounds that could downregulate the transcription factors (TFs) of ACE2 and upregulate miRNAs of ACE2 were screened via a network pharmacology approach. Hepatocyte nuclear factor 4 alpha (HNF4A), peroxisome proliferator-activated receptor gamma (PPARG), hsa-miR-2113, and hsa-miR-421 were found to regulate ACE2. Several compounds, such as quercetin, decreased ACE2 expression by regulating the aforementioned TFs or miRNAs. After comparison with the compounds present in Glycyrrhiza Radix et Rhizoma, quercetin, glabridin, and gallic acid present in the herbal formulas and medicines were found to alter ACE2 expression. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to search for possible molecular mechanisms of these compounds. In conclusion, traditional Chinese medicine (TCM) plays a pivotal role in the prevention and treatment of COVID-19. Quercetin, glabridin, and gallic acid, the active components of recommended TCM formulas and medicines, can inhibit COVID-19 by downregulating ACE2.

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