Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
1.
Nat Immunol ; 2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1778617

ABSTRACT

Although mRNA vaccine efficacy against severe coronavirus disease 2019 remains high, variant emergence has prompted booster immunizations. However, the effects of repeated exposures to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens on memory T cells are poorly understood. Here, we utilize major histocompatibility complex multimers with single-cell RNA sequencing to profile SARS-CoV-2-responsive T cells ex vivo from humans with one, two or three antigen exposures, including vaccination, primary infection and breakthrough infection. Exposure order determined the distribution between spike-specific and non-spike-specific responses, with vaccination after infection leading to expansion of spike-specific T cells and differentiation to CCR7-CD45RA+ effectors. In contrast, individuals after breakthrough infection mount vigorous non-spike-specific responses. Analysis of over 4,000 epitope-specific T cell antigen receptor (TCR) sequences demonstrates that all exposures elicit diverse repertoires characterized by shared TCR motifs, confirmed by monoclonal TCR characterization, with no evidence for repertoire narrowing from repeated exposure. Our findings suggest that breakthrough infections diversify the T cell memory repertoire and current vaccination protocols continue to expand and differentiate spike-specific memory.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324124

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in thousands of deaths in the world. Information about prediction model of prognosis of SARS-CoV-2 infection is scarce. We used machine learning for processing laboratory findings of 110 patients with SARS-CoV-2 pneumonia (including 51 non-survivors and 59 discharged patients). The maximum relevance minimum redundancy (mRMR) algorithm and the least absolute shrinkage and selection operator (LASSO) logistic regression model were used for selection of laboratory features. Seven laboratory features selected by machine learning were: prothrombin activity, urea, white blood cell, interleukin-2 receptor, indirect bilirubin, myoglobin, and fibrinogen degradation products. The signature constructed using the seven features had 98% [93%, 100%] sensitivity and 91% [84%, 99%] specificity in predicating outcome of SARS-CoV-2 pneumonia. Thus it is feasible to establish an accurate prediction model of outcome of SARS-CoV-2 pneumonia with machine learning.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323693

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) was classified as a global pandemic by the World Health Organization. In addition to health effects, it has also brought about psychological problems due to its economic and social impact. Psychological effects have led to drug and alcohol abuse. To inform physician decisions, there is a need to characterize the physical and psychological characteristics of nitrous oxide abusers during the COVID-19 Pandemic. Methods: : We enrolled six nitrous oxide abusers who sought treatment at Taizhou Hospital of Zhejiang province between May 2020 and June 2020. Clinical data including socio-demographic, physical examination, laboratory examination, electromyography, neuroimaging, and psychological assessment were collected. Results: : The enrolled patients had a mean age of 22±4.3. Clinical presentations included varying degrees of limb numbness and an ataxic gait. Under laboratory examination, it was revealed that all the patients did not have pernicious anemia, 4 patients had decreased vitamin B12 while 3 patients exhibited elevated homocysteine levels. MR of the spinal cord revealed that 4 patients had abnormal signals in the cervical spinal cord. These signals were of high symmetry with splayed or inverted V sign after T2WI. Peripheral nerve damage was observed in 5 patients who were subjected to an electromyogram (EMG) test. The Symptom Checklist 90 (SCL-90) psychological evaluation indicated that all patients had severe anxiety, depression and psychosis. The psychological status of nitrous oxide abusers was significantly different from that of health controls. After treatment by vitamin B12, the patients’ physical symptoms improved, and they were discharged from the hospital. For the evaluation of mental and psychological outcomes post-discharge, patients were asked to go to the psychological department for check-up and follow-up. Conclusion: The enrolled 6 patients caused by abuse of nitrous oxide presented with symptoms of subacute combined with spinal degeneration. They had more serious psychological problems related to the COVID-19 pandemic. These problems require immediate attention and interventional approaches. The national government and other departments should take active measures to control abuse of nitrous oxide. Trial registration: Not applicable.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312501

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression into account. Methods: A single-centered, retrospective study was carried out, which included moderate (n=76) and severe COVID-19 cases (n=22). The difference of laboratory findings from blood routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression was indicated by oxygenation index. Results: Age is a risk factor for disease progression from moderate to severe. Lymphocytopenia, neutrophilia, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients. Conclusions: Lymphocytopenia and neutrophilia, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia in severe COVID-19. Oxygenation index presented potentiality as predictor on the progression of COVID-19.

5.
Journal of Hospitality and Tourism Management ; 50:10-20, 2021.
Article in English | EuropePMC | ID: covidwho-1602190

ABSTRACT

Wearing a facemask is an effective part of personal hygiene management (WHO, 2020). Not only can it offer healthy people some protection against coronavirus disease 2019 (COVID-19) infection, but it can also reduce the spread of the virus. Wearing facemasks, as a part of the various regulations and guidelines encouraged by the Chinese government and hospitality firms, has been widely accepted by the public in the post-COVID-19 era in China. But few studies have considered the effects of employees wearing facemasks on the customer service experience. Based on signaling theory, this experimental study explores the effects of hotel employees wearing facemasks on customer perceptions of service quality. The results indicate three main effects. (a) Having employees wear facemasks can improve perceptions of customer service quality. (b) Customers commonly feel that female employees wearing facemasks could provide higher service quality than male mask-wearing employees, but the improvement in customer perception with male employees wearing facemasks is greater than the situation between facemask-less and facemask-wearing females. (c) Customer perceptions of employee expertise, employee trustworthiness, and hotel trustworthiness play serial mediating roles. Recommendations to help hotel managers improve customers’ service evaluations during the COVID-19 pandemic are provided.

6.
MAbs ; 14(1): 2005507, 2022.
Article in English | MEDLINE | ID: covidwho-1585297

ABSTRACT

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a serious public health crisis worldwide, and considering the novelty of the disease, preventative and therapeutic measures alike are urgently needed. To accelerate such efforts, the development of JS016, a neutralizing monoclonal antibody directed against the SARS-CoV-2 spike protein, was expedited from a typical 12- to 18-month period to a 4-month period. During this process, transient Chinese hamster ovary cell lines are used to support preclinical, investigational new drug-enabling toxicology research, and early Chemistry, Manufacturing and Controls development; mini-pool materials to supply Phase 1 clinical trials; and a single-clone working cell bank for late-stage and pivotal clinical trials were successively adopted. Moreover, key process performance and product quality investigations using a series of orthogonal and state-of-the-art techniques were conducted to demonstrate the comparability of products manufactured using these three processes, and the results indicated that, despite observed variations in process performance, the primary and high-order structures, purity and impurity profiles, biological and immunological functions, and degradation behaviors under stress conditions were largely comparable. The study suggests that, in particular situations, this strategy can be adopted to accelerate the development of therapeutic biopharmaceuticals and their access to patients.


Subject(s)
Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/therapeutic use , Antibody Affinity/immunology , Antibody Specificity/immunology , CHO Cells , COVID-19/prevention & control , COVID-19/virology , Chromatography, High Pressure Liquid/methods , Circular Dichroism , Clone Cells , Cricetinae , Cricetulus , Humans , Immunoglobulin G/chemistry , Immunoglobulin G/immunology , Immunoglobulin G/therapeutic use , Isoelectric Point , SARS-CoV-2/metabolism , SARS-CoV-2/physiology , Spike Glycoprotein, Coronavirus/metabolism
7.
Emerg Microbes Infect ; 10(1): 1519-1529, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1316787

ABSTRACT

The spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutated continuously and newly emerging variants escape from antibody-mediated neutralization raised great concern. S protein is heavily glycosylated and the glycosylation sites are relatively conserved, thus glycans on S protein surface could be a target for the development of anti-SARS-CoV-2 strategies against variants. Here, we collected 12 plant-derived lectins with different carbohydrate specificity and evaluated their anti-SARS-CoV-2 activity against mutant strains and epidemic variants using a pseudovirus-based neutralization assay. The Lens culinaris-derived lentil lectin which specifically bind to oligomannose-type glycans and GlcNAc at the non-reducing end terminus showed most potent and broad antiviral activity against a panel of mutant strains and variants, including the artificial mutants at N-/O-linked glycosylation site, natural existed amino acid mutants, as well as the epidemic variants B.1.1.7, B.1.351, and P.1. Lentil lectin also showed antiviral activity against SARS-CoV and MERS-CoV. We found lentil lectin could block the binding of ACE2 to S trimer and inhibit SARS-CoV-2 at the early steps of infection. Using structural information and determined N-glycan profile of S trimer, taking together with the carbohydrate specificity of lentil lectin, we provide a basis for the observed broad spectrum anti-SARS-CoV-2 activity. Lentil lectin showed weak haemagglutination activity at 1 mg/mL and no cytotoxicity activity, and no weight loss was found in single injection mouse experiment. This report provides the first evidence that lentil lectin strongly inhibit infection of SARS-COV-2 variants, which should provide valuable insights for developing future anti-SARS-CoV-2 strategies.


Subject(s)
Antiviral Agents/pharmacology , Lens Plant/chemistry , Plant Extracts/pharmacology , Plant Lectins/pharmacology , SARS-CoV-2/drug effects , Animals , Antiviral Agents/chemistry , Humans , Mice , Mice, Inbred BALB C , Plant Extracts/chemistry , Plant Lectins/chemistry , SARS-CoV-2/growth & development , Seeds/chemistry
8.
International Journal of Hospitality Management ; 97:102996, 2021.
Article in English | ScienceDirect | ID: covidwho-1267695

ABSTRACT

The attractiveness of service employees can have a significant impact on customer attitudes and behaviors. While frontline employees can reduce the risk of the COVID-19 transmission and infection by wearing facemasks, doing so can also influence customers’ perceptions of employees’ attractiveness and thus affect customer satisfaction. Based on the Gestalt theory, this study explores the impact of hotel employees’ facemask-wearing on customer satisfaction through two experimental studies. The results indicate that average-looking frontline employees who wear facemasks induce high levels of customer satisfaction. However, while the impact of wearing facemasks on customer satisfaction is not significant for attractive-looking male frontline employees, attractive-looking female frontline employees who wear facemasks induce lower customer satisfaction. Customers’ perception of employees’ physical attractiveness fully mediates the effects of wearing facemasks on customer satisfaction in the case of average-looking employees. Customers’ self-perceived physical attractiveness moderates the mediated effects. Implications that can help hotel managers improve customers’ service evaluations during the COVID-19 pandemic are provided.

9.
Eur J Radiol Open ; 8: 100338, 2021.
Article in English | MEDLINE | ID: covidwho-1191646

ABSTRACT

The clinical and imaging data of 121 ICU patients with SARS-CoV-2 infection (63 survivors and 58 non-survivors) were retrospectively reviewed. The clinical results and radiographic features were compared between survivors and non-survivors. Compared with survivors, non-survivors were more likely to develop ARDS (53 [91 %] vs. 22 [35 %], P < 0.0001), shock (6 [10 %] vs. 0, P = 0.009), cardiac injury(18 [31 %] vs. 6 [10 %], P = 0.003), acute kidney injury(21 [36 %] vs. 10 [16 %], P = 0.01), and pneumothorax(5 [9%] vs. 0, P = 0.017). There were typical radiographic features for ICU patients with SARS-CoV-2 pneumonia. Extensive air-space opacities could be seen in all patients. Middle and lower lung involvement was significantly more serious than upper lung (score 6.8 ±â€¯1.9, 7.2 ±â€¯2.1, and 5.7 ±â€¯1.7, respectively, P < 0.0001). Based on X-ray involvement score, non-survivors were in a more critical condition than survivors (20.3 ±â€¯4.6 vs. 19.1 ±â€¯3.1, P = 0.038).

10.
Medicine (Baltimore) ; 99(43): e22766, 2020 Oct 23.
Article in English | MEDLINE | ID: covidwho-894694

ABSTRACT

The aim of this study was to evaluate the association between overweight and severity, drug response, and clinical outcomes of novel coronavirus disease 2019 (COVID-19).In this retrospective cohort study, we reviewed medical records of 240 COVID-19 patients admitted to Union Hospital in Wuhan, China, between December 24, 2019, and March 25, 2020. Physical, clinical, laboratory, radiological characteristics, treatment, and outcome data were abstracted. Patients who were obese [body mass index (BMI) ≥28 kg/m], underweight (BMI < 18.5 kg/m), under 18 years old, pregnant, or still in hospital were excluded. Disease severity was classified as moderate or severe pneumonia based on the World Health Organization interim guidance. Overweight was defined as BMI ≥24 kg/m and <28 kg/m. Patients were followed for discharge or death through April 10, 2020. We used logistic regression models to identify risk factors for severe disease, Cox proportional hazard models to explore associations between medications and patient outcomes (discharge or in-hospital death), and Kaplan-Meier survival curves and Cox regression models to evaluate risk factors for in-hospital death.One-half of patients (120, 50.0%) had severe pneumonia, while nearly one-half (114, 47.5%) were overweight. Among patients over 45 years old, overweight patients had significantly lower rates of fatigue, higher rates of headache, and higher median C-reactive protein levels. Patients under 45 years old had higher rates of cough and myalgia and higher proportions of increased alanine aminotransferase and lactic dehydrogenase, as well as more pulmonary lobes involved in the pneumonia revealed by chest computed tomography scans. Overweight patients were at higher risk of developing severe pneumonia. Although weight was not a risk factor for in-hospital death, overweight patients showed different responses to medications compared with normal weight patients. Intravenous interferon-α, intravenous glucocorticoids, and antifungal drugs were associated with reduced mortality in overweight patients. Intravenous immunoglobulin, oseltamivir, and ribavirin were associated with reduced mortality in normal weight patients.Overweight is a worldwide health problem. We found overweight to be related to the COVID-19 severity but not to in-hospital death. Clinicians should be aware that overweight COVID-19 patients require increased attention for different clinical features and treatment response.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Overweight/complications , Pneumonia, Viral/diagnosis , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19 , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Coronavirus Infections/mortality , Female , Follow-Up Studies , Hospital Mortality , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Pneumonia, Viral/mortality , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Survival Analysis
11.
EClinicalMedicine ; 26: 100503, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-805325

ABSTRACT

BACKGROUND: Cancer patients had been profoundly affected by the outbreak of COVID-19 especially after quarantine restrictions in China. We aimed to explore the treatment changes and delays of early breast cancer (EBC) during the first quarter of 2020. METHODS: We did this retrospective, multicentre, cohort study at 97 cancer centres in China. EBC patients who received treatment regardless of preoperative therapy, surgery or postoperative therapy during first quarter of 2020 were included. FINDINGS: 8397 patients were eligible with a median age of 50 (IQR 43-56). 0·2% (15/8397) of EBC patients were confirmed as COVID-19 infection. Only 5·2% of breast cancer diagnosis occurred after quarantine in Hubei compared with 15·3% in other provinces (OR= 0·30, 95%CI 0·24-0·38). postoperative endocrine therapy were least affected compared with different regions after quarantine (OR=0·37 [95%CI 0·19-0·73]). The proportion of surgery decreased from 16·4% in December last year to 2·6% in February in Hubei. Compared with intervals from diagnosis to treatment before quarantine restrictions, the average time increased with significance from 3·5 to 7·7 days in Hubei and 5·7 to 7·7 days in other provinces (p< 0·001). There were also 18·5 and 7·2 days delay in Hubei and other provinces respectively when calculating interval from surgery to postoperative therapy. INTERPRETATION: EBC from high risk regions had a comparative rate of COVID-19 infection. After implementation of COVID-19 quarantine restrictions, fewer diagnosis and surgery with significant delays were seen when compared with treatment before. FUNDING: Beijing Medical Award Foundation (YJ0120).

13.
Sci Rep ; 10(1): 14042, 2020 08 20.
Article in English | MEDLINE | ID: covidwho-725830

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in thousands of deaths in the world. Information about prediction model of prognosis of SARS-CoV-2 infection is scarce. We used machine learning for processing laboratory findings of 110 patients with SARS-CoV-2 pneumonia (including 51 non-survivors and 59 discharged patients). The maximum relevance minimum redundancy (mRMR) algorithm and the least absolute shrinkage and selection operator logistic regression model were used for selection of laboratory features. Seven laboratory features selected in the model were: prothrombin activity, urea, white blood cell, interleukin-2 receptor, indirect bilirubin, myoglobin, and fibrinogen degradation products. The signature constructed using the seven features had 98% [93%, 100%] sensitivity and 91% [84%, 99%] specificity in predicting outcome of SARS-CoV-2 pneumonia. Thus it is feasible to establish an accurate prediction model of outcome of SARS-CoV-2 pneumonia based on laboratory findings.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/blood , Models, Statistical , Pneumonia, Viral/blood , Aged , Bilirubin/blood , COVID-19 , Coronavirus Infections/therapy , Coronavirus Infections/virology , Data Accuracy , Feasibility Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Forecasting/methods , Humans , Leukocytes , Machine Learning , Male , Myoglobin/blood , Pandemics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Prognosis , Prothrombin/analysis , Receptors, Interleukin-2/blood , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity , Treatment Outcome , Urea/blood
14.
Front Oncol ; 10: 924, 2020.
Article in English | MEDLINE | ID: covidwho-611825

ABSTRACT

Background: The outbreak of coronavirus disease 2019 (COVID-19) had become a global public health event. Lymphoma patients need to be distinguished from the general population because of their deficient immune status and intensive anti-tumor treatment. The impacts of cancer subtypes and treatment on COVID-19 infection are unclear. Case Presentation: We here report the case of a primary mediastinal large B-cell lymphoma patient who was infected with COVID-19 after intensive immunochemotherapy (DA-EPOCH-R). The patient developed a neutropenic fever during chemotherapy, and fever was persistent, although antibiotics were used. Initial chest CT was negative, and the patient received a throat swab test since the second CT showed evidence of pneumonia. With treatment with Arbidol Hydrochloride and LianHuaQingWen capsule, his COVID-19 was cured. Conclusions: To the best of our knowledge, this is the first report focusing on COVID-19 infection in a lymphoma patient undergoing intensive immunochemotherapy. For those patients being treated with immunochemotherapy in epidemic areas, a reduced dose intensity of intensive chemotherapy should be considered, and the effect of immunotherapies such as rituximab on COVID-19 infection should be considered. The impacts of anti-cancer treatment on COVID-19 infection need to be explored further.

15.
Lancet Oncol ; 21(7): 904-913, 2020 07.
Article in English | MEDLINE | ID: covidwho-437090

ABSTRACT

BACKGROUND: Patients with cancer are a high-risk population in the COVID-19 pandemic. We aimed to describe clinical characteristics and outcomes of patients with cancer and COVID-19, and examined risk factors for mortality in this population. METHODS: We did a retrospective, multicentre, cohort study of 205 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and with a pathological diagnosis of a malignant tumour in nine hospitals within Hubei, China, from Jan 13 to March 18, 2020. All patients were either discharged from hospitals or had died by April 20, 2020. Clinical characteristics, laboratory data, and cancer histories were compared between survivors and non-survivors by use of χ2 test. Risk factors for mortality were identified by univariable and multivariable logistic regression models. FINDINGS: Between Jan 13 and Mar 18, 2020, 205 patients with cancer and laboratory-confirmed SARS-CoV-2 infection were enrolled (median age 63 years [IQR 56-70; range 14-96]; 109 [53%] women). 183 (89%) had solid tumours and 22 (11%) had haematological malignancies. The median duration of follow-up was 68 days (IQR 59-78). The most common solid tumour types were breast (40 [20%] patients), colorectal (28 [14%]), and lung cancer (24 [12%]). 54 (30%) of 182 patients received antitumour therapies within 4 weeks before symptom onset. 30 (15%) of 205 patients were transferred to an intensive care unit and 40 (20%) died during hospital admission. Patients with haematological malignancies had poorer prognoses than did those with solid tumours: nine (41%) of 22 patients with haematological malignancies died versus 31 (17%) of 183 patients with solid tumours (hazard ratio for death 3·28 [95% CI 1·56-6·91]; log rank p=0·0009). Multivariable regression analysis showed that receiving chemotherapy within 4 weeks before symptom onset (odds ratio [OR] 3·51 [95% CI 1·16-10·59]; p=0·026) and male sex (OR 3·86 [95% CI 1·57-9·50]; p=0·0033) were risk factors for death during admission to hospital. INTERPRETATION: Patients with cancer and COVID-19 who were admitted to hospital had a high case-fatality rate. Unfavourable prognostic factors, including receiving chemotherapy within 4 weeks before symptom onset and male sex, might help clinicians to identify patients at high risk of fatal outcomes. FUNDING: National Natural Science Foundation of China.


Subject(s)
Coronavirus Infections/mortality , Coronavirus Infections/pathology , Neoplasms/mortality , Neoplasms/pathology , Pneumonia, Viral/mortality , Pneumonia, Viral/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Neoplasms/therapy , Pandemics , Pneumonia, Viral/therapy , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome , Young Adult
16.
Medicine (Baltimore) ; 99(20): e20208, 2020 May.
Article in English | MEDLINE | ID: covidwho-344693

ABSTRACT

INTRODUCTION: Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected more than 1,000,000 population in the world. Subcutaneous emphysema and pneumothorax are uncommon complications of SARS-CoV-2 pneumonia. Herein, we describe a fatal case of SARS-CoV-2 pneumonia with subcutaneous emphysema and pneumothorax. PATIENT CONCERNS: Subcutaneous emphysema was found in neck, bilateral chest walls, abdomen wall, groin area, and scrotum of a 67-year-old man. Extensive air-space opacities, subcutaneous emphysema and a small amount of pneumothorax were found in his chest X-ray scan. Echocardiography showed left ventricular enlargement with ejection fraction 20%. DIAGNOSIS: This resident of Wuhan with laboratory-confirmed SARS-CoV-2 infection had chronic pulmonary and cardiac diseases. Liver dysfunction, myocardial injury, and coagulation disorder were suggested by laboratory findings. Pneumonia, subcutaneous emphysema, and pneumothorax were confirmed with chest X-ray. Heart failure was revealed by echocardiography. INTERVENTIONS: He was transferred to intensive care unit, where invasive ventilation was used for him during the whole hospitalization. Prone position ventilation, vasoconstrictor, antibacteria, and antiviral therapy were given. OUTCOMES: He died on the twelfth day after admission. CONCLUSIONS: Subcutaneous emphysema and pneumothorax may occur in patients with SARS-CoV-2 pneumonia and chronic pulmonary disease. Chronic cardiac disease might be aggravated by SARS-CoV-2 infection, and develop heart failure.


Subject(s)
Coronavirus Infections/complications , Mediastinal Emphysema/etiology , Pneumothorax/etiology , Subcutaneous Emphysema/etiology , Aged , Betacoronavirus , Coronavirus Infections/physiopathology , Humans , Male , SARS-CoV-2
17.
J Anesth ; 34(4): 613-618, 2020 08.
Article in English | MEDLINE | ID: covidwho-306212

ABSTRACT

An outbreak of novel coronavirus pneumonia occurred worldwide since December 2019, which had been named COVID-19 subsequently. It is extremely transmissive that infection in pregnant women were unavoidable. The delivery process will produce large amount of contaminated media, leaving a challenge for medical personnel to ensure both the safety of the mother and infant and good self-protection. Only rare cases of pregnant women with COVID-19 are available for reference. Here, we report a 30-year-old woman had reverse transcription polymerase chain reaction-confirmed COVID-19 at 36 weeks 2 days of gestation. Significant low and high variability of fetal heart rate baseline and severe variable decelerations were repeated after admission. An emergency cesarean section at 37 weeks 1 day of gestation under combined spinal and epidural anesthesia was performed with strict protection for all personnel. Anesthesia and operation went uneventfully. None of the participants were infected. We can conclude that when confronted with cesarean section in parturient with COVID-19, careful planning and detailed preparation can improve the safety of the mother and infant and reduce the risk of infection for medical staff to help preventing and controlling the epidemic.


Subject(s)
Anesthesia, Obstetrical/methods , Betacoronavirus , Cesarean Section , Coronavirus Infections , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious , Adult , Anesthesia, Epidural/methods , Anesthesia, Spinal/methods , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/diagnostic imaging , Female , Humans , Lung/diagnostic imaging , Personal Protective Equipment , Pneumonia, Viral/diagnostic imaging , Pregnancy , Radiography, Thoracic , SARS-CoV-2 , Tomography, X-Ray Computed
18.
EMBO Mol Med ; 12(7): e12421, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-306055

ABSTRACT

Progression to severe disease is a difficult problem in treating coronavirus disease 2019 (COVID-19). The purpose of this study is to explore changes in markers of severe disease in COVID-19 patients. Sixty-nine severe COVID-19 patients were included. Patients with severe disease showed significant lymphocytopenia. Elevated level of lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, and D-dimer was found in most severe cases. Baseline interleukin-6 (IL-6) was found to be associated with COVID-19 severity. Indeed, the significant increase of baseline IL-6 was positively correlated with the maximal body temperature during hospitalization and with the increased baseline of CRP, LDH, ferritin, and D-dimer. High baseline IL-6 was also associated with more progressed chest computed tomography (CT) findings. Significant decrease in IL-6 and improved CT assessment was found in patients during recovery, while IL-6 was further increased in exacerbated patients. Collectively, our results suggest that the dynamic change in IL-6 can be used as a marker for disease monitoring in patients with severe COVID-19.


Subject(s)
Coronavirus Infections/pathology , Interleukin-6/analysis , Pneumonia, Viral/pathology , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Betacoronavirus/isolation & purification , Biomarkers/analysis , C-Reactive Protein/analysis , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Female , Humans , Lymphopenia/etiology , Male , Middle Aged , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/virology , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed
20.
AJR Am J Roentgenol ; 215(2): W31-W32, 2020 08.
Article in English | MEDLINE | ID: covidwho-144091
SELECTION OF CITATIONS
SEARCH DETAIL