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1.
J Integr Med ; 20(6): 561-574, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1966871

ABSTRACT

OBJECTIVE: Severe cases of coronavirus disease 2019 (COVID-19) are expected to have a worse prognosis than mild cases. Shenhuang Granule (SHG) has been shown to be a safe and effective treatment for severe COVID-19 in a previous randomized clinical trial, but the active chemical constituents and underlying mechanisms of action remain unknown. The goal of this study is to explore the chemical basis and mechanisms of SHG in the treatment of severe COVID-19, using network pharmacology. METHODS: Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry was employed to screen chemical constituents of SHG. Putative therapeutic targets were predicted by searching traditional Chinese medicine system pharmacology database and analysis platform, SwissTargetPrediction, and Gene Expression Omnibus (GEO) databases. The target protein-protein interaction network and enrichment analysis were performed to investigate the hub genes and presumptive mechanisms. Molecular docking and molecular dynamics simulations were used to verify the stability and interaction between the key chemical constituents of SHG and COVID-19 protein targets. RESULTS: Forty-five chemical constituents of SHG were identified along with 131 corresponding therapeutic targets, including hub genes such as HSP90AA1, MMP9, CXCL8, PTGS2, IFNG, DNMT1, TYMS, MDM2, HDAC3 and ABCB1. Functional enrichment analysis indicated that SHG mainly acted on the neuroactive ligand-receptor interaction, calcium signaling pathway and cAMP signaling pathway. Molecular docking showed that the key constituents had a good affinity with the severe acute respiratory syndrome coronavirus 2 protein targets. Molecular dynamics simulations indicated that ginsenoside Rg4 formed a stable protein-ligand complex with helicase. CONCLUSION: Multiple components of SHG regulated multiple targets to inhibit virus invasion and cytokine storm through several signaling pathways; this provides a scientific basis for clinical applications and further experiments.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , Humans , COVID-19/drug therapy , Molecular Docking Simulation , Ligands , Network Pharmacology , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/therapeutic use , Drugs, Chinese Herbal/chemistry , Medicine, Chinese Traditional
2.
Chin J Integr Med ; 28(10): 885-893, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1942845

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of Baidu Jieduan Granules (BDJDG) to treat common type coronavirus disease 2019 (COVID-19). METHODS: This multicenter, retrospective, and observational clinical trial included 230 common COVID-19 patients in Leishenshan, Huangshi, and Laohekou Hospitals in Wuhan from January 21 to March 26, 2020. The included patients were further divided into two subgroups according to the use of supplemental oxygen, mild and moderate groups. During the first 14 d of hospitalization, all patients were administered BDJDG combined with conventional Western medicine, and observed for continuous 28 d. Primary outcomes were disease progression rate and discharge rate. Secondary outcomes included negative conversion time of nucleic acid, hospitalization duration, clinical symptom subsidence time, and symptom regression rate. RESULTS: A total of 230 common COVID-19 patients were analyzed (138 in moderate group and 92 in mild group). By day 28, the disease progression rate was 4.3% and the discharge rate was 95.7%. All mild cases recovered and were discharged from hospital. The median negative conversion time of nucleic acid of all 230 COVID-19 patients was 12 d [inter-quartile range (IQR) 3.5-17], the median hospitalization duration was 15 d (IQR 12-20). The median time to fever, cough, and fatigue recovery was 4 d (IQR 2-6), 8 d (IQR 5-12), and 8 d (IQR 5-11). The recovery rate of fever, cough, and fatigue was 94.6%, 90.5%, and 93.5%. The median time to clinical improvement was 12 d (IQR 10-17). Compared with the baseline, total leukocyte counts, neutrophil counts, lymphocyte counts, and platelet counts were increased significantly on days 7 and 14 (P<0.01). C-reactive protein markedly increased on day 3 and significantly decreased on days 7 and 14 (P<0.01). No serious adverse events occurred during treatment. CONCLUSION: BDJDG may be effective and safe for treatment of common type COVID-19. (Registration No. ChiCTR2000030836).


Subject(s)
COVID-19 , Nucleic Acids , C-Reactive Protein , COVID-19/drug therapy , China , Cough/drug therapy , Disease Progression , Fatigue , Fever , Humans , Oxygen , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
3.
BMJ Open ; 12(3): e049749, 2022 03 30.
Article in English | MEDLINE | ID: covidwho-1769910

ABSTRACT

OBJECTIVE: The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing devastating implications for the mental health. This study aimed to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with healthy individuals. METHODS: A total of 486 patients with RD and 486 age-matched and sex-matched healthy individuals were recruited into the study. For each participant, we collected demographic and clinical characteristics data. The PTSD Checklist for DSM-5 (PCL-5) and four items from the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the prevalence and severity of PTSD and sleep quality, respectively. RESULTS: Compared with healthy control subjects (n=486), patients with RD (n=486) had a higher prevalence of PTSD (12.1% vs 4.1%; p<0.001). Higher total scores on the PCL-5 and on all four items from the PSQI (p≤0.001) were also observed. Female, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors of PTSD in patients with RD during the COVID-19 epidemic. CONCLUSION: During the COVID-19 outbreak, patients with RD presented a higher prevalence and severity of PTSD and showed more sleep disturbances. Our findings confirm the importance of psychological assessment and mental healthcare out of regular clinical care for patients with RD during the pandemic.


Subject(s)
COVID-19 , Rheumatic Diseases , Stress Disorders, Post-Traumatic , COVID-19/epidemiology , Case-Control Studies , China/epidemiology , Cross-Sectional Studies , Female , Humans , Pandemics , Rheumatic Diseases/complications , Rheumatic Diseases/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology
4.
mBio ; 13(2): e0040222, 2022 04 26.
Article in English | MEDLINE | ID: covidwho-1765083

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection triggers cytokine-mediated inflammation, leading to a myriad of clinical presentations in COVID-19. The SARS-CoV-2 open reading frame 8 (ORF8) is a secreted and rapidly evolving glycoprotein. Patients infected with SARS-CoV-2 variants with ORF8 deleted are associated with mild disease outcomes, but the molecular mechanism behind this is unknown. Here, we report that SARS-CoV-2 ORF8 is a viral cytokine that is similar to but distinct from interleukin 17A (IL-17A) as it induces stronger and broader human IL-17 receptor (hIL-17R) signaling than IL-17A. ORF8 primarily targeted blood monocytes and induced the heterodimerization of hIL-17RA and hIL-17RC, triggering a robust inflammatory response. Transcriptome analysis revealed that besides its activation of the hIL-17R pathway, ORF8 upregulated gene expression for fibrosis signaling and coagulation dysregulation. A naturally occurring ORF8 L84S variant that was highly associated with mild COVID-19 showed reduced hIL-17RA binding and attenuated inflammatory responses. This study reveals how SARS-CoV-2 ORF8 by a viral mimicry of the IL-17 cytokine contributes to COVID-19 severe inflammation. IMPORTANCE Patients infected with SARS-CoV-2 variants lacking open reading frame 8 (ORF8) have been associated with milder infection and disease outcome, but the molecular mechanism behind how this viral accessory protein mediates disease pathogenesis is not yet known. In our study, we revealed that secreted ORF8 protein mimics host IL-17 to activate IL-17 receptors A and C (IL-17RA/C) and induces a significantly stronger inflammatory response than host IL-17A, providing molecular insights into the role of ORF8 in COVID-19 pathogenesis and serving as a potential therapeutic target.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Inflammation/genetics , Interleukin-17/genetics , Open Reading Frames , SARS-CoV-2/genetics , Viral Proteins/metabolism
5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324167

ABSTRACT

Background: The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing alarming implications for the mental health. This study aims to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with the levels in healthy people. Methods: A questionnaire survey was conducted in a cross-sectional study of 486 RD patients and 486 healthy control subjects. We collected participants’ demographic and clinical characteristics and surveyed the prevalence and severity of PTSD and sleep quality in the samples using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Findings: Compared with healthy control subjects (n=486), RD patients (n=486) had a higher prevalence of PTSD (12·1% vs. 4·1%;p<0·001). They also had higher total scores on the PCL-5 and on all four items from the PSQI (p≤ 0·001). Female gender, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors for PTSD in RD patients during the COVID-19 epidemic. Interpretation: During the COVID-19 outbreak, RD patients presented a higher prevalence and severity of PTSD and more sleep disturbances. Our findings confirm the importance of psychological assessment and mental health care in addition to regular clinical care for RD patients during the pandemic. Funding: National Natural Science Foundation of China, China Ministry of Science and Technology, Shanghai Municipal Key Clinical Specialty Fund.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: This study was approved by the Human Research Ethics Committee of Changzheng Hospital, and informed consent was obtained from all participants.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324162

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is now recognized as a multi-system disease. The CDC recommends multiple preventive methods, including social distancing, hand hygiene, and wearing masks. In addition, some states imposed stay-at-home (SAH) and mandatory face mask (MFM) orders, to reduce the spread of COVID-19. The purpose of this study was to characterize the relationship between SAH and MFM approaches with the incidence rate and fatality-case-ratios (CFR).Methods: The research design is a cross-sectional study examining changes in incidence rate and CFR between states with and without SAH and MFM using available database from CDC during the pandemic periods of the date of the first positive case of each state to the date of 2020-08-23.Findings: The new daily cases curve of the nation was bent or flattened under the order of SAH and increased following the end of SAH and several nation-wide social gathering events. SAH+MFM states (n=34) and SAH+no-MFM states (n=9) have similar incidence rates, but significantly higher averages in daily new cases and daily fatality, and CFR than no-SAH+no-MFM states (n=7 states. P < 0.05), respectively. When normalized to population density, beside higher CFR in no-SAH+no-MFM, there are no significant differences in total positive cases, average daily new cases and average daily fatality among the 3 groups. When comparing masking during the period of SAH, there are significantly higher incidence rates and average daily new cases in MFM states than in no-MFM states (p<0.05). When normalized to population density, there are no significant differences in total positive cases and average daily new cases between the 2 groups.Interpretation: Our results were inconsistent with the intent of public health strategies in lowering transmission and fatality. From the policy making level, we suggested that following the CDC recommendation may be efficient for general public prevention during the pandemic.Funding: Not applicable.Declaration of Interests: The authors declare no competing financial interests.

7.
Int J Oncol ; 60(2)2022 Feb.
Article in English | MEDLINE | ID: covidwho-1662722

ABSTRACT

miR­1291 exerts an anti­tumor effect in a subset of human carcinomas, including pancreatic cancer. However, its role in colorectal cancer (CRC) is largely unknown. In the present study, the expression and effect of miR­1291 in CRC cells was investigated. It was identified that miR­1291 significantly suppressed the proliferation, invasion, cell mobility and colony formation of CRC cells. Additionally, miR­1291 induced cell apoptosis. A luciferase reporter assay revealed that miR­1291 directly bound the 3'­untranslated region sequence of doublecortin­like kinase 1 (DCLK1). miR­1291 also suppressed DCLK1 mRNA and protein expression in HCT116 cells that expressed DCLK1. Furthermore, miR­1291 suppressed cancer stem cell markers BMI1 and CD133, and inhibited sphere formation. The inhibitory effects on sphere formation, invasion and mobility in HCT116 cells were also explored and verified using DCLK1 siRNAs. Furthermore, miR­1291 induced CDK inhibitors p21WAF1/CIP1 and p27KIP1 in three CRC cell lines, and the overexpression of DCLK1 in HCT116 cells led to a decrease of p21WAF1/CIP1 and p27KIP1. Intravenous administration of miR­1291 loaded on the super carbonate apatite delivery system significantly inhibited tumor growth in the DLD­1 xenograft mouse model. Additionally, the resultant tumors exhibited significant upregulation of the p21WAF1/CIP1 and p27KIP1 protein with treatment of miR­1291. Taken together, the results indicated that miR­1291 served an anti­tumor effect by modulating multiple functions, including cancer stemness and cell cycle regulation. The current data suggested that miR­1291 may be a promising nucleic acid medicine against CRC.


Subject(s)
Cell Line/metabolism , Colonic Neoplasms/drug therapy , MicroRNAs/pharmacology , Cell Line/immunology , Colonic Neoplasms/physiopathology , /metabolism , Humans , MicroRNAs/administration & dosage
8.
Zhongguo Yaolixue yu Dulixue Zazhi = Chinese Journal of Pharmacology and Toxicology ; - (8):561, 2021.
Article in English | ProQuest Central | ID: covidwho-1564979

ABSTRACT

Since the outbreak of the novel coronavirus (SARS-CoV-2), the number of people infected worldwide has been increasing, and the medical situation is very severe. In emergency situations, the development of innovative drugs and the treatment of new coronavirus pneumonia (COVID-19) new adaptations on the market The development of the certificate has become the only way to find specific therapeutic drugs and the best treatment plan for COVID-19. The mechanism of angiotensin-converting enzyme 2 (ACE2) that mediates the invasion of host cells by SARS-CoV-2 has been discovered and is based on SARS-CoV- 2. Potential therapeutic targets of host and host, mainly including RNA-dependent RNA polymerase, 3CL protease, papain-like protease, Janus kinase, interleukin 6 and immunomodulators, etc. According to the above-mentioned pharmacological mechanism of action, the treatment of marketed drugs Great progress has been made in the development of new indications for COVID-19 and the clinical research and development of innovative drugs, but no specific drugs have been found. Some traditional Chinese medicines in China can block the SARS-CoV-2 replication cycle, regulate the body's immune response, and treat COVID-19. Biopharmaceuticals are currently undergoing phase I clinical studies in the world for the treatment of COVID-19. Biopharmaceuticals are progressing rapidly, accounting for 67%. At present, the research and development of drugs for the treatment of COVID-19 in China is facing severe challenges and biosafety The number of protection laboratories is small, the research on the mechanism of SARS-CoV-2 infection and the body's response mechanism is not in-depth, the resources of non-clinical cells and animal models are scarce, and the professional quantitative pharmacology research platform and professional talent training system are not perfect to treat COVID-19 The informatization of drug clinical trials and sample testing capabilities are in urgent need of improvement. If China can use this to improve its ability to develop new drugs in emergency situations, it will be able to better protect people's health.

10.
Cell Rep Med ; 2(11): 100453, 2021 11 16.
Article in English | MEDLINE | ID: covidwho-1521606

ABSTRACT

While pregnancy increases the risk for severe COVID-19, the clinical and immunological implications of COVID-19 on maternal-fetal health remain unknown. Here, we present the clinical and immunological landscapes of 93 COVID-19 mothers and 45 of their SARS-CoV-2-exposed infants through comprehensive serum proteomics profiling for >1,400 cytokines of their peripheral and cord blood specimens. Prenatal SARS-CoV-2 infection triggers NF-κB-dependent proinflammatory immune activation. Pregnant women with severe COVID-19 show increased inflammation and unique IFN-λ antiviral signaling, with elevated levels of IFNL1 and IFNLR1. Furthermore, SARS-CoV-2 infection re-shapes maternal immunity at delivery, altering the expression of pregnancy complication-associated cytokines, inducing MMP7, MDK, and ESM1 and reducing BGN and CD209. Finally, COVID-19-exposed infants exhibit induction of T cell-associated cytokines (IL33, NFATC3, and CCL21), while some undergo IL-1ß/IL-18/CASP1 axis-driven neonatal respiratory distress despite birth at term. Our findings demonstrate COVID-19-induced immune rewiring in both mothers and neonates, warranting long-term clinical follow-up to mitigate potential health risks.


Subject(s)
COVID-19/immunology , Cytokines/blood , Inflammation , Proteomics , Adolescent , Adult , COVID-19/blood , COVID-19/metabolism , Female , Humans , Infant, Newborn , Mothers , Pregnancy , Serum/metabolism , Young Adult
11.
Zhongguo Anquan Shengchan Kexue Jishu = Journal of Safety Science and Technology ; - (10):11, 2021.
Article in English | ProQuest Central | ID: covidwho-1519232

ABSTRACT

In order to comprehensively and systematically prevent and control the major infectious diseases and break the deadlock of local security, a model of the prevention and control of major infectious diseases was established from the perspective of macro security.By expatiating the transformation from local security to comprehensive security, a new perspective of macro security was put forward to understand the spread of major infectious diseases.Combined with the characteristics of security events, the causative path of major infectious diseases was deeply analyzed, then the four key nodes and three time states in the transmission process were obtained, and the evolution, development and characteristics of major infectious disease security events in the perspective of macro security were defined.The internal and external factors influencing the prevention and control of major infectious diseases were determined from the prevention perspective of accident causes, and two prevention and control strategies of emergency management and response mechanism were proposed, so as to construct the model of the prevention and control of major infectious diseases in the perspective of macro security.The results showed that the model had good practicability in the prevention and control process of COVID-19,and the model has important theoretical and practical significance for discussing the security perspective and logic of epidemic prevention and control.

12.
Front Pharmacol ; 12: 692768, 2021.
Article in English | MEDLINE | ID: covidwho-1436022

ABSTRACT

Objectives: Anti-tumor necrosis factor (TNF) agents have been regarded as the most effective treatment for ankylosing spondylitis (AS) so far. However, economic factors limited the prescription of original biologicals in China. Yisaipu® is a biosimilar for etanercept as pre fill syringes (PFS), which has entered China's national medical insurance catalog for more than 10 yr and was widely used because it greatly reduced the economic burden of AS patients. Yisaipu® is provided subcutaneous injection in hospital setting only. We collected clinical data of AS patients before, during and after COVID-19 epidemic, in an attempt to investigate the advantages and disadvantages of original biologicals and Yisaipu® during regular follow up and COVID-19 epidemic. Methods: AS patients who received original biologicals or Yisaipu® in our department for more than 1 yr were included in our study. General data, demographic characteristics, disease activity, quality of life and medical compliance were collected from regular visits. The patients were followed up through telephone interviews from April 20th to 27th, 2020 about the overall impact of the COVID-19 epidemic. Results: There was no significant difference in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-CRP (ASDAS-CRP) between the two groups. Health Assessment Questionnaire for Spondyloarthropathies (HAQ-s) showed that Yisaipu® group was superior to original biological group in terms of eating, gripping and driving. In addition, the medical cost of Yisaipu® was lower than that of original biologicals. The overall impact of the COVID-19 epidemic on patients of original biological group was comparatively smaller than that on Yisaipu® group. Conclusions: Yisaipu® provided AS patients with an economical selection during regular follow-up, while original biologicals had certain advantages in the COVID-19 epidemic setting, including a longer time interval between two drug administrations and the self-injection dose form of medication.

13.
Front Med (Lausanne) ; 8: 620727, 2021.
Article in English | MEDLINE | ID: covidwho-1241175

ABSTRACT

Background and Objectives: Although the pathogenesis and treatment of coronavirus disease 2019 (COVID-19) have been gradually revealed, the risk for re-emergence of coronavirus nucleic acids in recovered patients remains poorly understood. Hence, this study evaluated the risk predictors associated with re-positivity for virus nucleic acid. Methods: Between February 1 and March 20, 2020, we retrospectively reviewed the clinical epidemiological data of 129 COVID-19 patients who were treated at Zhongxiang People's Hospital of Hubei Province in China. Subsequently, a risk prediction model for the re-positivity of virus nucleic acid was developed, and a receiver operating characteristic (ROC) curve was drawn for further validation. Results: In this study, the rate of re-positivity for virus nucleic acid was 17.8% (23/129) where all re-positivity cases were asymptomatic. The median time interval from discharge to nucleic acid re-positivity to discharge after being cured again was 11.5 days (range: 7-23 days). Multivariate logistic regression analysis showed that leukocytopenia [odds ratio (OR) 7.316, 95% confidence interval (CI) 2.319-23.080, p = 0.001], prealbumin < 150 mg/L (OR 4.199, 95% CI 1.461-12.071, p = 0.008), and hyperpyrexia (body temperature >39°C, OR 4.643, 95% CI 1.426-15.117, p = 0.011) were independent risk factors associated with re-positivity. The area under the ROC curve was 0.815 (95% CI, 0.729-0.902). Conclusion: COVID-19 patients with leukocytopenia, low prealbumin level, and hyperpyrexia are more likely to test positive for virus nucleic acid after discharge. Timely and effective treatment and appropriate extension of hospital stays and quarantine periods may be feasible strategies for managing such patients.

14.
Psychosom Med ; 83(4): 345-350, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1218025

ABSTRACT

OBJECTIVE: According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic. METHODS: This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted. RESULTS: The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%-29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670-3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580-3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326-0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463-0.846) were less likely to have depression. CONCLUSIONS: The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.


Subject(s)
COVID-19/psychology , Depression, Postpartum/epidemiology , Depression/epidemiology , Pregnancy Complications/psychology , Adult , COVID-19/complications , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Depression, Postpartum/etiology , Female , Humans , Logistic Models , Pandemics/statistics & numerical data , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/etiology , Prevalence , Surveys and Questionnaires
15.
Case Rep Neurol Med ; 2021: 5564802, 2021.
Article in English | MEDLINE | ID: covidwho-1207518

ABSTRACT

The SARS-CoV-2 infection affects numerous organs, including the central nervous system. The neuroinvasive abilities and neuroinflammation may lead to short- and long-term neurological manifestations. Among neurological disorders associated with SARS-CoV-2 infection, posterior reversible encephalopathy syndrome (PRES) has been described in a few case-based observational studies during the acute phase of COVID-19 hospitalization. We present a case of a patient who developed seizures and PRES after recovering from an acute severe COVID-19 infection. A 90-year-old African American female with multiple comorbidities and a severe COVID-19 infection was discharged home in stable condition after two weeks of hospitalization. A week later, she developed new-onset generalized tonic-clonic seizures requiring readmission to the hospital. The patient's clinical course and brain imaging supported PRES. Her mentation returned to baseline with supportive care and anticonvulsant treatment. Follow-up brain MRI four months later demonstrated resolution of FLAIR signal abnormalities confirming PRES. SARS-CoV-2 insult on the cerebrovascular endothelial cells likely continued and despite the clinical recovery eventually resulted in PRES. We believe that this is the first case describing the presentation of PRES after recovery from severe acute COVID-19 infection.

16.
Virol Sin ; 36(5): 901-912, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1182321

ABSTRACT

Genome sequencing has shown strong capabilities in the initial stages of the COVID-19 pandemic such as pathogen identification and virus preliminary tracing. While the rapid acquisition of SARS-CoV-2 genome from clinical specimens is limited by their low nucleic acid load and the complexity of the nucleic acid background. To address this issue, we modified and evaluated an approach by utilizing SARS-CoV-2-specific amplicon amplification and Oxford Nanopore PromethION platform. This workflow started with the throat swab of the COVID-19 patient, combined reverse transcript PCR, and multi-amplification in one-step to shorten the experiment time, then can quickly and steadily obtain high-quality SARS-CoV-2 genome within 24 h. A comprehensive evaluation of the method was conducted in 42 samples: the sequencing quality of the method was correlated well with the viral load of the samples; high-quality SARS-CoV-2 genome could be obtained stably in the samples with Ct value up to 39.14; data yielding for different Ct values were assessed and the recommended sequencing time was 8 h for samples with Ct value of less than 20; variation analysis indicated that the method can detect the existing and emerging genomic mutations as well; Illumina sequencing verified that ultra-deep sequencing can greatly improve the single read error rate of Nanopore sequencing, making it as low as 0.4/10,000 bp. In summary, high-quality SARS-CoV-2 genome can be acquired by utilizing the amplicon amplification and it is an effective method in accelerating the acquisition of genetic resources and tracking the genome diversity of SARS-CoV-2.


Subject(s)
COVID-19 , Nanopore Sequencing , Genome, Viral , High-Throughput Nucleotide Sequencing , Humans , Pandemics , RNA, Viral/genetics , SARS-CoV-2
17.
BMC Geriatr ; 21(1): 186, 2021 03 17.
Article in English | MEDLINE | ID: covidwho-1140479

ABSTRACT

BACKGROUND: A large number of studies have explored the association between frailty and mortality among COVID-19 patients, with inconsistent results. The aim of this meta-analysis was to synthesize the evidence on this issue. METHODS: Three databases, PubMed, Embase, and Cochrane Library, from inception to 20th January 2021 were searched for relevant literature. The Newcastle-Ottawa Scale (NOS) was used to assess quality bias, and STATA was employed to pool the effect size by a random effects model. Additionally, potential publication bias and sensitivity analyses were performed. RESULTS: Fifteen studies were included, with a total of 23,944 COVID-19 patients, for quantitative analysis. Overall, the pooled prevalence of frailty was 51% (95% CI: 44-59%). Patients with frailty who were infected with COVID-19 had an increased risk of mortality compared to those without frailty, and the pooled hazard ratio (HR) and odds ratio (OR) were 1.99 (95% CI: 1.66-2.38) and 2.48 (95% CI: 1.78-3.46), respectively. In addition, subgroup analysis based on population showed that the pooled ORs for hospitalized patients in eight studies and nursing home residents in two studies were 2.62 (95% CI: 1.68-4.07) and 2.09 (95% CI: 1.40-3.11), respectively. Subgroup analysis using the frailty assessment tool indicated that this association still existed when using the clinical frailty scale (CFS) (assessed in 6 studies, pooled OR = 2.88, 95% CI: 1.52-5.45; assessed in 5 studies, pooled HR = 1.99, 95% CI: 1.66-2.38) and other frailty tools (assessed in 4 studies, pooled OR = 1.98, 95% CI: 1.81-2.16). In addition, these significant positive associations still existed in the subgroup analysis based on study design and geographic region. CONCLUSION: Our study indicates that frailty is an independent predictor of mortality among patients with COVID-19. Thus, frailty could be a prognostic factor for clinicians to stratify high-risk groups and remind doctors and nurses to perform early screening and corresponding interventions urgently needed to reduce mortality rates in patients infected by SARS-CoV-2.


Subject(s)
COVID-19 , Frailty , Aged , Frail Elderly , Frailty/diagnosis , Humans , Prevalence , SARS-CoV-2
18.
World J Clin Cases ; 8(23): 6016-6025, 2020 Dec 06.
Article in English | MEDLINE | ID: covidwho-994304

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly discovered coronavirus that has generated a worldwide outbreak of infections. Many people with coronavirus disease-2019 (COVID-19) have developed severe illness, and a significant number have died. However, little is known regarding infection by the novel virus in pregnant women. We herein present a case of COVID-19 confirmed in a woman delivering a neonate who was negative for SARS-CoV-2 and related it to a review of the literature on pregnant women and human coronavirus infections. CASE SUMMARY: The patient was a 36-year-old pregnant woman in her third trimester who had developed progressive clinical symptoms when she was confirmed as infected with SARS-CoV-2. Given the potential risks for both the pregnant woman and the fetus, an emergency cesarean section was performed, and the baby and his mother were separately quarantined and cared for. As a result, the baby currently shows no signs of SARS-CoV-2 infection (his lower respiratory tract samples were negative for the virus), while the mother completely recovered from COVID-19. CONCLUSION: Although we presented a single case, the successful result is of great significance for pregnant women with SARS-CoV-2 infection and with respect to fully understanding novel coronavirus pneumonia.

19.
chemRxiv; 2020.
Preprint in English | ChemRxiv | ID: ppcovidwho-3038

ABSTRACT

Utilizing an interdigitated microelectrode chip modified with an antibody probe, and integrating dielectrophoresis enrichment with interfacial capacitance sensing, a real-time immunosensor is presented for detection of trace level biomarkers from virus. <br>

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