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1.
Signal Transduct Target Ther ; 7(1): 166, 2022 05 21.
Article in English | MEDLINE | ID: covidwho-1947279

ABSTRACT

The therapeutic use of messenger RNA (mRNA) has fueled great hope to combat a wide range of incurable diseases. Recent rapid advances in biotechnology and molecular medicine have enabled the production of almost any functional protein/peptide in the human body by introducing mRNA as a vaccine or therapeutic agent. This represents a rising precision medicine field with great promise for preventing and treating many intractable or genetic diseases. In addition, in vitro transcribed mRNA has achieved programmed production, which is more effective, faster in design and production, as well as more flexible and cost-effective than conventional approaches that may offer. Based on these extraordinary advantages, mRNA vaccines have the characteristics of the swiftest response to large-scale outbreaks of infectious diseases, such as the currently devastating pandemic COVID-19. It has always been the scientists' desire to improve the stability, immunogenicity, translation efficiency, and delivery system to achieve efficient and safe delivery of mRNA. Excitingly, these scientific dreams have gradually been realized with the rapid, amazing achievements of molecular biology, RNA technology, vaccinology, and nanotechnology. In this review, we comprehensively describe mRNA-based therapeutics, including their principles, manufacture, application, effects, and shortcomings. We also highlight the importance of mRNA optimization and delivery systems in successful mRNA therapeutics and discuss the key challenges and opportunities in developing these tools into powerful and versatile tools to combat many genetic, infectious, cancer, and other refractory diseases.


Subject(s)
COVID-19 , COVID-19/genetics , COVID-19/therapy , Humans , Pandemics , Proteins , RNA, Messenger/genetics
2.
Adv Funct Mater ; : 2204692, 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-1935644

ABSTRACT

SARS-CoV-2 variants are now still challenging all the approved vaccines, including mRNA vaccines. There is an urgent need to develop new generation mRNA vaccines with more powerful efficacy and better safety against SARS-CoV-2 variants. In this study, a new set of ionizable lipids named 4N4T are constructed and applied to form novel lipid nanoparticles called 4N4T-LNPs. Leading 4N4T-LNPs exhibit much higher mRNA translation efficiency than the approved SM-102-LNPs. To test the effectiveness of the novel delivery system, the DS mRNA encoding the full-length S protein of the SARS-CoV-2 variant is synthesized and loaded in 4N4T-LNPs. The obtained 4N4T-DS mRNA vaccines successfully trigger robust and durable humoral immune responses against SARS-CoV-2 and its variants including Delta and Omicron. Importantly, the novel vaccines have higher RBD-specific IgG titers and neutralizing antibody titers than SM-102-based DS mRNA vaccine. Besides, for the first time, the types of mRNA vaccine-induced neutralizing antibodies are found to be influenced by the chemical structure of ionizable lipids. 4N4T-DS mRNA vaccines also induce strong Th1-skewed T cell responses and have good safety. This work provides a novel vehicle for mRNA delivery that is more effective than the approved LNPs and shows its application in vaccines against SARS-CoV-2 variants.

3.
Signal Transduct Target Ther ; 7(1): 199, 2022 06 25.
Article in English | MEDLINE | ID: covidwho-1908147

ABSTRACT

Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative opportunistic pathogen that infects patients with cystic fibrosis, burn wounds, immunodeficiency, chronic obstructive pulmonary disorder (COPD), cancer, and severe infection requiring ventilation, such as COVID-19. P. aeruginosa is also a widely-used model bacterium for all biological areas. In addition to continued, intense efforts in understanding bacterial pathogenesis of P. aeruginosa including virulence factors (LPS, quorum sensing, two-component systems, 6 type secretion systems, outer membrane vesicles (OMVs), CRISPR-Cas and their regulation), rapid progress has been made in further studying host-pathogen interaction, particularly host immune networks involving autophagy, inflammasome, non-coding RNAs, cGAS, etc. Furthermore, numerous technologic advances, such as bioinformatics, metabolomics, scRNA-seq, nanoparticles, drug screening, and phage therapy, have been used to improve our understanding of P. aeruginosa pathogenesis and host defense. Nevertheless, much remains to be uncovered about interactions between P. aeruginosa and host immune responses, including mechanisms of drug resistance by known or unannotated bacterial virulence factors as well as mammalian cell signaling pathways. The widespread use of antibiotics and the slow development of effective antimicrobials present daunting challenges and necessitate new theoretical and practical platforms to screen and develop mechanism-tested novel drugs to treat intractable infections, especially those caused by multi-drug resistance strains. Benefited from has advancing in research tools and technology, dissecting this pathogen's feature has entered into molecular and mechanistic details as well as dynamic and holistic views. Herein, we comprehensively review the progress and discuss the current status of P. aeruginosa biophysical traits, behaviors, virulence factors, invasive regulators, and host defense patterns against its infection, which point out new directions for future investigation and add to the design of novel and/or alternative therapeutics to combat this clinically significant pathogen.


Subject(s)
COVID-19 , Pseudomonas Infections , Animals , Drug Resistance, Microbial , Humans , Mammals/metabolism , Pseudomonas Infections/drug therapy , Pseudomonas Infections/genetics , Pseudomonas aeruginosa/genetics , Technology , Virulence Factors/genetics , Virulence Factors/metabolism , Virulence Factors/pharmacology
4.
Mediterr J Hematol Infect Dis ; 14(1): e2022033, 2022.
Article in English | MEDLINE | ID: covidwho-1865591

ABSTRACT

Background: COVID-19 is characterized by endothelial dysfunction and is presumed to have long-term cardiovascular sequelae. In this cross-sectional study, we aimed to explore the serum levels of endothelial biomarkers in patients who recovered from COVID-19 one year after hospital discharge. Methods: In this clinical follow-up study, 345 COVID-19 survivors from Huanggang, Hubei, and 119 age and gender-matched medical staff as healthy controls were enrolled. A standardized symptom questionnaire was performed, while electrocardiogram and Doppler ultrasound of lower extremities, routine blood tests, biochemical and immunological tests, serum soluble vascular cell adhesion molecule-1(VCAM-1), intercellular cell adhesion molecule-1(ICAM-1), P-selectin, and fractalkine were measured by enzyme-linked immunosorbent assays (ELISA). Results: At one year after discharge, 39% of recovers possessed post-COVID syndromes, while a few had abnormal electrocardiogram manifestations, and no deep vein thrombosis was detected in all screened survivors. There were no significant differences in circulatory inflammatory markers (leukocytes, neutrophils, lymphocytes, C-reactive protein and interleukin-6), alanine aminotransferase, estimated glomerular filtration rate, glucose, triglycerides, total cholesterol and D-dimer observed among healthy controls with previously mild or severe infected. Furthermore, serum levels of VCAM-1, ICAM-1, P-selectin, and fractalkine do not significantly differ between survivors and healthy controls. Conclusions: SARS-CoV-2 infection may not impose a higher risk of developing long-term cardiovascular events, even for those recovering from severe illness.

5.
BMC Pregnancy Childbirth ; 22(1): 412, 2022 May 16.
Article in English | MEDLINE | ID: covidwho-1846811

ABSTRACT

OBJECTIVE: To understand the use of online antenatal education classes accessed via the Mother and Child Health Handbook app during the COVID-19 pandemic in order to provide a basis and suggestions for optimizing Internet education during pregnancy under public health emergencies. METHODS: We compared and analyzed the use of online antenatal education classes via the Mother and Child Health Handbook app in Hangzhou in 2019 and 2020 (during the COVID-19 pandemic). RESULTS: Between January 1, 2019, and December 31, 2020, a total of 229,794 pregnant women created files and registered for the app, including 124,273 women in 2019 and 105,521 women in 2020. More pregnant women participated in online antenatal education learning (n = 36,379/34.5% vs. 29,226/23.5%, p = 0.000) in 2020 than in 2019. The proportion of pregnant women in the 18-34-year-old group who participated in online learning was higher than that in the advanced age group, and the difference was statistically significant (2019: 24.3% vs. 18.8%, p = 0.000) (2020: 35.7% vs. 27.4%, p = 0.000). More pregnant women accessed online antenatal education during early pregnancy (n = 13,463/37.0% vs. 9088/31.1%, p = 0.000) in 2020 than in 2019. Similar percentages of pregnant women participated in online antenatal education during mid-pregnancy (n = 15,426/52.8% vs. 19,269/53.0%, p = 0.639) in 2019 and 2020. Fewer pregnant women accessed online antenatal education during late pregnancy (n = 10,246/28.2% vs. 9476/32.4%, p = 0.000) in 2020 than in 2019. Fewer pregnant women choose to take 'Puerperal Health' courses in 2020 than in 2019 (early pregnancy: 36.20% vs. 42.79%, p = 0.000; mid-pregnancy: 41.65% vs. 48.19%, p = 0.000; late pregnancy: 55.31% vs. 58.41%, p = 0.000). Fewer pregnant women choose to take 'Psychological Adjustment' courses in 2020 than in 2019 (early pregnancy: 21.59% vs. 29.60%, p = 0.000; mid-pregnancy: 26.20% vs. 40.50%, p = 0.000; late pregnancy: 12.79% vs. 42.53%, p = 0.000). More pregnant women choose to study 'Nutrition and Exercise' in 2020 than in 2019 (early pregnancy: 44.48% vs. 25.95%, p = 0.000; mid-pregnancy: 47.77% vs. 40.75%, p = 0.000; late pregnancy: 55.94% vs. 42.99%, p = 0.000). "Pregnancy Care and Fetal Development" was the most selected course by pregnant women in early pregnancy (2019: 67.50%; 2020: 71.39%) and middle pregnancy (2019: 67.01%; 2020: 82.05%), and the proportion in 2020 was higher than it was in 2019. "Baby care" was the most selected course by pregnant women in late pregnancy, and the proportion in 2020 was higher than it was in 2019 (78.31% vs. 72.85%). CONCLUSION: During the COVID-19 pandemic, online antenatal education was well-used by pregnant women. More women participated in the online antenatal education modules during the COVID-19 pandemic than during 2019.The proportion of choosing different courses for pregnant women before and after the COVID-19 epidemic varied, and the learning course needs of pregnant women in different trimesters were different.


Subject(s)
COVID-19 , Education, Distance , Mobile Applications , Prenatal Education , Adolescent , Adult , Child , Female , Humans , Pandemics , Pregnancy , Pregnant Women/psychology , Prenatal Care , Young Adult
6.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329378

ABSTRACT

Objective: To clarify the accuracy of clusters of regularly spaced short palindrome repeats (CRISPR) technology and chest CT in the diagnosis of Corona Virus Disease2019(COVID-19). Methods: The term "Corona Virus Disease " "clustered regularly spaced short palindromic repeats" "CRISPR", "chest CT", "sensitivity and specificity" as the subject words or keywords were searched in databases such as Pubmed, Embase, Cochrane Library, Wiley and Scopus and Chinese academic databases (such as CNKI, Wanfang and Chongqing VIP data) for relevant literature on the use of CRISPR technology and chest CT for the diagnosis of COVID-19. Meta-analysis was performed after literature screening, quality assessment and data extraction . Results: A total of 418 articles were retrieved, and 17 articles were finally included. The results showed that the combined sensitivity of CRISPR technology for diagnosing new coronary pneumonia infection was 0.96 [95% CI (0.93, 0.98)], and the combined specificity was 1.00 [95% CI (0.92, 1.00)], the combined positive likelihood ratio is 458.69 [95%CI (11.51, 18280.8)], the combined negative likelihood ratio is 0.04 [95% CI (0.02, 0.07)], the area under the SROC curve is 0.99 [95%CI(0.97,0.99)]. The combined sensitivity of chest CT in diagnosing new coronary pneumonia infection was 0.94 [95%CI (0.83, 0.98)], combined specificity was 0.55 [95% CI (0.22, 0.83)], combined diagnostic odds ratio was 19.90 [95% CI (7.88, 50.25)], the combined positive likelihood ratio is 2.08 [95%CI (1.00, 4.32)], the combined negative likelihood ratio is 0.10 [95% CI (0.05, 0.23)], the area under the SROC curve is 0.91 [95% CI (0.88, 0.93)]. The Deek funnel chart indicates that there is no potential publication bias among the included studies (PCRISPR = 0.03, P chest CT = 0.55). Conclusion: CRISPR technology has a better ability to detect infections in patients with COVID-19, and is better than chest CT in disease diagnosis. CRISPR technology, especially non-SHERLOCK type and multi-target gene detection, can be used to diagnose COVID-19 with higher accuracy ,and can be used for large-scale population screening.

7.
Front Psychol ; 12: 600826, 2021.
Article in English | MEDLINE | ID: covidwho-1518527

ABSTRACT

This study examined the role of individual differences in horizontal and vertical individualism and collectivism, trust and worries, and concerns about COVID-19 in predicting the attitudes toward compliance of health advice and psychological responses during the COVID-19 pandemic. Chinese university students (N=384, 324 female) completed measures of individualism and collectivism, trust, attitudes toward compliance, and psychological responses to the pandemic. Results showed that not only vertical collectivist orientation but also horizontal individualist orientation significantly predicted higher willingness to comply, whereas vertical individualist orientation significantly predicted lower willingness to comply. Vertical individualist and vertical collectivist orientations predicted higher psychological response in terms of distress, anxiety, and depression, while horizontal collectivistic orientation significantly predicted less psychological problems. Implications of the effect of individual-level cultural orientations on attitudes toward public health compliance and psychological well-being during global health crises are discussed.

8.
ACS Med Chem Lett ; 12(11): 1838-1844, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1507014

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has stimulated the search for effective drugs for its prevention and treatment. Natural products are an important source for new drug discovery. Here, we report that, NK007(S,R), a tylophorine malate, displays high antiviral activity against SARS-CoV-2 with an EC50 0.03 µM in vitro, which is substantially lower than that of remdesivir (EC50: 0.8 µM in vitro), the only authorized drug to date. The histopathological research revealed that NK007(S,R) (5 mg/kg/dose) displayed a protection effect in lung injury induced by SARS-CoV-2, which is better than remdesivir (25 mg/kg/dose). We also prepared two nanosized preparations of NK007(S,R), which also showed good efficacy (EC50: NP-NK007, 0.007 µM in vitro; LP-NK007, 0.014 µM in vitro). Our findings suggest that tylophora alkaloids, isolated from the traditional Chinese medicine Cynanchum komarovii AL, offer a new skeleton for the development of anticoronavirus drug candidate.

9.
Integr Med Res ; 10: 100798, 2021.
Article in English | MEDLINE | ID: covidwho-1472010

ABSTRACT

BACKGROUND: We aimed to investigate use of infection control behaviours, preventative and therapeutic interventions, and outcomes among respondents to an online survey during the COVID-19 pandemic in China. METHODS: The survey was designed by an international team, translated and adapted to simplified Chinese, including 132 kinds of traditional Chinese medicine (TCM) preparation recommended by guidelines. It was distributed and collected from February to May 2021, with data analysed by WPS spreadsheet and wjx.cn. Descriptive statistics were used to describe demographics and clinical characteristics, diagnosis, treatments, preventative behaviours and interventions, and their associated outcomes. RESULTS: The survey was accessed 503 times with 341 (67.8%) completions covering 23 provinces and four municipalities in China. Most (282/341, 82.7%) respondents reported no symptoms during the pandemic and the majority (290/341, 85.0%) reported having a SARS-CoV-2 PCR test at some point. Forty-five (13.2%) reported having a respiratory infection, among which 19 (42.2%) took one or more categories of modern medicine, e.g. painkillers, antibiotics; 16 (35.6%) used TCM interventions(s); while seven respondents combined TCM with modern medicine. All respondents reported using at least one behavioural or medical approach to prevention, with 22.3% taking TCM and 5.3% taking modern medicines. No respondents reported having a critical condition related to COVID-19. CONCLUSION: We found evidence of widespread use of infection control behaviours, modern medicines and TCM for treatment and prevention of COVID-19 and other respiratory symptoms. Larger scale studies are warranted, including a more representative sample exploring TCM preparations recommended in clinical guidelines.

10.
J Control Release ; 335: 449-456, 2021 07 10.
Article in English | MEDLINE | ID: covidwho-1240426

ABSTRACT

COVID-19 pandemic has resulted in an unprecedented global public health crisis. It is obvious that SARS-CoV-2 vaccine is needed to control the global COVID-19 public health crisis. Since obvious advantages including fast manufacturing speed, potent immunogenicity and good safety profile, six mRNA vaccines have been used to prevent SARS-CoV-2 infections in clinic with lipid nanoparticles (LNP) formulation via intramuscular injection. In this work, we first constructed RBD-encoding mRNA (RBD-mRNA) formulated in liposomes (LPX/RBD-mRNA) and investigated the influence of administration routes on the immunogenicity. LPX/RBD-mRNA can express RBD in vivo and successfully induced SARS-CoV-2 RBD specific antibodies in the vaccinated mice, which efficiently neutralized SARS-CoV-2 pseudotyped virus. Moreover, the administration routes were found to affect the virus neutralizing capacity of sera derived from the immunized mice and the types (Th1-type and Th2-type) of cellular immune responses. This study indicated that liposome-based RBD-mRNA vaccine with optimal administration route might be a potential candidate against SARS-CoV-2 infection with good efficacy and safety.


Subject(s)
COVID-19 , Vaccines , Animals , Antibodies, Neutralizing , Antibodies, Viral , COVID-19 Vaccines , Humans , Liposomes , Mice , Mice, Inbred BALB C , Pandemics , RNA, Messenger , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
11.
Front Pharmacol ; 11: 583450, 2020.
Article in English | MEDLINE | ID: covidwho-1133942

ABSTRACT

Objective: To present the evidence of the therapeutic effects and safety of Chinese herbal medicine (CHM) used with or without conventional western therapy for COVID-19. Methods: Clinical studies on the therapeutic effects and safety of CHM for COVID-19 were included. We summarized the general characteristics of included studies, evaluated methodological quality of randomized controlled trials (RCTs) using the Cochrane risk of bias tool, analyzed the use of CHM, used Revman 5.4 software to present the risk ratio (RR) or mean difference (MD) and their 95% confidence interval (CI) to estimate the therapeutic effects and safety of CHM. Results: A total of 58 clinical studies were identified including RCTs (17.24%, 10), non-randomized controlled trials (1.72%, 1), retrospective studies with a control group (18.97%, 11), case-series (20.69%, 12) and case-reports (41.38%, 24). No RCTs of high methodological quality were identified. The most frequently tested oral Chinese patent medicine, Chinese herbal medicine injection or prescribed herbal decoction were: Lianhua Qingwen granule/capsule, Xuebijing injection and Maxing Shigan Tang. In terms of aggravation rate, pooled analyses showed that there were statistical differences between the intervention group and the comparator group (RR 0.42, 95% CI 0.21 to 0.82, six RCTs; RR 0.38, 95% CI 0.23 to 0.64, five retrospective studies with a control group), that is, CHM plus conventional western therapy appeared better than conventional western therapy alone in reducing aggravation rate. In addition, compared with conventional western therapy, CHM plus conventional western therapy had potential advantages in increasing the recovery rate and shortening the duration of fever, cough and fatigue, improving the negative conversion rate of nucleic acid test, and increasing the improvement rate of chest CT manifestations and shortening the time from receiving the treatment to the beginning of chest CT manifestations improvement. For adverse events, pooled data showed that there were no statistical differences between the CHM and the control groups. Conclusion: Current low certainty evidence suggests that there maybe a tendency that CHM plus conventional western therapy is superior to conventional western therapy alone. The use of CHM did not increase the risk of adverse events.

14.
Clin J Am Soc Nephrol ; 15(9): 1259-1266, 2020 09 07.
Article in English | MEDLINE | ID: covidwho-647141

ABSTRACT

BACKGROUND AND OBJECTIVES: During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively. RESULTS: Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported. CONCLUSIONS: The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Family/psychology , Kidney Diseases/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Renal Replacement Therapy , Adaptation, Psychological , Adolescent , Adult , Age Factors , COVID-19 , Caregivers/psychology , Child , China/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cost of Illness , Family Relations , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Health Services Accessibility , Host Microbial Interactions , Humans , Kidney Diseases/psychology , Male , Mental Health , Middle Aged , Patient Safety , Pneumonia, Viral/psychology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Renal Replacement Therapy/adverse effects , Risk Assessment , Risk Factors , SARS-CoV-2 , Time Factors , Treatment Outcome
15.
J Infect Dis ; 222(6): 894-898, 2020 08 17.
Article in English | MEDLINE | ID: covidwho-613973

ABSTRACT

In a retrospective study of 39 COVID-19 patients and 32 control participants in China, we collected clinical data and examined the expression of endothelial cell adhesion molecules by enzyme-linked immunosorbent assays. Serum levels of fractalkine, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and vascular adhesion protein-1 (VAP-1) were elevated in patients with mild disease, dramatically elevated in severe cases, and decreased in the convalescence phase. We conclude the increased expression of endothelial cell adhesion molecules is related to COVID-19 disease severity and may contribute to coagulation dysfunction.


Subject(s)
Amine Oxidase (Copper-Containing)/blood , Betacoronavirus , Cell Adhesion Molecules/blood , Chemokine CX3CL1/blood , Coronavirus Infections/blood , Intercellular Adhesion Molecule-1/blood , Pneumonia, Viral/blood , Vascular Cell Adhesion Molecule-1/blood , Amine Oxidase (Copper-Containing)/metabolism , Blood Coagulation Disorders/virology , COVID-19 , Cell Adhesion Molecules/metabolism , Chemokine CX3CL1/metabolism , China , Enzyme-Linked Immunosorbent Assay , Female , Humans , Intercellular Adhesion Molecule-1/metabolism , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Vascular Cell Adhesion Molecule-1/metabolism
16.
Eur Radiol ; 30(12): 6788-6796, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-621236

ABSTRACT

OBJECTIVE: To explore the value of CT texture analysis (CTTA) for determining coronavirus disease 2019 (COVID-19) severity. METHODS: The clinical and CT data of 81 patients with COVID-19 were retrospectively analyzed. The texture features were extracted using LK2.1. The two-sample t test or Mann-Whitney U test was used to find the significant features. Minimum redundancy and maximum relevance (MRMR) method was performed to find the features with maximum correlation and minimum redundancy. These features were then used to construct a radiomics texture model to discriminate the severe patients using multivariate logistic regression method. Besides, a clinical model was also built. ROC analyses were conducted to evaluate the performance of two models. The correlations of clinical features and textural features were analyzed using the Spearman correlation analysis. RESULTS: Of the total cases included, 60 were common and 21 were severe. (1) For textural features, 20 radiomics features selected by MRMR showed good performance in discriminating the two groups (AUC > 70%). (2) For clinical features, chi-square tests or Mann-Whitney U tests identified 16 clinical features as significant, and 12 were discriminative (p < 0.05) between two groups analyzed by univariate logistic analysis. Of these, 10 had an AUC > 70%. (3) Prediction models for textural features and clinical features were established, and both showed high predictive accuracy. The AUC values of textural features and clinical features were 0.93 (0.86-1.00) and 0.95 (0.95-0.99), respectively. (4) The Spearman correlation analysis showed that most textural and clinical features had above-moderate correlations with disease severity (> 0.4). CONCLUSION: Texture analysis can provide reliable and objective information for differential diagnosis of COVID-19. KEY POINTS: • CT texture analysis can well differentiate common and severe COVID-19 patients. • Some textural features showed above-moderate correlations with clinical factors. • CT texture analysis can provide useful information to judge the severity of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Lung/diagnostic imaging , Multidetector Computed Tomography/methods , Pneumonia, Viral/diagnosis , COVID-19 , Coronavirus Infections/epidemiology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , ROC Curve , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
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