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1.
BMJ Open ; 12(3): e055365, 2022 03 28.
Article in English | MEDLINE | ID: covidwho-1769912

ABSTRACT

OBJECTIVES: We aimed to provide an insight into the life of survivors of critical COVID-19 in China. METHODS: We conducted an online survey and qualitative interviews among intensive care unit survivors of critical COVID-19 between November and December 2020 in Wuhan, China. Eligible participants were asked to complete the EQ-5D-5L and the Short Form 36-Item Survey, and invited to participate in a semistructured face-to-face interview. Descriptive analyses and phenomenological approach were adopted to analyse quantitative and qualitative data, respectively. RESULTS: Of 10 survivors who completed the questionnaire, 8 participated in the interview. The mean scores±SD of EuroQol-5 Dimensions-5 Level utility and EuroQol-Visual Analogue Scale were 0.88±0.15 and 80.9±14.2, respectively. The qualitative interview identified four themes, namely poor physical health, post-traumatic stress, social stigma and family support. CONCLUSIONS: COVID-19 survivors continue fighting physical and psychological impacts. Despite strong family support, these patients are struggling with social stigma. It is a long, challenging journey to recovery for patients and society.


Subject(s)
COVID-19 , COVID-19/epidemiology , China/epidemiology , Humans , Intensive Care Units , Qualitative Research , Survivors/psychology
2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308332

ABSTRACT

Background: The incubation period is a key index of epidemiology in understanding of the spread of infectious diseases and the decision-making of the disease control. However, the incubation period of the emerging COVID-19 is still unclear. Methods Between January 19, 2020 and September 21, 2020, we collected information on 11545 patients in Mainland China outside Hubei. The 218 patients with precise data was validation population. The incubation period was fitted with lognormal model by the coarseDataTools package in R. Results In 11545 patients, the mean incubation period of COVID-19 was 7.1 days (95% Confidence interval [CI], 7.0–7.2). About 5.4% of patients had precise incubation period less than 3 days, 10.2% longer than 14 days, and 2.1% longer than 21 days. There was no statistically significant difference in incubation period between male and female ( P  = 0.603). It was similar in the 218 patients. The mean accurate incubation period was 6.8 days (6.2–7.4). Of which, 14.7% (32/218) of patients had incubation period less than 3 days, 12.4% (27/218) longer than 14 days, and 0.9% (2/218) longer than 21 days. Conclusions For COVID-19, the mean incubation period is 7.1 days and 10.2% of patients developed disease 14 days after infection, which challenges the current 14-day quarantine strategy.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308309

ABSTRACT

Background: COVID-19 is a viral respiratory disease caused by the severe acute respiratory syndrome-Coronavirus type 2 (SARS-CoV-2). Patients with this disease may be more prone to venous or arterial thrombosis because of the activation of many factors involved in it, including inflammation, platelet activation and endothelial dysfunction. Interferon gamma inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein 1-alpha (MIP1α) are cytokines related to thrombosis. Therefore, this study focused on these three indicators in COVID-19, with the hope to find biomarkers that are associated with patients’ outcome. Methods: This is a retrospective single-center study involving 74 severe and critically ill COVID-19 patients recruited from the ICU department of the Tongji Hospital in Wuhan, China. The patients were divided into two groups: severe patients and critically ill patients. The serum IP-10, MCP-1 and MIP1α level in both groups was detected using the enzyme-linked immunosorbent assay (ELISA) kit. The clinical symptoms, laboratory test results, and the outcome of COVID-19 patients were retrospectively analyzed. Results: The serum IP-10 and MCP-1 level in critically ill patients was significantly higher than that in severe patients ( P <0.001). However, no statistical difference in MIP1α between the two groups was found. The analysis of dynamic changes showed that these indicators remarkably increased in patients with poor prognosis. Since the selected patients were severe or critically ill, no significant difference was observed between survival and death. Conclusions: IP-10 and MCP-1 are biomarkers associated with the severity of COVID-19 disease and can be related to the risk of death in COVID-19 patients.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324250

ABSTRACT

Background: Despite the control measure taken against the coronavirus disease 2019(COVID-19) at global level, the pandemic has started to rebound and transmitted rapidly worldwide due to the delta strain. This strain is more virulent than the original severe acute respiratory syndrome coronavirus 2 virus. The approved vaccines or drugs can reduce mortality;still various efforts are being made to seek a complete cure. Currently, it remains controversial whether angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are useful in managing COVID-19 patients having comorbidities like chronic kidney disease(CKD). Evidence concerning the application of ACEIs/ARBs needs to be established through advanced meta-analyses and systematic reviews. Methods: /design: This study is designed following the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses). The studies published from December 1, 2019, to August 31, 2021 will be considered. The primary databases such as Cochrane Library, MEDLINE, EMBASE, and Chinese Biomedical Literature Database will be included, and meeting records and grey literature databases will be retrieved to compare at least two terminations or discontinued ACEIs or ARBs in clinical intervention studies. The primary results will include kidney function biomarkers, blood pressure, and long-term mortality or hospital admission severity. Pairwise random effects and meta-analyses will be performed for the selected literature using RevMan (V.5.3). The bias risk evaluation, heterogeneity, consistency, transitivity, and evidence quality will be followed as described in the Cochrane Handbook for Systematic Reviews of Interventions suggestions. Discussion: This review will use a structured and effective method to analyze the effectiveness and security of ACEIs and ARBs in treating COVID-19 patients with CKD. Research results can present valuable evidence for patients, clinicians, researchers, or decision-makers. Systerm review: PROSPERO registration number CRD42021268701.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323544

ABSTRACT

The coronavirus disease-19 (COVID-19) caused by SARS-CoV-2 infection can lead to a series of clinical settings from non-symptomatic viral carriers/spreaders to severe illness characterized by acute respiratory distress syndrome (ARDS)1,2. A sizable part of patients with COVID-19 have mild clinical symptoms at the early stage of infection, but the disease progression may become quite rapid in the later stage with ARDS as the common manifestation and followed by critical multiple organ failure, causing a high mortality rate of 7-10% in the elderly population with underlying chronic disease1-3. The pathological investigation in the lungs and other organs of fatal cases is fundamental for the mechanistic understanding of severe COVID-19 and the development of specific therapy in these cases. Gross anatomy and molecular markers allowed us to identify, in two fatal patients subject to necropsy, the main pathological features such as exudation and hemorrhage, epithelium injuries, infiltration of macrophages and fibrosis in the lungs. The mucous plug with fibrinous exudate in the alveoli and the activation of alveolar macrophages were characteristic abnormalities. These findings shed new insights into the pathogenesis of COVID-19 and justify the use of interleukin 6 (IL6) receptor antagonists and convalescent plasma with neutralizing antibodies against SARS-CoV-2 for severe patients.Authors Chaofu Wang, Jing Xie, Lei Zhao, Xiaochun Fei, Heng Zhang, and Yun Tan contributed equally to this work. Authors Chaofu Wang, Jun Cai, Rong Chen, Zhengli Shi, and Xiuwu Bian jointly supervised this work.

6.
Mol Med ; 27(1): 151, 2021 12 03.
Article in English | MEDLINE | ID: covidwho-1551198

ABSTRACT

BACKGROUND: We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality. METHODS: The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed. RESULTS: The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan-Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors. CONCLUSIONS: COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19.


Subject(s)
COVID-19/blood , COVID-19/therapy , Endothelium/metabolism , Glycocalyx/metabolism , Syndecan-1/blood , Aged , Biomarkers/blood , Blood Coagulation , COVID-19/mortality , China/epidemiology , Cytokines/metabolism , Endothelium, Vascular/pathology , Female , Humans , Inflammation , Intensive Care Units , Interleukin-6/blood , Kaplan-Meier Estimate , Male , Middle Aged , Oxygen , ROC Curve , SARS-CoV-2 , Thrombomodulin/blood , Treatment Outcome , Tumor Necrosis Factor-alpha/blood
7.
Infect Dis Poverty ; 10(1): 119, 2021 Sep 17.
Article in English | MEDLINE | ID: covidwho-1496233

ABSTRACT

BACKGROUND: The incubation period is a crucial index of epidemiology in understanding the spread of the emerging Coronavirus disease 2019 (COVID-19). In this study, we aimed to describe the incubation period of COVID-19 globally and in the mainland of China. METHODS: The searched studies were published from December 1, 2019 to May 26, 2021 in CNKI, Wanfang, PubMed, and Embase databases. A random-effect model was used to pool the mean incubation period. Meta-regression was used to explore the sources of heterogeneity. Meanwhile, we collected 11 545 patients in the mainland of China outside Hubei from January 19, 2020 to September 21, 2020. The incubation period fitted with the Log-normal model by the coarseDataTools package. RESULTS: A total of 3235 articles were searched, 53 of which were included in the meta-analysis. The pooled mean incubation period of COVID-19 was 6.0 days (95% confidence interval [CI] 5.6-6.5) globally, 6.5 days (95% CI 6.1-6.9) in the mainland of China, and 4.6 days (95% CI 4.1-5.1) outside the mainland of China (P = 0.006). The incubation period varied with age (P = 0.005). Meanwhile, in 11 545 patients, the mean incubation period was 7.1 days (95% CI 7.0-7.2), which was similar to the finding in our meta-analysis. CONCLUSIONS: For COVID-19, the mean incubation period was 6.0 days globally but near 7.0 days in the mainland of China, which will help identify the time of infection and make disease control decisions. Furthermore, attention should also be paid to the region- or age-specific incubation period.


Subject(s)
COVID-19 , Global Health , Infectious Disease Incubation Period , Adolescent , Adult , COVID-19/epidemiology , China/epidemiology , Databases, Factual , Female , Global Health/statistics & numerical data , Humans , Male , Middle Aged , Observational Studies as Topic , Young Adult
8.
Journal of Urban History ; : 1, 2021.
Article in English | Academic Search Complete | ID: covidwho-1443719

ABSTRACT

COVID-19 calls for a new understanding of urban landscape and associated living. As an emerging topic, lockdown urbanism involves an unpredictable future where lockdown or quarantine may be a come and go new normal for everyday practice, but the topic itself seems to have escaped historical inquiry. This paper attempts to answer why the strict lockdown is suitable for China by revealing a long and complex history of urbanization and its social and administrative organization. The urban fabric is characterized by a system of urban patterns: enclosed communities, the spatial layout and service distribution of the neighborhood, and the formation of the center. It was also animated by daily ritualistic practices, such as the control of time, quotidian lockdown practice (yejin), and individual ties within the enclosed neighborhood. This paper contributes to a better understanding of the deep history of urban form and the order and logic behind lockdown urbanism. [ABSTRACT FROM AUTHOR] Copyright of Journal of Urban History is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

9.
Infect Genet Evol ; 93: 104939, 2021 09.
Article in English | MEDLINE | ID: covidwho-1373189

ABSTRACT

The rise in human adenovirus (HAdV) infections poses a serious challenge to public health in China. Real-time (RT) sequencing provides solutions for achieving rapid pathogen identification during outbreaks, whereas high-throughput sequencing yields higher sequence accuracy. In the present study, we report the outcomes of applying nanopore and BGI platforms in the identification and genomic analysis of an HAdV outbreak in Hubei province, China in May of 2019. A mixed sample of nine nasopharyngeal swabs and one single sample were submitted to direct nanopore sequencing (MinION device), generating their first HAdV-55 reads within 13 and 20 min, respectively. The sequences were confirmed by RT-polymerase chain reaction (PCR). Ten HAdV-positive samples were further sequenced using next-generation high-throughput sequencing (BGISEQ-500 device). Phylogenetic analysis revealed that the outbreak strain had a close genetic relation to strains isolated in Sichuan province. Metagenomic analysis showed that HAdV-55 was not a dominant species in samples from which the whole HAdV-55 genome could not be assembled. The present results highlight the value of combining sequencing platforms and using mixed samples for nucleic acid enrichment in pathogen detection of infectious disease outbreaks.


Subject(s)
Adenovirus Infections, Human/diagnosis , Adenoviruses, Human/isolation & purification , Metagenome , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/virology , Adenoviruses, Human/genetics , China/epidemiology , Disease Outbreaks , High-Throughput Nucleotide Sequencing , Metagenomics , Phylogeny , Real-Time Polymerase Chain Reaction
10.
Drug Evaluation Research ; 43(4):606-612, 2020.
Article in Chinese | CAB Abstracts | ID: covidwho-1352919

ABSTRACT

Since the initial cases of the Coronavirus Disease in 2019 (COVID-19) occurred in Wuhan in December 2019, more and more cases have been found and confirmed, not only in central China but also in other countries. Given there are still no effective drugs many approved "old drugs" are in clinical test for treating COVID-19 at present. Artemisinin, a first-line antimalarial drug recommended by WHO, has been validated to possess a variety of pharmacological effects, including, without limitation, antiinflammatory, immune regulation, anti-pulmonary fibrosis, antibacterial, antiviral and cardiovascular effects, and the like. In this paper, various pharmacological effects of Artemisinin and its derivatives have been summarized, with the emphasis on the mechanism of action, so as to explore its potential medicinal value, especially for treating COVID-19.

11.
Drug Evaluation Research ; 43(4):591-600, 2020.
Article in Chinese | CAB Abstracts | ID: covidwho-1352917

ABSTRACT

Objective: To study the potential mechanism of Tankejing in the treatment of respiratory system based on network pharmacology, and to evaluate the possibility of Tankejing in the prevention and treatment of COVID-19 pneumonia.

12.
Appl Spat Anal Policy ; : 1-15, 2021 Aug 03.
Article in English | MEDLINE | ID: covidwho-1342775

ABSTRACT

The identification of seriously infected areas across a city, region, or country can inform policies and assist in resources allocation. Concentration of coronavirus infection can be identified through applying cluster detection methods to coronavirus cases over space. To enhance the identification of seriously infected areas by relevant studies, this study focused on coronavirus infection by small area across a city during the second wave. Specifically, we firstly explored spatiotemporal patterns of new coronavirus cases. Subsequently, we detected spatial clusters of new coronavirus cases by small area. Empirically, we used the London-wide small-area coronavirus infection data aggregately collected. Methodologically, we applied a fast Bayesian model-based detection method newly developed to new coronavirus cases by small area. As empirical evidence on the association of socioeconomic factors and coronavirus spread have been found, spatial patterns of coronavirus infection are arguably associated with socioeconomic and built environmental characteristics. Therefore, we further investigated the socioeconomic and built environmental characteristics of the clusters detected. As a result, the most significant clusters of new cases during the second wave are likely to occur around the airports. And, lower income or lower healthcare accessibility is associated with concentration of coronavirus infection across London.

13.
Sustainability ; 13(12):6806, 2021.
Article in English | MDPI | ID: covidwho-1273508

ABSTRACT

Since the outbreak of the Novel Coronavirus Pneumonia in 2019, several cities have been blocked to prevent the expansion of the infection. This qualitative study aimed to determine the motives of urban residents for visiting urban green spaces during the epidemic (especially within the context of the city blockade), and what might weaken these motives. In total, 47 residents (17 men and 30 women) were recruited from Chengdu, in China, to participate in interviews. A thematic analysis was used to analyze the interview data. According to the results, the motives of the respondents were divided into strong motives and weak motives. These strong motives for visiting UGS can be divided into four themes: “A place for health”, “Escape”, “Social support”, and “A safe and important place for outdoor activities”. Residents classified as the weak motive primarily considered the reasons of “Keep distance with others”, “Potential infection risk” and “Seek compensation”. The results of this study are significant for current and future urban management, green space planning, and social well-being.

14.
Curr Med Res Opin ; 37(6): 917-927, 2021 06.
Article in English | MEDLINE | ID: covidwho-1137872

ABSTRACT

BACKGROUND: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. METHODS: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. RESULTS: Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts. CONCLUSIONS: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.


Subject(s)
COVID-19 , Risk Assessment/methods , COVID-19/epidemiology , COVID-19/mortality , China , Hospitalization/statistics & numerical data , Humans , Italy , Risk Factors
15.
Ann Transl Med ; 9(4): 276, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1134638

ABSTRACT

BACKGROUND: Many studies have revealed several risk factors associated with the prognosis of patients with coronavirus disease 2019 (COVID-19), but the risk factors associated with death in critically ill COVID-19 patients still needs to be fully elucidated. Therefore, we analyzed clinical characteristics and laboratory data of ICU patients to identify risk factors associated with COVID-19 death. METHODS: Patients with COVID-19 from the ICU in the Sino-French New City Branch of Tongji Hospital Wuhan, China, between February 4 and February 29, 2020, were enrolled in this study. The final date of follow-up was April 4, 2020. Clinical manifestations, laboratory tests, treatment, and outcome of participants before and during the ICU stay were retrospectively collected and analyzed. RESULTS: A total of 92 patients were admitted or transferred to the ICU from February 4 to February 29, 2020. Compared to survivors, the majority of non-survivors (73.8%) presented with dyspnea. A random forest classifier and ROC curve were used to develop a predictive model. IL-6, D-dimer, lymphocytes, and albumin achieved good performance with AUCs of 0.9476, 0.9165, 0.8994, and 0.9251, respectively, which were consistent with clinical observations, such as inflammation, lymphopenia, and coagulation dysfunction. Combining IL-6 and D-dimer improved the performance of this model with an excellent AUC (0.997). CONCLUSIONS: Mortality in COVID-19 was not rare in critically ill patients. The model that combined IL-6 and D-dimer was valuable for predicting the mortality of patients with COVID-19 with excellent performance. This model needs to be further optimized by adding more indicators and then evaluated with a multicenter study.

16.
Med (N Y) ; 2(4): 435-447.e4, 2021 04 09.
Article in English | MEDLINE | ID: covidwho-1057073

ABSTRACT

BACKGROUND: To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC). METHODS: We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with ≥2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM). FINDINGS: Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92-0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions. CONCLUSIONS: The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients. FUNDING: This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006).


Subject(s)
COVID-19 , Blood Cell Count , Hospital Mortality , Humans , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2
17.
Hypertension ; 76(4): 1104-1112, 2020 10.
Article in English | MEDLINE | ID: covidwho-992137

ABSTRACT

The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03] P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47] P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09] P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36] P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02] P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%-50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19-associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.


Subject(s)
Coronavirus Infections , Creatine Kinase, MB Form/blood , Heart Diseases , Natriuretic Peptide, Brain/blood , Pandemics , Peptide Fragments/blood , Pneumonia, Viral , Troponin I/blood , Betacoronavirus/isolation & purification , Biomarkers/blood , COVID-19 , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Female , Heart Diseases/blood , Heart Diseases/mortality , Heart Diseases/virology , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Mortality , Outcome Assessment, Health Care , Pneumonia, Viral/blood , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Predictive Value of Tests , Prognosis , Retrospective Studies , SARS-CoV-2
18.
Sci Total Environ ; 758: 143595, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-922132

ABSTRACT

In this study, we aimed to examine spatial inequalities of COVID-19 mortality rate in relation to spatial inequalities of socioeconomic and environmental factors across England. Specifically, we first explored spatial patterns of COVID-19 mortality rate in comparison to non-COVID-19 mortality rate. Subsequently, we established models to investigate contributions of socioeconomic and environmental factors to spatial variations of COVID-19 mortality rate across England (N = 317). Two newly developed specifications of spatial regression models were established successfully to estimate COVID-19 mortality rate (R2 = 0.49 and R2 = 0.793). The level of spatial inequalities of COVID-19 mortality is higher than that of non-COVID-19 mortality in England. Although global spatial association of COVID-19 mortality and non-COVID-19 mortality is positive, local spatial association of COVID-19 mortality and non-COVID-19 mortality is negative in some areas. Expectedly, hospital accessibility is negatively related to COVID-19 mortality rate. Percent of Asians, percent of Blacks, and unemployment rate are positively related to COVID-19 mortality rate. More importantly, relative humidity is negatively related to COVID-19 mortality rate. Moreover, among the spatial models estimated, the 'random effects specification of eigenvector spatial filtering model' outperforms the 'matrix exponential spatial specification of spatial autoregressive model'.


Subject(s)
COVID-19 , England/epidemiology , Health Status Disparities , Humans , Mortality , SARS-CoV-2 , Socioeconomic Factors
19.
Cell Res ; 30(12): 1078-1087, 2020 12.
Article in English | MEDLINE | ID: covidwho-912896

ABSTRACT

Silent hypoxia has emerged as a unique feature of coronavirus disease 2019 (COVID-19). In this study, we show that mucins are accumulated in the bronchoalveolar lavage fluid (BALF) of COVID-19 patients and are upregulated in the lungs of severe respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mice and macaques. We find that induction of either interferon (IFN)-ß or IFN-γ upon SARS-CoV-2 infection results in activation of aryl hydrocarbon receptor (AhR) signaling through an IDO-Kyn-dependent pathway, leading to transcriptional upregulation of the expression of mucins, both the secreted and membrane-bound, in alveolar epithelial cells. Consequently, accumulated alveolar mucus affects the blood-gas barrier, thus inducing hypoxia and diminishing lung capacity, which can be reversed by blocking AhR activity. These findings potentially explain the silent hypoxia formation in COVID-19 patients, and suggest a possible intervention strategy by targeting the AhR pathway.


Subject(s)
Interferons/metabolism , Mucus/metabolism , Receptors, Aryl Hydrocarbon/metabolism , Animals , COVID-19/pathology , COVID-19/virology , Cell Line , Epithelial Cells/cytology , Epithelial Cells/metabolism , Epithelial Cells/virology , Humans , Hypoxia , Interferon-beta/pharmacology , Interferon-gamma/pharmacology , Lung/metabolism , Lung/pathology , Macaca , Mice , Mice, Inbred ICR , Mice, Transgenic , Mucins/metabolism , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Signal Transduction , Up-Regulation/drug effects
20.
Mol Med ; 26(1): 97, 2020 10 29.
Article in English | MEDLINE | ID: covidwho-894988

ABSTRACT

BACKGROUND: COVID-19 is a viral respiratory disease caused by the severe acute respiratory syndrome-Coronavirus type 2 (SARS-CoV-2). Patients with this disease may be more prone to venous or arterial thrombosis because of the activation of many factors involved in it, including inflammation, platelet activation and endothelial dysfunction. Interferon gamma inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein 1-alpha (MIP1α) are cytokines related to thrombosis. Therefore, this study focused on these three indicators in COVID-19, with the hope to find biomarkers that are associated with patients' outcome. METHODS: This is a retrospective single-center study involving 74 severe and critically ill COVID-19 patients recruited from the ICU department of the Tongji Hospital in Wuhan, China. The patients were divided into two groups: severe patients and critically ill patients. The serum IP-10, MCP-1 and MIP1α level in both groups was detected using the enzyme-linked immunosorbent assay (ELISA) kit. The clinical symptoms, laboratory test results, and the outcome of COVID-19 patients were retrospectively analyzed. RESULTS: The serum IP-10 and MCP-1 level in critically ill patients was significantly higher than that in severe patients (P < 0.001). However, no statistical difference in MIP1α between the two groups was found. The analysis of dynamic changes showed that these indicators remarkably increased in patients with poor prognosis. Since the selected patients were severe or critically ill, no significant difference was observed between survival and death. CONCLUSIONS: IP-10 and MCP-1 are biomarkers associated with the severity of COVID-19 disease and can be related to the risk of death in COVID-19 patients.


Subject(s)
Chemokine CCL2/blood , Chemokine CXCL10/blood , Coronavirus Infections/complications , Cytokine Release Syndrome/complications , Disseminated Intravascular Coagulation/complications , Pneumonia, Viral/complications , Pulmonary Embolism/complications , Respiratory Insufficiency/complications , Adaptor Proteins, Signal Transducing/blood , Aged , Betacoronavirus/pathogenicity , Biomarkers/blood , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/virology , Critical Illness , Cytokine Release Syndrome/diagnosis , Cytokine Release Syndrome/mortality , Cytokine Release Syndrome/virology , Disseminated Intravascular Coagulation/diagnosis , Disseminated Intravascular Coagulation/mortality , Disseminated Intravascular Coagulation/virology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/virology , Prognosis , Pulmonary Embolism/diagnosis , Pulmonary Embolism/mortality , Pulmonary Embolism/virology , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/mortality , Respiratory Insufficiency/virology , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Survival Analysis
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