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1.
Virus evolution ; 2022.
Article in English | EuropePMC | ID: covidwho-1998565

ABSTRACT

Phylogenetic analysis has been widely used to describe, display and infer the evolutionary patterns of viruses. The unprecedented accumulation of SARS-CoV-2 genomes has provided valuable materials for the real-time study of SARS-CoV-2 evolution. However, the large number of SARS-CoV-2 genome sequences also poses great challenges for data analysis. Several methods for subsampling these large data sets have been introduced. However, current methods mainly focus on the spatiotemporal distribution of genomes without considering their genetic diversity, which might lead to postsubsampling bias. In this study, a subsampling method named covSampler was developed for the subsampling of SARS-CoV-2 genomes with consideration of both their spatiotemporal distribution and their genetic diversity. First, covSampler clusters all genomes according to their spatiotemporal distribution and genetic variation into groups that we call divergent pathways. Then, based on these divergent pathways, two kinds of subsampling strategies, representative subsampling and comprehensive subsampling, were provided with adjustable parameters to meet different users’ requirements. Our performance and validation tests indicate that covSampler is efficient and stable, with an abundance of options for user customization. Overall, our work has developed an easy-to-use tool and a webserver (https://www.covsampler.net) for the subsampling of SARS-CoV-2 genome sequences.

2.
Comput Struct Biotechnol J ; 20: 4015-4024, 2022.
Article in English | MEDLINE | ID: covidwho-1966470

ABSTRACT

Co-infection of RNA viruses may contribute to their recombination and cause severe clinical symptoms. However, the tracking and identification of SARS-CoV-2 co-infection persist as challenges. Due to the lack of methods for detecting co-infected samples in a large amount of deep sequencing data, the lineage composition, spatial-temporal distribution, and frequency of SARS-CoV-2 co-infection events in the population remains unclear. Here, we propose a hypergeometric distribution-based method named Cov2Coinfect with the ability to decode the lineage composition from 50,809 deep sequencing data. By resolving the mutational patterns in each sample, Cov2Coinfect can precisely determine the co-infected SARS-CoV-2 variants from deep sequencing data. Results from two independent and parallel projects in the United States achieved a similar co-infection rate of 0.3-0.5 % in SARS-CoV-2 positive samples. Notably, all co-infected variants were highly consistent with the co-circulating SARS-CoV-2 lineages in the regional epidemiology, demonstrating that the co-circulation of different variants is an essential prerequisite for co-infection. Overall, our study not only provides a robust method to identify the co-infected SARS-CoV-2 variants from sequencing samples, but also highlights the urgent need to pay more attention to co-infected patients for better disease prevention and control.

3.
PLoS One ; 17(7): e0270345, 2022.
Article in English | MEDLINE | ID: covidwho-1951544

ABSTRACT

BACKGROUND: The situation of the COVID-19 outbreak in the border areas of China and Vietnam is complex, and its progress may affect the willingness of urban and rural residents to receive the vaccine. OBJECTIVE: This study aims to understand the influence of the COVID-19 epidemic situation on the willingness of urban and rural residents in China-Vietnam border areas to get vaccinated and the factors that affect the vaccinations. METHODS: A cross-sectional survey was conducted in Hani-Yi Autonomous Prefecture of Honghe, a border area between China and Vietnam, using online and paper questionnaires from April 1 to June 4, 2021. A total of 8849 valid questionnaires were surveyed to compare the differences in the willingness of urban and rural residents to receive the COVID-19 vaccine. Single factor analysis and multivariate logistic regression analysis were used to explore the influence of the epidemic situation on the willingness to be vaccinated. RESULTS: In the border areas between China and Vietnam in Yunnan Province, both urban and rural residents had a high willingness (> 90%) to receive the COVID-19 vaccination, with a higher level of willingness in urban than in rural areas and a higher willingness among residents aged ≥ 56 years. Rural residents mainly concerned about the vaccination were different from urban residents (p< 0.05). About 54.8% of urban respondents and 59.2% of rural respondents indicated that their willingness to get COVID-19 vaccine would be affected by new COVID-19 cases. Respondents who were divorced, had an occupation other than farming, had contraindications to vaccination, were concerned about the safety of vaccines and worried about virus mutation, thought that the epidemic situation would not affect their willingness to get vaccinated (p< 0.05). CONCLUSION: The prevention and control of epidemics in border areas is of considerable importance. It is necessary to conduct targeted health education and vaccine knowledge popularization among urban and rural residents to increase the vaccination rate and consolidate the epidemic prevention and control at the border.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Cross-Sectional Studies , Humans , Vaccination , Vietnam/epidemiology
4.
Chinese Journal of School Health ; 43(5):751-754, 2022.
Article in Chinese | GIM | ID: covidwho-1903998

ABSTRACT

Objective: To investigate the progression of depressive and anxiety symptoms of children, especially whose parents were frontline workers in the combat of the coronavirus disease 2019(COVID-19), and to provide evidence for children's mental health promotion.

5.
Chinese Journal of School Health ; 43(5):679-684, 2022.
Article in Chinese | GIM | ID: covidwho-1903996

ABSTRACT

Children were vulnerable groups in major public health emergencies. In 2020, the coronavirus disease 2019 (COVID-19) pandemic was widespread in the world. The mental health of school-age children has become a worldwide concern. Herein, we conducted this review to evaluate the impact of COVID-19 on the mental health of general children and special children with a high risk of psychological problems, focusing on the prevalence of anxiety, depression, and post-traumatic stress disorder among school-age children in different countries and regions during the COVID-19 epidemic. Considering the susceptibility between individuals and the accessibility of social resources, we further explored the child, family, and social related factors affecting the mental health of school-age children. Finally, some suggestions on the construction of children's mental health service system in major public health emergencies were put forward at the national, school-family-community, and individual levels. Building a safe and reliable child mental health protection network required the joint efforts of all sectors of society.

6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324312

ABSTRACT

Background: PM 2.5 (particles matter smaller aerodynamic diameter of 2.5 μm ) exposure, as one major environmental risk factor for the global burden of disease, is associated with high risks of respiratory diseases and lung cancer. Heme-oxygenase 1 (HMOX1) has been considered as one of the major molecular antioxidant defenses to mediate cytoprotective effects against diverse stressors, including PM 2.5 -induced toxicity and SARS-CoV-2 infection;however, the regulatory mechanism of HMOX1 expression still needs to be elucidated. In this study, using PM 2.5 as a typical stressor, we explored whether microRNAs (miRNAs) might modulate HMOX1 expression in lung cells. Results: : Systematic bioinformatics analysis showed that seven miRNAs have the potential to target HMOX1 gene. Among these, hsa-miR-760 was identified as a response miRNA to PM 2.5 exposure. More importantly, we revealed a “non-conventional” miRNA function in hsa-miR-760 upregulating HMOX1 expression, by targeting the coding region and interacting with YBX1 protein. In addition, we observed that exogenous hsa-miR-760 effectively elevated HMOX1 expression, reduced the reactive oxygen agents (ROS) levels, and then rescued the lung cells from PM 2.5 -induced apoptosis. Conclusion: Our results revealed that hsa-miR-760 might play an important role in protecting lung cells against PM 2.5 -induced toxicity, by elevating HMOX1 expression, and offered new clues to elucidate the diverse function of miRNAs.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322986

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a worldwide public health pandemic with a high mortality rate, among severe cases. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. It is important to ensure early detection of the virus to curb disease progression to severe COVID-19. This study aimed to establish a clinical-nomogram model to predict the progression to severe COVID-19 in a timely, efficient manner. Methods This retrospective study included 202 patients with COVID-19 who were admitted to the Fifth Affiliated Hospital of Sun Yat-sen University and Shiyan Taihe Hospital from January 17 to April 30, 2020. The patients were randomly assigned to the training dataset (n = 163, with 43 progressing to severe COVID-19) or the validation dataset (n = 39, with 10 progressing to severe COVID-19) at a ratio of 8:2. The optimal subset algorithm was applied to filter for the clinical factors most relevant to the disease progression. Based on these factors, the logistic regression model was fit to distinguish severe (including severe and critical cases) from non-severe (including mild and moderate cases) COVID-19. Sensitivity, specificity, and area under the curve (AUC) were calculated using the R software package to evaluate prediction performance. A clinical nomogram was established and performance assessed with the discrimination curve. Results Risk factors, including demographics data, symptoms, laboratory and image findings were recorded for the 202 patients. Eight of the 52 variables that were entered into the selection process were selected via the best subset algorithm to establish the predictive model;they included gender, age, BMI, CRP, D-dimer, TP, ALB, and involved-lobe. Sensitivity, specificity and AUC were 0.91, 0.84 and 0.86 for the training dataset, and 0.87, 0.66, and 0.80 for the validation dataset. Conclusions We established an efficient and reliable clinical nomogram model which showed that gender, age, and initial indexes including BMI, CRP, D-dimer, involved-lobe, TP, and ALB could predict the risk of progression to severe COVID-19.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312927

ABSTRACT

Background: COVID-19 vaccine hesitancy is one of the major concerns in the roll out of vaccines in many countries. The aim of the study was to assess the level of COVID-19 vaccine acceptability among the population in Herat, Afghanistan, the third largest city in the country. Methods: : This cross-sectional study was conducted between 15 April 2021 and 20 April 2021 among the general population of Herat City to examine the acceptability rate of COVID-19 vaccine. Sample size was calculated at 555. Different variables were collected using a questionnaire developed. Data were evaluated in IBM SPSS program. Results: : Only 10.63% of the participants were willing to receive COVID-19 vaccine without having any concern and reservation. 45% were willing to receive the COVID-19 vaccine. 66.5% were concerned about the vaccine and its side effects and 29% were afraid of being infected by transmission of COVID-19 through the administration of vaccine on them. Conclusion: This research demonstrates that, concerns about the vaccine, myths and misinformation are widespread which will undermine the vaccination process. This study recommends the initiation of more health-related campaigns and awareness programs by the government for general population to enhance and expedite the roll out of COVID-19 vaccine.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315663

ABSTRACT

Developing conversational agents to interact with patients and provide primary clinical advice has attracted increasing attention due to its huge application potential, especially in the time of COVID-19 Pandemic. However, the training of end-to-end neural-based medical dialogue system is restricted by an insufficient quantity of medical dialogue corpus. In this work, we make the first attempt to build and release a large-scale high-quality Medical Dialogue dataset related to 12 types of common Gastrointestinal diseases named MedDG, with more than 17K conversations collected from the online health consultation community. Five different categories of entities, including diseases, symptoms, attributes, tests, and medicines, are annotated in each conversation of MedDG as additional labels. To push forward the future research on building expert-sensitive medical dialogue system, we proposes two kinds of medical dialogue tasks based on MedDG dataset. One is the next entity prediction and the other is the doctor response generation. To acquire a clear comprehension on these two medical dialogue tasks, we implement several state-of-the-art benchmarks, as well as design two dialogue models with a further consideration on the predicted entities. Experimental results show that the pre-train language models and other baselines struggle on both tasks with poor performance in our dataset, and the response quality can be enhanced with the help of auxiliary entity information. From human evaluation, the simple retrieval model outperforms several state-of-the-art generative models, indicating that there still remains a large room for improvement on generating medically meaningful responses.

10.
JMIR Mhealth Uhealth ; 10(1): e34054, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1662535

ABSTRACT

BACKGROUND: Mental disorders impose varying degrees of burden on patients and their surroundings. However, people are reluctant to take the initiative to seek mental health services because of the uneven distribution of resources and stigmatization. Thus, mobile apps are considered an effective way to eliminate these obstacles and improve mental health awareness. OBJECTIVE: This study aims to evaluate the quality, function, privacy measures, and evidence-based and professional background of multipurpose mental health apps in Chinese commercial app stores. METHODS: A systematic search was conducted on iOS and Android platforms in China to identify multipurpose mental health apps. Two independent reviewers evaluated the identified mobile apps using the Mobile App Rating Scale (MARS). Each app was downloaded, and the general characteristics, privacy and security measures, development background, and functional characteristics of each app were evaluated. RESULTS: A total of 40 apps were analyzed, of which 35 (87.5%) were developed by companies and 33 (82.5%) provided links to access the privacy policy; 21 (52.5%) apps did not mention the involvement of relevant professionals or the guidance of a scientific basis in the app development process. The main built-in functions of these apps include psychological education (38/40, 95%), self-assessment (34/40, 85%), and counseling (33/40, 82.5%). The overall quality average MARS score of the 40 apps was 3.54 (SD 0.39), and the total score was between 2.96 and 4.30. The total MARS score was significantly positively correlated with the scores of each subscale (r=0.62-0.88, P<.001). However, the user score of the app market was not significantly correlated with the total MARS score (r=0.17, P=.33). CONCLUSIONS: The quality of multipurpose mental health apps in China's main app market is generally good. However, health professionals are less involved in the development of these apps, and the privacy protection policy of the apps also needs to be described in more detail. This study provides a reference for the development of multipurpose mental health apps.


Subject(s)
Mobile Applications , China , Delivery of Health Care , Humans , Mental Health , Privacy
11.
Open Forum Infect Dis ; 8(9): ofaa540, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1475824

ABSTRACT

BACKGROUND: This study aimed to investigate pulmonary function and radiological outcomes in a group of coronavirus disease 2019 (COVID-19) survivors. METHODS: One hundred seventy-two COVID-19 survivors in a follow-up clinic in a referral hospital underwent high-resolution computed tomography (CT) of the thorax and pulmonary function at 3 months after hospital discharge. RESULTS: The median duration from hospital discharge to radiological and pulmonary function test (interquartile range) was 90 (88-95) days. Abnormal pulmonary function was found in 11 (6.40%) patients, and abnormal small airway function (FEF25-75%) in 12 (6.98%). Six (3.49%) patients had obstructive ventilation impairment, and 6 (3.49%) had restrictive ventilatory impairment. No significant differences in lung function parameters were observed between the nonsevere and severe groups. Of 142 COVID-19 patients who underwent CT scan, 122 (85.91%) showed residual CT abnormalities and 52 (36.62%) showed chronic and fibrotic changes. The ground-glass opacities absorption in the lungs of severe cases was less satisfactory than that of nonsevere patients. The severe patients had higher CT scores than the nonsevere cases (2.00 vs 0.00; P < .001). CONCLUSIONS: Of the COVID-19 survivors in our study, 6.40% still presented pulmonary function abnormality 3 months after discharge, which did not vary by disease severity during hospitalization; 85.91% of patients had abnormalities on chest CT, with fibrous stripes and ground-glass opacities being the most common patterns.

13.
Nonlinear Dyn ; 106(2): 1411-1424, 2021.
Article in English | MEDLINE | ID: covidwho-1401058

ABSTRACT

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been causing an outbreak of a new type of pneumonia globally, and repeated outbreaks have already appeared. Among the studies on the spread of the COVID-19, few studies have investigated the repeated outbreaks in stages, and the quantitative condition of a controllable spread has not been revealed. In this paper, a brief compartmental model is developed. The effective reproduction number (ERN) of the model is interpreted by the ratio of net newly infectious individuals to net isolation infections to assess the controllability of the spread of COVID-19. It is found that the value of the ERN at the inflection point of the pandemic is equal to one. The effectiveness of the quarantine, even the treatment, is parametrized in various stages with Gompertz functions to increase modeling accuracy. The impacts of the vaccinations are discussed by adding a vaccinated compartment. The results show that the sufficient vaccinations can make the inflection point appear early and significantly reduce subsequent increases in newly confirmed cases. The analysis of the ERNs of COVID-19 in the United States, Spain, France, and Peru confirms that the condition of a repeated outbreak is to relax or lift the interventions related to isolation and quarantine interventions to a level where the ERN is greater than one.

14.
Front Pharmacol ; 12: 626510, 2021.
Article in English | MEDLINE | ID: covidwho-1317239

ABSTRACT

Aim: Kidney impairment is observed in patients with COVID-19. The effect of anti-COVID-19 agent remdesivir on kidneys is currently unknown. We aimed to determine the effect of remdesivir on renal fibrosis and its downstream mechanisms. Methods: Remdesivir and its active nucleoside metabolite GS-441524 were used to treat TGF-ß stimulated renal fibroblasts (NRK-49F) and human renal epithelial (HK2) cells. Vehicle or remdesivir were given by intraperitoneal injection or renal injection through the left ureter in unilateral ureteral obstruction (UUO) mice. Serum and kidneys were harvested. The concentrations of remdesivir and GS-441524 were measured using LC-MS/MS. Renal and liver function were assessed. Renal fibrosis was evaluated by Masson's trichrome staining and Western blotting. Results: Remdesivir and GS-441524 inhibited the expression of fibrotic markers (fibronectin and aSMA) in NRK-49F and HK2 cells. Intraperitoneal injection or renal injection of remdesivir attenuated renal fibrosis in UUO kidneys. Renal and liver function were unchanged in remdesivir treated UUO mice. Two remdesivir metabolites were detected after injection. Phosphorylation of Smad3 that was enhanced in cell and animal models for renal fibrosis was attenuated by remdesivir. In addition, the expression of Smad7, an anti-fibrotic factor, was increased after remdesivir treatment in vitro and in vivo. Moreover, knockdown of Smad7 blocked the antifibrotic effect of GS and RDV on renal cells. Conclusion: Remdesivir inhibits renal fibrosis in obstructed kidneys.

15.
J Med Internet Res ; 23(5): e27811, 2021 05 21.
Article in English | MEDLINE | ID: covidwho-1262583

ABSTRACT

BACKGROUND: COVID-19 has spread around the world and has increased the public's need for health information in the process. Meanwhile, in the context of lockdowns and other measures for preventing SARS-CoV-2 spread, the internet has surged as a web-based resource for health information. Under these conditions, social question-and-answer communities (SQACs) are playing an increasingly important role in improving public health literacy. There is great theoretical and practical significance in exploring the influencing factors of SQAC users' willingness to adopt health information. OBJECTIVE: The aim of this study was to establish an extended unified theory of acceptance and use of technology model that could analyze the influence factors of SQAC users' willingness to adopt health information. Particularly, we tried to test the moderating effects that different demographic characteristics had on the variables' influences. METHODS: This study was conducted by administering a web-based questionnaire survey and analyzing the responses from a final total of 598 valid questionnaires after invalid data were cleaned. By using structural equation modelling, the influencing factors of SQAC users' willingness to adopt health information were analyzed. The moderating effects of variables were verified via hierarchical regression. RESULTS: Performance expectation (ß=.282; P<.001), social influence (ß=.238; P=.02), and facilitating conditions (ß=.279; P=.002) positively affected users' willingness to adopt health information, whereas effort expectancy (P=.79) and perceived risk (P=.41) had no significant effects. Gender had a significant moderating effect in the structural equation model (P<.001). CONCLUSIONS: SQAC users' willingness to adopt health information was evidently affected by multiple factors, such as performance expectation, social influence, and facilitating conditions. The structural equation model proposed in this study has a good fitting degree and good explanatory power for users' willingness to adopt health information. Suggestions were provided for SQAC operators and health management agencies based on our research results.


Subject(s)
Health Information Management/methods , Internet Use/trends , Adolescent , Adult , China , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Quality Control , Residence Characteristics , Surveys and Questionnaires , Young Adult
16.
Biosens Bioelectron ; 187: 113329, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1230376

ABSTRACT

Coronavirus disease 2019 (COVID-19) as a severe acute respiratory syndrome infection has spread rapidly across the world since its emergence in 2019 and drastically altered our way of life. Patients who have recovered from COVID-19 may still face persisting respiratory damage from the virus, necessitating long-term supervision after discharge to closely assess pulmonary function during rehabilitation. Therefore, developing portable spirometers for pulmonary function tests is of great significance for convenient home-based monitoring during recovery. Here, we propose a wireless, portable pulmonary function monitor for rehabilitation care after COVID-19. It is composed of a breath-to-electrical (BTE) sensor, a signal processing circuit, and a Bluetooth communication unit. The BTE sensor, with a compact size and light weight of 2.5 cm3 and 1.8 g respectively, is capable of converting respiratory biomechanical motions into considerable electrical signals. The output signal stability is greater than 93% under 35%-81% humidity, which allows for ideal expiration airflow sensing. Through a wireless communication circuit system, the signals can be received by a mobile terminal and processed into important physiological parameters, such as forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). The FEV1/FVC ratio is then calculated to further evaluate pulmonary function of testers. Through these measurement methods, the acquired pulmonary function parameters are shown to exhibit high accuracy (>97%) in comparison to a commercial spirometer. The practical design of the self-powered flow spirometer presents a low-cost and convenient method for pulmonary function monitoring during rehabilitation from COVID-19.


Subject(s)
Biosensing Techniques , COVID-19 , Humans , SARS-CoV-2 , Spirometry , Vital Capacity
17.
Virol Sin ; 35(6): 785-792, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1217481

ABSTRACT

Healthcare workers (HCWs) are at high risk of occupational exposure to the new pandemic human coronavirus, SARS-CoV-2, and are a source of nosocomial transmission in airborne infectious isolation rooms (AIIRs). Here, we performed comprehensive environmental contamination surveillance to evaluate the risk of viral transmission in AIIRs with 115 rooms in three buildings at the Shanghai Public Health Clinical Center, Shanghai, during the treatment of 334 patients infected with SARS-CoV-2. The results showed that the risk of airborne transmission of SARS-CoV-2 in AIIRs was low (1.62%, 25/1544) due to the directional airflow and strong environmental hygiene procedures. However, we detected viral RNA on the surface of foot-operated openers and bathroom sinks in AIIRs (viral load: 55.00-3154.50 copies/mL). This might be a source of contamination to connecting corridors and object surfaces through the footwear and gloves used by HCWs. The risk of infection was eliminated by the use of disposable footwear covers and the application of more effective environmental and personal hygiene measures. With the help of effective infection control procedures, none of 290 HCWs was infected when working in the AIIRs at this hospital. This study has provided information pertinent for infection control in AIIRs during the treatment of COVID-19 patients.


Subject(s)
COVID-19/transmission , Environmental Monitoring/methods , Hospitals, Isolation , SARS-CoV-2/isolation & purification , Air Microbiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , China/epidemiology , Cross Infection/transmission , Environmental Microbiology , Health Personnel , Humans , Infection Control/instrumentation , Infection Control/methods , Pandemics/prevention & control , RNA, Viral/isolation & purification , Risk Factors , Viral Load
18.
Sci Rep ; 11(1): 4145, 2021 02 18.
Article in English | MEDLINE | ID: covidwho-1091456

ABSTRACT

The pandemic of Coronavirus Disease 2019 (COVID-19) is causing enormous loss of life globally. Prompt case identification is critical. The reference method is the real-time reverse transcription PCR (RT-PCR) assay, whose limitations may curb its prompt large-scale application. COVID-19 manifests with chest computed tomography (CT) abnormalities, some even before the onset of symptoms. We tested the hypothesis that the application of deep learning (DL) to 3D CT images could help identify COVID-19 infections. Using data from 920 COVID-19 and 1,073 non-COVID-19 pneumonia patients, we developed a modified DenseNet-264 model, COVIDNet, to classify CT images to either class. When tested on an independent set of 233 COVID-19 and 289 non-COVID-19 pneumonia patients, COVIDNet achieved an accuracy rate of 94.3% and an area under the curve of 0.98. As of March 23, 2020, the COVIDNet system had been used 11,966 times with a sensitivity of 91.12% and a specificity of 88.50% in six hospitals with PCR confirmation. Application of DL to CT images may improve both efficiency and capacity of case detection and long-term surveillance.


Subject(s)
COVID-19/diagnostic imaging , COVID-19/diagnosis , Tomography, X-Ray Computed/methods , COVID-19/epidemiology , COVID-19/metabolism , China/epidemiology , Data Accuracy , Deep Learning , Humans , Lung/pathology , Pneumonia/diagnostic imaging , Retrospective Studies , SARS-CoV-2/isolation & purification , Sensitivity and Specificity
19.
Diabetes ; 70(5): 1061-1069, 2021 05.
Article in English | MEDLINE | ID: covidwho-1088886

ABSTRACT

Obesity has caused wide concerns due to its high prevalence in patients with severe coronavirus disease 2019 (COVID-19). Coexistence of diabetes and obesity could cause an even higher risk of severe outcomes due to immunity dysfunction. We conducted a retrospective study in 1,637 adult patients who were admitted into an acute hospital in Wuhan, China. Propensity score-matched logistic regression was used to estimate the risks of severe pneumonia and requiring in-hospital oxygen therapy associated with obesity. After adjustment for age, sex, and comorbidities, obesity was significantly associated with higher odds of severe pneumonia (odds ratio [OR] 1.47 [95% CI 1.15-1.88]; P = 0.002) and oxygen therapy (OR 1.40 [95% CI 1.10-1.79]; P = 0.007). Higher ORs of severe pneumonia due to obesity were observed in men, older adults, and those with diabetes. Among patients with diabetes, overweight increased the odds of requiring in-hospital oxygen therapy by 0.68 times (P = 0.014) and obesity increased the odds by 1.06 times (P = 0.028). A linear dose-response curve between BMI and severe outcomes was observed in all patients, whereas a U-shaped curve was observed in those with diabetes. Our findings provide important evidence to support obesity as an independent risk factor for severe outcomes of COVID-19 infection in the early phase of the ongoing pandemic.


Subject(s)
COVID-19/epidemiology , Diabetes Mellitus/epidemiology , Obesity/epidemiology , Age Factors , Aged , Body Mass Index , COVID-19/physiopathology , COVID-19/therapy , China/epidemiology , Extracorporeal Membrane Oxygenation , Female , Humans , Intensive Care Units , Male , Middle Aged , Odds Ratio , Overweight/epidemiology , Oxygen Inhalation Therapy , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Sex Factors
20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(12): 1423-1427, 2020 Dec.
Article in Chinese | MEDLINE | ID: covidwho-1067796

ABSTRACT

OBJECTIVE: To investigate the clinical efficacy and short-term and long-term adverse reactions for different antiviral regiments for coronavirus disease 2019 (COVID-19) in Ningxia Hui Autonomous Region during hospitalization and follow-up in 3 months. METHODS: A single-center retrospective study was conducted to enroll the COVID-19 patients in isolation ward of the only designated hospital to receive COVID-19 patients (the Fourth People's Hospital of Ningxia Hui Autonomous Region) when the authors were assigned by the Ningxia Health Commission as experts from January 20, 2020 to March 15, 2020. According to the antiviral regimen, the patients were divided into conventional antiviral group and unconventional antiviral group. The conventional antiviral group received α-interferon combined with Lopinavir/Ritonavir (LPV/R). The unconventional antiviral group was given α-interferon combined with LPV/R and Abidor or Ribavirin or Chloroquine. The patients were divided into mild (13 cases), ordinary (45 cases), severe (14 cases) and critical (1 case) types. The clinical data, length of hospital stay, the first 2019 novel coronavirus (2019-nCoV) nucleic acid negative recovery time, cost of hospitalization, 2019-nCoV nucleic acid positive reversal after 14 days of discharge, and the combination of hormones and antibiotics were collected. The differences in blood routine, liver function, blood lipid level and adverse reactions of antiviral drugs during hospitalization were compared between the two groups at 1, 3 and 7 days after admission and 1 and 3 months after discharge. RESULTS: (1) General information: a total of 75 patients with confirmed COVID-19 were admitted, and 73 patients were eventually enrolled, including 47 cases in the conventional antiviral group and 26 cases in the unconventional antiviral group. Patients with different clinical classification were analyzed, the higher the clinical classification and the patients' age, the higher the proportion of primary diseases and the cost of treatment, and the longer the length of hospital stay. Compared with conventional antiviral group, in unconventional antiviral group the percentage of severe and critical patients were higher [34.6% (9/26) vs. 10.6% (5/47), 3.8% (1/26) vs. 0 (0/47)], the length of hospital stay (days: 16.1±5.6 vs. 11.6±3.3), first nucleic acid negative recovery time (days: 12.4±4.5 vs. 10.0±3.5) were longer, and hospitalization cost was higher [Yuan: 11 984.2 (9 000.6, 24 424.7) vs. 8 140.4 (6 715.7,9 707.7)], with statistically significant differences (all P < 0.05). There were no significant differences in gender, age, proportion of patients with primary diseases and nucleic acid positive reversal rate after 14 days of discharge between the unconventional and conventional antiviral groups (all P > 0.05). (2) Laboratory tests: during the hospitalization, white blood cell count (WBC), platelet count (PLT), total bilirubin (TBil) and three acyl glycerin (TG) levels were first increased and then reduced, lymphocyte count (LYM) was first decreased and then increased in two groups. In the unconventional antiviral group, WBC [(6.53±2.78)×109/L], PLT [(250.77±96.12)×109/L], and TG [(1.94±0.96) µmol/L] all reached their peak values at 7 days after admission. TBil peaked at 3 days after admission, which was (23.69±12.14) µmol/L, and LYM reached the peak 1 month after discharge, which was (1.82±0.50)×109/L; however, there was no statistical significance among the above indicators between two groups. There were no statistically significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total cholesterol (TC) between the two groups at each time point. (3) The ratio of combined use of hormones in the non-antiviral group was significantly higher than that in the conventional antiviral group [26.9% (7/26) vs. 4.3% (2/47), P < 0.05]. CONCLUSIONS: Age and associated primary diseases are related to the severity of COVID-19 patients. Unconventional antiviral treatment regimens are mostly used for severe COVID-19 patients whose ucleic acid did not turn negative for a long time. Individual antiviral therapy can be used based on the patients' response and tolerance to drugs.


Subject(s)
Antiviral Agents , COVID-19 , Antiviral Agents/adverse effects , Humans , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
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