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1.
BMC Public Health ; 21(1): 79, 2021 01 07.
Article in English | MEDLINE | ID: covidwho-1015851

ABSTRACT

BACKGROUND: About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. METHODS: In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic "snowball" or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) - along with residential living arrangements and conditions - were measured along with psychological stress and emotional responses to the COVID-19 pandemic. RESULTS: Three thousand eighty-eight questionnaires were returned: 1749 females (56.6%) and 1339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD = 2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (< 45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19, completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). "Protective" factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. CONCLUSIONS: The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.


Subject(s)
Adaptation, Psychological , Employment/psychology , Resilience, Psychological , Sex Factors , Stress, Psychological/psychology , Adult , Age Factors , China/epidemiology , Cross-Sectional Studies , Disease Outbreaks , Emotions , Employment/statistics & numerical data , Female , Humans , Male , Mental Health , Mental Health Services , Middle Aged , Needs Assessment , Pandemics , Risk Factors , Stress, Psychological/epidemiology , Surveys and Questionnaires
2.
J Med Virol ; 2020 Nov 24.
Article in English | MEDLINE | ID: covidwho-986260

ABSTRACT

OBJECTIVE: To investigate the effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on the prognosis in patients with coronavirus disease 2019 (COVID-19). METHODS: A meta-analysis was performed. We systematically searched PubMed, the Cochrane Library, the Web of Science, EMBASE, medRxiv and bioRxiv database through October 30, 2020. The primary and secondary outcomes were mortality and severe COVID-19, respectively. RESULTS: We included 25 studies with 22,734 COVID-19 patients, and we compared the outcomes between patients who did and did not receive ACEIs/ARBs. The use of ACEIs/ARBs was not associated with higher risks of severe disease (OR = 0.89, 95% CI: 0.63, 1.15, I2=38.55%), mechanical ventilation (OR = 0.89, 95% CI: 0.61, 1.16, I2=3.19%), dialysis (OR = 1.24, 95% CI: 0.09, 2.39, I2=0.00%), or the length of hospital stay (SMD = 0.05, 95% CI: -0.16, 0.26, I2=84.43%) in COVID-19 patients. The effect estimates showed an overall protective effect of ACEIs/ARBs against mortality (OR = 0.65, 95% CI: 0.46, 0.85, I2= 73.37%), severity/mortality (OR = 0.69, 95% CI: 0.43, 0.95, I2=22.90%), transfer to the intensive care unit (ICU) among COVID-19 patients with hypertension (OR = 0.36, 95% CI: 0.19, 0.53, I2=0.00%), hospitalization (OR = 0.79, 95% CI: 0.60, 0.98, I2=0.00%) and acute respiratory distress syndrome (ARDS) (OR = 0.71, 95% CI: 0.46, 0.95, I2=0.00%). CONCLUSION: The use of renin-angiotensin-aldosterone system (RAAS) inhibitor was not associated with increased mortality or disease severity in COVID-19 patients. This study supports the current guidelines that discourage the discontinuation of RAAS inhibitors in COVID-19 patients. This article is protected by copyright. All rights reserved.

3.
Emerg Microbes Infect ; 9(1): 2571-2577, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-944151

ABSTRACT

Following acute infection, individuals COVID-19 may still shed SARS-CoV-2 RNA. However, limited information is available regarding the active shedding period or whether infectious virus is also shed. Here, we monitored the clinical characteristics and virological features of 38 patients with COVID-19 (long-term carriers) who recovered from the acute disease, but still shed viral RNA for over 3 months. The median carrying history of the long-term carriers was 92 days after the first admission, and the longest carrying history was 118 days. Negative-positive viral RNA-shedding fluctuations were observed. Long-term carriers were mostly elderly people with a history of mild infection. Infectious SARS-CoV-2 was isolated from the sputum, where high level viral RNA was found. All nine full-length genomes of samples obtained in March-April 2020 matched early viral clades circulating in January-February 2020, suggesting that these patients persistently carried SARS-CoV-2 and were not re-infected. IgM and IgG antibodies and neutralizing-antibody profiles were similar between long-term carriers and recovered patients with similar disease courses. In summary, although patients with COVID-19 generated neutralizing antibodies, they may still shed infectious SARS-CoV-2 for over 3 months. These data imply that patients should be monitored after discharge to control future outbreaks.

5.
Cell ; 182(1): 50-58.e8, 2020 07 09.
Article in English | MEDLINE | ID: covidwho-343611

ABSTRACT

COVID-19 has spread worldwide since 2019 and is now a severe threat to public health. We previously identified the causative agent as a novel SARS-related coronavirus (SARS-CoV-2) that uses human angiotensin-converting enzyme 2 (hACE2) as the entry receptor. Here, we successfully developed a SARS-CoV-2 hACE2 transgenic mouse (HFH4-hACE2 in C3B6 mice) infection model. The infected mice generated typical interstitial pneumonia and pathology that were similar to those of COVID-19 patients. Viral quantification revealed the lungs as the major site of infection, although viral RNA could also be found in the eye, heart, and brain in some mice. Virus identical to SARS-CoV-2 in full-genome sequences was isolated from the infected lung and brain tissues. Last, we showed that pre-exposure to SARS-CoV-2 could protect mice from severe pneumonia. Our results show that the hACE2 mouse would be a valuable tool for testing potential vaccines and therapeutics.


Subject(s)
Betacoronavirus/physiology , Coronavirus Infections/pathology , Disease Models, Animal , Mice, Transgenic , Pneumonia, Viral/pathology , Animals , Female , Humans , Lung Diseases, Interstitial/pathology , Lung Diseases, Interstitial/virology , Male , Mice , Mice, Inbred C3H , Mice, Inbred C57BL , Mice, Transgenic/genetics , Pandemics , Peptidyl-Dipeptidase A/genetics , Viral Tropism , Weight Loss
6.
Ann Palliat Med ; 2020 Apr 20.
Article in English | MEDLINE | ID: covidwho-101323

ABSTRACT

The coronavirus disease 2019 (COVID-19) is a new infectious disease, firstly appeared in Wuhan city and has rapidly spread to 114 countries outside China, which is receiving worldwide attention. As two important means of examination, computed tomography (CT) and real-time reverse transcription polymerase chain reaction (RT-PCR) have always been controversial in the clinical diagnosis of COVID-19 pneumonia. Here, we report a family cluster case of a father and a son diagnosed as COVID-19 at our hospital, and described the clinical manifestations, laboratory results, CT changes, diagnosis and treatment strategy of these two patients. Focus on the value of these two methods in the diagnosis and treatment of diseases, as well as their respective deficiencies. For patient 1 (father), the efficacy of RT-PCR is not satisfactory either in terms of diagnosis or follow-up, which may cause misdiagnosis and delay treatment. For patient 2 (son), the clinical symptoms were not obvious, but CT imaging clearly displayed dynamic changes of the lung lesions. Meanwhile, the two patients respectively underwent five chest CT examinations during their hospitalization and discharge follow-up, showing the potential harm of radiation. Therefore, in clinical work, doctors should make full use of the advantages of CT and RT-PCR, and take other measures to make up for their disadvantages.

8.
Nature ; 579(7798): 270-273, 2020 03.
Article in English | MEDLINE | ID: covidwho-246

ABSTRACT

Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats1-4. Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans5-7. Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor-angiotensin converting enzyme II (ACE2)-as SARS-CoV.


Subject(s)
Betacoronavirus/classification , Betacoronavirus/genetics , Chiroptera/virology , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Outbreaks , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Animals , Antibodies, Viral/blood , Betacoronavirus/metabolism , Betacoronavirus/ultrastructure , Cell Line , China/epidemiology , Chlorocebus aethiops , Female , Genome, Viral/genetics , Humans , Male , Peptidyl-Dipeptidase A/metabolism , Phylogeny , SARS Virus/classification , SARS Virus/genetics , Sequence Homology, Nucleic Acid , Severe Acute Respiratory Syndrome , Vero Cells
9.
Preprint | bioRxiv | ID: ppbiorxiv-914952

ABSTRACT

Since the SARS outbreak 18 years ago, a large number of severe acute respiratory syndrome related coronaviruses (SARSr-CoV) have been discovered in their natural reservoir host, bats1-4. Previous studies indicated that some of those bat SARSr-CoVs have the potential to infect humans5-7. Here we report the identification and characterization of a novel coronavirus (nCoV-2019) which caused an epidemic of acute respiratory syndrome in humans, in Wuhan, China. The epidemic, started from December 12th, 2019, has caused 198 laboratory confirmed infections with three fatal cases by January 20th, 2020. Full-length genome sequences were obtained from five patients at the early stage of the outbreak. They are almost identical to each other and share 79.5% sequence identify to SARS-CoV. Furthermore, it was found that nCoV-2019 is 96% identical at the whole genome level to a bat coronavirus. The pairwise protein sequence analysis of seven conserved non-structural proteins show that this virus belongs to the species of SARSr-CoV. The nCoV-2019 virus was then isolated from the bronchoalveolar lavage fluid of a critically ill patient, which can be neutralized by sera from several patients. Importantly, we have confirmed that this novel CoV uses the same cell entry receptor, ACE2, as SARS-CoV.

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