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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324319

ABSTRACT

Background: Due to the increased risk of viral infection and the severe shortage of medical resources during the pandemic of COVID-19, most hospitals in the epidemic areas significantly reduced non-emergency admissions and services, if not closed. As a result, it has been difficult to treat cancer patients on time, which adversely affects their prognosis. To address this problem, cancer centers must develop a strategic plan to manage both inpatients and outpatients during the pandemic, provide them with the necessary treatment, and at the same time prevent the spread of the virus among patients, visitors and medical staff. Methods: : Based upon the epidemic situation in Zhejiang Province, China, the number of running non-emergency medical wards in the Zhejiang Cancer Hospital was gradually increased in a controlled manner. All staff of the hospital received COVID-19 preventive training and was provided with three different levels of protection according to the risks of their services. Only patients without a known history of SARS-CoV-2 contact were eligible to schedule an appointment. Body temperature was measured on all patients upon their arrival at the hospital. Chest CT image, blood cell counting and travel/contact history were investigated in patients with fever. Respiratory tract samples, such as sputum and throat swabs, from all patients, including those clinically suspected of SARS-CoV-2 infection, were collected for nucleic acid detection of SARS-CoV-2 before treatment. Results: : A total of 3697 inpatients and 416 outpatients seeking cancer treatment were enrolled from February 1 to April 3, 2020, in compliance with the hospital’s infection-control interventions. The clinicopathological parameters of the patients were summarized herein. 4237 samples from 4101 patients produced negative RNA testing results. Four clinically suspected patients all presented negative RNA test results and were excluded from the SARS-CoV-2 infection through follow-up retesting and monitoring. Seven patients with only N-gene positive results were retested, followed by CT scan and SARS-CoV-2 contact history investigation. All of them were finally diagnosed as non-infected patients. There was one outpatient who was confirmed positive by virus RNA test and then followed up. She might be an asymptomatic laboratory-confirmed case. During the study period, there was no SARS-CoV-2 infection among staff, patients and escorts of patients in the Zhejiang Cancer Hospital. Conclusion: This study suggested our infection-control interventions, including viral nucleic acid test, could be used as a reliable method to screen cancer patients in the area with moderate COVID-19 prevalence. Cancer may not be a high-risk factor of SARS-CoV-2 infection.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315267

ABSTRACT

Background: The current worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has posed a serious threat to global public health, and the mortality rate of critical ill patients remains high. The purpose of this study was to identify factors that early predict the progression of COVID-19 from severe to critical illness. Methods: : This retrospective cohort study included adult patients with severe or critical ill COVID-19 who were consecutively admitted to the Zhongfaxincheng campus of Tongji Hospital (Wuhan, China) from February 8 to 18, 2020. Baseline variables, data at hospital admission and during hospital stay, as well as clinical outcomes were collected from electronic medical records system. The primary endpoint was the development of critical illness. A multivariable logistic regression model was used to identify independent factors that were associated with the progression from severe to critical illness. Results: : A total of 138 patients were included in the analysis;of them 119 were diagnosed as severe cases and 16 as critical ill cases at hospital admission. During hospital stay, 19 more severe cases progressed to critical illness. For all enrolled patients, longer duration from diagnosis to admission (odds ratio [OR] 1.108, 95% CI 1.022-1.202;P=0.013), pulse oxygen saturation at admission <93% (OR 5.775, 95% CI 1.257-26.535;P=0.024), higher neutrophil count (OR 1.495, 95% CI 1.177-1.899;P=0.001) and higher creatine kinase-MB level at admission (OR 2.449, 95% CI 1.089-5.511;P=0.030) were associated with a higher risk, whereas higher lymphocyte count at admission (OR 0.149, 95% CI 0.026-0.852;P=0.032) was associated with a lower risk of critical illness development. For the subgroup of severe cases at hospital admission, the above factors except creatine kinase-MB level were also found to have similar correlation with critical illness development. Conclusions: : Higher neutrophil count and lower lymphocyte count at admission were early independent predictors of progression to critical illness in severe COVID-19 patients.

3.
Proc Natl Acad Sci U S A ; 119(4)2022 01 25.
Article in English | MEDLINE | ID: covidwho-1621335

ABSTRACT

After binding to its cell surface receptor angiotensin converting enzyme 2 (ACE2), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the host cell through directly fusing with plasma membrane (cell surface pathway) or undergoing endocytosis traveling to lysosome/late endosome for membrane fusion (endocytic pathway). However, the endocytic entry regulation by host cell remains elusive. Recent studies show ACE2 possesses a type I PDZ binding motif (PBM) through which it could interact with a PDZ domain-containing protein such as sorting nexin 27 (SNX27). In this study, we determined the ACE2-PBM/SNX27-PDZ complex structure, and, through a series of functional analyses, we found SNX27 plays an important role in regulating the homeostasis of ACE2 receptor. More importantly, we demonstrated SNX27, together with retromer complex (the core component of the endosomal protein sorting machinery), prevents ACE2/virus complex from entering lysosome/late endosome, resulting in decreased viral entry in cells where the endocytic pathway dominates. The ACE2/virus retrieval mediated by SNX27-retromer could be considered as a countermeasure against invasion of ACE2 receptor-using SARS coronaviruses.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/metabolism , Endosomes/metabolism , SARS-CoV-2 , Sorting Nexins/chemistry , COVID-19/virology , Cell Line , Cell Line, Tumor , Cell Membrane/metabolism , Crystallography, X-Ray , Cytosol/metabolism , Endocytosis , Gene Expression Profiling , HEK293 Cells , HeLa Cells , Homeostasis , Humans , Lentivirus , Lysosomes/metabolism , Peptides/chemistry , Protein Binding , Protein Conformation , Protein Domains , Sorting Nexins/metabolism , Virus Internalization
4.
Front Microbiol ; 12: 723818, 2021.
Article in English | MEDLINE | ID: covidwho-1581279

ABSTRACT

COVID-19 is a severe disease in humans, as highlighted by the current global pandemic. Several studies about the metabolome of COVID-19 patients have revealed metabolic disorders and some potential diagnostic markers during disease progression. However, the longitudinal changes of metabolomics in COVID-19 patients, especially their association with disease progression, are still unclear. Here, we systematically analyzed the dynamic changes of the serum metabolome of COVID-19 patients, demonstrating that most of the metabolites did not recover by 1-3 days before discharge. A prominent signature in COVID-19 patients comprised metabolites of amino acids, peptides, and analogs, involving nine essential amino acids, 10 dipeptides, and four N-acetylated amino acids. The levels of 12 metabolites in amino acid metabolism, especially three metabolites of the ornithine cycle, were significantly higher in severe patients than in mild ones, mainly on days 1-3 or 4-6 since onset. Integrating blood metabolomic, biochemical, and cytokine data, we uncovered a highly correlated network, including 6 cytokines, 13 biochemical parameters, and 49 metabolites. Significantly, five ornithine cycle-related metabolites (ornithine, N-acetylornithine, 3-amino-2-piperidone, aspartic acid, and asparagine) highly correlated with "cytokine storms" and coagulation index. We discovered that the ornithine cycle dysregulation significantly correlated with inflammation and coagulation in severe patients, which may be a potential mechanism of COVID-19 pathogenicity. Our study provided a valuable resource for detailed exploration of metabolic factors in COVID-19 patients, guiding metabolic recovery, understanding the pathogenic mechanisms, and creating drugs against SARS-CoV-2 infection.

5.
Front Psychol ; 12: 721304, 2021.
Article in English | MEDLINE | ID: covidwho-1463507

ABSTRACT

The current study investigates the impact of fear related to coronavirus 2019 (COVID-19) disease on situational humor, and also on social networking sites (SNS) usage as a mediator. Furthermore, this study investigates the impact of fear-related COVID-19 disease on situation humor via SNS usage, focusing on the gender perspective of university students. This study also examined the impact of fear related to COVID-19 disease on situational humor in students from various degree programs, such as BS and MS. For this cross-sectional study, data were collected from 24 different Pakistani universities using purposive sampling between December 2020 and May 2021. This study used social media platforms like WhatsApp, Facebook, LinkedIn, and Twitter (and also email) to collect data online. According to the findings of this study, fear related to COVID-19 disease was found to be significantly negatively related to situational humor and SNS usage, whereas SNS usage was positively related to situational humor. The findings also revealed that SNS usage is a key mediator in the relationship between fear related to COVID-19 disease and situational humor. In addition, male university students used more SNS and had a higher situational humor response than female university students, and female university students reported a higher fear related to COVID-19 disease. This study provided useful findings of the impact of fear related to COVID-19 disease on situational humor among students in various academic programs, such as bachelor's program and master's program.

6.
International Journal of Infectious Diseases ; 95:436-440, 2020.
Article in English | CAB Abstracts | ID: covidwho-1409652

ABSTRACT

Background: The differential diagnosis between novel coronavirus pneumonia patients (NCPP) and influenza patients (IP) remains a challenge in clinical practice.

7.
Brief Bioinform ; 22(2): 946-962, 2021 03 22.
Article in English | MEDLINE | ID: covidwho-1352109

ABSTRACT

Given the scale and rapid spread of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, or 2019-nCoV), there is an urgent need to identify therapeutics that are effective against COVID-19 before vaccines are available. Since the current rate of SARS-CoV-2 knowledge acquisition via traditional research methods is not sufficient to match the rapid spread of the virus, novel strategies of drug discovery for SARS-CoV-2 infection are required. Structure-based virtual screening for example relies primarily on docking scores and does not take the importance of key residues into consideration, which may lead to a significantly higher incidence rate of false-positive results. Our novel in silico approach, which overcomes these limitations, can be utilized to quickly evaluate FDA-approved drugs for repurposing and combination, as well as designing new chemical agents with therapeutic potential for COVID-19. As a result, anti-HIV or antiviral drugs (lopinavir, tenofovir disoproxil, fosamprenavir and ganciclovir), antiflu drugs (peramivir and zanamivir) and an anti-HCV drug (sofosbuvir) are predicted to bind to 3CLPro in SARS-CoV-2 with therapeutic potential for COVID-19 infection by our new protocol. In addition, we also propose three antidiabetic drugs (acarbose, glyburide and tolazamide) for the potential treatment of COVID-19. Finally, we apply our new virus chemogenomics knowledgebase platform with the integrated machine-learning computing algorithms to identify the potential drug combinations (e.g. remdesivir+chloroquine), which are congruent with ongoing clinical trials. In addition, another 10 compounds from CAS COVID-19 antiviral candidate compounds dataset are also suggested by Molecular Complex Characterizing System with potential treatment for COVID-19. Our work provides a novel strategy for the repurposing and combinations of drugs in the market and for prediction of chemical candidates with anti-COVID-19 potential.


Subject(s)
Antiviral Agents/pharmacology , SARS-CoV-2/drug effects , Drug Discovery , Drug Repositioning/methods , Molecular Docking Simulation
8.
J Cardiovasc Pharmacol ; 78(5): e648-e655, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1331600

ABSTRACT

ABSTRACT: The novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved into a global pandemic. The substantial morbidity and mortality associated with the infection has prompted us to understand potential risk factors that can predict patient outcomes. Hypertension has been identified as the most prevalent cardiovascular comorbidity in patients infected with COVID-19 that demonstrably increases the risk of hospitalization and death. Initial studies implied that renin-angiotensin-aldosterone system inhibitors might increase the risk of viral infection and aggravate disease severity, thereby causing panic given the high global prevalence of hypertension. Nonetheless, subsequent evidence supported the administration of antihypertensive drugs and noted that they do not increase the severity of COVID-19 infection in patients with hypertension, rather may have a beneficial effect. To date, the precise mechanism by which hypertension predisposes to unfavorable outcomes in patients infected with COVID-19 remains unknown. In this mini review, we elaborate on the pathology of SARS-CoV-2 infection coexisting with hypertension and summarize potential mechanisms, focusing on the dual roles of angiotensin-converting enzyme 2 and the disorders of renin-angiotensin-aldosterone system in COVID-19 and hypertension. The effects of proinflammatory factors released because of immune response and gastrointestinal dysfunction in COVID-19 are also discussed.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Hypertension/enzymology , Renin-Angiotensin System , SARS-CoV-2/pathogenicity , Angiotensin-Converting Enzyme 2/antagonists & inhibitors , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Animals , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , COVID-19/enzymology , COVID-19/mortality , COVID-19/therapy , Comorbidity , Host-Pathogen Interactions , Humans , Hypertension/drug therapy , Hypertension/mortality , Hypertension/physiopathology , Inflammation Mediators/metabolism , Prognosis , Renin-Angiotensin System/drug effects , Risk Assessment , Risk Factors , Severity of Illness Index
9.
Open Journal of Preventive Medicine ; 11(4):159-167, 2021.
Article in English | CAB Abstracts | ID: covidwho-1263022

ABSTRACT

New coronavirus pneumonia spread rapidly all over the world in the first half of 2020, which is a new respiratory disease with strong infectiousness. At present, the epidemic situation in China has been effectively controlled, but the global epidemic situation remains grim, and the National Health Commission has instructed that the prevention and control of new coronavirus pneumonia should become normalized. As outposts for surveillance of public health events, hospitals are an important front in the fight against the epidemic. Therefore, it is very crucial to construct infection prevention and control system actively to contain the outbreak. This paper analyzes and summarizes the normal prevention and control management strategy of Infection Control Branch Management (hereinafter referred to as Hospital Infection-Control Dept) in a certain designated comprehensive third-grade hospital in Guangdong Province and transforms the prevention and control means in emergency state into measures for sustainable development, which also provides basis and reference for Hospital Infection-Control Dept of medical institutions to formulate prevention and control guidelines.

10.
Asian J Androl ; 23(5): 479-483, 2021.
Article in English | MEDLINE | ID: covidwho-1225879

ABSTRACT

The novel coronavirus disease (COVID-19) pandemic is emerging as a global health threat and shows a higher risk for men than women. Thus far, the studies on andrological consequences of COVID-19 are limited. To ascertain the consequences of COVID-19 on sperm parameters after recovery, we recruited 41 reproductive-aged male patients who had recovered from COVID-19, and analyzed their semen parameters and serum sex hormones at a median time of 56 days after hospital discharge. For longitudinal analysis, a second sampling was obtained from 22 of the 41 patients after a median time interval of 29 days from first sampling. Compared with controls who had not suffered from COVID-19, the total sperm count, sperm concentration, and percentages of motile and progressively motile spermatozoa in the patients were significantly lower at first sampling, while sperm vitality and morphology were not affected. The total sperm count, sperm concentration, and number of motile spermatozoa per ejaculate were significantly increased and the percentage of morphologically abnormal sperm was reduced at the second sampling compared with those at first in the 22 patients examined. Though there were higher prolactin and lower progesterone levels in patients at first sampling than those in controls, no significant alterations were detected for any sex hormones examined over time following COVID-19 recovery in the 22 patients. Although it should be interpreted carefully, these findings indicate an adverse but potentially reversible consequence of COVID-19 on sperm quality.


Subject(s)
COVID-19/physiopathology , SARS-CoV-2 , Semen/physiology , Spermatozoa/physiology , Adult , Asthenozoospermia/virology , COVID-19/complications , China , Gonadal Steroid Hormones/blood , Humans , Male , Progesterone/blood , Prolactin/blood , Semen Analysis , Sperm Count , Sperm Motility , Spermatozoa/abnormalities , Time Factors
11.
Ann Palliat Med ; 10(1): 37-44, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-972002

ABSTRACT

BACKGROUND: To explore computed tomography (CT) characteristics of the 2019 novel coronavirus (COVID-19) pneumonia and explore variations among the different clinical types. METHODS: Clinical and CT imaging data of 43 patients diagnosed with COVID-19 in our hospital and the cooperative hospital between January 15-30, 2020 were collected (27 male and 16 female). Patients were classified as common type (26 cases, 60%), severe type (14 cases, 33%) or critical type (three cases, 7%) according to the new coronavirus pneumonia treatment scheme (sixth edition). Patient clinical data and CT images were analyzed and evaluated. RESULTS: Fever was the main symptom in common type COVID-19 cases (23/26, 88.46%). Both severe and critical type COVID-19 patients had fever and cough symptoms, and dyspnea was observed in all three critical COVID-19 patients. CT manifestations in the common type COVID-19 cohort were bilateral involvement (20/26, 71%), multiple lesions (14/26, 54%), ground-glass density shadow (17/26, 65%), and some cases were accompanied by local consolidation (9/26, 35%), which is consistent with early stage COVID-19 CT performance. CT manifestations in the severe and critical types involved both lungs. Severe COVID-19 cases predominantly consisted of multiple mixed-density lesions (10/14, 71%), and a few patients showed diffuse lung glass density shadows in both lungs (4/14, 29%), which is consistent with the progression stage COVID-19 CT performance. Critical COVID-19 cases exhibited mixed-density lesions, and two cases displayed "white lung", which is the CT manifestation at the severe COVID-19 stage. Only one critical COVID-19 patient had pleural effusion. CONCLUSIONS: The CT manifestations of COVID-19 are specific and there are variations between different clinical types. Thus, CT is an important clinical tool for early diagnosis and assessment of the severity of COVID-19.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Female , Humans , Lung/virology , Male , Middle Aged , Retrospective Studies
12.
PLoS One ; 15(12): e0243195, 2020.
Article in English | MEDLINE | ID: covidwho-953970

ABSTRACT

BACKGROUND: The current worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has posed a serious threat to global public health, and the mortality rate of critical ill patients remains high. The purpose of this study was to identify factors that early predict the progression of COVID-19 from severe to critical illness. METHODS: This retrospective cohort study included adult patients with severe or critical ill COVID-19 who were consecutively admitted to the Zhongfaxincheng campus of Tongji Hospital (Wuhan, China) from February 8 to 18, 2020. Baseline variables, data at hospital admission and during hospital stay, as well as clinical outcomes were collected from electronic medical records system. The primary endpoint was the development of critical illness. A multivariable logistic regression model was used to identify independent factors that were associated with the progression from severe to critical illness. RESULTS: A total of 138 patients were included in the analysis; of them 119 were diagnosed as severe cases and 16 as critical ill cases at hospital admission. During hospital stay, 19 more severe cases progressed to critical illness. For all enrolled patients, longer duration from diagnosis to admission (odds ratio [OR] 1.108, 95% CI 1.022-1.202; P = 0.013), pulse oxygen saturation at admission <93% (OR 5.775, 95% CI 1.257-26.535; P = 0.024), higher neutrophil count (OR 1.495, 95% CI 1.177-1.899; P = 0.001) and higher creatine kinase-MB level at admission (OR 2.449, 95% CI 1.089-5.511; P = 0.030) were associated with a higher risk, whereas higher lymphocyte count at admission (OR 0.149, 95% CI 0.026-0.852; P = 0.032) was associated with a lower risk of critical illness development. For the subgroup of severe cases at hospital admission, the above factors except creatine kinase-MB level were also found to have similar correlation with critical illness development. CONCLUSIONS: Higher neutrophil count and lower lymphocyte count at admission were early independent predictors of progression to critical illness in severe COVID-19 patients.


Subject(s)
COVID-19/diagnosis , Critical Illness , Disease Progression , COVID-19/pathology , COVID-19/therapy , Cohort Studies , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Treatment Outcome
13.
Future Virol ; 2020 Oct.
Article in English | MEDLINE | ID: covidwho-895275

ABSTRACT

Aim: The outbreak of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has had serious repercussions worldwide. This study was aimed to evaluate the accuracy of a new kit for detection of SARS-CoV-2 compared with similar detection kit. Materials & methods: A total of 500 subjects were included and tested with both the new test and control kits. Clinical diagnosis results were taken as the reference standard. Results: Compared with clinical diagnosis, the sensitivity of the test kit was 82.64%, specificity was 98.45% and total coincidence rate was 90.80%. The total coincidence rate, sensitivity and specificity between control kit and clinical diagnosis were 89.20%, 78.10% and 99.61%, respectively. Conclusions: The new kit was comparable to the similar detection kit for detection of SARS-CoV-2 in sensitivity, specificity and total coincidence rate.

14.
Ind Crops Prod ; 158: 112985, 2020 Dec 15.
Article in English | MEDLINE | ID: covidwho-893964

ABSTRACT

Optimizing the processing technology is an effective way to improve the yield of active ingredients for the industrial production of medicinal crops. Baikal Skullcap (Scutellaria baicalensis Georgi) is a perennial herb in the Lamiaceae family and its dried root is used as a famous traditional Chinese medicine (TCM). Modern pharmacological studies have shown that the active ingredients of S. baicalensis have important pharmacological effects including anti-oxidation, anti-bacterial, anti-viral, anti-tumor, and anti-inflammation. Specifically, it is recently found that S. baicalensis has significant curative effects on the treatment of corona virus disease 2019 (COVID-19). In recent years, the market demand for the medicinal products of S. baicalensis is increasing because of its great medicinal values. However, the annual yield of active ingredients originated from the root of S. baicalensis is limited due to that little progress has been made on the traditional processing technology used in the extraction process. A pressing issue faced by both herbalists and scientists is how to improve the processing efficiency, thereby obtaining the maximum yield of products for S. baicalensis. In this study, a systematic analysis on the effects of growth years and post-harvest processing on the contents of medicinal active ingredients of S. baicalensis was conducted. The contents of eight active ingredients (baicalin, wogonoside, baicalein, wogonin, scutellarin, scutellarein, apigenin, and chrysin) in roots of S. baicalensis of different growth years (ranging from 1 year to 15 years) were estimated using high performance liquid chromatography (HPLC) and further analyzed to determine the optimal harvest period. In particular, the contents of six active ingredients in different parts (cortex and stele) of the root of S. baicalensis were estimated and compared. Meanwhile, the dynamic changes of the contents of active ingredients in fresh-crush and fresh-cut roots of S. baicalensis at room temperature were compared and analyzed to reveal the influence of post-harvest treatment on the contents of active ingredients. In addition, the effects of six different post-harvest treatments on the contents of active ingredients were systematically designed and compared to determine the best primary processing technology. The results showed that the best harvesting period for S. baicalensis should be determined as 2-3 years based on comprehensive evaluation of active ingredient content, annual yield increment, and land use efficiency. The contents of active ingredients including baicalin, wogonoside, baicalein, and wogonin in cortex were significantly higher than those in stele (P ≤  0.05). The contents of baicalin, wogonoside, and scutellarin in fresh roots of S. baicalensis significantly reduced as the storage time increased, but the reduction of fresh-cutting was significantly lower than that of fresh-crushing. For the effects of different processing treatments, the contents of four main active ingredients (baicalin, wogonoside, baicalein, and wogonin) under drying (D) and cutting-drying (C-D) treatments were significantly higher than those of the other four treatments (P ≤  0.05). Collectively, the above results will not only provide novel processing methods that will improve the yield of active ingredients for S. baicalensis, but also shed light on the optimization of processing technology for the industrial production of medicinal crops.

15.
Front Med (Lausanne) ; 7: 374, 2020.
Article in English | MEDLINE | ID: covidwho-646639

ABSTRACT

Background: The predictive value of prealbumin for the prognosis of coronavirus disease 2019 (COVID-19) has not been extensively investigated. Methods: A total of 1,115 patients with laboratory-confirmed COVID-19 were enrolled at Tongji hospital from February to April 2020 and classified into fatal (n = 129) and recovered (n = 986) groups according to the patient's outcome. Prealbumin and other routine laboratory indicators were measured simultaneously. Results: The level of prealbumin on admission was significantly lower in fatal patients than in recovered patients. For predicting the prognosis of COVID-19, the performance of prealbumin was better than most routine laboratory indicators, such as albumin, lymphocyte count, neutrophil count, hypersensitive C-reactive protein, d-dimer, lactate dehydrogenase, creatinine, and hypersensitive cardiac troponin I. When a threshold of 126 mg/L was used to discriminate between fatal and recovered patients, the sensitivity and specificity of prealbumin were, respectively, 78.29 and 90.06%. Furthermore, a model based on the combination of nine indexes showed an improved performance in predicting the death of patients with COVID-19. Using a cut-off value of 0.19, the prediction model was able to distinguish between fatal and recovered individuals with a sensitivity of 86.82% and a specificity of 90.37%. Conclusions: A lower level of prealbumin on admission may indicate a worse outcome of COVID-19. Immune and nutritional status may be vital factors for predicting disease progression in the early stage of COVID-19.

16.
J Clin Immunol ; 40(7): 960-969, 2020 10.
Article in English | MEDLINE | ID: covidwho-641161

ABSTRACT

BACKGROUND: There are currently rare satisfactory markers for predicting the death of patients with coronavirus disease 2019 (COVID-19). The aim of this study is to establish a model based on the combination of serum cytokines and lymphocyte subsets for predicting the prognosis of the disease. METHODS: A total of 739 participants with COVID-19 were enrolled at Tongji Hospital from February to April 2020 and classified into fatal (n = 51) and survived (n = 688) groups according to the patient's outcome. Cytokine profile and lymphocyte subset analysis was performed simultaneously. RESULTS: The fatal patients exhibited a significant lower number of lymphocytes including B cells, CD4+ T cells, CD8+ T cells, and NK cells and remarkably higher concentrations of cytokines including interleukin-2 receptor, interleukin-6, interleukin-8, and tumor necrosis factor-α on admission compared with the survived subjects. A model based on the combination of interleukin-8 and the numbers of CD4+ T cells and NK cells showed a good performance in predicting the death of patients with COVID-19. When the threshold of 0.075 was used, the sensitivity and specificity of the prediction model were 90.20% and 90.26%, respectively. Meanwhile, interleukin-8 was found to have a potential value in predicting the length of hospital stay until death. CONCLUSIONS: Significant increase of cytokines and decrease of lymphocyte subsets are found positively correlated with in-hospital death. A model based on the combination of three markers provides an attractive approach to predict the prognosis of COVID-19.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/mortality , Cytokines/blood , Lymphocyte Subsets/immunology , Models, Biological , Pneumonia, Viral/mortality , Aged , Aged, 80 and over , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Biomarkers/blood , COVID-19 , COVID-19 Testing , China/epidemiology , Clinical Laboratory Techniques/methods , Coronavirus Infections/blood , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Cytokines/immunology , Female , Humans , Length of Stay , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Prognosis , RNA, Viral/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction , Risk Assessment/methods , SARS-CoV-2
17.
Medicine (Baltimore) ; 99(26): e20837, 2020 Jun 26.
Article in English | MEDLINE | ID: covidwho-616556

ABSTRACT

To compare clinical and imaging features between patients with an initial negative reverse-transcription-polymerase chain-reaction (RT-PCR) test and patients with an initial positive RT-PCR test. CT follow-up analysis in the negative RT-PCR group is also described.Thirty-three patients with SARS-CoV-2 infection confirmed by RT-PCR, with 216 lesions upon CT, were included. Demographic information and chest CT imaging features were collected.The average age in the whole study group was 46.9 ±â€Š11.1 years, with 18 males and 15 females. Patients in the positive RT-PCR test group were more likely to have a fever than patients in the negative RT-PCR test group (85.7% vs 50%, P < .05). Lesions in the positive group were more likely to be located in the peripheral area than lesions in the negative group (83.6% vs 68.2%, P < .05). Regarding the appearance of 216 lesions, ground-glass opacities (GGOs) with consolidation (43.2%) was the most common appearance in the negative group, followed by pure GGOs (31.8%), while in the positive group, pure GGOs (32%) and GGOs with interlobular septal thickening (32.8%) were both most frequent, and the difference between them was evident (P < .05). For the follow-up analysis, the largest short-axis of a lesion was smaller upon follow-up (median size 13.6 mm vs 14 mm), albeit by a smaller margin. Pure GGOs decreased in frequency, from 31.3% to 21.3%, while consolidation increased in frequency, from 7.5% to 12.5%.The manifestations of COVID-19 in patients with a first negative RT-PCR test and patients with a positive first RT-PCR test are different to some extent. The consolidation component may increase after follow-up.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Radiography, Thoracic/statistics & numerical data , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Adult , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Coronavirus Infections/diagnosis , False Negative Reactions , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Retrospective Studies , SARS-CoV-2
19.
Int J Infect Dis ; 95: 436-440, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-155290

ABSTRACT

BACKGROUND: The differential diagnosis between novel coronavirus pneumonia patients (NCPP) and influenza patients (IP) remains a challenge in clinical practice. METHODS: Between January 2018 and March 2020, 1,027 NCPP and 1,140 IP were recruited from Tongji hospital. Routine blood examination, biochemical indicators and coagulation function analysis were simultaneously performed in all participants. RESULTS: There was no sex predominance in NCPP. The NCPP were frequently encountered in the sixth and seventh decades of life. The mean age of NCPP (56±16 years) was higher than IP (47±17 years), but without statistical difference. Although most results of routine laboratory tests between NCPP and IP had no significant differences, some laboratory tests showed an obvious change in NCPP. It was observed that NCPP had significantly decreased white blood cells, alkaline phosphatase and d-dimer compared with IP. However, the results of lactate dehydrogenase, erythrocyte sedimentation rate and fibrinogen were significantly increased in NCPP compared with IP. The diagnostic model based on a combination of 18 routine laboratory indicators showed an area under the curve of 0.796 (95% CI, 0.777-0.814), with a sensitivity of 46.93% and specificity of 90.09% when using a cut-off value of 0.598. CONCLUSIONS: Some routine laboratory results had statistical difference between NCPP and IP. A diagnostic model based on a combination of routine laboratory results provided an adjunct approach in the differential diagnosis between NCPP and IP.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Influenza, Human/diagnosis , Pneumonia, Viral/diagnosis , Adult , Aged , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Diagnosis, Differential , Female , Humans , Leukocyte Count , Male , Middle Aged , Pandemics , SARS-CoV-2
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