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1.
Clin Infect Dis ; 71(15): 778-785, 2020 07 28.
Article in English | MEDLINE | ID: covidwho-1217823

ABSTRACT

BACKGROUND: The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)-based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. METHODS: The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort. RESULTS: The median duration of IgM and IgA antibody detection was 5 (IQR, 3-6) days, while IgG was detected 14 (IQR, 10-18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%). CONCLUSIONS: The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Immunity, Humoral/immunology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Adult , Amino Acid Sequence , Antibodies, Viral/immunology , Child , Child, Preschool , Coronavirus Infections/virology , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/virology , Polymerase Chain Reaction/methods
2.
Am J Psychiatry ; : appiajp202020070979, 2021 Apr 26.
Article in English | MEDLINE | ID: covidwho-1201589

ABSTRACT

OBJECTIVE: Increased anxiety in response to the COVID-19 pandemic has been widely noted. The purpose of this study was to test whether the prepandemic functional connectome predicted individual anxiety induced by the pandemic. METHODS: Anxiety scores from healthy undergraduate students were collected during the severe and remission periods of the pandemic (first survey, February 22-28, 2020, N=589; second survey, April 24 to May 1, 2020, N=486). Brain imaging data and baseline (daily) anxiety ratings were acquired before the pandemic. The predictive performance of the functional connectome on individual anxiety was examined using machine learning and was validated in two external undergraduate student samples (N=149 and N=474). The clinical relevance of the findings was further explored by applying the connectome-based neuromarkers of pandemic-related anxiety to distinguish between individuals with specific mental disorders and matched healthy control subjects (generalized anxiety disorder, N=43; major depression, N=536; schizophrenia, N=72). RESULTS: Anxiety scores increased from the prepandemic baseline to the severe stage of the pandemic and remained high in the remission stage. The prepandemic functional connectome predicted pandemic-related anxiety and generalized to the external sample but showed poor performance for predicting daily anxiety. The connectome-based neuromarkers of pandemic-related anxiety further distinguished between participants with generalized anxiety and healthy control subjects but were not useful for diagnostic classification in major depression and schizophrenia. CONCLUSIONS: These findings demonstrate the feasibility of using the functional connectome to predict individual anxiety induced by major stressful events (e.g., the current global health crisis), which advances our understanding of the neurobiological basis of anxiety susceptibility and may have implications for developing targeted psychological and clinical interventions that promote the reduction of stress and anxiety.

3.
Int J Med Sci ; 18(10): 2128-2136, 2021.
Article in English | MEDLINE | ID: covidwho-1190599

ABSTRACT

Purpose: To analyze the chest CT imaging findings of patients with initial negative RT-PCR and to compare with the CT findings of the same sets of patients when the RT-PCR turned positive for SARS-CoV-2 a few days later. Materials and methods: A total of 32 patients (8 males and 24 females; 52.9±7years old) with COVID-19 from 27 January and 26 February 2020 were enrolled in this retrospective study. Clinical and radiological characteristics were analyzed. Results: The median period (25%, 75%) between initial symptoms and the first chest CT, the initial negative RT-PCR, the second CT and the positive RT-PCR were 7(4.25,11.75), 7(5,10.75), 15(11,23) and 14(10,22) days, respectively. Ground glass opacities was the most frequent CT findings at both the first and second CTs. Consolidation was more frequently observed on lower lobes, and more frequently detected during the second CT (64.0%) with positive RT-PCR than the first CT with initial negative RT-PCR (53.1%). The median of total lung severity score and the number of lobes affected had significant difference between twice chest CT (P=0.007 and P=0.011, respectively). Conclusion: In the first week of disease course, CT was sensitive to the COVID-19 with initial negative RT-PCR. Throat swab test turned positive while chest CT mostly demonstrated progression.


Subject(s)
/methods , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed/methods , /etiology , Female , Humans , Male , Middle Aged , Pneumonia, Viral/etiology , Reverse Transcriptase Polymerase Chain Reaction , Thorax , Time Factors
4.
Sociological Perspectives ; : 1, 2021.
Article | WHO COVID | ID: covidwho-1183476

ABSTRACT

Using an inductive framing analysis of news coverage, we examine how the most popular liberal and conservative news media in the United States and South Korea mobilize different nationalist narratives on China in responding to social, economic, and political upheavals during the early stages of the COVID-19 pandemic We identify three major areas of political cleavage in both Korean and U S media discourse on nationalist identities vis-à-vis the construction of the national or racialized “Other ” This includes (1) imagined solidarity against China as an adversary;(2) political disputes over boundary-making;(3) and the construction of ethnonational belonging and exclusion Our research underscores how intrastate and interstate shifts during periods of crisis can heighten political cleavages along racial and ethnic fault lines and complicate dominant frameworks of civic and ethnic nationalism in both countries [ABSTRACT FROM AUTHOR] Copyright of Sociological Perspectives 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 )

5.
Science ; 2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1180894

ABSTRACT

Vaccination and infection promote the formation, tissue distribution, and clonal evolution of B cells, which encode humoral immune memory. We evaluated convergent antigen-specific antibody genes of similar sequences shared between individuals in pediatric and adult blood, and deceased organ donor tissues. B cell memory varied for different pathogens. Polysaccharide antigen-specific clones were not exclusive to the spleen. Adults had higher clone frequencies and greater class-switching in lymphoid tissues than blood, while pediatric blood had abundant class-switched convergent clones. Consistent with reported serology, pre-pandemic children had class-switched convergent clones to SARS-CoV-2 with weak cross-reactivity to other coronaviruses, while adult blood or tissues showed few such clones. The results highlight the prominence of early childhood B cell clonal expansions and cross-reactivity for future responses to novel pathogens.

7.
J Infect Dis ; 2021 Apr 04.
Article in English | MEDLINE | ID: covidwho-1169673

ABSTRACT

BACKGROUND: Post-discharge immunity and its correlation with clinical features among patients recovered from COVID-19 are poorly described. This prospective cross-sectional study explored the inflammatory profiles and clinical recovery of COVID-19 patients at 3 months post-discharge. METHODS: COVID-19 patients discharged from four hospitals in Wuhan, recovered asymptomatic patients (APs) from an isolation hotel, and uninfected healthy controls (HCs) were recruited. Viral nucleic acid and antibody detection, laboratory examination, computed tomography, pulmonary function assessment, multiplex cytokine assay, and flow cytometry were performed. RESULTS: The 72 age-, sex- and body mass index-matched participants included 19 severe/critical patients (SPs), 20 mild/moderate patients (MPs), 16 APs, and 17 HCs. At 3 months after discharge, levels of pro-inflammatory cytokines and factors related to vascular injury/repair in recovered COVID-19 patients had not returned to those of the HCs, especially among recovered SPs compared to recovered MPs and APs. These cytokines were significantly correlated with impaired pulmonary function and chest CT abnormalities. However, levels of immune cells had returned to nearly normal levels and were not significantly correlated with abnormal clinical features. CONCLUSION: Vascular injury, inflammation, and chemotaxis persisted in COVID-19 patients and were correlated with abnormal clinical features 3 months after discharge, especially in recovered SPs.

8.
Curr Drug Targets ; 2021 Mar 19.
Article in English | MEDLINE | ID: covidwho-1145507

ABSTRACT

ACE2 has long been known as an injury protective protein, it can protect a variety of organ damage such as heart, liver, kidney and lung. Especially in cardiovascular diseases, ACE2, as a negative regulator of RAAS, is an extremely important protective factor that mainly plays a role by converting Ang Ⅱ to Ang-(1-7). Nevertheless, with the recent outbreak of COVID-19, it was exposed that another identity of ACE2 is the entry receptor for SARS-CoV-2, which previously served as the entry receptor for SARS. With the in-depth clinical research, it was found that the severity and susceptibility of COVID-19 are related to cardiovascular disease, and SARS-CoV-2 binding to ACE2 receptor is also potentially associated with heart injury symptoms. Therefore, in this article, we mainly review the relationship between ACE2, COVID-19 and cardiovascular system diseases/heart injury.

9.
Front Microbiol ; 11: 1552, 2020.
Article in English | MEDLINE | ID: covidwho-686841

ABSTRACT

Respiratory virus infections are one of the major causes of acute respiratory disease or exacerbation of chronic obstructive pulmonary disease (COPD). However, next-generation sequencing has not been used for routine viral detection in clinical respiratory samples owing to its sophisticated technology. Here, several pharyngeal samples with COPD were collected to enrich viral particles using an optimized method (M3), which involved M1 with centrifugation, filtration, and concentration, M2 (magnetic beads) combined with mixed nuclease digestion, and M4 with no pretreatment as a control. Metagenomic sequencing and bioinformatics analyses showed that the M3 method for viral enrichment was superior in both viral sequencing composition and viral taxa when compared to M1, M2, and M4. M3 acquired the most viral reads and more complete sequences within 15-h performance, indicating that it might be feasible for viral detection in multiple respiratory samples in clinical practice. Based on sequence similarity analysis, 12 human viruses, including nine Anelloviruses and three coronaviruses, were characterized. Coronavirus OC43 with the largest number of viral reads accounted for nearly complete (99.8%) genome sequences, indicating that it may be a major viral pathogen involved in exacerbation of COPD.

11.
Nat Commun ; 12(1): 1346, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1111984

ABSTRACT

SARS-CoV-2 is the underlying cause for the COVID-19 pandemic. Like most enveloped RNA viruses, SARS-CoV-2 uses a homotrimeric surface antigen to gain entry into host cells. Here we describe S-Trimer, a native-like trimeric subunit vaccine candidate for COVID-19 based on Trimer-Tag technology. Immunization of S-Trimer with either AS03 (oil-in-water emulsion) or CpG 1018 (TLR9 agonist) plus alum adjuvants induced high-level of neutralizing antibodies and Th1-biased cellular immune responses in animal models. Moreover, rhesus macaques immunized with adjuvanted S-Trimer were protected from SARS-CoV-2 challenge compared to vehicle controls, based on clinical observations and reduction of viral loads in lungs. Trimer-Tag may be an important platform technology for scalable production and rapid development of safe and effective subunit vaccines against current and future emerging RNA viruses.


Subject(s)
/therapeutic use , /prevention & control , /pathogenicity , Animals , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunity, Cellular/physiology , Immunization, Passive , Immunohistochemistry , Macaca mulatta , Mice , Mice, Inbred BALB C , Microscopy, Electron , /immunology
13.
Chin J Acad Radiol ; : 1-8, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1099019

ABSTRACT

Since the outbreak of the coronavirus disease 2019 (COVID-19), it had rapidly spread to the whole world and seriously threatened the global health. Imaging examination plays an important role in the clinical diagnosis of this disease, which leads to the high infection risk of the medical staff in the radiology department. In this review, the authors thoroughly summed up the experience in the management and operation of radiology department and shared their experience of the protective and control strategies and work plan during the epidemic, including but not limited to the management framework of the radiology department, the environment and layout in the department, the requirements for protection of different posts and the equipment, as well as the essential diagnosis of COVID-19. It is worth noting that the main goal of the radiology department in every country is to complete the radiology examination safely and make an accurate diagnosis of COVID-19 patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s42058-021-00055-5.

14.
International Journal of Medical Sciences ; 18(6):1492-1501, 2021.
Article in English | WHO COVID | ID: covidwho-1089157

ABSTRACT

Objectives: As of 11 Feb 2020, a total of 1,716 medical staff infected with laboratory-confirmed the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) in China had been reported The predominant cause of the infection among medical staff remains unclear We sought to explore the epidemiological, clinical characteristics and prognosis of infected medical staff

15.
Clin Infect Dis ; 2021 Feb 17.
Article in English | MEDLINE | ID: covidwho-1087721

ABSTRACT

BACKGROUND: Elucidation of the molecular mechanisms involved in the pathogenesis of coronavirus disease (COVID-19) may help to discover therapeutic targets. METHODS: To determine the metabolomic profile of circulating plasma from COVID-19 survivors with pulmonary sequelae 3 months after discharge, a random, outcome-stratified case-control sample was analyzed. We enrolled 103 recovered COVID-19 patients as well as 27 healthy donors, and performed pulmonary function tests, computerized tomography (CT) scans, laboratory examinations, and liquid chromatography-mass spectrometry. RESULTS: Plasma metabolite profiles of COVID-19 survivors with abnormal pulmonary function were evidently different from those of healthy donors or subjects with normal pulmonary function. These alterations were associated with disease severity and mainly involved amino acid, and glycerophospholipid metabolic pathways. Furthermore, increased levels of triacylglycerols, phosphatidylcholines, prostaglandin E2, arginine, and decreased levels of betain and adenosine were associated with pulmonary CO diffusing capacity and total lung capacity. The global plasma metabolomic profile differed between subjects with abnormal and normal pulmonary function. CONCLUSIONS: Further metabolite-based analysis may help to identify the mechanisms underlying pulmonary dysfunction in COVID-19 survivors, and provide potential therapeutic targets in the future.

16.
Signal Transduct Target Ther ; 6(1): 58, 2021 02 10.
Article in English | MEDLINE | ID: covidwho-1078577

ABSTRACT

Treatment of severe Coronavirus Disease 2019 (COVID-19) is challenging. We performed a phase 2 trial to assess the efficacy and safety of human umbilical cord-mesenchymal stem cells (UC-MSCs) to treat severe COVID-19 patients with lung damage, based on our phase 1 data. In this randomized, double-blind, and placebo-controlled trial, we recruited 101 severe COVID-19 patients with lung damage. They were randomly assigned at a 2:1 ratio to receive either UC-MSCs (4 × 107 cells per infusion) or placebo on day 0, 3, and 6. The primary endpoint was an altered proportion of whole lung lesion volumes from baseline to day 28. Other imaging outcomes, 6-minute walk test (6-MWT), maximum vital capacity, diffusing capacity, and adverse events were recorded and analyzed. In all, 100 COVID-19 patients were finally received either UC-MSCs (n = 65) or placebo (n = 35). UC-MSCs administration exerted numerical improvement in whole lung lesion volume from baseline to day 28 compared with the placebo (the median difference was -13.31%, 95% CI -29.14%, 2.13%, P = 0.080). UC-MSCs significantly reduced the proportions of solid component lesion volume compared with the placebo (median difference: -15.45%; 95% CI -30.82%, -0.39%; P = 0.043). The 6-MWT showed an increased distance in patients treated with UC-MSCs (difference: 27.00 m; 95% CI 0.00, 57.00; P = 0.057). The incidence of adverse events was similar in the two groups. These results suggest that UC-MSCs treatment is a safe and potentially effective therapeutic approach for COVID-19 patients with lung damage. A phase 3 trial is required to evaluate effects on reducing mortality and preventing long-term pulmonary disability. (Funded by The National Key R&D Program of China and others. ClinicalTrials.gov number, NCT04288102.


Subject(s)
/therapy , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Umbilical Cord , Aged , Allografts , /physiopathology , Double-Blind Method , Female , Humans , Male , Middle Aged , Treatment Outcome
17.
Behavioral Sciences ; 11(2):13, 2021.
Article in English | WHO COVID | ID: covidwho-1045464

ABSTRACT

The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from 14 February 2020 to 3 March 2020 to complete an online survey Linear regression was used to examine the predictors of symptoms of depression and psychological distress Living in a non-urban area and the number of confirmed cases in their city of residence were positively associated with symptoms of depression Female gender, not being married, practicing social distancing, the amount of time spent daily on social media searching for and reading information on COVID-19, the number of confirmed cases of COVID-19 in their city of residence, and having confirmed or suspected cases of COVID-19 in personal networks were positively associated with psychological distress Social distancing is a widely used public health approach for population-wide virus-containment of COVID-19 However, reductions in population-wide psychological well-being are inadvertent consequences of social distancing There is an emerging need to negate factors that increase adverse mental health vulnerabilities during the COVID-19 pandemic

18.
Chinese Journal of Immunology ; 36(19):2330-2333, 2020.
Article in Chinese | WHO COVID | ID: covidwho-1040544

ABSTRACT

In this semester, we adopted the strategy of combining online teaching and offline practice in teaching class of Progress in Molecular Immunology and Medicine for graduate students majoring in biology Under the background of outbreak of COVID-19, content of courses with the core of "anti-virus immunity" was adopted The immunological mechanisms of COVID-19 induced by SARS-CoV2 were taught throughout the whole process, and the latest research progress of disease was taken as one of the teaching contents We also combine the teaching concept of "moral education" with the teaching content In the extension course, students are guided to participate in scientific educational activities and review writing We shared the preparation before teaching, new design of teaching content, achievements from students' learning, and summaries of characteristics and shortcomings of teaching in this paper, in order to provide direction for further improvement of teaching

19.
Int J Med Sci ; 18(3): 736-743, 2021.
Article in English | MEDLINE | ID: covidwho-1029243

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has resulted in more than 610,000 deaths worldwide since December 2019. Given the rapid deterioration of patients' condition before death, markers with efficient prognostic values are urgently required. During the treatment process, notable changes in plasma potassium levels have been observed among severely ill patients. We aimed to evaluate the association between average plasma potassium (Ka +) levels during hospitalization and 30-day mortality in patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the Zhongfaxincheng branch of Tongji Hospital in Wuhan, China from February 8 to 28, 2020 were enrolled in this study. We followed patients up to 30 days after admission. Results: A total of 136 patients were included in the study. The average age was 62.1±14.6 years and 51.5% of patients were male. The median baseline potassium level was 4.3 (3.9-4.6) mmol/L and Ka + level during hospitalization was 4.4 (4.2-4.7) mmol/L; the median number of times that we measured potassium was 4 (3-5). The 30-day mortality was 19.1%. A J-shaped association was observed between Ka + and 30-day mortality. Multivariate Cox regression showed that compared with the reference group (Ka + 4.0 to <4.5 mmol/L), 30-day mortality was 1.99 (95% confidence interval [CI]=0.54-7.35, P=0.300), 1.14 (95% CI=0.39-3.32, P=0.810), and 4.14 (95% CI=1.29-13.29, P=0.017) times higher in patients with COVID-19 who had Ka + <4.0, 4.5 to <5.0, and ≥5.0 mmol/L, respectively. Conclusion: Patients with COVID-19 who had a Ka + level ≥5.0 mmol/L had a significantly increased 30-day mortality compared with those who had a Ka + level 4.0 to <4.5 mmol/L. Plasma potassium levels should be monitored routinely and maintained within appropriate ranges in patients with COVID-19.


Subject(s)
/mortality , Hospital Mortality , Potassium/blood , Aged , Biomarkers/blood , /diagnosis , China/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment/methods , Risk Factors , Severity of Illness Index
20.
Nat Med ; 27(1): 125-135, 2021 01.
Article in English | MEDLINE | ID: covidwho-1023963

ABSTRACT

Most of what we know about adaptive immunity has come from inbred mouse studies, using methods that are often difficult or impossible to confirm in humans. In addition, vaccine responses in mice are often poorly predictive of responses to those same vaccines in humans. Here we use human tonsils, readily available lymphoid organs, to develop a functional organotypic system that recapitulates key germinal center features in vitro, including the production of antigen-specific antibodies, somatic hypermutation and affinity maturation, plasmablast differentiation and class-switch recombination. We use this system to define the essential cellular components necessary to produce an influenza vaccine response. We also show that it can be used to evaluate humoral immune responses to two priming antigens, rabies vaccine and an adenovirus-based severe acute respiratory syndrome coronavirus 2 vaccine, and to assess the effects of different adjuvants. This system should prove useful for studying critical mechanisms underlying adaptive immunity in much greater depth than previously possible and to rapidly test vaccine candidates and adjuvants in an entirely human system.


Subject(s)
Influenza Vaccines/immunology , Palatine Tonsil/immunology , Adjuvants, Immunologic , B-Lymphocytes/cytology , B-Lymphocytes/immunology , Germinal Center/cytology , Hemagglutinin Glycoproteins, Influenza Virus , Humans , In Vitro Techniques , Lymphoid Tissue/immunology , Measles-Mumps-Rubella Vaccine/immunology , Organoids/cytology , Organoids/immunology , Rabies Vaccines/immunology , T-Lymphocytes/immunology
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