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1.
Chin Med J (Engl) ; 134(17): 2131-2133, 2021 Aug 23.
Article in English | MEDLINE | ID: covidwho-1769420
2.
Int J Environ Res Public Health ; 19(6)2022 03 21.
Article in English | MEDLINE | ID: covidwho-1753495

ABSTRACT

Given that the concept of risk perception stems primarily from consumer behaviour, tourism research has tended to address the issue from tourists' perspective, resulting in a lack of consideration of destination residents' risk perception and its impact on their attitudes and subsequent behaviour. Based on the social amplification of risk framework (SARF) and the knowledge, attitudes, and practices (KAP) theory, this study constructed a theoretical model to deepen the understanding of destination residents' support for tourism. Results indicate that residents' social media use, knowledge of COVID-19 and attitudes to tourism and tourists are all positively related to their support for tourism. Furthermore, residents' risk perception is negatively associated with their attitudes to tourism, attitudes to tourists and support for tourism. However, the relationship between residents' social media use and risk perception was not confirmed. Theoretical and managerial implications were discussed.


Subject(s)
COVID-19 , Tourism , COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Humans
3.
Chin Med J (Engl) ; 133(9): 1015-1024, 2020 May 05.
Article in English | MEDLINE | ID: covidwho-1722617

ABSTRACT

BACKGROUND: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. METHODS: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. RESULTS: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown ß-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. CONCLUSION: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.


Subject(s)
Betacoronavirus , Coronavirus Infections/virology , Pneumonia, Viral/virology , Adult , Aged , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/therapy , SARS-CoV-2 , Tomography, X-Ray , Treatment Outcome
4.
Ann Transl Med ; 10(5): 264, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1716329

ABSTRACT

Since December 8, 2019, an acute respiratory illness has spread rapidly in China, causing 3,097 people to die as of March 7, and it has become a global crisis. The common symptoms are fever, fatigue, dry cough, myalgia, and dyspnea. This case report presents a 36-year-old male who was diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected pneumonia on February 2, 2020. This patient received veno-venous extracorporeal membrane oxygenation (V-V ECMO) last for 10 days as salvage treatment as his condition became critical in the acute setting. As soon as his status became stable, he began to receive an early rehabilitation program performed by our rehabilitation team. After 43 days of treatment under the efforts of our teamwork, the patient was able to walk 800 meters, and then was discharged the next day. To our knowledge, this is the first report of early physical therapy for a patient with coronavirus disease 2019 (COVID-19) who was receiving extracorporeal membrane oxygenation (ECMO) whilst awake. This case indicates that early physical rehabilitation is safe and feasible and resulted in an expedited recovery using ECMO whilst awake. The goals for physiotherapy management include avoiding atelectasis, airway clearance, weaning and increasing the functional level. This report may contribute to the current literature on early physical therapy rehabilitation programs for awake ECMO patients.

5.
Int J Environ Res Public Health ; 19(4)2022 02 14.
Article in English | MEDLINE | ID: covidwho-1690236

ABSTRACT

The recovery of the tourism industry is an important issue that has attracted much attention during the COVID-19 pandemic. Sustainable and safe festival tourism is considered an effective way of aiding in the recovery of the industry. A face-to-face survey of participants in the Guangzhou Hanfu Festival was conducted to examine the relationship between fears of COVID-19, perceived risks, perceptual evaluations, festival attitudes, behavioral intentions, and crowding during this difficult time. Results clarified how fear affects behavioral intentions in festival research, and the mediation role of perceived risk and the moderation role of crowding was confirmed. A timely set of recommendations was provided to festival operators and local governments.


Subject(s)
COVID-19 , COVID-19/epidemiology , Fear , Holidays , Humans , Intention , Pandemics , SARS-CoV-2
6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325227

ABSTRACT

Objectives: To evaluate the frequency and time course of RHS on CT in patient with COVID-19 pneumonia. Materials: and methods A total of 147 patients with COVID-19 pneumonia were divided into mild, moderate, severe and critical categories. The number, location, shape, wall appearance of RHS on CT were analyzed. Other parenchymal abnormalities include GGO, consolidation and linear opacity were also recorded. Results: RHS was observed in 37 (25.2%) of 147 patients and it was more common in patients with moderate disease than severe or critical disease (31.3% vs. 13.0%, P = 0.019). Time from symptom onset to appearance of RHS was 9 ± 5 days in moderate patients and 14 ± 8 days in severe/critical patients. A total of 64 RHS lesions were identified and the majority of lesions were located in peripheral aspect of lungs (55, 85.9%) and lower lobes (52, 81.2%). All lesions with RHS were round or oval-shaped. The rim of RHS were smooth in 54 (84.4%) and irregular in 10 (15.6%). Follow-up CT scans of 27 patients (50 lesions) showed 43(86%) lesions gradually resolved or developed into GGO and linear opacities and 7(14%) lesions remained unchanged appearance. Conclusions: RHS occurred sooner after symptom onset and with higher frequency in patients with moderate compared to those with severe or critical disease. RHS may represent a favorable prognostic sign in COVID-19 pneumonia. Key Points • 37 (25.2%) of 147 patients with COVID-19 pneumonia had RHS on at least one CT• RHS was more prevalent in patients with moderate disease than those with severe or critical disease• RHSs (78.4%) mostly occurred within 2 weeks after symptom onset

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325034

ABSTRACT

Background: A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. Objective: To examine the clinical characteristics of COVID-19in infected patients out of Wuhan, from China. Patients and Methods: Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27andFebruary 8, 2020, in Baoji city, Shanxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected;cases were divided into two groups according to the severity of infection (mild or severe). Results: : Nine (9/13) COVID-19patientsexhibitedmild disease severity, and defined as second-generation, human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P >0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms;however, there was no statistical difference between mild and severe cases in this regard (all P >0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19infection, with statistically significant differences between those with severe disease and mild infection (all P <0.05).Twelve of 13COVID-19patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P <0.05). Conclusion: Most cases of COVID-19infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19varied.Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19diseaselackedtypicalcharacteristics such as fever and changes in CT imaging features.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324186

ABSTRACT

Severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2 have been thought to originate from bat, but whether the cross-species transmission occurred directly from bat to human or through an intermediate host remains elusive. In this study, we performed CoV screening of 102 samples collected from animal-selling stalls of Wuhan Huanan Market (WHM) and pharyngeal and anal swabs from13,064 bats collected at 703 locations across China, covering almost all known southern hotspots for sarbecovirus, between 2016 and 2021. This is the first systematic survey of bat CoV in China during the outbreak of Corona Virus Disease 2019. We found four non-sarbeco CoVs in samples of WHM, and 142 SARS-CoV related CoVs (SARSr-CoV) and 4 recombinant CoVs in bats, of which YN2020B-G share the highest sequence identity with SARS-CoV among all known bat CoVs, suggesting endemic SARSr-CoVs in bats in China. However, we did not find any SARS-CoV-2 related CoVs (SC2r-CoV) in any samples, including specimens collected from the only two domestic places where RaTG13 and RmYN02 were previously reported (the Tongguan caves and the karst caves around the Xishuangbanna Tropical Botanical Garden), indicating that SC2r-CoVs might not actively circulate among bats in China. Phylogenetic analysis showed that there are three different lineages of sarbecoviruses, L1 (SARSr-CoV), L2 (SC2r-CoV), and L-R (a novel CoV lineage from L1 and L2 recombination), in China. Of note, L-R CoVs are only found in R. pusillus. Further macroscopical analysis of the genetic diversity, host specificity for colonization and accidental infection, and geographical characteristics of available CoVs in database revealed the presence of a general geographical distribution pattern for bat sarbecoviruses, with the highest genetic diversity and sequence homology to SARS-CoV or SARS-CoV-2 along the southwest border of China, the least in the northwest of China. Considering the receptor binding motifs for spike gene of sarbecoviruses in Indochina Peninsula show the greatest diversity, our data provide the rationale that extensive surveys in further south and southwest to or of China might be needed for finding closer ancestors of SARS-CoV and SARS-CoV-2.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315401

ABSTRACT

Objectives: To delineate the evolution of CT findings in patients with mild COVID-19 pneumonia outside of Wuhan. Methods: CT images and medical records of 88 patients with confirmed mild COVID-19 pneumonia outside of Wuhan, a baseline and at least one follow-up CT were retrospectively reviewed. CT features including lobar distribution and presence of ground glass opacities (GGO), consolidation, and linear opacities, were analyzed on per patient basis during each of five time intervals spanning the three weeks after disease onset. Total severity scores were calculated. Results: 85.2 % of patients had travel history to Wuhan or known contact with infected individuals. The most common symptoms were fever (84.1%) and cough (56.8%). The baseline CT was obtained on average 5 days from symptom onset. Four patients (4.5%) had negative initial CT. Significant differences were found among the time intervals in the proportion of pulmonary lesions that are 1) pure GGO, 2) mixed attenuation, 3) mixed attenuation with linear opacities, 4) consolidation with linear opacities, and 5) pure consolidation. The majority of patients had involvement of ≥ 3 lobes. Bilateral involvement was more prevalent than unilateral involvement. The proportions of patients observed to have pure GGO or GGO and consolidation decreased over time while proportion of patients with GGO and linear opacities increased. Total severity score showed an increasing trend in the first two weeks. Conclusions: While bilateral GGO are predominant features, CT findings changed during different time intervals in the three weeks after symptom onset in patients with COVID-19.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310861

ABSTRACT

With the growing importance of preventing the COVID-19 virus, face images obtained in most video surveillance scenarios are low resolution with mask simultaneously. However, most of the previous face super-resolution solutions can not handle both tasks in one model. In this work, we treat the mask occlusion as image noise and construct a joint and collaborative learning network, called JDSR-GAN, for the masked face super-resolution task. Given a low-quality face image with the mask as input, the role of the generator composed of a denoising module and super-resolution module is to acquire a high-quality high-resolution face image. The discriminator utilizes some carefully designed loss functions to ensure the quality of the recovered face images. Moreover, we incorporate the identity information and attention mechanism into our network for feasible correlated feature expression and informative feature learning. By jointly performing denoising and face super-resolution, the two tasks can complement each other and attain promising performance. Extensive qualitative and quantitative results show the superiority of our proposed JDSR-GAN over some comparable methods which perform the previous two tasks separately.

11.
Pharmacol Res ; 176: 106083, 2022 02.
Article in English | MEDLINE | ID: covidwho-1638968

ABSTRACT

The pathogenic hyper-inflammatory response has been revealed as the major cause of the severity and death of the Corona Virus Disease 2019 (COVID-19). Xuanfei Baidu Decoction (XFBD) as one of the "three medicines and three prescriptions" for the clinically effective treatment of COVID-19 in China, shows unique advantages in the control of symptomatic transition from moderate to severe disease states. However, the roles of XFBD to against hyper-inflammatory response and its mechanism remain unclear. Here, we established acute lung injury (ALI) model induced by lipopolysaccharide (LPS), presenting a hyperinflammatory process to explore the pharmacodynamic effect and molecular mechanism of XFBD on ALI. The in vitro experiments demonstrated that XFBD inhibited the secretion of IL-6 and TNF-α and iNOS activity in LPS-stimulated RAW264.7 macrophages. In vivo, we confirmed that XFBD improved pulmonary injury via down-regulating the expression of proinflammatory cytokines such as IL-6, TNF-α and IL1-ß as well as macrophages and neutrophils infiltration in LPS-induced ALI mice. Mechanically, we revealed that XFBD treated LPS-induced acute lung injury through PD-1/IL17A pathway which regulates the infiltration of neutrophils and macrophages. Additionally, one major compound from XFBD, i.e. glycyrrhizic acid, shows a high binding affinity with IL17A. In conclusion, we demonstrated the therapeutic effects of XFBD, which provides the immune foundations of XFBD and fatherly support its clinical applications.


Subject(s)
Acute Lung Injury/drug therapy , Drugs, Chinese Herbal/pharmacology , Interleukin-17/metabolism , Macrophages/drug effects , Neutrophils/drug effects , Programmed Cell Death 1 Receptor/metabolism , Signal Transduction/drug effects , Acute Lung Injury/metabolism , Animals , COVID-19/drug therapy , COVID-19/metabolism , Cell Line , China , Cytokines/metabolism , Leukocyte Count/methods , Macrophages/metabolism , Male , Mice , Mice, Inbred C57BL , Neutrophils/metabolism , RAW 264.7 Cells
12.
Small Methods ; 5(5): e2001108, 2021 05.
Article in English | MEDLINE | ID: covidwho-1599126

ABSTRACT

During the global outbreak of COVID-19 pandemic, "cytokine storm" conditions are regarded as the fatal step resulting in most mortality. Hemoperfusion is widely used to remove cytokines from the blood of severely ill patients to prevent uncontrolled inflammation induced by a cytokine storm. This article discoveres, for the first time, that 2D Ti3 C2 Tx MXene sheet demonstrates an ultrahigh removal capability for typical cytokine interleukin-6. In particular, MXene shows a 13.4 times higher removal efficiency over traditional activated carbon absorbents. Molecular-level investigations reveal that MXene exhibits a strong chemisorption mechanism for immobilizing cytokine interleukin-6 molecules, which is different from activated carbon absorbents. MXene sheet also demonstrates excellent blood compatibility without any deleterious side influence on the composition of human blood. This work can open a new avenue to use MXene sheets as an ultraefficient hemoperfusion absorbent to eliminate the cytokine storm syndrome in treatment of severe COVID-19 patients.


Subject(s)
COVID-19/immunology , Cytokine Release Syndrome/drug therapy , Hemoperfusion/methods , Nanostructures/administration & dosage , SARS-CoV-2/immunology , Titanium/administration & dosage , Adsorption , COVID-19/transmission , COVID-19/virology , Cytokine Release Syndrome/blood , Cytokine Release Syndrome/virology , Humans , Interleukin-6/immunology , Nanostructures/chemistry , SARS-CoV-2/isolation & purification , Titanium/chemistry
13.
iScience ; 25(1): 103682, 2022 Jan 21.
Article in English | MEDLINE | ID: covidwho-1587461

ABSTRACT

Human respiratory viruses are of vastly different virulence, giving rise to symptoms ranging from common cold to severe pneumonia or even death. Although this most likely impacts molecular evolution of the corresponding viruses, the specific differences in their evolutionary patterns remain largely unknown. By comparing structural and nonstructural genes within respiratory viruses, greater similarities in codon usage bias (CUB) between nonstructural genes and humans were observed in weakly virulent viruses, whereas in strongly virulent viruses, it was structural genes whose CUBs were more similar to that of humans. Further comparisons between genomes of weakly and strongly virulent coronaviruses revealed greater similarities in CUBs between strongly virulent viruses and humans. Finally, using phylogenetic independent contrasts, dissimilation of viral CUB from that of humans was observed in SARS-CoV-2. Our work revealed distinct CUB evolutionary patterns between weakly and strongly virulent viruses, a previously unrecognized interaction between CUB and virulence in respiratory viruses.

14.
Engineering (Beijing) ; 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1487711

ABSTRACT

Traditional Chinese medicine (TCM) has been successfully applied worldwide in the treatment of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the pharmacological mechanisms underlying this success remain unclear. Hence, the aim of this review is to combine pharmacological assays based on the theory of TCM in order to elucidate the potential signaling pathways, targets, active compounds, and formulas of herbs that are involved in the TCM treatment of COVID-19, which exhibits combatting viral infections, immune regulation, and amelioration of lung injury and fibrosis. Extensive reports on target screening are elucidated using virtual prediction via docking analysis or network pharmacology based on existing data. The results of these reports indicate that an intricate regulatory mechanism is involved in the pathogenesis of COVID-19. Therefore, more pharmacological research on the natural herbs used in TCM should be conducted in order to determine the association between TCM and COVID-19 and account for the observed therapeutic effects of TCM against COVID-19.

15.
Front Med (Lausanne) ; 8: 715519, 2021.
Article in English | MEDLINE | ID: covidwho-1477836

ABSTRACT

Background: Secondary infections pose tremendous challenges in Coronavirus disease 2019 (COVID-19) treatment and are associated with higher mortality rates. Clinicians face of the challenge of diagnosing viral infections because of low sensitivity of available laboratory tests. Case Presentation: A 66-year-old woman initially manifested fever and shortness of breath. She was diagnosed as critically ill with COVID-19 using quantitative reverse transcription PCR (RT-qPCR) and treated with antiviral therapy, ventilator and extracorporeal membrane oxygenation (ECMO). However, after the condition was relatively stabled for a few days, the patient deteriorated with fever, frequent cough, increased airway secretions, and increased exudative lesions in the lower right lung on chest X-rays, showing the possibility of a newly acquired infection, though sputum bacterial and fungal cultures and smears showed negative results. Using metagenomic next-generation sequencing (mNGS), we identified a reactivation of latent human herpes virus type 1 (HHV-1) in the respiratory tract, blood and gastrointestinal tract, resulting in a worsened clinical course in a critically ill COVID-19 patient on ECMO. Anti-HHV-1 therapy guided by these sequencing results effectively decreased HHV-1 levels, and improved the patient's clinical condition. After 49 days on ECMO and 67 days on the ventilator, the 66-year-old patient recovered and was discharged. Conclusions: This case report demonstrates the potential value of mNGS for evidence-based treatment, and suggests that potential reactivation of latent viruses should be considered in critically ill COVID-19 patients.

16.
J Ethnopharmacol ; 283: 114701, 2022 Jan 30.
Article in English | MEDLINE | ID: covidwho-1446835

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Xuanfei Baidu Decoction (XFBD), one of the "three medicines and three prescriptions" for the clinically effective treatment of COVID-19 in China, plays an important role in the treatment of mild and/or common patients with dampness-toxin obstructing lung syndrome. AIM OF THE STUDY: The present work aims to elucidate the protective effects and the possible mechanism of XFBD against the acute inflammation and pulmonary fibrosis. METHODS: We use TGF-ß1 induced fibroblast activation model and LPS/IL-4 induced macrophage inflammation model as in vitro cell models. The mice model of lung fibrosis was induced by BLM via endotracheal drip, and then XFBD (4.6 g/kg, 9.2 g/kg) were administered orally respectively. The efficacy and molecular mechanisms in the presence or absence of XFBD were investigated. RESULTS: The results proved that XFBD can effectively inhibit fibroblast collagen deposition, down-regulate the level of α-SMA and inhibit the migration of fibroblasts. IL-4 induced macrophage polarization was also inhibited and the secretions of the inflammatory factors including IL6, iNOS were down-regulated. In vivo experiments, the results proved that XFBD improved the weight loss and survival rate of the mice. The XFBD high-dose administration group had a significant effect in inhibiting collagen deposition and the expression of α-SMA in the lungs of mice. XFBD can reduce bleomycin-induced pulmonary fibrosis by inhibiting IL-6/STAT3 activation and related macrophage infiltration. CONCLUSIONS: Xuanfei Baidu Decoction protects against macrophages induced inflammation and pulmonary fibrosis via inhibiting IL-6/STAT3 signaling pathway.


Subject(s)
COVID-19/drug therapy , Drugs, Chinese Herbal , Inflammation/drug therapy , Macrophages/drug effects , SARS-CoV-2 , Signal Transduction/drug effects , Animals , Cell Survival/drug effects , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/therapeutic use , Fibroblasts/drug effects , Gene Expression Regulation/drug effects , Gene Regulatory Networks , Humans , Interleukin-6/antagonists & inhibitors , Interleukin-6/genetics , Interleukin-6/metabolism , Male , Mice , Mice, Inbred C57BL , NIH 3T3 Cells , Phytotherapy , Pulmonary Fibrosis/pathology , Pulmonary Fibrosis/prevention & control , RAW 264.7 Cells , STAT3 Transcription Factor/antagonists & inhibitors , STAT3 Transcription Factor/genetics , STAT3 Transcription Factor/metabolism
17.
Chin Med J (Engl) ; 134(17): 2131-2133, 2021 Aug 23.
Article in English | MEDLINE | ID: covidwho-1405069
18.
J Med Virol ; 92(9): 1681-1683, 2020 09.
Article in English | MEDLINE | ID: covidwho-1384206

ABSTRACT

As an emerging infectious disease, the clinical course and virological course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remain to be further investigated. In this case report, we described a case of SARS-CoV-2 infection with the clinical course for more than 2 months. This patient had recovered from pneumonia after treatment. The viral RNA of throat swabs became negative and the viral-specific antibodies were produced during the recovery period. However, the viral RNA reappeared and additionally persisted in throat swabs for more than 40 days. In addition, the viral RNA was detected in multiple types of specimens with extremely high titers in the saliva. In conclusion, these findings indicate that SARS-CoV-2 can cause a long clinical course. The coexistence of viral RNA and viral-specific antibodies may imply an immune evasion of SARS-CoV-2 from the host's immune system.


Subject(s)
COVID-19/diagnosis , COVID-19/virology , RNA, Viral , SARS-CoV-2/genetics , Virus Shedding , Adult , Biomarkers , Disease Management , Humans , Male , Symptom Assessment , Time Factors , Tomography, X-Ray Computed
19.
Hepatobiliary Surg Nutr ; 10(4): 486-497, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1372186

ABSTRACT

BACKGROUND: Increased risks have been found for patients undergoing liver transplantation due to the blood supply shortage following the ongoing coronavirus disease 2019 (COVID-19) pandemic. Hence, exploring a method to alleviate this dilemma is urgent. This phase I, nonrandomized, prospective trial aimed to evaluate the safety and feasibility of using donor-specific red blood cell transfusion (DRBCT) as an urgent measurement to alleviate the blood supply shortage in deceased donor liver transplantation (DDLT). METHODS: The outcomes of 26 patients who received DRBCT and 37 patients in the control group who only received 3rd party packed red blood cells (pRBCs) transfusion between May 2020 and January 2021 were compared. RESULTS: Patients receiving DRBCT did not develop transfusion-related complications, and the incidence of postoperative infection was similar to that in the control group (23.1% vs. 18.9%, P=0.688). Because the patients received the red blood cells from organ donors, the median volume of intraoperative allogeneic red blood cell transfusion from blood bank was 4.0 U (IQR 1.1-8.0 U) in the DRBCT group, which is significantly lower than that (7.5 U, IQR 4.0-10.0 U) in the control group (P=0.018). The peak aspartate aminotransferase (AST) level was significantly lower in the DRBCT group than in the control group (P=0.008) and so were the AST levels in the first two days after the operation (P=0.006 and P=0.033). CONCLUSIONS: DRBCT is a safe and effective procedure to lower the need for blood supply and is associated with a reduction in AST levels after transplantation. DRBCT is beneficial to patients receiving life-saving transplantation without sufficient blood supply during the COVID-19 pandemic.

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