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1.
Vaccines (Basel) ; 10(6)2022 Jun 04.
Article in English | MEDLINE | ID: covidwho-1884429

ABSTRACT

Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the association between influenza vaccination and COVID-19 outcomes. A total of 48,408 participants (mean age 67 years; 54.1% females) were included. The prevalence of influenza vaccination was 38.3%. After adjusting for 15 potential confounders, influenza vaccination was significantly associated with a lower risk of positivity for COVID-19 (OR = 0.95; p < 0.0001), symptomatic forms (OR = 0.87; p < 0.0001), and hospitalization for COVID-19 (OR = 0.95; p < 0.0001). The results were similar when using a propensity score approach. In conclusion, influenza vaccination may be beneficial for the prevention of COVID-19, as the present study found that influenza vaccination was associated with a small/moderate lower risk of COVID-19 infection and adverse outcomes.

2.
Infect Dis Model ; 7(2): 189-195, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1867204

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) outbreak on the Diamond Princess (DP) ship has caused over 634 cases as of February 20, 2020. We model the transmission process on DP ship as a stochastic branching process, and estimate the reproduction number at the innitial phase of 2.9 (95%CrI: 1.7-7.7). The epidemic doubling time is 3.4 days, and thus timely actions on COVID-19 control were crucial. We estimate the COVID-19 transmissibility reduced 34% after the quarantine program on the DP ship which was implemented on February 5. According to the model simulation, relocating the population at risk may sustainably decrease the epidemic size, postpone the timing of epidemic peak, and thus relieve the tensive demands in the healthcare. The lesson learnt on the ship should be considered in other similar settings.

3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337818

ABSTRACT

Annual notification number of Legionnaires’ disease (LD) increased from 66 cases in 2015 to 104 cases in 2020 in Hong Kong, with a case fatality rate (CFR) of 17.3% in 2020. This study investigated possible meteorological factors associated with confirmed LD cases and deaths. The negative binomial regression model was used for monthly LD confirmed cases and the Poisson regression model was used for monthly LD mortality cases. A decision tree model was adopted to identify the thresholds of meteorological factors if any. The confirmed LD cases were highest in July while the LD mortality were highest in August. A negative binomial regression model confirmed that maximum air temperature (P=0.081, RR=1.3, 95% CI=0.97-1.75) and rainfall (P=0.009, RR=1.02, 95% CI=1.0004-1.003) were positively correlated with the increase in confirmed LD cases. A Poisson regression model confirmed that maximum air temperature (P=0.034, RR=1.71, 95%CI=1.04-2.80) was positively correlated with the surge in LD mortality. When rainfall exceeds 78.8 mm, the public should be alerted of the increased risk of contracting LD. Temperature and rainfall were positively associated with the confirmed LD cases in Hong Kong.

4.
Res Aging ; : 1640275221100949, 2022 May 18.
Article in English | MEDLINE | ID: covidwho-1854625

ABSTRACT

OBJECTIVE: Globally, the oldest-old population is growing rapidly. Little is known about the perceived well-being of the community-dwelling oldest-old, especially during the COVID-19 pandemic. This study examined the oldest-old's perceptions of aging well and the COVID-related impacts on them. METHODS: Semi-structured in-depth interviews with 22 adults aged 85 or above were conducted with purposive sampling methods. Transcripts were analyzed using thematic analysis. RESULTS: Four main themes emerged: 1) sustaining functional ability; 2) staying active with a positive attitude; 3) feeling grateful for support from society and family; 4) COVID-19-related anxieties and policies destabilizing their well-being. DISCUSSION: This study provides direct evidence from the oldest-old on how they maintained their well-being. While they valued support from society and family, COVID-19-related measures disturbed their routines and prevented them from self-attaining well-being. The findings should be considered when developing interventions for this vulnerable group.

5.
Sensors ; 22(9):3352, 2022.
Article in English | ProQuest Central | ID: covidwho-1843240

ABSTRACT

Electrohysterogram (EHG) is a promising method for noninvasive monitoring of uterine electrical activity. The main purpose of this study was to characterize the multichannel EHG signals to distinguish between term delivery and preterm birth, as well as deliveries within and beyond 24 h. A total of 219 pregnant women were grouped in two ways: (1) term delivery (TD), threatened preterm labor (TPL) with the outcome of preterm birth (TPL_PB), and TPL with the outcome of term delivery (TPL_TD);(2) EHG recording time to delivery (TTD) ≤ 24 h and TTD > 24 h. Three bipolar EHG signals were analyzed for the 30 min recording. Six EHG features between multiple channels, including multivariate sample entropy, mutual information, correlation coefficient, coherence, direct partial Granger causality, and direct transfer entropy, were extracted to characterize the coupling and information flow between channels. Significant differences were found for these six features between TPL and TD, and between TTD ≤ 24 h and TTD > 24 h. No significant difference was found between TPL_PB and TPL_TD. The results indicated that EHG signals of TD were more regular and synchronized than TPL, and stronger coupling between multichannel EHG signals was exhibited as delivery approaches. In addition, EHG signals propagate downward for the majority of pregnant women regardless of different labors. In conclusion, the coupling and propagation features extracted from multichannel EHG signals could be used to differentiate term delivery and preterm birth and may predict delivery within and beyond 24 h.

6.
Int J Infect Dis ; 118: 264-269, 2022 May.
Article in English | MEDLINE | ID: covidwho-1838867

ABSTRACT

OBJECTIVES: The study aimed to explore the efficacy and safety of linezolid-based chemotherapeutic regimens for patients with postoperative multidrug-resistant spinal tuberculosis. METHODS: The randomized controlled study included 50 Mycobacterium tuberculosis culture or pathological-confirmed multidrug resistant tuberculosis patients who received spinal surgery from January 2018 to February 2020. Twenty-five patients were assigned to the control group and the study group, respectively. Random number method was used for patient allocation and they were treated with levofloxacin, pyrazinamide, thioisonicotinamide enteric-coated tablet, amikacin sulfate injection, and sodium p-amino salicylate injection, accompanied by linezolid or not. RESULTS: The overall effective rate of the study group was higher than that of the control group (88.00% vs 64.00%, P<0.05). The severity of pain at 3 and 6 months postoperatively was lower in the study group than that in the control group (P<0.05). Postoperatively, the study group had higher bone graft fusion rate, shorter mean bone graft fusion time, and higher paraspinal cyst absorption rate than the control group (P<0.05). Postoperatively, the study group had lower levels of PCT, ESR, and CRP than the control group (P <0.05). All patients had normal hepatic and renal function, and no statistical difference of adverse effects between 2 groups were found. CONCLUSIONS: Linezolid-based chemotherapeutic regimens can effectively treat patients with postoperative multidrug-resistant spinal tuberculosis but have higher rates of adverse reactions.


Subject(s)
Linezolid , Tuberculosis, Multidrug-Resistant , Tuberculosis, Spinal , Humans , Linezolid/adverse effects , Mycobacterium tuberculosis/drug effects , Treatment Outcome , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/surgery , Tuberculosis, Spinal/drug therapy , Tuberculosis, Spinal/surgery
7.
Preprint in English | bioRxiv | ID: ppbiorxiv-490815

ABSTRACT

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic. The virus has infected more than 505 million people and caused more than 6 million deaths. However, data on non-responders to SARS-CoV-2 vaccines in the general population are limited. The objective of the study is to comprehensively compare the immunological characteristics of non-responders to SARS-CoV-2 vaccines in the 18-59 years with that in the 60 years and older using internationally recognized cutoff values. Participants included 627 individuals who received physical examinations and volunteered to participate in COVID-19 vaccination from the general population. The main outcome was an effective seroconversion characterized by anti-SARS-CoV-2 spike IgG level of at least 4-fold increase from baseline. Profiling of naive immune cells was analyzed prior to vaccination to demonstrate baseline immunity. Outcomes of effective seroconversion in the 18-59 years with that in the 60 years and older were compared. The quantitative level of the anti-spike IgG was significantly lower in the 60 years and older and in men among the 18-59 years. There were 7.5% of non-responders among the 18-59 years and 11.7% of non-responders in the 60 years and older using the 4-fold increase parameter. The effective seroconversion rate was significantly related to the level of certain immune cells before vaccination, such as CD4 cells, CD8 cells and B cells and the age. An individual with a titer of anti-SARS-CoV-2 spike IgG that is below 50 BAU/mL might be considered a non-responder between 14-90 days after the last vaccine dose. Booster vaccination or additional protective measures should be recommended for non-responders as soon as possible to reduce disease severity and mortality.

8.
Geospat Health ; 17(s1)2022 Mar 18.
Article in English | MEDLINE | ID: covidwho-1780141

ABSTRACT

Coronavirus disease 2019 (COVID-19) has strongly impacted society since it was first reported in mainland China in December 2020. Understanding its spread and consequence is crucial to pandemic control, yet difficult to achieve because we deal with a complex context of social environment and variable human behaviour. However, few efforts have been made to comprehensively analyse the socio-economic influences on viral spread and how it promotes the infection numbers in a region. Here we investigated the effect of socio-economic factors and found a strong linear relationship between the gross domestic product (GDP) and the cumulative number of confirmed COVID-19 cases with a high value of R2 (between 0.57 and 0.88). Structural equation models were constructed to further analyse the social-economic interaction mechanism of the spread of COVID-19. The results show that the total effect of GDP (0.87) on viral spread exceeds that of population influx (0.58) in the central cities of mainland China and that the spread mainly occurred through its interplay with other factors, such as socio-economic development. This evidence can be generalized as socio-economic factors can accelerate the spread of any infectious disease in a megacity environment. Thus, the world is in urgent need of a new plan to prepare for current and future pandemics.

9.
Preprint in English | medRxiv | ID: ppmedrxiv-22273272

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic with more than 485 millions infected. Questions about non-responders to SARS-CoV-2 vaccines remain unaddressed. Here, we report data from people after administering the complete dose of SARS-CoV-2 vaccines using the World Health Organization International Standard for anti-SARS-CoV-2 immunoglobulin. Our study showed that immune cells such as CD4 cells, CD8 cells, and B cells and anti-spike immunoglobulin G levels were significantly reduced in the elderly. There were 7.5% non-responders among the 18-59 yr group and 11.7% in the [≥]60 yr group. A titer of anti-SARS-CoV-2 spike immunoglobulin G is blew 50 BAU/mL to be considered as non-responders at intervals of 30 to 90 days after the last vaccine dose. Booster vaccination may be recommended for non-responders to reduce the disease severity and mortality.

10.
BMC Geriatr ; 22(1): 250, 2022 03 25.
Article in English | MEDLINE | ID: covidwho-1759698

ABSTRACT

INTRODUCTION: The oldest-old are highly vulnerable to sarcopenia. Physical distancing remains a common and effective infection-control policy to minimize the risk of COVID-19 transmission during the pandemic. Sarcopenia is known to be associated with impaired immunity. Moderate-to-vigorous physical activity (MVPA) and life-space mobility (LSM) are potential strategies for minimizing the risk of sarcopenia. However, a physical distancing policy might jeopardize the practice of MVPA and LSM. The purposes of this study were to identify the prevalence of sarcopenia and examine the association between MVPA and LSM with sarcopenia in the community-dwelling oldest-old during the COVID-19 pandemic. METHODS: This study employed a cross-sectional and observational design. The study was conducted in 10 community centres for older people in Hong Kong during the period of the COVID-19 pandemic (September to December 2020). Eligible participants were the oldest-old people aged ≥85 years, who were community-dwelling and had no overt symptoms of cognitive impairment or depression. Key variables included sarcopenia as measured by SARC-F, LSM as measured by a GPS built into smartphones, and MVPA as measured by a wrist-worn ActiGraph GT3X+. Variables were described by mean and frequency. A multiple linear regression was employed to test the hypotheses. The dependent variable was sarcopenia and the independent variables included LSM and MVPA. RESULTS: This study recruited 151 eligible participants. Their mean age was 89.8 years and the majority of them were female (n = 93/151, 61.6%). The prevalence of sarcopenia was 24.5% (n = 37/151) with a margin of error of 6.86%. MVPA was negatively associated with sarcopenia in older people (ß = - 0.002, SE = 0.001, p = 0.029). However, LSM was not associated with sarcopenia. CONCLUSION: The prevalence of sarcopenia in the community-dwelling oldest-old population is high. MVPA is negatively associated with sarcopenia. LSM is unrelated to sarcopenia. Sarcopenia should be recognized and the oldest-old with sarcopenia should be accorded priority treatment during the COVID-19 pandemic.


Subject(s)
COVID-19 , Sarcopenia , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Exercise , Female , Humans , Male , Pandemics/prevention & control , Physical Distancing , Policy , Sarcopenia/diagnosis , Sarcopenia/epidemiology , Sarcopenia/prevention & control
11.
Tomography ; 8(2): 869-890, 2022 03 21.
Article in English | MEDLINE | ID: covidwho-1753687

ABSTRACT

The automatic recognition of COVID-19 diseases is critical in the present pandemic since it relieves healthcare staff of the burden of screening for infection with COVID-19. Previous studies have proven that deep learning algorithms can be utilized to aid in the diagnosis of patients with potential COVID-19 infection. However, the accuracy of current COVID-19 recognition models is relatively low. Motivated by this fact, we propose three deep learning architectures, F-EDNC, FC-EDNC, and O-EDNC, to quickly and accurately detect COVID-19 infections from chest computed tomography (CT) images. Sixteen deep learning neural networks have been modified and trained to recognize COVID-19 patients using transfer learning and 2458 CT chest images. The proposed EDNC has then been developed using three of sixteen modified pre-trained models to improve the performance of COVID-19 recognition. The results suggested that the F-EDNC method significantly enhanced the recognition of COVID-19 infections with 97.75% accuracy, followed by FC-EDNC and O-EDNC (97.55% and 96.12%, respectively), which is superior to most of the current COVID-19 recognition models. Furthermore, a localhost web application has been built that enables users to easily upload their chest CT scans and obtain their COVID-19 results automatically. This accurate, fast, and automatic COVID-19 recognition system will relieve the stress of medical professionals for screening COVID-19 infections.


Subject(s)
COVID-19 , Deep Learning , Algorithms , COVID-19/diagnostic imaging , Humans , Neural Networks, Computer , Tomography, X-Ray Computed/methods
12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-317496

ABSTRACT

Background: More evidence in understanding the heterogeneity of COVID-19-associated acute respiratory distress syndrome (ARDS) and in improving strategy to increase the survival from the critical patients intubated is always needed. The study aimed to comprehensively explore the features of COVID-19-associated ARDS and the features and outcomes between the early and late intubation groups. Methods: : This retrospective cohort included 65 adult COVID-19 inpatients with ARDS at two hospitals in Hubei, China. The ARDS in these patients was diagnosed according to the Berlin criteria. We defined intubation within 7 days of ARDS diagnosis as ‘early’ intubation and that performed from the eighth day as ‘late’ intubation based on literatures. The outcomes were invasive mechanical ventilation and in-hospital death. The log-binomial regression models were used to explore the risk factors and the Kaplan-Meier statistic was used to estimate the risk of mortality. Results: : The median number of days from symptom onset to ARDS diagnosis was 11.0 (IQR, 8.0–13.0). Up to 84.1% COVID-19-related ARDS patients demonstrated multiple organ injuries. The mortality rates were 41.9% and 85.7% in moderate and severe ARDS. The early intubation and the late intubation had the differences in days from symptom onset/hospital admission/ARDS diagnosis to intubation (P = 0.023, P = 0.011, P < 0.001). Compared with the early-intubation group, the late-intubation group showed less severity at admission (median oxygenation index 159.0 95% CI 134.0-203.0 vs. 133.9 95% CI 98.3-183.2), but required more aggressive therapies (ICU 80% vs. 70%, CRRT 50% vs. 10%, prone-position 50% vs. 30%, and ECMO 50% vs. 10%) and had higher risk to die at hospital (RR, 3.18;95% CI 1.98-5.12). Conclusion: The ARDS caused by COVID-19 was not typical ARDS due to prolonged onset time, multiple organ injuries, and higher mortalities. The late-intubation group showed less severity at admission but higher risk of in-hospital death than the early-intubation group.

13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-317495

ABSTRACT

Background: The reviews on the risk factors with ARDS and the worse outcomes concluded lacking robust data of risk factors to prevent COVID-19 and identified an urgent need for large sample and high-quality research in this area, as well as the features of the ARDS. Methods: : This retrospective cohort study included 333 COVID-19 inpatients at two hospitals in Hubei of China in 2020. The COVID-19-related ARDS was diagnosed according to the Berlin criteria. The outcomes were ARDS development and the intubation or in-hospital death. The cox proportional hazard ratio (HR) models were employed to determine the significant risk factors. Results: : The median number of days from symptom onset to ARDS diagnosis was 11.0 (IQR, 8.0–13.0). Up to 84.1% COVID-19-related ARDS patients demonstrated multiple organ injuries. The mortality rates were 41.9% and 85.7% in moderate and severe ARDS. The survival patients on invasive mechanical ventilation (IMV) had been intubated earlier since ARDS diagnosis than those who had not survived (5.5 median days, IQR 4.0-7.0 days versus 11.5 median days, IQR 6.0-14.0 days, P < 0.001). Males and all abnormal laboratory indices associated with the higher risk of ARDS (P<0.05) but were not linked with the risk of intubation or death (P>0.05). The sensitivity analyses found that lymphocyte count of < 1000 per mm3 at hospital admission were still significantly associated with developing ARDS when adjusting for age and male gender (HR, 4.10;95% CI, 2.40-7.10), and oxygenation index (OI) ratio < 150 were more likely to predict the intubation/death after age adjustment (HR, 2.50;95% CI, 1.17-5.30). Conclusion: The SARS-CoV-2-caused ARDS was not the typical ARDS according to Berlin criteria. The alive patients with IMV had been intubated earlier since ARDS diagnosis than those who had not survived. We identified male gender and abnormal laboratory indices associated with the ARDS but were not linked with the intubation/death. Sensitivity analysis concluded lymphocyte count of < 1000 per mm3 could predict ARDS while OI ratio less than 150 could predict intubation/death.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315214

ABSTRACT

A recent experimental study found that the binding affinity between the cellular receptor human angiotensin converting enzyme 2 (ACE2) and receptor-binding domain (RBD) in spike (S) protein of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is more than 10-fold higher than that of the original severe acute respiratory syndrome coronavirus (SARS-CoV). However, main-chain structures of the SARS-CoV-2 RBD are almost the same with that of the SARS-CoV RBD. Understanding physical mechanism responsible for the outstanding affinity between the SARS-CoV-2 S and ACE2 is the "urgent challenge" for developing blockers, vaccines and therapeutic antibodies against the coronavirus disease 2019 (COVID-19) pandemic. Considering the mechanisms of hydrophobic interaction, hydration shell, surface tension, and the shielding effect of water molecules, this study reveals a hydrophobic-interaction-based mechanism by means of which SARS-CoV-2 S and ACE2 bind together in an aqueous environment. The hydrophobic interaction between the SARS-CoV-2 S and ACE2 protein is found to be significantly greater than that between SARS-CoV S and ACE2. At the docking site, the hydrophobic portions of the hydrophilic side chains of SARS-CoV-2 S are found to be involved in the hydrophobic interaction between SARS-CoV-2 S and ACE2. We propose a method to design live attenuated viruses by mutating several key amino acid residues of the spike protein to decrease the hydrophobic surface areas at the docking site. Mutation of a small amount of residues can greatly reduce the hydrophobic binding of the coronavirus to the receptor, which may be significant reduce infectivity and transmissibility of the virus.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315204

ABSTRACT

Preliminary epidemiologic, phylogenetic and clinical findings suggest that several novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have increased transmissibility and decreased efficacy of several existing vaccines. Four mutations in the receptor-binding domain (RBD) of the spike protein that are reported to contribute to increased transmission. Understanding physical mechanism responsible for the affinity enhancement between the SARS-CoV-2 variants and ACE2 is the "urgent challenge" for developing blockers, vaccines and therapeutic antibodies against the coronavirus disease 2019 (COVID-19) pandemic. Based on a hydrophobic-interaction-based protein docking mechanism, this study reveals that the mutation N501Y obviously increased the hydrophobic attraction and decrease hydrophilic repulsion between the RBD and ACE2 that most likely caused the transmissibility increment of the variants. By analyzing the mutation-induced hydrophobic surface changes in the attraction and repulsion at the binding site of the complexes of the SARS-CoV-2 variants and antibodies, we found out that all the mutations of N501Y, E484K, K417N and L452R can selectively decrease or increase their binding affinity with some antibodies.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310365

ABSTRACT

Background: Since December 2019, China has carried out dramatic containment measures to control the spread of COVID-19. As of April 6, 2020, most of the confirmed cases outside Hubei province have been cured or confirmed dead. In this study, we aimed to understand environmental factors leading to COVID-19-related mortality outside of Hubei province, in mainland China. Methods We collected spatial-temporal and environmental data of 99 cases of COVID-19-related deaths outside of Hubei province in Mainland China between January 22, 2020 and April 6, 2020. A descriptive analysis, including a spatial-temporal distribution of daily reported diagnosed cases and related deaths, was conducted. We analyzed the possible environmental factors that affect the provincial-level CFR of COVID-19 outside Hubei, China. Results Among the 99 reported deaths, 59 (59.6%) were male and 40 (40.4%) were female. The mean age at death was 71.30 (SD 12.98) years and 74 deaths were among those 65 years or older. The CFR was negatively correlated with temperature (r=-0.679, P  < 0.001) and humidity (r=-0.607, P  = 0.002), while latitude was positively correlated with the CFR (r = 0.636, P  = 0.001). There were no statistically significant associations between CFR and the social environment factors. Conclusion Higher CFR of COVID-19 was associated with lower temperature, lower humidity, and higher latitude. Continual analysis of daily reported diagnoses and mortality data can help healthcare professionals and policy makers understand the trends within a country in order to better prepare nationwide prevention and care guidelines, along with adequately appropriate funds accordingly.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309717

ABSTRACT

Background: The long-term functional outcome of discharged patients with coronavirus disease 2019 (COVID-19) remains unresolved. We aimed to describe a six-month follow-up of functional status of COVID-19 survivors. Methods: We reviewed the data of COVID-19 patients who had been consecutively admitted to the Tumor Center of Union Hospital (Wuhan, China) between 15 February and 14 March 2020. We quantified a six-month functional outcome reflecting symptoms and disability in COVID-19 survivors using a post-COVID-19 functional status scale ranging from 0 to 5 (PCFS). We examined the risk factors for the incomplete functional status defined as a PCFS > 0 at a six-month follow-up after discharge. Results: We included a total of 95 COVID-19 survivors with a median age of 62 (IQR 53-69) who had a complete functional status (PCFS grade 0) at baseline in this retrospective observational study. At six-month follow-up, 67 (70.5%) patients had a complete functional outcome (grade 0), 9 (9.5%) had a negligible limited function (grade 1), 12 (12.6%) had a mild limited function (grade 2), 7 (7.4%) had moderate limited function (grade 3). Univariable logistic regression analysis showed a significant association between the onset symptoms of muscle or joint pain and an increased risk of incomplete function (unadjusted OR 4.06, 95%CI 1.33 - 12.37). This association remained after adjustment for age and admission delay (adjusted OR 3.39, 95%CI 1.06 - 10.81, p = 0.039). Conclusions: A small proportion of discharged COVID-19 patients may have an incomplete functional outcome at a six-month follow-up;intervention strategies are required.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325021

ABSTRACT

Chinese herbal formulas, notably the lung-cleaning and toxicity-excluding (LCTE) soup has played an important role in treating an ongoing and life-threating worldwide pandemic, COVID-19 (caused by SARS-CoV-2). Applying LCTE outside of China may be difficult for medical society to approach due to the unfamiliar rationale behind its application in terms of Traditional Chinese Medicine. To overcome this barrier, we illuminate the chemical and biological mechanisms behind LCTE’s effects, by exploring the chemical compounds contained in LCTE ingredients, the proteins targeted by these compounds as well as undertaking the network pharmacology analysis. The results disclosed that LCTE contains compounds with the potential to directly inhibit SARS-CoV-2 and inflammation, and that the compounds targeted proteins significantly related to the main symptoms seen in COVID-19. The general effect of LCTE was to affect the pathways involved in viral and other microbe infection, inflammation/cytokine response, and lung diseases. Our work provided chemical biological explanations for using LCTE to treat COVID-19.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324828

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) caused an ongoing pandemic and bring heavy burden globally. We retrospectively investigated the effect of glucocorticoids on clinical symptoms, course of disease, and negative change of nucleic acid detection in patients with severe COVID-19. Methods Individual demographics data, CT images, clinical outcomes, laboratory investigations, treatment of patients with severe COVID-19 were collected from electronic medical records of the Central Hospital of Wuhan, from January 28 to February 28, 2020. Results Eighteen severe cases of COVID-19 received low-dose of glucocorticoid treatments. They were initially treated with 40 mg methylprednisolone with gradually reduced doses and changed into oral prednisolone. The courses of glucocorticoid treatments ranged from 4 to 30 days. The pulmonary infections were absorbed to different degrees in 16 cases, one case deteriorated in CT imaging and one had no significant change. All cases had fever regression. Fifteen cases could respire without oxygen supply. Two were still inhaled oxygen through nasal catheters and one with high flow oxygen gradually transferred to face mask for oxygen supply. Five cases discharged. Twelve cases who were in stable conditions for treatment remained in hospital. One case was still in critical condition. The results of three re-examinations of SARS-Cov-2 nucleic acids by RT-PCR were negative. Conclusions The early use of low-dose glucocorticoid therapy in severe COVID-19 infection may have a positive effect on the prevention and treatment of disease deterioration.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324281

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) was identified as a serious public health emergency. The Chinese government required people to stay at home. The purpose of this study was to analyse the effect of home exercise prescription solutions on the physical and mental health of youth during the COVID-19 period. Methods: A home exercise prescription was formulated after investigating and categorizing the home exercise status of 4000 undergraduates during the period of COVID-19. In this prospective cohort study, 200 young people were recruited for a home exercise prescription intervention, and 200 individuals did not undergo any intervention for 4 weeks in February 2020. Physical and mental health indexes including anxiety factors, obsessive-compulsive symptoms factors, depression factors, somatization subscale factors, and sleep and diet factors were evaluated. Results: Of 4,000 undergraduates living at home, 64.8% were dissatisfied with their physical and mental condition. Ninety-three percent wanted to adopt an exercise practice at home during the period of COVID-19. In the prospective cohort study, the average anxiety scores and sleep and diet scores before the intervention were 2.14 ± 0.43 and 2.24 ± 0.54, respectively, in the intervention group. After 4 weeks, participants reported that negative emotions were reduced. The scores for all factors were less than 2 points, and there were significant differences between the pre-intervention and post-intervention time points ( P  < 0.05). Differences between the two groups were statistically significant at 2 and 4 weeks (P < 0.05). Conclusion: There was an urgent need for home exercise programmes for youth during the period of COVID-19. Formulating appropriate home exercise prescriptions could help maintain physical and mental health, enhance immunity, and prevent disease. Trial registration ChiCTR, ChiCTR2000030090, Registered February 24th, 2020. http://www.chictr.org.cn/edit.aspx

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