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1.
Frontiers in psychology ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1733447

ABSTRACT

Background In the early days of COVID-19 outbreak, the normally orderly health system was severely challenged by large numbers of feverish patients and shortage of healthcare workers. The outbreak played a harmful role in the mental health of these healthcare workers. Objective We aim to assess the prevalence of moderate or severe anxiety and depression symptoms (ADSs) of healthcare workers in different regions during COVID-19 disaster and identify the potential risk factors. Methods We did a cross-sectional study on ADS of healthcare workers in epicenter-Hubei province and regions in lower epidemic-other provinces by questionnaire online. The data of ADS, the demographic characteristics, occupational exposure, physical condition, family situation, and coping styles were collected and analyzed. Results A total of 24.68% of the respondents had experienced moderate or severe ADS. Moderate or severe ADSs were in a higher prevalence in Hubei (32.39%) than other provinces (18.22%). Suspicious symptoms on their own and in family members were independent risk factors of moderate or severe ADS of all health workers. Working on the frontline was the independent risk factor for participants in Hubei province, whereas quarantine was the independent risk factor for those in other provinces. Moreover, among all participants, those with negative coping style were more than four times more likely to have moderate or severe ADS than those with positive coping style. Conclusion Moderate or severe ADSs were in a higher prevalence in healthcare workers of Hubei province during COVID-19 outbreak. The coping style may have major impact on ADS in such situation.

2.
Brain Behav Immun ; 87: 18-22, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719333

ABSTRACT

Viral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system.


Subject(s)
Coronavirus Infections/physiopathology , Nervous System Diseases/physiopathology , Pneumonia, Viral/physiopathology , Betacoronavirus , COVID-19 , Consciousness Disorders/etiology , Consciousness Disorders/physiopathology , Coronavirus 229E, Human , Coronavirus Infections/complications , Coronavirus NL63, Human , Coronavirus OC43, Human , Dysgeusia/etiology , Dysgeusia/physiopathology , Encephalitis/etiology , Encephalitis/physiopathology , Encephalitis, Viral/etiology , Encephalitis, Viral/physiopathology , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/physiopathology , Humans , Middle East Respiratory Syndrome Coronavirus , Nervous System Diseases/etiology , Neurotoxicity Syndromes/etiology , Neurotoxicity Syndromes/physiopathology , Neurotoxicity Syndromes/virology , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Pandemics , Pneumonia, Viral/complications , Polyneuropathies/etiology , Polyneuropathies/physiopathology , SARS Virus , SARS-CoV-2 , Seizures/etiology , Seizures/physiopathology , Severe Acute Respiratory Syndrome/complications , Severe Acute Respiratory Syndrome/physiopathology , Stroke/etiology , Stroke/physiopathology
3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312750

ABSTRACT

Background: Since December, 2019, the emerge of a Novel Coronavirus Disease 2019 (COVID-19) have caused global concern, the majority viewpoints are that the deaths are related to advanced ages, however, the emergence of younger deaths needs immediate attention. Methods Clinical characteristics, laboratory results, chest CT scans and treatment measures were retrospectively reviewed for six deceased patients under 60 years old with confirmed COVID-19 who were admitted to Wuhan Pulmonary Hospital in Wuhan, Hubei Province, China, from 6th January to 4th March, 2020. Results The age range of the patients was 50.17 ± 3.25 years (45–55 years), none of them had underlying diseases. All of patients presented with the symptoms of fever, respiratory system and digestive system. The level of albumin and lymphocyte counts decreased early in the stages of the disease, and then gradually increased. The neutrophil to lymphocyte ratio (NLR) increased (higher than normal range) in early stage and gradually decreased when the disease progressed. All the six patients showed ground-glass opacity (GGO) and bilateral patchy shadowing in early stage under the computed tomography (CT). All the patients died of severe pneumonia and multiple organ failure. Conclusions The decreased level of serum albumin occurred in the early stages of the disease, and delays in the first admission to hospital probably aggravate the disease development. The increase of the NLR in early stage of disease may be a risk of death for COVID-19. These findings may provide useful information for optimizing supportive care for COVID-19 pneumonia.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310860

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a current global pandemic. However, impact of recent influenza A virus infection on the clinical course and outcomes of severe COVID-19 adult inpatients needs to be further explored. Methods: : In this retrospective cohort study, severe, laboratory confirmed COVID-19 adult patients from Wuhan Tongji Hospital were included. Data were obtained from electronic medical records and compared between patients with and without recent influenza A virus infection. Results: : 200 patients were included, 51.5% with recent influenza A virus infection. Recent influenza A virus infection group presented with longer persistence of cough and sputum from illness onset (35.0 vs. 27.0 days, P = 0.018) and (33.0 vs. 26.0 days, P = 0.015), respectively. Median time of progression to critical illness from illness onset was shorter (day 11.5 vs. day 16.0, P = 0.034). Time to clinical improvement and length of hospital stay were longer in recent infection group (23.0 vs. 19.0 days, P = 0.044) and (22.0 vs. 18.0 days, P = 0.030), respectively. Conclusions: : Patients with recent influenza A virus infection showed a delay in time to clinical improvement and increased length of hospital stay. There is a high clinical need to improve the detection of common respiratory pathogens to identify co-infection during the epidemic of COVID-19.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324606

ABSTRACT

Background: Since December 2019, the outbreak of COVID-19 caused a large number of hospital admissions in China. Many patients with COVID-19 have symptoms of acute respiratory distress syndrome, even are in danger of death. This is the first study to evaluate dynamic changes of D-Dimer and Neutrophil-Lymphocyte Count Ratio (NLR) as a prognostic utility in patients with COVID-19 for clinical use. Methods In a retrospective study, we collected data from 349 hospitalized patients who diagnosed as the infection of the COVID-19 in Wuhan Pulmonary Hospital. We used ROC curves and Cox regression analysis to explore critical value (optimal cut-off point associated with Youden index) and prognostic role of dynamic changes of D-Dimer and NLR. Results 349 participants were enrolled in this study and the mortality rate of the patients with laboratory diagnosed COVID-19 was 14.9%. The initial and peak value of D-Dimer and NLR in deceased patients were higher statistically compared with survivors (P<0.001). There was a more significant upward trend of D-Dimer and NLR during hospitalization in the deceased patients, initial D-Dimer and NLR were lower than the peak tests (MD) -25.23, 95% CI: -31.81- -18.64, P <0.001;(MD) -43.73, 95% CI:-59.28- -31.17, P <0.001. The test showed a stronger correlation between hospitalization days, PCT and peak D-Dimer than initial D-Dimer. The areas under the ROC curves of peak D-Dimer and peak NLR tests were higher than the initial tests (0.94(95%CI: 0.90-0.98) vs. 0.80 (95% CI: 0.73-0.87);0.93 (95%CI:0.90-0.96) vs. 0.86 (95%CI:0.82-0.91). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR was 0.73 mg/L, 3.78 mg/L,7.13 and 14.31 respectively. 35 (10.03%) patients were intubated. In the intubated patients, initial and peak D-Dimer and NLR were much higher than non-intubated patients (P<0.001). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR in prognosticate of intubation was 0.73 mg/L, 12.75 mg/L,7.28 and 27.55. The multivariable Cox regression analysis showed that age (HR 1.04, 95% CI 1.00-1.07, P=0.01), the peak D-Dimer (HR 1.03, 95% CI 1.01-1.04, P<0.001) were prognostic factors for COVID-19 patients’death. Conclusions To dynamically observe the ratio of D-Dimer and NLR was more valuable during the prognosis of COVID-19. The rising trend in D-Dimer and NLR, or the test results higher than the critical values may indicate a risk of death for participants with COVID-19.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324478

ABSTRACT

Abstract Background SARS-CoV-2 pneumonia occasionally exacerbates to critical condition that is hard to manage. We aim to describe exacerbations of SARS-CoV-2 pneumonia among inpatients. Methods We included confirmed SARS-CoV-2 patients with pneumonia exacerbation admitted to Wuhan Pulmonary Hospital, Hubei Province, China between January 6 and February 17, 2020 and discharged or died before February 25. Their demographic characteristics, clinical symptoms, laboratory tests, CT manifestations, complications and clinical outcomes were collected. Results A total of 158 patients were collected, among them 107 patients were stable and discharged after recovery, 24 patients were already critically severe at hospital admission. 14 patients were excluded for insufficient clinical data. Eventually, 13 confirmed cases were included. The mean age was 65 (± 9.81) years. Ten of the 13 (76.9%) patients were female. Nine (69.2%) had underlying comorbidities. Fever and cough were the most common symptoms (12/13, 92.3%). 10/13(76.9%) patients had their exacerbation in the second week of disease course. All patients had both negative and positive nucleic acid test (NAT) results during the course. Increased range of ground-glass opacity (GGO) on CT imaging are consistent to disease exacerbation. ARDS, MODS, respiratory failure were found in 5/13(38.5%), 3/13(23.1%), 6/13(46.2%) patients respectively. Five (38.5%) patients did not survive. Conclusions SARS-CoV-2 pneumonia exacerbations often occurs in the second week of disease course. Negative NAT result could not exclude exacerbation. CT manifestation is consistent with disease progression. Early admissions have positive effects on reducing complications and mortality.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323643

ABSTRACT

The elevated level of D-dimer and its relationship with poor outcomes in COVID-19 pneumonia patients have been demonstrated. In addition to a hypercoagulable state, D-dimer is also a biomarker of inflammation. We investigated the relationship between D-dimer level and chest computed tomography (CT) severity score, which could reflect the severity of inflammation in COVID-19 pneumonia patients. We retrospectively enrolled 86 consecutive COVID-19 pneumonia patients. CT severity scores were computed to quantify the overall lung involvement. The D-dimer level among CT score tertiles and the association of the D-dimer level with CT score were analyzed. Our results showed that the median D-dimer level was 0.70 mg/L (IQR: 0.35-1.76). 49 patients (57.0%) had D-dimer level above the normal range (≤ 0.55mg/L). The D-dimer levels were significantly different across CT score tertiles (0.37 mg/l [IQR, 0.31-0.87], 0.66 mg/l [IQR, 0.39-1.43], 1.83 mg/l [IQR, 0.85-4.41], P<0.001). The natural logarithm of the D-dimer level was significantly associated with the CT score (r s =0.586, P <0.001). In conclusion, the D-dimer level may predict the severity of inflammation of COVID-19 pneumonia prior to coagulopathy/thrombosis. This could be an additional explanation for the mechanism of elevated D-dimer level predicting higher mortality.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315710

ABSTRACT

Background: Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for the prevention of cognitive decline in elderly population. This study aims to assess cognitive status and longitudinal decline at 6 months post-infection in elderly patients recovered from COVID-19.Methods: This cross-sectional study recruited 1013 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to March 13, 2020. In total, 262 uninfected living spouses of COVID-19 patients were selected as controls. Subjects were examined for their current cognitive status using a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) and longitudinal cognitive decline using an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cognitive assessments were performed 6 months after patient discharge.Findings: COVID-19 patients had significantly lower TICS-40 scores (patients: 29.73±6.13;controls: 30.74±5.95, p=0.016) and higher IQCODE scores (patients: 3.40±0.81;controls: 3.15±0.39, p<0.001) than the controls. Severe COVID-19 patients had lower TICS-40 scores and higher IQCODE scores than non-severe COVID-19 patients (TICS-40: 22.98±7.12 vs. 30.46±5.53, p<0.001;IQCODE: 4.06±1.39 vs. 3.33±0.68, p<0.001) and controls (TICS-40: 22.98±7.12 vs. 30.74±5.95, p<0.001;IQCODE: 4.06±1.39 vs. 3.15±0.39, p<0.001). Severe COVID-19 patients had a higher proportion of cases with a current cognitive impairment and longitudinal cognitive decline than non-severe COVID-19 patients and controls. COVID-19 severity (OR: 8.142, 95% CI: 5.007-13.239) was associated with worse current cognitive function. Older age (OR: 1.024, 95% CI: 1.003 to 1.046), COVID-19 severity (OR: 2.277, 95% CI: 1.308 to 3.964), mechanical ventilation (OR: 5.388, 95% CI: 3.007 to 9.656), and hypertension (OR: 1.866, 95% CI: 1.376 to 2.531) were associated with an increased risk of longitudinal cognitive decline.Interpretation: SARS-CoV-2 infection is associated with delayed cognitive decline in elderly population. COVID-19 patients with risk factors, including severe disease, older age, mechanical ventilation, and hypertension, should be intensively monitored for delayed cognitive decline. Funding: National Natural Science Foundation of China.Conflict of Interest: We declared no conflict of interests.Ethical Approval: The study protocols were approved by the institutional review boards of the hospitals. Verbal informed consent was obtained from all participants prior to the survey.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315661

ABSTRACT

Background: Qingfei Paidu decoction (QFPDD) is a Chinese medicine compound formula recommended for combating corona virus disease 2019 (COVID-19) by National Health Commission of the People's Republic of China. This study aims to identify the main constituents in QFPDD and the absorbed components (including prototypes and metabolites) in serum and tissues after oral administration of QFPDD to mice. Methods: : A practical and sensitive method of UHPLC-Q-Exactive-Orbitrap HRMS was developed to identify the chemical constituents in QFPDD and the absorbed prototypes as well as the metabolites in mice serum and tissues following oral administration of QFPDD. Results: : A total of 405 chemicals, including 40 kinds of alkaloids, 162 kinds of flavonoids, 44 kinds of organic acids, 71 kinds of triterpene saponins and 88 kinds of other compounds in the water extract of QFPDD were tentatively identified via comparison with the retention times and MS/MS spectra of the standards or refereed by literature. With the help of the standards and in vitro metabolites, 195 chemical components (including 104 prototypes and 91 metabolites) were identified in mice serum after oral administration of QFPDD. In addition, 165, 177, 112, 120, 44, 53 constituents were identified in the lung, liver, heart, kidney, brain, and spleen of QFPDD-treated mice, respectively. Conclusions: : An UHPLC-Q-Orbitrap HRMS based method was established for chemical profiling the constituents in QFPDD, while the absorbed prototypes and metabolites occurring in mice serum and tissues were investigated following oral administration of QFPDD. These findings provided key information and guidance for further investigation on the pharmacologically active substances and clinical applications of QFPDD.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315368

ABSTRACT

Background: Corona virus infective disease 19 (COVID-19) is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and spreads very rapidly, which become a worldwide public healthy crisis. Until now, there is no effective antivirus drugs or vaccines specifically used for its treatment. So it is urgent to discover efficient therapeutic methods. The same as SARS-CoV, SARS-CoV-2 also invades organism by combining with Angiotensin-converting enzyme 2 (ACE2). Recently, there are reports about SARS-CoV-2 infected host not only through the respiratory tract, but also gastrointestinal tract. However, it is proved that ACE2 plays a key role in protecting subjects from lung injury and resisting the inflammation caused by intestinal epithelial damage. Interestingly, the expression of ACE2 protein is reduced after SARS-CoV infection. Methods: : According to the dataset of genes co-expressed with ACE2 in the colonic epithelial cells, we established a protein-protein interaction (PPI) Network and selected hub genes from them. The cluster analysis was performed to find out the dense region of the PPI Network. Then, gene ontology (GO) and pathway enrichment analysis were performed to explore the main function of genes co-expressed with ACE2. Finally, we predicted the potential drugs for the treatment of COVID-19 based on the connectivity map (Cmap) . Results: We constructed a PPI network containing 125 hub genes of genes co-expressed with ACE2 in the colonic epithelial cells and obtained two modules through cluster analysis. The GO analysis and the KEGG pathway revealed these genes were aggregated in ribosome, exosomes, extracellular cellular components;structure constituent of ribosome, G-protein coupled receptor activity, MHC class I and II receptor activity biological processes;immune response, protein metabolism, signal transduction biological processes;and ribosome, graft-versus-host disease, viral myocarditis pathways. The result from Cmap indicated ikarugamycin, molsidomine had highly correlated scores with the query files. Conclusion: We found out that ikarugamycin and molsidomine were the potential drugs for the treatment of COVID-19.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315191

ABSTRACT

Bcakground: This study was to investigate the clinical characteristics and prognosis of COVID-19 patients combined with or without major chronic diseases like diabetes, hypertension or coronary. Methods: We retrospectively analyzed 183 patients with COVID-19 diagnosed at First People's Hospital of Jiangxia District (FPHJD) in Wuhan, China attended by Affiliated Hospital of Jiangsu University supporting medical team from February 1, 2020 to March 15, 2020. Patients were divided into simple COVID-19 group(n=134), COVID-19 combined with diabetes, hypertension or coronary group(n=49). Besides, COVID-19 patients with diabetes, hypertension or coronary were further classified into severe pneumonia group(n=23) and common pneumonia group(n=26), death group(n=17) and survival group(n=32). The prognosis of COVID-19 patients was evaluated by analyzing the clinical data and the results of laboratory tests. Results: 183 patients were included in this study, of whom 166 were discharged and 16 died in hospital. 49 (26.92%) patients had a comorbidity, with hypertension being the most common [37 (20.33%) patients], followed by diabetes [25 (13.74%) patients] and coronary heart disease [4 (2.2%) patients]. Compared with simple COVID-19 group, the proportion of history of chronic respiratory system disease, age, D-dimer, procalcitonin, C-reactive protein, myoglobin, cardiac troponin I, creatine kinase MB, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage, blood urea nitrogen, creatinine and mortality rate were significantly higher in COVID-19 combined with chronic diseases group, whereas lymphocyte count, lymphocyte percentage and alanine transferase were significantly lower in COVID-19 combined with chronic diseases group. Among COVID-19 patients with chronic diseases, D-dimer, procalcitonin, C-reactive protein, myoglobin, cardiac troponin I, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage, blood urea nitrogen, death rate was significantly higher in severe pneumonia group than common pneumonia group. While lymphocyte count and lymphocyte percentage were significantly lower in severe pneumonia group than common pneumonia group. Besides, we found that the proportion of history of chronic respiratory system disease, D-dimer, procalcitonin, myoglobin, cardiac troponin I, creatine kinase MB, lactate dehydrogenase, neutrophil count, neutrophil percentage, blood urea nitrogen were significantly higher in death group compared with survival group, whereas lymphocyte count and lymphocyte percentage were significantly lower in survival group. In COVID-19 combined with chronic diseases group, univariate logistic regression showed that the risk for severe pneumonia were D-dimer, C-reactive protein, lactate dehydrogenase, white blood cell count, neutrophil count and neutrophil percentage. Univariate logistic regression also showed that the risk for death were D-dimer, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage and blood urea nitrogen. Multivariate regression logistic showed that lactate dehydrogenase were independent risk factors for death among COVID-19 patients combined with chronic diseases. Cox regression analysis showed that compared with simple COVID-19 group, the RR(95% CI) in COVID-19 patients combined with diabetes, hypertension, and coronary were 2.187 (1.141~4.191) for death (P<0.05). Conclusion: Among COVID-19 patients combined with diabetes, hypertension or coronary, the risk factors for severe pneumonia were D-dimer, C-reactive protein, lactate dehydrogenase, white blood cell count, neutrophil count and neutrophil percentage, whereas the risk factors for death were D-dimer, lactate dehydrogenase, white blood cell count, neutrophil count, neutrophil percentage and blood urea nitrogen. Moreover, lactate dehydrogenase were independent risk factors for death. The mortality rate of COVID-19 patients combined with diabetes, hypertension or coronary was higher than that of simple COVID-19 patien s.

12.
Front Psychiatry ; 12: 749379, 2021.
Article in English | MEDLINE | ID: covidwho-1551543

ABSTRACT

Background: COVID-19 has had a wide impact on the mental health of college students. This study aims to explore the relationship between time perception, risk perception, and the mental health of college students during COVID-19 through a questionnaire survey. Subjects: One thousand two hundred and eighteen college students, 449 male and 769 female, who studied online during the COVID-19 epidemic were selected. Methods: Time Perception Scale, Risk Perception Scale, and SCL-90 were used to investigate the relationship using correlation analysis. Results: During the COVID-19 period, mental health problems of college students were widespread, and 65.93% of college students reported moderate to severe mental health problems. The correlation analysis showed that risk perception, time perception, and the mental health of college students were significantly related. Risk perception played a partial mediating role between present enjoyment and mental health, and risk perception played a partial mediating role between future time perception and mental health. Conclusion: In the case of sudden public crises, we should pay close attention to the mental health of college students, adjust their attitude toward the present and the future, and pay attention to their perception of risk so as to improve their mental health level under crisis.

13.
Influenza Other Respir Viruses ; 16(3): 395-401, 2022 May.
Article in English | MEDLINE | ID: covidwho-1526375

ABSTRACT

BACKGROUND: The pandemic of COVID-19 has a persistent impact on global health, yet its sequelae need to be addressed at a wide scale around the globe. This study aims to investigate the characteristics, prevalence, and risk factors for mid-term (>6 months) clinical sequelae in a cohort of COVID-19 survivors. METHODS: Totally 715 COVID-19 survivors discharged before April 1, 2020, from three medical centers in Wuhan, China, were included. The longitudinal study was conducted by telephone interviews based on a questionnaire including the clinical sequelae of general, respiratory, and cardiovascular systems. Demographics and some characteristics of clinical sequelae of the survivors were recorded and analyzed. Multivariate logistic regression analysis was applied to explore the risk factors for the sequelae. RESULTS: The median time interval from discharge to telephone interview was 225.0 days. The COVID-19 survivors' median ages were 69 years, and 51.3% were male. Among them, 29.9% had at least one clinical sequela. There were 19.2%, 22.7%, and 5.0% of the survivors reporting fatigue, respiratory symptoms, and cardiovascular symptoms, respectively. Comorbidities, disease severity, the application of mechanical ventilation and high-flow oxygen therapy, and the history of re-admission were associated with the presence of clinical sequelae. CONCLUSIONS: Our study provides further evidence for the prevalence and characteristics of clinical sequelae of COVID-19 survivors, suggesting long-term monitoring and management is needed for their full recovery.


Subject(s)
COVID-19 , Aged , COVID-19/complications , COVID-19/epidemiology , China/epidemiology , Humans , Longitudinal Studies , Male , Pandemics , SARS-CoV-2 , Survivors
14.
Front Med (Lausanne) ; 8: 749318, 2021.
Article in English | MEDLINE | ID: covidwho-1497094

ABSTRACT

Although the pathologic investigation of liver injury was observed in a couple of cases in China, the detailed description of liver histopathologic and ultrastructural changes in a relatively larger series of liver tissues from COVID-19 patients is lacking. Samples from the liver were obtained from 24 COVID-19 cases from February 1 to April 1, 2020. Light microscopy showed that all liver sections had different degrees of liver injury manifested as swelling of the hepatocytes, hepatocellular necrosis, steatosis, lobular inflammation, portal inflammation, dilatation of sinusoids, and so on. SARS-CoV-2 induced liver injury might be independent of pre-existing Schistosoma infection or obstructive cholestasis. Patients combined with respiratory failure had more severe hepatocellular necrosis and male patients were more susceptible to liver injury. Although coronavirus particles or viral inclusions were not detected in the liver tissues for all cases, vacuolar degenerations in hepatocytes, edematous of mitochondria with the disruption of cristae, and expansions of the endoplasmic reticulum were observed. In conclusion, pathologic changes of liver tissues provide us a further understanding of liver injury in COVID-19 patients. Changes in the liver seem to be related to the underlying diseases/conditions.

15.
Tob Induc Dis ; 19: 83, 2021.
Article in English | MEDLINE | ID: covidwho-1498144

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, various types of disinformation have emerged from the media. This study focuses on the online disinformation about tobacco and the COVID-19 on the Sina Weibo, the Chinese largest new media microblog platform. METHODS: The related posts from the beginning of the epidemic in December 2019 to 19 January 2021 were searched. Text mining technology was applied on these posts to identify content on 'smoking can prevent COVID-19'. Descriptive research was used to analyze the dataset. RESULTS: Among the 912 original posts, 508 informative posts were selected after artificial recognition, including 112 posts of spreading disinformation and 396 which dispel the disinformation. Of the disinformation posts, 74% (83/112) cited the results of scientific research, and 17% (19/112) mentioned that smog from burning Asian wormwood could prevent COVID-19. By analyzing the public's comments on these 112 disinformation posts, it was suggested that about 12% of the comments were in support, and 88% of the posts were opposed or invalid. The proportion of supportive comments on pseudo-scientific information was higher than on plain disinformation, 21% and 9%, respectively. CONCLUSIONS: The disinformation of promoting smoking as a way to prevent COVID-19 has the typical feature of using pseudo-scientific arguments to package disinformation, making it very difficult for readers without professional knowledge to identify. Such actions harm both tobacco control and COVID-19 prevention.

16.
Front Med (Lausanne) ; 8: 764493, 2021.
Article in English | MEDLINE | ID: covidwho-1450820

ABSTRACT

[This corrects the article DOI: 10.3389/fmed.2020.584342.].

17.
J Intensive Care ; 9(1): 49, 2021 Aug 06.
Article in English | MEDLINE | ID: covidwho-1342829

ABSTRACT

BACKGROUND: Systemic inflammation relates to the initiation and progression of acute respiratory distress syndrome (ARDS). Neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW)/albumin ratio have been reported to be predictive prognostic biomarkers in ARDS patients. However, the role of monocyte-to-lymphocyte ratio (MLR) as a prognostic inflammatory biomarker in a variety of diseases is rarely mentioned in ARDS. In this study, we explored the relationship between MLR and disease severity in ARDS patients and compared it with other indicators associated with 28-day mortality in patients with ARDS. METHODS: We retrospectively included 268 patients who fulfilled the Berlin definition of ARDS and were admitted to a single institute from 2016 to 2020. Clinical characteristics and experimental test data were collected from medical records within 24 h after the ARDS diagnosis. MLR, NLR, and RDW/albumin ratio levels were calculated. The primary clinical outcome was 28-day mortality. Logistic regression analysis was used to illustrate the relationship between indicators and 28-day mortality. Receiver operating characteristic (ROC) curve was used to evaluate the area under the curve (AUC), and propensity score matching (PSM) was employed to validate our findings. RESULTS: The median MLR values were higher for non-survivors than for survivors before and after matching (P<0.001, P=0.001, respectively). MLR values were significantly associated with 28-day mortality (OR 2.956; 95% CI 1.873-4.665; P<0.001). MLR and NLR indicators were combined for predictive efficacy analysis, and its AUC reached 0.750. There was a significant increase in 28-day mortality depending on the increasing MLR level: low MLR group 38 (20.4%), high MLR group 47 (57.3%) (P<0.001). CONCLUSIONS: Higher MLR values were associated with 28-day mortality in patients with ARDS. Further investigation is required to verify this relationship with prospectively collected data.

18.
Ann Palliat Med ; 10(7): 8271-8275, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1344623

ABSTRACT

The response to the COVID-19 outbreak was evaluated by analyzing the literature published after the outbreak. By reviewing and summarizing the different stages, nodes and measures during the occurrence and development of COVID-19, other countries can draw on their experience and reference for the fight against COVID-19 in China. In December 2019, the COVID-19 was first reported in Wuhan, China, and then the whole world continued to pay close attention to the development of the COVID-19 in China. Until now, the outbreak and development of the COVID-19 has lasted for more than a year. Looking back on the process of the COVID-19, several key stages and events have had a profound impact on the development of the COVID-19. We divided the evolution of the outbreak since its origin into different phases. The policy changes of the Chinese government in different periods of the COVID-19 pandemic were evaluated, and the transformation nodes of the policies and differences in each stage were determined. We divided the evolution of the outbreak into three stages of the outbreak are initial outbreak stage, the carrying of the virus (people or goods) stage, and the non-direct contact transmission (goods transmission) stage. This paper reviews the three stages of the evolution of responses by the Chinese government to COVID-19 using a phase analysis method to examine different policy starting points, changes to policy, and reasons for policy change. The study provides a resource for COVID-19 policy review and includes image of the three-phase shift in policy as the epidemic progressed. By summarizing and describing the policy changes in the three phases of the response to COVID-19 in China, this paper provides a resource for others in formulating their response to the pandemic. The commentary is also designed to provoke scholarly dialog among the readers of the journal.


Subject(s)
COVID-19 , Pandemics , China/epidemiology , Disease Outbreaks/prevention & control , Humans , SARS-CoV-2
19.
PLoS One ; 16(7): e0255373, 2021.
Article in English | MEDLINE | ID: covidwho-1334777

ABSTRACT

BACKGROUND: Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted. METHODS AND FINDINGS: About 0.5 million adults aged 30 to 79 years were recruited from 10 areas in China during 2004-2008. The present study included 430 977 participants without antihypertension treatment, cancer, or CVD at baseline. BP was measured at least twice in a single visit at baseline and CVD deaths during follow-up were collected via registries and the national health insurance databases. Multivariable Cox regression was used to estimate the associations between BP categories and CVD mortality. Overall, 16.3% had prehypertension-low, 25.1% had prehypertension-high, 14.1% had isolated systolic hypertension (ISH), 1.9% had isolated diastolic hypertension (IDH), and 9.1% had systolic-diastolic hypertension (SDH). During a median 10-year follow-up, 9660 CVD deaths were documented. Compared with normal, the hazard ratios (95% CI) of prehypertension-low, prehypertension-high, ISH, IDH, SDH for CVD were 1.10 (1.01-1.19), 1.32 (1.23-1.42), 2.04 (1.91-2.19), 2.20 (1.85-2.61), and 3.81 (3.54-4.09), respectively. All hypertension subtypes were related to the increased risk of CVD subtypes, with a stronger association for hemorrhagic stroke than for ischemic heart disease. The associations were stronger in younger than older adults. CONCLUSIONS: Prehypertension-high should be considered in CVD primary prevention given its high prevalence and increased CVD risk. All hypertension subtypes were independently associated with CVD and its subtypes mortality, though the strength of associations varied substantially.


Subject(s)
Blood Pressure , Hemorrhagic Stroke , Hypertension , Myocardial Ischemia , Adult , Age Factors , Aged , China/epidemiology , Disease-Free Survival , Female , Follow-Up Studies , Hemorrhagic Stroke/mortality , Hemorrhagic Stroke/physiopathology , Humans , Hypertension/mortality , Hypertension/physiopathology , Male , Middle Aged , Myocardial Ischemia/mortality , Myocardial Ischemia/physiopathology , Survival Rate
20.
Mol Neurodegener ; 16(1): 48, 2021 07 19.
Article in English | MEDLINE | ID: covidwho-1318288

ABSTRACT

BACKGROUND: Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for monitoring the cognitive decline in the elderly population. This study aims to assess the current cognitive status and the longitudinal cognitive decline in elderly patients recovered from COVID-19. METHODS: This cross-sectional study recruited 1539 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. In total, 466 uninfected spouses of COVID-19 patients were selected as controls. The current cognitive status was assessed using a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) and the longitudinal cognitive decline was assessed using an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cognitive assessments were performed 6 months after patient discharge. RESULTS: Compared with controls, COVID-19 patients had lower TICS-40 scores and higher IQCODE scores [TICS-40 median (IQR): 29 (25 to 32) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.19 (3.00 to 3.63) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had lower TICS-40 scores and higher IQCODE scores than non-severe COVID-19 patients [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.63 (3.13 to 4.31) vs. 3.13 (3.00 to 3.56), p < 0.001] and controls [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR) 3.63 (3.13 to 4.31) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had a higher proportion of cases with current cognitive impairment and longitudinal cognitive decline than non-severe COVID-19 patients [dementia: 25 (10.50 %) vs. 9 (0.69 %), p < 0.001; Mild cognitive impairment (MCI): 60 (25.21 %) vs. 63 (4.84 %), p < 0.001] and controls [dementia: 25 (10.50 %) vs. 0 (0 %), p < 0.001; MCI: 60 (25.21 %) vs. 20 (4.29 %), p < 0.001)]. COVID-19 severity, delirium and COPD were risk factors of current cognitive impairment. Low education level, severe COVID-19, delirium, hypertension and COPD were risk factors of longitudinal cognitive decline. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with an increased risk of long-term cognitive decline in elderly population. COVID-19 patients, especially severe patients, should be intensively monitored for post-infection cognitive decline.


Subject(s)
COVID-19/complications , Cognitive Dysfunction/virology , Aged , Aged, 80 and over , COVID-19/epidemiology , China , Cognitive Dysfunction/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , SARS-CoV-2
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