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1.
Angewandte Chemie (International ed. in English) ; 2022.
Article in English | EuropePMC | ID: covidwho-1813460

ABSTRACT

Natural products possessing unique scaffolds may have antiviral activity but their complex structures hinder facile synthesis. A pharmacophore-oriented semisynthesis approach was applied to (-)-maoelactone A ( 1 ) and oridonin ( 2 ) for the discovery of anti-SARS-CoV-2 agents. The Wolff rearrangement/lactonization cascade (WRLC) reaction was developed to construct the unprecedented maoelactone-type scaffold during semisynthesis of 1 . Further mechanistic study suggested a concerted mechanism for Wolff rearrangement and a water-assisted stepwise process for lactonization. The WRLC reaction then enabled the creation of a novel family by assembly of the maoelactone-type scaffold and the pharmacophore of 2 , whereby one derivative inhibited SARS-CoV-2 replication in HPA EpiC cells with a low EC50 value (19 ± 1 nM) and a high TI value (>1000), both values better than those of remdesivir.

2.
Commun Biol ; 5(1): 252, 2022 Mar 22.
Article in English | MEDLINE | ID: covidwho-1788322

ABSTRACT

The location of intraepithelial lymphocytes (IELs) between epithelial cells provide a first line of immune defense against enteric infection. It is assumed that IELs migrate only along the basement membrane or into the lateral intercellular space (LIS) between epithelial cells. Here, we identify a unique transepithelial migration of porcine IELs as they move to the free surface of the intestinal epithelia. The major causative agent of neonatal diarrhea in piglets, porcine epidemic diarrhea virus (PEDV), increases the number of IELs entering the LIS and free surface of the intestinal epithelia, driven by chemokine CCL2 secreted from virus-infected intestinal epithelial cells. Remarkably, only virus pre-activated IELs inhibits PEDV infection and their antiviral activity depends on the further activation by virus-infected cells. Although high levels of perforin is detected in the co-culture system, the antiviral function of activated IELs is mainly mediated by IFN-γ secretion inducing robust antiviral response in virus-infected cells. Our results uncover a unique migratory behavior of porcine IELs as well as their protective role in the defense against intestinal infection.


Subject(s)
Coronavirus Infections , Intestinal Diseases , Intraepithelial Lymphocytes , Porcine epidemic diarrhea virus , Virus Diseases , Animals , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Porcine epidemic diarrhea virus/physiology , Swine
3.
Front Pharmacol ; 13: 764305, 2022.
Article in English | MEDLINE | ID: covidwho-1785389

ABSTRACT

Background: To explore the effect of combining traditional Chinese medicine (TCM) and Western medicine in hemodialysis patients with coronavirus disease 2019 (COVID-19). Methods: This study was conducted from 27 January 2020 to 17 March 2020 in Wuhan Third Hospital Guanggu Branch, Wuhan, China. Fifty-three patients were included and divided into a control group (CG), which received Western medicine and a combined treatment group, which received TCM and Western medicine (TG). Clinical and laboratory data, TCM symptom scores, and chest computed tomography results were extracted and compared between the two groups. Results: The TG included 21 (67.7%) men and 10 (32.3%) women with a mean age of 61.02 (standard deviation [SD] 15.07, range 26-89) years. The mean dialysis duration in the TG was 49 (SD 31) months. Of all patients in the TG, 27 (87.1%) had fatigue, 18 (58.1%) had dry cough, 16 (51.6%) had anorexia, 11 (35.5%) had dyspnea, and 11 (35.5%) had fever. The CG included 14 (63.6%) men and 8 (36.4%) women with a mean age of 61.45 (SD 13.78, range 36-84) years. The mean dialysis duration in the CG was 63 (SD 46) months. Of all patients in the CG, 21 (95.5%) had fatigue, 12 (54.5%) had dry cough, 17 (77.3%) had anorexia, 12 (54.5%) had dyspnea, and 7 (31.8%) had fever. After treatment, the TCM symptom scores of the two groups decreased; the anorexia scores were lower in the TG than in the CG (p < 0.05). After treatment, albumin increased and D-dimer, C-reactive protein, and lactate dehydrogenase levels decreased in the TG. The d-dimer levels were lower and the albumin level was higher in the TG than in the CG after treatment (p < 0.05). The cure rate was higher, and the mortality rate was lower in the TG than in the CG (p < 0.05). Conclusion: A combination of TCM and Western medicine in hemodialysis patients with COVID-19 could relieve symptoms and help recovery. Further evidence from larger randomized controlled trials is needed to confirm our results.

4.
Environ Sci Pollut Res Int ; 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1767584

ABSTRACT

The outbreak of the novel coronavirus disease 2019 (COVID-19) has posed a great impact on people's mental health, especially for undergraduate students. This study aimed to compare the mental health conditions and academic burnout between medical and non-medical undergraduates in China when the COVID-19 pandemic is mitigating. A cross-sectional online survey was conducted among 4,972 undergraduates between October 2020 and April 2021, when the pandemic was basically under control. The survey included basic demographics information and standardized scales to evaluate depression, anxiety, perceived stress, daytime sleepiness, alcohol abuse/dependence, quality of life, fatigue, and academic burnout. Compared with medical undergraduates, non-medical undergraduates had higher rates of moderate to severe depression symptoms (29.1% vs. 17.9%, P < 0.001), moderate to severe anxiety symptoms (19.7% vs. 8.9%, P < 0.001), alcohol abuse/dependence (16.3% vs.10.3%, P < 0.001), excessive daytime sleepiness (47.4% vs. 43.4%, P = 0.018), high perceived stress (34.7% vs. 22.2%, P < 0.001), high level of fatigue (51.8% vs. 42.2%, P < 0.001), low QOL (35.8% vs. 21.4%, P < 0.001), and higher academic burnout score (59.4 vs. 57.5, P < 0.001). Being non-medical undergraduates, depression, alcohol abuse/dependence, excessive daytime sleepiness, and high perceived stress were positively associated with academic burnout, while high QOL was negatively associated with the burnout (all P < 0.001). Excessive daytime sleepiness was the strongest predictor for academic burnout.

6.
J Adv Nurs ; 2022 Feb 23.
Article in English | MEDLINE | ID: covidwho-1703444

ABSTRACT

AIMS: The present study investigated the association between resilience, stigma, life satisfaction and the intention to receive a COVID-19 vaccination among Chinese HCWs. It also explored the mediating role of stigma and life satisfaction on the association between resilience and intention to receive a COVID-19 vaccination. DESIGN: An anonymous cross-sectional survey. METHODS: 1733 HCWs from five hospitals in four provinces of mainland China completed a cross-sectional online survey in October and November 2020. RESULTS: Among the HCWs, the rate of intention to receive a COVID-19 vaccination was 73.1%. Results from structural equation modelling showed that resilience was associated both directly, and indirectly with greater intent to receive a COVID-19 vaccination through two pathways: first by increasing life satisfaction, and second by reducing stigma and increasing life satisfaction. CONCLUSION: Promoting the resilience of HCWs has the potential to increase the COVID-19 vaccination uptake rate among HCWs in China. IMPACT: This study tested the relationship between several psychological factors and the COVID-19 vaccination intention of HCWs in China, finding that resilience played a significant role in improving COVID-19 vaccination intention rates by reducing stigma and increasing life satisfaction.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325536

ABSTRACT

Coronaviruses are identify in different species of animals, including camels, bats and avian. Avian infectious bronchitis virus (IBV) always infect and invade from the respiratory tract, where submucosal dendritic cells (DCs) are the first guard to defend it. However, different IBV subtypes, such as QX and M41, could suppress the function of dendritic cells and escape the degradation and presentation, which might help coronaviruses to transfer and migrant. Hence, it is necessary to illustrate the uncovered mechanisms how IBV inhibited the antigen-presentation of avian DCs. Initially, we compared two types IBV's function in activating avian bone marrow dendritic cells (BMDCs) and found that both IBV (QX and M41) did not significantly increase the expression of MHCII. Subsequent global analyses identified 21 significantly different expressed (DE) microRNAs and 2888 DE long non-coding RNAs (lncRNAs) in IBV M41 stimulated group, while IBV (QX) stimulation only identified 4 DE microRNAs and 1782 DE lncRNAs. Moreover, GO and KEGG analysis of microRNAs target and lncRNAs lead to endocytosis and cytokine-cytokine receptor interaction, which might contribute to the differences in pathogenicity of QX and M41. Meantime, a significant decrease of the m 6 A modification level in mRNA, but an increased in the ut RNA were observed in avian BMDCs upon the prevalent IBV (QX) infection. Interestingly, an opposite consequence was seen in avian BMDCs during the IBV (M41) infection. Further study found that both non-structural protein 7 (NSP7) and NSP16 inhibited the maturation and cytokines secretion of BMDCs, as well as their antigen-presentation ability. Lastly, we found that gga-miR21, induced and increased by both NSP7 and NSP16, inhibited the antigen presentation of avian BMDCs. Taken together, our results illustrated how IBV inhibited the antigen-presentation of avian DCs and provide a clue for the systemic transmission of the COVID-19.Funding Statement: This work was supported by the National Key Research and Development Program of China (2017YFD500706), the Jiangsu Excellent Youth Natural Science Foundation (BK20190077), the National Natural Science Foundation of China (No. 31702197) to J.L. Moreover, this work was also supported by National Natural Science Foundation of China (31930109 and 31772777), the Fundamental Research Funds for the Central Universities (JCQY201906) and A Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD) to Q.Y and Q.HY. Furthermore, this work was financially supported by the Fundamental Research Funds for the Central Universities (KJQN202060), the National Natural Science Foundation of China (31900907), the Natural Science Foundation of Jiangsu Province (BK20190528) to M.CDeclaration of Interests: The authors of this editorial have no conflicts of interest to declare. The authors have no other relevant affiliations or financial involvement in any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Ethics Approval Statement: This study was approved by the Ethics Committee of Animal Experiments center of Nanjing Agricultural University. All animal studies were approve by the Institutional Animal Care and Use Committee of Nanjing Agricultural University (SYXK-2017-0007), and followed the National Institutes of Health guidelines for the performance of animalexperiments.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324813

ABSTRACT

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has caused serious threats to people’s health and lives. The police officers are bravely fighting on the front lines of the epidemic. Our study is the first survey of psychological response in the police officers of China during the tumultuous time of the COVID − 19 outbreak. Methods A cross-sectional online questionnaire was conducted to the police officers from 5 districts (Yijiang, Sanshan, Jiujiang, jinghu and Jingkai) and 4 counties (Wuhu, Nanling,Fanchang and Wuwei) of Wuhu City through Wechat, and the data were collected between 10 and 26 March 2020. A total of 3561 questionnaires were received in the study, of which 3517 were considered valid. The questionnaires included the demographic information and psychological survey. The depression scale of the patient health questionnaire (PHQ-9) and generalized anxiety disorder 7-item scale (GAD-7) were employed to assess depression and anxiety, respectively. Results The mean depression score of the participants was 4.10 ± 4.87 (0 ~ 27). 12.17% of the police officers had moderate to severe depression. The mean anxiety score of the participants was 3.59 ± 4.228 (0 ~ 21). 8.79% the police officers had moderate to severe anxiety. The participants of senior high school or below and academy had lower depression and anxiety scores than these of bachelor or above, respectively. The police officers Unmarried had lower anxiety scores than married. The different location and police classification were associated with the different degree of depression and anxiety. The participants who did not take sleeping pills had lower depression and anxiety scores than those who took sleeping pills. The depression scores of the police officers were strongly correlated with their anxiety scores of the police officers. Conclusion The police officers have different levels of anxiety and depression during the COVID-19 epidemic in Wuhu. We should call for attention to the psychological response of police officers during the epidemic, and provide them with corresponding help and follow-up.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324497

ABSTRACT

The outbreak of COVID-19 Disease due to the novel coronavirus has caused a shortage of medical resources. To aid and accelerate the diagnosis process, automatic diagnosis of COVID-19 via deep learning models has recently been explored by researchers across the world. While different data-driven deep learning models have been developed to mitigate the diagnosis of COVID-19, the data itself is still scarce due to patient privacy concerns. Federated Learning (FL) is a natural solution because it allows different organizations to cooperatively learn an effective deep learning model without sharing raw data. However, recent studies show that FL still lacks privacy protection and may cause data leakage. We investigate this challenging problem by proposing a simple yet effective algorithm, named \textbf{F}ederated \textbf{L}earning \textbf{o}n Medical Datasets using \textbf{P}artial Networks (FLOP), that shares only a partial model between the server and clients. Extensive experiments on benchmark data and real-world healthcare tasks show that our approach achieves comparable or better performance while reducing the privacy and security risks. Of particular interest, we conduct experiments on the COVID-19 dataset and find that our FLOP algorithm can allow different hospitals to collaboratively and effectively train a partially shared model without sharing local patients' data.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315788

ABSTRACT

Background: The novel coronavirus diseases (COVID-19) has led to a pandemic and affected people's lives greatly, including their health seeking behavior. We aimed to evaluate the impact of the current COVID-19 pandemic on characteristics and trends of emergency department (ED) visits in Shanghai, China. Methods: This was a retrospective observational study using medical record databases from the Shanghai Sixth People's Hospital (East Campus) for years 2016 through 2020. All the patients referred to the ED between January 2016 and June 2020 were retrospectively reviewed. January 1, 2020, was chosen as the cutoff date for the statistical analysis and data of January and February in 2020 was compared with the same period of 2019. Results: During the first two months of 2020, there was a 60.9% decline in ED visits when compared with the same period of 2019 (9,904 vs. 25,316, respectively), and the waiting time in ED has been greatly reduced correspondingly (12±4 vs. 66±19 min, p < 0.001);ED visits for acute ischemic stroke (AIS) and acute coronary syndrome(ACS) decreased by 53.9% and 41.2% respectively;proportion of intravenous thrombolysis for AIS has dropped(42.1% vs. 11.4%, p = 0.003), and percutaneous coronary intervention for ACS was similar (70.6% vs. 63.3%, p = 0.668);and onset-to-door time (ODT) of these patients increased significantly (AIS: 217(136-374) vs. 378(260-510)min, ACS: 135(85-195) vs. 226(155-368)min, all p < 0.001). Conclusion: The outbreak of COVID-19 pandemic was correlated with a significant decline in the number of ED visits including AIS and ACS patients when compared to the pre-COVID-19 period. ODT of AIS and ACS patients increased significantly. Raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated stroke and myocardial infarction attack.

11.
BMJ Open ; 12(1): e053051, 2022 01 05.
Article in English | MEDLINE | ID: covidwho-1606133

ABSTRACT

INTRODUCTION: COVID-19 pandemic caused by SARS-CoV-2 has become a global health challenge. SARS-CoV-2 can infect host cells via the ACE2 receptor, which is widely expressed in the corpus cavernosum, testis and male reproductive tract, and participates in erection, spermatogenesis and androgen metabolism. Also, the immune response and persistent fever resulting from COVID-19 may lead to damage of the testicular activity, consequently compromising male fertility. METHODS AND ANALYSIS: PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal database, Chinese Biomedical Databases and Wanfang Data will be systematically searched for observational studies (case-control and cohort) published up to March 2021 in English or in Chinese literature on the impacts of COVID-19 and SARS-CoV-2 on male reproductive function. This protocol will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and Meta-analysis of Observational Studies in Epidemiology. The primary outcome will be semen parameters, and the additional outcomes will include: (a) detection of SARS-COV-2 in semen, (b) male sexual hormones, (c) sperm DNA fragmentation index, (d) erectile function, (e) evaluation of testis and also the male genital tract. Two reviewers will independently extract data from the included studies based on a predesigned data extraction form. The risk of bias of included studies will be evaluated through the Newcastle-Ottawa Scale for observational studies. Review Manager software V.5.3 will be used for statistical analysis. Q statistic and I² test will be performed to assess the heterogeneity among studies. Sensitivity analysis will be used to explore the robustness of pooled effects. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. ETHICS AND DISSEMINATION: Ethical approval is not required and results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021245161.


Subject(s)
COVID-19 , Case-Control Studies , Humans , Male , Meta-Analysis as Topic , Observational Studies as Topic , Pandemics , Research Design , SARS-CoV-2 , Systematic Reviews as Topic
12.
Front Public Health ; 9: 739068, 2021.
Article in English | MEDLINE | ID: covidwho-1581125

ABSTRACT

Background: Positive affect (PA) is crucial for individuals to cope with the current pandemic and buffer the lingering fears after it, especially for patients with substance-use disorders (SUDs). The current study aimed to explore PA and its related factors during the COVID-19 pandemic in male patients with the heroin-use disorder (HUD) and patients with the methamphetamine-use disorder (MAUD), respectively. Methods: A total of 325 male patients with SUDs (106 with HUD and 219 with MAUD, all were single-substance users) in a compulsory rehabilitation center underwent semi-structured interviews during the pandemic. The demographic information, drug-use characteristics, active coping styles (ACSs, by Simple Coping Style Questionnaire), and PA (by the Positive and Negative Affect Scale) of participants were collected and recorded. Results: There were significant differences between the two groups in age, the proportion of full-time workers before the epidemic, duration of drug use, the proportion of patients with long-term withdrawal during the epidemic, cravings, ACS, and PA. Correlation and multiple linear regression analysis showed that duration of drug use, ACS, and stable jobs were significant predictive factors for PA in patients with HUD, while long-term withdrawal, ACS, and stable jobs during the epidemic were significant predictive factors for PA in patients with MAUD. Conclusions: Our study demonstrated the factors for PA in patients with HUD and MAUD during the pandemic. The results provided a basis for the comprehensive understanding of the PA of patients with SUDs and the development of targeted treatments.


Subject(s)
COVID-19 , Methamphetamine , Pharmaceutical Preparations , Adaptation, Psychological , Heroin , Humans , Male , Methamphetamine/adverse effects , Pandemics , SARS-CoV-2
13.
Glob Health Res Policy ; 6(1): 37, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1448492

ABSTRACT

BACKGROUND: COVID-19 has seriously affected people's mental health and changed their behaviors. Previous studies for mental state and behavior promotion only targeted limited people or were not suitable for daily activity restrictions. Therefore, we decided to explore the effect of health education videos on people's mental state and health-related behaviors. METHODS: Based on WeChat, QQ, and other social media, we conducted an online survey by snowball sampling. Spearman's non-parametric method was used to analyze the correlation related to mental health problems and health-related behaviors. Besides, we used binary logistic regression analyses to examine mental health problems and health-related behaviors' predictors. We performed SPSS macro PROCESS (model 4 and model 6) to analyze mediation relationships between exposure to health education videos and depression/anxiety/health-related behaviors. These models were regarded as exploratory. RESULTS: Binary logistic regression analyses indicated that people who watched the health education videos were more likely to wear masks (OR 1.15, p < 0.001), disinfect (OR 1.26, p < 0.001), and take temperature (OR 1.37, p < 0.001). With higher level of posttraumatic growth (PTG) or perceived social support (PSS), people had lower percentage of depression (For PSS, OR 0.98, p < 0.001; For PTG, OR 0.98, p < 0.01) and anxiety (For PSS, OR 0.98, p < 0.001; For PTG, OR 0.98, p = 0.01) and better health behaviors. The serial multiple-mediation model supported the positive indirect effects of exposure to health education videos on the depression and three health-related behaviors through PSS and PTG (Depression: B[SE] = - 0.0046 [0.0021], 95% CI - 0.0098, - 0.0012; Mask-wearing: B[SE] = 0.0051 [0.0023], 95% CI 0.0015, 0.0010; Disinfection: B[SE] = 0.0059 [0.0024], 95% CI 0.0024, 0.0012; Temperature-taking: B[SE] = 0.0067 [0.0026], 95% CI 0.0023, 0.0013). CONCLUSION: Exposure to health education videos can improve people's self-perceived social support and inner growth and help them cope with the adverse impact of public health emergencies with better mental health and health-related behaviors.


Subject(s)
COVID-19/psychology , Health Behavior , Health Education/statistics & numerical data , Mental Health/statistics & numerical data , Public Health/statistics & numerical data , Adult , Aged , China , Female , Health Education/methods , Humans , Male , Middle Aged , Social Support , Young Adult
15.
China CDC Wkly ; 2(34): 645-650, 2020 Aug 21.
Article in English | MEDLINE | ID: covidwho-1355404

ABSTRACT

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Coronavirus disease 2019 (COVID-19) has become a global pandemic, while the profile of antibody response against the COVID-19 virus has not been well clarified. WHAT IS ADDED BY THIS REPORT?: In this study, 210 serum samples from 160 confirmed COVID-19 cases with different disease severities were recruited. The IgM, IgA, IgG, and neutralizing antibodies (NAb) against COVID-19 virus were determined. Our findings indicated that four antibodies could be detectable at low levels within 2 weeks of disease onset, then rapidly increasing and peaking from the 3rd to 5th Weeks. NAb decreased between 5th and 9th Weeks, and a higher IgM/IgA level was observed in the groups with mild/moderate severity within 2 weeks (p<0.05), while all 4 types of antibodies were higher in the group with severe/critical severity after 4 weeks (p<0.05). WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Our study on the dynamics of serological antibody responses against COVID-19 virus among COVID-19 patients complements the recognition regarding the humoral immune response to COVID-19 virus infection. The findings will help in the interpretation of antibody detection results for COVID-19 patients and be beneficial for the evaluation of vaccination effects.

16.
Front Psychiatry ; 12: 697472, 2021.
Article in English | MEDLINE | ID: covidwho-1346425

ABSTRACT

Background: The outbreak of the novel coronavirus disease 2019 (COVID-19) has become the greatest public health emergency and has attracted global attention. During the COVID-19 pandemic, the negative affect (NA) of elderly patients with substance use disorders (SUDs) has also become a more serious public concern. The current study aims to clarify the NA and its influencing factors in elderly patients with SUDs during the pandemic. Methods: Two psychiatrists conducted semi-structured interviews with 77 SUD patients aged above 50 years to collect their demographical information and certain drug use characteristics. Barratt Impulse Scale and the Positive and Negative Affect Scale were used to obtain information about patients' self-reported impulsivity and NA. Results: Univariate linear regression analysis showed that NA was positively correlated with the frequency of drug use, type of SUDs, cravings during COVID-19, and impulsivity. Multiple linear regression analysis showed that being female, higher frequency of drug use, stronger cravings, and greater impulsiveness jointly accounted for the variation of NA in elderly patients with SUDs. Conclusions: This study confirmed that, during the COVID-19 pandemic, gender, frequency of drug use, cravings, and impulsivity were associated with NA in elderly patients with SUDs. This study provided a theoretical basis for clinicians to reduce the patients' NA.

17.
BMC Neurol ; 21(1): 238, 2021 Jun 24.
Article in English | MEDLINE | ID: covidwho-1282244

ABSTRACT

BACKGROUND AND PURPOSE: The purpose of our study was to analyse endovascular treatment (EVT) in patients presenting acute anterior circulation ischemic stroke with large-vessel occlusion (AIS-LVO) during the pandemic and post-epidemic periods. METHODS: Patients with AIS-LVO of the anterior circulation who underwent EVT were enrolled. According to the times of Wuhan closure and reopening, patients were divided into a pre-pandemic group (from November 8, 2019, to January 22, 2020), pandemic group (from January 23, 2020, to April 8, 2020) and post-epidemic group (from April 9, 2020, to June 24, 2020). The primary endpoints were the time delay among symptom onset to arriving hospital door, to groining puncture and to vascular reperfusion. Secondary endpoints were the functional outcomes evaluated by 90-day modified Rankin scale (mRS) score. RESULTS: In total, the times from onset to reperfusion (OTR, median 356 min vs. 310 min, p = 0.041) and onset to door (OTD, median 238 min vs. 167 min, p = 0.017) were prolonged in the pandemic group compared to the pre-pandemic group, and the delay continue in the post-epidemic period. In the subgroup analysis, the time from door to imaging (DTI) was significantly prolonged during the pandemic period. Interestingly, the prolonged DTI was corrected in the directly admitted subgroup during post-epidemic period. In addition, the functional outcomes showed no significant differences across the three periods. CONCLUSIONS: Total time and prehospital time were prolonged during the pandemic and post-epidemic periods. Urgent public education and improved in-hospital screening processes are necessary to decrease time delays.


Subject(s)
COVID-19 , Endovascular Procedures/methods , Ischemic Stroke/therapy , Aged , Aged, 80 and over , Brain Ischemia/therapy , Female , Humans , Male , Middle Aged , Reperfusion/methods , Retrospective Studies , Treatment Outcome
18.
Am J Chin Med ; 49(5): 1063-1092, 2021.
Article in English | MEDLINE | ID: covidwho-1263933

ABSTRACT

Coronavirus disease (COVID-19) is a new infectious disease associated with high mortality, and traditional Chinese medicine decoctions (TCMDs) have been widely used for the treatment of patients with COVID-19 in China; however, the impact of these decoctions on severe and critical COVID-19-related mortality has not been evaluated. Therefore, we aimed to address this gap. In this retrospective cohort study, we included inpatients diagnosed with severe/critical COVID-19 at the Tongren Hospital of Wuhan University and grouped them depending on the recipience of TCMDs (TCMD and non-TCMD groups). We conducted a propensity score-matched analysis to adjust the imbalanced variables and treatments and used logistic regression methods to explore the risk factors associated with in-hospital death. Among 282 patients with COVID-19 who were discharged or died, 186 patients (66.0%) received TCMD treatment (TCMD cohort) and 96 (34.0%) did not (non-TCMD cohort). After propensity score matching at a 1:1 ratio, 94 TCMD users were matched to 94 non-users, and there were no significant differences in baseline clinical variables between the two groups of patients. The all-cause mortality was significantly lower in the TCMD group than in the non-TCMD group, and this trend remained valid even after matching (21.3% [20/94] vs. 39.4% [37/94]). Multivariable logistic regression model showed that disease severity (odds ratio: 0.010; 95% CI: 0.003, 0.037; [Formula: see text]¡ 0.001) was associated with increased odds of death and that TCMD treatment significantly decreased the odds of in-hospital death (odds ratio: 0.115; 95% CI: 0.035, 0.383; [Formula: see text]¡ 0.001), which was related to the duration of TCMD treatment. Our findings show that TCMD treatment may reduce the mortality in patients with severe/critical COVID-19.


Subject(s)
COVID-19/drug therapy , COVID-19/mortality , Drugs, Chinese Herbal/administration & dosage , Aged , COVID-19/pathology , Critical Illness , Female , Humans , Male , Medicine, Chinese Traditional , Middle Aged , Retrospective Studies , Severity of Illness Index
19.
Mult Scler J Exp Transl Clin ; 7(2): 20552173211017159, 2021.
Article in English | MEDLINE | ID: covidwho-1262487

ABSTRACT

BACKGROUND: Hesitancy to receive COVID-19 vaccination is a major public health concern. COVID-19 vaccine willingness and the factors contributing to willingness in adults with multiple sclerosis (MS) is unknown. We administered an online survey from 1 December 2020 to 7 January 2021 to adults with MS to estimate COVID-19 vaccine willingness among adults with MS. Bivariate analysis with chi-square testing compared categorical variables associated with vaccine willingness. RESULTS: Of 401 respondents, 70.1% were willing to receive an authorized COVID-19 vaccination if it was available to them, 22.7% were unsure, and 7.2% were unwilling. The most frequent concern for those unsure was vaccine safety. Vaccine willingness was associated with increased perceived personal risk of COVID-19 (χ2 = 45.4; p < 0.0001), prior influenza vaccine acceptance (χ2 = 97.6; p < 0.0001), higher educational level (χ2 = 50.2; p < 0.0001), and if respondents discussed or planned to discuss the COVID-19 vaccine with their neurologists (χ2 = 64.3; p < 0.0001). CONCLUSION: While COVID-19 vaccination willingness is high among people with MS, nearly 30% were either unwilling or unsure about being vaccinated. Neurologists should be aware of patient-centered factors associated with COVID-19 vaccine willingness and address COVID-19 vaccine safety concerns in discussions with their vaccine-unsure MS patients.

20.
China CDC Wkly ; 3(21): 441-447, 2021 May 21.
Article in English | MEDLINE | ID: covidwho-1237076

ABSTRACT

What is known about this topic? Few major outbreaks of coronavirus disease 2019 (COVID-19) have occurred in China after major non-pharmaceutical interventions and vaccines have been deployed and implemented. However, sporadic outbreaks that had high possibility to be linked to cold chain products were reported in several cities of China.. What is added by this report? In July 2020, a COVID-19 outbreak occurred in Dalian, China. The investigations of this outbreak strongly suggested that the infection source was from COVID-19 virus-contaminated packaging of frozen seafood during inbound unloading personnel contact. What are the implications for public health practice? Virus contaminated paper surfaces could maintain infectivity for at least 17-24 days at -25 ℃. Exposure to COVID-19 virus-contaminated surfaces is a potential route for introducing the virus to a susceptible population. Countries with no domestic transmission of COVID-19 should consider introducing prevention strategies for both inbound travellers and imported goods. Several measures to prevent the introduction of the virus via cold-chain goods can be implemented.

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