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1.
Chinese Journal of Communication ; : 1-24, 2022.
Article in English | Taylor & Francis | ID: covidwho-1784235
2.
Psychol Res Behav Manag ; 15: 823-837, 2022.
Article in English | MEDLINE | ID: covidwho-1777465

ABSTRACT

Background: The COVID-19 pandemic motivated people to stay at home to reduce the risk of COVID-19 infection and community transmission, but limited research has investigated the behavioral mechanisms underlying home quarantine. Methods: Based on the theory of planned behavior (TPB), this study explored the mediating role of intention toward home quarantine and the moderating role of nationality among attitude, subjective norms, and perceived behavioral control. A total of 827 college students from the United States and China were recruited to complete an online survey. Results: The results of structural equation modeling showed that antecedents (ie, attitude, subjective norms, and perceived behavioral control) could predict actual home-quarantine behavior through the role of intention. Notably, the relation between both attitude and intention and perceived behavioral control and intention were moderated by nationality. Specifically, attitude was a stronger predictor of intention for American participants than for Chinese participants; however, perceived behavioral control was a stronger predictor of intention for Chinese participants. Conclusion: These findings reveal the internal mechanism of home-quarantine behavior and the heterogeneous explanations attributed to cultural diversity during the pandemic, which not only expands the application of TPB but also provides a reference for infectious disease mitigation in the field of public health policy.

3.
Int J Mol Sci ; 23(7)2022 Apr 06.
Article in English | MEDLINE | ID: covidwho-1776252

ABSTRACT

Entry inhibitors against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are urgently needed to control the outbreak of coronavirus disease 2019 (COVID-19). This study developed a robust and straightforward assay that detected the molecular interaction between the receptor-binding domain (RBD) of viral spike protein and the angiotensin-converting enzyme 2 (ACE2) receptor in just 10 min. A drug library of 1068 approved compounds was used to screen for SARS-CoV2 entry inhibition, and 9 active drugs were identified as specific pseudovirus entry inhibitors. A plaque reduction neutralization test using authentic SARS-CoV-2 virus in Vero E6 cells confirmed that 2 of these drugs (Etravirine and Dolutegravir) significantly inhibited the infection of SARS-CoV-2. With molecular docking, we showed that both Etravirine and Dolutegravir are preferentially bound to primary ACE2-interacting residues on the RBD domain, implying that these two drug blocks may prohibit the viral attachment of SARS-CoV-2. We compared the neutralizing activities of these entry inhibitors against different pseudoviruses carrying spike proteins from alpha, beta, gamma, and delta variants. Both Etravirine and Dolutegravir showed similar neutralizing activities against different variants, with EC50 values between 4.5 to 5.8 nM for Etravirine and 10.2 to 22.9 nM for Dolutegravir. These data implied that Etravirine and Dolutegravir may serve as general spike inhibitors against dominant viral variants of SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Angiotensin-Converting Enzyme 2 , COVID-19/drug therapy , Humans , Molecular Docking Simulation , RNA, Viral , Spike Glycoprotein, Coronavirus/metabolism
4.
Brief Bioinform ; 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1774343

ABSTRACT

Coronavirus disease 2019 pandemic continues globally with a growing number of infections, but there are currently no effective antibody drugs against the virus. In addition, 90% amino acid sequence identity between the S2 subunit of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV S proteins attracts us to examine S2-targeted cross-neutralizing antibodies that are not yet well defined. We therefore immunized RenMab mice with the full-length S protein and constructed a high-throughput antibody discovery method based on single-cell sequencing technology to isolate SARS-CoV-2 S-targeted neutralizing antibodies and cross-neutralizing antibodies against the S2 region of SARS-CoV-2/SARS-CoV S. Diversity of antibody sequences in RenMab mice and consistency in B-cell immune responses between RenMab mice and humans enabled screening of fully human virus-neutralizing antibodies. From all the frequency >1 paired clonotypes obtained from single-cell V(D)J sequencing, 215 antibodies with binding affinities were identified and primarily bound S2. However, only two receptor-binding domain-targeted clonotypes had neutralizing activity against SARS-CoV-2. Moreover, 5' single-cell RNA sequencing indicated that these sorted splenic B cells are mainly plasmablasts, germinal center (GC)-dependent memory B-cells and GC B-cells. Among them, plasmablasts and GC-dependent memory B-cells were considered the most significant possibility of producing virus-specific antibodies. Altogether, using a high-throughput single cell-based antibody discovery approach, our study highlighted the challenges of developing S2-binding neutralizing antibodies against SARS-CoV-2 and provided a novel direction for the enrichment of antigen-specific B-cells.

5.
International Journal of Environmental Research and Public Health ; 19(7):3851, 2022.
Article in English | MDPI | ID: covidwho-1762344

ABSTRACT

In Hong Kong, where the aging problem is inevitable, it is increasingly common for older adults to be admitted to day care centers. However, there has been limited research exploring conceivable indicators of healthy aging among older adults in such settings. The present study investigated the associations among the three indicators (physical competence, physical well-being, and perceived physical literacy) among older adults in day care centers of Hong Kong. A total of 97 participants (aged 60 years old or above) participated in the study from April to July 2021 amid the COVID-19 pandemic. Data on participants' sociodemographic information, physical competence (PC), physical well-being (PWB), and perceived physical literacy (PPL) were collected. Our results showed that the level of PC reached a high level among the participants. Positive correlations were found between PC and PWB and between PPL and PWB (r = 0.22–0.23, p < 0.05). However, PC was not associated with PPL (r = 0.11, p > 0.05). In addition, as a component within PPL, 'knowledge and understanding';(KU) was found to be correlated with PC (r = 0.21, p < 0.05) and had a positive and moderate correlation with PWB (r = 0.35, p < 0.01). The results suggest that older adults admitted to day care centers maintain and enhance their physical competence to improve their physical well-being. Greater knowledge and understanding of physical literacy and physical health should be delivered among day care centers considering future development.

6.
J Clin Invest ; 2022 Mar 22.
Article in English | MEDLINE | ID: covidwho-1752968

ABSTRACT

BACKGROUND: The Delta and Omicron variants of SARS-CoV-2 are currently responsible for breakthrough infections due to waning immunity. We report phase 1/2 trial results of UB-612, a multitope subunit vaccine containing S1-RBD-sFc protein and rationally-designed promiscuous peptides representing Sarbecovirus conserved Th and CTL epitopes on the nucleocapsid (N), membrane (M) and spike (S2) proteins. METHODS: We conducted a phase-1 primary 2-dose (28-day apart) trial of 10-, 30-, or 100-µg UB-612 in sixty healthy young adults aged 20-55 years, and fifty of them were boosted with 100-µg of UB-612 ~7-9 months post-2nd dose. A separate placebo-controlled and randomized phase-2 study was conducted with two doses of 100-µg UB-612 (n = 3,875, aged 18-85 years). We evaluated interim safety and immunogenicity of the phase-1 until 14 days post-3rd (booster) dose and of the phase-2 until 28 days post-2nd dose. RESULTS: No vaccine-related serious adverse events (SAE) were recorded. The most common solicited AEs were injection site pain and fatigue, mostly mild and transient. In both trials, UB-612 elicited respective neutralizing antibody titers similar to a panel of human convalescent sera. The most striking findings were: long-lasting viral-neutralizing antibodies and broad T-cell immunity against SARS-CoV2 Variants of Concern (VoCs) including Delta and Omicron, and a strong booster-recalled memory immunity with high cross-reactive neutralizing titers against the Delta and Omicron variants. CONCLUSION: UB-612 has presented a favorable safety profile, potent booster effect against VoCs, and long-lasting B- and broad T-cell immunity that warrants further development for both primary immunization and heterologous boosting of other COVID-19 vaccines. CLINICAL TRIALS: gov: NCT04545749, NCT04773067 and NCT04967742. FUNDING: United Biomedical Inc., Asia, Vaxxinity Inc., and Taiwan Centers for Disease Control, Ministry of Health and Welfare.

8.
Ann Transl Med ; 10(4): 166, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1737500

ABSTRACT

Background: The present study aimed to analyze the impact of frailty on mortality risk among hospitalized patients with coronavirus disease 2019 (COVID-19). Methods: Literature searches were conducted using the MEDLINE, Embase, and Cochrane databases for articles reporting the association between frailty and mortality in hospitalized patients with COVID-19. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). A random-effects meta-analysis was performed to calculate the pooled effects. Results: A total of 21 studies with 26,652 hospitalized patients were included. Sixteen studies used the Clinical Frailty Score (CFS), and five used other frailty assessment tools. The pooled estimates of frailty in hospitalized patients with COVID-19 were 51.4% [95% confidence interval (CI): 39.9-62.9%]. In the CFS group, frail patients experienced a higher rate of short-term mortality than non-frail patients [odds ratio (OR) =3.0; 95% CI: 2.3-3.9; I2=72.7%; P<0.001]. In the other tools group, frail patients had a significantly increased short-term mortality risk compared with non-frail patients (OR =2.4; 95% CI: 1.4-4.1; P=0.001). Overall, a higher short-term mortality risk was observed for frail patients than non-frail patients (OR =2.8; 95% CI: 2.3-3.5; P<0.001). In older adults, frail patients had a higher rate of short-term mortality than non-frail patients (OR =2.3; 95% CI: 1.8-2.9; P<0.001). Conclusions: Compared to non-frail hospitalized patients with COVID-19, frail patients suffered a higher risk of all-cause mortality, and this result was also found in the older adult group.

9.
Medicine (Baltimore) ; 101(9): e28967, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1730759

ABSTRACT

BACKGROUND: Since December 2019, the coronavirus disease (COVID-19) has spread worldwide, leading to a global health threat. This study aimed to investigate the effectiveness of tocilizumab in COVID-19 patients. METHODS: We systematically searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and World Health Organization International Clinical Trials Registry Platform to March 10, 2021 for randomized controlled trials in which patients were randomly assigned to receive tocilizumab plus usual care or usual care alone in hospitalized adults with COVID-19. A random-effects meta-analysis model was used to pool studies. All data analyses were performed using Review Manager version 5.4. RESULTS: Eleven studies with 6579 patients were included in our meta-analysis, of which 3406 and 3173 were assigned to tocilizumab and control groups, respectively. Tocilizumab significantly reduced the 28 to 30-day mortality (relative risk [RR] = 0.89, 95% confidence interval [CI] 0.80-0.99, P = .04), incidence of mechanical ventilation (MV) (RR = 0.79, 95% CI 0.71-0.89, P < .001), composite outcome of MV or death (RR = 0.81, 95% CI 0.72-0.90, P < .001), time-to-hospital discharge (hazard ratio = 1.30, 95% CI 1.16-1.45, P < .001), intensive care unit admission (RR = 0.64, 95% CI 0.47-0.88, P = .006), serious infection (RR = 0.61, 95% CI 0.40-0.94, P = .02), and number of serious adverse events (RR = 0.64, 95% CI 0.47-0.86, P = .004). CONCLUSION: Tocilizumab reduced short-term mortality, incidence of MV, composite outcome of death or MV, intensive care unit admission, serious infection, serious adverse events, and time-to-hospital discharge in hospitalized COVID-19 patients. Further studies are required to determine the optimal dose.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/drug therapy , Adult , Humans , Randomized Controlled Trials as Topic , Respiration, Artificial , SARS-CoV-2
10.
J Chin Med Assoc ; 84(11): 1028-1037, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1699812

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic continues to affect countries worldwide. To inhibit the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), testing of patients, contact tracing, and quarantine of their close contacts have been used as major nonpharmaceutical interventions. The advantages of antigen tests, such as low cost and rapid turnaround, may allow for the rapid identification of larger numbers of infectious persons. This meta-analysis aimed to evaluate the diagnostic accuracy of antigen tests for SARS-CoV-2. METHODS: We searched PubMed, Embase, Cochrane Library, and Biomed Central databases from inception to January 2, 2021. Studies evaluating the diagnostic accuracy of antigen testing for SARS-CoV-2 with reference standards were included. We included studies that provided sufficient data to construct a 2 × 2 table on a per-patient basis. Only articles in English were reviewed. Summary sensitivity and specificity for antigen tests were generated using a random-effects model. RESULTS: Fourteen studies with 8624 participants were included. The meta-analysis for antigen testing generated a pooled sensitivity of 79% (95% CI, 66%-88%; 14 studies, 8624 patients) and a pooled specificity of 100% (95% CI, 99%-100%; 14 studies, 8624 patients). The subgroup analysis of studies that reported specimen collection within 7 days after symptom onset showed a pooled sensitivity of 95% (95% CI, 78%-99%; four studies, 1342 patients) and pooled specificity of 100% (95% CI, 97%-100%; four studies, 1342 patients). Regarding the applicability, the patient selection, index tests, and reference standards of studies in our meta-analysis matched the review title. CONCLUSION: Antigen tests have moderate sensitivity and high specificity for the detection of SARS-CoV-2. Antigen tests might have a higher sensitivity in detecting SARS-CoV-2 within 7 days after symptom onset. Based on our findings, antigen testing might be an effective method for identifying contagious individuals to block SARS-CoV-2 transmission.


Subject(s)
Antigens, Viral/analysis , COVID-19 Serological Testing/methods , COVID-19/diagnosis , SARS-CoV-2/immunology , Humans , Sensitivity and Specificity
11.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-326323

ABSTRACT

Computer aided diagnosis (CAD) increases diagnosis efficiency, helping doctors providing a quick and confident diagnosis, it has played an important role in the treatment of COVID19. In our task, we solve the problem about abnormality detection and classification. The dataset provided by Kaggle platform and we choose YOLOv5 as our model. We introduce some methods on objective detection in the related work section, the objection detection can be divided into two streams: onestage and two stage. The representational model are Faster RCNN and YOLO series. Then we describe the YOLOv5 model in the detail. Compared Experiments and results are shown in section IV. We choose mean average precision (mAP) as our experiments' metrics, and the higher (mean) mAP is, the better result the model will gain. mAP@0.5 of our YOLOv5s is 0.623 which is 0.157 and 0.101 higher than Faster RCNN and EfficientDet respectively.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325236

ABSTRACT

Background: A number of reports have documented the clinical characteristics of patients with severe coronavirus disease 2019 (COVID-19) in Wuhan. Clinical features of severe-critically ill COVID-19 patients in Jiangsu, outside Wuhan, remains unknown. Methods This multi-centered retrospective study collected the information of 631 laboratory-confirmed COVID-19 patients hospitalized at 28 authorized hospitals in Jiangsu province between January 23, 2019 and March 13, 2020. Epidemiological and demographic information, clinical and radiological characteristics, laboratory results and treatment of these patients were analyzed. Results A total of 583 adult patients with laboratory-confirmed COVID-19 were enrolled for final analysis, including 84 severe-critically ill patients and 499 mild-moderate patients. Median age of the severe-critically ill patients was 57.0 years [interquartile range (IQR), 49.0-65.8], and 50 (59.5%) were males. Multisystemic laboratory abnormalities were observed on admission in severe-critically ill patients. The severe-critically ill patients showed more noticeable radiologic abnormalities and more coexisting health issues as compared to mild-moderate patients. Most of the severe-critically ill COVID-19 patients become deteriorated in two weeks after diagnosis. Age [odds ratio (OR) 1.08, 95% confidence interval (CI) (1.03-1.14)], D-dimer (OR 3.21, 95% CI 1.39-7.40), and lymphocytes (OR 0.28, 95% CI 0.04-0.88) were independently associated with the progression of severe-critically illness. Conclusions Older age, higher D-dimer levels and less lymphocyte counts on admission are potential risk factors for COVID-19 patients to develop into severe and critically illness. The results would help clinicians to identify high-risk patients in advance.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322479

ABSTRACT

Background: The number of deaths caused by COVID-19 are on the rising worldwide. This study focused on severe and critically ill COVID-19, aim to explore independent risk factors associated with disease severity and to build a nomogram to predict patients’ prognosis. Methods: : Patients with laboratory-confirmed COVID-19 admitted to the Union Hospital, Tongji Medical College and Hankou Hospital of Wuhan, China, from February 8th to April 6th, 2020. LASSO Regression and Multivariate Analysis were applied to screen independent factors. COX Nomogram was built to predict the 7-day, 14-day and 1-month survival probability. Results: : A total of 115 severe [73 (63.5%)] and critically ill [42 (36.5%)] patients were included in this study, containing 93 (80.9%) survivors and 22 (19.1%) non-survivors. For disease severity, D-dimer [OR 6.33 (95%CI, 1.27-45.57], eosinophil percentage [OR 8.02 (95%CI, 1.82-45.04)], total bilirubin [OR 12.38 (95%CI, 1.24-223.65)] and lung involvement score [OR 1.22 (95%CI, 1.08-1.40)] were the independent factors associated with critical illness. Troponin [HR 9.02 (95%CI, 3.02, 26.97)] and total bilirubin [HR 3.16 (95%CI, 1.13, 8.85)] were the independent predictors for patients’ prognosis. Troponin≥26.2 ng/L and total bilirubin>20 μmol/L were associated with poor prognosis. The nomogram based on the independent risk factors had a C-index of 0.92 (95%CI, 0.87, 0.98) for predicting survival probability. The survival nomogram validated in the critically ill patients had a C-index of 0.83 (95%CI: 0.75, 0.94). Conclusions: : In conclusion, in severe and critically ill patients with COVID-19, D-dimer, eosinophil percentage, total bilirubin and lung involvement score were the independent risk factors associated with disease severity. The proposed survival nomogram accurately predicted prognosis. The survival analysis may suggest that early incidence of multiple organ dysfunction may be an important predictor of poor prognosis.

14.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321363

ABSTRACT

Public concern detection provides potential guidance to the authorities for crisis management before or during a pandemic outbreak. Detecting people's concerns and attention from online social media platforms has been widely acknowledged as an effective approach to relieve public panic and prevent a social crisis. However, detecting concerns in time from massive information in social media turns out to be a big challenge, especially when sufficient manually labeled data is in the absence of public health emergencies, e.g., COVID-19. In this paper, we propose a novel end-to-end deep learning model to identify people's concerns and the corresponding relations based on Graph Convolutional Network and Bi-directional Long Short Term Memory integrated with Concern Graph. Except for the sequential features from BERT embeddings, the regional features of tweets can be extracted by the Concern Graph module, which not only benefits the concern detection but also enables our model to be high noise-tolerant. Thus, our model can address the issue of insufficient manually labeled data. We conduct extensive experiments to evaluate the proposed model by using both manually labeled tweets and automatically labeled tweets. The experimental results show that our model can outperform the state-of-art models on real-world datasets.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-319810

ABSTRACT

Identification of people with elevated body temperature can reduce or dramatically slow down the spread of infectious diseases like COVID-19. We present a novel fever-screening system, F3S, that uses edge machine learning techniques to accurately measure core body temperatures of multiple individuals in a free-flow setting. F3S performs real-time sensor fusion of visual camera with thermal camera data streams to detect elevated body temperature, and it has several unique features: (a) visual and thermal streams represent very different modalities, and we dynamically associate semantically-equivalent regions across visual and thermal frames by using a new, dynamic alignment technique that analyzes content and context in real-time, (b) we track people through occlusions, identify the eye (inner canthus), forehead, face and head regions where possible, and provide an accurate temperature reading by using a prioritized refinement algorithm, and (c) we robustly detect elevated body temperature even in the presence of personal protective equipment like masks, or sunglasses or hats, all of which can be affected by hot weather and lead to spurious temperature readings. F3S has been deployed at over a dozen large commercial establishments, providing contact-less, free-flow, real-time fever screening for thousands of employees and customers in indoors and outdoor settings.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318919

ABSTRACT

Background: To evaluate recurrence of lymphedema and its influencing factors in discharged breast cancer patients with treated lymphedema during the COVID-19 pandemic and to propose feasible improvements. Methods: A multicenter, cross-sectional, hospital-based survey of discharged breast cancer patients was conducted during the COVID-19 pandemic in eight first-class hospitals in Wuhan city, China. Norman Questionnaire was used for assessing lymphedema, and multivariable binary logistic regression was performed to risk factors of moderate or severe lymphedema. Difference in living characteristics, anxiety and depression between no or mild group and moderate or severe group were compared. Preference in management of lymphedema were collected. Results: 202 valid patients were included. 191 participants reported recurred lymphedema (prevalence: 94.6%, 95%CI 90.5% to 97.3%). 134 of them was mild and 57 were moderate/severe. In the 191 patients, the main symptom was swelling (140, 69.3%) and pain (56, 27.7%). Multivariable regression showed that age (odds ratio, 1.06, 95%CI: 1.02-1.10), radical surgery (OR=4.35, 95%CI: 1.54-12.50) and fully complete radiotherapy (OR=2.62, 95%CI: 1.17-5.87, P=0.019) was associated with the risk of moderate or severe lymphedema. No significant difference in lifestyles was observed but moderate or severe group experienced higher rate of anxiety and depression. patients preferred treatment in hospital and self-care at home equally. Conclusion: The high recurrence rate of lymphedema in breast cancer patients with during COVID-19 should draw our great attention, continuous efforts should be made to identify patient at risk of lymphedema and distribute feasible guidance and education for self-management for these patients.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316015

ABSTRACT

Objectives: The novel coronavirus pneumonia (COVID-19),spread rapidly world wide, was first reported in December 2019. Meanwhile, there are still a large number of patients who need to undergo various surgical treatments. However, the consensus on whether patients with COVID-19 receive emergency or elective surgery will influence their perioperative mortality and complications still cannot be reached. Therefore, we used meta-analysis to explore the impact of patients with COVID-19 perioperative mortality and complications, aiming to provide evidence for clinical decision-making.Methods: We searched PubMed, Embase, Web of Science, Wan Fang database, date from December 2019 to July 2020 for collecting clinical trail on the impact of patients with COVID-19 perioperative mortality and complications. According to the Cochrane system evaluation method, the data is meta-analyzed with RevMan5.3 software.Results: Eight studies involving 2037 patients, 261 (12.81%) patients with COVID-19 and 1776(87.19%) without COVID-19, were included. The results of meta-analysis showed: the COVID-19 group vs Non-COVID-19 group , perioperative mortality and postoperative pneumonia syndrome increased in COVID-19 group(OR:3.84,95%CI:2.10-7.02,I2 =46%, P <0.0001), (OR: 33.42,95%CI:15.49-72.07,I 2 =0%, P <0.00001), The number of postoperative fever were significantly higher in COVID-19 , There were no significant difference in postoperative complications and ICU admission between the two groups.Conclusions: In our study, The risk of perioperative death and postoperative pulmonary is significantly increased in patients with COVID-19. These data suggested that consideration should be taken for postponing non-critical procedures and promoting nonoperative treatment to delay or avoid the need for surgery during the pandemic of COVID-19.Funding Statement: Natural Science Foundation of China, Grant number: 31760327/ 81760191Declaration of Interests: The authors declare no competing interests.

18.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315705

ABSTRACT

Background: A new type of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in Wuhan, China. However, the risk factors and characteristics related to the severity of the disease and its outcomes need to be further explored. Methods: : In this retrospective study, we evaluated COVID-19 patients with severe disease and those who were critically ill, as diagnosed at Jinyintan Hospital (Wuhan, China). The demographic information, clinical characteristics, complications, and laboratory results for the patients were evaluated. Multivariate logistic regression methods were used to analyze risk factors related to hospital deaths. Results: : The 235 COVID-19 patients included were divided into a severe group of 183 (78%) and a critical group of 52 (22%). Of these patients, 185 (79%) were discharged, and 50 (21%) died during hospitalization. In multivariate logistic analyses, age (OR=1.07, 95% CI 1.02-1.14, P=0.009), critical disease (OR=48.23, 95% CI 10.91-323.13, P<0.001), low lymphocyte counts (OR=15.48, 95% CI 1.98-176.49, P=0.015), elevated interleukin 6 (IL-6) (OR=9.11, 95% CI 1.69-67.75, P=0.017), and elevated aspartate aminotransferase (AST) (OR=8.46, 95% CI 2.16-42.60, P=0.004) were independent risk factors for adverse outcomes. Conclusions: : The results show that advanced age (> 64 years), critical illness, low lymphocyte levels, and elevated IL-6 and AST were factors for the risk of death for COVID-19 patients who had severe disease and those who were critically ill.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315652

ABSTRACT

Background: Coronavirus Disease-2019 (COVID-19) has become a major health event that endangers people health throughout China and the world. Understanding the factors associated with COVID-19 disease severity could support the early identification of patients with high risk for disease progression, inform prevention and control activities, and potentially reduce mortality. This study aims to describe the characteristics of patients with COVID-19 and factors associated with severe or critically ill presentation. Methods: : Multicentre retrospective cohort study of all individuals with confirmed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infections diagnosed at 24 COVID-19-designated hospitals in Jiangsu province between the 10th January and 15th March 2020. Demographic, clinical, laboratory, and radiological data were collected at hospital admission and data on disease severity were collected at from admission. Patients were categorised as asymptomatic/mild/moderate, and severe/critically ill according to the worst level of COVID-19 recorded during hospitalisation. Results: : A total of 625 patients, 64 (10.2%) were severe/critically ill and 561 (89.8%) were asymptomatic/mild/moderate. All patients were discharged and no patients died. Patients with severe/critically ill COVID-19 were more likely to be older, to be single onset (i.e. not to a cluster of cases in family/community), to have a medical history of hypertension and diabetes;had higher temperature, faster respiratory rates, lower peripheral capillary oxygen saturation (SpO 2 ), and higher CT image quadrant scores and pulmonary opacity percentage;had increased C-reactive protein, fibrinogen, and D-dimer on admission;and had lower white blood cells, lymphocyte, and platelet counts and albumin on admission than asymptomatic/mild/moderate cases. Multivariable regression showed that odds of being a severe/critically ill case were associated with age (year) (OR 1.06, 95%CI 1.03-1.09), lymphocyte count (10 9 /L) (OR 0.25, 95%CI 0.08-0.74), and pulmonary opacity in CT (per 5%) on admission (OR 1.31, 95%CI 1.15-1.51). Conclusions: : Severe or critically ill patients with COVID-19 is about one-tenths of patients in Jiangsu. Age, lymphocyte count, and pulmonary opacity in CT on admission were associated with risk of severe or critically ill COVID-19.

20.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315222

ABSTRACT

Background: Secondary bloodstream infection (SBI) is considered one of the most perilous complications of coronavirus disease 2019 (COVID-19). Although the etiology of SBI has been reported, the clinical course and outcomes of this illness have not been well described. Methods In this retrospective study, all patients with confirmed SBI were included from a cohort of 1,651 patients hospitalized with COVID-19 in the Wuhan Union Hospital between January 25 and April 23, 2020. Demographics, clinical features, laboratory findings, treatments and outcomes were extracted from electronic medical records. The data were compared between survivors and non-survivors based on whether patients died within 30 days following SBI onset. Results A total of 31 patients corresponding to 1.9% (31/1,651) who exhibited SBI were included in the present study. The median time from admission to the onset of SBI was 22.0 days (2.0–64.0). The most common symptoms were shortness of breath (74%), fever (65%) and decreased blood pressure (52%) at the onset of SBI. The levels of white blood cell count, C-reactive protein, and procalcitonin were mostly elevated. Carbapenem-resistant Klebsiella pneumoniae (15 [48%]) and Acinetobacter baumannii (7 [23%]) were the main pathogens. In empirical treatment, carbapenems were still the first choice. The 30-day mortality following SBI onset and the hospital mortality of the 31 patients were 67.7% (21/31) and 77.4% (24/31), respectively. Almost every patient with SBI had complication due to sepsis (28 [90%]). The median time periods to sepsis and septic shock were 1 days (1.0 ~ 5.0) and 3.0 days (1.0 ~ 12.0), respectively. The proportion of carbapenem-resistant gram-negative bacteria (CRGNB) detected in blood cultures of non-survivors was higher (18 [86%] vs. 4 [40%]) compared to that of the survivors. These patients were more likely to develop sepsis (21 [100%] vs. 7 [70%]), and acute cardiac injury (19 [90%] vs. 5 [50%]). Conclusions The mortality of SBI patients with COVID-19 is considerable. Increased risk of mortality was noted for the following three subgroups: Patients infected with CRGNB, patients with complications of sepsis and patients with acute cardiac injury.

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