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1.
J Acquir Immune Defic Syndr ; 90(4): 408-417, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1909062

ABSTRACT

BACKGROUND: The effect of the COVID-19 epidemic on HIV self-testing (HIVST) remains unclear. We aimed to quantify the impact of COVID restrictions on HIVST kit purchasing behaviors in mainland China. METHODS: Deidentified transaction data were retrieved from a large online shopping platform. An interrupted time series model was constructed to examine the impact of COVID restrictions on the weekly number of anonymous customers purchasing HIVST kits, online orders, and purchased kits. RESULTS: A total of 2.32 million individuals submitted 4.46 million orders for 4.84 million HIVST kits between January 7, 2016, and April 22, 2020. Compared with expected levels, assuming COVID-19 epidemic and related restrictions had not happened, the number of purchasers, orders, and kits decreased by an estimated 10,500 (51.7%), 18,000 (55.3%), and 18,500 (54.9%) in the first week (January 23, 2020, to January 29, 2020) after COVID restrictions were implemented, respectively. As restrictions eased, the number of purchasers, orders, and kits increased by an average of 7.4%, 4.8%, and 4.9% per week, respectively. In the first week after COVID restrictions were lifted (April 9, 2020, to April 15, 2020), the number of purchasers returned to expected levels, whereas the number of orders and kits were still lower than expected levels. The impact of COVID restrictions on outcomes at the beginning of COVID restrictions and the increasing trends of outcomes were larger among those living in regions with higher COVID-19 incidence (eg, Wuhan city and Hubei province). CONCLUSIONS: Online sales of HIVST kits were significantly impacted by COVID restrictions, and HIVST kit purchasing patterns returned to expected levels after restrictions were lifted.


Subject(s)
COVID-19 , HIV Infections , COVID-19/epidemiology , Commerce , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Testing , Humans , Mass Screening , Self-Testing
2.
J Med Virol ; 94(8): 3722-3730, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1888725

ABSTRACT

To mitigate SARS-CoV-2 transmission, vaccines have been urgently approved. With their limited availability, it is critical to distribute the vaccines reasonably. We simulated the SARS-CoV-2 transmission for 365 days over four intervention periods: free transmission, structural mitigation, personal mitigation, and vaccination. Sensitivity analyses were performed to obtain robust results. We further evaluated two proposed vaccination allocations, including one-dose-high-coverage and two-doses-low-coverage, when the supply was low. 33.35% (infection rate, 2.68 in 10 million people) and 40.54% (2.36) of confirmed cases could be avoided as the nonpharmaceutical interventions (NPIs) adherence rate rose from 50% to 70%. As the vaccination coverage reached 60% and 80%, the total infections could be reduced by 32.72% and 41.19%, compared to the number without vaccination. When the durations of immunity were 90 and 120 days, the infection rates were 2.67 and 2.38. As the asymptomatic infection rate rose from 30% to 50%, the infection rate increased 0.92 (SD, 0.16) times. Conditioned on 70% adherence rate, with the same amount of limited available vaccines, the 20% and 40% vaccination coverage of one-dose-high-coverage, the infection rates were 2.70 and 2.35; corresponding to the two-doses-low-coverage with 10% and 20% vaccination coverage, the infection rates were 3.22 and 2.92. Our results indicated as the duration of immunity prolonged, the second wave of SARS-CoV-2 would be delayed and the scale would be declined. On average, the total infections in two-doses-low-coverage was 1.48 times (SD, 0.24) as high as that in one-dose-high-coverage. It is crucial to encourage people in order to improve vaccination coverage and establish immune barriers. Particularly when the supply is limited, a wiser strategy to prevent SARS-CoV-2 is equally distributing doses to the same number of individuals. Besides vaccination, NPIs are equally critical to the prevention of widespread of SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/prevention & control , Humans , Models, Theoretical , Vaccination
3.
Zool Res ; 43(4): 514-522, 2022 Jul 18.
Article in English | MEDLINE | ID: covidwho-1856595

ABSTRACT

Bats are reservoirs of various viruses. The widely distributed cave nectar bat ( Eonycteris spelaea) is known to carry both filoviruses and coronaviruses. However, the potential transmission of theses bat viruses to humans is not fully understood. In this study, we tracked 16 E. spelaea bats in Mengla County, Yunnan Province, China, using miniaturized GPS devices to investigate their movements and potential contact with humans. Furthermore, to determine the prevalence of coronavirus and filovirus infections, we screened for the nucleic acids of the Menglà virus (MLAV) and two coronaviruses (GCCDC1-CoV and HKU9-CoV) in anal swab samples taken from bats and for antibodies against these viruses in human serum samples. None of the serum samples were found to contain antibodies against the bat viruses. The GPS tracking results showed that the bats did not fly during the daytime and rarely flew to residential areas. The foraging range of individual bats also varied, with a mean cumulative nightly flight distance of 25.50 km and flight speed of up to 57.4 km/h. Taken together, these results suggest that the risk of direct transmission of GCCDC1-CoV, HKU9-CoV, and MLAV from E. spelaea bats to humans is very low under natural conditions.


Subject(s)
Chiroptera , Coronavirus Infections , Viruses , Animals , China/epidemiology , Coronavirus Infections/veterinary , Humans , Phylogeny , Plant Nectar
4.
Curr Med Imaging ; 2022 May 09.
Article in English | MEDLINE | ID: covidwho-1847042

ABSTRACT

BACKGROUND: COVID-19 patients' courses vary in length, indicating a variable prognosis. The disease duration revealed by different examination methods may differ. OBJECTIVE: To compare the differences in the disease course of patients with COVID-19 by chest computed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) assay and explore the factors that affect the course of the illness. METHODS: 106 patients confirmed with COVID-19 were enrolled and divided into two groups (age <60 years and age 60 years). The clinical characteristics of the two groups were analyzed. The intervals from symptoms onset to initial positive time point (ISIP), symptoms onset to initial negative time point (ISIN), and initial positive to initial negative time point (IIPN) indicated by chest CT and RT-PCR assay were analyzed. Multiple regression analysis was performed to assess the correlations between independent factors and the intervals. RESULTS: Chest CT showed an earlier positive time point, a later negative time point, and a longer disease duration than RT-PCR assay (P<.001, respectively). Older patients over 60 years old showed a later negative time point and a longer disease duration by chest CT than younger patients (P<.01 vs. P<.05, respectively). The CT score and clinical grades of older patients were greater than those of younger patients (P<.001, respectively). Age and clinical grades were significantly correlated with the disease course shown by chest CT (P<.05, respectively), and CT score was positively correlated with the illness course shown by chest CT and RT-PCR assay (P<.01, respectively). CONCLUSION: The disease course revealed by chest CT and RT-PCR assay was asynchronous. Chest CT showed a 17-day longer period compared to the RT-PCR assay. Older patients had a longer duration than younger ones. A prolonged course is predicted by increasing age, CT score, and clinical grades.

5.
BMJ Open ; 11(7), 2021.
Article in English | ProQuest Central | ID: covidwho-1842705

ABSTRACT

ObjectivesDuring a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic.DesignA cross-sectional facility-based survey.SettingHospitals around the country with different levels of care.ParticipantsA total of 1795 respondents, including 360 men and 1435 women who participated in the survey.Primary outcome measuresBurnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout.ResultsOf the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39, p=0.019), caring for patients with COVID-19 (aOR=3.90, 95% CI 1.14 to 13.37, p=0.031) and having depressive disorder (aOR=9.44, 95% CI 7.44 to 11.97, p<0.001).ConclusionsPhysicians and nurses are vulnerable to burnout during a pandemic, especially those working in ACC divisions. Anxiety disorder, depressive disorder and care of patients with COVID-19 may be factors that influence the occurrence of burnout among healthcare providers.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324319

ABSTRACT

Background: Due to the increased risk of viral infection and the severe shortage of medical resources during the pandemic of COVID-19, most hospitals in the epidemic areas significantly reduced non-emergency admissions and services, if not closed. As a result, it has been difficult to treat cancer patients on time, which adversely affects their prognosis. To address this problem, cancer centers must develop a strategic plan to manage both inpatients and outpatients during the pandemic, provide them with the necessary treatment, and at the same time prevent the spread of the virus among patients, visitors and medical staff. Methods: : Based upon the epidemic situation in Zhejiang Province, China, the number of running non-emergency medical wards in the Zhejiang Cancer Hospital was gradually increased in a controlled manner. All staff of the hospital received COVID-19 preventive training and was provided with three different levels of protection according to the risks of their services. Only patients without a known history of SARS-CoV-2 contact were eligible to schedule an appointment. Body temperature was measured on all patients upon their arrival at the hospital. Chest CT image, blood cell counting and travel/contact history were investigated in patients with fever. Respiratory tract samples, such as sputum and throat swabs, from all patients, including those clinically suspected of SARS-CoV-2 infection, were collected for nucleic acid detection of SARS-CoV-2 before treatment. Results: : A total of 3697 inpatients and 416 outpatients seeking cancer treatment were enrolled from February 1 to April 3, 2020, in compliance with the hospital’s infection-control interventions. The clinicopathological parameters of the patients were summarized herein. 4237 samples from 4101 patients produced negative RNA testing results. Four clinically suspected patients all presented negative RNA test results and were excluded from the SARS-CoV-2 infection through follow-up retesting and monitoring. Seven patients with only N-gene positive results were retested, followed by CT scan and SARS-CoV-2 contact history investigation. All of them were finally diagnosed as non-infected patients. There was one outpatient who was confirmed positive by virus RNA test and then followed up. She might be an asymptomatic laboratory-confirmed case. During the study period, there was no SARS-CoV-2 infection among staff, patients and escorts of patients in the Zhejiang Cancer Hospital. Conclusion: This study suggested our infection-control interventions, including viral nucleic acid test, could be used as a reliable method to screen cancer patients in the area with moderate COVID-19 prevalence. Cancer may not be a high-risk factor of SARS-CoV-2 infection.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323633

ABSTRACT

To discuss influencing factors on critical COVID-19 patient’s prognosis, construct a basic model and predict their mortality risks. Retrospectively analyzed the general condition and respective laboratory biomarkers of critical patients with duration≥24 h from Feb. 10th, 2020 to Mar. 30th, 2020 to separate them into a survival group and death group based on their clinical features. Multiple logistic regression analysis was performed to assess risk factors for critical COVID-19 patient’s and a nomogram was constructed based on screened risk factors. A receiver operating curve (ROC) was created to evaluate the accuracy of the nomogram. Multi-factor Logistic recovery analysis results show: Age, Peripheral blood leucocyte count,Lymphocyte percentage, Thrombocyte count and Hyper C-reactive protein are single danger factors of critical COVID-19 patient’s mortality risk (p<0.05). ROC curve indicates Nomogram predictive model AUC is 0.958 (95%CI: 0.923-0.993), which has high predictive value. Findings from this study suggest advanced age, high peripheral blood leucocyte count, high hyper C-reactive protein, low lymphocyte percentage and low thrombocyte count are risk factors of critical COVID-19 patient’s death.The Nomogram model is helpful for timely intervention to reduce the incidence of critical COVID-19 patients.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322955

ABSTRACT

Background: In order to prevent COVID-19, Taiwan Central Epidemic Command Center established group quarantine centers in January 2020 to implement isolation and epidemic prevention. The task groups in the group quarantine centers included the safety, logistics, and health groups. The objectives of this study were to understand whether the emotional distresses of group quarantine centers personnel are disturbed under high-pressure work environment. Methods: A structured questionnaire was designed. Its content contained two parts: the first part collected the demographical information of the participants, and the second part was a scale named the Brief Symptom Rating Scale (BSRS-5). The data collected were entered and analyzed using IBM SPSS Statistics for Windows, Version 21.0, and the difference analysis among the three groups were conducted in terms of the variables (significance level p <0.05);related factors affecting emotional scores on the BSRS-5 were identified through multiple regression analysis. Results: The online questionnaires were filled out from August 6 to August 13, 2020, and a total of 155 staffs were analyzed further. The safety group was collected 70 staffs (45.2%), the health group was collected 57 staffs (36.8%) and the logistics group was collected 28 staffs (18.0%). According to the analysis we found that three important results. First, no positive cases of COVID-19 been screened, the personnel do not feel distressed on duty in group quarantine centers. Second, when a quarantine case is screened positive for COVID-19, it will increase staff's emotional distress in all three group and the odds ratio with a BSRS-5 score greater than or equal to 6 points is 4.53 times (OR=4.53, 95%CI: 1.83-11.21) of cases that have not been screened as positive. Final, Cases screened as positive did not cause emotional problems in retired personnel serving in group quarantine centers. Conclusion: In the face of COVID-19 disease, our government should not only take care of people in the community, but also protect and take care of the front-line epidemic prevention personnel. Our government should be understand the emotional distresses of personnel and provide counseling and care, so that personnel can continue to protect people of Taiwan during epidemic prevention.

9.
ACS Nano ; 16(2): 2629-2639, 2022 02 22.
Article in English | MEDLINE | ID: covidwho-1634583

ABSTRACT

Population-wide surveillance of COVID-19 requires tests to be quick and accurate to minimize community transmissions. The detection of breath volatile organic compounds presents a promising option for COVID-19 surveillance but is currently limited by bulky instrumentation and inflexible analysis protocol. Here, we design a hand-held surface-enhanced Raman scattering-based breathalyzer to identify COVID-19 infected individuals in under 5 min, achieving >95% sensitivity and specificity across 501 participants regardless of their displayed symptoms. Our SERS-based breathalyzer harnesses key variations in vibrational fingerprints arising from interactions between breath metabolites and multiple molecular receptors to establish a robust partial least-squares discriminant analysis model for high throughput classifications. Crucially, spectral regions influencing classification show strong corroboration with reported potential COVID-19 breath biomarkers, both through experiment and in silico. Our strategy strives to spur the development of next-generation, noninvasive human breath diagnostic toolkits tailored for mass screening purposes.


Subject(s)
COVID-19 , Humans , Mass Screening , Point-of-Care Systems , SARS-CoV-2 , Spectrum Analysis, Raman/methods
10.
Obesity (Silver Spring) ; 30(4): 858-863, 2022 04.
Article in English | MEDLINE | ID: covidwho-1626268

ABSTRACT

OBJECTIVE: This study evaluated whether the transition of a face-to-face behavioral intervention to videoconferencing-based telehealth delivery during the COVID-19 pandemic resulted in significantly smaller weight losses than those typically observed in gold-standard, face-to-face programs. METHODS: Participants were 160 adults with obesity (mean [SD] age = 49.2 [11.9] years, BMI = 36.1 [4.2] kg/m2 ) enrolled in two cohorts of a 16-week comprehensive weight-management program. Cohort 1 began in person and transitioned to telehealth (Zoom) delivery during week 11 of the intervention because of COVID-19; Cohort 2 was conducted completely remotely. A noninferiority approach (using a clinically relevant noninferiority margin of 2.5%) was used to assess whether the weight losses observed were inferior to the 8% losses from baseline typically produced by gold-standard, face-to-face lifestyle interventions. RESULTS: From baseline to postintervention, participants lost an average of 7.4 [4.9] kg, representing a reduction of 7.2% [4.6%]. This magnitude of weight change was significantly greater than 5.5% (t[159] = 4.7, p < 0.001), and, thus, was within the proposed noninferiority margin. CONCLUSIONS: These findings demonstrate that the results of behavioral weight-management interventions are robust, whether delivered in person or remotely, and that individuals can achieve clinically meaningful benefits from behavioral treatment even during a global pandemic. Pragmatic "lessons learned," including modified trial recruitment techniques, are discussed.


Subject(s)
COVID-19 , Telemedicine , Adult , COVID-19/therapy , Humans , Middle Aged , Obesity/epidemiology , Obesity/therapy , Pandemics , Telemedicine/methods , Videoconferencing
11.
BMJ Open ; 12(1): e051582, 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1605670

ABSTRACT

INTRODUCTION: Early intervention (EI) endorses family-centred and participation-focused services, but there remain insufficient options for systematically enacting this service approach. The Young Children's Participation and Environment Measure electronic patient-reported outcome (YC-PEM e-PRO) is an evidence-based measure for caregivers that enables family-centred services in EI. The Parent-Reported Outcomes for Strengthening Partnership within the Early Intervention Care Team (PROSPECT) is a community-based pragmatic trial examining the effectiveness of implementing the YC-PEM e-PRO measure and decision support tool as an option for use within routine EI care, on service quality and child outcomes (aim 1). Following trial completion, we will characterise stakeholder perspectives of facilitators and barriers to its implementation across multiple EI programmes (aim 2). METHODS AND ANALYSIS: This study employs a hybrid type 1 effectiveness-implementation study design. For aim 1, we aim to enrol 223 caregivers of children with or at risk for developmental disabilities or delays aged 0-3 years old that have accessed EI services for three or more months from one EI programme in the Denver Metro catchment of Colorado. Participants will be invited to enrol for 12 months, beginning at the time of their child's annual evaluation of progress. Participants will be randomised using a cluster-randomised design at the EI service coordinator level. Both groups will complete baseline testing and follow-up assessment at 1, 6 and 12 months. A generalised linear mixed model will be fitted for each outcome of interest, with group, time and their interactions as primary fixed effects, and adjusting for child age and condition severity as secondary fixed effects. For aim 2, we will conduct focus groups with EI stakeholders (families in the intervention group, service coordinators and other service providers in the EI programme, and programme leadership) which will be analysed thematically to explain aim 1 results and identify supports and remaining barriers to its broader implementation in multiple EI programmes. ETHICS AND DISSEMINATION: This study has been approved by the institutional review boards at the University of Illinois at Chicago (2020-0555) and University of Colorado (20-2380). An active dissemination plan will ensure that findings have maximum reach for research and practice. TRIAL REGISTRATION NUMBER: NCT04562038.


Subject(s)
Caregivers , Early Intervention, Educational , Child , Child, Preschool , Electronics , Family , Humans , Infant , Infant, Newborn , Patient Reported Outcome Measures
12.
Hum Vaccin Immunother ; 17(12): 4971-4981, 2021 12 02.
Article in English | MEDLINE | ID: covidwho-1565874

ABSTRACT

BACKGROUND: Men who have sex with men (MSM), a population bearing the greatest HIV burden in many countries, may also be vulnerable to COVID-19. COVID-19 vaccines are essential to containing the pandemic. However, vaccine hesitancy may compromise vaccine coverage. We aimed to understand the uptake of COVID-19 vaccine and factors associated with COVID-19 vaccine hesitancy among HIV-infected MSM in mainland China. METHODS: A cross-sectional online survey among HIV-infected MSM was conducted between 13 and 21 February 2021 in mainland China. Variables including demographics, mental health status, HIV characteristics, and knowledge of and attitudes toward COVID-19 pandemic and COVID-19 vaccine were collected. Chi-square tests and multivariable logistic regression were used to analyze factors associated with COVID-19 vaccine hesitancy. RESULTS: A total of 1295 participants were included. The median age was 29.3 years (interquartile range [IQR] 25.2-34.0 years). The uptake of COVID-19 vaccine was 8.7%. Two main reasons for receiving vaccines were "regarded vaccination as self-health protection" (67.3%) and "trust in domestic medical technology" (67.3%). Among participants who did not initiate vaccination, concern about side effects (46.4%) and disclosure of HIV infection (38.6%) were top two reasons, and 47.2% had higher vaccine hesitancy. Men who had with high antiretroviral therapy (ART) adherence (adjusted odds ratio [aOR] 0.53, 95% confidence interval [CI] 0.35-0.80), often (0.26, 0.17-0.40) or sometimes (0.46, 0.31-0.67) paid attention to information about the COVID-19 vaccine, preferred domestic vaccines (0.37, 0.24-0.59), thought the pandemic had moderate (0.58, 0.38-0.90) and moderately severe or severe impact (0.54, 0.38-0.78) on immunity, who were waiting for vaccination programs organized at workplace (0.60, 0.44-0.81) and who were unaware of where to get COVID-19 vaccine (0.61, 0.45-0.82) had lower degree of COVID-19 vaccine hesitancy. Men who were concerned about the efficacy (1.72, 1.16-2.54) and side effects (2.44, 1.78-3.35) had higher degree of COVID-19 vaccine hesitancy. CONCLUSION: COVID-19 vaccine uptake among HIV-infected MSM is still suboptimal. Understanding influencing factors of vaccine hesitancy among this group and making tailored measures to alleviate hesitancy would help improve the coverage of COVID-19 vaccination in this population.


Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Adult , COVID-19/prevention & control , COVID-19 Vaccines , China/epidemiology , Cross-Sectional Studies , HIV Infections/complications , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Pandemics , SARS-CoV-2 , Vaccination
13.
Hum Vaccin Immunother ; 17(12): 4964-4970, 2021 12 02.
Article in English | MEDLINE | ID: covidwho-1565873

ABSTRACT

OBJECTIVES: The coronavirus disease-2019 (COVID-19) pandemic continues to ravage the world. People living with HIV (PLHIV) are one of the most vulnerable groups. This study aims to identify the factors associated with the uptake and adverse reactions of COVID-19 vaccination. METHODS: We recruited PLHIV in China by convenience sampling between 7 and 23 February 2021. Participants were asked to complete an online questionnaire. Chi-squared test and multivariable logistic regression were used to assess factors associated with vaccine uptake. RESULTS: A total of 527 vaccinated and 1091 unvaccinated PLHIV were recruited. Individuals who had a higher education, engaged in occupations with a higher risk of COVID-19 infection, received influenza or pneumonia vaccine in the past 3 years (5.40, 3.36-8.77), believed in the effectiveness of vaccines (3.01, 2.20-4.12), and received media information regarding COVID-19 vaccine (2.23, 1.61-3.11), were more likely to be vaccinated. Concerning about adverse reactions (0.31, 0.22-0.44), negative impact on the progression of HIV/AIDS (0.36, 0.26-0.50) or antiretroviral therapy (ART) (0.61, 0.44-0.85), disclosure of HIV infection status (0.69, 0.49-0.96), comorbidities (0.33, 0.22-0.47), being unmarried (0.43, 0.28-0.66) and older age were negatively associated with vaccination. Of the 527 vaccinated PLHIV, 155 (29.4%) PLHIV reported adverse reactions, with pain at the injection site being the most common (18.2%). CONCLUSIONS: PLHIV, who are concerned about adverse reactions, negative impact on ART outcome and disclosure of HIV infection status, were less likely to adopt COVID-19 vaccination. To increase vaccination coverage among PLHIV, health-care professionals should emphasize the benefits and necessity of vaccination and provide consultancy regarding adverse reactions.


Subject(s)
COVID-19 , HIV Infections , Influenza Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Case-Control Studies , China/epidemiology , HIV Infections/complications , Humans , Influenza Vaccines/adverse effects , SARS-CoV-2 , Vaccination/adverse effects
14.
Int J Gen Med ; 14: 7337-7348, 2021.
Article in English | MEDLINE | ID: covidwho-1504988

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) was associated with a higher risk of arrhythmia in infected patients. However, there are no reports about the effect of the ongoing pandemic on arrhythmias in the non-infected population. We measured the arrhythmia burden in a non-infected population with cardiac implantable devices. METHODS: The arrhythmia burden during the COVID-19 pandemic was compared to a 6-month interval in the pre-COVID-19 period. The COVID-19 pandemic was divided into high-risk (17 January 2020 to 16 March 2020) and low-risk periods (17 March 2020 to 17 July 2020) according to whether there were locally infected patients. Arrhythmia burdens were compared among the pre-COVID-19, high-risk, and low-risk periods. RESULTS: A total of 219 patients with 1859 episodes were included. We observed a larger proportion of patients with atrial fibrillation (AF) during the COVID-19 pandemic (38.36% vs 26.03%, p = 0.006). There was not significantly more ventricular arrhythmia during the COVID period than the pre-COVID-19 period (p > 0.05). During the high-risk period, daily frequency of non-sustained ventricular tachycardia (NSVT) (0.0172, 0.0475 vs 0.0109, 0.0164, p < 0.05), atrial tachycardia (AT) (0.0345, 0.0518 vs 0.0164, 0.0219 p < 0.05) and AF (0.0345, 0.0432 vs 0.0164, 0.0186, p < 0.05) and daily duration of NSVT (0.1982, 0.2845 vs 0.0538, 0.1640 p < 0.05) were higher and longer than those in the pre-COVID-19 period. Regression modeling showed that the impact of COVID-19 pandemic lead to an increased onset of AF (odds ratio 2.465; p < 0.01). Patients with paroxysmal AF who had undergone a previous radiofrequency ablation had a lower burden of AF (incidence 21.43% vs 55.00%, P = 0.049, daily frequency 0.0000, 0.0027 vs 0.0000, 241.7978, P = 0.020) during the pandemic. CONCLUSION: The COVID-19 pandemic contributed to a higher burden of arrhythmias in non-infected patients. Patients would experience a lower burden of AF following radiofrequency ablation treatment, and this effect persisted during the pandemic.

15.
Infect Dis Poverty ; 10(1): 128, 2021 Oct 24.
Article in English | MEDLINE | ID: covidwho-1482013

ABSTRACT

BACKGROUND: Coronaviruses can be isolated from bats, civets, pangolins, birds and other wild animals. As an animal-origin pathogen, coronavirus can cross species barrier and cause pandemic in humans. In this study, a deep learning model for early prediction of pandemic risk was proposed based on the sequences of viral genomes. METHODS: A total of 3257 genomes were downloaded from the Coronavirus Genome Resource Library. We present a deep learning model of cross-species coronavirus infection that combines a bidirectional gated recurrent unit network with a one-dimensional convolution. The genome sequence of animal-origin coronavirus was directly input to extract features and predict pandemic risk. The best performances were explored with the use of pre-trained DNA vector and attention mechanism. The area under the receiver operating characteristic curve (AUROC) and the area under precision-recall curve (AUPR) were used to evaluate the predictive models. RESULTS: The six specific models achieved good performances for the corresponding virus groups (1 for AUROC and 1 for AUPR). The general model with pre-training vector and attention mechanism provided excellent predictions for all virus groups (1 for AUROC and 1 for AUPR) while those without pre-training vector or attention mechanism had obviously reduction of performance (about 5-25%). Re-training experiments showed that the general model has good capabilities of transfer learning (average for six groups: 0.968 for AUROC and 0.942 for AUPR) and should give reasonable prediction for potential pathogen of next pandemic. The artificial negative data with the replacement of the coding region of the spike protein were also predicted correctly (100% accuracy). With the application of the Python programming language, an easy-to-use tool was created to implements our predictor. CONCLUSIONS: Robust deep learning model with pre-training vector and attention mechanism mastered the features from the whole genomes of animal-origin coronaviruses and could predict the risk of cross-species infection for early warning of next pandemic.


Subject(s)
Coronavirus Infections , Coronavirus , Pandemics , Animals , Coronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/veterinary , Deep Learning , Humans , Models, Statistical , Risk Assessment/methods
16.
Front Med (Lausanne) ; 8: 657006, 2021.
Article in English | MEDLINE | ID: covidwho-1403481

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are two major infectious diseases posing significant public health threats, and their coinfection (aptly abbreviated COVID-TB) makes the situation worse. This study aimed to investigate the clinical features and prognosis of COVID-TB cases. Methods: The PubMed, Embase, Cochrane, CNKI, and Wanfang databases were searched for relevant studies published through December 18, 2020. An overview of COVID-TB case reports/case series was prepared that described their clinical characteristics and differences between survivors and deceased patients. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) for death or severe COVID-19 were calculated. The quality of outcomes was assessed using GRADEpro. Results: Thirty-six studies were included. Of 89 COVID-TB patients, 19 (23.46%) died, and 72 (80.90%) were male. The median age of non-survivors (53.95 ± 19.78 years) was greater than that of survivors (37.76 ± 15.54 years) (p < 0.001). Non-survivors were more likely to have hypertension (47.06 vs. 17.95%) or symptoms of dyspnea (72.73% vs. 30%) or bilateral lesions (73.68 vs. 47.14%), infiltrates (57.89 vs. 24.29%), tree in bud (10.53% vs. 0%), or a higher leucocyte count (12.9 [10.5-16.73] vs. 8.015 [4.8-8.97] × 109/L) than survivors (p < 0.05). In terms of treatment, 88.52% received anti-TB therapy, 50.82% received antibiotics, 22.95% received antiviral therapy, 26.23% received hydroxychloroquine, and 11.48% received corticosteroids. The pooled ORs of death or severe disease in the COVID-TB group and the non-TB group were 2.21 (95% CI: 1.80, 2.70) and 2.77 (95% CI: 1.33, 5.74) (P < 0.01), respectively. Conclusion: In summary, there appear to be some predictors of worse prognosis among COVID-TB cases. A moderate level of evidence suggests that COVID-TB patients are more likely to suffer severe disease or death than COVID-19 patients. Finally, routine screening for TB may be recommended among suspected or confirmed cases of COVID-19 in countries with high TB burden.

17.
Eye Contact Lens ; 47(10): 573-574, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1393486

ABSTRACT

ABSTRACT: In the current coronavirus disease 2019 (COVID-19) pandemic, important public health measures such as the utilization of face masks has been widely enforced, including community-wide mandatory face mask use. During this period, there have been observations of an increasing number of patients presenting with dry eye symptoms among regular mask users with no history of ocular surface pathology. Individuals have reported being aware of air blowing upward from the mask into their eyes that is likely to increase the evaporation of their tear film leading to ocular irritation. Although face mask use is essential in combatting the COVID-19 pandemic, it is important to recognize the potential effects it may have on ocular health. We report a case of face mask-associated ocular complication. After an initial cornea abrasion from mask use, the patient developed recurrent corneal erosion syndrome that was complicated by microbial keratitis after the enforcement of mandatory mask use in public areas.


Subject(s)
COVID-19 , Keratitis , Cornea , Humans , Masks , Pandemics , SARS-CoV-2
18.
Atmospheric Environment ; 259:118508, 2021.
Article in English | ScienceDirect | ID: covidwho-1252473

ABSTRACT

Aerosols greatly impact the global and regional climate system and public health. We conducted lidar measurements at Wuhan (30.53°N, 114.37°E) from October 2010 to June 2020 and analyzed the massive dataset with an automatic lidar processing algorithm, to investigate the long-term variations of aerosols. Lidar-derived total aerosol optical depth (AOD) at 532 nm shows an interannual decrease of −0.049 since 2010. Compared with AODs in other megacities worldwide, the AOD for Wuhan shows the largest decrease rate. After separating AOD contributions from boundary layer (BL) and free troposphere (FT), different evolution patterns are revealed with AOD decrease rates of −0.009 and −0.044 per year for FT and BL, respectively, which indicates more than 80% of AOD decrease are associated with reductions of local emissions. In addition, BL AOD was always larger than FT AOD before COVID-19 lockdown. However, this relation was conversed thereafter, with the lowest value of 0.125 for BL AOD since 2010, which is only the half of FT AOD within the same period. This feature corroborates strong influences of COVID-19 lockdown on human activities and local emissions. These findings can improve our understandings of regional aerosol responses to pollution controls and aerosol direct impacts on regional climate.

19.
J Med Virol ; 93(1): 528-532, 2021 01.
Article in English | MEDLINE | ID: covidwho-1217362

ABSTRACT

The situation of the coronavirus disease 2019 (COVID-19) continues to evolve, our study explored the significance of serum levels of matrix metalloproteinase 3 (MMP3) as a marker for patients with COVID-19. Sixty-two COVID-19 patients in the First Hospital of Hunan University of Chinese Medicine and Loudi Center for Diseases Prevention and Control, from January to March 2020, were sampled as the novel coronavirus pneumonia infected group. One hundred and thirty-one cases from the First Hospital of Hunan University of Chinese Medicine, including 67 healthy individuals and 64 non-COVID-19 inpatients, served as the noninfected group. Approximately every 5 days, sera from 20 cases were collected and analyzed three times, using an automatic biochemical analyzer, to detect serum MMP3 concentrations. Correlation was analyzed between MMP3 and other proinflammatory cytokines. Following normality tests, differences in serum MMP3 levels between the infected and noninfected group were analyzed via SPSS (version 25.0) software, using the Wilcoxon rank sum test. The MMP3 concentration was 44.44 (23.46 ~ 72.12) ng/mL in the infected group and 32.42 (28.16 ~ 41.21) ng/mL in the noninfected group. The difference between the two groups was statistically significant (Z = -2.799, P = .005 < .05). A positive correlation was found between MMP3 and interleukin 1ß (IL-1ß; r = .681, P = .000 < .05), and IL-6 (r = .529, P = .002 < .05). Serum MMP3 concentration, measured over three separate time points, were 55.98 (30.80 ~ 75.97) ng/mL, 34.84 (0.00 ~ 51.84) ng/mL, and 5.71 (0.00 ~ 40.46) ng/mL, respectively. Detection of serum MMP3 levels may play an important role in the development of therapeutic approaches for COVID-19 and may indicate the severity of disease.


Subject(s)
COVID-19/blood , COVID-19/enzymology , Matrix Metalloproteinase 3/blood , Biomarkers/blood , Gene Expression Regulation, Enzymologic , Humans , Inflammation/metabolism , Matrix Metalloproteinase 3/metabolism
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