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1.
Journal of Medical Virology ; 26:26, 2023.
Article in English | MEDLINE | ID: covidwho-2209121

ABSTRACT

BACKGROUNDS: Recent evidence has emerged concerning delayed cutaneous hypersensitivity reactions after infliximab or adalimumab applications in patients with coronavirus disease 2019 (COVID-19). A few real-world studies compared the events, clinical features, and prognosis of infliximab- or adalimumab-related delayed cutaneous hypersensitivity reactions in COVID-19 patients.

2.
Frontiers in Microbiology ; 13 (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2199024

ABSTRACT

Porcine epidemic diarrhea virus (PEDV) in the Coronavirus family is a highly contagious enteric pathogen in the swine industry, which has evolved mechanisms to evade host innate immune responses. The PEDV-mediated inhibition of interferons (IFNs) has been linked to the nuclear factor-kappa B (NF-kappaB) pathway. MicroRNAs (miRNAs) are involved in virus-host interactions and IFN-I regulation. However, the mechanism by which the PEDV regulates IFN during PEDV infection has not yet been investigated in its natural target cells. We here report a novel mechanism of viral immune escape involving miR-615, which was screened from a high-throughput sequencing library of porcine intestinal epithelial cells (IECs) infected with PEDV. PEDV infection altered the profiles of miRNAs and the activities of several pathways involved in innate immunity. Overexpression of miR-615 increased PEDV replication, inhibited IFN expression, downregulated the NF-kappaB pathway, and blocked p65 nuclear translocation. In contrast, knockdown of miR-615 enhanced IFN expression, suppressed PEDV replication, and activated the NF-kappaB pathway. We further determined that IRAK1 is the target gene of miR-615 in IECs. Our findings show that miR-615 suppresses activation of the NF-kappaB pathway by suppressing the IRAK1 protein and reducing the generation of IFN-IIIs, which in turn facilitates PEDV infection in IECs. Moreover, miR-615 inhibited PEDV replication and NF-kappaB pathway activation in both IECs and MARC-145 cells. These findings support an important role for miR-615 in the innate immune regulation of PEDV infections and provide a novel perspective for developing new treatments. Copyright © 2022 Zheng, Li, Zhu, Wang, Yin, Zhang, Feng, Yin, Huang and Zhang.

3.
International Journal of Clinical Practice ; 2022 (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2194227

ABSTRACT

Objectives. The clinical and imaging features of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 and symptomatic COVID-19 patients. Methods. The clinical and chest computed tomography imaging data of 47 asymptomatic carriers and 36 symptomatic COVID-19 patients were derived. All patients underwent 4-6 CT scans over a period of 2-5 days. Results. The bulk of asymptomatic carriers who developed symptoms and most of the COVID-19 patients were older than 18 years of age with a decreased lymphocyte count, abnormal hepatic and renal function, and increased D-dimer and C-reactive protein. In the early stage, the pulmonary lesion involved mostly 1-2 lobes at the peripheral area in asymptomatic carriers but more than three lobes at both the central and peripheral areas in COVID-19 patients. In the progression stage, the lesion of asymptomatic carriers extended from the peripheral to the central area, and no significant difference was found in the lesion range compared with the symptomatic control group. In early improvement stage, the lesion was rapidly absorbed, and lesions were located primarily at the peripheral area in asymptomatic carriers;contrastingly, lesions were primarily located at both the central and peripheral areas in symptomatic patients. Asymptomatic carriers reflected a significantly shorter duration from disease onset to peak progression stage compared with the symptomatic. Conclusions. Asymptomatic carriers are a potential source of transmission and may become symptomatic COVID-19 patients despite indicating less severe pulmonary damage, earlier improvement, and better prognosis. Early isolation and intervention can eliminate such carriers as potential sources of transmission and improve their prognosis. Copyright © 2022 Xi Ma et al.

4.
Journal of Medicinal Chemistry ; 10:10, 2023.
Article in English | MEDLINE | ID: covidwho-2185475

ABSTRACT

Exploring potent adjuvants and new vaccine strategies is crucial for the development of protein vaccines. In this work, we synthesized a new TLR4 agonist, structurally simplified lipid A analogue GAP112, as a potent built-in adjuvant to improve the immunogenicity of SARS-CoV-2 spike RBD protein. The new TLR4 agonist GAP112 was site-selectively conjugated on the N-terminus of RBD to construct an adjuvant-protein conjugate vaccine in a liposomal formulation. It is the first time that a TLR4 agonist is site-specifically and quantitatively conjugated to a protein antigen. Compared with an unconjugated mixture of GAP112/RBD, a two-dose immunization of the GAP112-RBD conjugate vaccine strongly activated innate immune cells, elicited a 223-fold increase in RBD-specific antibodies, and markedly enhanced T-cell responses. Antibodies induced by GAP112-RBD also effectively cross-neutralized SARS-CoV-2 variants (Delta/B.1.617.2 and Omicron/B.1.1.529). This conjugate strategy provides an effective method to greatly enhance the immunogenicity of antigen in protein vaccines against SARS-CoV-2 and other diseases.

5.
Supportive Care in Cancer ; 31(2):121, 2023.
Article in English | MEDLINE | ID: covidwho-2174189

ABSTRACT

OBJECTIVE: The COVID-19 outbreak has adversely affected breast cancer patients both physically and mentally. Managing Cancer and Living Meaningfully (CALM) is a psychological intervention that is easy to implement. It also decreases the possibility of virus transmission because it can be administered online. Therefore, this study investigated the effects of CALM on the sleep quality, memory, psychological distress, and quality of life (QoL) of breast cancer patients during the ongoing COVID-19 pandemic.

6.
BMC Infectious Diseases ; 22(1):929, 2022.
Article in English | MEDLINE | ID: covidwho-2162307

ABSTRACT

BACKGROUNDS: Interleukin-6 (IL-6) blockers including tocilizumab and sarilumab were approved by the U.S. Food and Drug Administration (FDA) in June 2021 for the treatment of patients with moderate to severe COVID-19. The use of sarilumab or tocilizumab in COVID-19 patients has been related to a reduction in mortality compared to standard care. Recent evidence has emerged concerning drug-induced liver injury (DILI) after sarilumab or tocilizumab applications in COVID-19 patients.

7.
Chinese Journal of School Health ; 43(4):632-640, 2022.
Article in Chinese | Scopus | ID: covidwho-2155904

ABSTRACT

In recent decades, there is a decreasing trend in physical activity, which might be associated with decline in physical and mental health among children and adolescents in China. The outbreak and spread of the COVID-19 further aggravated this trend. Under the background of normalized epidemic prevention and control, in order to deeply understand the relationship between physical activity and physical and mental health of children and adolescents, this study sorted out relevant domestic and foreign literatures, and analyzed the effects of physical activity on children and adolescents' health and fitness. The positive effects of physical activity, cognition, and mental health were found to be significantly different in the type, intensity, and time of physical activity in the related health effects. © 2022 Chinese Academy of Sciences. All rights reserved.

8.
Chinese Journal of School Health ; 43(4):481-485, 2022.
Article in Chinese | Scopus | ID: covidwho-2155902

ABSTRACT

The health of children and adolescents is of great significance to the realization of a "Healthy China". However, the current health problems of children and adolescents are showing a trend of frequent, high incidence and younger age. Complex and diverging characteristics of the environment, family and personal life behavior patterns contribute to risks and problems for children and adolescent health prevention and improvement. The outbreak and spread of COVID-19 epidemic has brought even more severe challenges to the health promotion of children and adolescents. In view of the connection between physical activity and the health benefits, consistent focus on "Physical Activity" and innovative ways and methods of health promotion through physical activity, can help provide an important guarantee for achieving the goal of "Healthy China". © 2022 Chinese Academy of Sciences. All rights reserved.

9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(11): 1663-1667, 2022 Nov 06.
Article in Chinese | MEDLINE | ID: covidwho-2119387

ABSTRACT

Due to the wide variety of pathogens causing respiratory tract infection and the close symptoms, coronavirus disease 2019 (COVID-19) needs to be differentiated from other common infections. Early comprehensive detection and accurate identification of respiratory infection pathogens is of great value for early diagnosis, curative effect, as well as monitor of the diseases. Combined detection of multiple pathogens can quickly and accurately detect and distinguish the pathogens, then provide rapid and reliable laboratory diagnostic basis for further treatment. This article elaborates the application and development of multiplex detection assay in the diagnosis of COVID-19 according to the recent research.


Subject(s)
COVID-19 , Respiratory Tract Infections , Humans , COVID-19/diagnosis , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/therapy , Sensitivity and Specificity
10.
American Journal of Cancer Research ; 12(8):4040-4049, 2022.
Article in English | EMBASE | ID: covidwho-2084307

ABSTRACT

The outbreak of the COVID-19 pandemic has greatly impacted patients with non-small cell lung cancer (NSCLC), making the fear of cancer recurrence (FCR) more pronounced. We explored the effects of FCR on immunotherapy efficacy and quality of life during the COVID-19 pandemic in China among the 124 NSCLC patients enrolled in this study. Quality of life and immunotherapy efficacy were compared between high- and low-FCR groups after completing 4-6 courses of treatment or cancer progression. Worse immunotherapy efficacy and quality of life were reported for the high-FCR group than for the low-FCR group. These findings emphasize the need to pay close attention to the level of FCR in NSCLC patients. Efforts should be taken to alleviate FCR levels among NSCLC patients. Moreover, research is needed to investigate the possible link between immunotherapy efficacy and FCR. Copyright © 2022 E-Century Publishing Corporation. All rights reserved.

11.
Fudan University Journal of Medical Sciences ; 49(4):537-547, 2022.
Article in Chinese | Scopus | ID: covidwho-2055554

ABSTRACT

Objective To understand the status of family services and residents’demands for services in Shanghai in order to construct and improve the key elements of family services in public health events. Methods We used a combining method of individual in-depth interviews and focused group interviews. The informants were domestic and foreign experts in public health, health services, education, safety, etc., community workers and residents. The interview questions were as follow:problems in family services, residents’demands and suggestions for family services, etc. Results We found 7 major family services problems in Shanghai’s response to public health events:The boundary of authorities and responsibilities were not clearly defined between the upper and lower departments. The team construction of public health professions at the community level was flawed. There were miscommunications between upper and lower medical institutions during the epidemic outbreaks. Residents were not aware of the available family services provided by their communities. Unnoticed insanitary spots still existed in public spaces, and the maintenance of residential emergence equipment needs to be strengthened. The public opinion guidance required further strengthening, and the elderly people lack an effective medium for information acquisition. The emergency plan of closed management to solve practical problems after Shanghai’s COVID lockdown was insufficient. The residents’demands included the following 6 aspects:comprehensive family services, supply and guarantee of basic living materials and special materials, professionals providing family services as a means of support, emergency medical services, receiving psychological intervention and understanding knowledge of mental health, security of food and food supply chain security. Conclusion ‘Government led’‘cross-border cooperation’‘clear executive body’and ‘based on the needs of residents’were key factors. Therefore, we suggest family services are included in the normalizing construction of government. © 2022 Fudan University. All rights reserved.

12.
25th International Conference on Miniaturized Systems for Chemistry and Life Sciences, MicroTAS 2021 ; : 863-864, 2021.
Article in English | Scopus | ID: covidwho-2012593

ABSTRACT

The demand for scalable, rapid and sensitive COVID-19 diagnostics is particularly pressing at present to help contain the spread of infection and prevent overwhelming the capacity of health systems. While high-income countries have managed to rapidly expand diagnostic capacities, such is not the case in resource-limited settings of low- to medium-income countries. We report the development of an integrated modular centrifugal microfluidic platform costing less than 250 USD to perform loop-mediated isothermal amplification (LAMP) of viral RNA directly from heat-inactivated nasopharyngeal swab samples. The platform was validated with a panel of 131 nasopharyngeal swab samples collected from symptomatic COVID-19 patients. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

13.
Annals of the Rheumatic Diseases ; 81:1685, 2022.
Article in English | EMBASE | ID: covidwho-2009040

ABSTRACT

Background: Novel Coronavirus pneumonia 2019 (COVID-19) is a systemic infectious disease with prominent involvement of the respiratory tract, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[1]. Systemic lupus erythematosus is charcterized by an aberrant immune response with the presence of circulating autoantibodies, lymphopenia, and proinfammatory[2]. They are immune-compromised and vulnerable to infections with immune-suppressants treatment. However, data regarding the impact of COVID-19 pandemic in patients with SLE and drug use were relatively scarce. Objectives: The prevalence of COVID-19 in SLE patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of SLE patients with COVID-19 was investigated. Methods: Cross-sectional investigations and case series on SLE and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to November 10, 2021 were searched. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Inconsistency was evaluated by using the I2. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Results: A total of 14 studies comprising 5365 patients were identifed (Table 1). Overall prevalence of COVID-19 in SLE patients was 1.5% (95%CI: 1.2%-1.8%). Eight of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 29.8% (95%CI: 25.8%-33.8%) hospitalization rates and 14.6% (95%CI: 11.5%-17.8%) adverse outcome rates. Among patients treated with hydroxychloroquine throughout the course of disease, the prevalence was 0.7% (95%CI: 0.4%-1.0%, Figure 1). Conclusion: Patients with SLE had a higher risk of COVID-19. Hydroxychloro-quine might beneft to reduce the overall hospitalization rate and prevalence rate of COVID-19, and alleviate infammatory damage in the chronic stage of viral infection by inhibiting over activation of the immune system.

14.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005697

ABSTRACT

Background: To investigate the efficacy and safety of anti-PD-1 antibody plus regorafenib in refractory microsatellite stable (MSS) metastatic colorectal cancer (mCRC). Methods: We retrospectively analyzed the efficacy and safety of 103 MSS mCRC patients treated with anti -PD-1 antibodies(including nivolumab, pembrolizumab, camrelizumab, sintilimab, and toripalimab) combined with regorafenib(80 mg once daily for 21 days on/7 days off)between July 2019 and June 2021 in Hunan Cancer Hospital. Results: 103 patients had received at least one dose of regorafenib plus anti -PD-1 antibody. Due to COVID-19 pandemics, economic or other reasons, 48 patients (46.6%) did not return to hospital for second cycle of combination treatment .With a median follow-up of 5.30 months (range 0.50-22.50), the median overall survival (mOS) and progression-free survival (mPFS) were 8.40 months (95%CI:6.40-12.70) and 2.50 months (95%CI:2.27-3.47) in the entire cohort, respectively. The mOS and mPFS were significantly longer in patients who received more than 1 cycle (n = 55, 53.4%) compared to those who received just 1 cycle(n = 48, 46.6%). (16.07 vs. 4.37 months, HR 0.21;95%CI:[0.12-0.38];P<0.001;3.10 vs. 1.11 months, HR 0.12;95%CI: [0.05-0.31];P<0.001). Further analyses revealed that sintilimab (n = 66, 64.1%) significantly improved mPFS from 1.61 months to 3.30 months, compared to other anti-PD-1 antibodies (n = 37, 35.9%) (HR 0.55;95%CI:[0.31-0.99];P = 0.044). Cox multivariate regression analysis demonstrated that cycles of regorafenib plus PD-1 was a significant independent risk factor for the OS and PFS(P0.001).Patients who had previously undergone surgery were better than those who had not (P= 0.029).Sintilimab plus regorafenib had a better PFS benefit(P= 0.044.)Seven patients were diagnosed as partial response and another 16 cases were diagnosed as stable disease in the 55 patients who were evaluated, but no complete response. Thus the objective response rate was 12.7% and the disease control rate was 41.8%.Treatment-related adverse events of grade 3 or higher occurred in 13 (12.6%) patients. Conclusions: The combination of regorafenib plus anti-PD-1 antibody had a manageable safety profile and promising efficacy in MSS mCRC patients, especially in patients who received more than one cycle. Compared with the other anti-PD-1 antibodies, sintilimab may have more encouraging efficacy, which needs further prospective studies.

15.
Cancer Research ; 82(12), 2022.
Article in English | EMBASE | ID: covidwho-1986485

ABSTRACT

Introduction: Despite the development of two mRNA vaccines, there is an urgent unmet need of finding new antiviral strategies. One such potential antiviral strategy is to target the synthetic lethal (SL) partners of transcriptionally altered genes in infected host cells, thereby selectively killing them to halt the infection at its heels (Mast FD, JCB, 2020). Methods: Here we conduct a first proof-of-concept SL inference approach to predict anti-SARS-CoV-2 targets in a systematic genome-wide manner. This effort capitalizes on our recently published pipeline for inferring clinically relevant SL interactions in cancer (Lee et al, Cell, 2021). Based on the latter, we comprehensively analyzed multiple in vitro and in vivo bulk and single-cell RNA-sequencing datasets of SARS-CoV-2 infection to predict candidate antiviral targets that are SL with altered host genes. Importantly, as our predictions are fine-tuned based on the analysis of patients' data, they are more likely to be of translational value. Results: Our key results are twofold:1) The predicted SL-based targets are highly enriched for genes that are reported in four SARS-CoV-2 CRISPR-Cas9 genome-wide genetic screens to inhibit growth of infected cells. 2) A subset of top predicted 26 genes were experimentally tested in a targeted siRNA screen conducted in both infected and non-infected human Caco-2 cells. Remarkably, as expected given that these targets were predicted to be SL specific with genes upregulated in infected cells, indeed, knocking down these targets reduced viral replication and cell viability only under the infected condition without harming non-infected cells. Conclusion: In summary, this study is the first to demonstrate the potential of a synthetic lethality approach to identify viral (specifically anti-SARS-CoV-2) targets. Importantly, as both single cell and bulk transcriptomics patients' data is considered from both infected people and controls, they are more likely to be of clinical relevance. Targeting host genes identified via an SL-based approach is probably more suitable when the infection is at the early stage and host can still tolerate the loss of infected host cells.

16.
Chinese Journal of Experimental Traditional Medical Formulae ; 28(4):172-180, 2022.
Article in Chinese | Scopus | ID: covidwho-1893394

ABSTRACT

Objective: To explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019 (COVID-19) based on the differences of syndromes and traditional Chinese medicine (TCM) treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. Method: Demographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system (HIS) of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. Result: A total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai, dominated by young and middle-aged males, had clinical symptoms of fever, abnormal sweating, and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat, with manifest cold, dampness, and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness, accompanied by draining depressed heat. The core Chinese medicines used are Poria, Armeniacae Semen Amarum, Gypsum Fibrosum, Citri Reticulatae Pericarpium, and Pogostemonis Herba. By contrast, the 105 patients in Ruili, dominated by young females, had atypical clinical symptoms, and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach, with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen, resolving dampness, and dispersing Qi with light drugs. The core Chinese medicines used are Poria, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Coicis Semen, Platycodonis Radix, Lonicerae Japonicae Flos, and Pogostemonis Herba. Conclusion: The differences in clinical characteristics, TCM syndromes, and medication of COVID-19 patients from the two places may result from different regions, population characteristics, and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments. © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

17.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880602
18.
BMC Public Health ; 22(1): 248, 2022 02 07.
Article in English | MEDLINE | ID: covidwho-1673908

ABSTRACT

BACKGROUND: The COVID-19 pandemic generated a growing interest in and need for evidence-based tools to facilitate the implementation of emergency management strategies within public health practice. Quality improvement (QI) is a key framework and philosophy to guide organizational emergency response efforts; however, the nature and extent to which it has been used in public health settings during the COVID-19 pandemic remains unclear. METHODS: We conducted a scoping review of literature published January 2020 - February 2021 and focused on the topic of QI at public health agencies during the COVID-19 pandemic. The search was conducted using four bibliographic databases, in addition to a supplementary grey literature search through custom Google search engines and targeted website search methods. Of the 1,878 peer-reviewed articles assessed, 15 records met the inclusion criteria. An additional 11 relevant records were identified during the grey literature search, for a total of 26 records included in the scoping review. RESULTS: Records were organized into five topics: 1) collaborative problem solving and analysis with stakeholders; 2) supporting learning and capacity building in QI; 3) learning from past emergencies; 4) implementing QI methods during COVID-19; and 5) evaluating performance using frameworks/indicators. CONCLUSIONS: The literature indicates that QI-oriented activities are occurring at the organizational and program levels to enhance COVID-19 response. To optimize the benefits that QI approaches and methodologies may offer, it is important for public health agencies to focus on both widespread integration of QI as part of an organization's management philosophy and culture, as well as project level activities at all stages of the emergency management cycle.


Subject(s)
COVID-19 , Pandemics , Humans , Pandemics/prevention & control , Public Health , Quality Improvement , SARS-CoV-2
19.
Emerg Microbes Infect ; 11(1): 240-249, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1585242

ABSTRACT

ABSTRACTThe COVID-19 pandemic and measures against it provided a unique opportunity to understand the transmission of other infectious diseases and to evaluate the efficacy of COVID-19 prevention measures on them. Here we show a dengue epidemic in Yunnan, China, during the pandemic of COVID-19 was dramatically reduced compared to non-pandemic years and, importantly, spread was confined to only one city, Ruili. Three key features characterized this dengue outbreak: (i) the urban-to-suburban spread was efficiently blocked; (ii) the scale of epidemic in urban region was less affected; (iii) co-circulation of multiple strains was attenuated. These results suggested that countermeasures taken during COVID-19 pandemic are efficient to prevent dengue transmission between cities and from urban to suburban, as well to reduce the co-circulation of multiple serotypes or genotypes. Nevertheless, as revealed by the spatial analysis, once the dengue outbreak was established, its distribution was very stable and resistant to measures against COVID-19, implying the possibility to develop a precise prediction method.


Subject(s)
Communicable Disease Control/methods , Dengue Virus , Dengue/epidemiology , Dengue/prevention & control , Dengue/transmission , Animals , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Chlorocebus aethiops , Disease Outbreaks/prevention & control , Genotype , Humans , Pandemics/prevention & control , Phylogeny , RNA, Viral , SARS-CoV-2 , Serogroup , Spatial Analysis , Vero Cells
20.
Chinese Journal of Emergency Medicine ; 30(10):1220-1228, 2021.
Article in Chinese | Scopus | ID: covidwho-1576023

ABSTRACT

Objective To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment. Methods A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University. Results The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant (P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥ 39 °C);other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥ 39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases (P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases (OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively. © 2021 Chinese Medical Association. All rights reserved.

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