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1.
Behav Sci (Basel) ; 12(6)2022 May 30.
Article in English | MEDLINE | ID: covidwho-1869475

ABSTRACT

To mitigate the unexpected closure of educational institutions during the COVID-19 pandemic, e-learning has become a practical alternative to conventional face-to-face instruction. Videoconferencing, a synchronous computer-mediated communication (SCMC) approach, has been adopted as a venue to continue student learning activities. However, in the field of second-language (L2) education, videoconferencing had already been integrated into learning tasks, enabling L2 learners to have more opportunities to access authentic linguistic input and participate in interactions with more proficient users or native speakers of the target languages. Research has reported the pedagogical benefits of learners' L2 achievement that are provided by videoconferencing, whereas some studies have reached a different conclusion. To further ascertain the effectiveness of videoconferencing in L2 learning, meta-analysis can be used to provide statistical evidence of the significance of study results, which serves as a useful reference for the application of videoconferencing to current e-learning practices. Thus, systematic meta-analysis was used in this study to synthesize the findings from experimental and quasi-experimental research into the effectiveness of videoconferencing for L2 learning. Videoconferencing approaches led to positive, medium overall effects in control/experimental group comparisons (g = 0.35, p < 0.5) on the L2 language development of listening and speaking abilities. However, this conclusion is based on five studies and, thus, needs to be treated cautiously. The implications of the findings and suggestions for future studies are discussed.

2.
International Journal of Environmental Research and Public Health ; 19(10):6293, 2022.
Article in English | MDPI | ID: covidwho-1857875

ABSTRACT

Taiwan is expected to reach super-aged status by 2026, leading to an increased demand for elderly caregiving services. Low local unemployment and a dwindling working-age population mean the island's care system relies heavily on female foreign domestic workers (FDWs) from Southeast Asian neighbors such as Vietnam to satisfy labor shortages. Although suggested by anecdotal evidence, limited research has been conducted on the link between the shortfall in FDW qualifications, training, preparedness, and expertise and their employment stressors. Therefore, this study aims to assist FDWs by evaluating their stressors and helping them better understand health care delivery by (1) administering the Modified Caregiver Strain Index (MCSI) revised 2003 questionnaire, (2) performing semi-structured in-depth one-on-one interviews, (3) classifying interview results according to thematic analysis, and (4) using these themes to devise and deliver a 12-week multilingual health education teach-back program. Our results indicate that Vietnamese FDWs face specific challenges, including language barriers, homesickness, intensive physical and psychological work demands, stress adaptation, and occupational exposures. Despite yielding no significant improvements in caregiving strain, our intervention, conducted at the height of the COVID-19 pandemic, pinpoints and classifies areas of grave concern and proposes recommendations that can assist long-term care (LTC) stakeholders in understanding and overcoming their respective challenges, thereby improving the quality of elderly care.

3.
Signa Vitae ; 18(3):33-39, 2022.
Article in English | Academic Search Complete | ID: covidwho-1856561

ABSTRACT

Emergency department (ED) crowdedness is a global phenomenon that can lead to many adverse effects. The relationship of crowdedness and emergency department cardiac arrest (EDCA) occurrence is still debated. The COVID-19 pandemic precipitated a change in the patient volume of the ED and the crowdedness of the ED varied with the epidemic in a continuous period. Different degrees of crowdedness provided us with an opportunity to study the relationship between crowdedness and EDCA occurrence. Our aim of this study was to determine the relationship between EDCA occurrence and prognosis and ED crowdedness.This was a longitudinal study conducted in a tertiary teaching hospital. The study period was from October 1, 2019, to September 30, 2020, and was divided into three periods according to daily patient volume and crowdedness. All nontraumatic and adult EDCA patients during the study period were included, and out-of-hospital cardiac arrest (OHCA) patients and patients with do-not-resuscitate orders were excluded.During the study period, a total of 126 EDCA patients were included. The ratio of EDCA events to daily patient volume was compared among these 3 periods, and there was no significant difference (P2: p = 0.109, P3: p = 0.761, P1 as reference). No significant difference in the prognosis of EDCA patients was found among the 3 periods, regardless of the return of spontaneous circulation (ROSC) (p = 0.437) or survival rates (p = 0.838). In conclusion, there was no obvious correlation between ED crowdedness and EDCA occurrence. The prognosis of EDCA patients was not significantly associated with crowdedness. The metrics of ED overcrowding is unknown and may need further study to develop a generally accepted standard or index. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

4.
Front Cell Infect Microbiol ; 12: 854505, 2022.
Article in English | MEDLINE | ID: covidwho-1847155

ABSTRACT

Objective: Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community acquired pneumonia. With the outbreak of coronavirus disease 2019 (COVID-19), the prevalence of some infectious respiratory diseases has varied. Epidemiological features of M. pneumoniae in children from Beijing (China) before and during the COVID-19 pandemic were investigated. Methods: Between June 2016 and May 2021, a total of 569,887 children with respiratory infections from Children's Hospital Affiliated to Capital Institute of Pediatrics (Beijing, China) were included in this study. M. pneumoniae specific-IgM antibody in serum specimens of these patients was tested by a rapid immunochromatographic assay kit. The relevant clinical data of M. pneumoniae-positive cases were also collected, and analyzed by RStudio software. Results: The results showed that 13.08% of collected samples were positive for M. pneumoniae specific-IgM antibody. The highest annual positive rate was 17.59% in 2019, followed by 12.48% in 2018, 12.31% in 2017, and 11.73% in 2016, while the rate dropped to 8.9% in 2020 and 4.95% in 2021, with significant difference. Among the six years, the positive rates in summer and winter seasons were significantly higher than those in spring and autumn seasons (p < 0.001). The positive rate was the highest in school-age children (22.20%), and lowest in the infant group (8.76%, p < 0.001). The positive rate in boys (11.69%) was lower than that in girls (14.80%, p < 0.001). There were no significant differences in different seasons, age groups, or genders before and during the COVID-19 pandemic (p > 0.05). Conclusions: Our study demonstrated that an M. pneumoniae outbreak started from the summer of 2019 in Beijing. After the COVID-19 pandemic outbreak in the end of 2019, the M. pneumoniae positive rates dropped dramatically. This may be due to the restrictive measures of the COVID-19 pandemic, which effectively controlled the transmission of M. pneumoniae. The relationships between M. pneumoniae positive rates and season, age, and gender were not statistically significant before and during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pneumonia, Mycoplasma , Beijing/epidemiology , COVID-19/epidemiology , Child , Female , Humans , Immunoglobulin M , Infant , Male , Mycoplasma pneumoniae , Pandemics , Pneumonia, Mycoplasma/epidemiology , Prevalence
5.
Journal of clinical medicine ; 11(9), 2022.
Article in English | EuropePMC | ID: covidwho-1842142

ABSTRACT

The number of patients requiring prolonged mechanical ventilation (PMV) is increasing worldwide, placing a burden on healthcare systems. Therefore, investigating the pathophysiology, risk factors, and treatment for PMV is crucial. Various underlying comorbidities have been associated with PMV. The pathophysiology of PMV includes the presence of an abnormal respiratory drive or ventilator-induced diaphragm dysfunction. Numerous studies have demonstrated that ventilator-induced diaphragm dysfunction is related to increases in in-hospital deaths, nosocomial pneumonia, oxidative stress, lung tissue hypoxia, ventilator dependence, and costs. Thus far, the pathophysiologic evidence for PMV has been derived from clinical human studies and experimental studies in animals. Moreover, recent studies have demonstrated the outcome benefits of pharmacological agents and rehabilitative programs for patients requiring PMV. However, methodological limitations affected these studies. Controlled prospective studies with an adequate number of participants are necessary to provide evidence of the mechanism, prognosis, and treatment of PMV. The great epidemiologic impact of PMV and the potential development of treatment make this a key research field.

6.
Health Aff (Millwood) ; 41(4): 523-530, 2022 04.
Article in English | MEDLINE | ID: covidwho-1775464

ABSTRACT

Although private equity acquisition of short-term acute care hospitals purportedly improves efficiency and cost-effectiveness, financial performance after acquisition remains unexamined. We compared changes in the financial performance of 176 hospitals acquired during 2005-14 versus changes in matched control hospitals. Acquisition was associated with a $432 decrease in cost per adjusted discharge and a 1.78-percentage-point increase in operating margin. The majority of acquisitions-134 members of the Hospital Corporation of America, acquired in 2006-were associated with a $559 decrease in cost per adjusted discharge but no change in operating margin. Conversely, non-HCA hospitals exhibited a 3.27-percentage-point increase in operating margin without a concomitant change in cost per adjusted discharge. When we examined markers of hospital capacity, operational efficiency, and costs, we found that private equity acquisition was associated with decreases in total beds, ratio of outpatient to inpatient charges, and staffing (total personnel and nursing full-time equivalents and total full-time equivalents per occupied bed). Therefore, financial performance improved after acquisition, whereas patient throughput and inpatient utilization increased and staffing metrics decreased. Future research is needed to identify any unintended trade-offs with safety and quality.


Subject(s)
Hospitals , Humans , Workforce
7.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331897

ABSTRACT

Large-scale populations in the world have been vaccinated with COVID-19 vaccines, however, breakthrough infections of SARS-CoV-2 are still growing rapidly due to the emergence of immune-evasive variants, especially Omicron. It is urgent to develop effective broad-spectrum vaccines to better control the pandemic of these variants. Here, we present a mosaic-type trimeric form of spike receptor-binding domain (mos-tri-RBD) as a broad-spectrum vaccine candidate, which carries the key mutations from Omicron and other circulating variants. Tests in rats showed that the designed mos-tri-RBD, whether used alone or as a booster shot, elicited potent cross-neutralizing antibodies against not only Omicron but also other immune-evasive variants. Neutralizing antibody titers induced by mos-tri-RBD were substantially higher than those elicited by homo-tri-RBD (containing homologous RBDs from prototype strain) or the inactivated vaccine BBIBP-CorV. Our study indicates that mos-tri-RBD is highly immunogenic, which may serve as a broad-spectrum vaccine candidate in combating SARS-CoV-2 variants including Omicron.

8.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331690

ABSTRACT

The unprecedented coronavirus disease (COVID-19) epidemic has created a worldwide public health emergency, and there is an urgent need to develop an effective antiviral drug to control this severe infectious disease. Here, we found that the E, or M membrane proteins of coronavirus could be targeted by a 28-residue antibody mimetic by fusing two antibody Fab complementarity-determining regions (VHCDR1 and VLCDR3) through a cognate framework region (VHFR2) of the antibodies which recognize the coronavirus E or M proteins. We constructed a fusion protein, pheromonicin-covid-19 (PMC-covid-19), by linking colicin Ia, a bactericidal molecule produced by E.coli which kills target cells by forming a voltage-dependent channel in target lipid bilayers, to that antibody mimetic. The E, or M protein/antibody mimetic interaction initiated the formation of irreversible PMC-covid-19 channel in the covid-19 envelope and infected host cell membrane resulting in leakage of cellular contents. PMC-covid-19 demonstrates broad-spectrum protective efficacy against tested variants of coronavirus severe acute respiratory syndrome (p<0.01-0.0001). PMC-covid-19 significantly altered outcomes of in vivo fatal covid-19 challenge infection without evident toxicity, making it an appropriate candidate for further clinical evaluation.

9.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-331322

ABSTRACT

Background: The lack of interaction in pharmacology courses, especially in terms of the Coronavirus Disease 2019 (COVID-19) pandemic, has required a fast shift to remote learning at medical schools, causing students to feel anxious and isolated. As a result, new interactive teaching approaches are required to improve pharmacology learning attention and interaction in traditional classrooms or remoting education. Methods: : We introduced the bullet screen into pharmacology teaching. Then, a survey was distributed to first-, second- and third-year pre-clinical undergraduate medical and nursing students at the Shanghai Jiaotong University School of Medicine from November 2020 to March 2022. We evaluated the essential features, instructional effectiveness, and recreational value of bullet screens. Responses to structured and open-ended questions about strengths and weaknesses of the bullet screen and overall reflections were coded and compared between medical and nursing students. Results: : For the essential features, bullet screen has a high degree of acceptability among students, and this novel instructional style conveniently increased the classroom interaction. For instructional effectiveness, bullet screen might inspire students’ in-depth thinking. Meanwhile, students tended to consider bullet-screen comments as a way to express their support rather than to make additional comments or to express their opposition. For the recreational value, the process of using bullet screen was interesting. The lack of idea might lead to the relative differences between medical and nursing students, indicating that guiding the appropriate use of bullet screen is necessary. Conclusions: : The bullet screen may be popularized as an auxiliary teaching approach to promote interaction between teachers and students in the curriculum as well as remote education. It's interesting and beneficial in pharmacology courses, yet there are several aspects that might be improved for popularization.

10.
Biomedicines ; 10(4):773, 2022.
Article in English | MDPI | ID: covidwho-1762736

ABSTRACT

Polymorphonuclear neutrophils (PMNs) are the most abundant white blood cells in the circulation. These cells act as the fast and powerful defenders against environmental pathogenic microbes to protect the body. In addition, these innate inflammatory cells can produce a number of cytokines/chemokines/growth factors for actively participating in the immune network and immune homeostasis. Many novel biological functions including mitogen-induced cell-mediated cytotoxicity (MICC) and antibody-dependent cell-mediated cytotoxicity (ADCC), exocytosis of microvesicles (ectosomes and exosomes), trogocytosis (plasma membrane exchange) and release of neutrophil extracellular traps (NETs) have been successively discovered. Furthermore, recent investigations unveiled that PMNs act as a double-edged sword to exhibit paradoxical activities on pro-inflammation/anti-inflammation, antibacteria/autoimmunity, pro-cancer/anticancer, antiviral infection/COVID-19-induced immunothrombotic dysregulation. The NETs released from PMNs are believed to play a pivotal role in these paradoxical activities, especially in the cytokine storm and immunothrombotic dysregulation in the recent SARS-CoV-2 pandemic. In this review, we would like to discuss in detail the molecular basis for these strange activities of PMNs.

11.
Preprint in English | bioRxiv | ID: ppbiorxiv-486173

ABSTRACT

Large-scale populations in the world have been vaccinated with COVID-19 vaccines, however, breakthrough infections of SARS-CoV-2 are still growing rapidly due to the emergence of immune-evasive variants, especially Omicron. It is urgent to develop effective broad-spectrum vaccines to better control the pandemic of these variants. Here, we present a mosaic-type trimeric form of spike receptor-binding domain (mos-tri-RBD) as a broad-spectrum vaccine candidate, which carries the key mutations from Omicron and other circulating variants. Tests in rats showed that the designed mos-tri-RBD, whether used alone or as a booster shot, elicited potent cross-neutralizing antibodies against not only Omicron but also other immune-evasive variants. Neutralizing antibody titers induced by mos-tri-RBD were substantially higher than those elicited by homo-tri-RBD (containing homologous RBDs from prototype strain) or the inactivated vaccine BBIBP-CorV. Our study indicates that mos-tri-RBD is highly immunogenic, which may serve as a broad-spectrum vaccine candidate in combating SARS-CoV-2 variants including Omicron.

12.
Acta psychologica ; 2022.
Article in English | EuropePMC | ID: covidwho-1749830

ABSTRACT

Background Coronavirus disease 2019 (COVID-19) is profoundly affecting lives around the globe. Previous studies on COVID-19 mainly focused on epidemiological, clinical, and radiological features of patients with confirmed infection. Little attention has been paid to the follow-up of recovered patients. As a vulnerable population to adverse events, the health status of the COVID-19 recovered pediatric patients is of great concern. We aimed to investigate the prevalence of behavioral problems among pediatric patients recovered from the COVID-19 in Wuhan, China. Methods A total of 122 children who were suspected or confirmed COVID-19 cases and hospitalized for treatment were enrolled in the study between April 2020 and May 2020 in Wuhan, China. We collected related information about hospitalization and discharge of the children and emotional symptoms of their parents through electronic medical records and questionnaire. The behavioral problems of children were examined by applying the parent-reported the Strengths and Difficulties Questionnaire (SDQ). Results The participant children were discharged from hospital after about two months. Among them, 76 (62%) were boys, and the mean age was 6.71 years old. The highest prevalence of behavioral problems among pediatric children with COVID-19 was for prosocial behavior (15%), followed by total difficulties (13%), emotional symptoms (11%), hyperactivity (10%), conduct problems (9%), and peer problems (1%). With regarding to their parents, 26% reported having symptoms of anxiety and 23% as having symptoms of depression. The scores of SDQ were higher in those children whose parents have emotional problems compared to parents without. Conclusion Long-term follow up studies on the psychological and behavioral problems of COVID-19 recovered children and their parents are warranted.

13.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330069

ABSTRACT

Recent SARS-CoV-2 wastewater-based epidemiology (WBE) surveillance have documented a positive correlation between the number of COVID-19 patients in a sewershed and the level of viral genetic material in the wastewater. Efforts have been made to use the wastewater SARS-CoV-2 viral load to predict the infected population within each sewershed using a multivariable regression approach. However, reported clear and sustained variability in SARS-CoV-2 viral load among treatment facilities receiving industrial wastewater have made clinical prediction challenging. Several classes of molecules released by regional industries and manufacturing facilities, particularly the food processing industry, can significantly suppress the SARS-CoV-2 signals in wastewater by breaking down the lipid-bilayer of the membranes. Therefore, a systematic ranking process in conjugation with metabolomic analysis was developed to identify the wastewater treatment facilities exhibiting SARS-CoV-2 suppression and identify and quantify the chemicals suppressing the SARS-COV-2 signals. By ranking the viral load per diagnosed case among the sewersheds, we successfully identified the wastewater treatment facilities in Missouri, USA that exhibit SARS-CoV-2 suppression (significantly lower than 5 × 10 11 gene copies/reported case) and determined their suppression rates. Through both untargeted global chemical profiling and targeted analysis of wastewater samples, 40 compounds were identified as candidates of SARS-CoV-2 signal suppression. Among these compounds, 14 had higher concentrations in wastewater treatment facilities that exhibited SARS-CoV-2 signal suppression compared to the unsuppressed control facilities. Stepwise regression analyses indicated that 4-nonylphenol, palmitelaidic acid, sodium oleate, and polyethylene glycol dioleate are positively correlated with SARS-CoV-2 signal suppression rates. Suppression activities were further confirmed by incubation studies, and the suppression kinetics for each bioactive compound were determined. According to the results of these experiments, bioactive molecules in wastewater can significantly reduce the stability of SARS-CoV-2 genetic marker signals. Based on the concentrations of these chemical suppressors, a correction factor could be developed to achieve more reliable and unbiased surveillance results for wastewater treatment facilities that receive wastewater from similar industries.

14.
Psychology research and behavior management ; 15:569-579, 2022.
Article in English | EuropePMC | ID: covidwho-1733471

ABSTRACT

Purpose COVID-19 has affected the health and well-being of tens of millions of people and contributed to smartphone addiction. The prior studies found several characteristics that influenced smartphone addiction, but little research was undertaken on the epidemic. This study aims to test a moderated mediation model of smartphone addiction. Methods Three classes in each grade from grade 7 through grade 9 at random were recruited in the target junior high schools. A total of 931 Chinese adolescents (Mage=13.54 years, SDage =1.08) completed valid questionnaires via online surveys from February 5–19, 2021. Results Parent phubbing had a positive effect on smartphone addiction. Boredom proneness played a mediating role in this relationship. Additionally, refusal self-efficacy moderated the effect of parent phubbing on smartphone addiction. Refusal self-efficacy moderated the effect of boredom proneness on smartphone addiction. Conclusion Findings of this study shed light on a correlation between parent phubbing and smartphone addiction. Moreover, this study emphasizes the value of intervening in adolescents’ boredom proneness and increasing the ability of refusal self-efficacy to prevent and intervene in the context of COVID-19.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315787

ABSTRACT

Background: Haematological markers such as absolute lymphopenia has been associated with severe COVID-19 infection. However, the described cohorts were generally unwell with a large proportion of patients requiring intensive care stay. It is uncertain if these markers apply to a population with less severe illness. We sought to describe the haematological profile of patients with mild disease with COVID-19 that were admitted to a single centre in Singapore. Methods: We examined 554 consecutive PCR positive SARS-COV-2 patients who were admitted to a single tertiary healthcare institution from Feb 2020 to April 2020 2020. We examined patients based on their haematological profile based on full blood count obtained within 24h of presentation. Results: Patients with pneumonia had higher neutrophil percentages (66.5±11.6 vs 55.2±12.6%, p<0.001), lower absolute lymphocyte count (1.5±1.1 vs 1.9±2.1 x109/L, p<0.011) and absolute eosinophil count (0.2±0.9 vs 0.7±1.8 x109/L, p=0.002). Platelet counts (210±56 vs 230±61, p=0.020) were slightly lower in the group with pneumonia. We did not demonstrate significant differences in the neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio and platelet-lymphocyte ratio in patients with or without pneumonia. Sixty-eight patients (12.3%) had peripheral eosinophilia. This was more common in migrant workers living in dormitories. Conclusion: Neutrophilia and lymphopenia were found to be markers associated with severe COVID-19 illness. We did not find that combined haematological parameters: NLR, MLR and PLR, had any association with disease severity in our cohort of patients with mild-moderate disease. Migrant workers living in dormitories had eosinophilia which may reflect concurrent chronic parasitic infection.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315626

ABSTRACT

The therapeutic effect of tocilizumab remains controversial. We aimed to evaluate whether tocilizumab might be beneficial in COVID-19 patients. We searched PubMed, Embase and Cochrane library from inception to June 23, 2020. Summary estimates of overall response rate (ORR) and all-cause death rate in all patients were analyzed. This study was registered with PROSPERO (CRD42020191313). We included data from 28 articles including 991 COVID-19 patients who underwent tocilizumab administration. The pooled ORR was 72% (95% CI, 66-79%) and pooled all-cause death rate was 16% (95% CI, 11-22%). The optimal timing of administration was the 7.15 day from the symptom onset and with the lowest death rate of 13.11%. 562 patients were defined as with severe infection, and the pooled ORR was 78% (95% CI, 70-85%). The pooled ORR of 56 organ transplantation recipients was 53% (95% CI, 26-78%), which was lower than non-transplant patients [75% (95% CI, 69-81%)]. Nearly all studies confirmed the safety of tocilizumab administration. Tocilizumab improves the clinical outcome of COVID-19 patients, especially in severe cases, and the optimal timing of administration may provide the guidance for management. However, tocilizumab may be used with caution in solid transplant recipients for the suboptimal efficacy.

17.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315504

ABSTRACT

Background: A national outbreak of respiratory syncytial virus (RSV) has been observed in the community since August 2020 in Taiwan even under strict COVID-19 related public health measures.Methods: We reviewed a national laboratory-based surveillance network established by Taiwan Centers for Disease Control for respiratory viral pathogens between 2010 and 2020. A retrospective study of 257 children < 5 years old hospitalized with RSV infection at Chang Gung Memorial Hospital Lin Kou and Kaohsiung branches between 2018 and 2020 was conducted, and 193 samples positive for RSV-A were sequenced. Clinical data were obtained and stratified by genotype and year.Findings: National data from 2020 showed an enormous increase in RSV case numbers. The RSV positivity rate in 2020 had an approximately 4-fold surge compared to 2010 in Taiwan (OR 3.79;95% CI, 3.06–4.69;p < 0.001), surpassing previous years during which ON1 was prevalent. Phylogenetic analysis of G protein showed that novel ON1 variants in 2020 with 6 amino acid changes that emerged gradually in 2019 and a novel substitution, E257K were clustered separately from those of 2018 and 2019 seasons and ON1 reference strains. The F protein of the variant carried T12I and H514N substitutions, which weren’t at antigenic sites. Age (OR: 0.97;95% CI: 0.94–0.99;p =0.02) and 2020 ON1 variant (OR: 2.52;95% CI: 1.13–5.63;p = 0.025) were independently associated with oxygen saturation <94% during hospitalization.Interpretation: The unprecedented 2020 RSV epidemic caused by novel ON1 variants suggests that the mutations may confer a fitness advantage over other genotypes. Further studies on viral replication, antigenic changes, and virulence are required.Funding: This work was supported by the Chang Gung Memorial Hospital in Taiwan [Grant CMRPG3K1011 and CMRPG3K1141 ];Ministry of Science Technology in Taiwan [MOST 108-2314-B-182A-156-MY3];China Medical University, Taiwan [Grant CMU 108-S-23, CMU109-MF-111]Declaration of Interests: No potential conflict of interest was reported by the authors.Ethics Approval Statement: This study was approved by the Research and Ethics Committee of Chang Gung Memorial Hospital (IRB:202100450B0, 202100569A3).

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315245

ABSTRACT

Background: Chest computed tomography (CT) has been accepted to provide reference for the diagnose and assessment the severity of Corona Virus Disease 2019 (COVID-19). Decrease in the counts of lymphocyte and leukocyte is used as the diagnostic indicator of suspected COVID-19 cases. However, there is few study on exploring the hysteresis of chest CT changes and the predictive role of lymphocyte count in peripheral blood before treatment in the severity of the disease. Methods A retrospective analysis was carried out focusing on the data of patients tested to be positive for RNA nucleic acid test of SARS-CoV-2 with nasopharyngeal swabs in 4 hospitals. An independent assessment was performed by one clinician using the DEXIN FACT Workstation Analysis System, and the assessment results were reviewed by another clinician. Furthermore, the mean hysteresis time was calculated according to the median time from progression to the most serious situation to improvement of chest CT in patients after fever relief. The optimal scaling regression analysis was performed by including variables with statistical significance in univariate analysis. In addition, a multivariate regression model was established to investigate the relationship of the percentage of lesion/total lung volume with lymphocyte and other variables. Results In the included 166 patients with COVID-19, the average value of the most serious percentage of lesion/total lung volume was 6.62, of which 90 patients with fever had an average hysteresis time of 4.5 days after symptom relief, with a similar trend observed in those without fever. Multivariate analysis revealed that lymphocyte count in peripheral blood and transcutaneous oxygen saturation decreased with the increase of the percentage of lesion/total lung volume. Meanwhile, age, fever and C-reactive protein exhibited no such effect in the established model. Conclusions There is a hysteresis effect in the improvement of chest CT image in relative to fever relief in patients with COVID-19. Besides, the percentage of lesion/total lung volume of chest CT correlates negatively with lymphocyte count in peripheral blood and transcutaneous oxygen saturation. Findings in our study may contribute to understanding the disease status of patients with COVID-19 and grasping the opportunity of treatment by clinicians.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315212

ABSTRACT

Background: Multiorgan damage by SARS-CoV-2 results in alterations of many clinical measures associated with mortality of COVID-19. This research discussed the pioneering pathogenicity factors that lead to the extensive damage elusive. Objectives: A cohort of COVID-19 patients. Methods: : We conducted a correlational analysis of hospital outcomes with an independent cohort of COVID-19 patients and we also presented a death case to illustrate for time course of immune cell density. Results: : The results showed that dysregulated immune cell densities were correlated with hospitalization duration before death, not before discharge. High neutrophil densities allowed sorting out one third of total death cases while a density of less than 70% of the white blood cells allowed sorting out 70% of surviving cases. Conclusion: Collectively surged neutrophil was a top trigger for mortality in patients with COVID-19.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315211

ABSTRACT

Background: Worldwide spread of the novel coronavirus disease 2019 (COVID-19) has made hundreds of thousands people sick and fortunately many of them have been treated and discharged. However, it remains unclear how well the discharged patients were recovering. Chest CT scan, with demonstrated high sensitivity to COVID-19, was used here to examine clinical manifestations in patients at discharge. Methods: This study registered retrospectively single-center case series of 180 discharged patients, all confirmed with COVID-19 at Wuhan Red Cross Hospital in Wuhan, China. Epidemiological, demographic, clinical, laboratory and treatment data were collected. CT imaging features of absorption vs progressive stage were compared and analyzed. Results: Five pulmonary lobes were affected in 54 (30%) of the 180 patients at the absorption stage, comparing to 66% of them at the progressive stage ( P=1.45×10 -11 ). Forty five (25%) patients had pleural effusion on admission and 13 of them still carried hydrothorax when discharged as per standard discharge criteria( P=4.48×10 -6 ). Besides, compared with those at progressive stage, 97 (54%) discharged patients had interlobular thickening ( P=6.95×10 -3 ) and 43% of them still presented adjacent pleura thickening ( P=5.58×10 -5 ). The median total CT score of discharged patients at absorption stage was lower than progressive stage (3 vs 12.5 ). The median total CT score recovery rate was 67% (range, 0-100%) and 139 (77%) patients showed less than 90% improvement at discharge. Conclusions: A majority (77%) of the discharged patients had not recovered completely. The current discharge criteria may need to include 90% or higher CT score-based recovery rate.Authors Jingwen Li, Xi Long, Fang Fang, and Xuefei Lv contributed equally to this work.Authors Zhicheng Lin and Nian Xiong are joint last coauthors.

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