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1.
Bioengineering ; 9(4):135, 2022.
Article in English | ProQuest Central | ID: covidwho-1809682

ABSTRACT

Footwear is among the most important equipment in sports to decrease injuries and enhance performance during exercise. In this study, we investigated differences in lower extremity plantar pressure and muscle activations during jump rope activities. Ten participants performed jump rope under two landing conditions with different footwear. A force platform (AMTI, 1000 Hz), a Novel Pedar-X system (Nove, 100 Hz), and a wireless electromyography (EMG) system (Noraxon, 1500 Hz) were used to measure biomechanical parameters during the jump rope exercise. Vertical ground reaction forces (vGRF), plantar pressure, and lower extremity muscle activations were analyzed. One-leg landing resulted in a significantly greater vGRF and shorter fly time than two-leg landing (p < 0.05). A significantly higher peak pressure and lesser toe (LT) area pressure was shown with the jumping shoe (all p < 0.05), but lower plantar pressure resulted in the middle foot area (p < 0.05). The EMG results of tibialis anterior (TA) were significantly greater with one-leg landing (all p < 0.05) during the pre- and background activity (BGA) phases. The results suggest that plantar pressure distribution should be considered when deciding on footwear during jump rope exercises, but care should be taken with regards to recovery after repeated collisions and fatigue. The jumping shoe provides benefits in terms of decreased plantar pressure sustained during jump rope exercises.

2.
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
3.
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.

4.
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.

5.
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.

6.
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.

7.
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.

8.
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.

9.
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.

10.
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.

11.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328528

ABSTRACT

Once challenged by the SARS-CoV-2 virus, the human host immune system triggers a dynamic process against infection. We constructed a simplistic mathematical model to describe host innate and adaptive immune response to viral challenge. Based on the dynamic properties of viral load and immune response, we classified the resulting dynamics into four modes, corresponding to the increasing severity of COVID-19 disease. We found immune efficacy against viral attack, clearance of infected cells, and IL-6 levels to be prognostic determinants, especially for severe and critical patients. We also investigated vaccine-induced protection against SARS-CoV-2 infection. Results strongly suggested that immune efficacy based on memory T cells, as well as neutralizing antibody titers, could be true indicators of vaccine protection rates. Finally, we analyzed infection dynamics of SARS-CoV-2 variants within the construct of our mathematical model. Overall, our results provide a systematic framework for understanding the dynamics of host response upon challenge by SARS-CoV-2 infection, and this framework can be used to predict vaccine protection and perform clinical diagnosis.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324527

ABSTRACT

Background: The coronavirus disease 2019 is in the global epidemic, which seriously affects the normal medical order. How to effectively manage colorectal cancer under the background of regular epidemic prevention and control need to gather the experience and wisdom of countries all over the world to study together. Methods: : A retrospective observational study was performed to compare colorectal cancer patients’ clinical characters between the severe epidemic group (SEG,January 20, 2020 to March 20, 2020) versus the epidemic remission group (ERG, April 20, 2019 to June 20, 2020). The demographic characteristics, surgical data, postoperative pathological features and postoperative clinical characteristics of the two groups were compared. Results: : 112 patients were enrolled in the study, including 47 patients in SEG and 65 patients in ERG. There was no significant difference in age, sex, height, weight and body mass index between two groups. The proportion of local patients in SEG was significantly higher than that in ERG ( P =0.001). More patients in ERG received preoperative neoadjuvant chemoradiotherapy (Neo-CRT) ( P =0.025). There was no significant difference in pT staging, pN staging and pM staging between the two groups ( P > 0.05), but the overall pTNM staging was earlier in the SEG ( P < 0.001). At the same time, the proportion of vascular invasion ( P =0.004) and perineural invasion ( P < 0.001) in SEG was higher than that in ERG. There were no postoperative complications in STG group, but 6 patients in ECG group had postoperative complications, including 4 cases of incision infection and 2 cases of anastomotic leakage. It should be noted that, 5 of these 6 patients received Neo-CRT before operation. Conclusion: our study shows that due to the interference of serious epidemic situation to medical activities and more patients choosing preoperative neoadjuvant chemoradiotherapy, some patients delayed operation to the period of the epidemic remission, which may lead to the progress of tumor staging and increase the risk of postoperative complications. In addition, we hope that our strategy for colorectal cancer diagnosis and treatment during the epidemic will help other surgeons.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324233

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is profoundly affecting lives around the globe, and up to now, a large of patients have clinically recovered from their initial illness. As the vulnerable population to adverse events, the effect of the COVID-19 outbreak on pediatric recovered patients are of great concern, but relevant researches are limited. We aimed to investigate the prevalence of behavioral problems among pediatric patients with COVID-19 infection after discharge. 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 for the children and emotional symptoms for their parents through electronic medical records and questionnaire. The behavioral problems for children were examined applying the parent-reported the Strengths and Difficulties Questionnaire (SDQ). Results: The participant children were discharged from hospital for about two months. Among them, 76 (62%) were boys, and the mean age were 6.71 years old. The highest prevalence of behavioral problems among pediatric children with COVID-19 was 15% (prosocial behavior), followed by 13% (total difficulties), 11% (emotional symptoms), 10% (hyperactivity), 9% (conduct problems), and 1% (peer problems). With regarding to their parents, 26% of them reported having anxiety symptoms and 23% having depression symptoms. Compared with children without anxious or depressive parents, the scores of SDQ were higher in children whose parents have emotional problems. Conclusions: : The long-term follow up studies on the psychological and behavioral problems of children infected with COVID-19 and their parents are warranted.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324166

ABSTRACT

Utilizing computed tomography (CT) images to quickly estimate the severity of cases with COVID-19 is one of the most straightforward and efficacious methods. Two tasks were studied in this present paper. One was to segment the mask of intact lung in case of pneumonia. Another was to generate the masks of regions infected by COVID-19. The masks of these two parts of images then were converted to corresponding volumes to calculate the physical proportion of infected region of lung. A total of 129 CT image set were herein collected and studied. The intrinsic Hounsfiled value of CT images was firstly utilized to generate the initial dirty version of labeled masks both for intact lung and infected regions. Then, the samples were carefully adjusted and improved by two professional radiologists to generate the final training set and test benchmark. Two deep learning models were evaluated: UNet and 2.5D UNet. For the segment of infected regions, a deep learning based classifier was followed to remove unrelated blur-edged regions that were wrongly segmented out such as air tube and blood vessel tissue etc. For the segmented masks of intact lung and infected regions, the best method could achieve 0.972 and 0.757 measure in mean Dice similarity coefficient on our test benchmark. As the overall proportion of infected region of lung, the final result showed 0.961 (Pearson's correlation coefficient) and 11.7% (mean absolute percent error). The instant proportion of infected regions of lung could be used as a visual evidence to assist clinical physician to determine the severity of the case. Furthermore, a quantified report of infected regions can help predict the prognosis for COVID-19 cases which were scanned periodically within the treatment cycle.

15.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323755

ABSTRACT

Information overload is a prevalent challenge in many high-value domains. A prominent case in point is the explosion of the biomedical literature on COVID-19, which swelled to hundreds of thousands of papers in a matter of months. In general, biomedical literature expands by two papers every minute, totalling over a million new papers every year. Search in the biomedical realm, and many other vertical domains is challenging due to the scarcity of direct supervision from click logs. Self-supervised learning has emerged as a promising direction to overcome the annotation bottleneck. We propose a general approach for vertical search based on domain-specific pretraining and present a case study for the biomedical domain. Despite being substantially simpler and not using any relevance labels for training or development, our method performs comparably or better than the best systems in the official TREC-COVID evaluation, a COVID-related biomedical search competition. Using distributed computing in modern cloud infrastructure, our system can scale to tens of millions of articles on PubMed and has been deployed as Microsoft Biomedical Search, a new search experience for biomedical literature: https://aka.ms/biomedsearch.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323695

ABSTRACT

Knowing the residual and future effect of SARS-CoV-2 on recovered COVID-19 patients is critical for optimized long-term patient management. Recent studies focus on the symptoms and clinical indices of recovered patients, but the pathophysiological change is still unclear. To address this question, we examined the metabolomic profiles of recovered asymptomatic (RA), moderate (RM) and severe and critical (RC) patients without previous underlying diseases discharged from the hospital for 3 months, along with laboratory and CT findings. We found that the serum metabolic profiles in recovered COVID-19 patients still conspicuously differed from that in healthy control (HC), especially in the RM, and RC patients. Additionally, these changes bore close relationship with the function of pulmonary, renal, hepatic, microbial and energetic metabolism and inflammation. These findings suggested that RM and RC patients sustained multi-organ and multi-system damage and these patients should be followed up on regular basis for possible organ and system damage.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323529

ABSTRACT

Background: Whether coronavirus disease 2019 (COVID-19) pandemic would affect pregnancy-associated factors of uninfected pregnant women was rarely reported.Methods: A total of 32,277 pregnant women from six sites (Hubei Province, Guangdong Province, Hebei Province, Shandong Province, Yunnan Province and Beijing City) were finally recruited. We conducted a retrospective combined cohort study to analyze the associations between the number of prenatal examinations (NPE), delivery gestational week (DGW), the risk of caesarean section (CS), stillbirth, neonatal weight, preterm birth, macrosomia, small for gestational age (SGA), large for gestational age (LGA) and the COVID-19 in two time-periods, the pre-pandemic period (P-2019, 1/1/19-5/31/19) and the pandemic period (P-2020, 1/1/20-5/31/20).Findings: After adjusting for other covariates, we found the NPE, DGW, and SGA were negatively associated with the COVID-19 pandemic, whereas the CS and preterm birth rates were positively associated with the COVID-19, with adjusted relative risks (aRRs) of 1.11 [95% confidence interval (CI) 1.06–1.17] and 1.37 (95% CI: 1.02–1.84) respectively in Hubei. For Guangdong, the associations of CS and preterm birth with the COVID-19 were similar in Hubei. In contrast, limited associations were evident in other areas, except for a positive association with macrosomia [aRR = 1.26 (95% CI: 1.03–1.55)] in Beijing.Interpretation: The CS and preterm birth rates increased slightly in areas that were more affected by the pandemic than other areas among uninfected pregnant women. NPEs were not significantly interrupted and most maternal and neonatal clinical characteristics were within the normal ranges.Funding: National Key Research and Development Program, National Natural Science Foundation of China and National Health Commission Capacity Building and Continuing Education Center.Declaration of Interests: All authors declare to have no conflict of interest.Ethics Approval Statement: The study was approved by the Peking University ethics board (no. IRB00001052-20025).

18.
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.

19.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312191

ABSTRACT

Background: To analyze the clinical characteristics of the re-positive discharged COVID-19 patients and find markers to distinguish them. Methods: : The demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, illness severities and chest CT scan results of 267 patients were collected during 1st January and 15th February 2020. COVID-19 was diagnosed by RT-PCR. The subsequent clinical symptoms and nucleic acid test results was obtained during the 14 days post-hospitalization quarantine. Results: : 30 out of 267 COVID-19 patients were detected re-positive during the post-hospitalization quarantine. Re-positive patients couldn’t be distinguished by demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, chest CT scan results or subsequent clinical symptoms. However, the re-positive rate were found illness severity correlated, along with APACHE II and CURB-65. Conclusion: Common clinical characteristics arn’t able to distinguish re-positive patients. However, severe and critical cases with high APACHE II and CURB-65 scores are more likely to turn re-positive after discharge.Authors Shengyang He, Wenwu Sun, Kefu Zhou contributed equally to this work.

20.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311721

ABSTRACT

Background: Pulmonary embolism is a severe condition prone to misdiagnosis given its nonspecific signs and symptoms. Previous studies on the pneumonia outbreak caused by coronavirus disease 2019 (COVID-19) showed a number of patients with elevated d-dimer, whether those patients combined with pulmonary embolism got our attention. Methods: Data on clinical manifestations, laboratory and radiological findings, treatment, and disease progression of 19 patients with laboratory-confirmed COVID-19 pneumonia,who completed computed tomographic pulmonary angiography (CTPA) during hospitalization in the Central Hospital of Wuhan from January 2 to March 26, 2020, were reviewed. Results: Of the 19 suspected pulmonary embolism and subjected to CTPA patients, six were diagnosed with pulmonary embolism. The Wells’ score of the six patients with pulmonary embolism was 0–1, which suggested a low risk of pulmonary embolism. The median level of d-dimers collected at the day before or on the day of CTPA completion in the patients with pulmonary embolism was 18.36 (interquartile range [IQR]: 6.69–61.46) µg/mL, which was much higher than that in the patients without pulmonary embolism (median 9.47 [IQR: 4.22–28.02] µg/mL). Of the 6 patients diagnosed with pulmonary embolism, all patients received anticoagulant therapy, 5 of which survived and were discharged and 1 died. Conclusion: A potential causal relationship exists between COVID-19 infection and pulmonary embolism, but whether this phenomenon is common remains uncertain. The clinical manifestations of COVID-19 patients who developed pulmonary embolism are similar to those of patients with increased d-dimer alone, prompting a significant challenge on differential diagnoses.

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