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1.
Journal of Functional Foods ; 72:104076, 2020.
Article | WHO COVID | ID: covidwho-627367

ABSTRACT

The main flavonoid components of Radix Tetrastigma (RTF) were extracted and characterized by high performance liquid chromatography In vitro, RTF suppressed the viability of A549 cells, and inhibited the invasion and migration of A549 by damaging the lamellipodium and the structure of F-actin In vivo, compared to the model group, RTF inhibited the growth of tumor volumes in nude mice, and decreased the weight of tumor To uncover the inner mechanism, the proliferation-related proteins: PCNA, Ki67 and the apoptosis-related proteins: caspase-3, caspase-9, Bax and Bcl-2 were examined by immunohistochemical and western blot analysis Compared to the model group, the production levels of PCNA, Ki67 and Bcl-2 were significantly down-regulated by RTF, and the expression levels of caspase-3, caspase-9 and Bax were markedly up-regulated Comprehensively, RTF could suppress the proliferation of A549 and promote the apoptosis of A549, suggesting RTF as a potential resource to fight against non-small cell lung cancer (NSCLC)

2.
BMC Infect Dis ; 20(1): 637, 2020 Aug 27.
Article in English | MEDLINE | ID: covidwho-733046

ABSTRACT

BACKGROUND: An ongoing outbreak of coronavirus disease 2019 (COVID-19) is spreading globally. Recently, several articles have mentioned that the early acute respiratory distress syndrome (ARDS) caused by COVID-19 significantly differ from those of ARDS due to other causes. Actually, we newly observed that some mechanically ventilated COVID-19 patients recovering from severe ARDS (more than 14 days after invasive ventilation) often experienced evidently gradual increases in CO2 retention and minute ventilation. However, the underlying mechanics remain unclear. CASE PRESENTATION: To explain these pathophysiological features and discuss the ventilatory strategy during the late phase of severe ARDS in COVID-19 patients, we first used a metabolic module on a General Electric R860 ventilator (Engstrom Carestation; GE Healthcare, USA) to monitor parameters related to gas metabolism, lung mechanics and physiological dead space in two COVID-19 patients. We found that remarkably decreased ventilatory efficiency (e.g., the ratio of dead space to tidal volume 70-80%, arterial to end-tidal CO2 difference 18-23 mmHg and ventilatory ratio 3-4) and hypermetabolism (oxygen consumption 300-400 ml/min, CO2 elimination 200-300 ml/min) may explain why these patients experienced more severe respiratory distress and CO2 retention in the late phase of ARDS caused by COVID-19. CONCLUSION: During the recovery period of ARDS among mechanically-ventilated COVID-19 patients, attention should be paid to the monitoring of physiological dead space and metabolism. Tidal volume (8-9 ml/kg) could be increased appropriately under the limited plateau pressure; however, barotrauma should still be kept in mind.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Respiration, Artificial , Respiratory Distress Syndrome, Adult/therapy , Aged , Coronavirus Infections/complications , Female , Humans , Monitoring, Physiologic , Oxygen Consumption , Pandemics , Pneumonia, Viral/complications , Respiratory Distress Syndrome, Adult/etiology , Tidal Volume , Ventilators, Mechanical
3.
Acad. J. Second Mil. Med. Univ. ; 6(41): 581-587, 2020.
Article in Chinese | ELSEVIER | ID: covidwho-727541

ABSTRACT

Objective To sum up the clinical characteristics and chest computed tomography (CT) findings of severe and critical coronavirus disease 2019 (COVID-19) patients, and to explore the factors affecting the outcomes, so as to provide experience for the clinical diagnosis and treatment of severe and critical COVID-19. Methods The data of 25 severe and critical COVID-19 patients, who were treated in our hospital from Jan. 23, 2020 to Mar. 5, 2020, were collected. The clinical characteristics were retrospectively analyzed, and the clinical and laboratory indexes were compared between cured patients and uncured patients. The laboratory indicators of cured patients were further compared between the progressive and recovery stages. The chest CT findings of the patients were observed, and the lesion volume was quantified to assess the evolution of lung lesions using the CT image-based intelligent pneumonia lesion quantitative analysis software. Results There were 19 male and six female COVID-19 patients, and there were three deaths. The median age of 25 patients was 65 (63, 75) years old, and the body mass index (BMI) was 25.60 (23.51, 28.65) kg/m2. Twenty-two patients had a clear epidemiological history. Fever (22 cases) and cough (14 cases) were the most common first symptoms, and 18 patients had underlying diseases. Twelve patients were cured and discharged (median hospital stay was 25.5 d), and 13 patients were not cured, including three deaths and 10 cases with hospital stay>25 d with no remission. Compared with the uncured patients, the cured patients had significantly lower BMI, longer time from onset to progression to severe or critical illness, and higher CD4 +T lymphocyte counts (all P<0.05). Multivariate logistic regression analysis showed that high CD4 +T lymphocyte count was an independent protective factor for the cure and discharge of severe and critical COVID-19 patients (P=0.031). Compared with those in the progressive stage, the lymphocyte count and CD4 +T lymphocyte count of 12 cured patients were significantly higher in the progression stage, and the C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR) and procalcitonin level were significantly lower (all P<0.01). Twenty-one patients received chest CT examination in the progressive stage; and all of them had multiple ground-glass opacities and consolidation shadows of the multiple-lobe lateral band and the dorsal side of bilateral lungs, 20 cases had pleural thickening, 9 cases had a small amount of bilateral pleural effusion, and 8 cases had mediastinal lymphadenopathy. The 12 cured patients received CT examination during the recovery period, and their lesions were all improved to different extents; some patients had irregular fiber grid shadows and stripe shadows; and the pleural thickening and pleural effusion were reduced to different extents. The quantitative analysis curves showed that lesion volume in the 12 cured patients obviously increased in the progressive stage and reduced in the absorption stage, showing an inverted V shape; and lesion volume in the uncured patients (nine cases received CT examination for two or more times) showed a rapid increase in the progressive stage. Conclusion Most severe and critical COVID-19 patients in Shanghai are older, with higher BMI and underlying diseases. Low BMI, slow disease progression, and high CD4 +T lymphocyte count are beneficial to the improvement of COVID-19. The main findings of chest CT include multiple ground-glass opacities and consolidation shadows, mainly distributing in the lateral band and the dorsal side of lungs and mostly involving the pleura. The laboratory indexes, including the lymphocyte, CRP, CD4 +T lymphocyte, ESR and procalcitonin, and chest CT examination play an important role in the diagnosis, disease monitoring and prognosis assessment of COVID-19

4.
J. Jilin Univ. Med. Ed. ; 3(46): 625-629, 20200501.
Article in Chinese | ELSEVIER | ID: covidwho-727532

ABSTRACT

Objective: To investigate the effect of modified fecal drainage device on avoiding the occupational exposure infection of the medical staffs in the treatment of corona virus disease 2019 (COVID-19), and to provide the reference for the clinical treatment of COVID-19 and avoiding the occupational exposure infection of the medical staffs. Methods: The clinical data of a critical COVID-19 patient with diarrhea as the main symptom were collected. The modified fecal drainage device of F18 silicone gastric tube connected with disposable negative pressure drainage device was uesd to treat the fecal excrement of the patient. The general data of the medical staffs, containing 16 doctors and 48 nurses∗ were collected. The COVID-19 serological antibodies and pharyngeal swabs of the medical staffs were tested every 2 weeks. Results: The 78-year-old woman patient was admitted to hospital due to diarrhea∗ cough and expectoration for 15 d, chest distress and shortness of breath for 10 d» and fever for 1 d. The test result of COVID-19 pharyngeal swabs of the patient was positive. After the feces were collected with the modified fecal drainage device, the average operation time of medical staffs was reduced from 20 min to 10 min, the patient's perianal skin flushing subsided, and no incontinence-associated dermatitis ( IAD ) occurred. The patient was cured but remained in hospital for the other underlying diseases. The test results of COVID-19 serological antibodies and pharyngeal swabs of 64 medical staffs were all negative, all the medical staffs had no infection. Conclusion: The modified fecal drainage device has better stability, which can effectively prevent IAD and the spread of COVID-19 and reduce the risk of occupational exposure infection of medical staffs, and it is suitable for clinical promotion application.

5.
Antibody Therapeutics ; 2020.
Article | WHO COVID | ID: covidwho-723521

ABSTRACT

Facing the COVID-19 global healthcare crisis, scientists worldwide are collaborating to develop prophylactic and therapeutic interventions against the disease Antibody therapeutics hold enormous promise for treatment of COVID-19 In March 2020, the Chinese Antibody Society, in collaboration with The Antibody Society, initiated the “COVID-19 Antibody Therapeutics Tracker” (“Tracker”) (https://chineseantibody org/covid-19-track/) program to track the antibody-based COVID-19 interventions in preclinical and clinical development globally The data are collected from the public domain and verified by volunteers on an ongoing basis Here, we present exploratory data analyses and visualization to demonstrate the latest trends of COVID-19 antibody development, based on data for over 150 research and development programs and molecules included in the “Tracker” as of August 8th, 2020 We categorized the data mainly by their targets, formats, development status, developers and country of origin Although details are limited in some cases, all of the anti-SARS-CoV-2 antibody candidates appear to target the viral spike protein (S protein), and most are full length monoclonal antibodies Most of the current COVID-19 antibody therapeutic candidates in clinical trials are repurposed drugs aimed at targets other than virus-specific proteins, while most of these virus-specific therapeutic antibodies are in discovery or preclinical studies As of August 8, 2020, eight antibody candidates targeting the SARS-CoV-2 S protein have entered clinical studies, including LY-CoV555, REGN-COV2, JS016, TY027, CT-P59, BRII-196, BRII-198 and SCTA01 Ongoing clinical trials of SARS-CoV-2 neutralizing antibodies will help define the utility of these antibodies as a new class of therapeutics for treating COVID-19 and future coronavirus infections

6.
Curr Med Sci ; 40(4): 625-635, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-697010

ABSTRACT

Nurses' work-related fatigue has been recognized as a threat to nurse health and patient safety. The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan, China, and to analyze its influencing factors on fatigue. A multi-center, descriptive, cross-sectional design with a convenience sample was used. The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3, 2020 to March 10, 2020 in Wuhan of China. A total of 2667 samples from 2768 contacted participants completed the investgation, with a response rate of 96.35%. Social-demographic questionnaire, work-related questionnaire, Fatigue Scale-14, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Chinese Perceived Stress Scale were used to conduct online survey. The descriptive statistic of nurses' social-demographic characteristics was conducted, and the related variables of work, anxiety, depression, perceived stress and fatigue were analyzed by t-tests, nonparametric test and Pearson's correlation analysis. The significant factors which resulted in nurses' fatigue were further analyzed by multiple linear regression analysis. The median score for the first-line nurses' fatigue in Wuhan was 4 (2, 8). The median score of physical and mental fatigue of them was 3 (1, 6) and 1 (0, 3) respectively. According to the scoring criteria, 35.06% nurses (n=935) of all participants were in the fatigue status, their median score of fatigue was 10 (8, 11), and the median score of physical and mental fatigue of them was 7 (5, 8) and 3 (2, 4) respectively. Multiple linear regression analysis revealed the participants in the risk groups of anxiety, depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses' fatigue, the frequency of exercise and nurses' fatigue had a statistically significant negative correlation, and average daily working hours had a significantly positive correlation with nurses' fatigue, and the frequency of weekly night shift had a low positive correlation with nurses' fatigue (P<0.01). There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan, China. Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors, and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses, and to enhance their health status and provide a safe occupational environment worldwide. Promoting both medical and nursing safety while combating with the pandemic currently is warranted.


Subject(s)
Betacoronavirus , Coronavirus Infections/nursing , Fatigue/etiology , Nurses , Occupational Diseases/etiology , Occupational Stress/etiology , Pandemics , Pneumonia, Viral/nursing , Adult , China/epidemiology , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Fatigue/epidemiology , Fatigue/psychology , Female , Humans , Linear Models , Male , Mental Fatigue/epidemiology , Mental Fatigue/etiology , Mental Fatigue/psychology , Middle Aged , Nurses/psychology , Occupational Diseases/epidemiology , Occupational Diseases/psychology , Occupational Stress/epidemiology , Occupational Stress/psychology , Pneumonia, Viral/epidemiology , Prevalence , Risk Factors , Surveys and Questionnaires , Tertiary Care Centers , Workload/psychology , Young Adult
8.
Infect Dis Poverty ; 9(1): 88, 2020 Jul 10.
Article in English | MEDLINE | ID: covidwho-690345

ABSTRACT

BACKGROUND: An outbreak of infection caused by SARS-CoV-2 recently has brought a great challenge to public health. Rapid identification of immune epitopes would be an efficient way to screen the candidates for vaccine development at the time of pandemic. This study aimed to predict the protective epitopes with bioinformatics methods and resources for vaccine development. METHODS: The genome sequence and protein sequences of SARS-CoV-2 were retrieved from the National Center for Biotechnology Information (NCBI) database. ABCpred and BepiPred servers were utilized for sequential B-cell epitope analysis. Discontinuous B-cell epitopes were predicted via DiscoTope 2.0 program. IEDB server was utilized for HLA-1 and HLA-2 binding peptides computation. Surface accessibility, antigenicity, and other important features of forecasted epitopes were characterized for immunogen potential evaluation. RESULTS: A total of 63 sequential B-cell epitopes on spike protein were predicted and 4 peptides (Spike315-324, Spike333-338, Spike648-663, Spike1064-1079) exhibited high antigenicity score and good surface accessibility. Ten residues within spike protein (Gly496, Glu498, Pro499, Thr500, Leu1141, Gln1142, Pro1143, Glu1144, Leu1145, Asp1146) are forecasted as components of discontinuous B-cell epitopes. The bioinformatics analysis of HLA binding peptides within nucleocapsid protein produced 81 and 64 peptides being able to bind MHC class I and MHC class II molecules respectively. The peptides (Nucleocapsid66-75, Nucleocapsid104-112) were predicted to bind a wide spectrum of both HLA-1 and HLA-2 molecules. CONCLUSIONS: B-cell epitopes on spike protein and T-cell epitopes within nucleocapsid protein were identified and recommended for developing a protective vaccine against SARS-CoV-2.


Subject(s)
Betacoronavirus/genetics , Betacoronavirus/immunology , Computational Biology/methods , Coronavirus Infections/prevention & control , Epitopes, B-Lymphocyte/immunology , Epitopes, T-Lymphocyte/immunology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Viral Vaccines/immunology , Amino Acid Sequence , Coronavirus Infections/immunology , Coronavirus Infections/virology , Drug Design , Epitopes, B-Lymphocyte/chemistry , Epitopes, T-Lymphocyte/chemistry , Humans , Immunogenicity, Vaccine/immunology , Models, Molecular , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Sequence Alignment , Sequence Analysis , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Viral Envelope Proteins/immunology
9.
Kidney Blood Press Res ; 45(4): 612-622, 2020.
Article in English | MEDLINE | ID: covidwho-680430

ABSTRACT

INTRODUCTION: Severe acute respiratory viral infections are frequency accompanied by multiple organ dysfunction, including acute kidney injury (AKI). In December 2019, the coronavirus disease 2019 (COVID-19) outbreak began in Wuhan, Hubei Province, China, and rapidly spread worldwide. While diffuse alveolar damage and acute respiratory failure are the main features of COVID-19, other organs may be involved, and the incidence of AKI is not well described. We assessed the incidence and clinical characteristics of AKI in patients with laboratory-confirmed COVID-19 and its effects on clinical outcomes. METHODS: We conducted a multicenter, retrospective, observational study of patients with COVID-19 admitted to two general hospitals in Wuhan from 5 January 2020 to 21 March 2020. Demographic data and information on organ dysfunction were collected daily. AKI was defined according to the KDIGO clinical practice guidelines. Early and late AKI were defined as AKI occurring within 72 h after admission or after 72 h, respectively. RESULTS: Of the 116 patients, AKI developed in 21 (18.1%) patients. Among them, early and late AKI were found in 13 (11.2%) and 8 (6.9%) patients, respectively. Compared with patients without AKI, patients with AKI had more severe organ dysfunction, as indicated by a higher level of disease severity status, higher sequential organ failure assessment (SOFA) score on admission, an increased prevalence of shock, and a higher level of respiratory support. Patients with AKI had a higher SOFA score on admission (4.5 ± 2.1 vs. 2.8 ± 1.4, OR 1.498, 95% CI 1.047-2.143 ) and greater hospital mortality (57.1% vs. 12.6%, OR 3.998, 95% CI 1.088-14.613) than patients without AKI in both the univariate and multivariate analyses. Patients with late AKI, but not those with early AKI, had a significantly prolonged length of stay (19.6 vs. 9.6 days, p = 0.015). CONCLUSION: Our findings show that admission SOFA score was an independent risk factor for AKI in COVID-19 patients, and patients with AKI had higher in-hospital mortality. Moreover, AKI development after 72 h of admission was related to prolonged hospitalization time.


Subject(s)
Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Coronavirus Infections/complications , Pneumonia, Viral/complications , Acute Kidney Injury/mortality , Adult , Aged , Aged, 80 and over , China/epidemiology , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Disease Progression , Female , Hospital Mortality , Hospitals, General , Humans , Incidence , Kidney Function Tests , Length of Stay , Male , Middle Aged , Multiple Organ Failure/etiology , Multiple Organ Failure/therapy , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Practice Guidelines as Topic , Retrospective Studies , Treatment Outcome , Water-Electrolyte Balance
11.
World J Otorhinolaryngol Head Neck Surg ; 2020 Jun 06.
Article in English | MEDLINE | ID: covidwho-548039
12.
Thromb Res ; 192: 3-8, 2020 08.
Article in English | MEDLINE | ID: covidwho-259326

ABSTRACT

OBJECTIVE: To investigate the clinical features of COVID-19 cases in Suzhou China. Biomarkers were screened out of hematological parameters for risk stratification. METHOD: Confirmed COVID-19 adult patients in Suzhou were included. The patient data was collected, and the results of laboratory examinations were compared between the mild/moderate and severe COVID-19 groups. A ROC was calculated to compare the diagnostic performance of candidate indexes, and dynamic levels of hematological indexes were compared between the two groups. RESULT: 75 patients were enrolled, with a mean age of 46.6 ±â€¯14 years, and 45 patients were male. All patients were classified into two groups: the mild/moderate group and the severe group. WBC, neutrophil to lymphocyte ratio (NLR), D-dimer, and fibrinogen levels of the severe group were significantly higher (P < 0.05) than the mild/moderate, and the lymphocyte was lower. The ROC test showed that the hematological parameters had a larger AUC than that of inflammatory factors. There was a significant difference in lymphocyte and fibrinogen levels between the two groups on day 1 (P < 0.05). However, NLR of the severe group was higher than the mild/moderate on days 1, 4 and 14 (P < 0.01), and so was D-dimer on days 1, 7 and 14 (P < 0.05). CONCLUSION: The common COVID-19 abnormal hematological indexes on admission included hyperfibrinogenemia, lymphopenia, the elevation of D-dimer, and leukopenia, which were significantly different between the mild/moderate and severe COVID-19 groups. Furthermore, the dynamic change of NLR and D-dimer level can distinguish severe COVID-19 cases from the mild/moderate.


Subject(s)
Betacoronavirus/pathogenicity , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Fibrin Fibrinogen Degradation Products/analysis , Lymphocytes , Neutrophils , Pneumonia, Viral/diagnosis , Adult , Aged , Biomarkers/blood , China , Coronavirus Infections/blood , Coronavirus Infections/therapy , Coronavirus Infections/virology , Female , Host-Pathogen Interactions , Humans , Lymphocyte Count , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Predictive Value of Tests , Prognosis , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Young Adult
14.
Emerg Infect Dis ; 26(6): 1324-1326, 2020 06.
Article in English | MEDLINE | ID: covidwho-6800

ABSTRACT

We report co-infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A virus in a patient with pneumonia in China. The case highlights possible co-detection of known respiratory viruses. We noted low sensitivity of upper respiratory specimens for SARS-CoV-2, which could further complicate recognition of the full extent of disease.


Subject(s)
Coronavirus Infections/diagnosis , Influenza, Human/diagnosis , Pneumonia, Viral/diagnosis , Aged , Betacoronavirus/isolation & purification , Bronchoalveolar Lavage Fluid/virology , China , Clinical Laboratory Techniques , Coinfection , Coronavirus Infections/virology , Humans , Influenza A virus , Influenza, Human/virology , Male , Nasopharynx/virology , Pandemics , Pneumonia, Viral/virology
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