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2.
Front Public Health ; 9: 741083, 2021.
Article in English | MEDLINE | ID: covidwho-1775896

ABSTRACT

This study aimed to investigate the association between passive smoking and physical and psychological health in Chinese nurses. Participants of this cross-sectional study comprised 2,484 non-smoking nurses. Passive smoking and demographic information were assessed using a self-administered questionnaire. Physical, psychological, and overall health status of nurses were measured using the Cornell Medical Index (CMI) health questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for nurses' health were estimated by exposure to passive smoking using unconditional logistic regression models. A total of 1,219 nurses (49.07%) were exposed to passive smoking. Of these, 609 (24.52%), 160 (6.44%), and 587 (23.63%) nurses had poorer physical, mental, and overall health, respectively. After adjusting for other confounding factors, compared with the non-passive smoking group, passive smoking was associated with poor physical (OR = 1.51, 95% CI: 1.25-1.83), mental (OR = 1.48, 95% CI: 1.07-2.07), and overall (OR = 1.58, 95% CI: 1.30-1.93) health of nurses, respectively. We also carried out subgroup analyses stratified by age, department, and professional title, which showed that most findings supported the main results. This study demonstrated that exposure to passive smoking was a risk factor for overall decreased physical and mental health status among Chinese nurses.


Subject(s)
Health Status , Nurses , Tobacco Smoke Pollution , China/epidemiology , Cross-Sectional Studies , Humans , Surveys and Questionnaires
3.
World journal of psychiatry ; 12(2):338-347, 2022.
Article in English | EuropePMC | ID: covidwho-1749852

ABSTRACT

BACKGROUND Frontline nurses in Wuhan directly fighting severe acute respiratory syndrome coronavirus-2 diseases are at a high risk of infection and are extremely susceptible to psychological stress, especially due to the global coronavirus disease 2019 (COVID-19) pandemic. The psychological after-effects of this public health emergency on frontline nurses will last for years. AIM To assess factors influencing post-traumatic stress disorder (PTSD) among frontline nurses in Wuhan 6 mo after the COVID-19 pandemic began. METHODS A total of 757 frontline nurses from five hospitals in Wuhan, China, participated in an online survey from July 27 to August 13, 2020. This cross-sectional online study used a demographic information questionnaire, the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, the Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-4. The chi-square test and logistic regression were used to analyze the association of demographics, COVID-19-related variables, and PTSD. Logistic regression was also conducted to investigate which variables were associated with PTSD outcomes. RESULTS A total of 13.5%, 24.3%, and 21.4% of the frontline nurses showed symptoms of PTSD, depression, and anxiety, respectively. The multivariate logistic regression analysis showed that the following factors were strongly associated with PTSD: Having a relative, friend, or colleague who died of COVID-19;experiencing stigma;or having psychological assistance needs, depressive symptoms or anxiety. Showing resilience and receiving praise after the COVID-19 outbreak were protective factors. CONCLUSION Frontline nurses still experienced PTSD (13.5%) six months after the COVID-19 outbreak began. Peer support, social support, official recognition, reward mechanisms, exercise, better sleep, and timely provision of information (such as vaccine research progress) by the government via social media, and adequate protective supplies could mitigate the level of PTSD among nurses responding to COVID-19. Stigmatization, depression, and anxiety might be associated with a greater risk of PTSD among nurses.

4.
Scientific Programming ; : 1-12, 2022.
Article in English | Academic Search Complete | ID: covidwho-1745622

ABSTRACT

The COVID-19 pneumonia epidemic in early 2020 severely affected all sectors of the Chinese economy, with economic growth plummeting but the property market continuing to heat up after a brief contraction. How to formulate an effective monetary policy in the face of the COVID-19 shock to achieve stable economic growth while curbing excessive real estate price inflation has become a pressing issue for Chinese policymakers today. To this end, this paper focuses on the impact of two types of monetary policy, price-based and quantity-based, on macro-economic variables such as real estate prices and aggregate output by developing a multi-sectoral DSGE model incorporating the COVID-19 shock and comparing them. The analysis finds that both monetary policy rules can achieve the objective of dampening real estate prices. Nevertheless, while causing the same magnitude of real estate price contraction, quantity-based monetary policy leads to greater volatility in variables such as aggregate output, while other economic variables are less volatile under the price-based monetary policy. [ FROM AUTHOR] Copyright of Scientific Programming is the property of Hindawi Limited 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.)

6.
J Am Soc Nephrol ; 33(3): 565-582, 2022 03.
Article in English | MEDLINE | ID: covidwho-1731641

ABSTRACT

BACKGROUND: Endothelial cell injury is a common nidus of renal injury in patients and consistent with the high prevalence of AKI reported during the coronavirus disease 2019 pandemic. This cell type expresses integrin α5 (ITGA5), which is essential to the Tie2 signaling pathway. The microRNA miR-218-5p is upregulated in endothelial progenitor cells (EPCs) after hypoxia, but microRNA regulation of Tie2 in the EPC lineage is unclear. METHODS: We isolated human kidney-derived EPCs (hkEPCs) and surveyed microRNA target transcripts. A preclinical model of ischemic kidney injury was used to evaluate the effect of hkEPCs on capillary repair. We used a genetic knockout model to evaluate the effect of deleting endogenous expression of miR-218 specifically in angioblasts. RESULTS: After ischemic in vitro preconditioning, miR-218-5p was elevated in hkEPCs. We found miR-218-5p bound to ITGA5 mRNA transcript and decreased ITGA5 protein expression. Phosphorylation of 42/44 MAPK decreased by 73.6% in hkEPCs treated with miR-218-5p. Cells supplemented with miR-218-5p downregulated ITGA5 synthesis and decreased 42/44 MAPK phosphorylation. In a CD309-Cre/miR-218-2-LoxP mammalian model (a conditional knockout mouse model designed to delete pre-miR-218-2 exclusively in CD309+ cells), homozygotes at e18.5 contained avascular glomeruli, whereas heterozygote adults showed susceptibility to kidney injury. Isolated EPCs from the mouse kidney contained high amounts of ITGA5 and showed decreased migratory capacity in three-dimensional cell culture. CONCLUSIONS: These results demonstrate the critical regulatory role of miR-218-5p in kidney EPC migration, a finding that may inform efforts to treat microvascular kidney injury via therapeutic cell delivery.


Subject(s)
Acute Kidney Injury/etiology , Acute Kidney Injury/metabolism , Endothelial Progenitor Cells/metabolism , Endothelial Progenitor Cells/pathology , Integrin alpha5/metabolism , MicroRNAs/physiology , Acute Kidney Injury/pathology , Animals , Disease Models, Animal , Humans , Mice , Mice, Inbred C57BL , Mice, Knockout , Receptor, TIE-2/physiology , Signal Transduction/physiology
7.
Transl Psychiatry ; 12(1): 49, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1692636

ABSTRACT

In recent decades, respiratory infections, including SARS, HINI and the currently spreading COVID-19, caused by various viruses such as influenza and coronavirus have seriously threatened human health. It has generated inconsistent recommendations on the mandatory use of facemasks across countries on a population level due to insufficient evidence on the efficacy of facemask use among the general population. This meta-analysis aimed to explore (1) the efficacy of facemask use on preventing respiratory infections, and (2) the perceptions, intentions, and practice about facemask use among the general population worldwide. We searched PubMed, MEDLINE, Web of Science, Cochrane, bioRxiv, and medRxiv databases since inception to August 17, 2020. From 21,341 records identified, eight RCTs on facemask in preventing infections and 78 studies on perception, intention, and practice of facemask use among the general population were included in the analysis. The meta-analysis of RCTs found a significant protective effect of facemask intervention (OR = 0.84; 95% CI = 0.71-0.99; I2 = 0%). This protective effect was even more pronounced when the intervention duration was more than two weeks (OR = 0.76; 95% CI = 0.66-0.88; I2 = 0%). The meta-analysis of observational studies on perception, intention, and practice on facemask use showed that 71% of respondents perceived facemasks to be effective for infection prevention, 68% of respondents would wear facemasks, and 54% of respondents wore facemasks for preventing respiratory infections. Differences in perception, intention, and practice behavior of facemask use in different regions may be related to the impact of respiratory infections, regional culture, and policies. The governments and relevant organizations should make effort to reduce the barriers in the use of facemasks.


Subject(s)
COVID-19 , Respiratory Tract Infections , Humans , Masks , Respiratory Tract Infections/prevention & control , SARS-CoV-2
8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323771

ABSTRACT

Background: Sudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking.MethodsA retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People’s Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed.ResultsThe study found that fibrinogen(FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100% and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P<0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19.ConclusionsBased on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-313410

ABSTRACT

The transmission dynamics of COVID-19 is investigated in this study. A SINDy-LM modeling method that can effectively balance model complexity and prediction accuracy is proposed based on data-driven technique. First, the Sparse Identification of Nonlinear Dynamical systems (SINDy) method is used to discover and describe the nonlinear functional relationship between the dynamic terms in the model in accordance with the observation data of the COVID-19 epidemic. Moreover, the Levenberg–Marquardt (LM) algorithm is utilized to optimize the obtained model for improving the accuracy of the SINDy algorithm. Second, the obtained model, which is consistent with the logistic model in mathematical form with small errors and high robustness, is leveraged to review the epidemic situation in China. Otherwise, the evolution of the epidemic in Australia and Egypt is predicted, which demonstrates that this method has universality for constructing the global COVID-19 model. The proposed model is also compared with the extreme learning machine (ELM), which shows that the prediction accuracy of the SINDy-LM method outperforms that of the ELM method and the generated model has higher sparsity.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312714

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has now spread worldwide. This study aimed to provide a reference for comprehensive treatment, personal protection, and team management of patients with critical COVID-19. Methods: The study included critical COVID-19 cases at a single centre in Wuhan, China. We retrospectively analysed data on symptoms, laboratory tests, radiology findings, treatment, and outcomes. Air samples and environmental surface swabs in the isolation ward were tested for SARS-CoV-2. Results: Fourteen critically ill patients (mean age 62.1 years) were treated between February 4, 2020 and April 6, 2020. Less than half had underlying diseases, including hypertension (n=6, 42.9%) and diabetes (n=4, 28.6%). Laboratory tests showed decreased lymphocyte levels and increased serum ferritin and inflammatory cytokine levels. More than half of the patients received antiviral drugs, including lopinavir/ritonavir (n=10;71.4%) and arbidol (n=6, 42.9%). Eight patients (57.1%) received convalescent plasma, and 12 (85.7%) received systemic glucocorticoids. Eleven (78.6%) received high-flow nasal cannula oxygen therapy, five (35.7%) received non-invasive positive pressure ventilation, seven (50.0%) received invasive positive pressure ventilation, and three (21.4%) received extracorporeal membrane oxygenation. By April 6, 2020, nine (64.3%) patients were discharged, four remained in hospital, and one had died. All air samples tested negative for SARS-CoV-2. Of 128 environmental surface swabs, one gastric tube swab and one anal tube swab were positive for SARS-CoV-2. All oropharyngeal swabs taken from medical staff tested negative for SARS-CoV-2. Conclusions: Individualised comprehensive treatment, appropriate personal protection, and teamwork may improve the prognosis in patients with COVID-19 who are critically ill.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307613

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently spread worldwide partly through environmental and airborne contamination. The number of patients requiring intensive care unit (ICU)-based healthcare services exceeds the available negative-pressure isolation ICU room capacity. Some general wards of Wuhan hospitals have been temporarily converted into COVID-19 ICU wards and pose safety concerns. We explored the safety of these temporary COVID-19 ICU wards. Methods: : Fifteen air samples and 128 environmental surface swabs were collected from 14 patients in 4 departments with temporary COVID-19 ICU wards. Quantitative real-time PCR (RT-PCR) methods confirmed the existence of COVID-19 pathogens. Results: : Four of the 15 air samples were obtained during aerosol-generating medical procedures (1 tracheostomy, 1 high-flow nasal cannula [HFNC], 1 HFNC+nebulization, 1 non-invasive positive pressure ventilation). Five patients were administered invasive positive pressure ventilation through tracheostomy. All air samples tested negative for SARS-CoV-2 by RT-PCR. Viruses were detected on the surface of a patient’s gastric tube, and an anal tube swab tested positive. Five days later, the anal swab of the patient remained positive, although viral RNA of the nasopharyngeal swap turned negative. Conclusions: : Establishing temporary isolation COVID-19 ICU wards is a safe and effective method to increase surge capacity in a hospital. SARS-CoV-2 sheds from the enteric canal after viral clearance in the respiratory tract. Reinforcing disinfection of tubes and circuits given to the patients is essential in COVID-19 isolation wards to decrease nosocomial transmission.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325284

ABSTRACT

Background: The phenomenon of COVID-19 patients tested positive for SARS-CoV-2 after discharge (redetectable as positive, RP) emerged globally. The data of incidence rate and risk factors for RP event and the clinical features of RP patients may provide recommendations for virus containment and discharge assessment for COVID-19. Methods: The baseline included 285 adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Guangzhou Eighth People's Hospital. We started the Observation on Jan 20, 2020, and acquired all their definite clinical outcome (becoming RP or keeping normal during post-discharge surveillance) by Mar 10, 2020. The dynamic clinical data of patients during observation were prospectively collected and analyzed. Univariate and multivariate-adjusted logistic regression were used to explore the risk factors related to RP events in COVID-19 patients. Results: By March 10, 27 (9.5%) discharged patients had tested positive for SARS-CoV-2 in their nasopharyngeal swab after a median duration of 7·0 days (IQR 5·0-8·0). Age, sex, epidemiological history, clinical symptoms and underlying diseases were similar between RP and non-RP patients (p>0.05). Compared to first admission, RP patients generally had milder clinical symptoms, lower viral load, shorter length of stay and improved pulmonary conditions at readmission (p<0.05). Elder RP patients (≥ 60 years old) were more likely to be symptomatic compared to younger patients (7/8, 87.5% vs. 3/19, 18.8%, p=0.001) at readmission. A prolonged duration of viral shedding (>10 days) during the first hospitalization [adjusted odds ratio [aOR]: 5.82, 95% confidence interval [CI]: 2.50-13.57 for N gene;aOR: 9.64, 95% CI: 3.91-23.73 for ORF gene] and higher Ct value (ORF) in the third week of the first hospitalization (aOR: 0.69;95% CI: 0.50-0.95) were associated with RP events. Conclusions: RP events occurred in nearly 10% of COVID-19 patients which deserves globally attention. During hospitalization, patients’ low efficiency of viral clearance was a risk factor for RP event. Elderly RP patients were more likely to develop clinical symptoms. To reduce the possibility of reinfection and readmission during the management of COVID-19, more rigorously monitoring on patients’ viral load should be carried out especially in elder patients and later stage of hospitalization.

13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325097

ABSTRACT

3D Convolutional Neural Networks (CNNs) have been widely adopted for airway segmentation. The performance of 3D CNNs is greatly influenced by the dataset while the public airway datasets are mainly clean CT scans with coarse annotation, thus difficult to be generalized to noisy CT scans (e.g. COVID-19 CT scans). In this work, we proposed a new dual-stream network to address the variability between the clean domain and noisy domain, which utilizes the clean CT scans and a small amount of labeled noisy CT scans for airway segmentation. We designed two different encoders to extract the transferable clean features and the unique noisy features separately, followed by two independent decoders. Further on, the transferable features are refined by the channel-wise feature recalibration and Signed Distance Map (SDM) regression. The feature recalibration module emphasizes critical features and the SDM pays more attention to the bronchi, which is beneficial to extracting the transferable topological features robust to the coarse labels. Extensive experimental results demonstrated the obvious improvement brought by our proposed method. Compared to other state-of-the-art transfer learning methods, our method accurately segmented more bronchi in the noisy CT scans.

14.
Energy ; : 123272, 2022.
Article in English | ScienceDirect | ID: covidwho-1648481

ABSTRACT

The CNG2020 strategy proposed in 2016 has directly impacted the global aviation industry, and the ensuing COVID-19 pandemic has brought the global aviation industry to a standstill. This paper calculates the Pollution Abatement Costs (PAC) index and regulated profits of the global aviation industry by establishing Data Envelopment Analysis (DEA) model. Then, considering the airlines’ different recovery times from COVID-19, we predict the data of 25 international benchmark airlines from 2021 to 2027 based on the actual data during 2012–2019. The regulated profits can help judge whether airlines can achieve a win-win situation of carbon emission reduction and revenue growth in the future recovery process. We have some findings: 1. Air France-KLM has the maximum regulated profits, while EasyJet has the minimal regulated gains. 2. The setting of route conditions impacts whether airlines can achieve a win-win situation.

15.
Clin Lab ; 68(1)2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1622821

ABSTRACT

BACKGROUND: Since December 2019, there has been a global outbreak of COVID-19. As of the end of July 2020, more than 600,000 deaths had been reported globally. The purpose of this paper is to further explore the application of non-invasive ventilation in severe COVID-19 patients. METHODS: A retrospective study was conducted to included 57 confirmed COVID-19 patients, among which 36 cases were severe. According to different oxygen inhalation methods, they were divided into non-invasive ventilator assisted ventilation group with 21 cases (group A) and 15 cases of nasal catheter oxygen inhalation group (group B). The data of respiration (RR), heart rate (HR), partial arterial pressure of oxygen (PaO2), partial arterial pressure of carbon dioxide (PaCO2), and oxygenation index (OI) before the treatment of noninvasive ventilator assisted ventilation or nasal catheter oxygen treatment at 24, 48, and 72 hours of treatment of the 2 groups were collected and analyzed to determine whether the above indicators were statistically different in each time period. RESULTS: After 24 hours of treatment with noninvasive ventilator assisted ventilation in group A, RR gradually decreased, PaO2 and OI were significantly higher than before treatment, while after 24 hours of treatment, PaO2, RR, HR and other indexes in group B showed no significant improvement, and OI increased gradually after 48 hours of treatment, with statistically significant difference compared with that before treatment. CONCLUSIONS: Early adoption of non-invasive ventilation can effectively improve the hypoxic state of patients with severe COVID-19. The combination of underlying diseases will not prolong the use of non-invasive ventilation.


Subject(s)
COVID-19 , Humans , Respiration, Artificial , Retrospective Studies , SARS-CoV-2 , Ventilators, Mechanical
16.
Front Psychol ; 12: 601383, 2021.
Article in English | MEDLINE | ID: covidwho-1608970

ABSTRACT

In the environment of COVID-19, people are faced with mortality salience (MS) and socioeconomic crisis. According to the terror management theory, the MS would lead to particular consumption attitudes and behaviors caused by the self-esteem and cultural worldview defense. The creativity as a potential value of products needs to be examined to explore how the MS changed the creativity evaluation of three types of products categorized into normal, renovative, and innovative products, based on the degree of originality (Zhang et al., 2019). Two experiments were conducted to examine (1) the MS effect on the creativity and purchase intention evaluation and (2) both MS and country-of-origin effect on the evaluations. The results show that usefulness and purchase intention are affected by both effects, and the novelty is mainly affected by MS.

17.
Ann Hepatol ; 27(1): 100653, 2022.
Article in English | MEDLINE | ID: covidwho-1588313

ABSTRACT

The epidemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has increasingly attracted worldwide concern. Liver damage or dysfunction occurred in patients with COVID-19 (mainly characterized by moderately elevated serum aspartate aminotransferase levels). However, it is not yet clear whether the COVID-19-related liver injury is mainly caused by the virus infection, potentially hepatotoxic drugs, or other coexisting conditions. Progression of pre-existing chronic liver disease (CLD) may be the underlying mechanism of liver injury. Although COVID-19 patients with CLD, such as nonalcoholic fatty liver disease, liver cirrhosis, and liver cancer, have been deemed at increased risk for serious illness in many studies, little is known about the impact of CLD on the natural history and outcome of COVID-19 patients. Thereby, based on the latest evidence from case reports and case series, this paper discusses the clinical manifestations, treatment, prognosis, and management of the COVID-19 patients with different CLD. This article also reviews the effect of COVID-19 on liver transplantation patients (LT), hoping to work for future prevention, management, and control measures of COVID-19. However, due to the lack of relevant research, most of them are still limited to the theoretical stage, further study of COVID-19 and CLD needs to be improved in the future.


Subject(s)
COVID-19/therapy , Liver Diseases/epidemiology , Liver Transplantation , SARS-CoV-2 , Transplant Recipients , COVID-19/epidemiology , Chronic Disease , Comorbidity , Humans , Liver Diseases/surgery , Pandemics , Prognosis
18.
World J Clin Cases ; 8(21): 5099-5103, 2020 Nov 06.
Article in English | MEDLINE | ID: covidwho-1527033

ABSTRACT

The coronavirus disease 2019 pandemic has become a major global public health problem. Governments are taking the necessary steps to reduce the movement of people to contain the spread of the virus. However, these measures have caused considerable distress to patients with gastric cancer who are newly diagnosed or are undergoing treatment. In addition to the cancer, they must deal with longer waiting times for surgery and poor communication with doctors. Furthermore, gastric cancer patients generally have low immunity and a poor nutritional status, so they are a high-risk group for infection with the novel coronavirus. Therefore, it is necessary to formulate reasonable outpatient management strategies to reduce the adverse effects of the pandemic on their treatment. We summarize the management strategies for patients with gastric cancer during the pandemic.

19.
Biomed Res Int ; 2021: 5565549, 2021.
Article in English | MEDLINE | ID: covidwho-1476874

ABSTRACT

OBJECTIVES: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus causing substantial morbidity and mortality worldwide. We performed a cross-sectional investigation of SARS-CoV-2 clusters in Suzhou to determine the transmissibility of the virus among close contacts and to assess the demographic and clinical characteristics between index and secondary cases. METHODS: We review the clustered patients with SARS-CoV-2 infections in Suzhou between 22 January and 29 February 2020. The demographic and clinical characteristics were compared between index and secondary cases. We calculated the basic reproduction number (R 0) among close contacts with SLI model. RESULTS: By 22 February, 87 patients with SARS-CoV-2 infection were reported, including 50 sporadic and 37 clustered cases, who were generated from 13 clusters. On admission, 5 (20.8%) out of 24 secondary cases were asymptomatic. The male ratio of index cases was significantly higher than that of secondary cases. Additionally, the index cases were more likely to have fever and increased CRP levels than the secondary cases. The R 0 values of clusters displayed a significantly declining trend over time for all clusters. The relative risk of infection in blood-related contacts of cases versus unrelated contacts was 1.60 for SARS-CoV-2 (95% CI: 0.42-2.95). CONCLUSIONS: In conclusion, SARS-CoV-2 has great person-to-person transmission capability among close contacts. The secondary cases are more prone to have mild symptoms than index cases. There is no increased RR of secondary infection in blood relatives versus unrelated contacts. The high rate of asymptomatic SARS-CoV-2 infections highlights the urgent need to enhance active case finding strategy for early detection of infectious patients.


Subject(s)
COVID-19/epidemiology , Contact Tracing , Family Characteristics , SARS-CoV-2 , Adult , COVID-19/transmission , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Risk Factors
20.
mBio ; 12(5): e0137221, 2021 10 26.
Article in English | MEDLINE | ID: covidwho-1462899

ABSTRACT

Interleukin6 (IL-6) is a key driver of hyperinflammation in COVID-19, and its level strongly correlates with disease progression. To investigate whether variability in COVID-19 severity partially results from differential IL-6 expression, functional single-nucleotide polymorphisms (SNPs) of IL-6 were determined in Chinese COVID-19 patients with mild or severe illness. An Asian-common IL-6 haplotype defined by promoter SNP rs1800796 and intronic SNPs rs1524107 and rs2066992 correlated with COVID-19 severity. Homozygote carriers of C-T-T variant haplotype were at lower risk of developing severe symptoms (odds ratio, 0.256; 95% confidence interval, 0.088 to 0.739; P = 0.007). This protective haplotype was associated with lower levels of IL-6 and its antisense long noncoding RNA IL-6-AS1 by cis-expression quantitative trait loci analysis. The differences in expression resulted from the disturbance of stimulus-dependent bidirectional transcription of the IL-6/IL-6-AS1 locus by the polymorphisms. The protective rs2066992-T allele disrupted a conserved CTCF-binding locus at the enhancer elements of IL-6-AS1, which transcribed antisense to IL-6 and induces IL-6 expression in inflammatory responses. As a result, carriers of the protective allele had significantly reduced IL-6-AS1 expression and attenuated IL-6 induction in response to acute inflammatory stimuli and viral infection. Intriguingly, this low-producing variant that is endemic to present-day Asia was found in early humans who had inhabited mainland Asia since ∼40,000 years ago but not in other ancient humans, such as Neanderthals and Denisovans. The present study suggests that an individual's IL-6 genotype underlies COVID-19 outcome and may be used to guide IL-6 blockade therapy in Asian patients. IMPORTANCE Overproduction of cytokine interleukin-6 (IL-6) is a hallmark of severe COVID-19 and is believed to play a critical role in exacerbating the excessive inflammatory response. Polymorphisms in IL-6 account for the variability of IL-6 expression and disparities in infectious diseases, but its contribution to the clinical presentation of COVID-19 has not been reported. Here, we investigated IL-6 polymorphisms in severe and mild cases of COVID-19 in a Chinese population. The variant haplotype C-T-T, represented by rs1800796, rs1524107, and rs2066992 at the IL-6 locus, was reduced in patients with severe illness; in contrast, carriers of the wild-type haplotype G-C-G had higher risk of severe illness. Mechanistically, the protective variant haplotype lost CTCF binding at the IL-6 intron and responded poorly to inflammatory stimuli, which may protect the carriers from hyperinflammation in response to acute SARS-CoV-2 infection. These results point out the possibility that IL-6 genotypes underlie the differential viral virulence during the outbreak of COVID-19. The risk loci we identified may serve as a genetic marker to screen high-risk COVID-19 patients.


Subject(s)
COVID-19/metabolism , COVID-19/prevention & control , Interleukin-6/metabolism , A549 Cells , Genotype , Haplotypes/genetics , HeLa Cells , Humans , Interleukin-6/genetics , Polymorphism, Single Nucleotide/genetics , Real-Time Polymerase Chain Reaction , Software
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