[Preliminary clinical analysis of direct renin inhibitor aliskiren in the treatment of severe coronavirus disease 2019 patients with hypertension].

Objective: To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe or critical coronavirus disease 2019 (COVID-19) patients with hypertension. Methods: The antihypertensive effects and safety of aliskiren was retrospectively analyzed in three severe and one critical COVID-19 patients with hypertension. Results: Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three were diagnosed by positive novel coronavirus 2019 (2019-nCoV) nucleic acid or antibody, and the critical patient with cardiac insufficiency was clinically determined. Two patients were treated with calcium channel antagonist (CCB), one with angiotensin converting enzyme inhibitor (ACEI), and one with angiotensin Ⅱ receptor antagonist (ARB). After admission, ACEI and ARB were discontinued, one patient with heart failure was treated by aliskiren combined with diuretic.Three patients were treated with aliskiren combined with CCB among whom two withdrew CCB due to low blood pressure after 1 to 2 weeks. Based on comprehensive treatment including antiviral and oxygenation treatment, blood pressure was satisfactorily controlled by aliskiren after three to four weeks without serious adverse events. All patients were finally discharged. Conclusion: Our preliminary clinical data shows that antihypertensive effect of aliskiren is satisfactory and safe for severe COVID-19 patients complicated with hypertension.

What convalescent plasma in treating severe acute respiratory infections of viral aetiology can hint for COVID-19? Evidence from a meta-analysis.

OBJECTIVE: To explore whether convalescent plasma therapy is beneficial to patients with severe acute respiratory infections and gave hints to the management of COVID-19. METHODS: A comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane library was conducted for all eligible studies range from inception to February 29, 2020. Studies with control group were included. Treatment group received convalescent plasma therapy, and control group may receive any therapy other than convalescent plasma therapy. Odds ratios (ORs), mean differences (MDs) and 95% confidence intervals (CIs) were pooled for categorical and continuous outcomes. RESULTS: A total of 1997 patients from 13 studies were included, and seven studies were prospectively designed. Pooled analysis indicated convalescent plasma treatment significantly reduced the mortality by 51% (OR=0.49, 95% CI: 0.36 to 0.67). Subgroup analyses by publication time, study design, and influenza A revealed similar results. Sensitivity analyses suggested that the results were stable. In addition, convalescent plasma therapy reduced mechanical ventilation requirement (OR: 0.35, 95% CI: 0.21 to 0.59), while it was not associated with less use of extracorporeal membrane oxygenation (OR: 2.0, 95% CI: 0.83 to 4.83) and shorter length of hospital stay (MD: -2.20, 95% CI: -4.98 to 0.57days). Pooled estimates showed there was no difference in serious adverse effects between the convalescent plasma treatment and control groups (OR: 0.75, 95% CI: 0.50 to 1.13). CONCLUSION: Convalescent plasma therapy significantly reduced the mortality and mechanical ventilation requirements of patients with virus-induced severe acute respiratory infections, without serious adverse effects. More studies are needed to explore whether this treatment can be extrapolated into COVID-19.

A wireless sensor technology' application in clinical nursing of hospital internet of things

Background : With the continuous development of sensing technology, people begin to use all kinds of sensors to monitor the human condition, such as early rising ECG instrument. Although this kind of equipment has the characteristics of high precision and high sensitivity, it has the defects of large volume, high power consumption, harsh use conditions and high cost. With the continuous development of wireless sensor network technology and integration technology, it is more and more possible to design a device with small size, high mobility and greatly reduced cost on the premise of maintaining the advantages of dual height. The purpose of this study is to explore how to apply wireless sensor network technology to clinical field, and to study the exact benefits of wireless sensor network technology for clinical neighborhood. Methods : Body temperature is an important monitoring index of whether there is abnormality in human body. Taking this as a breakthrough, we designed a real- time temperature acquisition device that can be worn on the arm of patients for a long time by using wireless sensor network technology and high- sensitivity sensor (sensitivity < 0.1°C). In addition, in order to complete the normal transmission of body temperature data, we also designed data aggregation node, gateway node and data processing platform. Through the system, the patient's temperature data can be monitored by the medical staff in real time. Results : Compared with the traditional methods of body temperature measurement (mercury thermometer, infrared thermometer), With the same accuracy, it can record the patient's temperature change in more detail (usually the temperature measurement in the hospital is tested every 6 hours, while the system can be tested every 30 minutes, 1 hour and 2 hours, and the test interval only needs to be completed through the system setting). The use of the system can greatly reduce the workload of medical staff (from the perspective of temperature measurement alone, it subverts the traditional way of temperature measurement, from a way of medical staff to a way of patient to a way of system automatically recording the patient's temperature data, which can be viewed by medical staff when they need to), and it can realize the non- contact temperature monitoring between doctors and patients, which can control infectious diseases such as SARS, novel coronavirus is of great significance Conclusions : The combination of sensor technology, low power consumption technology, integration technology and wireless sensor network makes it possible to realize medical grade physical examination equipment with high precision, long time and easy to carry. This kind of equipment can greatly reduce the nursing workload of medical staff for patients. Reliable and accurate data also provides powerful data support for the treatment of patients later.