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1.
Toxins ; 14(4):N.PAG-N.PAG, 2022.
Article in English | Academic Search Complete | ID: covidwho-1834904

ABSTRACT

Animal feed (including forage and silage) can be contaminated with mycotoxins. Here, 200 maize silage samples from around China were collected in 2019 and analyzed for regulated mycotoxins, masked mycotoxins (deoxynivalenol, 3-acetyldeoxynivalenol, 15-acetyldeoxynivalenol, and deoxynivalenol-3-glucoside), and emerging mycotoxins (beauvericin, enniatins, moniliformin, and alternariol). Deoxynivalenol and zearalenone were detected in 99.5% and 79.5% of the samples, respectively. Other regulated mycotoxins were detected in fewer samples. The highest deoxynivalenol and zearalenone concentrations were 3600 and 830 μg/kg, respectively. The most commonly detected masked mycotoxin was 15-acetyldeoxynivalenol, which was detected in 68.5% of the samples and had median and maximum concentrations of 61.3 and 410 μg/kg, respectively. The emerging mycotoxins beauvericin, alternariol, enniatin A, enniatin B1, and moniliformin were detected in 99.5%, 85%, 80.5%, 72.5%, and 44.5%, respectively, of the samples but at low concentrations (medians <25 μg/kg). The samples tended to contain multiple mycotoxins, e.g., the correlation coefficients for the relationships between the concentrations of beauvericin and deoxynivalenol, deoxynivalenol and zearalenone, and zearalenone and beauvericin were 1.0, 0.995, and 0.995, respectively. The results indicated that there needs to be more awareness of the presence of one or more masked and emerging mycotoxins in maize silage in China. [ FROM AUTHOR] Copyright of Toxins is the property of MDPI 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.)

2.
Journal of biosafety and biosecurity ; 4(1):54-58, 2022.
Article in English | EuropePMC | ID: covidwho-1711105

ABSTRACT

Nucleic acid detection, widely used in clinical diagnosis, biological analysis, and environmental monitoring, is of great significance for disease diagnosis and basic research. With the outbreak of COVID-19, the demand for fast and high-throughput nucleic acid detection from large numbers of samples has increased sharply. Automated nucleic acid detection systems can meet these needs, and also play important roles in disease screening and infectious disease prevention and control. In this review, we introduce and compare the current mainstream nucleic acid automatic detection instruments and equipment, then discuss the future demands of nucleic acid detection.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322992

ABSTRACT

Background: The epidemic of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has spread worldwide, but the factors that may affect the SARS-CoV-2 viral shedding time in coronavirus disease 2019 (COVID-19) patients were rarely reported. Methods We retrospectively recruited 40 confirmed common COVID-19 patients and classified them into two groups according to the SARS-CoV-2 viral shedding time (group A (less than 10 days) and group B (10 days or more)). The demographic, laboratory parameters and chest computed tomography (CT) features on admission and the 3 rd day after treatment were analyzed respectively. Results Fourteen patients were in group A and 26 patients in group B, the median SARS-CoV-2 viral shedding time of the two groups was 7 and 16 days respectively. Compared to the group A, the comorbidity, epidemiological risk history, serum glucose and CD4/8 on admission were significantly higher in the group B (P<0.05). On the 3 rd day after treatment, the group B got significantly higher IL-6, IL-2R, TNF-α and CD4/8, and lower platelet and CD8 + T lymphocyte counts than group A (P<0.05). Logistic regression analyses revealed that the higher epidemiological risk history, serum glucose and CD4/8 on admission were significantly associated with a longer SARS-CoV-2 viral shedding time (OR=7.5, 11.41, 9.21 respectively, P<0.05), as well as the higher TNF-α and lower CD8 + T lymphocytes on the 3 rd day after treatment (OR=2.36, 0.98 respectively, P<0.05). Conclusions Our study provides the evidence that the prolonged SARS-CoV-2 viral shedding time might be correlated with the patients’ epidemiological risk history, as well as the serum glucose and CD4/8 on admission, TNF-α and CD8 + T lymphocytes on the 3 rd day after treatment. Our result may help clinicians to distinguish the patients with a prolonged viral shedding time at the early stage.

4.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-326503

ABSTRACT

Background: SARS-CoV-2 is released directly into the air through breathing by COVID-19 patients. Understanding the particle size distribution of SARS-CoV-2 in the exhaled breath of COVID-19 patients is essential for SARS-CoV-2 infection prevention policies. Methods: Here, serial nasopharyngeal swabs, exhaled breath specimens and environmental surface samples were collected at different days of COVID-19 patient hospitalization. Exhaled breath specimen collection was performed through a viral sampling tube and an air sampler. SARS-CoV-2 RNA detection was determined by real-time quantitative reverse transcription polymerase chain reaction (qRT–PCR). Results: We found that the COVID-19 patients exhaled ten million SARS-CoV-2 RNA copies per hour. The SARS-CoV-2 particles in the exhaled breath were mainly distributed in respiratory droplets (>4.7 μm), accounting for 87.14% of the total virus. There was a positive correlation between viral loads of nasopharyngeal swabs and exhaled breath specimens. The viral load of exhaled breath also showed a positive correlation with the viral load of environmental surface. Conclusions: SARS-CoV-2 in the exhaled breath of COVID-19 patients might be mainly transmitted via respiratory droplets. The viral load in the exhaled breath is determined by the viral load in the nasopharyngeal swab, and the viral load in the exhaled breath determines the presence and extent of environmental surface contamination. Therefore, the exhaled breath of COVID-19 patients plays a major role in the transmission of SARS-CoV-2.

5.
Clin Infect Dis ; 73(9): e2819, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1541514
6.
View ; 2(4), 2021.
Article in English | ProQuest Central | ID: covidwho-1375622

ABSTRACT

The unprecedented global COVID‐19 pandemic strongly argues the critical need for innovative diagnostic tools meeting the requirement of test speed, accuracy, and throughput. Owing to the integration of optics and microfluidics technologies, optofluidic technology enables highly precise flow manipulation and highly sensitive signal detection at the microscale, thus offering the promising potential for developing biodiagnostic applications. Research toward this direction is fast growing into an emerging area. In this paper, we give an overview of emerging optofluidic technologies for biodiagnostic applications with the focus on three common types of biomarkers: nucleic acid, protein, and cell. We conclude by discussing the challenges, opportunities, and future perspectives of this field.

7.
Food Control ; : 108372, 2021.
Article in English | ScienceDirect | ID: covidwho-1284090

ABSTRACT

The trend today leans towards urbanization and large farming enterprises. However, in 2019–2020, with the impact of the COVID-19 pandemic, the supply of commercial milk was disrupted, and the local smallholder dairy farmers played an important role in stabilizing nutritional security in rural, arid areas of China. The aim of this study was to describe and understand the operation of smallholder dairy farms and suggest what improvements are needed. We interviewed 45 smallholder dairy farmers from Gansu Province. A questionnaire was used to collect information on the dairy operation, including, number of cows, cow breeds, feed offered, yield and on management and open-ended discussions on the needs of the farmers to improve their dairies. Feed samples were collected at each farm to determine composition and milk samples were collected to analyze for composition and fatty acid content, and to compare the quality with commercial milk. Smallholder farmers generally fed dairy cows local, low-quality forages, mainly wheat straw and corn stover (CS/WS), and the milk yield was low, however, milk had a high content of beneficial unsaturated and polyunsaturated fatty acids. Milk from smallholder farms had lower concentrations of undesirable saturated fatty acids, higher concentrations of beneficial unsaturated and polyunsaturated fatty acids, and a lower atherogenic index than commercial milk. Proper sanitation measures and veterinary care were often lacking in these remote areas, leading to high somatic cell counts (SCC). A modified version of grounded theory was used to construct categories of what the farmers perceived was needed to improve their dairies. Four categories emerged in the following order: 1) equipment and management, 2) government support, 3) better cows, and 4) better feed. In a follow-up survey in 2020 of 18 farmers, conditions generally remained the same, including feed offered the animals, which would indicate that the milk composition remained the same. It was concluded that smallholder dairy farmers can provide nutritional security, especially for local residents in remote, rural, arid areas, but improvements in facilities, management, feed, cow breeds and sanitation are needed. Government subsidies should be implemented to help the smallholder dairy farmers. Results from this study provide information for local governments in their decision-making policies to stabilize smallholder dairies.

8.
Nat Cell Biol ; 23(6): 620-630, 2021 06.
Article in English | MEDLINE | ID: covidwho-1263492

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection often causes severe complications and even death. However, asymptomatic infection has also been reported, highlighting the difference in immune responses among individuals. Here we performed single-cell chromatin accessibility and T cell-receptor analyses of peripheral blood mononuclear cells collected from individuals convalescing from COVID-19 and healthy donors. Chromatin remodelling was observed in both innate and adaptive immune cells in the individuals convalescing from COVID-19. Compared with healthy donors, recovered individuals contained abundant TBET-enriched CD16+ and IRF1-enriched CD14+ monocytes with sequential trained and activated epigenomic states. The B-cell lineage in recovered individuals exhibited an accelerated developmental programme from immature B cells to antibody-producing plasma cells. Finally, an integrated analysis of single-cell T cell-receptor clonality with the chromatin accessibility landscape revealed the expansion of putative SARS-CoV-2-specific CD8+ T cells with epigenomic profiles that promote the differentiation of effector or memory cells. Overall, our data suggest that immune cells of individuals convalescing from COVID-19 exhibit global remodelling of the chromatin accessibility landscape, indicative of the establishment of immunological memory.


Subject(s)
COVID-19/genetics , Epigenesis, Genetic , Epigenomics , Genes, T-Cell Receptor , Immunologic Memory , Lymphocyte Subsets/immunology , Monocytes/immunology , SARS-CoV-2/immunology , Single-Cell Analysis , Adaptive Immunity , Adolescent , Adult , Aged , B-Lymphocytes/immunology , B-Lymphocytes/metabolism , B-Lymphocytes/virology , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/virology , COVID-19/immunology , COVID-19/metabolism , COVID-19/virology , Case-Control Studies , Cell Differentiation , Chromatin Assembly and Disassembly , Female , Gene Expression Profiling , Host-Pathogen Interactions , Humans , Immunity, Innate , Lymphocyte Subsets/metabolism , Lymphocyte Subsets/virology , Male , Middle Aged , Monocytes/metabolism , Monocytes/virology , SARS-CoV-2/pathogenicity , Young Adult
9.
Clin Infect Dis ; 72(1): 183, 2021 01 23.
Article in English | MEDLINE | ID: covidwho-1244877

Subject(s)
COVID-19 , Humans , SARS-CoV-2
10.
Lab Chip ; 21(12): 2398-2406, 2021 06 15.
Article in English | MEDLINE | ID: covidwho-1219412

ABSTRACT

COVID-19 is a new strain of highly contagious coronavirus, and at present, more than 221.4 million people have been infected with this virus, and the death toll exceeds 2793398. Early and fast detection of COVID-19 from infected individuals is critical to limit its spreading. Here, we report an innovative approach to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) protein by combining DNA/RNA oligomers as aptamers and a graphene oxide (GO) coated optical microfiber as a sensor system. The DNA/RNA aptamers can effectively capture the SARS-CoV-2 N protein in vitro, with the GO coated optical microfiber aptasensor for real-time monitoring of the SARS-CoV-2 N protein. Due to the extremely high surface-to-volume ratio and excellent optical and biochemical properties of the GO surface layer, the fixing effect of the microfiber surface is significantly improved and the lowest limit of detection (LOD) is 6.25 × 10-19 M. Furthermore, in order to prove the feasibility of this sensing method in clinical applications, we use this sensor to detect the N protein mixed in fetal bovine serum (FBS) samples. The experimental results show that the biosensor can quickly and effectively detect the N protein (1 × 10-9 M) in a complex sample matrix within 3 minutes. These findings suggest that this approach can be utilized for quantitative monitoring of coronavirus particles due to its high sensitivity, which can help to quickly exclude patients who do not have the infection. Collectively, the optical microfiber sensor system could be expected to become an important platform for the diagnosis of coronavirus due to its simple detection scheme and easy miniaturization.


Subject(s)
COVID-19 , Graphite , Humans , Limit of Detection , SARS-CoV-2
11.
BMC Pulm Med ; 21(1): 64, 2021 Feb 24.
Article in English | MEDLINE | ID: covidwho-1102335

ABSTRACT

OBJECTIVES: We aimed to identify high-risk factors for disease progression and fatality for coronavirus disease 2019 (COVID-19) patients. METHODS: We enrolled 2433 COVID-19 patients and used LASSO regression and multivariable cause-specific Cox proportional hazard models to identify the risk factors for disease progression and fatality. RESULTS: The median time for progression from mild-to-moderate, moderate-to-severe, severe-to-critical, and critical-to-death were 3.0 (interquartile range: 1.8-5.5), 3.0 (1.0-7.0), 3.0 (1.0-8.0), and 6.5 (4.0-16.3) days, respectively. Among 1,758 mild or moderate patients at admission, 474 (27.0%) progressed to a severe or critical stage. Age above 60 years, elevated levels of blood glucose, respiratory rate, fever, chest tightness, c-reaction protein, lactate dehydrogenase, direct bilirubin, and low albumin and lymphocyte count were significant risk factors for progression. Of 675 severe or critical patients at admission, 41 (6.1%) died. Age above 74 years, elevated levels of blood glucose, fibrinogen and creatine kinase-MB, and low plateleta count were significant risk factors for fatality. Patients with elevated blood glucose level were 58% more likely to progress and 3.22 times more likely to die of COVID-19. CONCLUSIONS: Older age, elevated glucose level, and clinical indicators related to systemic inflammatory responses and multiple organ failures, predict both the disease progression and the fatality of COVID-19 patients.


Subject(s)
Blood Glucose/metabolism , COVID-19/blood , COVID-19/mortality , Disease Progression , Hyperglycemia/blood , Adult , Age Factors , Aged , Aged, 80 and over , Bilirubin/blood , C-Reactive Protein/metabolism , China/epidemiology , Critical Illness , Female , Fever/virology , Humans , Hyperglycemia/complications , L-Lactate Dehydrogenase/blood , Lymphocyte Count , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , SARS-CoV-2 , Serum Albumin/metabolism , Time Factors
12.
Infect Dis Poverty ; 9(1): 161, 2020 Nov 25.
Article in English | MEDLINE | ID: covidwho-949105

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is pandemic. It is critical to identify COVID-19 patients who are most likely to develop a severe disease. This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression. METHODS: Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing, China from December 27, 2019 to March 12, 2020 were enrolled in this study and followed-up to March 16, 2020. Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by the χ2 test or the Fisher exact test (categorical variables) and independent group t test or Mann-Whitney U test (continuous variables). The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19. RESULTS: The mean incubation was 8.67 (95% confidence interval, 6.78-10.56) days. Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38 (9.86-12.90) days. Compared to pneumonia-free patients, pneumonia patients were 16.5 years older and had higher frequencies of having hypertension, fever, and cough and higher circulating levels of neutrophil proportion, interleukin-6, low count (< 190/µl) of CD8+ T cells, and neutrophil/lymphocyte ratio. Thirteen patients deteriorated during hospitalization. Cox regression analysis indicated that older age and higher serum levels of interleukin-6, C-reactive protein, procalcitonin, and lactate at admission significantly predicted the progression of COVID-19. During hospitalization, circulating counts of T lymphocytes, CD4+ T cells, and CD8+ T cells were lower, whereas neutrophil proportion, neutrophil/lymphocyte ratio, and the circulating levels of interleukin-6, C-reactive protein, and procalcitonin were higher, in pneumonia patients than in pneumonia-free patients. CD8+ lymphocyte count in pneumonia patients did not recover when discharged. CONCLUSIONS: Older age and higher levels of C-reactive protein, procalcitionin, interleukin-6, and lactate might predict COVID-19 progression. T lymphocyte, especially CD8+ cell-mediated immunity is critical in recovery of COVID-19. This study may help in predicting disease progression and designing immunotherapy for COVID-19.


Subject(s)
CD8-Positive T-Lymphocytes/pathology , COVID-19/pathology , Interleukin-6/blood , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , Child , Child, Preschool , China/epidemiology , Disease Progression , Female , Hospitalization , Humans , Leukocyte Count , Male , Middle Aged , Neutrophils/pathology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Risk Factors , SARS-CoV-2 , Young Adult
14.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-513

ABSTRACT

Background: With the outbreak of COVID-19 from Wuhan, HubeProvince, China since January 2020, there is a tremendous pressure on medical resources. We studie

15.
Signal Transduct Target Ther ; 5(1): 172, 2020 08 27.
Article in English | MEDLINE | ID: covidwho-733534

ABSTRACT

No effective drug treatments are available for coronavirus disease 2019 (COVID-19). Host-directed therapies targeting the underlying aberrant immune responses leading to pulmonary tissue damage, death, or long-term functional disability in survivors require clinical evaluation. We performed a parallel assigned controlled, non-randomized, phase 1 clinical trial to evaluate the safety of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) infusions in the treatment of patients with moderate and severe COVID-19 pulmonary disease. The study enrolled 18 hospitalized patients with COVID-19 (n = 9 for each group). The treatment group received three cycles of intravenous infusion of UC-MSCs (3 × 107 cells per infusion) on days 0, 3, and 6. Both groups received standard COVID-treatment regimens. Adverse events, duration of clinical symptoms, laboratory parameters, length of hospitalization, serial chest computed tomography (CT) images, the PaO2/FiO2 ratio, dynamics of cytokines, and IgG and IgM anti-SARS-CoV-2 antibodies were analyzed. No serious UC-MSCs infusion-associated adverse events were observed. Two patients receiving UC-MSCs developed transient facial flushing and fever, and one patient developed transient hypoxia at 12 h post UC-MSCs transfusion. Mechanical ventilation was required in one patient in the treatment group compared with four in the control group. All patients recovered and were discharged. Our data show that intravenous UC-MSCs infusion in patients with moderate and severe COVID-19 is safe and well tolerated. Phase 2/3 randomized, controlled, double-blinded trials with long-term follow-up are needed to evaluate the therapeutic use of UC-MSCs to reduce deaths and improve long-term treatment outcomes in patients with serious COVID-19.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , Cord Blood Stem Cell Transplantation/methods , Coronavirus Infections/therapy , Hematopoietic Stem Cells/virology , Mesenchymal Stem Cell Transplantation/methods , Pneumonia, Viral/therapy , Adult , Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/virology , Drug Combinations , Female , Glucocorticoids/therapeutic use , Hematopoietic Stem Cells/drug effects , Hematopoietic Stem Cells/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Lopinavir , Male , Middle Aged , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Respiration, Artificial , Ritonavir , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome
16.
J Hepatol ; 73(3): 724-725, 2020 09.
Article in English | MEDLINE | ID: covidwho-722625
17.
Hepatol Int ; 14(5): 701-710, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-688878

ABSTRACT

BACKGROUND AND AIM: Cytokine storm has been reported in patients with coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We examine the incidence of acute on chronic liver failure (ACLF) in COVID-19 patients with pre-existing compensated chronic liver disease (CLD). METHODS: From 20 Jan 2020 to 7 Feb 2020, we studied 140 consecutive COVID-19 patients admitted to either Fuyang Second People's Hospital (FYSPH), Anhui or the Fifth Medical Center of Chinese PLA General Hospital (PLAGH) in Beijing, China. Pre-existing CLD includes those with liver cirrhosis assessed by APRI/FIB-4 score and /or ultrasound; NAFLD as identified by either ultrasound or hepatic steatosis index with significant liver fibrosis and chronic hepatitis B (CHB) or hepatitis C (CHC) infection. The diagnosis, grading of severity and clinical management of COVID-19 patients complied to the guideline and clinical protocol issued by the China National Health Commission. All patients had liver function test at least twice weekly till discharge with full recovery or death. RESULTS: In total, 3 had liver cirrhosis, 6 patients had CHB, 13 had NAFLD with significant liver fibrosis (one also had CHB). On admission, none had liver decompensation. COVID-19 disease progression was significantly less frequent in non-CLD patients (10/118 8.5%) than CLD patients (13/22 59.1%, p < 0.001). One patient with CLD had acute-on-chronic liver failure (ACLF). CONCLUSION: Disease progression is significantly higher in those COVID-19 patients with CLD as compared to those with no CLD. ACLF can also occur in patient with pre-existing compensated CLD who had severe COVID-19.


Subject(s)
Acute-On-Chronic Liver Failure , Coronavirus Infections , Hepatitis B, Chronic , Liver Cirrhosis , Non-alcoholic Fatty Liver Disease , Pandemics , Pneumonia, Viral , Acute-On-Chronic Liver Failure/diagnosis , Acute-On-Chronic Liver Failure/epidemiology , Acute-On-Chronic Liver Failure/etiology , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Progression , Female , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/diagnosis , Humans , Incidence , Liver/diagnostic imaging , Liver Cirrhosis/diagnosis , Liver Cirrhosis/epidemiology , Liver Cirrhosis/etiology , Liver Function Tests/methods , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , SARS-CoV-2 , Ultrasonography/methods
18.
Nat Commun ; 11(1): 3410, 2020 07 08.
Article in English | MEDLINE | ID: covidwho-635899

ABSTRACT

COVID-19 is associated with 5.1% mortality. Although the virological, epidemiological, clinical, and management outcome features of COVID-19 patients have been defined rapidly, the inflammatory and immune profiles require definition as they influence pathogenesis and clinical expression of COVID-19. Here we show lymphopenia, selective loss of CD4+ T cells, CD8+ T cells and NK cells, excessive T-cell activation and high expression of T-cell inhibitory molecules are more prominent in severe cases than in those with mild disease. CD8+ T cells in patients with severe disease express high levels of cytotoxic molecules. Histochemical studies of lung tissue from one fatality show sub-anatomical distributions of SARS-CoV-2 RNA and massive infiltration of T cells and macrophages. Thus, aberrant activation and dysregulation of CD8+ T cells occur in patients with severe COVID-19 disease, an effect that might be for pathogenesis of SARS-CoV-2 infection and indicate that immune-based targets for therapeutic interventions constitute a promising treatment for severe COVID-19 patients.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Adult , Aged , Aged, 80 and over , Betacoronavirus/immunology , Biomarkers/metabolism , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/pathology , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/pathology , COVID-19 , Chemotaxis, Leukocyte , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/virology , Cytokines/blood , Female , Humans , Inflammation , Killer Cells, Natural/immunology , Killer Cells, Natural/pathology , Leukocyte Count , Lung/immunology , Lung/virology , Lymphocyte Activation , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/virology , SARS-CoV-2
19.
J Allergy Clin Immunol Pract ; 8(8): 2585-2591.e1, 2020 09.
Article in English | MEDLINE | ID: covidwho-609222

ABSTRACT

BACKGROUND: The clinical management of coronavirus disease 2019 (COVID-19) is dependent on understanding the underlying factors that contribute to the disease severity. In the absence of effective antiviral therapies, other host immunomodulatory therapies such as targeting inflammatory response are currently being used without clear evidence of their effectiveness. Because inflammation is an essential component of host antiviral mechanisms, therapies targeting inflammation may adversely affect viral clearance and disease outcome. OBJECTIVE: To understand whether the persistent presence of the virus is a key determinant in the disease severity during COVID-19 and to determine whether the viral reactivation in some patients is associated with infectious viral particles. METHODS: The data for patients were available including the onset of the disease, duration of viral persistence, measurements of inflammatory markers such as IL-6 and C-reactive protein, chest imaging, disease symptoms, and their durations among others. Follow-up tests were performed to determine whether the viral negative status persists after their recovery. RESULTS: Our data show that patients with persistent viral presence (>16 days) have more severe disease outcomes including extensive lung involvement and requirement of respiratory support. Two patients who died of COVID-19 were virus-positive at the time of their death. Four patients demonstrated virus-positive status on the follow-up tests, and these patient samples were sent to viral culture facility where virus culture could not be established. CONCLUSIONS: These data suggest that viral persistence is the key determining factor of the disease severity. Therapies that may impair the viral clearance may impair the host recovery from COVID-19.


Subject(s)
Coronavirus Infections/physiopathology , Inflammation/physiopathology , Pneumonia, Viral/physiopathology , Adolescent , Adult , Aged , Betacoronavirus , C-Reactive Protein/immunology , COVID-19 , Child , Child, Preschool , Comorbidity , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Female , Glucocorticoids/therapeutic use , Humans , Infant , Inflammation/epidemiology , Inflammation/immunology , Inflammation Mediators/immunology , Interleukin-6/immunology , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Real-Time Polymerase Chain Reaction , Respiration, Artificial , SARS-CoV-2 , Severity of Illness Index , Young Adult
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