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2.
J Biol Regul Homeost Agents ; 34(4):1541-1542, 2020.
Article | WHO COVID | ID: covidwho-771130
3.
Chinese Journal of Laboratory Medicine ; 43(4):358-363, 2020.
Article | WHO COVID | ID: covidwho-769448

ABSTRACT

Objective: To investigate the effect of virus inactivation on weak positive result of 2019 novel coronavirus(2019-nCoV) nucleic acid test Methods: A retrospective study was conducted on the nasopharyngeal swabs of three patients with positive PCR nucleic acid test for 2019-nCoV at different concentrations in the Second affiliated Hospital of Zhejiang University Medical College from January to February 2020 The virus in nasopharyngeal swab specimens were inactivated by water bath at 56 ℃ for 30 min, dry bath at 56 ℃ for 60 min and dry bath at 60 ℃ for 30 min respectively After treatment, these samples RNA were extracted and then detected by three new commercial quantitative real-time polymerase chain reaction reagent kits for 2019-nCoV Cycle threshold (Ct) value was used to evaluate the effect of virus inactivation on nucleic acid detection of 2019-nCoV Results: There was no significant difference between the groups before and after inactivation Ct values of ORF1ab gene before inactivation were 23 28±0 28, 25 25±0 25, 28 93±0 44, 32 06±0 47, 35 20±0 38, 32 89±0 38, 36 24±0 23, 33 30±0 46, and those after inactivation were, group 1:23 60±0 20, 27 29±0 30, 31 83±0 51, 37 41±0 46, group 2: 24 25±0 34, 27 18±0 42, 31 84±0 61, 34 99±1 01, 34 89±0 45,group 3: 23 37±0 17, 26 89±0 52, 32 05±0 50 Ct value of N gene before inactivation were 24 38±0 09, 26 64±0 11, 30 35±0 12, 33 29±0 33, 36 93±0 11, 34 50±0 12, 35 63±0 12, those after inactivation were, group 1: 24 66±0 11, 28 52±0 14, 32 71±0 14, 37 00±0 13;group 2: 25 41±0 10, 28 79±0 15, 33 29±0 28;group 3: 23 37±0 11, 28 68±0 11, 33 54±0 13, 37 18±0 23(ORF1ab gene: t=-1 416;N gene: t=-1 379, P>0 05) There was no significant difference among the three inactivation groups, the specific Ct values are shown above(ORF1ab gene: t=-0 460;N gene: t=-0 132, P>0 05) However, the Ct values of the inactivated groups (1,2,3) and the non-inactivated group at different dilution times were different (10 ×:Ct value of ORF1ab was 25 25±0 25 in the non-inactivated group, and 27 29±0 30, 27 18±0 42 and 26 89±0 52 in the inactivated group1,2 and 3,t(ORF1ab)=-7 327, P0 05) and among the three reagents(reagent 1:7/11, 4/11, 3/11, 3/11, reagent 2:8/11, 4/11, 3/11, 3/11, reagent 3:5/11, 3/11, 3/11, 2/11)(χ2=1 199, P>0 05) Conclusion: The virus inactivation can degrade the nucleic acid of the 2019-nCoV, resulting in the decrease of the Ct value and the false negative results of the low-concentration specimens

4.
Frontiers in Medicine ; 7, 2020.
Article | WHO COVID | ID: covidwho-769242

ABSTRACT

Background: Lung mechanics during invasive mechanical ventilation (IMV) for both prognostic and therapeutic implications;however, the full trajectory lung mechanics has never been described for novel coronavirus disease 2019 (COVID-19) patients requiring IMV The study aimed to describe the full trajectory of lung mechanics of mechanically ventilated COVID-19 patients The clinical and ventilator setting that can influence patient-ventilator asynchrony (PVA) and compliance were explored Post-extubation spirometry test was performed to assess the pulmonary function after COVID-19 induced ARDS Methods: This was a retrospective study conducted in a tertiary care hospital All patients with IMV due to COVID-19 induced ARDS were included High-granularity ventilator waveforms were analyzed with deep learning algorithm to obtain PVAs Asynchrony index (AI) was calculated as the number of asynchronous events divided by the number of ventilator cycles and wasted efforts Mortality was recorded as the vital status on hospital discharge Results: A total of 3,923,450 respiratory cycles in 2,778 h were analyzed (average: 24 cycles/min) for seven patients Higher plateau pressure (Coefficient: −0 90;95% CI: −1 02 to −0 78) and neuromuscular blockades (Coefficient: −6 54;95% CI: −9 92 to −3 16) were associated with lower AI Survivors showed increasing compliance over time, whereas non-survivors showed persistently low compliance Recruitment maneuver was not able to improve lung compliance Patients were on supine position in 1,422 h (51%), followed by prone positioning (499 h, 18%), left positioning (453 h, 16%), and right positioning (404 h, 15%) As compared with supine positioning, prone positioning was associated with 2 31 ml/cmH2O (95% CI: 1 75 to 2 86;p < 0 001) increase in lung compliance Spirometry tests showed that pulmonary functions were reduced to one third of the predicted values after extubation Conclusions: The study for the first time described full trajectory of lung mechanics of patients with COVID-19 The result showed that prone positioning was associated with improved compliance;higher plateau pressure and use of neuromuscular blockades were associated with lower risk of AI

5.
J Med Internet Res ; 2020.
Article | WHO COVID | ID: covidwho-769064

ABSTRACT

BACKGROUND: COVID-19 has become a global pandemic not long after its inception in late 2019 SARS-CoV-2 genomes are being sequenced and shared on public repositories at a fast pace To keep up with these updates, scientists need to frequently refresh and reclean datasets, which is ad hoc and labor-intensive Further, scientists with limited bioinformatics or programming knowledge may find it difficult to analyze SARS-CoV-2 genomes OBJECTIVE: To address these challenges, we developed CoV-Seq, an integrated webserver to enable simple and rapid analysis of SARS-CoV-2 genomes METHODS: Given a new sequence, CoV-Seq automatically predicts gene boundaries and identifies genetic variants, which are displayed in an interactive genome visualizer and are downloadable for further analysis A command-line interface is also available for high-throughput processing Also, we aggregate all publicly available SARS-CoV-2 sequences from GISAID, NCBI, ENA, and CNGB, and extract genetic variants from these sequences for download and downstream analysis The CoV-Seq database is updated weekly RESULTS: CoV-Seq is implemented in Python and JavaScript The web server is available at http://covseq baidu com/ and the source code is available from https://github com/boxiangliu/covseq CONCLUSIONS: We have developed CoV-Seq, an integrated web service for fast and easy analysis of custom SARS-CoV-2 sequences The web server provides an interactive module for the analysis of custom sequences and weekly updated database of genetic variants from all publicly accessible SARS-CoV-2 sequences We hope CoV-Seq will help improve our understanding of the genetic underpinnings of COVID-19

7.
Clin Microbiol Infect ; 2020 Jul 09.
Article in English | MEDLINE | ID: covidwho-641315

ABSTRACT

OBJECTIVES: Asymptomatic patients, together with those with mild symptoms of coronavirus disease 2019 (COVID-19), may play an important role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. However, the dynamics of virus shedding during the various phases of the clinical course of COVID-19 remains unclear at this stage. METHODS: A total of 18 patients found to be positive for SARS-CoV-2 infection by real-time reverse transcription PCR (RT-PCR) assay and admitted to Chongqing University Central Hospital between 29 January and 5 February 2020 were enrolled into this study. Medical data, pulmonary computed tomographic (CT) scan images and RT-PCR results were periodically collected during the patients' hospital stay. All participants were actively followed up for 2 weeks after discharge. RESULTS: A total of nine (50%) asymptomatic patients and nine (50%) patients with mild symptoms of COVID-19 were identified at admission. Six patients (66.7%) who were asymptomatic at admission developed subjective symptoms during hospitalization and were recategorized as being presymptomatic. The median duration of virus shedding was 11.5, 28 and 31 days for presymptomatic, asymptomatic and mildly symptomatic patients, separately. Seven patients (38.9%) continued to shed virus after hospital discharge. During the convalescent phase, detectable antibodies to SARS-CoV-2 and RNA were simultaneously observed in five patients (27.8%). CONCLUSIONS: Long-term virus shedding was documented in patients with mild symptoms and in asymptomatic patients. Specific antibody production to SARS-CoV-2 may not guarantee virus clearance after discharge. These observations should be considered when making decisions regarding clinical and public health, and when considering strategies for the prevention and control of SARS-CoV-2 infection.

8.
Clin Microbiol Infect ; 2020 Jun 09.
Article in English | MEDLINE | ID: covidwho-637775

ABSTRACT

OBJECTIVES: Since December 2019, the novel coronavirus disease 2019 (COVID-19) that emerged in Wuhan city has spread rapidly around the world. The risk for poor outcome dramatically increases once a patient progresses to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in individuals with mild to moderate COVID-19. METHODS: We conducted a cohort study that included 1007 individuals with mild to moderate COVID-19 from three hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients were followed up for 28 days for observation of disease progression. The end point was the progression to a more severe disease stage. RESULTS: During a follow up of 28 days, 720 patients (71.50%) had recovered or were symptomatically stable, 222 patients (22.05%) had progressed to severe disease, 22 patients (2.18%) had progressed to the critically ill stage and 43 patients (4.27%) had died. Multivariate Cox proportional hazards models identified that increased age (hazard ratio (HR) 2.56, 95% CI 1.97-3.33), male sex (HR 1.79, 95% CI 1.41-2.28), presence of hypertension (HR 1.44, 95% CI 1.11-1.88), diabetes (HR 1.82, 95% CI 1.35-2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38-2.93) and coronary artery disease (HR 1.83, 95% CI 1.26-2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34-0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02-2.90), urea nitrogen (HR 1.72, 95% CI 1.21-2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26-7.21) and D-dimer (HR 2.01, 95% CI 1.12-3.58) at baseline were also associated with risk for disease progression. CONCLUSIONS: This study identified a panel of risk factors for disease progression in individuals with mild to moderate COVID-19.

9.
Quantitative imaging in medicine and surgery ; 10(6):1307-1317, 2020.
Article | WHO COVID | ID: covidwho-604098

ABSTRACT

BACKGROUND: Many studies have described lung lesion computed tomography (CT) features of coronavirus disease 2019 (COVID-19) patients at the early and progressive stages In this study, we aim to evaluate lung lesion CT radiological features along with quantitative analysis for the COVID-19 patients ready for discharge METHODS: From February 10 to March 10, 2020, 125 COVID-19 patients (age: 16-67 years, 63 males) ready for discharge, with two consecutive negative reverse transcription-polymerase chain reaction (RT-PCR) and no clinical symptoms for more than 3 days, were included The pre-discharge CT was performed on all patients 1-3 days after the second negative RT-PCR test, and the follow-up CTs were performed on 44 patients 2-13 days later The imaging features and quantitative analysis were evaluated on both the pre-discharge and the follow-up CTs, by both radiologists and an artificial intelligence (AI) software RESULTS: On the pre-discharge CT, the most common CT findings included ground-glass opacity (GGO) (99/125, 79 2%) with bilateral mixed distribution, and fibrosis (56/125, 44 8%) with bilateral subpleural distribution Enlarged mediastinal lymph nodes were also commonly observed (45/125, 36 0%) AI enabled quantitative analysis showed the right lower lobe was mostly involved, and lesions most commonly had CT value of -570 to -470 HU consistent with GGO Follow-up CT showed GGO decrease in size and density (40/40, 100%) and fibrosis reduction (17/26, 65 4%) Compared with the pre-discharge CT results, quantitative analysis shows the lung lesion volume regressed significantly at follow-up CONCLUSIONS: For COVID-19 patients ready for discharge, GGO and fibrosis are the main CT features and they further regress at follow-up

10.
Zhonghua Nei Ke Za Zhi ; 59(9): 677-688, 2020 Sep 01.
Article in Chinese | MEDLINE | ID: covidwho-598957

ABSTRACT

Severe patients with coronaviras disease 2019 (COVID-19) are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects: (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancement, stress cardiomyopathy, diffuse cardiac depression and other multiple abnormalities; (3) Critical ultrasonography helps with initiating early treatment in the suspect patient, screening confirmed patients after intensive care unit admission, early assessment of sudden critical events, rapid grading assessment and treatment based on it; (4) Critical ultrasonography helps to quickly screen for the etiology of respiratory failure in patients with COVID-19, make oxygen therapeutic strategy, guide the implementation of lung protective ventilation, graded management and precise off-ventilator; (5) Critical ultrasonography is helpful for assessing the circulatory status of patients with COVID-19, finding chronic cardiopulmonary diseases and guiding extracorporeal membrane oxygenation management; (6) Critical ultrasonography contributes to the management of organs besides based on cardiopulmonary oxygen transport; (7) Critical ultrasonography can help to improve the success of operation; (8) Critical ultrasonography can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19. In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19 patients therapy.


Subject(s)
Coronavirus Infections/therapy , Coronavirus , Critical Care/methods , Practice Guidelines as Topic , Telemedicine , Ultrasonography/methods , Artificial Intelligence , Betacoronavirus , Coronavirus Infections/diagnosis , Humans , Pandemics , Pneumonia, Viral
11.
Allergy ; 2020 Jun 12.
Article in English | MEDLINE | ID: covidwho-596293

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. METHOD: The scientific information on COVID-19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet. RESULTS: Based on diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. CONCLUSIONS: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID-19 pandemic.

12.
Clin Microbiol Infect ; 2020 Jun 09.
Article in English | MEDLINE | ID: covidwho-591568

ABSTRACT

OBJECTIVES: Since December 2019, the novel coronavirus disease 2019 (COVID-19) that emerged in Wuhan city has spread rapidly around the world. The risk for poor outcome dramatically increases once a patient progresses to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in individuals with mild to moderate COVID-19. METHODS: We conducted a cohort study that included 1007 individuals with mild to moderate COVID-19 from three hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients were followed up for 28 days for observation of disease progression. The end point was the progression to a more severe disease stage. RESULTS: During a follow up of 28 days, 720 patients (71.50%) had recovered or were symptomatically stable, 222 patients (22.05%) had progressed to severe disease, 22 patients (2.18%) had progressed to the critically ill stage and 43 patients (4.27%) had died. Multivariate Cox proportional hazards models identified that increased age (hazard ratio (HR) 2.56, 95% CI 1.97-3.33), male sex (HR 1.79, 95% CI 1.41-2.28), presence of hypertension (HR 1.44, 95% CI 1.11-1.88), diabetes (HR 1.82, 95% CI 1.35-2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38-2.93) and coronary artery disease (HR 1.83, 95% CI 1.26-2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34-0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02-2.90), urea nitrogen (HR 1.72, 95% CI 1.21-2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26-7.21) and D-dimer (HR 2.01, 95% CI 1.12-3.58) at baseline were also associated with risk for disease progression. CONCLUSIONS: This study identified a panel of risk factors for disease progression in individuals with mild to moderate COVID-19.

15.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(2): 302-307, 2020 Apr 18.
Article in Chinese | MEDLINE | ID: covidwho-93865

ABSTRACT

OBJECTIVE: To analyze how governments, hospitals and information technology(IT) companies use Internet technology to provide online health services during the early stage of corona virus disease 2019 (COVID-19) epidemic in January 2020 in China, and then provide suggestions and coping strategies for the later stage and post-epidemic time. METHODS: We searched for information on ehealth services related to the outbreak of COVID-19 in China. The sources of information were mainstream search engines such as Baidu and the popular interactive social platforms such as Webchat. The keywords were "Internet+pneumonia", "Internet clinic", "pneumonia online clinic" and so on. The time of information was from January 20 to February 3, 2020. The key information was extracted and encoded by two persons back-to-back. The coding information included: name of organization provider, launching time, location of provider, service items, user, health workers engaging in the service, and so on. The coded information was entered and analyzed with SPSS 24.0 and Excel. RESULTS: There were totally 57 projects launched by local governments, hospitals and IT companies. Most of them were launched from January 24th to 27th, the hospital and government projects services regionally, especially in eastern provinces. In this study, 90.48% of the enterprises and 100.00% of the hospitals had online fever clinic and consultation services for COVID-19, 66.67% of the enterprises and 37.04% of the hospitals serviced derivative health problems. Only a few projects provided tele-medical consultation. There were individual projects that provided online health management for home quarantine people. Physicians were the main force of various projects. In some hospital projects, there were also nurses, pharmacists and professional technicians to provide featured consultation. CONCLUSION: Ehealth is useful and helpful for the health care system to rapidly cope with health demand during instantaneous and post epidemic time. Regional distribution of ehealth is unbalanced. There are institutional and technical feasibilities for the emergency application of Internet technology. However, community health centers seldom provide ehealth or connect with tertiary hospitals with Internet. Therefore, all kinds of providers within healthcare system should promote emergence ehealth. Tele-medical diagnosis and referral should be developed by local governments during COVID-19. The application of "Internet+medical treatment" in community medical institutions and synergy among various institutions should be promoted.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Telemedicine , China , Humans
16.
J Hosp Infect ; 105(2): 183-187, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-45756

ABSTRACT

The study analysed healthcare workers' (HCWs) knowledge, practices, and attitudes regarding coronavirus disease 2019 (COVID-19). A cross-sectional survey was conducted from February 4th to February 8th, 2020, involving a total of 1357 HCWs across 10 hospitals in Henan, China. Of those surveyed, 89% of HCWs had sufficient knowledge of COVID-19, more than 85% feared self-infection with the virus, and 89.7% followed correct practices regarding COVID-19. In addition to knowledge level, some risk factors including work experience and job category influenced HCWs' attitudes and practice concerning COVID-19. Measures must be taken to protect HCWs from risks linked to job category, work experience, working hours, educational attainment, and frontline HCWs.


Subject(s)
Attitude of Health Personnel , Betacoronavirus , Coronavirus Infections/psychology , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Pneumonia, Viral/psychology , Professional Competence/statistics & numerical data , China , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Guideline Adherence/statistics & numerical data , Hospitals , Humans , Male , Pandemics , Pneumonia, Viral/epidemiology , Surveys and Questionnaires
17.
Eur Rev Med Pharmacol Sci ; 24(6): 3411-3421, 2020 03.
Article in English | MEDLINE | ID: covidwho-49973

ABSTRACT

OBJECTIVE: On December 8, 2019, many cases of pneumonia with unknown etiology were first reported in Wuhan, China, subsequently identified as a novel coronavirus infection aroused worldwide concern. As the outbreak is ongoing, more and more researchers focused interest on the COVID-19. Therefore, we retrospectively analyzed the publications about COVID-19 to summarize the research hotspots and make a review, to provide reference for researchers in the world. MATERIALS AND METHODS: We conducted a search in PubMed using the keywords "COVID-19" from inception to March 1, 2020. Identified and analyzed the data included title, corresponding author, language, publication time, publication type, research focus. RESULTS: 183 publications published from 2020 January 14 to 2020 February 29 were included in the study. The first corresponding authors of the publications were from 20 different countries. Among them, 78 (42.6%) from the hospital, 64 (35%) from the university and 39 (21.3%) from the research institution. All the publications were published in 80 different journals. Journal of Medical Virology published most of them (n=25). 60 (32.8%) were original research, 29 (15.8%) were review, 20 (10.9%) were short communications. 68 (37.2%) epidemiology, 49 (26.8%) virology and 26 (14.2%) clinical features. CONCLUSIONS: According to our review, China has provided a large number of research data for various research fields, during the outbreak of COVID-19. Most of the findings play an important role in preventing and controlling the epidemic around the world. With research on the COVID-19 still booming, new vaccine and effective medicine for COVID-19 will be expected to come out in the near future with the joint efforts of researchers worldwide.


Subject(s)
Bibliometrics , Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Outbreaks , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology
18.
Eur Rev Med Pharmacol Sci ; 24(6): 3360-3384, 2020 03.
Article in English | MEDLINE | ID: covidwho-48591

ABSTRACT

Beginning in December 2019, coronavirus disease 2019 (COVID-19), due to 2019-nCoV infection, emerged in Wuhan and spread rapidly throughout China and even worldwide. Employing combined therapy of modern medicine and traditional Chinese medicine has been proposed, in which Ma Xing Shi Gan Decoction (MXSGD) was recommended as a basic prescription and applied widely in the clinical treatment of COVID-19. We investigated the underlying mechanism of MXSGD in treating COVID-19 utilizing the approaches of integrating network pharmacology. A total of 97 active ingredients of MXSGD were screened out, and 169 targets were predicted. The protein-protein interaction network exhibited hub targets of MXSGD, such as Heat shock protein 90, RAC-alpha serine/threonine-protein kinase, Transcription factor AP-1, Mitogen-activated protein kinase 1, Cellular tumor antigen p53, Vascular endothelial growth factor A, and Tumour necrosis factor. Gene Ontology functional enrichment analysis demonstrated that the biological processes altered within the body after taking MXSGD were closely related to the regulation of such processes as the acute inflammatory response, chemokine production, vascular permeability, response to oxygen radicals, oxidative stress-induced apoptosis, T cell differentiation involved in the immune response, immunoglobulin secretion, and extracellular matrix disassembly. KEGG enrichment analysis indicated that the targets of MXSGD were significantly enriched in inflammation-related pathways, immunomodulation-related pathways, and viral infection-related pathways. The therapeutic mechanisms of MXSGD on COVID-19 may primarily involve the following effects: reducing inflammation, suppressing cytokine storm, protecting the pulmonary alveolar-capillary barrier, alleviating pulmonary edema, regulating the immune response, and decreasing fever.


Subject(s)
Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Medicine, Chinese Traditional , Pneumonia, Viral/drug therapy , Coronavirus Infections/genetics , Coronavirus Infections/metabolism , Gene Regulatory Networks/drug effects , Humans , Pandemics , Pneumonia, Viral/genetics , Pneumonia, Viral/metabolism
19.
Ann Oncol ; 31(7): 894-901, 2020 07.
Article in English | MEDLINE | ID: covidwho-16011

ABSTRACT

BACKGROUND: Cancer patients are regarded as a highly vulnerable group in the current Coronavirus Disease 2019 (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain largely unknown. PATIENTS AND METHODS: In this retrospective cohort study, we included cancer patients with laboratory-confirmed COVID-19 from three designated hospitals in Wuhan, China. Clinical data were collected from medical records from 13 January 2020 to 26 February 2020. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death. RESULTS: A total of 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male. Median (interquartile range) age was 65.0 (56.0-70.0) years. Lung cancer was the most frequent cancer type (n = 7; 25.0%). Eight (28.6%) patients were suspected to have hospital-associated transmission. The following clinical features were shown in our cohort: fever (n = 23, 82.1%), dry cough (n = 22, 81%), and dyspnoea (n = 14, 50.0%), along with lymphopaenia (n = 23, 82.1%), high level of high-sensitivity C-reactive protein (n = 23, 82.1%), anaemia (n = 21, 75.0%), and hypoproteinaemia (n = 25, 89.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 21, 75.0%) and patchy consolidation (n = 13, 46.3%). A total of 15 (53.6%) patients had severe events and the mortality rate was 28.6%. If the last antitumour treatment was within 14 days, it significantly increased the risk of developing severe events [hazard ratio (HR) = 4.079, 95% confidence interval (CI) 1.086-15.322, P = 0.037]. Furthermore, patchy consolidation on CT on admission was associated with a higher risk of developing severe events (HR = 5.438, 95% CI 1.498-19.748, P = 0.010). CONCLUSIONS: Cancer patients show deteriorating conditions and poor outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour treatments should have vigorous screening for COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 coinfection.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Hospitalization/trends , Neoplasms/diagnostic imaging , Neoplasms/epidemiology , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , Aged , China/epidemiology , Cohort Studies , Coronavirus Infections/therapy , Female , Humans , Male , Middle Aged , Neoplasms/therapy , Pandemics , Pneumonia, Viral/therapy , Retrospective Studies
20.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(5): 401-408, 2020 May 12.
Article in Chinese | MEDLINE | ID: covidwho-6079

ABSTRACT

Novel coronavirus pneumonia was a novel coronavirus infection that has dominated pulmonary infection since December 2019. The main manifestations were fever, dry cough, shortness of breath, normal or leukopenia in peripheral blood and changes in chest CT and in severe cases, multiple organ failure might occur. The National Health Commission, PRC has revised the consensus on diagnosis and treatment seven times in a short period of time, indicating the growing understanding of the disease. Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset, or have been exposed to patients who had fever or respiratory symptoms from the epidemic area, or had clustering diseases. However, novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic. The diagnosis and differential diagnosis of novel coronavirus pneumonia were challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic, but also patients with other diseases from different areas to search for medical care. In this article, the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases. We try to find the similarities and differences among them, and to identify clues to the diagnosis of novel coronavirus pneumonia, so as to ensure accurate diagnosis and treatment.


Subject(s)
Coronavirus Infections , Diagnosis, Differential , Hospitals, General , Lung Diseases , Pandemics , Pneumonia, Viral , Pneumonia , Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Hospitals, General/methods , Humans , Lung Diseases/diagnosis , Pneumonia/diagnosis , Pneumonia/etiology , Pneumonia, Viral/complications
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