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1.
Emerging Microbes & Infections ; 9(1):246-255, 2020.
Article | WHO COVID | ID: covidwho-774889

ABSTRACT

Human coronavirus NL63 (HCoV-NL63) is primarily associated with common cold in children, elderly and immunocompromised individuals Outbreaks caused by HCoV-NL63 are rare Here we report a cluster of HCoV-NL63 cases with severe lower respiratory tract infection that arose in Guangzhou, China, in 2018 Twenty-three hospitalized children were confirmed to be HCoV-NL63 positive, and most of whom were hospitalized with severe pneumonia or acute bronchitis Whole genomes of HCoV-NL63 were obtained using next-generation sequencing Phylogenetic and single amino acid polymorphism analyses showed that this outbreak was associated with two subgenotypes (C3 and B) of HCoV-NL63 Half of patients were identified to be related to a new subgenotype C3 One unique amino acid mutation at I507 L in spike protein receptor binding domain (RBD) was detected, which segregated this subgenotype C3 from other known subgenotypes Pseudotyped virus bearing the I507 L mutation in RBD showed enhanced entry into host cells as compared to the prototype virus This study proved that HCoV-NL63 was undergoing continuous mutation and has the potential to cause severe lower respiratory disease in humans

2.
J Affect Disord ; 277: 368-374, 2020 Aug 23.
Article in English | MEDLINE | ID: covidwho-727653

ABSTRACT

BACKGROUND: Previous studies about the reliability and validity of the updated PCL version for the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (PCL-5) have only been evaluated in certain samples of the population, which lacks in the sample of Healthcare Workers. Our study focused on the factor structure, reliability and validity of the PCL-5 among Chinese Healthcare Workers during the Outbreak of Corona Virus Disease 2019. METHODS: We conducted an online survey of frontline healthcare workers using the PCL-5 for PTSD. Total of 212 frontline healthcare providers were included in this study. RESULTS: The findings showed that PCL-5 is a reliable instrument in our sample. The total and subscale scores showed good internal consistency. The convergent and discriminant validity of the PCL-5 were also well demonstrated. Our result showed a better fit with the seven-factor hybrid model compared with other models and supported that the PCL-5 Chinese version can be used as a reliable screening tool to conduct psychological screening for Chinese healthcare workers. LIMITATION: We could not examine other aspects of reliability and validity like test-retest reliability or criterion validity. We didn't use the gold-standard structured interview for PTSD in our study. Besides, most of our samples were young people who had access to the internet. Not all professional levels and seniorities were presented because our sample had a lower mean income and educational level. CONCLUSION: Our study shows that the Chinese PCL-5 has good validity and reliability in frontline healthcare workers during the outbreak.

4.
JACC Cardiovasc Imaging ; 13(8): 1859-1860, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-718833
5.
Int J Infect Dis ; 98: 334-346, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-703039

ABSTRACT

BACKGROUND: Convalescent plasma (CP) has been used successfully to treat many types of infectious disease, and has shown initial effects in the treatment of the emerging 2019 coronavirus disease (COVID-19). However, its curative effects and feasibility have yet to be confirmed by formal evaluation and well-designed clinical trials. To explore the effectiveness of treatment and predict the potential effects of CP with COVID-19, studies of different types of infectious disease treated with CP were included in this systematic review and meta-analysis. METHODS: Related studies were obtained from databases and screened according to the inclusion criteria. The data quality was assessed, and the data were extracted and pooled for analysis. RESULTS: 40 studies on CP treatment for infectious diseases were included. Our study found that CP treatment could reduce the risk of mortality, with a low incidence of adverse events, promote the production of antibodies, lead to a decline in viral load, and shorten the disease course. A meta-analysis of 15 controlled studies showed that there was a significantly lower mortality rate in the group treated with CP (pooled OR=0.32; 95% CI=0.19-0.52; p<0.001, I2=54%) compared with the control groups. Studies were mostly of low or very low quality, with a moderate or high risk of bias. The sources of clinical and methodological heterogeneity were identified. The exclusion of heterogeneity indicated that the results were stable. CONCLUSIONS: CP therapy has some curative effect and is well tolerated in treating infectious diseases. It is a potentially effective treatment for COVID-19.

6.
Medicine (Baltimore) ; 99(31): e21487, 2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-696687

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a pandemic in the world and posed a great threat to people's health. Several meta-analyses have indicated that many comorbidities were associated with increased risk of COVID-19 severity or mortality. The original report also showed that the mortality rate of COVID-19 in breast cancer patients is more dependent on comorbidities than previous radiation therapy or current anti-cancer therapy. However, no meta-analysis has focused on this aspect. This systematic review aims to assess whether breast cancer will increase the severity and mortality of patients infected with COVID-19 and to explore which factors that may affect the severity or mortality rate of breast cancer patients with COVID-19. METHODS: We will search the PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang database from December 1, 2019 to June 30, 2020. Cohort studies comparing the disease severity and mortality of COVID-19 patients with and without breast cancer will be included. Two independent reviewers will assess the risk of bias of the included cohort studies using the modified Newcastle-Ottawa Scale. We will conduct meta-analyses to calculate the risk ratio (RR) and 95% confidence interval (95% CI) using the random-effects model with the Mantel-Haenszel method. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be used to rate the quality of the evidence. RESULTS: The results of this study will be published in a peer-reviewed journal. CONCLUSION: This study will provide comprehensive evidence for medical staff to adopt effective treatment strategies for breast cancer patients during the COVID-19 pandemic. PROSPERO REGISTRATION NUMBER: CRD42020188208.


Subject(s)
Betacoronavirus , Breast Neoplasms/mortality , Breast Neoplasms/virology , Coronavirus Infections/complications , Coronavirus Infections/mortality , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Coronavirus Infections/virology , Female , Humans , Meta-Analysis as Topic , Pandemics , Pneumonia, Viral/virology , Prognosis , Research Design , Systematic Reviews as Topic
8.
Curr Med Sci ; 40(4): 597-601, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-695683

ABSTRACT

In late December 2019, COVID-19 was firstly recognized in Wuhan, China and spread rapidly to all of the provinces of China. The West Campus of Wuhan Union Hospital, the designated hospital to admit and treat the severe and critically ill COVID-19 cases, has treated a large number of such patients with great success and obtained lots of valuable experiences based on the Chinese guideline (V7.0). To standardize and share the treatment procedures of severe and critically ill cases, Wuhan Union Hospital has established a working group and formulated an operational recommendation, including the monitoring, early warning indicators, and several treatment principles for severe and critically ill cases. The treatment experiences may provide some constructive suggestions for treating the severe and critically ill COVID-19 cases all over the world.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , China/epidemiology , Clinical Laboratory Techniques , Combined Modality Therapy , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Critical Illness , Dexamethasone/therapeutic use , Hospitals , Humans , Immunization, Passive , Medicine, Chinese Traditional , Pandemics , Pneumonia, Viral/epidemiology , Respiratory Therapy/methods
9.
Infect Genet Evol ; 85: 104494, 2020 Aug 05.
Article in English | MEDLINE | ID: covidwho-694026

ABSTRACT

A large number of coronavirus disease 2019 (COVID-19) patients have been cured and discharged due to timely and effective treatments. While some discharged patients have been found re-positive nucleic acid again in the recovery phase. Until now, there is still a great challenge to its infectivity and the specific potential mechanism which needs further discussion. However, more intensive attention should be paid to the prognosis of recovered patients. In this review, we mainly focus on the characteristics, potential reasons, infectivity, and outcomes of re-detectable positive patients, thereby providing some novel insights into the cognition of COVID-19.

10.
Clin Infect Dis ; 2020 Aug 04.
Article in English | MEDLINE | ID: covidwho-694866

ABSTRACT

To explore any relationship between the ABO blood group and the COVID-19 susceptibility, we compared ABO blood group distributions in 2,173 COVID-19 patients with local control populations, and found that blood group A was associated with an increased risk of infection, whereas group O was associated with a decreased risk.

13.
Chinese Medicine ; 15(1):78-78, 2020.
Article | WHO COVID | ID: covidwho-688856

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a new global public health emergency The therapeutic benefits of Cold‒Damp Plague Formula (CDPF) against COVID-19, which was used to treat “cold‒dampness stagnation in the lung” in Trial Versions 6 and 7 of the “Diagnosis and Treatment Protocol for COVID-19”, have been demonstrated, but the effective components and their mechanism of action remain unclear In this study, a network pharmacology approach was employed, including drug-likeness evaluation, oral bioavailability prediction, protein‒protein interaction (PPI) network construction and analysis, Gene Ontology (GO) terms, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway annotation, and virtual docking, to predict the bioactive components, potential targets, and molecular mechanism of CDPF for COVID-19 treatment The active compound of herbs in CDPF and their candidate targets were obtained through database mining, and an herbs—ingredients—targets network was constructed Subsequently, the candidate targets of the active compounds were compared to those relevant to COVID-19, to identify the potential targets of CDPF for COVID-19 treatment Subsequently, the PPI network was constructed, which provided a basis for cluster analysis and hub gene screening The seed targets in the most significant module were selected for further functional annotation GO enrichment analysis identified four main areas: (1) cellular responses to external stimuli, (2) regulation of blood production and circulation, (3) free radical regulation, (4) immune regulation and anti-inflammatory effects KEGG pathway analysis also revealed that CDPF could play pharmacological roles against COVID-19 through “multi components‒multi targets‒multi pathways” at the molecular level, mainly involving anti-viral, immune-regulatory, and anti-inflammatory pathways;consequently, a “CDPF—herbs—ingredients—targets—pathways—COVID-19” network was constructed In hub target analysis, the top hub target IL6, and ACE2, the receptor via which SARS-CoV-2 typically enters host cells, were selected for molecular docking analyses, and revealed good binding activities This study revealed the active ingredients and potential molecular mechanism by which CDPF treatment is effective against COVID-19, and provides a reference basis for the wider application and further mechanistic investigations of CDPF in the fight against COVID-19

14.
Circulation ; 142(2): 114-128, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-684109

ABSTRACT

BACKGROUND: To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center. METHODS: We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT. RESULTS: Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1%: 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; P=0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; P<0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; P=0.031), Padua prediction score ≥4 (odds ratio, 4.016; P=0.04), D-dimer >1.0 µg/mL (odds ratio, 5.818; P<0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 µg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group (P=0.010). CONCLUSIONS: The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Venous Thrombosis/diagnosis , Adult , Aged , Anticoagulants/therapeutic use , Betacoronavirus/isolation & purification , Blood Pressure , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Kaplan-Meier Estimate , Lower Extremity/diagnostic imaging , Male , Middle Aged , Odds Ratio , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Prevalence , Prognosis , Respiratory Rate , Retrospective Studies , Risk Factors , Treatment Outcome , Venous Thrombosis/complications , Venous Thrombosis/drug therapy , Venous Thrombosis/epidemiology
15.
World J Otorhinolaryngol Head Neck Surg ; 2020 May 19.
Article in English | MEDLINE | ID: covidwho-679274

ABSTRACT

The 2019 Novel Coronavirus (2019-nCoV, SARS-CoV-2) infection has already been assigned as a Class B infectious disease requiring Class A management strategy according to "the Law on the Prevention and Control of Infectious Diseases of the People's Republic of China" and become a global pandemic. The incidence of emergencies in otorhinolaryngology, head and neck surgery such as foreign bodies in the esophagus and the respiratory tract, epistaxis, laryngeal obstruction with dyspnea, and head and neck trauma are relatively high. Emergency surgeries are required as some of these diseases progress rapidly and probably be life-threatening. In this article, we drafted the recommendations for diagnosis and treatment of emergency surgeries in otorhinolaryngology, head and neck surgery in the epidemic area of novel coronavirus pneumonia based on "Novel Coronavirus Pneumonia Diagnosis and Treatment Plan (Provisional; 7th Edition Revisions)"and WHO guidelines, combined with the experience of emergency surgeries in the Department of Otorhinolaryngology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, which is at the center outbreak area of the SARS-CoV-2 pneumonia (COVID-19) in China, to improve the success rate of treatment for otorhinolaryngology, head and neck surgery emergency surgeries and to reduce the SARS-CoV-2 infection rate in the perioperative period.

16.
Mol Diagn Ther ; 24(5): 601-609, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-672021

ABSTRACT

BACKGROUND AND OBJECTIVE: Without a specific antiviral treatment or vaccine, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic, affecting over 200 countries worldwide. A better understanding of B- and T-cell immunity is critical to the diagnosis, treatment and prevention of coronavirus disease 2019 (COVID-19). METHODS: A cohort of 129 patients with COVID-19 and 20 suspected cases were enrolled in this study, and a lateral flow immunochromatographic assay (LFIA) and a magnetic chemiluminescence enzyme immunoassay (MCLIA) were evaluated for SARS-CoV-2 IgM/IgG detection. Additionally, 127 patients with COVID-19 were selected for the detection of IgM and IgG antibodies to SARS-CoV-2 to evaluate B-cell immunity, and peripheral blood lymphocyte subsets were quantified in 95 patients with COVID-19 to evaluate T-cell immunity. RESULTS: The sensitivity and specificity of LFIA-IgM/IgG and MCLIA-IgM/IgG assays for detecting SARS-CoV infection were > 90%, comparable with reverse transcription polymerase chain reaction detection. IgM antibody levels peaked on day 13 and began to fall on day 21, while IgG antibody levels peaked on day 17 and were maintained until tracking ended. Lymphocyte and subset enumeration suggested that lymphocytopenia occurred in patients with COVID-19. CONCLUSIONS: LFIA-IgM/IgG and MCLIA-IgM/IgG assays can indicate SARS-CoV-2 infection, which elicits an antibody response. Lymphocytopenia occurs in patients with COVID-19, which possibly weakens the T-cell response.

17.
Infect Dis Poverty ; 9(1): 104, 2020 Jul 23.
Article in English | MEDLINE | ID: covidwho-672011

ABSTRACT

From December 25, 2019 to January 31, 2020, 33 cases of the coronavirus disease 2019 (COVID-19) were identified in the Department of Respiratory and Critical Care Medicine of Zhongnan Hospital of Wuhan University, China, yet none of the affiliated HCWs was infected. Here we analyzed the infection control measures used in three different departments in the Zhongnan Hospital of Wuhan University and correlated the measures with the corresponding infection data of HCWs affiliated with these departments. We found that three infection control measures, namely the isolation of the presumed positive patients, the use of facemasks and intensified hand hygiene play important roles in preventing nosocomial transmission of COVID-19.


Subject(s)
Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Hand Hygiene/statistics & numerical data , Health Personnel/statistics & numerical data , Masks/statistics & numerical data , Pandemics/prevention & control , Patient Isolation/statistics & numerical data , Pneumonia, Viral/prevention & control , Adult , Aged , Betacoronavirus/physiology , China , Coronavirus Infections/transmission , Cross Infection/transmission , Female , Hospitals, University , Humans , Male , Middle Aged , Pneumonia, Viral/transmission , Young Adult
18.
Lancet ; 395(10223): 497-506, 2020 02 15.
Article in English | MEDLINE | ID: covidwho-665705

ABSTRACT

BACKGROUND: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. METHODS: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. FINDINGS: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. INTERPRETATION: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. FUNDING: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Adult , Age Distribution , Aged , China/epidemiology , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/transmission , Cough/epidemiology , Cough/virology , Female , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Myalgia/epidemiology , Myalgia/virology , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , Prognosis , Radiography, Thoracic , Respiratory Distress Syndrome, Adult/epidemiology , Respiratory Distress Syndrome, Adult/virology , Time Factors , Tomography, X-Ray Computed , Young Adult
19.
Cell ; 182(5): 1284-1294.e9, 2020 09 03.
Article in English | MEDLINE | ID: covidwho-652603

ABSTRACT

The spike protein of SARS-CoV-2 has been undergoing mutations and is highly glycosylated. It is critically important to investigate the biological significance of these mutations. Here, we investigated 80 variants and 26 glycosylation site modifications for the infectivity and reactivity to a panel of neutralizing antibodies and sera from convalescent patients. D614G, along with several variants containing both D614G and another amino acid change, were significantly more infectious. Most variants with amino acid change at receptor binding domain were less infectious, but variants including A475V, L452R, V483A, and F490L became resistant to some neutralizing antibodies. Moreover, the majority of glycosylation deletions were less infectious, whereas deletion of both N331 and N343 glycosylation drastically reduced infectivity, revealing the importance of glycosylation for viral infectivity. Interestingly, N234Q was markedly resistant to neutralizing antibodies, whereas N165Q became more sensitive. These findings could be of value in the development of vaccine and therapeutic antibodies.

20.
JACC Cardiovasc Imaging ; 13(8): 1859-1860, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-627583
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