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1.
Front Cell Infect Microbiol ; 12: 864933, 2022.
Article in English | MEDLINE | ID: covidwho-1822356

ABSTRACT

Objective: The longitudinal effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the liver are unknown. This study aimed to characterize dynamic changes in liver function test abnormalities in patients with COVID-19 at the acute phase and recovery phase. Methods: A prospective cohort study involved patients with COVID-19 who were admitted to Shenzhen Third People's Hospital between January 11, 2020, and April 27, 2020. Patients underwent liver function tests at hospitalization and at the outpatient visit at the 1-month, 3-month, 6-month, and 12-month follow-ups. Results: Among 461 patients, 28.4% of patients had any kind of liver function tests abnormality at admission, manifested as elevated ALT (13.0%), AST (17.6%), and GGT (15.8%) levels. The trajectory analysis indicated a marked improvement in liver function after discharge, with any kind of liver function test abnormalities of 25.1% at 1 month, 13.2% at 3 months, 16.7% at 6 months, and 13.2% at 12 months after discharge. Persistent liver function abnormalities were observed in patients with pre-existing conditions during follow-up. A significantly higher prevalence of ultrasound determined fatty liver disease was found in those patients with more frequent LFT abnormalities at follow-up. Conclusion: In this study of patients with COVID-19, liver damage in COVID-19 was usually temporary and could return to normal at the end of the 12-month follow-up.


Subject(s)
COVID-19 , Liver Diseases , Aftercare , Female , Humans , Liver Function Tests , Patient Discharge , Pregnancy , Prospective Studies , SARS-CoV-2
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325087

ABSTRACT

Abstract Background. We aimed to analyze the influencing factors of virus duration and virus clearance in coronavirus disease 2019 (COVID-19) in Shenzhen, China, and to provide our experience in the treatment and management of COVID-19. Methods. The clinical data and laboratory test results of COVID-19 inpatients admitted to the Third People's Hospital of Shenzhen, Guangdong Province from January 2020 to March 2020 were retrospectively collected. In COVID-19 rehabilitation patients, two consecutive negative RT-PCR results on nasopharyngeal swabs were defined as virus clearance. The time from onset of the disease to virus clearance was defined as the virus duration. We analyzed the virus clearance rate at different time points and the impact of clinical features and treatments on virus clearance. Results. A total of 201 patients with COVID-19, including 89 women (44.3%) and 112 men (55.7%), were included in our study. According to the severity of the disease, the patients were divided into no severe patients and severe patients. The overall median virus duration for all patients was 17 days. The overall virus clearance rates within 1, 2, 3, 4, 5, and 6 weeks after onset were 1.5%, 36.6%, 73.4%, 90.2%, 97.3%, and 100%, respectively. A multiple linear regression model was performed to analyze the factors influencing virus clearanc.The factors influencing virus clearance within 2 weeks were treatment timing and glucocorticoid usage. The influencing factors for virus clearance within 4 weeks were treatment timing, glucocorticoid usage and age. Conclusion. Treatment timing was related to virus clearance. The earlier the treatment was initiated, the faster the virus clearance. For COVID-19 patients, early detection and early treatment strategies should be adopted. Glucocorticoid usage may be detrimental to virus clearance and should be more restricted. Age > 60 years may also be a detrimental factor for virus clearance.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309725

ABSTRACT

Objectives: To evaluate imaging features and performed quantitative analysis for mild novel coronavirus pneumonia (COVID-19) cases ready for discharge. Methods: : CT images of 125 patients (16-67 years, 63 males) recovering from COVID-19 were examined. We defined the double-negative period (DNp) as the period between the sampling days of two consecutive negative RT-PCR and three days thereafter. Lesion demonstrations and distributions on CT in DNp (CT DN ) were evaluated by radiologists and artificial intelligence (AI) software. Major lesion transformations and the involvement range for patients with follow-up CT were analyzed. Results: : Twenty (16.0%) patients exhibited normal CT DN ;abnormal CT DN for 105 indicated ground-glass opacity (GGO) (99/125, 79.2%) and fibrosis (56/125, 44.8%) as the most frequent CT findings. Bilateral-lung involvement with mixed or random distribution was most common for GGO on CT DN . Fibrous lesions often affected both lungs, tending to distribute on the subpleura. Follow-up CT showed lesion improvement manifesting as GGO thinning (40/40, 100%), fibrosis reduction (17/26, 65.4%), and consolidation fading (9/11, 81.8%), with or without range reduction. AI analysis showed the highest proportions for right lower lobe involvement (volume, 12.01±35.87cm 3 ;percentage;1.45±4.58%) and CT-value ranging –570 to –470 HU (volume, 2.93±7.04cm 3 ;percentage, 5.28±6.47%). Among cases with follow-up CT, most of lung lobes and CT-value ranges displayed a significant reduction after DNp. Conclusions: : The main CT imaging manifestations were GGO and fibrosis in DNp, which weakened with or without volume reduction. AI analysis results were consistent with imaging features and changes, possibly serving as an objective indicator for disease monitoring and discharge.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307602

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. According to the diagnosis and treatment guidelines of China, negative reverse transcription-polymerase chain reaction (RT-PCR) is the key criterion for discharging COVID-19 patients. However, repeated RT-PCR tests lead to medical waste and prolonged hospital stays for COVID-19 patients during the recovery period. Our purpose is to assess a model based on chest computed tomography (CT) radiomic features and clinical characteristics to predict RT-PCR negativity during clinical treatment. Methods: : From February 10 to March 10, 2020, 203 mild COVID-19 patients in Fangcang Shelter Hospital were retrospectively included (training: n=141;testing: n=62), and clinical characteristics were collected. Lung abnormalities on chest CT images were segmented with a deep learning algorithm. CT quantitative features and radiomic features were automatically extracted. Clinical characteristics and CT quantitative features were compared between RT-PCR-negative and RT-PCR-positive groups. Univariate logistic regression and Spearman correlation analyses identified the strongest features associated with RT-PCR negativity, and a multivariate logistic regression model was established. The diagnostic performance was evaluated for both cohorts. Results: : The RT-PCR-negative group had a longer time interval from symptom onset to CT exams than the RT-PCR-positive group (median 23 vs. 16 days, p<0.001). There was no significant difference in the other clinical characteristics or CT quantitative features. In addition to the time interval from symptom onset to CT exams, nine CT radiomic features were selected for the model. ROC curve analysis revealed AUCs of 0.811 and 0.812 for differentiating the RT-PCR-negative group, with sensitivity/specificity of 0.765/0.625 and 0.784/0.600 in the training and testing datasets, respectively. Conclusion: The model combining CT radiomic features and clinical data helped predict RT-PCR negativity during clinical treatment, indicating the proper time for RT-PCR retesting.

5.
Front Med (Lausanne) ; 8: 686878, 2021.
Article in English | MEDLINE | ID: covidwho-1662590

ABSTRACT

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge. Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement. Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time. Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

6.
Chinese Journal of Zoonoses ; 37(8):688-697, 2021.
Article in Chinese | GIM | ID: covidwho-1497431

ABSTRACT

Through bioinformatics, we systematically predicted and analyzed the structure and function of TMPRSS2, a key protease used by SARS-CoV-2 to invade host cells, thus providing a reliable reference for the research on the protein and the development of its inhibitors. We used ProtParam, Protscale, SignalP 4.0 Server, SecretomeP 2.0 server, TMHMM Server v. 2.0, SOPMA, SWISS-MODEL, MEGA-X and other software to predict the structure, function, evolution, biological processes and other aspects of the TMPRSS2 gene and protein. We comprehensively analyzed and demonstrated the results obtained with each program. TMPRSS2 protein was found to be a hydrophilic protein composed of 492 amino acids. It has a transmembrane helix structure and is a non-classical secreted protein. The expression of TMPRSS2 protein in the prostate was particularly abundant, and it has abundant post-translational modification sites. TMPRSS2 protein has a total of three superfamily conserved domains, and the amino acid sequence after the 100th position is relatively conserved. We report comprehensive prediction and analysis of the structure and function of the TMPRSS2 protein. From the perspective of bioinformatics, our results verify its characteristics as a serine protease and provide a possible mechanistic explanation for its participation in SARS-CoV-2 invasion of hosts. This work should facilitate further experiments and research related to TMPRSS2.

7.
J Infect Public Health ; 14(11): 1693-1700, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1446869

ABSTRACT

BACKGROUND: Severe COVID-19 caused by SARS-CoV-2 should closely be cared because of the relatively high mortality rate. If SARS-CoV-2 could be cleared as soon as possible, the mortality rate might lower. In the present study, we analyzed factors which might be related to the clearance of SARS-CoV-2. METHODS: One hundred and twenty-eight severe COVID-19 cases were enrolled. All of them had been isolated and treated at Shenzhen Third People's Hospital because they were positive for nucleic acid of SARS-CoV-2 tested by qRT-PCR. Their baseline clinical characteristics and antiviral regimens were collected and analyzed, respectively. RESULTS: Of the 128 enrolled severe COVID-19 cases, unfortunately 3 died. The mean viral duration of all patients was 23.5 (range 17-32) days. All patients achieved viral clearance during 9 weeks. 13.4% of patients achieved viral clearance within 2 weeks, and 63.0% of patients achieved viral clearance within 4 weeks. The combined regimens of three or more antiviral drugs, the use of invasive mechanical ventilation, and late admission might be related to the delay of viral clearance within 2 weeks. The use of arbidol, the use of invasive mechanical ventilation, and late admission might be related to the delay of viral clearance within 4 weeks. Patients often had a prolonged course of COVID-19 and hospitalization, and were more likely transferred to intensive care unit (ICU) for treatment, if they could not clear SARS-CoV-2 during 23 days. CONCLUSION: Severe COVID-19 cases should be admitted to hospital as soon as possible. The combined regimens of three or more antiviral drugs might not be useful for viral clearance, and should be performed carefully and cautiously.


Subject(s)
COVID-19 , Antiviral Agents/therapeutic use , Hospitalization , Humans , Respiration, Artificial , SARS-CoV-2
8.
Front Public Health ; 9: 657804, 2021.
Article in English | MEDLINE | ID: covidwho-1399184

ABSTRACT

Objective: Our objective is to explore the effect of applying cloud video conferencing methods to the informed consent process in an early-phase clinical trial during the COVID-19 pandemic. Methods: All participants who intended to participate in the trial were informed via a cloud video conference before signing the informed consent forms (ICF). Then, the attitudes of the participants with the cloud video conference and their understanding of the trial were evaluated using a questionnaire when they visited to sign the ICF onsite. Results: A total of 165 subjects participated in the cloud video conference process, and 142 visited the site to sign and date the ICFs at the center during the appointment time. The survey showed that nearly 100% of the subjects evaluated the video-based informed consent process as very good or good and gave correct answers to questions about the trial. Furthermore, 136 (95.8%) subjects believed that the knowledge about the trial derived via the video-based informed consent process was consistent with the onsite reality, and 139 (97.9%) subjects expressed their willingness to participate in an informed consent procedure undertaken through an online video conference. Conclusions: The video-based informed consent process achieved the same effects as an onsite informed consent process. The former saves time and cost of transportation for the subject and exhibits good public acceptance; especially in light of the COVID-19 pandemic, this process is conducive for reducing the risk of subject infection due to travel and would also help avoid crowding on site.


Subject(s)
COVID-19 , Pandemics , Healthy Volunteers , Humans , SARS-CoV-2 , Videoconferencing
9.
Therap Adv Gastroenterol ; 14: 17562848211035670, 2021.
Article in English | MEDLINE | ID: covidwho-1348281

ABSTRACT

BACKGROUND AND AIMS: Currently, there are no definitive therapies for coronavirus disease 2019 (COVID-19). Gut microbial dysbiosis has been proved to be associated with COVID-19 severity and probiotics is an adjunctive therapy for COIVD-19. However, the potential benefit of probiotics in COVID-19 has not been studied. We aimed to assess the relationship of probiotics use with clinical outcomes in patients with COVID-19. METHODS: We conducted a propensity-score matched retrospective cohort study of adult patients with COVID-19. Eligible patients received either probiotics plus standard care (probiotics group) or standard care alone (non-probiotics group). The primary outcome was the clinical improvement rate, which was compared among propensity-score matched groups and in the unmatched cohort. Secondary outcomes included the duration of viral shedding, fever, and hospital stay. RESULTS: Among the propensity-score matched groups, probiotics use was related to clinical improvement rates (log-rank p = 0.028). This relationship was driven primarily by a shorter (days) time to clinical improvement [difference, -3 (-4 to -1), p = 0.022], reduction in duration of fever [-1.0 (-2.0 to 0.0), p = 0.025], viral shedding [-3 (-6 to -1), p < 0.001], and hospital stay [-3 (-5 to -1), p = 0.009]. Using the Cox model with time-varying exposure, use of probiotics remained independently related to better clinical improvement rate in the unmatched cohort. CONCLUSION: Our study suggested that probiotics use was related to improved clinical outcomes in patients with COVID-19. Further studies are required to validate the effect of probiotics in combating the COVID-19 pandemic.

10.
Journal of Intensive Medicine ; 2021.
Article in Chinese | ScienceDirect | ID: covidwho-1253241

ABSTRACT

Background : The coronavirus disease 2019 (COVID-19) pandemic is currently threatening the health of individuals worldwide. We compared the clinical characteristics between younger patients (aged <60 years) and older patients (aged ≥60 years) with COVID-19, detected the risk factors associated with a prolonged hospital stay, and examined the treatments commonly used with a particular focus on antiviral therapies. Methods : This retrospective study was conducted at the West Campus, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology (Wuhan, China). The sample consisted of 123 patients admitted to the hospital between February 9, 2020, and March 3, 2020. The data related to the demographics, laboratory findings, and treatment were analyzed to identify discrepancies between younger and older patients and those with and without primary diseases. The risk factors that contribute to a prolonged hospital stay were subsequently identified. Results : Patients aged ≥60 years required longer hospital stay than younger patients (P = 0.021 and P = 0.001, respectively). The percentage of lymphocytes was significantly lower in older patients and those with primary diseases (P = 0.016 and P = 0.042, respectively). The findings revealed that the risk factors that contributed to the length of hospital stay were age, the number of days of illness before hospitalization, white blood cell (WBC) count and albumin levels at admission, a neutrophil fraction at discharge, and antibiotic treatment. Analysis using a model that consisted of the above five risk factors for predicting prolonged hospital stay (i.e., >14 days) yielded an area under the ROC (AuROC) curve of 0.716. Antiviral and antibiotic treatments were administered to 97.6% and 39.0% of patients, respectively. The antiviral drugs most commonly administered were traditional Chinese medicine (83.7%) and arbidol (75.6%). Conclusions : In this study, older patients and those with primary diseases were at a higher risk of worse clinical manifestations. The physicians who treat the patients should pay close attention to the risk factors that contribute to the length of hospital stay, which could be used for predicting prolonged hospital stay. Traditional Chinese medicine and arbidol were the most frequently used antiviral drugs. Nevertheless, the extent to which these medications can effectively treat COVID-19 warrants further investigation.

11.
BMC Public Health ; 21(1): 647, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1166901

ABSTRACT

BACKGROUND: In view of the ongoing coronavirus disease (COVID-19) pandemic, it remains unclear whether the severity of illness and time interval from symptom onset to release from quarantine differ between cases that originated from clusters and cases reported in other areas. This study aimed to assess epidemiological and intergenerational clinical characteristics of COVID-19 patients associated with cluster outbreaks to provide valuable data for the prevention and control of COVID-19. METHODS: We identified the first employee with COVID-19 at a supermarket and screened the close contacts of this index patient. Confirmed cases were divided into two groups according to the generation (first generation comprising supermarket employees [group A] and second or third generations comprising family members or friends of the supermarket employees [group B]). The epidemiological and clinical characteristics of the two groups were retrospectively compared. RESULTS: A total of 8437 people were screened, and 24 COVID-19 patients were identified. Seven patients (29.2%) were asymptomatic; three patients were responsible for six symptomatic cases. The interval from the confirmation of the first case to symptom onset in symptomatic patients was 5-11 days. The clinical manifestations of symptomatic patients upon admission were non-specific. All patients (including the seven asymptomatic patients) were admitted based on chest computed tomography features indicative of pneumonia. There were 11 cases in group A (first generation) and 13 cases in group B (second generation, 11 cases; third generation, 2 cases), with no significant differences in clinical and epidemiological characteristics between the two groups, except for sex, duration from symptom onset to hospitalization, and underlying disease (P > 0.05). CONCLUSIONS: For cluster outbreaks, it is important to comprehensively screen close the contacts of the index patient. Special attention should be paid to asymptomatic cases. The clinical management of cluster patients is similar to that of other COVID-19 patients.


Subject(s)
COVID-19/diagnosis , COVID-19/transmission , Contact Tracing , SARS-CoV-2 , Supermarkets , COVID-19/epidemiology , China , Female , Humans , Male , Retrospective Studies
12.
Front Public Health ; 9: 603273, 2021.
Article in English | MEDLINE | ID: covidwho-1145595

ABSTRACT

Background: Since the coronavirus disease-2019 (COVID-19) outbreak, intensive care unit (ICU) healthcare workers were responsible for the critical infected patients. However, few studies focused on the mental health of ICU healthcare workers. This study aimed to investigate the psychological impact of COVID-19 on ICU healthcare workers in China. Methods: We distributed the nine-item Patient Health Questionnaire (PHQ-9) and seven-item General Anxiety Disorder questionnaire (GAD-7) online to ICU healthcare workers in China. Respondents were divided into frontline and second-line according to whether they have contact with COVID-19 patients. Depressive and anxiety symptoms of all respondents were evaluated based on their questionnaire scores. Results: There were 731 ICU healthcare workers finally enrolled in our study, including 303 (41.5%) male, 383 (52.4%) doctors, and 617 (84.4%) aged 26-45 years. All in all, 482 (65.9%) ICU healthcare workers reported symptoms of depression, while 429 (58.7%) reported anxiety. There was no significant difference between frontline (n = 325) and second-line (n = 406) respondents in depression (P = 0.15) and anxiety severity (P = 0.56). Logistic regression analysis showed that being female, ICU work time >5 years, and night duty number ≥10 were risk factors of developing depressive and anxiety symptoms. Income reduction was separately identified as risk of anxiety. Additionally, ICU work time >5 years was also identified as risk of developing moderate-severe depressive and anxiety symptoms. Conclusions: Frontline ICU work was not associated with higher risk of depressive and anxiety symptoms during COVID-19 pandemic remission period in China. Actions like controlling night duty number, ensuring vacation, and increasing income should be taken to relieve mental health problem. Furthermore, we should pay close attention to those who had worked long years in ICU.


Subject(s)
Anxiety/epidemiology , COVID-19 , Depression/epidemiology , Health Personnel/statistics & numerical data , Intensive Care Units , Patient Health Questionnaire/statistics & numerical data , Adult , China/epidemiology , Cross-Sectional Studies , Female , Health Personnel/psychology , Humans , Male , Surveys and Questionnaires , Time Factors
13.
Exp Ther Med ; 21(1): 24, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-954685

ABSTRACT

A severe immune response in patients with coronavirus disease 2019 (COVID-19) can cause a potentially lethal unconstrained inflammatory cytokine storm, known as cytokine release syndrome (CRS). The present study provides an overview of the biology underlying CRS and how targeted inhibition of interleukin (IL)-6 signaling may improve outcomes and the survival of patients suffering from COVID-19. Preliminary clinical results have indicated that antagonism of the IL-6 receptor (IL-6R), including with the FDA-approved humanized monoclonal antibody tocilizumab, can improve the outcomes of patients with severe or critical COVID-19 while maintaining a good safety profile. The available clinical data support the expansion of clinical trials using IL-6R targeting inhibitors for severe and critical COVID-19 treatment.

14.
Anesthesiology ; 132(6): 1317-1332, 2020 06.
Article in English | MEDLINE | ID: covidwho-944425

ABSTRACT

The COVID-19 outbreak has led to 80,409 diagnosed cases and 3,012 deaths in mainland China based on the data released on March 4, 2020. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Providing best practices regarding intubation and ventilation for an overwhelming number of patients with COVID-19 amid an enhanced risk of cross-infection is a daunting undertaking. The authors presented the experience of caring for the critically ill patients with COVID-19 in Wuhan. It is extremely important to follow strict self-protection precautions. Timely, but not premature, intubation is crucial to counter a progressively enlarging oxygen debt despite high-flow oxygen therapy and bilevel positive airway pressure ventilation. Thorough preparation, satisfactory preoxygenation, modified rapid sequence induction, and rapid intubation using a video laryngoscope are widely used intubation strategies in Wuhan. Lung-protective ventilation, prone position ventilation, and adequate sedation and analgesia are essential components of ventilation management.


Subject(s)
Coronavirus Infections , Disease Transmission, Infectious/prevention & control , Intubation, Intratracheal/standards , Pandemics , Pneumonia, Viral , Respiration, Artificial/standards , COVID-19 , China , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Hospitals/standards , Humans , Pandemics/prevention & control , Patient Selection , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission
15.
BMC Med Imaging ; 20(1): 118, 2020 10 20.
Article in English | MEDLINE | ID: covidwho-883568

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. According to the diagnosis and treatment guidelines of China, negative reverse transcription-polymerase chain reaction (RT-PCR) is the key criterion for discharging COVID-19 patients. However, repeated RT-PCR tests lead to medical waste and prolonged hospital stays for COVID-19 patients during the recovery period. Our purpose is to assess a model based on chest computed tomography (CT) radiomic features and clinical characteristics to predict RT-PCR negativity during clinical treatment. METHODS: From February 10 to March 10, 2020, 203 mild COVID-19 patients in Fangcang Shelter Hospital were retrospectively included (training: n = 141; testing: n = 62), and clinical characteristics were collected. Lung abnormalities on chest CT images were segmented with a deep learning algorithm. CT quantitative features and radiomic features were automatically extracted. Clinical characteristics and CT quantitative features were compared between RT-PCR-negative and RT-PCR-positive groups. Univariate logistic regression and Spearman correlation analyses identified the strongest features associated with RT-PCR negativity, and a multivariate logistic regression model was established. The diagnostic performance was evaluated for both cohorts. RESULTS: The RT-PCR-negative group had a longer time interval from symptom onset to CT exams than the RT-PCR-positive group (median 23 vs. 16 days, p < 0.001). There was no significant difference in the other clinical characteristics or CT quantitative features. In addition to the time interval from symptom onset to CT exams, nine CT radiomic features were selected for the model. ROC curve analysis revealed AUCs of 0.811 and 0.812 for differentiating the RT-PCR-negative group, with sensitivity/specificity of 0.765/0.625 and 0.784/0.600 in the training and testing datasets, respectively. CONCLUSION: The model combining CT radiomic features and clinical data helped predict RT-PCR negativity during clinical treatment, indicating the proper time for RT-PCR retesting.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnostic imaging , Lung/pathology , Pneumonia, Viral/diagnostic imaging , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction/methods , Tomography, X-Ray Computed/methods , Adult , COVID-19 , China , Coronavirus Infections/pathology , Coronavirus Infections/virology , Female , Hospitals, Special , Humans , Image Interpretation, Computer-Assisted , Lung/diagnostic imaging , Machine Learning , Male , Middle Aged , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity
17.
Sci Total Environ ; 753: 142272, 2021 Jan 20.
Article in English | MEDLINE | ID: covidwho-752862

ABSTRACT

PURPOSE: To examine the association between meteorological factors (temperature, relative humidity, wind speed, and UV radiation) and transmission capacity of COVID-19. METHODS: We collected daily numbers of COVID-19 cases in 202 locations in 8 countries. We matched meteorological data from the NOAA National Centers for Environmental Information. We used a time-frequency approach to examine the possible association between meteorological conditions and basic reproductive number (R0) of COVID-19. We determined the correlations between meteorological factors and R0 of COVID-19 using multiple linear regression models and meta-analysis. We further validated our results using a susceptible-exposed-infectious-recovered (SEIR) metapopulation model to simulate the changes of daily cases of COVID-19 in China under different temperatures and relative humidity conditions. PRINCIPAL RESULTS: Temperature did not exhibit significant association with R0 of COVID-19 (meta p = 0.446). Also, relative humidity (meta p = 0.215), wind speed (meta p = 0.986), and ultraviolet (UV) radiation (meta p = 0.491) were not significantly associated with R0 either. The SEIR model in China showed that with a wide range of meteorological conditions, the number of COVID-19 confirmed cases would not change substantially. CONCLUSIONS: Meteorological conditions did not have statistically significant associations with the R0 of COVID-19. Warmer weather alone seems unlikely to reduce the COVID-19 transmission.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Weather , Betacoronavirus , COVID-19 , China , Humans , SARS-CoV-2 , Temperature
18.
Front Med (Lausanne) ; 7: 519, 2020.
Article in English | MEDLINE | ID: covidwho-732884

ABSTRACT

The current global spread of COVID-19, a highly contagious disease, has challenged healthcare systems, and placed immense burdens on medical staff globally. With a sharp increase in the number of newly confirmed cases and the rapid progression of the disease into a critically ill state, overstretched critical care units have had to contend with a shortage of beds, specialist personnel, and medical resources. Temporary intensive care units (ICUs) were therefore set up in isolated hospitals to provide the required standardized care for all severe cases. The current paper describes the authors' experience of setting up and managing such an ICU in Wuhan, Hubei Province, China, from the identification of critically ill COVID-19 patients through to the arranging and equipping of the unit, providing training and protection for staff, and standardizing all aspects of care.

19.
Eur J Med Chem ; 205: 112687, 2020 Nov 01.
Article in English | MEDLINE | ID: covidwho-679980

ABSTRACT

The novel coronavirus, 2019-nCoV, has quickly spread across the world and pose serious threat to public health because it can infect people very easily. The major clinical symptoms of 2019-nCoV infection include fever, dry cough, myalgia, fatigue, and diarrhea. The 2019-nCoV belongs to the betacoronavirus family, and gene sequencing results demonstrate that it is a single-stranded RNA virus, closely related to Severe Acute Respiratory Syndrome CoV (SARS-CoV) and Middle East Respiratory Syndrome CoV (MERS-CoV). It has been observed that the virus invades human body mainly through binding to angiotensin-converting enzyme 2 (ACE2) receptors similar to SARS-CoV and the main protease (Mpro) acts as a critical protease for digesting the polyprotein into functional polypeptides during the replication and transcription process of 2019-nCoV. In this review, we summarized the real-time information of 2019-nCoV treatment methods and mainly focused on the chemical drugs including lopinavir/ritonavir, chloroquine, hydroxychloroquine, arbidol, remdesivir, favipiravir and other potential innovative active molecules. Their potential targets, activity, clinical status and side effects are described. In addition, Traditional Chinese Medicine (TCM), Convalescent plasma therapy (CPT) and biological reagents available, as well as the promising vaccine candidates against 2019-nCoV are also discussed.


Subject(s)
Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , COVID-19 , Coronavirus Infections/therapy , Humans , Immunization, Passive , Immunotherapy/methods , Medicine, Chinese Traditional , Pandemics
20.
Quant Imaging Med Surg ; 10(6): 1307-1317, 2020 Jun.
Article in English | MEDLINE | 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.

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