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1.
Commun Biol ; 5(1): 262, 2022 03 24.
Article in English | MEDLINE | ID: covidwho-1799550

ABSTRACT

Understanding the underlying molecular mechanisms behind ADE of SARS-CoV-2 is critical for development of safe and effective therapies. Here, we report that two neutralizing mAbs, MW01 and MW05, could enhance the infection of SARS-CoV-2 pseudovirus on FcγRIIB-expressing B cells. X-ray crystal structure determination and S trimer-binding modeling showed that MW01 and MW05 could bind to RBDs in S trimer with both "up" and "down" states. While, the neutralizing mAb MW07, which has no ADE activity only binds to RBD in S trimer with "up" state. Monovalent MW01 and MW05 completely diminished the ADE activity compared with their bivalent counterparts. Moreover, both macropinocytosis and endocytosis are confirmed involving in ADE of SARS-CoV-2 pseudoviral infection. Blocking endosome transportation and lysosome acidification could inhibit the ADE activity mediated by MW05. Together, our results identified a novel ADE mechanism of SARS-CoV-2 pseudovirus in vitro, FcγRIIB-mediated uptake of SARS-CoV-2/mAb complex with bivalent interaction.


Subject(s)
Antibody-Dependent Enhancement , COVID-19 , Antibodies, Viral , Humans , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
2.
Atmosphere ; 13(5):640, 2022.
Article in English | MDPI | ID: covidwho-1792836

ABSTRACT

In order to control the spread of the COVID-19 pandemic, the prevention and control measures of public health emergencies were initiated in all provinces of China in early 2020, which had a certain impact on air quality. In this study, taking Jiangsu Province in China as an example, the air pollution levels in different regions under different levels of pandemic prevention and control (PPC) measures are evaluated. The implementation of the prevention and control policies of COVID-19 pandemic directly affected the concentration of air pollutants. No matter what level of PPC measures was implemented, the air quality index (AQI) and pollutant concentrations of NO2, CO, PM10 and PM2.5 were all reduced by varied degrees. The higher the level of PPC measures, the greater the reduction was in air pollutant concentrations. Specifically, NO2 was the most sensitive to PPC policies. The concentrations of CO and atmospheric particulate matter (PM10 and PM2.5) decreased most obviously under the first and second level of PPC. The response speed of air quality to different levels of PPC measures varied greatly among different cities. Southern Jiangsu, which has a higher level of economic development and is dominated by secondary and tertiary industries, had a faster response speed and a stronger responsiveness. The results of this study reflect the economic vitality of different cities in economically advanced regions (i.e., Jiangsu Province) in China. Furthermore, the results can provide references for the formulation of PPC policies and help the government make more scientific and reasonable strategies for air pollution prevention and control.

3.
Front Microbiol ; 13: 865336, 2022.
Article in English | MEDLINE | ID: covidwho-1775717

ABSTRACT

A reliable and reproducible model in vitro for swine enteric coronaviruses infection would be intestinal models that support virus replication and can be long-term cultured and manipulated experimentally. Here, we designed a robust long-term culture system for porcine intestinal organoids from the intestinal crypt or single LGR5+ stem cell by combining previously defined insights into the growth requirements of the intestinal epithelium of humans. We showed that long-term cultured swine intestinal organoids were expanded in vitro for more than 6 months and maintained the potential to differentiate into different types of cells. These organoids were successfully infected with porcine enteric coronavirus, including porcine epidemic diarrhea virus (PEDV) and transmissible gastroenteritis virus (TGEV), and were capable of supporting virus replication and progeny release. RNA-seq analysis showed robust induction of transcripts associated with antiviral signaling in response to enteric coronavirus infection, including hundreds of interferon-stimulated genes and cytokines. Moreover, gene set enrichment analysis indicated that PEDV infection could suppress the immune response in organoids. This 3D intestinal organoid model offers a long-term, renewable resource for investigating porcine intestinal infections with various pathogens.

4.
Frontiers in psychiatry ; 12, 2021.
Article in English | EuropePMC | ID: covidwho-1733470

ABSTRACT

Aims To investigate the psychological distress experienced by healthcare workers (HCWs) at a tertiary hospital in Changzhou, China, outside Wuhan, during the early stage of COVID-19 and evaluate the moderating effects of resilience and social support on the relationship between stress and psychological distress. Methods The study was conducted between February 10 and 15, 2020, in a non-probabilistic way. The survey included questions regarding the risk of exposure, sociodemographics, perceived stress [10-item Perceived Stress Scale (PSS-10)], resilience [10-item Connor–Davidson Psychological Resilience (CD-RISC-10)], social support [Multidimensional Scale of Perceived Social Support (MSPSS)], and psychological distress [12-item General Health Questionnaire (GHQ-12)]. We applied the PROCESS macro for SPSS to test the hypotheses that resilience and social support moderated the stress response. In addition, a simple slope analysis was conducted when the interaction effect was statistically significant. Results Some 33.6% of participants suffered from psychological distress (GHQ-12 ≥ 12). Perceived stress was positively related to psychological distress (r = 0.42, p < 0.001). In addition, resilience (ΔR2 = 0.03, p for interaction < 0.001) and social support (ΔR2 = 0.01, p for interaction <0.01) moderated the stress response. The impact of perceived stress on psychological distress was attenuated when subjects who were resilient (high β = 0.15, p < 0.001;low β = 0.36, p < 0.001), and perceived stress had less impact on psychological distress when social support was high (β = 0.24, p < 0.001) rather than low (β = 0.34, p < 0.001). Limitations The cross-sectional design led to a lack of causal relationships between variables. Conclusions Our data showed that resilience and social support moderated the stress response among HCWs in the pandemic, suggesting that improving resilience and social support could be appropriate targets to improve HCWs' mental health in the pandemic.

5.
Immun Ageing ; 19(1): 12, 2022 Mar 05.
Article in English | MEDLINE | ID: covidwho-1724508

ABSTRACT

BACKGROUND: COVID-19 patients may experience "cytokine storm" when human immune system produces excessive cytokines/chemokines. However, it remains unclear whether early responses of inflammatory cytokines would lead to high or low titers of anti-SARS-CoV-2 antibodies. METHODS: This retrospective study enrolled a cohort of 272 hospitalized patients with laboratory-confirmed SARS-CoV-2. Laboratory assessments of serum cytokines (IL-2R, IL-6, IL-8, IL-10, TNF-α), anti-SARS-CoV-2 IgG/IgM antibodies, and peripheral blood biomarkers were conducted during hospitalization. RESULTS: At hospital admission, 36.4% patients were severely ill, 51.5% patients were ≥ 65 years, and 60.3% patients had comorbidities. Higher levels of IL-2R and IL-6 were observed in older patients (≥65 years). Significant differences of IL-2R (week 2 to week ≥5 from symptom onset), IL-6 (week 1 to week ≥5), IL-8 (week 2 to week ≥5), and IL-10 (week 1 to week 3) were observed between moderately-ill and severely ill patients. Anti-SARS-CoV-2 IgG titers were significantly higher in severely ill patients than in moderately ill patients, but such difference was not observed for IgM. High titers of early-stage IL-6, IL-8, and TNF-α (≤2 weeks after symptom onset) were positively correlated with high titers of late-stage IgG (≥5 weeks after symptom onset). Deaths were mostly observed in severely ill older patients (45.9%). Survival analyses revealed risk factors of patient age, baseline COVID-19 severity, and baseline IL-6 that affected survival time, especially in severely ill older patients. CONCLUSION: Early responses of elevated cytokines such as IL-6 reflect the active immune responses, leading to high titers of IgG antibodies against COVID-19.

6.
Nanomaterials (Basel) ; 12(4)2022 Feb 14.
Article in English | MEDLINE | ID: covidwho-1715572

ABSTRACT

A novel Multi-Quantum-Well Deep Ultra Violet Light Emitting Diode (DUV-LED) device with a near-pole hole insertion layer and far-pole hole insertion layer was proposed and carefully studied. It was found that remarkable enhancements both in the light output power (LOP) and the internal quantum efficiency (IQE) could be realized by using the far-electrode hole insertion layer and near-electrode hole insertion layer compared to the conventional DUV-LED device. Inserting the near-polar hole insertion layer can increase the electric field in the hole injection layer, which will promote the ionization of the acceptor, increase the hole concentration, and enhance the light-emitting performance of the device. In addition, inserting the far-pole hole insertion layer can suppress electron leakage and promote the hole injection. At the same time, the updated electron barrier height of P-AlGaN/GaN will indirectly weaken the electrostatic field in the hole injection layer, which remains inconducive to the ionization of the acceptor, implying that the electrostatic field between the P-AGaN/GaN layer can optimize the efficiency droop of the device.

7.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327670

ABSTRACT

As of January 2022, at least 60 million individuals are estimated to develop post-acute sequelae of SARS-CoV-2 (PASC) after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While elevated levels of SARS-CoV-2-specific T cells have been observed in non-specific PASC, little is known about their impact on pulmonary function which is compromised in the majority of these individuals. This study compares frequencies of SARS-CoV-2-specific T cells and inflammatory markers with lung function in participants with pulmonary PASC and resolved COVID-19 (RC). Compared to RC, participants with respiratory PASC had up to 34-fold higher frequencies of IFN-γ- and TNF-α-producing SARS-CoV-2-specific CD4+ and CD8+ T cells in peripheral blood and elevated levels of plasma CRP and IL-6. Importantly, in PASC participants the frequency of TNF-α-producing SARS-CoV-2-specific CD4+ and CD8+ T cells, which exhibited the highest levels of Ki67 indicating they were activity dividing, correlated positively with plasma IL-6 and negatively with measures of lung function, including forced expiratory volume in one second (FEV1), while increased frequencies of IFN-γ-producing SARS-CoV-2-specific T cells associated with prolonged dyspnea. Statistical analyses stratified by age, number of comorbidities and hospitalization status demonstrated that none of these factors affect differences in the frequency of SARS-CoV-2 T cells and plasma IL-6 levels measured between PASC and RC cohorts. Taken together, these findings demonstrate elevated frequencies of SARS-CoV-2-specific T cells in individuals with pulmonary PASC are associated with increased systemic inflammation and decreased lung function, suggesting that SARS-CoV-2-specific T cells contribute to lingering pulmonary symptoms. These findings also provide mechanistic insight on the pathophysiology of PASC that can inform development of potential treatments to reduce symptom burden.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325300

ABSTRACT

Balancing common disease treatment and epidemic control is a key objective of medical supplies procurement in hospitals during a pandemic such as COVID-19. This problem can be formulated as a bi-objective optimization problem for simultaneously optimizing the effects of common disease treatment and epidemic control. However, due to the large number of supplies, difficulties in evaluating the effects, and the strict budget constraint, it is difficult for existing evolutionary multiobjective algorithms to efficiently approximate the Pareto front of the problem. In this paper, we present an approach that first transforms the original high-dimensional, constrained multiobjective optimization problem to a low-dimensional, unconstrained multiobjective optimization problem, and then evaluates each solution to the transformed problem by solving a set of simple single-objective optimization subproblems, such that the problem can be efficiently solved by existing evolutionary multiobjective algorithms. We applied the transform-and-divide evolutionary optimization approach to six hospitals in Zhejiang Province, China, during the peak of COVID-19. Results showed that the proposed approach exhibits significantly better performance than that of directly solving the original problem. Our study has also shown that transform-and-divide evolutionary optimization based on problem-specific knowledge can be an efficient solution approach to many other complex problems and, therefore, enlarge the application field of evolutionary algorithms.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325141

ABSTRACT

Objectives: The pneumonia caused by the 2019 novel coronavirus recently break out in Wuhan, China, and was named as COVID-19. With the spread of the disease, it bring numbers of casualties,so now we need a way could fast and accuracy diagnose the disease.This paper aims to compare two way for diagnose COVID-19 in outpatient :Chest CT and RT-PCR.Materials and methodsThe study picked 248 patients who treated in fever clinical of GanZhou people's hospital,their complete clinical and imaging data were analysed retrospectively.Epidemiological data,symoptoms,laboratory test results include RT-PCR and the CT results include CT features,lesion location,lesion distribution of suspected COVID-19 infected patients were gathered.ResultsAll of 248 patients,at last 20 patients confirmed COVID-19,15 patients were confirmed in outpatient.More than 200 cases has laboratory test results disnormal.Only 15/248 patients had initial positive RT-PCR for COVID-19,5 patients had COVID-19 confirmed by two or more RT-PCR.50 cases(20.2%) had Ground glass opacity,42 cases(16.9%) had Consolidation,39 cases(15.7%) had Spider web pattern,38 cases(15.3%) had Interlobular septal thickening.For lesion location,22 cases(8.9%) involved Single lobe of one lung,13 cases(5.2%) involved Multiple lobes of one lung,174 cases(70.2%) involved Multiple lobes of both lungs,9 cases(3.6%) involved Bilateral lower lungs,25 cases(10.1%) involved Bilateral middle and lower lungs.Regarding the distribution of the lesions in the lung lobes,119 cases(47.98%) involved Subpleural distribution,19 cases(7.7%) involved Diffuse distribution,7 cases(2.8%) involved Peribronchial distribution,81 cases(32.7%) involved Mixed distribution.ConclusionChest CT can be applied in outpatient to make early diagnosis with sensitivity and accuracy better than that of nucleic acid detection.Trial registrationChiCTR2000032574. Registered 3 May 2020. retrospectively registered

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324823

ABSTRACT

Background: The prognosis of severe COVID-19 patients is poor. There are currently no definitely effective vaccines or antivirus drugs for COVID-19.Methods This prospective cohort study compared the efficacy and safety of integrative Chinese-Western medicine (ICWM) treatments with Western medicine (WM) treatments in severe or critically ill patients. The outcomes included: mortality, hospital stay in ICU, days with ventilator-assisted ventilation, etc.Results A total of 36 confirmed COVID-19 patients in ICU were included. The median age of patients was 66 years (IQR: 53-77.5), and there were 16 female patients (44.4%). There were no significant differences in laboratory tests and complications after treatments between groups. A total of 18 (50%) patients died during hospitalization, and the mortality in the ICWM group (28.6%) was significantly lower than that of the WM group (63.6%, adjusted P  = 0.031). And the time of assisted ventilation was shorter in the ICWM group (adjusted P  = 0.67). However, the median hospital stay was significantly longer in the ICWM group (18 vs. 14 days, adjusted P ༜0.05).Conclusions ICWM treatments could significantly reduce the mortality and improve the clinical symptoms for severe or critically ill patients with COVID-19, and it was safe and cost-effective to add Chinese medicine.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321887

ABSTRACT

Currently, there is no specific treatment for COVID-19 proven by clinical trials. WHO and CDC guidelines therefore endorse supportive care only. However, frontline clinicians have been applying several virus-based and host-based therapeutics in order to combat SARS-CoV-2. Medications from COVID-19 case reports, observational studies and the COVID-19 Treatment Guideline issued by the China's National Health Commission (7th edition published March 3rd, 2020. Edited translation attached) are evaluated in this review. Key evidence from relevant in vitro researches, animal models and clinical studies in SARS-CoV-2, SARS-CoV and MERS-CoV are examined. Antiviral therapies remdesivir, lopinavir/ritonavir and umifenovir, if considered, could be initiated before the peak of viral replication for optimal outcomes. Ribavirin may be beneficial as an add-on therapy and is ineffective as a monotherapy. Corticosteroids use should be limited without indicating comorbidities. IVIG is not recommended due to lack of data in COVID-19. Xuebijing may benefit patients with complications of bacterial pneumonia or sepsis. The efficacy of interferon is unclear due to conflicting outcomes in SARS and MERS studies. Chloroquine and hydroxychloroquine have shown in vitro inhibition of SARS-CoV-2 and may be beneficial as both prophylactic and treatment therapy. For patients who developed cytokine release syndrome, interleukin-6 inhibitors may be beneficial. Given the rapid disease spread and increasing mortality, active treatment with readily available medications may be considered timely prior to disease progression.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-319474

ABSTRACT

Background: Extracorporeal membrane oxygenation (ECMO) is rapidly becoming a mainstream technology for lung or heart/lung support especially during the COVID-19 pandemic. “Awake ECMO”is frequently used to indicate an alternative approach of using ECMO without invasive mechanical ventilation, and it has the unique advantages of application. In this study, we explored the feasibility and stability of the establishment method and management strategy of long-term awake ECMO model in healthy sheep. As the sheep are healthy, according to the histopathological analysis , we explored the effect of ECMO circuit itself on organs and tissues. As a preclinical study in large animals, our study aims to provide clues for further research on application expansion, management strategy optimization, pathophysiology exploration, equipment development and subsequent establishment of the disease animal model. Methods: : Ten healthy sheep were treated with awake veno-arterial (V-A) or veno-venous (V-V) ECMO for 7 days. They were transferred into the monitoring cages after operation and were ambulatory after anesthesia recovery. ECMO configurations, hemodynamic and hematologic parameters were measured every day. Necropsy was conducted at the endpoint of the experiment to visualize the cannula position in vivo and to examine cannulation related injury and thrombus formation in blood vessels and major organs. Main organs and blood vessels were harvested for pathological investigation. Results: : All sheep survived to the end of the experiment (the 7th day). In the whole process of the experiment, the vital signs of which were stable, and no serious bleeding and coagulation events occurred. Hemoglobin concentration and platelet count were in normal reference range, plasma free hemoglobin concentration was maintained at a low level. ECMO flow was stable, and oxygenation performance of oxygenator was satisfied. There was no major adverse pathological injury occurred. Conclusions: : Long term awake extracorporeal membrane oxygenation model in large animal is feasible and stable. Perioperative management is the key to the success of this model. As a basic research, it can also provide an alternative strategy for mechanical circulatory support in patients with awake ECMO indications.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309993

ABSTRACT

Given concerns about mental health during periods of Covid-19 lockdown, it important to understand how engagement with online Covid-19 related material can affect mood. In the UK and Ireland, online community support initiatives (OCSIs) have emerged to help people manage their lives. Yet, little is known about how people engaged with these or whether they influenced subsequent mood. We conducted surveys to explore how people in the UK and Ireland engaged with OCSIs, and found that 70% did so to offer support (e.g. to provide company). Those who did so reported feeling significantly calmer afterwards, those who engaged for general concerns (e.g. in response to anti-social behaviour) reported feeling significantly more anxious afterwards, but there was no difference in reported mood for those who engaged for other reasons (e.g. to share experiences or views). Thus, engaging with an OCSI for altruistic purposes might help to make people feel calmer.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308233

ABSTRACT

Background: S i nce December 2019, an epidemic caused by novel coronavirus(2019-nCoV) infection has occurred unexpectedly in China. Because of the sudden nature of the outbreak and the infectious power of the virus, it will inevitably cause people anxiety and other stress reactions. Previous studies showed that Baduanjin exercise was effective for people in anxiety and insomnia. The purpose of this study was to evaluate the potential benefits of Baduanjin exercise on the anxiety and insomnia in COVID-2019 patients. Methods: : This is a Case-Control Study. The COVID-2019 patients including 39 Baduanjin exercises or willing to do Baduanjin exercises and 39 age-and gender-matched nonexercising controls. The anxiety and insomnia in COVID-2019 patients were measured by using the GAD-7 and SMH Sleep Questionnaire at baseline and discharge. Results: : In the study, the Paired T-test showed that two groups had improved the GAD-7 scores and SMH Sleep Questionnaire compared with baseline at discharge. Baseline results showed there were no significant differences in the GAD-7 scores and SMH Sleep Questionnaire between the two groups. However, the significant differences found in the Baduanjin group included a 43.9% lower (p<0.001) in the GAD-7 score and an approximately 75.9% higher (p=0.003) in SMH Sleep Questionnaire score compare with the control group at discharge. Conclusion: The Baduanjin exercise may improve the anxiety and insomnia in COVID-2019 patients. It can also be used as a form of rehabilitation exercise for discharged patients or patients isolated at home. Trial Registration: ChiCTR2000030528.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-306298

ABSTRACT

Background: COVID-19 has been currently spread all over the world with high mortality reported in severe COVID-19 patients. Many severe COVID-19 patients exacerbated from mild illness several days after hospital admissions. Pathophysiological evolution within this para-exacerbation period remain unclear. Methods: Twenty-two confirmed COVID-19 patients who underwent at least one exacerbation were included. Epidemiological, clinical, laboratory, and radiological data were extracted from electronic medical records and compared between the records of hospital admission day and the exacerbation day. Dynamic profiles of critical parameters were explored during the para-exacerbation period. Results: Most of the patients were elder (67, IQR63-79), male (81.8%), coexisted with comorbidities (72.7%), multi-segments radiologically involved and exacerbated from mild to severe illness with anoxia at a median interval of 4 days (IQR, 2-7) from hospital admissions. On exacerbations, various clinical parameters were worsened, including respiratory rate, PaO2/FiO2 rate (PFR), alveolar-arterial PO2 difference (A-aDO 2 ), hematological cellularities, biochemical parameters and radiological abnormalities. Dynamic profiles showed that neutrophil/lymphocyte ratio (NLR), and serum level of lactic acid, lactate dehydrogenase and coagulation parameters started to increase even at four days before the exacerbation. Conclusions: Anoxia due to impaired gas exchange progress pathophysiologically characterized the exacerbation of COVID-19 patients. Continuously monitoring crucial clinical parameters, such as NLR, serum albumin, LDH, lactic acid, and CT involvement scale will be helpful to improve the recognition of the disease progression in patients with COVID-19 at early stage. Trial registration: This retrospective study has been registered in Chinese Clinical Trial Registry (ChiCTR2000030580, www.chictr.org.cn)

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315375

ABSTRACT

Background: Rapid and convenient screening for identification of SARS-CoV-2 infected individuals are key to prevent and control this pandemic. Methods The peripheral blood samples were collected from coronavirus disease 2019 (COVID-19) patients and asymptomatic carriers to evaluate the test characteristics of the IgM-IgG combined assay for SARS-CoV-2 compared to that of serum samples and enzyme-linked immuno sorbent assay (ELISA). Close contacts, healthcare workers and workforces were recruited and screened using this assay. Results The sensitivity of the rapid IgM-IgG combined antibody test for SARS-CoV-2 using peripheral blood (sued as a POCT) was 97.0% and the specificity was 99.2%, which was consistent with the result obtained using serum sample (consistency is about 100%). Furthermore, this POCT assay also can detect IgM and IgG antibodies of SARS-CoV‐2 in asymptomatic carriers, with 19 of the 20 RT-PCR confirmed asymptomatic carriers testing positive. Therefore, this POCT assay was used for population screening of SARS-CoV-2 infection diagnosis. First, it found 4 positive close contacts among the 10 cases, and there were three IgM positive cases and one IgG positive case among them. It is worth noting that the IgM positive cases also tested positive for the nucleic acid of the SARS-CoV-2. Second, there was one IgM positive assay among the 63 healthcare workers, but RT-PCR of SARS CoV-2 was negative. Third, for workforces screening, there were no positive cases. Conclusions The IgM-IgG combined antibody test of SARS-CoV-2 can be used as a POCT for rapid screening of SARS-CoV-2 infection.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315174

ABSTRACT

The epidemic of COVID-19 has now spread globally and affected over 110 countries. As of Mar 10 th , using publicly available data and official news reports in Henan province, we tracked a total of 1272 cases and a retrospective study was conducted to investigate the related factors in COVID-19 spread and control. We confirmed 554 primary patients had travel or residential history of Wuhan in the recent 2 weeks. Secondary cases accounted for 77.9% (141/181) among all the patients aged 61 or older, in whom contacted with unconfirmed returnees from Wuhan was responsible for 27.0% (38/141). The median incubate period is 7 (IQR, 4-10) days by analyzing time information in 469 cases. For 442 patients with discharge dates, the duration from onset to cure is 19 (IQR, 15-23) days. The time from onset to seeking care at a hospital varied in age groups, and differed between primary and secondary cases. Patients visiting different hospitals affected the time from seeking care to cure. Thus, our results showed the spread of COVID-19 and factors associated with outcomes of patients in Henan province, which helps to understand the epidemiological features outside of the epidemic area and control the disease in other regions and countries.

18.
Infect Dis Poverty ; 11(1): 15, 2022 Feb 02.
Article in English | MEDLINE | ID: covidwho-1666677

ABSTRACT

BACKGROUND: COVID-19 pandemic continues, clarifying signatures in clinical characters and antibody responses between severe and non-severe COVID-19 cases would benefit the prognosis and treatment. METHODS: In this study, 119 serum samples from 37 severe or non-severe COVID-19 patients from the First People's Hospital of Yueyang were collected between January 25 and February 18 2020. The clinical features, antibody responses targeting SARS-CoV-2 spike protein (S) and its different domains, SARS-CoV-2-specific Ig isotypes, IgG subclasses, ACE2 competitive antibodies, binding titers with FcγIIa and FcγIIb receptors, and 14 cytokines were comprehensively investigated. The differences between severe and non-severe groups were analyzed using Mann-Whitney U test or Fisher's exact test. RESULTS: Severe group including 9 patients represented lower lymphocyte count, higher neutrophil count, higher level of LDH, total bile acid (TBA) (P < 1 × 10-4), r-glutaminase (P = 0.011), adenosine deaminase (P < 1 × 10-4), procalcitonin (P = 0.004), C-reactive protein (P < 1 × 10-4) and D-dimer (P = 0.049) compared to non-severe group (28 patients). Significantly, higher-level Igs targeting S, different S domains (RBD, RBM, NTD, and CTD), FcγRIIa and FcγRIIb binding capability were observed in a severe group than that of a non-severe group, of which IgG1 and IgG3 were the main IgG subclasses. RBD-IgG were strongly correlated with S-IgG both in severe and non-severe group. Additionally, CTD-IgG was strongly correlated with S-IgG in a non-severe group. Positive RBD-ACE2 binding inhibition was strongly associated with high titers of antibody (S-IgG1, S-IgG3, NTD-IgG, RBD-IgA, NTD-IgA, and CTD-IgA) especially RBD-IgG and CTD-IgG in the severe group, while in the non-severe group, S-IgG3, RBD-IgG, NTD-IgG, and NTD-IgM were correlated with ACE2 blocking rate. S-IgG1, NTD-IgM and S-IgM were negatively associated with illness day in a severe group, while S-IgG3, RBD-IgA, CTD-IgA in the severe group (r = 0.363, P = 0.011) and S-IgG1, NTD-IgA, CTD-IgA in the non-severe group were positively associated with illness day. Moreover, GRO-α, IL-6, IL-8, IP-10, MCP-1, MCP-3, MIG, and BAFF were also significantly elevated in the severe group. CONCLUSION: Antibody detection provides important clinical information in the COVID-19 process. The different signatures in Ig isotypes, IgG subclasses, antibody specificity between the COVID-19 severe and non-severe group will contribute to future therapeutic and preventive measures development.


Subject(s)
Antibodies, Viral/blood , COVID-19 , COVID-19/diagnosis , COVID-19/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin Isotypes/blood , Pandemics , SARS-CoV-2 , Severity of Illness Index , Spike Glycoprotein, Coronavirus/immunology
19.
Glob Health J ; 5(4): 215-219, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1654462

ABSTRACT

Health workers (HW) are on the frontline fighting against the COVID-19 pandemic, they are exposed to multiple occupational hazards. This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China. Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China. This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China. The comprehensive measures in China can be summarized as '6P-approach': public health emergency response, prompt learning from lessons, proactive measures of occupational health, precaution strategies against occupational hazards, personal protective equipment and medical devices supply, and professional networking. Through this 6P-approach, China was able to minimize the incidence of COVID-19 infection among HWs, while successfully containing the outbreak during the first quarter of 2020. Although the COVID-19 vaccines have been rolled out, however, the COVID-19 pandemic is still under rapidly evolving situation. Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.

20.
J Ultrasound Med ; 2021 Dec 25.
Article in English | MEDLINE | ID: covidwho-1589007

ABSTRACT

OBJECTIVES: Ultrasound-guided saline enema is highly successful in treating pediatric intussusception; however, early recurrence-within 48 hours-is possible. This study aimed to explore effective methods of reducing early recurrence. METHODS: This study included patients aged 0 to 14 years diagnosed with ileocolic intussusception with a symptom duration of <48 hours from January 2019 to March 2021. The patients were divided into control and intervention groups. All patients received successful treatment with ultrasound-guided saline enema; however, in patients treated before January 4, 2020 (control group), the intestinal fluid was drained immediately, and in patients treated after January 4, 2020 (intervention group), the intestinal fluid was drained after 15 minutes of intestinal pressure maintenance. Early recurrence rates of the groups were compared. RESULTS: Ileocolic intussusception was treated successfully by ultrasound-guided saline enema in 231 patients (116, control group;115, intervention group). The early recurrence rate in the intervention group (10%; 95% CI: 4.9-16.5) was numerically lower than that in the control group (19%; 95% CI: 12.3-27.3). No significant difference was observed in the number of recurrences per person between the groups (P = .448). Patients without early recurrence were older (P = .004) and received enemas of a shorter duration (P < .001) and lower pressure (P < .001) than patients without early recurrence. CONCLUSIONS: Maintaining reduction pressure for 15 minutes after a successful ultrasound-guided saline enema may reduce the early recurrence of intussusception. A randomized controlled trial is needed because the intervention and control cohorts were most probably incomparable (due to the COVID-19 pandemic).

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