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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313437

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has spread globally. However, the association between COVID-19 and disseminated intravascular coagulation (DIC) has been scarcely addressed. We aimed to systematically characterize the clinical features and examine risk factors for DIC development in COVID-19 patients. Methods: : In this single-centered, retrospective, and observational study, all patients with DIC (N=59) and 270 patients without DIC were matched by propensity score matching based on age, sex, and comorbidities. Demographic data, symptoms, radiological, laboratory examinations, and clinical outcomes were compared between patients with and without DIC. Furthermore, univariable and multivariable logistic regression were used to explore the risk factors associated with DIC development in COVID-19 patients. Results: : Higher proportion of patients with DIC and COVID-19 (54 of 59 [91·53%]) developed into death than non DIC patients (58 of 270 [21·48%]). Patients with DIC presented aggravated inflammation responses, liver damage, and especially coagulation dysfunction. Moreover, in addition to previously reported coagulation-related markers, such as FDP, D-dimer, and platelet, we also identified several novel risk factors associated with DIC development, including decreased fibrinogen (OR=0·476, 95%CI=0·380-0·596, P <0·0001) and ALB (0·901, 0·845- 0·961, P =0·0015), and elevated IL-6 (1·010, 1·005-1·015, P =0·00017) and TNF-α (1·053, 1·016-1·091, P =0·0045). Conclusions: : Patients with DIC and COVID-19 were predisposed to poor clinical outcomes. These risk factors identified may be helpful for early surveillance of disease progression and making standardized treatment strategies.

2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313435

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) has caused global pandemic, resulting in considerable mortality. The risk factors, clinical treatments and especially comprehensive risk models for COVID-19 death are urgently warranted. Methods In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex and comorbidities were enrolled from January 13, 2020 to March 31, 2020. Results Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cells subsets and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, outperforming previous risk models, which was significant for early clinical management for COVID-19. Conclusions The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325273

ABSTRACT

Objectives: The utilization of mobile health (m-health) has rapidly expanded during the COVID-19 pandemic, and there is still a lack of relevant clinical data pertaining to chronic low-back pain(CLBP)management. This study was designed to compare the effectiveness of m-health based exercise (via guidance plus education) versus exercise (via guidance) during CLBP management. Methods: : Participants (n = 40) were randomly assigned to intervention and control groups. The intervention group received m-health based exercise (via guidance plus education), whereas the control group received m-health based exercise (via guidance). The exercise prescription video and educational content were sent to participants by the application (app), Ding Talk . Repeated-measures analysis of variance was used to test the baseline’s intervention effects, 6-week follow-up, and 18-week follow-up. We selected function(Roland and Morris Disability Questionnaire)and pain intensity (current, mean, and most severe Numeric Rating Scale in the last 2 weeks)as the primary outcomes, changes of negative emotion (depression, anxious), and quality of life as the secondary outcomes. Results: : Time’s significant effect was found in pain, function, and health-related quality of life in both groups, but time did not show significant interaction effects. Participants were able to use m-based education with their anxiety and depression after treatment, but the relief only lasted until Week 6. No differences were found on the aspect of mental health-related quality of life. Conclusion: M-health based exercise (via guidance) is a convenient and effective method to treat CLBP. Additionally, plus education is more helpful in relieving short-term negative emotions and improving treatment adherence than guidance only. However, at the last follow-up(18-week), no significant differences were found between the intervention and control groups.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324174

ABSTRACT

Background: Recently, investments in the construction of medical resources have been increasing annually China, and consequently, the allocation of these resources has improved. However, the outbreak of covid-19 in 2020 highlights the problems in the distribution of medical institutions. After the occurrence of public health emergencies, the joint action of different levels of medical and health institutions can bring the role of urban medical and health system into full play. Therefore, after a global public health emergency, the study of medical institution distribution needs to be reconsidered. Methods: : With the continuous application and development of GIS, the application of GIS in civil planning is relatively mature, and research investigating distribution has been conducted in depth. Based on this foundation, this paper analyzes the factors impacting distribution, such as the transportation system, land use characteristics and personal factors, by a weighted spatial separation model of a representative city in a cold region in China. Results: : A weighted spatial separation model was built and applied to comprehensively consider several factors affecting accessibility, including the spatial coverage separation, the service areas separation, the road network separation, the population separation and the weather separation. To calculate the accessibility of medical institutions using a weighted spatial separation model, Harbin was chosen as a case study. The accessibility of medical institutions was analyzed. Conclusions: : The accessibility of medical institutions in this representative cold city in China was comparatively analyzed in this paper through theoretical research, software computations/simulations and model analysis based on the GIS paradigm. This study will help optimize the layout of medical institutions and improve medical equality. Trial registration: An ethics review and approval for this study was not required according to the local legislation and institutional requirements.

5.
HERD ; 15(1): 55-74, 2022 01.
Article in English | MEDLINE | ID: covidwho-1582507

ABSTRACT

OBJECTIVE: Entrusted by the Harbin Municipal Government, evaluation medical building system for prevention and control of sudden infectious diseases in the city has been established. BACKGROUND: China, as a country that found the COVID-19 earlier, has taken strict control measures. However, as the medical building system is not perfect enough to prevent and control sudden infectious diseases. METHOD: First, expert group methodology was used and evaluation index of ability of prevention and control of sudden infectious diseases in medical building system was selected; then fuzzy comprehensive evaluation was adopted to establish index set and to set weight and medical building system evaluation model for prevention and control of sudden infectious diseases was constructed; finally, it's to modify the indicators and weights in the evaluation set and to make an evaluation of the ability of Harbin medical building system to prevent and control sudden infectious diseases in accordance with the current management mode of system. RESULTS: The medical building system in Harbin is significantly unbalanced in its ability to prevent sudden infections where there are low indicators for response monitoring and forecasting terminals, there are high indicators for the construction of emergency center. CONCLUSIONS: The evaluation model of the ability of medical building system to prevent and control sudden infectious diseases was constructed. The model is adopted to make practical evaluation of infectious disease prevention and control ability in Harbin and to form the evaluation method of the direct connection between the theoretical research of medical architecture and medical building design.


Subject(s)
COVID-19 , China , Humans , SARS-CoV-2
6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-297104

ABSTRACT

Background: The utilization of mobile health (m-health) has rapidly expanded during the COVID-19 pandemic, and there is still a lack of relevant clinical data pertaining to chronic low-back pain(CLBP)management. This study was designed to compare the effectiveness of m-health based exercise (via guidance plus education) versus exercise (via guidance) during CLBP management. Methods: : Participants (n = 40) were randomly assigned to intervention and control groups. The intervention group received m-health based exercise (via guidance plus education), whereas the control group received m-health based exercise (via guidance). The exercise prescription video and educational content were sent to participants by the application (app), Ding Talk . Repeated-measures analysis of variance was used to test the baseline’s intervention effects, 6-week follow-up, and 18-week follow-up. We selected function(Roland and Morris Disability Questionnaire)and pain intensity (current, mean, and most severe Numeric Rating Scale in the last 2 weeks)as the primary outcomes, changes of negative emotion (depression, anxious), and quality of life as the secondary outcomes. Results: : Time’s significant effect was found in pain, function, and health-related quality of life in both groups, but time did not show significant interaction effects. Participants were able to use m-based education with their anxiety and depression after treatment, but the relief only lasted until Week 6. No differences were found on the aspect of mental health-related quality of life. Conclusion: M-health based exercise (via guidance) is a convenient and effective method to treat CLBP. Additionally, plus education is more helpful in improving treatment adherence than guidance only. However, at the last follow-up(18-week), no significant differences were found between the intervention and control groups. Trial registration: The trial was prospectively registered with the Chinese Clinical Trials Registry Number: ChiCTR2000041459(12/26/2020).

7.
Ann Palliat Med ; 10(10): 10414-10424, 2021 10.
Article in English | MEDLINE | ID: covidwho-1485617

ABSTRACT

BACKGROUND: Since December 2019, there have been cases of infectious pneumonia of unknown cause in Wuhan, Hubei Province, China. On January 12, 2020, the World Health Organization (WHO) named it COVID-19. There are few studies on the clinical characteristics of patients with COVID-19, and results vary widely in sample sizes. METHODS: Chinese and English databases were searched with "Infectious pneumonia", "COVID-19", "CT", "SARS-COV-2", and "Diagnose" as keywords. Rev Man 5.3 software provided by the Cochrane system was used to assess the quality of the included literature. RESULTS: Of the 18 included studies, ground-glass shadow was the most common computed tomography (CT) sign [95% confidence interval (CI): 0.79-0.97], followed by thickening of the blood vessels (95% CI: 0.63-0.78), and pleural thickening (95% CI: 0.02-0.15). Of the 18 studies, 12 reported that the lesions were externally subpleural (95% CI: 0.132-0.173), and 6 reported that the lesions were distributed in a single lobe (95% CI: 0.598-0.841). The heterogeneity test results showed that the morphology of the lesions was cord-like (95% CI: 0.092-0.172), grid-like (95% CI: 0.152-0.193), patchy (95% CI: 0.192-0.313), and nodular (95% CI: 0.591-0.745). DISCUSSION: Ground-glass opacity was a typical CT manifestation for patients with infectious pneumonia, and CT signs were instrumental in diagnosing this disease.


Subject(s)
COVID-19 , Humans , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , World Health Organization
8.
BMC Infect Dis ; 21(1): 951, 2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1412707

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. METHODS: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. RESULTS: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. CONCLUSIONS: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.


Subject(s)
COVID-19 , Sepsis , Humans , Intensive Care Units , Organ Dysfunction Scores , Prognosis , ROC Curve , Retrospective Studies , Risk Factors , SARS-CoV-2
9.
BMC Infect Dis ; 21(1): 951, 2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1406708

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted. METHODS: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020. RESULTS: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19. CONCLUSIONS: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.


Subject(s)
COVID-19 , Sepsis , Humans , Intensive Care Units , Organ Dysfunction Scores , Prognosis , ROC Curve , Retrospective Studies , Risk Factors , SARS-CoV-2
10.
Front Microbiol ; 12: 722178, 2021.
Article in English | MEDLINE | ID: covidwho-1376706

ABSTRACT

Prior infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides protective immunity against reinfection. However, whether prior infection blocks SARS-CoV-2 transmission is not yet clear. Here, we evaluated the impact of prior infection on SARS-CoV-2 transmission in Syrian hamsters. Our results showed that prior infection significantly reduced SARS-CoV-2 replication in Syrian hamsters, but sterilizing immunity was not achieved. Prior infection blocked the airborne transmission of SARS-CoV-2 from previously infected Syrian hamsters to naïve Syrian hamsters and previously infected Syrian hamsters. Moreover, prior infection substantially reduced the efficiency of direct contact transmission between previously infected Syrian hamsters. However, prior infection had limited impact on SARS-CoV-2 transmission from previously infected Syrian hamsters to naïve Syrian hamsters via direct contact in the early course of infection. Human reinfection and SARS-CoV-2 transmission between a previously infected population and a healthy population would be likely, and a higher vaccination coverage rate was needed to reach herd immunity. Our work will aid the implementation of appropriate public health and social measures to control coronavirus infectious disease 2019 (COVID-19) pandemic.

11.
Pathogens ; 10(6)2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1270096

ABSTRACT

Through 4 June 2021, COVID-19 has caused over 172.84 million cases of infection and 3.71 million deaths worldwide. Due to its rapid dissemination and high mutation rate, it is essential to develop a vaccine harboring multiple epitopes and efficacious against multiple variants to prevent the immune escape of SARS-CoV-2. An in silico approach based on the viral genome was applied to identify 19 high-immunogenic B-cell epitopes and 499 human leukocyte antigen (HLA)-restricted T-cell epitopes. Thirty multi-epitope peptide vaccines were designed by iNeo-Suite and manufactured by solid-phase synthesis. Docking analysis confirmed stable hydrogen bonds of epitopes with their corresponding HLA alleles. When four peptide candidates derived from the spike protein of SARS-CoV-2 were selected to immunize mice, a significantly larger amount of total IgG in serum, as well as an increase of CD19+ cells in the inguinal lymph nodes, were observed in the peptide-immunized mice compared to the control. The ratios of IFN-γ-secreting lymphocytes in CD4+ or CD8+ T-cells in the peptide-immunized mice were higher than those in the control mice. There were also a larger number of IFN-γ-secreting T-cells in the spleens of peptide-immunized mice. The peptide vaccines in this study successfully elicited antigen-specific humoral and cellular immune responses in mice. To further validate the safety and efficacy of this vaccine, animal studies using a primate model, as well as clinical trials in humans, are required.

13.
Front Pharmacol ; 11: 607075, 2020.
Article in English | MEDLINE | ID: covidwho-1082545

ABSTRACT

From the perspective of epidemiology, viral immunology and current clinical research, pulmonary fibrosis may become one of the complications of patients with Coronavirus Disease 2019 (COVID-19). Cytokine storm is a major cause of new coronavirus death. The purpose of this study was to explore the effects of antiviral drug arbidol on cytokine storm and pulmonary fibrosis. Here, we use a mouse model of bleomycin-induced pulmonary fibrosis and a mouse model of fecal dilution-induced sepsis to evaluate the effects of arbidol on pulmonary fibrosis and cytokine storm. The results showed that arbidol significantly reduced the area of pulmonary fibrosis and improved lung function (reduced inspiratory resistance, lung dynamic compliance and forced vital capacity increased). Treatment with arbidol promoted reduced sepsis severity 48 h after sepsis induction, based on weight, murine sepsis score and survival rate. Arbidol observably alleviates inflammatory infiltrates and injury in the lungs and liver. Finally, we also found that arbidol reduced serum levels of pro-inflammatory factors such as TNF-α and IL-6 induced by fecal dilution. In conclusion, our results indicate that arbidol can alleviate the severity of pulmonary fibrosis and sepsis, and provide some reference for the treatment of cytokine storm and sequelae of pulmonary fibrosis in patients with COVID-19.

15.
Sci Total Environ ; 751: 141820, 2021 Jan 10.
Article in English | MEDLINE | ID: covidwho-723550

ABSTRACT

In recent decades, air pollution has become an important environmental problem in the megacities of eastern China. How to control air pollution in megacities is still a challenging issue because of the complex pollutant sources, atmospheric chemistry, and meteorology. There is substantial uncertainty in accurately identifying the contributions of transport and local emissions to the air quality in megacities. The COVID-19 outbreak has prompted a nationwide public lockdown period and provides a valuable opportunity for understanding the sources and factors of air pollutants. The three-month period of continuous field observations for aerosol particles and gaseous pollutants, which extended from January 2020 to March 2020, covered urban, urban-industry, and suburban areas in the typical megacity of Hangzhou in the Yangtze River Delta in eastern China. In general, the concentrations of PM2.5-10, PM2.5, NOx, SO2, and CO reduced 58%, 47%, 83%, 11% and 30%, respectively, in the megacity during the COVID-Lock period. The reduction proportions of PM2.5 and CO were generally higher in urban and urban-industry areas than those in suburban areas. NOx exhibited the greatest reduction (>80%) among all the air pollutants, and the reduction was similar in the urban, urban-industry, and suburban areas. O3 increased 102%-125% during the COVID-Lock period. The daytime elevation of the planetary boundary layer height can reduce 30% of the PM10, PM2.5, NOx and CO concentrations on the ground in Hangzhou. During the long-range transport events, air pollutants on the regional scale likely contribute 40%-90% of the fine particles in the Hangzhou urban area. The findings highlight the future control and model forecasting of air pollutants in Hangzhou and similar megacities in eastern China.


Subject(s)
Air Pollutants , Air Pollution , Coronavirus Infections , Pandemics , Pneumonia, Viral , Air Pollutants/analysis , Air Pollution/analysis , Betacoronavirus , COVID-19 , China/epidemiology , Environmental Monitoring , Humans , Particulate Matter/analysis , Rivers , SARS-CoV-2
16.
Chin. Pharm. J. (China) ; 9(55): 692-699, 20200508.
Article in Chinese | WHO COVID, ELSEVIER | ID: covidwho-703886

ABSTRACT

OBJECTIVE: To evaluate the safety and rationality of Reduning injection in the treatment of COVID-19. METHODS: Through consulting, summarizing and analyzing literatures, the rapid HTA evaluation of Reduning was carried out, and its pharmacological rationality and drug monitoring for COVID-19 were discussed. RESULTS: Literature analysis indicated that COVID-19 belongs to the pestilence of TCM. It was characterized by “dampness, heat, deficiency, toxin and stasis”, and its clinical manifestations involved inflammatory factor storm, immune system damage, etc. Reduning injection was approved to the treatment of influenza, cough and respiratory tract infections caused by exopathic wind-heat, and a typical drug for heat-clearing and detoxifying. CONCLUSION: The rapid HTA evaluation showed that Reduning injection has good safety, effectiveness and economy. The mechanisms of Reduning in antipyretic and anti-inflammatory, immune regulation and anti-virus suggest the rationality of Reduning in treating COVID-19, but drug monitoring should be done well in the use process.

17.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 2020.
Article | WHO COVID | ID: covidwho-239020

ABSTRACT

OBJECTIVE: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. METHODS: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. RESULTS: Female patients are more likely to have anxiety (OR=3.206, 95%CI: 1.073-9.583, P<0.05) and depression (OR=9.111, 95%CI: 2.143-38.729, P<0.01) than male patients;patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (OR=3.267, 95%CI: 1.082-9.597, P<0.05). CONCLUSIONS: During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.

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