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1.
Industrial Management & Data Systems ; 121(12):2697-2721, 2021.
Article in English | ProQuest Central | ID: covidwho-1806829

ABSTRACT

Purpose>This paper aims to propose a social enterprise legitimation mechanism by combining the established logic and transformational logic to test the validity of the conceptual model.Design/methodology/approach>The authors construct the theoretical framework based on integrating organizational identity theory, attention-based view and collected 128 social enterprises data during the post-pandemic period in China. The authors applied multiple hierarchical regression analysis and mediation analysis to test the research hypothesis.Findings>The results show that strong organizational identity contributes significantly to the cognitive legitimacy of social enterprise. Besides, we found that social welfare logic and digital transformation can positively mediate the correlation between organizational identity and cognitive legitimacy.Practical implications>Social enterprises enhance legitimacy significantly by social welfare logic comparing with commercial logic, which indicates that social enterprises should allocate more internal resources and attention to present the organization's social value through various distributions. More importantly, social enterprises should embrace digital transformation to enhance transparency and efficiency, decrease transaction costs, enlarge organizational social impact to strengthen cognitive legitimacy.Originality/value>The paper first proposed and empirically tested that digital transformation is an important mechanism to enhance the social enterprise's cognitive legitimacy.

2.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330303

ABSTRACT

Objective: To gain a better understanding of decisions around adherence to self-isolation advice during the first phase of the COVID-19 response in England. Design: A mixed-methods cross sectional study. Setting: England Participants COVID-19 cases and contacts who were contacted by Public Health England (PHE) during the first phase of the response in England (January-March 2020). Results: Of 250 respondents who were advised to self-isolate, 63% reported not leaving home at all during their isolation period, 20% reported leaving only for lower risk activities (dog walking or exercise) and 16% reported leaving for potentially higher risk, reasons (shopping, medical appointments, childcare, meeting family or friends). Factors associated with adherence to never going out included: the belief that following isolation advice would save lives, experiencing COVID-19 symptoms, being advised to stay in their room (rather than just inside), having help from outside and having regular contact by text message from PHE. Factors associated with non-adherence included being angry about the advice to isolate, being unable to get groceries delivered and concerns about losing touch with friends and family. Interviews highlighted that a sense of duty motivated people to adhere to isolation guidance and where people did leave their homes, these decisions were based on rational calculations of the risk of transmission;people would only leave their homes when they thought they were unlikely to come into contact with others. Conclusions: Measures of adherence should be nuanced to allow for the adaptations people make to their behaviour during isolation. Understanding adherence to isolation and associated reasoning during the early stages of the pandemic is an essential part of pandemic preparedness for future emerging infectious diseases.

3.
Int J Infect Dis ; 117: 155-161, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1729824

ABSTRACT

BACKGROUND: Chemosensory disorders associated with COVID-19 have been widely discussed during the pandemic. We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19. METHODS: Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 1, 2019, and August 31, 2021. We selected random-effects model or fixed-effects model to pool data based on heterogeneity. The results were reported as odds ratios (ORs) or standardized mean differences (SMDs) and the corresponding 95% confidence intervals (CIs). Heterogeneity was reported as I2. RESULTS: Twenty-six studies with a total of 13,813 patients were included. The pooled data indicated that sex (OR 1.47; 95% CI 0.93-2.31), age (SMD -5.80; 95% CI -13.35 to 1.75), smoking (OR 2.04; 95% CI 0.72-5.79), and comorbidity (OR 1.21; 95% CI 0.58-2.53) of patients with COVID-19 had no effect on gustatory dysfunction. Olfactory dysfunction was more likely to occur in older patients with COVID-19 (SMD, -5.22; 95% CI, -8.28 to -2.16). Patients with COVID-19 with nasal congestion (OR 3.41; 95% CI 2.30-5.06) and rhinorrhea (OR 2.35; 95% CI 1.60-3.45) were more prone to olfactory dysfunction. CONCLUSION: These findings emphasize that older patients with COVID-19 are more likely to experience olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction.


Subject(s)
COVID-19 , Olfaction Disorders , Aged , COVID-19/complications , COVID-19/epidemiology , Humans , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Prevalence , SARS-CoV-2 , Taste Disorders/epidemiology , Taste Disorders/etiology
4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321219

ABSTRACT

Background: Infection with SARS-CoV-2 has been associated with liver dysfunction, aggravation of liver burden, and liver injury. This study aimed to assess the effects of liver injuries on the clinical outcomes of patients with COVID-19. Methods: A total of 1,564 patients with severe or critical COVID-19 from Huoshenshan Hospital, Wuhan, were enrolled. Chronic liver disease (CLD) was confirmed by consensus diagnostic criteria. Laboratory test results were compared between different groups. scRNA-seq data and bulk gene expression profiles were used to identify cell types associated with liver injury. Results: A total of 10.98% of patients with severe or critical COVID-19 developed liver injury after admission that was associated with significantly higher rates of mortality (21.74%, p <0.001) and intensive care unit admission (26.71%, p <0.001). A pre-existing CLD was not associated with a higher risk. However, fatty liver disease and cirrhosis were associated with higher risks, supported by evidences from single cell and bulk transcriptome analysis that showed more TMPRSS2 + cells in these tissues. By generating a model, we were able to predict the risk and severity of liver injury during hospitalization. Conclusion: We demonstrate that liver injury occurring during therapy in patients with COVID-19 is significantly associated with the severity of disease and mortality, but the presence of CLD is not associated. We provide a risk-score model that can predict whether patients with COVID-19 will develop liver injury or proceed to higher risk stages during subsequent hospitalizations. These findings may prove beneficial for the clinical management of patients infected with SARS-CoV-2.

5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-315636

ABSTRACT

Background: We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19.Methods: Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 01, 2019 to May 31, 2021. Select random effects model or fixed effects model to pool data based on heterogeneity. The results were reported as odds ratios or standardized mean differences and the corresponding 95% confidence intervals. Heterogeneity was reported as I2.Findings: Twenty-six studies with a total of 13813 patients were included. The pooled data indicated that sex (OR, 1.47;95% CI, 0.93-2.31), age (SMD, -5.80;95% CI, −13.35-1.75), smoking (OR, 2.04;95% CI, 0.72-5.79), and comorbidity (OR, 1.21;95% CI, 0.58-2.53) had no effect on gustatory dysfunction in COVID-19 patients. Elderly patients with COVID-19 were more prone to olfactory dysfunction (SMD, -5.22;95% CI, −8.28- −2.16). COVID-19 patients with nasal congestion (OR, 3.41;95%CI, 2.30-5.06) and rhinorrhea (OR, 2.35;95%CI, 1.60-3.45) are more likely to suffer from olfactory dysfunction.Interpretation: These findings emphasize that elderly COVID-19 patients are more likely to suffer from olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction. Funding Information: No funding received.Declaration of Interests: The authors declare that they have no competing interests.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315270

ABSTRACT

Background: Coronavirus disease (COVID-19) has resulted in high mortality worldwide. However, information regarding cardiac markers for precise risk-stratification is limited. We aimed to discover a sensitive and reliable early-warning biomarker for optimizing management and improving COVID-19 patients’ prognosis. Methods: : This single-center case series was conducted between February 4 and April 10, 2020. In total, 2,954 consecutive COVID-19 patients who were receiving treatment at Wuhan Huoshenshan Hospital in China were included in the retrospectively selected cohort. All patients were diagnosed with COVID-19 and treated at the study site. Data of serum levels of cardiac markers, coronary artery disease (CAD) diagnosis, and survival were collected after admission. Single-cell RNA-sequencing was performed to analyze severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor expression. Results: : Median patient age was 60 years (range, 50-68 years);1,461 (49.5%) were female, and 1,515 (51.3%) patients were in a severe/critical condition. Compared to mild/moderate patients (1,439, 48.7%), severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. Among severe/critical COVID-19 patients, those with abnormal serum levels of brain natriuretic peptide had a significantly higher mortality rate than patients with normal levels. Severe/critical COVID-19 patients with pre-existing CAD (165/1,155 [10.9%]) had more cases of abnormal brain natriuretic peptide levels than those without CAD. Enhanced SARS-CoV-2 receptor expression was observed in patients with CAD. Regression analysis revealed that patients with elevated brain natriuretic peptide levels were at a higher risk of death (hazards ratio, 1.001 [95% confidence interval, 1.0003-1.002]). Conclusions: : Brain natriuretic peptide is an effective biomarker for early risk assessment in COVID-19 patients with or without pre-existing CAD. Monitoring BNP status will improve the risk-stratification management and prognosis of patients within one week after admission.

7.
Front Psychiatry ; 12: 738610, 2021.
Article in English | MEDLINE | ID: covidwho-1686547

ABSTRACT

OBJECTIVE: Lack of information about mental health status among medical staff during the epidemic of COVID-19 in China is one of the major barriers to psychological interventions. This paper aims to evaluate the contributions of perceived psychological feelings to the symptoms of common mental disorders among medical staff during the epidemic of COVID-19 in China. METHOD: A large sample of medical staff based on a non-probability sampling design was collected from February 17 to 24, 2020. The symptoms of common mental disorders were screened based on self-reported instruments to evaluate psychological distress, anxious symptoms, and depressive symptoms during the past week. Perceived psychological feelings were based on self-report. Logistic regressions and elastic net regularizations were used to evaluate the independent effect of the psychological feelings controlled by hospitals and participants characteristics. RESULTS: Totally 4,677 medical staff completed the survey. The prevalence of psychological distress, anxious symptoms, and depressive symptoms were 15.9% (95% CI 14.8-16.9), 16.0% (95% CI 15.0-17.1), and 34.6% (95% CI 33.2-35.9). Feelings of having adequate personal protective equipment, receiving enough emotional supports from both family members and colleagues were significantly associated with fewer symptoms of common mental disorders, while the feelings of overloaded work and insufficient rest times contributed to more psychological problems. CONCLUSIONS: Psychological feelings make important contributions to the symptoms of common mental disorders of medical staff during the epidemic of COVID-19. Strategies of psychological aids or interventions could be developed based on these feelings.

8.
Small ; 18(12): e2107832, 2022 03.
Article in English | MEDLINE | ID: covidwho-1669645

ABSTRACT

The ability to detect pathogens specifically and sensitively is critical to combat infectious diseases outbreaks and pandemics. Colorimetric assays involving loop-mediated isothermal amplification (LAMP) provide simple readouts yet suffer from the intrinsic non-template amplification. Herein, a highly specific and sensitive assay relying on plasmonic sensing of LAMP amplicons via DNA hybridization, termed as plasmonic LAMP, is developed for the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) RNA detection. This work has two important advances. First, gold and silver (Au-Ag) alloy nanoshells are developed as plasmonic sensors that have 4-times stronger extinction in the visible wavelengths and give a 20-times lower detection limit for oligonucleotides over Au counterparts. Second, the integrated method allows cutting the complex LAMP amplicons into short repeats that are amendable for hybridization with oligonucleotide-functionalized Au-Ag nanoshells. In the SARS-CoV-2 RNA detection, plasmonic LAMP takes ≈75 min assay time, achieves a detection limit of 10 copies per reaction, and eliminates the contamination from non-template amplification. It also shows better detection specificity and sensitivity over commercially available LAMP kits due to the additional sequence identification. This work opens a new route for LAMP amplicon detection and provides a method for virus testing at its early representation.


Subject(s)
COVID-19 , Nucleic Acids , COVID-19/diagnosis , Humans , Molecular Diagnostic Techniques , Nucleic Acid Amplification Techniques/methods , RNA, Viral/genetics , SARS-CoV-2/genetics , Sensitivity and Specificity
9.
BMJ Open ; 12(1): e048267, 2022 Jan 03.
Article in English | MEDLINE | ID: covidwho-1604369

ABSTRACT

INTRODUCTION: Up to 80% of patients with respiratory tract infections (RTI) attending healthcare facilities in rural areas of China are prescribed antibiotics, many of which are unnecessary. Since 2009, China has implemented several policies to try to reduce inappropriate antibiotic use; however, antibiotic prescribing remains high in rural health facilities. METHODS AND ANALYSIS: A cluster randomised controlled trial will be carried out to estimate the effectiveness and cost effectiveness of a complex intervention in reducing antibiotic prescribing at township health centres in Anhui Province, China. 40 Township health centres will be randomised at a 1:1 ratio to the intervention or usual care arms. In the intervention group, practitioners will receive an intervention comprising: (1) training to support appropriate antibiotic prescribing for RTI, (2) a computer-based treatment decision support system, (3) virtual peer support, (4) a leaflet for patients and (5) a letter of commitment to optimise antibiotic use to display in their clinic. The primary outcome is the percentage of antibiotics (intravenous and oral) prescribed for RTI patients. Secondary outcomes include patient symptom severity and duration, recovery status, satisfaction, antibiotic consumption. A full economic evaluation will be conducted within the trial period. Costs and savings for both clinics and patients will be considered and quality of life will be measured by EuroQoL (EQ-5D-5L). A qualitative process evaluation will explore practitioner and patient views and experiences of trial processes, intervention fidelity and acceptability, and barriers and facilitators to implementation. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Biomedical Research Ethics Committee of Anhui Medical University (Ref: 20180259); the study has undergone due diligence checks and is registered at the University of Bristol (Ref: 2020-3137). Research findings will be disseminated to stakeholders through conferences and peer-reviewed journals in China, the UK and internationally. TRIAL REGISTRATION NUMBER: ISRCTN30652037.


Subject(s)
Anti-Bacterial Agents , Respiratory Tract Infections , Anti-Bacterial Agents/therapeutic use , China , Humans , Inappropriate Prescribing/prevention & control , Primary Health Care , Quality of Life , Randomized Controlled Trials as Topic , Respiratory Tract Infections/drug therapy
10.
Biol Pharm Bull ; 45(1): 19-26, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1599098

ABSTRACT

With the development of structural biology and data mining, computer-aided drug design (CADD) has been playing an important role in all aspects of new drug development. Reverse docking, a method of virtual screening based on molecular docking in CADD, is widely used in drug repositioning, drug rescue, and traditional Chinese medicine (TCM) research, for it can search for macromolecular targets that can bind to a given ligand molecule. This review revealed the principle of reverse docking, summarized common target protein databases and docking procedures, and enumerated the applications of reverse docking in drug repositioning, adverse drug reactions, traditional Chinese medicine, and coronavirus disease 2019 (COVID-19) treatment. Hope our work can give some inspiration to researchers engaged in drug development.


Subject(s)
Drug Design , Molecular Docking Simulation , COVID-19 , Databases, Protein , Drug Repositioning , Drug-Related Side Effects and Adverse Reactions , Humans , Medicine, Chinese Traditional , SARS-CoV-2/drug effects
11.
Vaccines (Basel) ; 9(12)2021 Nov 25.
Article in English | MEDLINE | ID: covidwho-1542820

ABSTRACT

The global Coronavirus Disease 2019 (COVID-19) pandemic has accelerated vaccine development at an unprecedented rate. A large population of people have received COVID-19 vaccines, while the vaccine safety data are limited. Here, we reported two cases of herpetic keratitis that occurred soon after receiving the inactivated COVID-19 vaccines. Case 1 was a 60-year-old woman who underwent penetrating keratoplasty (PKP) one year ago for corneal scarring caused by herpes simplex keratitis (HSK), and case 2 was a 51-year-old man with an unremarkable medical history. Both patients developed herpetic keratitis (HSK and varicella-zoster virus corneal endotheliitis, respectively) soon after receiving the inactivated COVID-19 vaccines (Sinovac). Herpetic keratitis was treated successfully with topical or plus oral antiviral ganciclovir. The short latency time in these two cases suggested that an inactivated COVID-19 vaccine may have a risk of triggering ocular herpes virus reactivation. Both clinicians and patients should be aware of this phenomenon. However, a causal relationship awaits confirmation.

12.
Endocrine ; 75(1): 1-9, 2022 01.
Article in English | MEDLINE | ID: covidwho-1491380

ABSTRACT

Type 2 diabetes (T2D) increases the risk of coronavirus disease (COVID-19). This study investigates the association between glucose control of COVID-19 patients with T2D in first 7 days after hospital admission and prognosis. A total of 252 infected inpatients with T2D in China were included. Well-controlled blood glucose was defined as stable fasting blood glucose (FBG) levels in the range of 3.9-7.8 mmol/L during first 7 days using indicators of average (FBGA), maximum (FBGM) or first-time (FBG1) FBG levels. The primary endpoint was admission to intensive care unit or death. Hazard ratio (HR) of poorly controlled glucose level group compared with well-controlled group were 4.96 (P = 0.021) for FBGM and 5.55 (P = 0.014) for FBGA. Well-controlled blood glucose levels in first 7 days could improve the prognosis of COVID-19 inpatients with diabetes.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Blood Glucose , Diabetes Mellitus, Type 2/complications , Humans , Inpatients , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2
13.
BMC Health Serv Res ; 21(1): 1048, 2021 Oct 05.
Article in English | MEDLINE | ID: covidwho-1455962

ABSTRACT

BACKGROUND: In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. METHODS: Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. RESULTS: PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. CONCLUSIONS: The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.


Subject(s)
Anti-Bacterial Agents , COVID-19 , Aged , Anti-Bacterial Agents/therapeutic use , China , Humans , Pandemics , Primary Health Care , SARS-CoV-2
14.
Front Immunol ; 12: 700449, 2021.
Article in English | MEDLINE | ID: covidwho-1325531

ABSTRACT

The identification of asymptomatic, non-severe presymptomatic, and severe presymptomatic coronavirus disease 2019 (COVID-19) in patients may help optimize risk-stratified clinical management and improve prognosis. This single-center case series from Wuhan Huoshenshan Hospital, China, included 2,980 patients with COVID-19 who were hospitalized between February 4, 2020 and April 10, 2020. Patients were diagnosed as asymptomatic (n = 39), presymptomatic (n = 34), and symptomatic (n = 2,907) upon admission. This study provided an overview of asymptomatic, presymptomatic, and symptomatic COVID-19 patients, including detection, demographics, clinical characteristics, and outcomes. Upon admission, there was no significant difference in clinical symptoms and CT image between asymptomatic and presymptomatic patients for diagnosis reference. The mean area under the receiver operating characteristic curve (AUC) of the differential diagnosis model to discriminate presymptomatic patients from asymptomatic patients was 0.89 (95% CI, 0.81-0.98). Importantly, the severe and non-severe presymptomatic patients can be further stratified (AUC = 0.82). In conclusion, the two-step risk-stratification model based on 10 laboratory indicators can distinguish among asymptomatic, severe presymptomatic, and non-severe presymptomatic COVID-19 patients on admission. Moreover, single-cell data analyses revealed that the CD8+T cell exhaustion correlated to the progression of COVID-19.


Subject(s)
Asymptomatic Infections , COVID-19/diagnosis , Aged , CD8-Positive T-Lymphocytes/pathology , China/epidemiology , Diagnosis, Differential , Disease Progression , Female , Humans , Male , Middle Aged , Models, Statistical , Prognosis , Risk Assessment , SARS-CoV-2
15.
Administrative Sciences ; 11(2):53, 2021.
Article in English | MDPI | ID: covidwho-1243940

ABSTRACT

The purpose of this study was to explore what types of digital content cultural institutions implemented during COVID-19 temporary closures and their effects on social media engagement. Existing research identified the role of digital content and social media in cultural institutions, but only in times of normal operations. This study adds to the existing literature by exploring the types of digital content implemented, impacts on social media engagement, measures of social media engagement, and future implications in regard to COVID-19 temporary closures. This study recruited 66 cultural institutions from across the United States to take part in in-depth semi-structured phone interviews to fulfill the research goals. Museums, zoos, aquariums, performing arts organizations, heritage foundations, and historical societies were represented. A qualitative approach was adopted, and content analysis on the interview transcripts indicated that cultural institutions implemented digital content to build communities through live and serialized content, partnerships, fundraising, increased transparency, and increased accessibility during temporary closures. Using primarily Instagram and Facebook with their digital content, cultural institutions increased social media engagement during this time. Although there was no consensus on best practices in measuring social media engagement, many institutions highlighted tracking active engagement such as likes, comments, and shares. As a result of the success of the digital content, cultural institutions planned continued digital content campaigns such as videos, blogs, partnerships, and paid educational content in times of normal operations.

16.
Crit Care ; 25(1): 158, 2021 04 26.
Article in English | MEDLINE | ID: covidwho-1204102

ABSTRACT

BACKGROUND: COVID-19 has resulted in high mortality worldwide. Information regarding cardiac markers for precise risk-stratification is limited. We aim to discover sensitive and reliable early-warning biomarkers for optimizing management and improving the prognosis of COVID-19 patients. METHODS: A total of 2954 consecutive COVID-19 patients who were receiving treatment from the Wuhan Huoshenshan Hospital in China from February 4 to April 10 were included in this retrospective cohort. Serum levels of cardiac markers were collected after admission. Coronary artery disease diagnosis and survival status were recorded. Single-cell RNA-sequencing and bulk RNA-sequencing from different cohorts of non-COVID-19 were performed to analyze SARS-CoV-2 receptor expression. RESULTS: Among 2954 COVID-19 patients in the analysis, the median age was 60 years (50-68 years), 1461 (49.5%) were female, and 1515 (51.3%) were severe/critical. Compared to mild/moderate (1439, 48.7%) patients, severe/critical patients showed significantly higher levels of cardiac markers within the first week after admission. In severe/critical COVID-19 patients, those with abnormal serum levels of BNP (42 [24.6%] vs 7 [1.1%]), hs-TNI (38 [48.1%] vs 6 [1.0%]), α- HBDH (55 [10.4%] vs 2 [0.2%]), CK-MB (45 [36.3%] vs 12 [0.9%]), and LDH (56 [12.5%] vs 1 [0.1%]) had a significantly higher mortality rate compared to patients with normal levels. The same trend was observed in the ICU admission rate. Severe/critical COVID-19 patients with pre-existing coronary artery disease (165/1,155 [10.9%]) had more cases of BNP (52 [46.5%] vs 119 [16.5%]), hs-TNI (24 [26.7%] vs 9.6 [%], α- HBDH (86 [55.5%] vs 443 [34.4%]), CK-MB (27 [17.4%] vs 97 [7.5%]), and LDH (65 [41.9%] vs 382 [29.7%]), when compared with those without coronary artery disease. There was enhanced SARS-CoV-2 receptor expression in coronary artery disease compared with healthy controls. From regression analysis, patients with five elevated cardiac markers were at a higher risk of death (hazards ratio 3.4 [95% CI 2.4-4.8]). CONCLUSIONS: COVID-19 patients with pre-existing coronary artery disease represented a higher abnormal percentage of cardiac markers, accompanied by high mortality and ICU admission rate. BNP together with hs-TNI, α- HBDH, CK-MB and LDH act as a prognostic biomarker in COVID-19 patients with or without pre-existing coronary artery disease.


Subject(s)
Biomarkers/blood , COVID-19/blood , COVID-19/therapy , Coronary Artery Disease/blood , Aged , COVID-19/epidemiology , China/epidemiology , Coronary Artery Disease/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment/methods
17.
Eur Radiol ; 31(10): 7342-7352, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1184662

ABSTRACT

OBJECTIVES: To investigate the association between longitudinal total pulmonary infection volume and volume ratio over time and clinical types in COVID-19 pneumonia patients. METHODS: This retrospective review included 367 patients with COVID-19 pneumonia. All patients underwent CT examination at baseline and/or one or more follow-up CT. Patients were categorized into two clinical types (moderate and severe groups). The severe patients were matched to the moderate patients via propensity scores (PS). The association between total pulmonary infection volume and volume ratio and clinical types was analyzed using a generalized additive mixed model (GAMM). RESULTS: Two hundred and seven moderate patients and 160 severe patients were enrolled. The baseline clinical and imaging variables were balanced using PS analysis to avoid patient selection bias. After PS analysis, 172 pairs of moderate patients were allocated to the groups; there was no difference in the clinical and CT characteristics between the two groups (p > 0.05). A total of 332 patients, including 396 CT scans, were assessed. The impact of total pulmonary infection volume and volume ratio with time was significantly affected by clinical types (p for interaction = 0.01 and 0.01, respectively) using GAMM. Total pulmonary infection volume and volume ratio of the severe group increased by 14.66 cm3 (95% confidence interval [CI]: 3.92 to 25.40) and 0.45% (95% CI: 0.13 to 0.77) every day, respectively, compared to that of the moderate group. CONCLUSIONS: Longitudinal total pulmonary infection volume and volume ratio are independently associated with the clinical types of COVID-19 pneumonia. KEY POINTS: • The impact of total pulmonary infection volume and volume ratio over time was significantly affected by the clinical types (p for interaction = 0.01 and 0.01, respectively) using the GAMM. • Total pulmonary infection volume and volume ratio of the severe group increased by 14.66 cm3 (95% CI: 3.92 to 25.40) and 0.45% (95% CI: 0.13 to 0.77) every day, respectively, compared to that of the moderate group.


Subject(s)
COVID-19 , Pneumonia , Humans , Lung/diagnostic imaging , Propensity Score , Retrospective Studies , SARS-CoV-2
18.
J Public Health (Oxf) ; 43(3): 508-516, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1072421

ABSTRACT

BACKGROUND: Evidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study, we examined the patterns of adherence to mitigation measures and reasons underpinning these behaviors. METHODS: Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic and to explore the reasons underpinning this behavior. RESULTS: We identified three categories of adherence to lockdown measures: (i) caution-motivated super-adherence (ii) risk-adapted partial-adherence and (iii) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures and perceived importance of/need for the behavior. CONCLUSIONS: This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.


Subject(s)
COVID-19 , Communicable Disease Control , Humans , Pandemics , Qualitative Research , SARS-CoV-2
19.
Hepatol Int ; 15(1): 202-212, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1064606

ABSTRACT

BACKGROUND: Infection with SARS-CoV-2 has been associated with liver dysfunction, aggravation of liver burden, and liver injury. This study aimed to assess the effects of liver injuries on the clinical outcomes of patients with COVID-19. METHODS: A total of 1520 patients with severe or critical COVID-19 from Huoshenshan Hospital, Wuhan, were enrolled. Chronic liver disease (CLD) was confirmed by consensus diagnostic criteria. Laboratory test results were compared between different groups. scRNA-seq data and bulk gene expression profiles were used to identify cell types associated with liver injury. RESULTS: A total of 10.98% of patients with severe or critical COVID-19 developed liver injury after admission that was associated with significantly higher rates of mortality (21.74%, p < 0.001) and intensive care unit admission (26.71%, p < 0.001). Pre-existing CLDs were not associated with a higher risk. However, fatty liver disease and cirrhosis were associated with higher risks, supported by evidences from single cell and bulk transcriptome analysis that showed more TMPRSS2+ cells in these tissues. By generating a model, we were able to predict the risk and severity of liver injury during hospitalization. CONCLUSION: We demonstrate that liver injury occurring during therapy as well as pre-existing CLDs like fatty liver disease and cirrhosis in patients with COVID-19 is significantly associated with the severity of disease and mortality, but the presence of other CLD is not associated. We provide a risk-score model that can predict whether patients with COVID-19 will develop liver injury or proceed to higher-risk stages during subsequent hospitalizations.


Subject(s)
COVID-19/complications , COVID-19/therapy , Liver Diseases/diagnosis , Liver Diseases/virology , Adult , Aged , COVID-19/mortality , China , Critical Care , Extracorporeal Membrane Oxygenation , Female , Hospitalization , Humans , Liver Diseases/mortality , Male , Middle Aged , Oxygen Inhalation Therapy , Respiration, Artificial , Risk Factors , Severity of Illness Index , Survival Rate
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