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1.
Diagnostic Microbiology and Infectious Disease ; : 115803, 2022.
Article in English | ScienceDirect | ID: covidwho-2004018

ABSTRACT

This study measured antibodies against different antigen targets in healthcare workers (HCW) who have been fully vaccinated with mRNA vaccines, recovered from natural infection, or patients during active infection. All vaccinated individuals were positive for anti-RBD, anti-S1, and anti-S2 antibodies. The non-vaccinated recovered cohort showed 90% seropositivity by Atellica total antibody, 73% by Atellica IgG, 84% by Bioplex anti-RBD, 77% by Bioplex anti-S1, 37% by Bioplex anti-S2, and 79% by Bioplex anti-nucleocapsid respectively. The active infection cohort exhibited a similar pattern as the recovered cohort. About 88% and 78% of the recovered and active infection cohort produced both anti-spike and anti-N antibodies with Anti-S1/anti-N ratios ranging from 0.07-16.26. In summary, fully vaccinated individuals demonstrated an average of 50-fold higher antibody levels than naturally infected unvaccinated individuals with immune reactivity strongly towards RBD/S1 and a weak response to S2. The results support vaccination regardless of previous COVID-infection status.

2.
Mult Scler Relat Disord ; 61: 103785, 2022 May.
Article in English | MEDLINE | ID: covidwho-1763908

ABSTRACT

BACKGROUND & OBJECTIVES: Certain disease modifying therapies may negatively impact the humoral response to SARS-CoV-2 vaccines. Many MS related clinical, demographic, and immunological characteristics can also affect vaccine response but those have not been fully explored. This study aimed to investigate potential correlations between clinical, demographic, and immunological variables in MS patients to post-vaccination spike protein antibody positivity rates and levels. METHODS: Patients with MS and related neuroimmunological disorders who requested verification of the immune response to the SARS-COV-2 vaccine were tested for the spike protein antibody from January to October 2021. We performed an exploratory analysis to compare patients with positive versus negative spike protein antibody. RESULTS: Fifty patients (mean age 53 ±12, 78% females) were included. There were 29 patients with positive post-vaccination spike protein antibody (58%) and 21 with negative antibody (42%). Patients with negative antibody were more likely to have been on B-cell therapy (86% vs 31%, P=.001) while positive patients were more likely to have been on a fumarate (31% vs 4.8%, P=.03). Thirty percent of positive patients on fumarate therapy had mild lymphopenia. No differences existed between groups in gender, age, race, disease phenotype, vaccine brand, and lymphocyte counts. Among patients on B-cell therapy, 33% had a positive spike protein antibody. There was an association between detectable CD19 cells at time of vaccination and positive humoral response to vaccination (P=0.049). There was no relationship between subgroups in terms of vaccine timing relative to B-cell therapy dose. Hypogammaglobulinemia was not associated with seroconversion rates, however it was associated with decreased quantitative spike protein antibody levels (p=0.045). DISCUSSION: B-cell therapy is associated with a negative humoral response to SARS-COV-2 vaccines. Patients on B-cell depleting therapy with detectable CD19 counts at the time of vaccination were associated with a positive humoral response. There was no relationship between hypogammaglobinemia and seroconversion rate, however it was associated with decreased spike protein antibody levels. The fumarates are associated with positive humoral response even in the presence of mild lymphopenia.


Subject(s)
COVID-19 , Lymphopenia , Multiple Sclerosis , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines , Female , Fumarates , Humans , Lymphocyte Count , Male , Multiple Sclerosis/drug therapy , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/therapeutic use , Vaccination
3.
Turkish Journal of Computer and Mathematics Education ; 12(11):4184-4192, 2021.
Article in English | ProQuest Central | ID: covidwho-1743518

ABSTRACT

The sudden attack of COVID-19 has brought more unstable factors to the economic development of China and even the world. The risk fluctuation in the market has attracted the attention of all parties in the risk game.In this paper, the KMV model is used to measure credit risk. Taking the listed companies that issued Ashares and issued credit bonds in Shanghai and Shenzhen Stock Exchange as samples from 2016 to 2020, the validity of the model is verified at first.It is found that the average DD of the companies listed in Shanghai Stock Exchange is slightly higher than that of the companies listed in Shenzhen Stock Exchange from 2016 to 2020.In 2017, the overall default risk of the sample increased year by year after the minimum;Through the fluctuation of DD mean value in recent 3 years, it is found that the credit risk course of the whole industry is rising, which is related to the impact of the epidemic in 2020 on the industry economy.

4.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327109

ABSTRACT

Antibody profiling of vaccinated versus naturally infected individuals is important in evaluating immunity and aiding diagnosis and booster strategies. This study measured antibodies against different antigen targets in healthcare workers (HCW) who have been fully vaccinated with mRNA vaccines, recovered from natural infection, or patients during active infection. All vaccinated individuals were positive for anti-RBD, anti-S1, and anti-S2 antibodies. The median index and interquartile range (IQR) by the Atellica IgG assay were 179 and 140-291 respectively. Among the different antigen targets within the Bioplex assay, the levels of anti-RBD were highest (median >3200 U/mL;IQR >3200 to >3200 U/mL), followed by anti-S1 (median 2132 U/mL;IQR 1649->3200 U/mL) and anti-S2 (median=42 U/mL;IQR=24-76 U/mL). The non-vaccinated recovered cohort showed 90% seropositivity (median index >10;IQR 3.6->10) by Atellica total antibody, 73% by Atellica IgG (median index 3.3;IQR 0.9-9.4), 84% by Bioplex anti-RBD (median 62;IQR 12-269 U/mL), 77% by Bioplex anti-S1 (median 45;IQR 10-83 U/mL), 37% by Bioplex anti-S2 (median 7;IQR 1-12 U/mL), and 79% by Bioplex anti-nucleocapsid (median 69;IQR 20-185U/mL) respectively. The active infection cohort exhibited a similar pattern as the recovered cohort. About 88% and 78% of the recovered and active infection cohort produced both anti-spike and anti-N antibodies with Anti-S1/anti-N ratios ranging from 0.07-16.26. In summary, fully vaccinated individuals demonstrated an average of 50-fold higher antibody levels than naturally infected unvaccinated individuals with immune reactivity strongly towards RBD/S1 and a weak response to S2. The results support vaccination regardless of previous COVID-infection status.

5.
Molecules ; 26(23)2021 Dec 05.
Article in English | MEDLINE | ID: covidwho-1555019

ABSTRACT

SARS-CoV-2 is highly homologous to SARS-CoV. To date, the main protease (Mpro) of SARS-CoV-2 is regarded as an important drug target for the treatment of Coronavirus Disease 2019 (COVID-19). Some experiments confirmed that several HIV protease inhibitors present the inhibitory effects on the replication of SARS-CoV-2 by inhibiting Mpro. However, the mechanism of action has still not been studied very clearly. In this work, the interaction mechanism of four HIV protease inhibitors Darunavir (DRV), Lopinavir (LPV), Nelfinavir (NFV), and Ritonavire (RTV) targeting SARS-CoV-2 Mpro was explored by applying docking, molecular dynamics (MD) simulations, and MM-GBSA methods using the broad-spectrum antiviral drug Ribavirin (RBV) as the negative and nonspecific control. Our results revealed that LPV, RTV, and NFV have higher binding affinities with Mpro, and they all interact with catalytic residues His41 and the other two key amino acids Met49 and Met165. Pharmacophore model analysis further revealed that the aromatic ring, hydrogen bond donor, and hydrophobic group are the essential infrastructure of Mpro inhibitors. Overall, this study applied computational simulation methods to study the interaction mechanism of HIV-1 protease inhibitors with SARS-CoV-2 Mpro, and the findings provide useful insights for the development of novel anti-SARS-CoV-2 agents for the treatment of COVID-19.


Subject(s)
COVID-19/drug therapy , Coronavirus 3C Proteases/chemistry , Drug Design , HIV Protease Inhibitors/chemistry , Humans , Protein Binding
6.
Chinese Journal of Information on Traditional Chinese Medicine ; 27(9):21-24, 2020.
Article in Chinese | CAB Abstracts | ID: covidwho-1352868

ABSTRACT

Moyuan Theory believes that Li Qi (e pidemic miasma) causes diseases, and it is lurking in Moyuan (interpleuro-diaphragmatic space). The main treatment method in clinic is to expel Li Qi. This theory has long been used to guide the treatment of plague. This article combined the literature reports published since the outbreak of coronavirus disease 2019 to explore the application significance of Moyuan Theory in this disease, so as to provide a reference for the treatment of viral infectious diseases.

7.
J Gastroenterol Hepatol ; 36(3): 694-699, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1301516

ABSTRACT

BACKGROUND AND AIM: Patients with 2019 novel coronavirus disease (COVID-19) could present with gastrointestinal symptoms without fever or respiratory manifestations, which could be overlooked by health-care providers. We aimed to evaluate the clinical characteristics of COVID-19 in patients presenting with initial gastrointestinal symptoms. METHODS: We evaluated all confirmed cases of COVID-19 in Zhongnan Hospital of Wuhan University between January 10 and February 29, 2020. We divided these patients into two groups: patients with initial gastrointestinal symptoms (group A, n = 183) and patients with respiratory syndrome and/or fever (group B, n = 1228). The clinical characteristics, radiological features, and laboratory data were assessed. RESULTS: The clinical procedures of both groups underwent 1-2 weeks rising period and were downward trend at 3 weeks; less than 5% of patients progressed to critical illness. In both groups, mean leukocyte count (P = 0.354) and lymphocyte count (P = 0.386) were below normal, and C-reactive protein level was elevated (P = 0.412). There was mild liver function injury (aspartate aminotransferase, 65.8 ± 12.7 vs 67.4 ± 9.3 U/L, P = 0.246; alanine aminotransferase, 66.4 ± 13.2 vs 69.6 ± 12.7 U/L, P = 0.352), and normal renal function was intact (blood urea nitrogen 6.4 ± 2.5 vs 5.6 ± 2.8 mmol/L P = 0.358; creatinine 85.7 ± 37.2, 91.2 ± 32.6 µmol/L, P = 0.297). After a series of treatment, 176 and 1169 were stable and alive in groups A and B, respectively. The survival rate did not differ significantly between the groups (P = 0.313). CONCLUSION: COVID-19 patients presented with initial gastrointestinal symptoms had similar clinical characteristics and outcomes, when compared with patients with fever and respiratory symptoms.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Gastrointestinal Diseases/virology , Adult , Aged , COVID-19/complications , COVID-19/mortality , Case-Control Studies , China/epidemiology , Female , Gastrointestinal Diseases/epidemiology , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Severity of Illness Index , Survival Analysis
8.
Patterns (N Y) ; 1(9): 100173, 2020 Dec 11.
Article in English | MEDLINE | ID: covidwho-1265822

ABSTRACT

[This corrects the article DOI: 10.1016/j.patter.2020.100092.].

9.
Risk Manag Healthc Policy ; 14: 1805-1813, 2021.
Article in English | MEDLINE | ID: covidwho-1229115

ABSTRACT

INTRODUCTION: Due to COVID-19 outbreak, since January 24, 2020, national medical teams from across the country and the armed forces have been dispatched to aid Hubei. The present review was designed to timely summarize the existing frontline information about nursing scheduling mode with special focus on the length of shifts with the aim to contribute to improve the nurses' job satisfaction and the quality of nursing services. METHODS: Articles from Jan 2020 to October 2020 were retrieved from China National Knowledge Infrastructure, Wanfang Data and Weipu Information, with the terms "COVID-19", "designated hospital", "Hubei-assisted", "makeshift hospital", "nursing", "nursing shift", "whole-system takeover" and variations of these, in the title and abstract fields and the Boolean combinations of these words as the retrieval strategy. RESULTS: Seventeen journal articles have been included in the target field, from the nurses in aiding Hubei Province, four kinds of shift length, 2-hour (h), 3-h, 4-h and 6-h shift have been considered, the main nursing scheduling mode adopted in designated hospitals for COVID-19 patients was dynamic scheduling based on workload, flexible scheduling based on working hours, workload and the number of critically ill patients admitted, humanized scheduling based on the daily reported health status of the nurses, and professional-integrated scheduling according to the professional distribution of nurses on the basis of four-hour shift length, and in makeshift hospitals for mild patients, the scheduling mode was 6-h based correspondingly. CONCLUSION: The descriptive results of the present systematic review shed light on the challenges and practical solutions of nursing scheduling mode in the context of cross-regional medical assistance. Additionally, the present systematic review could provide the academic community of nurses, nurse managers and administrators with baseline information and scientific productions from the content's points of view in the target field.

10.
Radiol Cardiothorac Imaging ; 2(2): e200126, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-1155978

ABSTRACT

PURPOSE: To compare radiologic characteristics of coronavirus disease 2019 (COVID-19) pneumonia at thin-section CT on admission between patients with mild and severe disease. MATERIALS AND METHODS: Seventy patients with COVID-19 pneumonia who were admitted to Zhongnan Hospital of Wuhan University between January 20, 2020 and January 27, 2020 were enrolled. On the basis of the World Health Organization guidelines, 50 patients were categorized with the mild form and 20 with the severe form based on clinical conditions. Imaging features, clinical, and laboratory data were reviewed and compared. RESULTS: Patients with the severe form (median age, 65 years; interquartile range [IQR]: 54.75-75.00 years) were older than those with the mild form of disease (median age, 42.5 years; IQR: 32.75-58.50 years) (P < .001). Patients with the severe form of disease had more lung segments involved (median number of segments: 17.5 vs 7.5, P ≤ .001) and also larger opacities (median number of segments with opacities measuring 3 cm to less than 50% of the lung segment: 5.5 vs 2.0, P = .006; ≥ 50% of lung segment: 7.5 vs 0.0, P < .001). They also had more interlobular septal thickening (75% vs 28%, P < .001), higher prevalence of air bronchograms (70% vs 32%, P = .004), and pleural effusions (40% vs 14%, P = .017). CONCLUSION: Ground-glass opacities with or without consolidation in a peripheral and basilar predominant distribution were the most common findings in COVID-19 pneumonia. Patients with the severe form of the disease had more extensive opacification of the lung parenchyma than did patients with mild disease. Interlobular septal thickening, air bronchograms, and pleural effusions were also more prevalent in severe COVID-19.© RSNA, 2020.

11.
Zhongguo Fei Ai Za Zhi ; 24(1): 31-35, 2021 Jan 20.
Article in Chinese | MEDLINE | ID: covidwho-1044653

ABSTRACT

Lung cancer is the malignant tumor with the highest incidence in China. Early detection and identification of symptomatic lung cancer patients and timely screen out asymptomatic patients from high-risk groups require multiple cooperation. At present, although combined imaging, serology, genomics, proteomics and other methods have been combined to screen for suspected lung cancer, there are still problems such as missed diagnosis and misdiagnosis. Meanwhile, the spread of the corona virus disease 2019 (COVID-19) epidemic has brought new challenges to early lung cancer screening. Under the normalization of epidemic prevention and control, the work of early lung cancer screening should be changed accordingly: improve the population's awareness of cancer prevention and control, strengthen the management of medical procedures, improve the efficiency of tumor detection, optimize detection technology, and utilize internet and big data platforms rationally. We should establish an ideal model, combining multiple screening methods, which is streamlined and efficient for early lung cancer screening under normal epidemic prevention and control.
.


Subject(s)
COVID-19/epidemiology , Lung Neoplasms/diagnosis , China/epidemiology , Early Detection of Cancer , Epidemics , Humans , Lung Neoplasms/prevention & control
12.
Travel Med Infect Dis ; 39: 101950, 2021.
Article in English | MEDLINE | ID: covidwho-966342

ABSTRACT

BACKGROUND: To investigate and compare the clinical and imaging features among family members infected with COVID-19. METHODS: We retrospectively collected a total of 34 COVID-19 cases (15 male, 19 female, aged 48 ± 16 years, ranging from 10 to 81 years) from 13 families from January 17, 2020 through February 15, 2020. Patients were divided into two groups: Group 1 - part of the family members (first-generation) who had exposure history and others (second-generation) infected through them, and Group 2 - patients from the same family having identical exposure history. We collected clinical symptoms, laboratory findings, and high-resolution computed tomography (HRCT) features for each patient. Comparison tests were performed between the first- and second-generation patients in Group 1. RESULTS: In total there were 21 patients in Group 1 and 20 patients in Group 2. For Group 1, first-generation patients had significantly higher white blood cell count (6.5 × 109/L (interquartile range (IQR): 4.9-9.2 × 109/L) vs 4.5 × 109/L (IQR: 3.7-5.3 × 109/L); P = 0.0265), higher neutrophil count (4.9 × 109/L (IQR: 3.6-7.3 × 109/L) vs 2.9 × 109/L (IQR: 2.1-3.3 × 109/L); P = 0.0111), and higher severity scores on HRCT (3.9 ± 2.4 vs 2.0 ± 1.3, P = 0.0362) than the second-generation patients. Associated underlying diseases (odds ratio, 8.0, 95% confidence interval: 3.4-18.7, P = 0.0013) were significantly correlated with radiologic severity scores in second-generation patients. CONCLUSION: Analysis of the family cluster cases suggests that COVID-19 had no age or sex predominance. Secondarily infected patients in a family tended to develop milder illness, but this was not true for those with existing comorbidities.


Subject(s)
COVID-19/pathology , Family , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , Child , China/epidemiology , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Young Adult
13.
Comb Chem High Throughput Screen ; 24(7): 1069-1082, 2021.
Article in English | MEDLINE | ID: covidwho-892411

ABSTRACT

Aims & Objective: Coronavirus Disease 2019 (COVID-19) caused by the human coronavirus 2019 (HCoV-19, also known as SARS-CoV-2) infection is currently in a global outbreak. COVID-19 has posed a huge threat to public health and economic stability worldwide. CR3022, a human monoclonal neutralizing antibody isolated from a Severe Acute Respiratory Syndrome (SARS) recovery patient, was confirmed to be able to bind the S protein of HCoV-19 with a certain degree of neutralizing activity. Crystal structural information indicated that CR3022 could bind to the epitope on the receptor binding domain (RBD) of HCoV-19, whose epitope consists of 28 amino acids, and 24 of them are conserved in SARS-CoV of SARS. However, the crystal structure is only a static conformation at a certain moment in time, and it cannot provide dynamic details of the interaction between antigen and antibody. METHODS: In this study, molecular dynamics (MD) simulation combined with MM/PBSA and CAS methods were performed to investigate the mechanism of binding of CR3022 against SARS-CoVRBD and HCoV-19-RBD in order to determine their holographic dynamic information. RESULTS: It was found that the CR3022-SARS-CoV-RBD complex was more stable during 100ns MD run than that of the CR3022-HCoV-19-RBD system. There were common conservative amino acids on the ß2 sheet of RBD, including Tyr369, Phe377, Lys378, Tyr380, Gly381, Lys386, Leu390 and others. These conservative amino acids play significant roles in the binding process of CR3022 antibody against SARS-CoV-RBD and HCoV-19-RBD. It was also found that the binding mode of CR3022 to its native target SARS-CoV-RBD is more comprehensive and uniform. Moreover, the ß2 sheet residue Thr385 and non-ß2 sheet residues Arg408 and Asp428 of the CR3022-SARS-CoV-RBD system were found to be crucial for their binding affinities, thus forming a special conformational epitope. However, these key amino acids are not present in the CR3022-HCoV-19-RBD system. The binding mode of CR3022 and HCoV-19-RBD is similar to that of SARS-CoV-RBD, but the deficiency of crucial hydrogen-bonds and salt-bridges. Therefore, the binding of CR3022 and HCoV-19-RBD only draws on the partial mode of the binding of CR3022 and SARS-CoV-RBD, so there is a loss of affinity. CONCLUSION: Thus, in order to better fight the epidemic of COVID-19 with the CR3022 antibody, this antibody needs to further improve the neutralization efficiency of HCoV-19 through mutation of it's CDR region.


Subject(s)
Antibodies, Monoclonal/metabolism , Antibodies, Neutralizing/metabolism , COVID-19/virology , Computational Biology , SARS Virus/metabolism , SARS-CoV-2/metabolism , Binding Sites, Antibody , Epitopes/metabolism , Humans , Molecular Dynamics Simulation
14.
Radiol Infect Dis ; 7(4): 208-212, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-872302

ABSTRACT

The coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China on December 2019 and has become a severe public health issue worldwide. A 36-year-old man was presented to the hospital staff with a fever that had already persisted for a three-day period, general weakness and diarrhea. He had no chronic diseases and was tested positive for COVID-19 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid. During his hospitalization, several abnormal indicators appeared in his laboratory tests, which implied systemic inflammation and multiple organ damage. A series of chest radiographs monitored the dynamic process of lung lesions, which could predict the clinical changes of the patient. His condition deteriorated rapidly, resulting in death due to acute respiratory distress syndrome (ARDS) on hospital day 13. The case indicates that inflammatory response may appear in people infected with SARS-CoV-2 and may lead to multiple organ damage (especially pancreatic damage). When a COVID-19 patient is entering into the critical stage, their condition could rapidly deteriorate.

15.
CAplus; 2020.
Preprint | CAplus | ID: ppcovidwho-2037

ABSTRACT

A review. Moyuan Theory believes that LQcauses disease, and it is lurking in Moyuan. The main treatment method is to expel LQin clinic. And this theory has long been used to guide the treatment of plague. This article combines the literature reports published since the outbreak of Corona Virus Disease 2019 to explore the application significance of membrane theory in this Disease1and so as to provide a reference for the treatment of viral infectious diseases.

16.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-733

ABSTRACT

Background: We aimed to evaluate the clinical characteristics of 2019 novel coronavirus disease (COVID-19) in patients presenting with gastrointestinal symptoms

17.
Infect Agent Cancer ; 15: 56, 2020.
Article in English | MEDLINE | ID: covidwho-788704

ABSTRACT

The rapid growth of 2019 novel coronavirus (COVID-19) outbreak in Wuhan, China, at the early December 2019. COVID-19 spread all over the word just a few months. The outbreak of COVID-19 infection poses major threat to international health and economy. World Health Organization (WHO) announced that the new coronavirus was an international public health emergency on January 30, 2020. However, with the spread of COVID-19, the routine medical care of lung cancer patients was affected. Because lung cancer patients have low immunity after anti-tumor treatment, they should become the main targets for epidemic prevention. Lung cancer patients are increasingly concerned about the prevention of COVID-19. It is necessary to provide individualized medical treatment and management for lung cancer patients based on patients' conditions and regional epidemic patterns.

18.
Mil Med Res ; 7(1): 41, 2020 09 04.
Article in English | MEDLINE | ID: covidwho-745023

ABSTRACT

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, coronavirus disease 2019 (COVID-19), affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage, we have issued "A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)"; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas: chemoprophylaxis, diagnosis, treatments, and discharge management. We searched the literature for direct evidence on the management of COVID-19, and assessed its certainty generated recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. Finally, we issued 34 statements. Among them, 6 were strong recommendations for, 14 were weak recommendations for, 3 were weak recommendations against and 11 were ungraded consensus-based statement. They covered topics of chemoprophylaxis (including agents and Traditional Chinese Medicine (TCM) agents), diagnosis (including clinical manifestations, reverse transcription-polymerase chain reaction (RT-PCR), respiratory tract specimens, IgM and IgG antibody tests, chest computed tomography, chest x-ray, and CT features of asymptomatic infections), treatments (including lopinavir-ritonavir, umifenovir, favipiravir, interferon, remdesivir, combination of antiviral drugs, hydroxychloroquine/chloroquine, interleukin-6 inhibitors, interleukin-1 inhibitors, glucocorticoid, qingfei paidu decoction, lianhua qingwen granules/capsules, convalescent plasma, lung transplantation, invasive or noninvasive ventilation, and extracorporeal membrane oxygenation (ECMO)), and discharge management (including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge). We also created two figures of these recommendations for the implementation purpose. We hope these recommendations can help support healthcare workers caring for COVID-19 patients.


Subject(s)
Chemoprevention/methods , Clinical Laboratory Techniques/methods , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Adult , Betacoronavirus , COVID-19 , COVID-19 Testing , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Evidence-Based Medicine , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Patient Discharge/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , SARS-CoV-2
19.
Front Oncol ; 10: 1345, 2020.
Article in English | MEDLINE | ID: covidwho-698288

ABSTRACT

Abnormal coagulation parameters and potential benefits of anticoagulant therapy in general population with novel coronavirus pneumonia (COVID-19) have been reported. However, limited data are available on cancer patients. Coagulation indexes and inflammation parameters in 57 cancer patients with SARS-CoV-2 infection with different severity were retrospectively analyzed. We found that D-dimer levels were increased in 33 patients (57.9%, median: 790 ng/mL). Compared with ordinary type patients, severe and critical ill patients had decreased MPV values (P = 0.006), prolonged PT (median: 13.3 vs. 11.5 vs. 11.4 s, P < 0.001), significant higher D-dimer levels (median: 2,400 vs. 940 vs. 280 ng/mL, P < 0.001), higher PCT levels (median: 0.17 vs. 0.055 vs. 0.045 ng/mL, P = 0.002), higher IL-6 (median: 20.6 vs. 2.3 vs. 3.0 pg/mL, P = 0.040), and decreased PaO2 (median: 68 vs. 84 vs. 96 mm Hg, P < 0.001). Importantly, three patients, one severe and two critical ill type, with increased D-dimer survived after anticoagulant therapy with continuous heparin infusion. Increased D-dimer levels positively correlated with increased PCT levels (r = 0.456, P = 0.002) and IL-6 levels (r = 0.501, P = 0.045). A negative correlation between D-dimer levels and PaO2 levels (r = -0.654, P = 0.021) were also existed. Cancer patients with COVID-19 showed prominent hypercoagulability associated with severe inflammation, anticoagulation therapy might be useful to improve the prognosis and should be immediately used after the onset of hypercoagulability.

20.
Cureus ; 12(6): e8915, 2020 Jun 29.
Article in English | MEDLINE | ID: covidwho-693652

ABSTRACT

While the majority of pediatric coronavirus disease 2019 (COVID-19) cases have not been critical, occurrences of a multisystem inflammatory syndrome in children (MIS-C) have been emerging as the pandemic progresses. Herein, we report our experience with a pediatric COVID-19 case that presented with shock and multisystem inflammation. Our patient notably had multiple negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) assays but tested positive for SARS-CoV-2 IgG antibody. This case not only highlights the utility of SARS-CoV-2 IgG in the diagnosis of COVID-19 when RT-PCR is negative but suggests MIS-C may be a post-infectious immune-mediated process.

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