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1.
Indian Journal of Heterocyclic Chemistry ; 32(4):429-432, 2022.
Article in English | Scopus | ID: covidwho-2207689

ABSTRACT

Nirmatrelvir is an effective ingredient in the anti COVID-19 drug Paxlovid. There were two key steps in the original synthetic route, which involved trifluoroacetylation and dehydration. A facile and efficient synthesis of nirmatrelvir is described in this work. Intermediate 7 was converted to nirmatrelvir in one-pot synthesis with trifluoroacetic anhydride. In addition, the condensation and deprotection conditions were optimized. The yield of nirmatrelvir produced from 1raised from 51.6% to 72.5%. © 2023,Cleveland Clinic Journal of Medicine.All Rights Reserved.

2.
International Journal of Environmental Research and Public Health ; 20(1) (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2215911

ABSTRACT

The COVID-19 pandemic highlighted the intricate relationships between human health and the social-ecological system in an era of climate and global change. Widespread COVID-19 adversely affected farmers' employment, production practices, and livelihood resilience. At the same time, climate change is a key issue limiting agricultural production worldwide. Emissions of greenhouse gases, such as carbon dioxide, are a major factor leading to global climate change. Greenhouse gas emissions from agricultural production are receiving increasing attention. Therefore, it is particularly important to develop low-carbon agriculture. Based on data from 920 family farms in Jiangsu province and Shaanxi province, this study constructs a structural equation model and empirically tests the relationship between the variables using the bootstrap method. The results show that: (1) climate change awareness did not directly stimulate farmers' willingness to pursue low-carbon production;(2) climate change awareness has an impact on low-carbon production willingness through perceived ease of use and consequence awareness;and (3) anti-risk ability can effectively moderate the impact of climate change awareness on low-carbon production behavior in agriculture. The theoretical model framework proposed in this study provides a reference for research in the field of low-carbon agriculture and also provides some insights and suggestions for environmentalists and governments. In addition, policymakers should effectively raise the sense of responsibility of farmers to address climate change and promote low-carbon agricultural production to achieve healthy and sustainable agricultural development. Copyright © 2022 by the authors.

3.
Frontiers in Public Health ; 10:993831, 2022.
Article in English | MEDLINE | ID: covidwho-2215425

ABSTRACT

Aim: COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health.

4.
Frontiers in Public Health ; 10:982289, 2022.
Article in English | MEDLINE | ID: covidwho-2215416

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) has caused massive infections and large death tolls worldwide. Despite many studies on the clinical characteristics and the treatment plans of COVID-19, they rarely conduct in-depth prognostic research on leveraging consecutive rounds of multimodal clinical examination and laboratory test data to facilitate clinical decision-making for the treatment of COVID-19. To address this issue, we propose a multistage multimodal deep learning (MMDL) model to (1) first assess the patient's current condition (i.e., the mild and severe symptoms), then (2) give early warnings to patients with mild symptoms who are at high risk to develop severe illness. In MMDL, we build a sequential stage-wise learning architecture whose design philosophy embodies the model's predicted outcome and does not only depend on the current situation but also the history. Concretely, we meticulously combine the latest round of multimodal clinical data and the decayed past information to make assessments and predictions. In each round (stage), we design a two-layer multimodal feature extractor to extract the latent feature representation across different modalities of clinical data, including patient demographics, clinical manifestation, and 11 modalities of laboratory test results. We conduct experiments on a clinical dataset consisting of 216 COVID-19 patients that have passed the ethical review of the medical ethics committee. Experimental results validate our assumption that sequential stage-wise learning outperforms single-stage learning, but history long ago has little influence on the learning outcome. Also, comparison tests show the advantage of multimodal learning. MMDL with multimodal inputs can beat any reduced model with single-modal inputs only. In addition, we have deployed the prototype of MMDL in a hospital for clinical comparison tests and to assist doctors in clinical diagnosis.

5.
Front Psychiatry ; 13, 2022.
Article in English | PubMed Central | ID: covidwho-2215397

ABSTRACT

Backgrounds: Recent studies have shown that the qualities of children and adolescents' positive youth development (PYD) enable them to cope with developmental challenges in an adaptive manner and maintain healthy functioning. During the COVID-19 pandemic, there is still a lack of reporting on changes in children and adolescents' PYD qualities and Internet addiction and their relationship. This study investigated the association between PYD qualities and Internet addiction among the children and adolescents who have experienced the COVID-19 lockdown. Methods: A school-based cohort survey was launched in December 2019 (Wave 1, before COVID-19 lockdown) and followed up in June 2020 (Wave 2, after COVID-19 lockdown). The Chinese PYD scale (80 items, scoring 80–480) and Young's Internet addiction test (20 items, scoring 20–100) were used to evaluate the children and adolescents' PYD qualities and the degree of their Internet addiction, respectively. Cross-sectional regressions, longitudinal regressions, and cross-lagged panel model were used to examine the association between PYD qualities and Internet addiction. Results: 7,985 children and adolescents completed both waves of surveys. Compared with children and adolescents before lockdown (Wave 1), their total PYD quality dropped from 4.99 to 4.96 after COVID-19 lockdown (Wave 2), and the mean score for Internet addiction rose from 35.56 to 36.16. Cross-sectional analysis showed that after controlling for basic characteristics such as age and gender, the total PYD quality of children and adolescents in two waves was negatively correlated with the degree of Internet addiction during the same period, with β of −6.10 and −6.95, respectively. Longitudinal analysis showed that after controlling for basic characteristics, children and adolescents' total PYD quality in Wave 1 was negatively correlated with the Wave 2 of Internet addiction and the change between the two waves of Internet addiction, with β of −3.35 and −0.26, respectively. Cross-lagged panel models showed a negative bilateral relationship between total PYD quality and Internet addiction. Conclusion: During the COVID-19 pandemic, the qualities of children and adolescents' PYD declined, which makes children and adolescents more vulnerable to Internet addiction. Therefore, it is necessary to widely implement programs in China that can comprehensively improve the qualities of children and adolescents' positive development to prevent Internet addiction, especially after the blockade due to public health emergencies.

6.
JMIR public health and surveillance ; 9:e40201, 2023.
Article in English | EMBASE | ID: covidwho-2215068

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, infodemic spread even more rapidly than the pandemic itself. The COVID-19 vaccine hesitancy has been prevalent worldwide and hindered pandemic exiting strategies. Misinformation around COVID-19 vaccines is a vital contributor to vaccine hesitancy. However, no evidence systematically summarized COVID-19 vaccine misinformation. OBJECTIVE(S): This review aims to synthesize the global evidence on misinformation related to COVID-19 vaccines, including its prevalence, features, influencing factors, impacts, and solutions for combating misinformation. METHOD(S): We performed a systematic review by searching 5 peer-reviewed databases (PubMed, Embase, Web of Science, Scopus, and EBSCO). We included original articles that investigated misinformation related to COVID-19 vaccines and were published in English from January 1, 2020, to August 18, 2022. We excluded publications that did not cover or focus on COVID-19 vaccine misinformation. The Appraisal tool for Cross-Sectional Studies, version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2), and Critical Appraisal Skills Programme Checklist were used to assess the study quality. The review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and registered with PROSPERO (CRD42021288929). RESULT(S): Of the 8864 studies identified, 91 observational studies and 11 interventional studies met the inclusion criteria. Misinformation around COVID-19 vaccines covered conspiracy, concerns on vaccine safety and efficacy, no need for vaccines, morality, liberty, and humor. Conspiracy and safety concerns were the most prevalent misinformation. There was a great variation in misinformation prevalence, noted among 2.5%-55.4% in the general population and 6.0%-96.7% in the antivaccine/vaccine hesitant groups from survey-based studies, and in 0.1%-41.3% on general online data and 0.5%-56% on antivaccine/vaccine hesitant data from internet-based studies. Younger age, lower education and economic status, right-wing and conservative ideology, and having psychological problems enhanced beliefs in misinformation. The content, format, and source of misinformation influenced its spread. A 5-step framework was proposed to address vaccine-related misinformation, including identifying misinformation, regulating producers and distributors, cutting production and distribution, supporting target audiences, and disseminating trustworthy information. The debunking messages/videos were found to be effective in several experimental studies. CONCLUSION(S): Our review provides comprehensive and up-to-date evidence on COVID-19 vaccine misinformation and helps responses to vaccine infodemic in future pandemics. TRIAL REGISTRATION: PROSPERO CRD42021288929;https://tinyurl.com/2prejtfa. Copyright ©Sihong Zhao, Simeng Hu, Xiaoyu Zhou, Suhang Song, Qian Wang, Hongqiu Zheng, Ying Zhang, Zhiyuan Hou. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 11.01.2023.

7.
Virology Journal ; 20(1):13, 2023.
Article in English | MEDLINE | ID: covidwho-2214603

ABSTRACT

BACKGROUND: Porcine epidemic diarrhea virus (PEDV) variant strains cause great economic losses to the global swine industry. However, vaccines do not provide sufficient protection against currently circulating strains due to viral mutations. This study traced the molecular characteristics of the most recent isolates in China and aimed to provide a basis for the prevention and treatment of PEDV.

8.
15th International Congress on Image and Signal Processing, BioMedical Engineering and Informatics, CISP-BMEI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2213167

ABSTRACT

In the face of the serious aging of the global population and the sudden outbreak of COVID-19, monitoring human vital signs such as heart rate is very important to save lives. For more accurate heartbeat detection, we propose a heartbeat detection scheme based on variational mode decomposition (VMD) and multiple technologies of noise and interference suppression. First, a filter is designed to suppress the impulse noise and reduce the loss of useful signal information. Then, VMD is performed to decompose the pre-processed vital signs into a series of intrinsic mode function (IMF) components. Thirdly, much attention is paid on denoising of IMF components corresponding to the heartbeat signals, an improved wavelet threshold denoising method is proposed to process these IMF components and reconstruct the heartbeat signal. Finally, an adaptive notch filter is used to process the residual respiratory harmonics in the reconstructed heartbeat signal. To verify the heartbeat detection accuracy of our method, the results are compared with a reliable reference sensor. Our results show that the mean average absolute error (AAE) of heart rate estimated by the proposed method is 1.06 bpm, which is 7.51 bpm better than the original method. © 2022 IEEE.

9.
J Occup Environ Med ; 2023.
Article in English | PubMed | ID: covidwho-2212988

ABSTRACT

OBJECTIVE: To identify stressors faced by essential workers amid the COVID-19 pandemic and effective interventions mitigating these stressors. METHODS: We reviewed literature on psychosocial, organizational, and environmental stressors faced by essential workers during the pandemic, the consequences of those stressors, and interventions to improve worker health and wellbeing. FINDINGS: Stressors included elevated risk of COVID-19 exposure, fear of spreading the virus, lack of social and organizational supports, and financial insecurity. Negative outcomes included burnout, depression, and high turnover. Promising interventions included robust safety protocols, increased wages, childcare benefits, enhanced access to mental health services, and frequent leadership communications. CONCLUSION: Stress has taken a heavy toll on essential workers' physical and emotional health, productivity, and job satisfaction. To effectively protect Total Worker Health®, employers should adopt evidence-based interventions promoting psychosocial, organizational, and environmental health and safety.

11.
Traditional Medicine Research ; 8(3), 2023.
Article in English | Web of Science | ID: covidwho-2207099

ABSTRACT

Background: Shengmai decoction, which has been included in the diagnosis and treatment of coronavirus disease 2019 (COVID-19), is effective in the early treatment of patients with severe COVID-19. Yiqi Fumai lyophilized injection (YQFM) is a modern Chinese medicine preparation of the Shengmai decoction. The mechanism of its intervention at the molecular level in the severe stage of COVID-19 remains unclear. Therefore, it is necessary to investigate the mechanism of YQFM in the treatment of patients with severe COVID-19. Methods: The corresponding target genes of the main active ingredients in YQFM and COVID-19 were obtained by using multiple databases and literature retrieval. A protein-protein interaction network was constructed, and enrichment analysis of the target was performed using Cytoscape 3.8.1. Lastly, the docking of all the identified compounds with angiotensin-converting enzyme II was confirmed by applying molecular docking technology. Results: YQFM has anti-inflammatory effects on RAW267.4 macrophages. The main active compounds of YQFM are all effective anti-inflammatory agents, and these active compounds also show beneficial physiological functions, such as anti-oxidation, anti-bacterial, and anticancer activities. Gene Ontology analysis showed enrichment in the following pathways: lipopolysaccharides, interleukins, NF-kappa B, interleukin-2 and others, revealing that YQFM may play a role in the treatment of patients with severe COVID-19 through these pathways. Conclusion: YQFM has multicomponent and multitarget characteristics, and it could reduce lung injury by inhibiting inflammatory reactions, promoting antiviral activities, and regulating immunity, among other functions, to treat patients with severe COVID-19.

12.
International Journal of Ophthalmology ; 16(1):10-15, 2023.
Article in English | Scopus | ID: covidwho-2204526

ABSTRACT

AIM: To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China, and to provide a profile for eye injuries in special times in future. METHODS: This is a multi-center cross-sectional study with 30 participated hospitals involving the China Ocular Trauma Society members. All hospitalized cases who visited the Ophthalmology Department in participated hospitals with eye injuries during the normalized period (2019) and the COVID-19 epidemic period (2020) were included in this study. Demographic characteristic of cases, date of injury, sites and types of injury were collected. RESULTS: This study involved 13 525 (61 cases with both eyes) injured cases. There were 7269 (53.74%) eye-injured cases and 6256 (46.26%) eye-injured cases in 2019 and 2020 separately. Compared with 2019, the incidence of ocular trauma in retirees, housewives and unemployed increased with year-on-year of 4.96%, 102.67%, and 11.64% among all occupations. In 2020, the incidence of eye injuries decreased in all injury sites except for an increase in home (30.29% year-on-year). The incidence of mechanical eye injuries decreased, while that of non-mechanical eye injuries (chemical/thermal/radiation) increased (47.45% year-on-year). There were 255 (3.51%, 255/7269) and 376 (6.01%, 376/6256) non-mechanical injured cases in 2019 and 2020 (Pearson Chi2=47.33, P<0.001) separately. CONCLUSION: During the COVID-19 epidemic period, the total cases of ocular trauma decrease but the proportion of non-mechanical ocular trauma increase. Penetrating is still the highest proportion among all types of mechanical ocular trauma. From a preventive point of view, protection for retired persons, housewives and unemployed persons should be improved during public health events period. © 2023 International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.

13.
Progress in Biochemistry and Biophysics ; 49(10):1889-1900, 2022.
Article in Chinese | Web of Science | ID: covidwho-2204243

ABSTRACT

Objective To detect the active ingredients in the traditional Chinese medicine prescription and its molecular mechanisms against SARS-CoV-2 by prescription mining and molecular dynamics simulations. Methods Herein, prescription mining and virtual screening of drugs were performed to screen the potential inhibitors against SARS-CoV-2. Molecular docking and molecular dynamics (MDs) simulations were further performed to explore the molecular recognition and inhibition mechanism between the potential inhibitors and SARS-CoV-2. Results The natural compounds library was constructed by 143 prescriptions of traditional Chinese medicine, which contained 640 natural compounds. Ten compounds were screened out from the natural compounds library. Among the 10 compounds, 23-trans-p-coumaryhormentic acid, the main active constituent of the Loquat leaf, showed the best binding affinity targeting the recognizing interface of SARS-CoV-2 S protein/ACE2. Upon binding 23-trans-p-coumaryhormentic acid, the key interactions between SARS-CoV-2 S protein and ACE2 were almost interrupted. Conclusion Ten compounds targeting SARS-CoV-2 S protein/ACE2 interface were screened out from natural compound library. And we inferred that 23-trans-p-coumaryhormentic acid is a potential inhibitor against SARS-CoV-2, which would contribute to the development of the antiviral drug for SARS-CoV-2.

14.
Progress in Biochemistry and Biophysics ; 49(10):1848-1865, 2022.
Article in Chinese | Web of Science | ID: covidwho-2204239

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus is highly contagious and spreads rapidly, posing a serious threat to the health and safety of people around the world. Proteomics technology has the characteristics of high throughput and high sensitivity, and plays an important role in biomarker discovery, molecular mechanism research, and therapeutic target research. Proteomics technology has been widely used in the research of COVID-19. Herein, this study provides a comprehensive review of the research progress of COVID-19 based on proteomics techniques. In section 1, the genome structure of SARS-CoV-2 and the process of SARS-CoV-2 infecting host cells were summarized. In section 2, the currently commonly used mass spectrometry (MS) -based proteomics techniques including liquid chromatography (LC)-MS and matrix-assisted laser desorption/ionization time-of-flight (MALDITOF) MS were reviewed. In section 3, the application progress in the research of precise diagnosis, molecular mechanism and drug therapy targets of COVID-19 based proteomics technology was highlighted. Proteomics have been employed in biomedical research to uncover biomarkers associated with COVID-19, it also provides a comprehensive snapshot of virus-induced changes to the host following infection, invasion, persistence, and pathogenesis and can prime the identification of novel therapeutic targets for preventing or lessening disease severity. In section 4, the future development direction of proteomics was prospected. It's hoped that this review can help to promote the development of proteomics technology in the precise diagnosis and treatment of diseases.

15.
Tropical Geography ; 42(11):1931-1942, 2022.
Article in Chinese | Scopus | ID: covidwho-2203849

ABSTRACT

To explore the movement of "city-suburb" tourism flow in the post-pandemic period, this study examines the tourist flow network of the Guangdong-Hong Kong-Macao Greater Bay Area from 2018 to 2021 based on online travel data. After screening and deduplication, 4882 valid travelogues were chosen and divided into pre-pandemic data (3, 967 articles) and post-pandemic data (915 articles) using November 2019 as the dividing line. A total of 4, 461 attractions on Ctrip. com were selected to build a scenic spot database of the Guangdong-Hong Kong-Macao Greater Bay Area, including the full names, aliases (common names), and city names of scenic spots. After matching the travelogues with the scenic spots in the attraction database, it was found that 1848 attractions appeared in the travel notes, and the top 300 attractions were chosen for the generation of tourism routes according to the number of matches. After converting travel routes to a directed connectivity matrix and the following dichotomization procedure, a social network analysis (SNA) was conducted to investigate the distribution of tourism flows and preferences in the Greater Bay Area. Using the SNA software Ucinet 6.0, the network density, centrality, and relevant metrics of the structural holes and cohesive subgroups were calculated. The node characteristics and network structure were analyzed, and the distribution characteristics of attractions and tourist intention trends in the Greater Bay Area were obtained. The study results indicate the following: 1) The tourism network density of the Greater Bay Area has decreased substantially since the COVID-19 outbreak. Megacities, especially overseas cities, were more affected by the pandemic. Tourism network connectivity and aggregation effects were severely weakened, and the network structure was more scattered and fragmented. 2) After the pandemic, the "core-periphery" structure of tourism networks weakened, and the boundaries between core and periphery areas blurred. Some suburban and rural scenic spots have become new core areas and their importance in the network has been significantly enhanced. 3) After the pandemic, the connectivity and control power of traditional core urban nodes, such as Hong Kong, Zhuhai, Macao, and Guangzhou, weakened. The cohesive subgroups of scenic points show a high cohesion of Guangzhou with cities on the west side of the Pearl River Estuary, such as Foshan, Zhuhai, and Macao, before the pandemic. After the pandemic, the cohesive subgroup of rural attractions was strengthened and tourism showed a development trend of multi-point and ruralization. 5) The tourism network has changed from the three-core development mode of Guangzhou-Hong Kong-Macao before the pandemic to the "four-wheel drive" mode of Guangzhou-Macao-Shenzhen-Foshan after the outbreak with the declined linkage of the Hong Kong-Zhuhai-Macao Bridge in the network. It is believed that travel mobility restrictions and tourism drivers are two-way driving forces for the structural change in tourism in the post-pandemic period. The Greater Bay Area's tourist flow network presents a two-loop structure with two-way dynamics owing to some pandemic factors, and may gradually show a decentralized and scattered development trend. Based on network analysis, it is proposed that more efforts be made to integrate city-suburb-countryside resources in the post-pandemic period. © 2022 Editorial Committee of Tropical Geography. All rights reserved.

16.
World J Clin Cases ; 11(1):73-83, 2023.
Article in English | PubMed Central | ID: covidwho-2203808

ABSTRACT

An outbreak of coronavirus disease 2019 (COVID-19) has spread globally, with over 500 million cases and 6 million deaths to date. COVID-19 is associated with a systemic inflammatory response and abnormalities of the extracellular matrix (ECM), which is also involved in inflammatory storms. Upon viral infection, ECM proteins are involved in the recruitment of inflammatory cells and interference with target organ metabolism, including in the lungs. Additionally, serum biomarkers of ECM turnover are associated with the severity of COVID-19 and may serve as potential targets. Consequently, understanding the expression and function of ECM, particularly of the lung, during severe acute respiratory syndrome of the coronavirus 2 infection would provide valuable insights into the mechanisms of COVID-19 progression. In this review, we summarize the current findings on ECM, such as hyaluronic acid, matrix metalloproteinases, and collagen, which are linked to the severity and inflammation of COVID-19. Some drugs targeting the extracellular surface have been effective. In the future, these ECM findings could provide novel perspectives on the pathogenesis and treatment of COVID-19.

17.
Zhongguo Dangdai Erke Zazhi ; 25(1):5-10, 2023.
Article in Chinese | MEDLINE | ID: covidwho-2203146

ABSTRACT

OBJECTIVES: To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection.

18.
Zhongguo Dangdai Erke Zazhi ; 24(12):1289-1294, 2022.
Article in Chinese | MEDLINE | ID: covidwho-2203144

ABSTRACT

OBJECTIVES: To investigate the persistent symptoms in preschool children after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection, and to provide a basis for developing follow-up plans after infection and reducing and preventing related symptoms after infection.

19.
Journal of Immunology ; 04:04, 2023.
Article in English | MEDLINE | ID: covidwho-2201459

ABSTRACT

Porcine epidemic diarrhea virus (PEDV) is a highly pathogenic porcine enteric coronavirus that causes severe watery diarrhea and even death in piglets. The neonatal Fc receptor (FcRn) is the only transport receptor for IgG. FcRn expressed by intestinal epithelial cells can transport IgG from breast milk to piglets to provide immune protection. Previous studies have shown that viral infection affects FcRn expression. In this study, we showed for the first time, to our knowledge, that FcRn expression can be influenced by methyltransferases. In addition, we found that PEDV inhibited FcRn protein synthesis in porcine small intestinal epithelial cells postinfection. Then, we found that PEDV interfered with the transcription of genes through aberrant methylation modification of the FcRn promoter. DNA methyltransferase 3b (DNMT3b) has been implicated in this process. Using a series of PEDV structural and nonstructural protein (nsp) expression plasmids, we showed that nsp13 plays an important role in this aberrant methylation modification. PEDV nsp13 can affect the NF-kappaB canonical pathway and promote DNMT3b protein expression by facilitating p65 protein binding to chromatin. PEDV caused aberrant methylation of the FcRn promoter via DNMT3b. The same phenomenon was found in animal experiments with large white piglets. IgG transcytosis demonstrated that PEDV nsp13 can inhibit bidirectional IgG transport by FcRn. In addition, the core region of nsp13 (230-597 aa) is critical for FcRn inhibition. Taken together, to our knowledge, our findings revealed a novel immune escape mechanism of PEDV and shed new light on the design and development of vaccines and drugs.

20.
Biomedical & Environmental Sciences ; 35(12):1100-1105, 2022.
Article in English | MEDLINE | ID: covidwho-2201248

ABSTRACT

Objective: To investigate neutralizing antibody levels in symptomatic and asymptomatic patients with coronavirus disease 2019 (COVID-19) at 6 and 10 months after disease onset.

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