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1.
World J Clin Cases ; 9(36): 11237-11247, 2021 Dec 26.
Article in English | MEDLINE | ID: covidwho-1623775

ABSTRACT

BACKGROUND: The onset symptoms of people infected by Chlamydia psittaci can mimic the coronavirus disease 2019 (COVID-19). However, the differences in laboratory tests and imaging features between psittacosis and COVID-19 remain unknown. AIM: To better understand the two diseases and then make an early diagnosis and treatment. METHODS: Six patients from two institutions confirmed as psittacosis by high-throughput genetic testing and 31 patients confirmed as COVID-19 were retrospectively included. The epidemiology, clinical characteristics, laboratory tests and computed tomography (CT) imaging features were collected and compared between the two groups. The follow-up CT imaging findings of patients with psittacosis were also investigated. RESULTS: The white blood cell count (WBC), neutrophil count and calcium were more likely to be decreased in patients with COVID-19 but were increased in patients with psittacosis (all P = 0.000). Lymphocyte count and platelet count were higher in patients with psittacosis than in those with COVID-19 (P = 0.044, P = 0.035, respectively). Lesions in patients with psittacosis were more likely to be unilateral (P = 0.001), involve fewer lung lobes (P = 0.006) and have pleural effusions (P = 0.002). Vascular enlargement was more common in patients with COVID-19 (P = 0.003). Consolidation in lung CT images was absorbed in all 6 patients. CONCLUSION: Psittacosis has the potential for human-to-human transmission. Patients with psittacosis present increased WBC count and neutrophil count and have specific CT imaging findings, including unilateral distribution, less involvement of lung lobes and pleural effusions, which might help us to differentiate it from COVID-19.

2.
J Allergy Clin Immunol Pract ; 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1604349

ABSTRACT

BACKGROUND: Food desensitization via oral immunotherapy (OIT) is gaining acceptance in clinical practice. Owing to adverse reactions, the duration of the buildup phase until a maintenance dose is achieved may be prolonged, and in a minority of cases, OIT is stopped. OBJECTIVE: We aimed to assess factors associated with the probability of reaching the maintenance dose in cow's milk (CM) OIT. METHODS: We collected data from patients undergoing CM OIT at the Montreal Children's Hospital, BC Children's Hospital, and Hospital for Sick Children. We compared univariable and multivariable Cox regressions to evaluate sociodemographic factors, comorbidities, clinical characteristics, and biomarkers at study entry associated with the likelihood of reaching a maintenance dose of 200 mL of CM. RESULTS: Among 69 children who reached 4 mL of milk, the median age was 12 years (interquartile range, 9-15 years); 59% were male. Median duration of buildup phase from 4 to 200 mL was 24.0 weeks (interquartile range, 17.7-33.4 weeks). After adjusting for age and sex, higher baseline levels of specific IgE antibodies for α-lactalbumin (hazard ratio [HR] = 0.80; 95% confidence interval [CI], 0.67-0.95), ß-lactoglobulin (HR = 0.86; 95% CI, 0.76-0.98), casein (HR = 0.82; 95% CI, 0.72-0.94), and total CM (HR = 0.79; 95% CI, 0.65-0.97) were associated with a decreased probability of reaching maintenance. In addition, for every 10-mL increase in CM tolerated at entry challenge, the probability of reaching maintenance increased by 10%. CONCLUSIONS: The data suggest that higher levels of CM-specific IgE decreased the likelihood of reaching maintenance, whereas an increased cumulative CM dose at entry challenge increased the likelihood. Assessing these factors before therapy may assist in predicting the success of CM OIT.

3.
Open forum infectious diseases ; 8(Suppl 1):S262-S263, 2021.
Article in English | EuropePMC | ID: covidwho-1601779

ABSTRACT

Background Long term sequelae across multiple medical domains, including the respiratory, psychiatric, and neurocognitive have been reported after COVID-19. Studies evaluating the impact of this symptom burden, however, are lacking. We aimed to describe the self-reported occurrence of symptoms and their effect on patient functioning six months after their acute hospitalization for COVID-19. Methods From a historical cohort study of patients hospitalized for COVID-19 between March 8, and June 14, 2020, we identified patients discharged home. The purpose of the study was explained, and they were asked to consent to a telephone questionnaire. We used a modified version of a previously validated general symptom questionnaire (GSQ-30) to assess multi-system symptom burden. The Patient Health Questionnaire-2 (PHQ-2) was used to screen for major depression. Results Of the original 565 patients, 258 patients were discharged home (45%). Of these, 57 (22%) patients were able to be contacted and agreed to participate in the survey. The mean (SD) age of the respondents was 55.1 (14.8) years, and 37 (64.9%) were female. The most common symptoms at follow-up were fatigue (60.0%), dyspnea (57.1%), feeling irritable, sad or decreased pleasure (56.4%), and memory difficulty (56.4%). Females had a significantly higher GSQ score (0.02) than males. Patients ages < 60 years tended to experience similar, if not greater, impaired functioning (p=0.07) compared with those ages ≥ 60 years (Table 1). Females were more likely to be irritable or sad (p=0.007), not feel rested on awakening (p=0.04), have shooting, stabbing and burning pain (p=0.02), have discomfort with normal light and sound (p=0.04), and have memory difficulty (p=0.04) than males (Table 2). Table 1. Self-Reported Post-Acute Sequelae of COVID syndrome in adults younger than 60 versus adults at or older than 60 Years. SD: Standard deviation, ICU: Intensive care unit, ED: Emergency department, GSQ - General symptom questionnaire, PHQ-2: Patient Health Questionnaire-2 Table 2. Self-Reported Post-acute Sequelae of COVID syndrome in female versus male adults. SD: Standard deviation, ED: Emergency department, GSQ - General symptom questionnaire, PHQ-2: Patient Health Questionnaire-2 Conclusion Our study describes the clinical burden of post-acute sequelae of COVID-19 (PASC) in four core domains: fatigue, neurologic, neuro-psychiatric and viral-like symptoms. Over 45% of patients ages < 60 years suffered impaired functioning, compared with 21.1% of patient’s ages 60 years and above. Females had significantly higher GSQ scores than men which strongly corelates with the functional impairment among the females. Larger studies are needed to further validate our findings. Disclosures All Authors: No reported disclosures

4.
IEEE Trans Med Imaging ; PP2021 Aug 12.
Article in English | MEDLINE | ID: covidwho-1593541

ABSTRACT

Early and accurate severity assessment of Coronavirus disease 2019 (COVID-19) based on computed tomography (CT) images offers a great help to the estimation of intensive care unit event and the clinical decision of treatment planning. To augment the labeled data and improve the generalization ability of the classification model, it is necessary to aggregate data from multiple sites. This task faces several challenges including class imbalance between mild and severe infections, domain distribution discrepancy between sites, and presence of heterogeneous features. In this paper, we propose a novel domain adaptation (DA) method with two components to address these problems. The first component is a stochastic class-balanced boosting sampling strategy that overcomes the imbalanced learning problem and improves the classification performance on poorly-predicted classes. The second component is a representation learning that guarantees three properties: 1) domain-transferability by prototype triplet loss, 2) discriminant by conditional maximum mean discrepancy loss, and 3) completeness by multi-view reconstruction loss. Particularly, we propose a domain translator and align the heterogeneous data to the estimated class prototypes (i.e., class centers) in a hyper-sphere manifold. Experiments on cross-site severity assessment of COVID-19 from CT images show that the proposed method can effectively tackle the imbalanced learning problem and outperform recent DA approaches.

5.
Brain ; 2021 Dec 16.
Article in English | MEDLINE | ID: covidwho-1594202

ABSTRACT

There is growing evidence that severe acute respiratory syndrome coronavirus 2 can affect the CNS. However, data on white matter and cognitive sequelae at the one-year follow-up are lacking. Therefore, we explored these characteristics in this study. We investigated 22 recovered coronavirus disease 2019 (COVID-19) patients and 21 matched healthy controls. Diffusion tensor imaging, diffusion kurtosis imaging and neurite orientation dispersion and density imaging were performed to identify white matter changes, and the subscales of the Wechsler Intelligence scale were used to assess cognitive function. Correlations between diffusion metrics, cognitive function, and other clinical characteristics were then examined. We also conducted subgroup analysis based on patient admission to the intensive care unit. The corona radiata, corpus callosum and superior longitudinal fasciculus had lower volume fraction of intracellular water in the recovered COVID-19 group than in the healthy control group. Patients who had been admitted to the intensive care unit had lower fractional anisotropy in the body of the corpus callosum than those who had not. Compared with the healthy controls, the recovered COVID-19 patients demonstrated no significant decline in cognitive function. White matter tended to present with fewer abnormalities for shorter hospital stays and longer follow-up times. Lower axonal density was detected in clinically recovered COVID-19 patients after one year. Patients who had been admitted to the intensive care unit had slightly more white matter abnormalities. No significant decline in cognitive function was found in recovered COVID-19 patients. The duration of hospital stay may be a predictor for white matter changes at the one-year follow-up.

6.
Neural Regen Res ; 17(7): 1576-1581, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1575953

ABSTRACT

Although some short-term follow-up studies have found that individuals recovering from coronavirus disease 2019 (COVID-19) exhibit anxiety, depression, and altered brain microstructure, their long-term physical problems, neuropsychiatric sequelae, and changes in brain function remain unknown. This observational cohort study collected 1-year follow-up data from 22 patients who had been hospitalized with COVID-19 (8 males and 11 females, aged 54.2 ± 8.7 years). Fatigue and myalgia were persistent symptoms at the 1-year follow-up. The resting state functional magnetic resonance imaging revealed that compared with 29 healthy controls (7 males and 18 females, aged 50.5 ± 11.6 years), COVID-19 survivors had greatly increased amplitude of low-frequency fluctuation (ALFF) values in the left precentral gyrus, middle frontal gyrus, inferior frontal gyrus of operculum, inferior frontal gyrus of triangle, insula, hippocampus, parahippocampal gyrus, fusiform gyrus, postcentral gyrus, inferior parietal angular gyrus, supramarginal gyrus, angular gyrus, thalamus, middle temporal gyrus, inferior temporal gyrus, caudate, and putamen. ALFF values in the left caudate of the COVID-19 survivors were positively correlated with their Athens Insomnia Scale scores, and those in the left precentral gyrus were positively correlated with neutrophil count during hospitalization. The long-term follow-up results suggest that the ALFF in brain regions related to mood and sleep regulation were altered in COVID-19 survivors. This can help us understand the neurobiological mechanisms of COVID-19-related neuropsychiatric sequelae. This study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (approval No. 2020S004) on March 19, 2020.

7.
Ann Palliat Med ; 2021 Nov 23.
Article in English | MEDLINE | ID: covidwho-1560745

ABSTRACT

BACKGROUND: The purpose of this study was to investigate the current status of diagnosis and treatment of Chinese patients with advanced non-small cell lung cancer (NSCLC) and the expert recommendation of the therapeutic regimens during the coronavirus disease 2019 (COVID-19) pandemic, and to analyze and summarize relevant rules. METHODS: Under the planning and coordination of the Lung Cancer Group of the Chinese Thoracic Society, we performed an online questionnaire survey among experts in lung cancer and patients with NSCLC. Convenience sampling was adopted for questionnaire survey of experts, and random sampling was adopted for questionnaire survey of patients. After collecting and sorting out the questionnaire, a descriptive analysis of the data was performed. RESULTS: Within 24 h from the distribution of questionnaires to the deadline, a total of 808 and 321 valid questionnaires from patients and experts were collected across China, respectively. There were 83.81% of the experts performed moderately and strongly anti-tumor therapy for patients with NSCLC during the COVID-19 pandemic. 76.6% of patients mainly receive online public welfare treatment, and the patient satisfaction rate reached up to 64.97%. For driver gene-positive patients with advanced NSCLC and nonCOVID-19, 82.87% of the experts recommended first-line simple targeted therapy, and 12.77% of the experts recommended targeted therapy with oral anti-angiogenic drugs. For patients who were unable to return to the hospital for treatment and showed resistance to the TKI therapy, 92.21% of the experts recommended oral anti-angiogenic drugs as the third-line home-based therapy and above. For patients with advanced NSCLC combined with COVID-19, 98.76% and 95.95% of the experts recommended discontinuation of chemotherapy and immunotherapy, respectively. CONCLUSIONS: During COVID-19, most Chinese patients with NSCLC were still able to receive timely diagnosis and treatment either by online public welfare consultation or at nearby hospitals.

8.
Front Microbiol ; 12: 767104, 2021.
Article in English | MEDLINE | ID: covidwho-1556004

ABSTRACT

Neurotropic viruses have neural-invasive and neurovirulent properties to damage the central nervous system (CNS), leading to humans' fatal symptoms. Neurotropic viruses comprise a lot of viruses, such as Zika virus (ZIKV), herpes simplex virus (HSV), rabies virus (RABV), and severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Effective therapy is needed to prevent infection by these viruses in vivo and in vitro. However, the blood-brain barrier (BBB) usually prevents macromolecules from entering the CNS, which challenges the usage of the traditional probes, antiviral drugs, or neutralizing antibodies in the CNS. Functionalized nanoparticles (NPs) have been increasingly reported in the targeted therapy of neurotropic viruses due to their sensitivity and targeting characteristics. Therefore, the present review outlines efficient functionalized NPs to further understand the recent trends, challenges, and prospects of these materials.

9.
Journal of Advanced Research ; 2021.
Article in English | ScienceDirect | ID: covidwho-1536633

ABSTRACT

Introduction The COVID-19 global pandemic is far from ending. There is an urgent need to identify applicable biomarkers for early predicting the outcome of COVID-19. Growing evidences have revealed that SARS-CoV-2 specific antibodies evolved with disease progression and severity in COIVD-19 patients. Objectives We assumed that antibodies may serve as biomarkers for predicting the clinical outcome of hospitalized COVID-19 patients on admission. Methods By taking advantage of a newly developed SARS-CoV-2 proteome microarray, we surveyed IgG responses against 20 proteins of SARS-CoV-2 in 1,034 hospitalized COVID-19 patients on admission and followed till 66 days. The microarray results were further correlated with clinical information, laboratory test results and patient outcomes. Cox proportional hazards model was used to explore the association between SARS-CoV-2 specific antibodies and COVID-19 mortality. Results Nonsurvivors (n=955) induced higher levels of IgG responses against most of non-structural proteins than survivors (n=79) on admission. In particular, the magnitude of IgG antibodies against 8 non-structural proteins (NSP1, NSP4, NSP7, NSP8, NSP9, NSP10, RdRp, and NSP14) and 2 accessory proteins (ORF3b and ORF9b) possessed significant predictive power for patient death, even after further adjustments for demographics, comorbidities, and common laboratory biomarkers for disease severity (all with p trend < 0.05). Additionally, IgG responses to all of these 10 non-structural/accessory proteins were also associated with the severity of disease, and differential kinetics and serum positive rate of these IgG responses were confirmed in COVID-19 patients of varying severities within 20 days after symptoms onset. The area under curves (AUCs) for these IgG responses, determined by computational cross-validations, were between 0.62 and 0.71. Conclusions Our findings might have important implications for improving clinical management of COVID-19 patients.

10.
Anal Chem ; 93(48): 16184-16193, 2021 12 07.
Article in English | MEDLINE | ID: covidwho-1531973

ABSTRACT

Nowadays, rapid and accurate diagnosis of respiratory tract viruses is an urgent need to prevent another epidemic outbreak. To overcome this problem, we have developed a clustered, regularly interspaced short palindromic repeats (CRISPR) loop mediated amplification (LAMP) technology to detect influenza A virus, influenza B virus, respiratory syncytial A virus, respiratory syncytial B virus, and severe acute respiratory syndrome coronavirus 2, including variants of concern (B.1.1.7), which utilized CRISPR-associated protein 12a (Cas12a) to advance LAMP technology with the sensitivity increased 10 times. To reduce aerosol contamination in CRISPR-LAMP technology, an uracil-DNA-glycosylase-reverse transcription-LAMP system was also developed which can effectively remove dUTP-incorporated LAMP amplicons. In vitro Cas12a cleavage reaction with 28 crRNAs showed that there were no position constraints for Cas12a/CRISPR RNA (crRNA) recognition and cleavage in LAMP amplicons, and even the looped position of LAMP amplicons could be effectively recognized and cleaved. Wild-type or spike N501Y can be detected with a limit of detection of 10 copies/µL (wild-type) even at a 1% ratio level on the background (spike N501Y). Combining UDG-RT-LAMP technology, CRISPR-LAMP design, and mutation detection design, we developed a CRISPR-LAMP detection platform that can precisely diagnose pathogens with better stability and significantly improved point mutation detection efficiency.

11.
JAMA Netw Open ; 4(11): e2135397, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1527393

ABSTRACT

Importance: COVID-19 is associated with a high incidence of thrombotic events; however, the need for extended thromboprophylaxis after hospitalization remains unclear. Objective: To quantify the rate of postdischarge arterial and venous thromboembolism in patients with COVID-19, identify the factors associated with the risk of postdischarge venous thromboembolism, and evaluate the association of postdischarge anticoagulation use with venous thromboembolism incidence. Design, Setting, and Participants: This is a cohort study of adult patients hospitalized with COVID-19 confirmed by a positive SARS-CoV-2 test. Eligible patients were enrolled at 5 hospitals of the Henry Ford Health System from March 1 to November 30, 2020. Data analysis was performed from April to June 2021. Exposures: Anticoagulant therapy after discharge. Main Outcomes and Measures: New onset of symptomatic arterial and venous thromboembolic events within 90 days after discharge from the index admission for COVID-19 infection were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Results: In this cohort study of 2832 adult patients hospitalized with COVID-19, the mean (SD) age was 63.4 (16.7) years (IQR, 53-75 years), and 1347 patients (47.6%) were men. Thirty-six patients (1.3%) had postdischarge venous thromboembolic events (16 pulmonary embolism, 18 deep vein thrombosis, and 2 portal vein thrombosis). Fifteen (0.5%) postdischarge arterial thromboembolic events were observed (1 transient ischemic attack and 14 acute coronary syndrome). The risk of venous thromboembolism decreased with time (Mann-Kendall trend test, P < .001), with a median (IQR) time to event of 16 (7-43) days. There was no change in the risk of arterial thromboembolism with time (Mann-Kendall trend test, P = .37), with a median (IQR) time to event of 37 (10-63) days. Patients with a history of venous thromboembolism (odds ratio [OR], 3.24; 95% CI, 1.34-7.86), peak dimerized plasmin fragment D (D-dimer) level greater than 3 µg/mL (OR, 3.76; 95% CI, 1.86-7.57), and predischarge C-reactive protein level greater than 10 mg/dL (OR, 3.02; 95% CI, 1.45-6.29) were more likely to experience venous thromboembolism after discharge. Prescriptions for therapeutic anticoagulation at discharge were associated with reduced incidence of venous thromboembolism (OR, 0.18; 95% CI, 0.04-0.75; P = .02). Conclusions and Relevance: Although extended thromboprophylaxis in unselected patients with COVID-19 is not supported, these findings suggest that postdischarge anticoagulation may be considered for high-risk patients who have a history of venous thromboembolism, peak D-dimer level greater than 3 µg/mL, and predischarge C-reactive protein level greater than 10 mg/dL, if their bleeding risk is low.

12.
Front Cell Infect Microbiol ; 11: 654272, 2021.
Article in English | MEDLINE | ID: covidwho-1497024

ABSTRACT

Introduction: Asymptomatic coronavirus disease 2019 (COVID-19) and moderate COVID-19 may be the most common COVID-19 cases. This study was designed to develop a diagnostic model for patients with asymptomatic and moderate COVID-19 based on demographic, clinical, and laboratory variables. Methods: This retrospective study divided the subjects into 2 groups: asymptomatic COVID-19 (without symptoms, n = 15) and moderate COVID-19 (with symptoms, n = 57). Demographic characteristics, clinical data, routine blood tests, other laboratory tests, and inpatient data were collected and analyzed to compare patients with asymptomatic COVID-19 and moderate COVID-19. Results: Comparison of the asymptomatic COVID-19 group with the moderate COVID-19 group yielded the following results: the patients were younger (P = 0.045); the cluster of differentiation (CD)8+ (cytotoxic) T cell level was higher (P = 0.017); the C-reactive protein (CRP) level was lower (P = 0.001); the white blood cell (WBC, P < 0.001), neutrophil (NEU, P = 0.036), lymphocyte (LYM, P = 0.009), and eosinophil (EOS, P = 0.036) counts were higher; and the serum iron level (P = 0.049) was higher in the asymptomatic COVID-19 group. The multivariate analysis showed that the NEU count (odds ratio [OR] = 2.007, 95% confidence interval (CI): 1.162 - 3.715, P = 0.014) and LYM count (OR = 9.380, 95% CI: 2.382 - 36.934, P = 0.001) were independent factors for the presence of clinical symptoms after COVID-19 infection. The NEU count and LYM count were diagnostic predictors of asymptomatic COVID-19. This diagnostic prediction model showed high discriminatory power, consistency, and net clinical benefits. Conclusions: The proposed model can distinguish asymptomatic COVID-19 from moderate COVID-19, thereby helping clinicians identify and distinguish patients with potential asymptomatic COVID-19 from those with moderate COVID-19.


Subject(s)
COVID-19 , Neutrophils , Humans , Lymphocytes , ROC Curve , Retrospective Studies , SARS-CoV-2
14.
Preprint in English | EuropePMC | ID: ppcovidwho-291839

ABSTRACT

Background: Understanding immune memory to COVID-19 vaccines is critical for the design and optimal vaccination schedule for curbing the COVID-19 pandemic. Here, we assessed the persistence of humoral and cellular immune responses for 12 months after two-dose CoronaVac.Methods: Participants aged 18–59 years received two doses of 3 μg CoronaVac 14 days apart, and blood samples were collected before vaccination (baseline) and at 1, 3, 6, and 12 months after the second shot. Humoral responses of specific antibodies and neutralising antibodies were measured by using chemiluminescent immunoassay and wild-type SARS-CoV-2 microneutralisation assay, respectively. Cellular responses were measured by immunospot-based and intracellular cytokine staining assays. This trial is registered with ClinicalTrials.gov, NCT05072496.Findings: Total 150 participants were enrolled, and 136 of them completed the study through the 12-month endpoint. At 1 month after vaccination, binding and neutralising antibodies emerged rapidly, the seropositive rate of binding antibodies and seroconversion rate of neutralizing antibodies was 99% and 50%, respectively. From 3 to 12 months, the binding and neutralizing antibodies declined slightly overtime. At 12 months, the binding and neutralizing antibodies were still detectable and significantly higher than the baseline. IFN-γ and IL-2 secretion specifically induced by RBD persisted at high levels until 6 months, and could be observed at 12 months, while the levels of IL-5 and Granzyme B were hardly detected, demonstrating a Th1-biased response. Besides, specific CD4+TCM, CD4+TEMM, CD8+ TEMand CD8+TE cells were all detectable and functional up to 12 months after the second dose, as the cells produced IFN-γ, IL-2, and GzmB in response to stimulation of SARS-CoV-2 RBD.Interpretation: CoronaVac not only induced durable binding and neutralising antibody responses, but also SARS-CoV-2-specific CD4+ and CD8+ memory T cells for up to 12 months.Trial Registration: This study is registered with ClinicalTrials.gov, NCT05072496.Funding: Beijing Municipal Science & Technology CommissionDeclaration of Interest: None to declare. Ethical Approval: The trial protocol was approved by the Ethics Committee of Beijing CDC (2020-28)

15.
Preprint in English | EuropePMC | ID: ppcovidwho-291513

ABSTRACT

Background: The long-term impact of COVID-19 on patient health has been a recent focus. This study aims to determine the persistent symptoms and psychological conditions of patients hospitalized with COVID-19 15 months after onset. The potential risk factors were also explored.Methods: A cohort of COVID-19 patients discharged from February 20, 2020 to March 31, 2020 was recruited. Follow-ups were conducted using validated questionnaires and psychological screening scales at 15 months after onset to evaluate the patients’ health status. The risk factors for long-term health impacts and their associations with disease severity was analyzed.Findings: 534 COVID-19 patients were enrolled. The median age of the patients was 62.0 years old (IQR 52.0-70.0) and 295 were female (55.2%). The median time from onset to follow-up was 460.0 (451.0-467.0) days. Sleep disturbance (18.5%, 99/534) and fatigue (17.2%, 92/534) were the most common persistent symptoms. 6.4% (34/534) of the patients had depression, 9.2% (49/534) were anxious, 13.0% (70/534) had insomnia and 4.7% (25/534) suffered from posttraumatic stress disorder (PTSD). Multivariate adjusted logistic regression analysis showed that glucocorticoid use during hospitalization (OR 3.58, 95% CI 1.12-11.44) was significantly associated with an increased risk of fatigue. The OR values for anxiety and sleep disorders were 2.36 (95% CI 1.07-5.20) and 2.16 (95% CI 1.13-4.14) in females compared with males. The OR value of PTSD was 25.6 (95% CI 3.3-198.4) in patients with persistent symptoms to those without persistent symptoms. No significant associations were observed between fatigue syndrome or adverse mental outcomes and disease severity.Interpretation: 15-month follow-up in this study aroused the need of extended rehabilitation intervention for complete recovery in COVID-19 patients. Funding: None to declare. Declaration of Interest: All the authors declare no competing interests.Ethical Approval: The Research Ethics Committee of Shanghai Changzheng Hospital approved this study (2020SL007).

16.
Journal of Intensive Medicine ; 2021.
Article in English | ScienceDirect | ID: covidwho-1446889

ABSTRACT

Background There have been many studies about coronavirus disease 2019 (COVID -19), but the clinical significance of quantitative serum severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)-specific IgM and IgG levels in COVID-19 patients have not been exhaustively studied. We aimed to study the time profiles of these IgM/IgG levels in COVID-19 patients and their correlations with clinical features. Methods A multicenter clinical study was conducted from February to March 2020. It involved 179 COVID-19 patients (108 males and 71 females) from five hospitals in Huangshi in Hubei Province, China. To detect SARS-CoV-2-specific IgM/IgG, quantitative antibody assays (two-step indirect immunoassays with direct chemiluminescence technology) based on the nucleocapsid protein (NP) and spike protein 1 (S1) were used. For normally distributed data, means were compared using the t test, χ2 test, or exact probability method. For categorical data, medians were compared using Mann-Whitney U test. Results The median age was 57(44-69) years (58(38-69) for males and 57(49-68) for females). The median duration of positive nucleic acid test was 22.32 (17.34-27.43) days. The mortality rate was relatively low (3/179, 1.68%). Serum SARS-CoV-2-specific IgG was detected around week 1 after illness onset, gradually increased until peaking in weeks 4 and 5, and then declined. Serum IgM peaked in weeks 2 and 3, then gradually declined and returned to its normal range by week 7 in all patients. Notably, children had milder respiratory symptoms with lower SARS-CoV-2-specific IgM/IgG levels. The duration of positive nucleic acid test in the chronic obstructive pulmonary disease (COPD) group was 30.36(18.99-34.76) days, which was significantly longer than that in the non-COPD group (21.52(16.75-26.51) days;P=0.011). The peak serum SARS-CoV-2-specific IgG was significantly positively correlated with the duration of positive nucleic acid test. The incidence rate of severe and critical cases in the IgMhi group (using the median IgM level of 29.95 AU/ml as the cutoff for grouping) was about 38% (19/50), which was twice as much as that in the IgMlo group (18.37%;9/49). The patients with positive chest imaging and lymphocytopenia (<1 × 109/L) had a higher SARS-CoV-2-specific IgM level. Conclusions Quantitative SARS-CoV-2-specific IgM and IgG levels are helpful for the diagnosis, severity classification, and management of COVID-19 patients, and they should be monitored in each stage of this disease.

17.
Front Med (Lausanne) ; 8: 663514, 2021.
Article in English | MEDLINE | ID: covidwho-1438417

ABSTRACT

Objective: To assess CT features of COVID-19 patients with different smoking status using quantitative and semi-quantitative technologies and to investigate changes of CT features in different disease states between the two groups. Methods: 30 COVID-19 patients with current smoking status (29 men, 1 woman) admitted in our database were enrolled as smoking group and 56 COVID-19 patients without smoking history (24 men, 32 women) admitted during the same period were enrolled as a control group. Twenty-seven smoking cases and 55 control cases reached recovery standard and were discharged. Initial and follow-up CT during hospitalization and follow-up CT after discharge were acquired. Thirty quantitative features, including the ratio of infection volume and visual-assessed interstitial changes score including total score, score of ground glass opacity, consolidation, septal thickening, reticulation and honeycombing sign, were analyzed. Results: Initial CT images of the smoking group showed higher scores of septal thickening [4.5 (0-5) vs. 0 (0-4), p = 0.001] and reticulation [0 (0-5.25) vs 0 (0-0), p = 0.001] as well as higher total score [7 (5-12.25) vs. 6 (5-7), p = 0.008] with statistical significance than in the control group. The score of reticulation was higher in the smoking group than in the control group when discharged [0.89 (0-0) vs. 0.09 (0-0), p = 0.02]. The score of septal thickening tended to be higher in the smoking group than the control group [4 (0-4) vs. 0 (0-4), p = 0.007] after being discharged. Quantitative CT features including infection ratio of whole lung and left lung as well as infection ratio within HU (-750, -300) and within HU (-300, 49) were higher in the control group of initial CT with statistical differences. The infection ratio of whole lung and left lung, infection ratio within HU (-750), and within HU (-750, -300) were higher in the control group with statistical differences when discharged. This trend turned adverse after discharge and the values of quantitative features were generally higher in the smoking group than in the control group without statistical differences. Conclusions: Patients with a history of smoking presented more severe interstitial manifestations and more residual lesion after being discharged. More support should be given for COVID-19 patients with a smoking history during hospitalization and after discharge.

18.
Front Microbiol ; 12: 692831, 2021.
Article in English | MEDLINE | ID: covidwho-1403487

ABSTRACT

Since December 2019, a novel coronavirus (SARS-CoV-2) has resulted in a global pandemic of coronavirus disease (COVID-19). Although viral nucleic acid test (NAT) has been applied predominantly to detect SARS-CoV-2 RNA for confirmation diagnosis of COVID-19, an urgent need for alternative, rapid, and sensitive immunoassays is required for primary screening of virus. In this study, we developed a smartphone-based nanozyme-linked immunosorbent assay (SP-NLISA) for detecting the specific nucleocapsid phosphoprotein (NP) of SARS-CoV-2 in 37 serum samples from 20 COVID-19 patients who were diagnosed by NAT previously. By using SP-NLISA, 28/37 (75.7%) serum samples were detected for NP antigens and no cross-reactivity with blood donors' control samples collected from different areas of China. In a control assay using the conventional enzyme-linked immunosorbent assay (ELISA), only 7/37 (18.91%) serum samples were detected for NP antigens and no cross-reactivity with control samples. SP-NLISA could be used for rapid detection of SARS-CoV-2 NP antigen in primary screening of SARS-CoV-2 infected individuals.

19.
IEEE/ACM Trans Comput Biol Bioinform ; PP2021 Aug 05.
Article in English | MEDLINE | ID: covidwho-1343786

ABSTRACT

Accurate and rapid diagnosis of coronavirus disease 2019 (COVID-19) from chest CT scans is of great importance and urgency. However, radiologists have to distinguish COVID-19 pneumonia from other pneumonia in a large number of CT scans, which is tedious and inefficient. Thus, it is urgently and clinically needed to develop an efficient and accurate diagnostic tool to help radiologists to fulfill the difficult task. In this study, we proposed a deep supervised autoencoder (DSAE) framework to automatically identify COVID-19 using multi-view features extracted from CT images. To fully explore features characterizing CT images from different frequency domains, DSAE was proposed to learn the latent representation by multi-task learning. The proposal was designed to both encode valuable information from different frequency features and construct a compact class structure for separability. To achieve this, we designed a multi-task loss function, which consists of a supervised loss and a reconstruction loss. Our proposed method was evaluated on a newly collected dataset of 787 subjects including COVID-19 pneumonia patients, other pneumonia patients, and normal subjects without abnormal CT findings. Extensive experimental results demonstrated that our proposed method achieved encouraging diagnostic performance and may have potential clinical application for the diagnosis of COVID-19.

20.
Expert Syst Appl ; 185: 115616, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1330818

ABSTRACT

Millions of positive COVID-19 patients are suffering from the pandemic around the world, a critical step in the management and treatment is severity assessment, which is quite challenging with the limited medical resources. Currently, several artificial intelligence systems have been developed for the severity assessment. However, imprecise severity assessment and insufficient data are still obstacles. To address these issues, we proposed a novel deep-learning-based framework for the fine-grained severity assessment using 3D CT scans, by jointly performing lung segmentation and lesion segmentation. The main innovations in the proposed framework include: 1) decomposing 3D CT scan into multi-view slices for reducing the complexity of 3D model, 2) integrating prior knowledge (dual-Siamese channels and clinical metadata) into our model for improving the model performance. We evaluated the proposed method on 1301 CT scans of 449 COVID-19 cases collected by us, our method achieved an accuracy of 86.7% for four-way classification, with the sensitivities of 92%, 78%, 95%, 89% for four stages. Moreover, ablation study demonstrated the effectiveness of the major components in our model. This indicates that our method may contribute a potential solution to severity assessment of COVID-19 patients using CT images and clinical metadata.

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