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1.
Indoor Built Environ. ; 2020.
Article in English | ELSEVIER | ID: covidwho-692787

ABSTRACT

The global pandemic of Corona Virus Disease 2019 (COVID-19) necessitated the rapid construction of field hospitals as the main strategies to control the detrimental effects of the outbreak. Little is known about the extent of the environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an urgently field hospital. A total of 66 surface samples were randomly collected from a general isolation ward and an ICU (intensive care unit) at a rapidly built field hospital (Wuhan Leishenshan Hospital) in Wuhan, China, from 12 March to 17 March 2020. The samples were used for SARS-CoV-2 detection and ATP (adenosine triphosphate) monitoring. Among these samples, 3.03% tested positive for SARS-CoV-2. The nurses' hands and nurse station in the ICU were weakly positive (CT value = 38.79; CT value = 37.56) and the ATP value of these two sites was higher than the mean value of all samples (ATP = 817; ATP = 577). The environmental cleaning and disinfection normalization bundle measures in Leishenshan hospital included air disinfection, object surface cleaning and disinfection, instrument equipment surface disinfection and hand hygiene, etc. These have been tested and were shown to be reliable and useful. Our experience can provide a useful reference in the fight against the ongoing pandemic of COVID-19.

2.
Journal of Medical Virology ; n/a(n/a), 2020.
Article | WHO COVID | ID: covidwho-691095

ABSTRACT

Abstract Coronavirus disease in 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is pandemic worldwide SARS-CoV-2 IgM/IgG tests have been developed around the world for diagnosis and management of COVID-19 patients, and sero-epidemiological surveillance1 This article is protected by copyright All rights reserved

3.
Clin Infect Dis ; 2020 Jul 28.
Article in English | MEDLINE | ID: covidwho-684735

ABSTRACT

BACKGROUND: SARS-CoV-2 has spread worldwide and has the ability to damage multiple organs. However, information on serum SARS-CoV-2 nucleic acid(RNAemia) in patients affected by COVID-19 is limited. METHODS: Patients who admitted to Zhongnan Hospital of Wuhan University with laboratory-confirmed COVID-19, were tested SARS-COV-2 RNA in serum from January 28, 2020, to February 9, 2020. Demographic data, laboratory findings, radiological, comorbidities and outcomes data were collected and analyzed. RESULTS: 85 patients were included in the analysis. The viral load of throat swabs was significantly higher than serum samples. The highest detection of SARS-CoV-2 RNA in serum samples was between 11 to 15 days after the symptom onset. Analysis to compare with and without RNAemia provided evidence that CT and some laboratory biomarkers(total protein, BUN, LDH, hypersensitive troponin I and D-dimer) were abnormal, and that the extent of these abnormalities was generally higher in RNAemia than in non-RNAemia. Organ damages(respiratory failure, cardiac damage, renal damage and coagulopathy) were more common in RNAemia than non-RNAemia. Patients with vs without RNAemia had shorter durations from serum testing SARS-CoV-2 RNA. The mortality rate was higher among patients with vs without RNAemia. CONCLUSIONS: This study provides evidence to support that SARS-CoV-2 may have an important role in multiple organ damage, such as respiratory failure, cardiac damage, renal damage and coagulopathy. We did not find strong evidence that SARS-CoV-2 plays a role in damage of liver and the central nervous system. And our evidence suggests that RNAemia has a significant association with a higher risk of in-hospital mortality.

5.
mSphere ; 5(4)2020 07 15.
Article in English | MEDLINE | ID: covidwho-647106

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a threat to global health. The mortality rate of severely ill patients in the early stage is 32.5%. The exacerbation of the condition and death of patients are closely associated with inflammatory cytokine storms, which are caused by excessive activation of the immune and complement systems as well as the coinfection of other pathogens. However, the immunological characteristics and the mechanisms underlying inflammatory storms have not been well elucidated. Here, we analyzed the clinical and immunological characteristics of 71 confirmed COVID-19 patients. Based on the National Health Commission of China (NHCC) guidelines, patients were stratified into mild and severe types. We compared the clinical and laboratory data obtained from electronic medical records between the two types. In regard to the hematological parameters, COVID-19 patients showed decreased erythrocyte count, hemoglobin, hematocrit, lymphocyte count, eosinophil count, and complement C1q, whereas neutrophils, C-reactive protein, and procalcitonin were significantly increased, especially in severe cases. We also found that CD3+ CD4+ T lymphocytes, CD3+ CD8+ T lymphocytes, CD19+ B lymphocytes, and CD16+ CD56+ NK cells in the peripheral blood of all patients were decreased. In addition, CD3+ CD8+ T lymphocytes, CD16+ CD56+ NK cells, and complement C1q in severely ill patients decreased more significantly. Additionally, interleukin 6 (IL-6) elevation was particularly prominent in all patients, especially in severe cases. These results suggest that CD3+ CD8+ T lymphocytes, CD16+ CD56+ NK cells, C1q as well as IL-6 may play critical roles in the inflammatory cytokine storm. The dysregulation of these aforementioned immune parameters, along with bacterial coinfection, were the important causes of exacerbation of the patients' condition and death. This study improves our understanding of the immune dysregulation of COVID-19 and provides potential immunotherapeutic strategies.IMPORTANCE The dysregulation of CD3+ CD8+ T lymphocytes, CD16+ CD56+ NK cells, C1q as well as IL-6, along with bacterial coinfection, were important causes of exacerbation of the patients' condition and death.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Cytokine Release Syndrome/pathology , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Adult , Aged , B-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Complement C1q/immunology , Coronavirus Infections/mortality , Cytokine Release Syndrome/mortality , Female , Humans , Interleukin-6/blood , Killer Cells, Natural/immunology , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality
6.
EClinicalMedicine ; 2020.
Article | WHO COVID | ID: covidwho-628008

ABSTRACT

Background Coronavirus disease 2019 (COVID-19) has been widely spread and caused tens of thousands of deaths, especially in patients with severe COVID-19 This analysis aimed to explore risk factors for mortality of severe COVID-19, and establish a scoring system to predict in-hospital deaths Methods Patients with COVID-19 were retrospectively analyzed and clinical characteristics were compared LASSO regression as well as multivariable analysis were used to screen variables and establish prediction model Findings A total of 2529 patients with COVID-19 was retrospectively analyzed, and 452 eligible severe COVID-19 were used for finally analysis In training cohort, the median age was 66•0 years while it was 73•0 years in non-survivors Patients aged 60–75 years accounted for the largest proportion of infected populations and mortality toll Anti-SARS-CoV-2 antibodies were monitored up to 54 days, and IgG levels reached the highest during 20–30 days No differences were observed of antibody levels between severe and non-severe patients About 60 2% of severe patients had complications Among acute myocardial injury (AMI), acute kidney injury (AKI) and acute liver injury (ALI), the heart was the earliest injured organ, whereas the time from AKI to death was the shortest Age, diabetes, coronary heart disease (CHD), percentage of lymphocytes (LYM%), procalcitonin (PCT), serum urea, C reactive protein and D-dimer (DD), were identified associated with mortality by LASSO binary logistic regression Then multivariable analysis was performed to conclude that old age, CHD, LYM%, PCT and DD remained independent risk factors for mortality Based on the above variables, a scoring system of COVID-19 (CSS) was established to divide patients into low-risk and high-risk groups This model displayed good discrimination (AUC=0·919) and calibration (P=0·264) Complications in low-risk and high-risk groups were significantly different (P<0·05) Use of corticosteroids in low-risk groups increased hospital stays by 4·5 days (P=0·036) and durations of disease by 7·5 days (P=0·012) compared with no corticosteroids Interpretation Old age, CHD, LYM%, PCT and DD were independently related to mortality CSS was useful for predicting in-hospital mortality and complications, and it could help clinicians to identify high-risk patients with poor prognosis Funding This work was supported by the Key Project for Anti-2019 novel Coronavirus Pneumonia from the Ministry of Science and Technology, China (grant number 2020YFC0845500)

8.
Front. Med. ; (7)20200522.
Article in English | ELSEVIER | ID: covidwho-612624

ABSTRACT

Background. The outbreak of COVID-19 has attracted the attention of the whole world. Our study aimed to describe illness progression and risk profiles for mortality in non-survivors. Methods. We retrospectively analyzed 155 patients with COVID-19 in Wuhan and focused on 18 non-survivors among them. Briefly, we compared the dynamic profile of biochemical and immune parameters and drew an epidemiological and clinical picture of disease progression from disease onset to death in non-survivors. The survival status of the cohort was indicated by a Kaplan–Meier curve. Results. Of the non-survivors, the median age was 73.5 years, and the proportion of males was 72.2%. Five and 13 patients were hospital-acquired and community-acquired infection of SARS-CoV-2, respectively. The interval between disease onset and diagnosis was 8.5 days (IQR, [4–11]). With the deterioration of disease, most patients experienced consecutive changes in biochemical parameters, including lymphopenia, leukocytosis, thrombocytopenia, hypoproteinemia, as well as elevated D-dimer and procalcitonin. Regarding the immune dysregulation, patients exhibited significantly decreased T lymphocytes in the peripheral blood, including CD3 +T, CD3 +CD4 +Th, and CD3 +CD8 +Tc cells. By the end of the disease, most patients suffered from severe complications, including ARDS (17/18; 94.4%), acute cardiac injury (10/18; 55.6%), acute kidney injury (7/18; 38.9%), shock (6/18; 33.3%), gastrointestinal bleeding (1/18; 5.6%), as well as perforation of intestine (1/18; 5.6%). All patients died within 45 days after the initial hospital admission with a median survivor time of 13.5 days (IQR, 8–17). Conclusions. Our data show that patients experienced consecutive changes in biochemical and immune parameters with the deterioration of the disease, indicating the necessity of early intervention.

11.
Acta Pharm Sin B ; 2020 Apr 20.
Article in English | MEDLINE | ID: covidwho-88716

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with Corona Virus Disease 2019 (COVID-19), we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. Food and Drug Administration (FDA) approved drug library, we identified an anticoagulation agent dipyridamole (DIP) in silico, which suppressed SARS-CoV-2 replication in vitro. In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers (P<0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

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