Association between ambient sulfur dioxide pollution and asthma mortality: Evidence from a nationwide analysis in China

There is a lack of research on the effects of acute exposure to ambient sulfur dioxide (SO2) on mortality caused by asthma, especially nationwide research in China. To explore the acute effect of exposure to ambient SO2 on asthma mortality using nationwide dataset in China from 2015 to 2020 and further evaluate the associations in subgroups with different geographical and demographic characteristics. We used data from China's Disease Surveillance Points system with 29,553 asthma deaths in China during 2015–2020. The exposure variable was the daily mean concentrations of SO2 from the ChinaHighSO2 10 km × 10 km daily grid dataset. Bilinear interpolation was used to estimate each individual's exposure to air pollutants and meteorological variables. We used a time-stratified case crossover design at the individual level to analyze the exposure response relationship between short-term exposure to SO2 and asthma mortality. Stratified analyses were carried out by sex, age group, marital status, warm season and cold season, urbanicity and region. Significant associations between short-term exposure to ambient SO2 and increased asthma mortality were found in this nationwide study. The excess risk (ER) for each 10 μg/m3 increase in SO2 concentrations at lag07 was 7.78 % (95 % CI, 4.16–11.52 %). Season appeared to significantly modify the association. The associations were stronger in cold season (ER 9.78 %, 95 % CI:5.82 −13.89 %). The association remained consistent using different lag periods, adjusting for other pollutants, and in the analysis during pre-Corona Virus Disease 2019 (COVID-19) period. Our study indicates increased risk of asthma mortality with acute exposures to SO2 in Chinese population. The current study lends support for greater awareness of the harmful effect of SO2 in China and other countries with high SO2 pollution. © 2022 The Authors

Developing Next-Generation Protein-Based Vaccines Using High-Affinity Glycan Ligand-Decorated Glyconanoparticles

Major diseases, such as cancer and COVID-19, are frightening global health problems, and sustained action is necessary to develop vaccines. Here, for the first time, ethoxy acetalated dextran nanoparticles (Ace-Dex-NPs) are functionalized with 9-N-(4H-thieno[3,2-c]chromene-2-carbamoyl)-Siaα2−3Galβ1−4GlcNAc (TCCSia-LacNAc) targeting macrophages as a universal vaccine design platform. First, azide-containing oxidized Ace-Dex-NPs are synthesized. After the NPs are conjugated with ovalbumin (OVA) and resiquimod (Rd), they are coupled to TCCSia-LacNAc-DBCO to produce TCCSia-Ace-Dex-OVA-Rd, which induce a potent, long-lasting OVA-specific cytotoxic T-lymphocyte (CTL) response and high anti-OVA IgG, providing mice with superior protection against tumors. Next, this strategy is exploited to develop vaccines against infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein is the main target for neutralizing antibodies. The TCCSia-Ace-Dex platform is preferentially used for designing an RBD-based vaccine. Strikingly, the synthetic TCCSia-Ace-Dex-RBD-Rd elicited potent RBD-neutralizing antibodies against live SARS-CoV-2 infected Vero E6 cells. To develop a universal SARS-CoV-2 vaccine, the TCCSia-Ace-Dex-N-Rd vaccine carrying SARS-CoV-2 nucleocapsid protein (N) is also prepared, which is highly conserved among SARS-CoV-2 and its variants of concern (VOCs), including Omicron (BA.1 to BA.5);this vaccine can trigger strong N-specific CTL responses against target cells infected with SARS-CoV-2 and its VOCs. © 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.

A retrospective study of Pupingqinghua prescription versus Lianhuaqingwen in Chinese participants infected with SARS-CoV-2 Omicron variants

Background: Coronavirus disease (COVID-19) seriously endangers global public health. Pupingqinghua prescription (PPQH) is an herbal formula from traditional Chinese medicine used for treatment of SARS-CoV-2 infection. This study aims to evaluate the clinical efficacy and safety of PPQH in Chinese participants infected with the SARS-CoV-2 Omicron variant. Methods: A total of 873 SARS-CoV-2 (Omicron)-infected patients were included. Among them, the patients were divided into the PPQH group (653 cases) and LHQW group (220 cases) according to different medications. The effectiveness indicators (hematological indicators, Ct values of novel Coronavirus nucleic acid tests, and viral load-shedding time) and safety indicators (liver and kidney function and adverse events) were analyzed. Results: There was no significant difference in baseline characteristics between the PPQH group and the LHQW group, except the gender;After the treatment, the levels of IL-5, IL-6, IL-10, NK cells, and INF-α of the patients in the PPQH group showed a downward trend (p < 0.05);The viral load shedding time was 5.0 (5.0, 7.0) in the PPQH group and 5.0 (4.0, 7.0) in the LHQW group;both PPQH and LHQW can shorten the duration of symptoms of fever, cough, and sore throat. The re-positive rate of COVID-19 test was 1.5 % in the PPQH group and 2.3 % in the LHQW group. In terms of safety, the levels of γ-GTT decreased significantly (p < 0.01);gastrointestinal reaction was the primary adverse reaction, and the reaction rate was 4.7 % in the PPQH group and 9.5 % in the LHQW group. Conclusion: PPQH can shorten the length of hospital stay and improve clinical symptoms of patients with SARS-COV-2 (Omicron), and it also has a good safety profile.

Clinical characteristics of pediatric cases infected with the SARS-CoV-2 Omicron variant in a tertiary children's medical center in Shanghai, China

Background: The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has increased. Here, we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai. Methods: A total of 676 pediatric coronavirus disease 2019 (COVID-19) cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30, 2022 were enrolled in this single-center, prospective, observational real-world study. Patient demographics and clinical characteristics, especially COVID-19 vaccine status, were assessed. Results: Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant, with no significant difference between sexes. A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia, neutropenia, and thrombocytopenia (P = 0.003, P = 0.021, and P = 0.017, respectively) but not with physical symptoms or radiographic chest abnormalities. Univariable linear regression models indicated that comorbidities (P = 0.001) were associated with a longer time until viral clearance, and increasing age (P < 0.001) and two doses of COVID-19 vaccine (P = 0.001) were associated with a shorter time to viral clearance. Multivariable analysis revealed an independent effect of comorbidities (P < 0.001) and age (P = 0.003). The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases (P < 0.001). Conclusion: This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children. © 2022, Children's Hospital, Zhejiang University School of Medicine.

Arrhythmia in patients with severe coronavirus disease (COVID-19): a meta-analysis.

OBJECTIVE: Many studies have reported arrhythmia to be associated with coronavirus disease (COVID-19), but no meta-analysis has explored whether arrhythmia is related to COVID-19 severity. Therefore, the purpose of this study was to evaluate arrhythmia in patients with severe and non-severe COVID-19 during the current COVID-19 pandemic. MATERIALS AND METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library for case control studies that were published between January 1 and July 25, 2020, and that had data on arrhythmia in patients with COVID-19. Random effects model was used with the odds ratio as the effect size. The frequency of arrhythmia was compared between COVID-19 patients with and without the composite endpoint of severity. We also determined the pooled prevalence of arrhythmia in patients with COVID-19. Publication bias and heterogeneity were considered by using subgroup analyses, meta-regression, and the trim and fill method. RESULTS: A total of 1553 patients with COVID-19 were included in the 5 articles we obtained. Of these, 349 cases (22.47%) and 1204 cases (77.53%) were severely ill and non-severely ill inpatients with COVID-19 pneumonia, respectively. There were 790 (50.87%) male patients. A total of 105 cases (30.09%) of severely ill inpatients with COVID-19 pneumonia had arrhythmia complications, and 34 cases (2.82%) of non-severely ill inpatients with COVID-19 pneumonia had arrhythmia complications. We found arrhythmia to be significantly associated with severely ill inpatients with COVID-19 pneumonia, with a pooled odds ratio of 17.97 (95% CI (11.30, 28.55), p<0.00001). CONCLUSIONS: This study showed that the incidence of arrhythmia in patients with severe COVID-19 was greater than that of those with non-severe COVID-19. Patients with severe COVID-19 had a higher risk of arrhythmia complications, which further showed that COVID-19 may be a risk factor for arrhythmia and that the incidence of arrhythmia may increase with the progression of the disease. More importantly, this meta-analysis graded the reliability of evidence for further basic and clinical research into arrhythmia in patients with COVID-19.

Prognosis of COVID-19 in patients with vein thrombosis: a systematic review and meta-analysis.

OBJECTIVE: SARS-CoV-2 is currently affecting millions of humans worldwide, thus contributing to the COVID-19 pandemic. Thromboembolic events have a higher incidence among patients with COVID-19, but there are few reports on the relationship between the prognosis of COVID-19 patients and thromboembolic events. The objectives of this meta-analysis were to explore the relationship between the prognosis of COVID-19 patients and thromboembolic events. MATERIALS AND METHODS: Medline (PubMed), the Web of Science, Embase, and the Cochrane Library were searched for case-control studies that included data on vein thrombosis in patients with COVID-19 and were published in English, between January 1 and July 25, 2020. According to the inclusion and exclusion criteria, the included data were confirmed, the prognoses of patients with and without concurrent thromboembolic events were compared, and the odds ratio (OR) was used as the effect size. RESULTS: Eighteen studies (2,030 patients) were included. Thromboembolic events complicated a total of 609 COVID-19 patients. The combined OR of the mortality of COVID-19 patients with thromboembolic events was 1.93 (95% CI: 1.13-3.27), that of ICU treatment rate was 2.63 (95% CI: 1.49-4.67), and that of treatment with invasive mechanical ventilation was 3.14 (95% CI: 1.97-5.02). CONCLUSIONS: As compared with COVID-19 patients with and without thromboembolism, the mortality, ICU treatment rate, and invasive mechanical ventilation treatment rate of COVID-19 patients with thromboembolism were found to be increased significantly, and the prognosis was worse.

Psychological support and the COVID-19 - A short report.

OBJECTIVE: The World Health Organization reported a cluster of cases of pneumonia of unknown cause detected on December 31, 2019 in China. Unfortunately, a 34-year-old Italian nurse has committed suicide after testing positive for coronavirus. It was the second case of suicide by a nurse in an Italian hospital and occurred only a few days after the first suicide. These consecutive suicides have aroused concern, and it is necessary to investigate the psychological issues of the medical staff in Italy regarding the COVID-19.

Screening of anti-SARS-CoV-2 small molecular compounds from traditional Chinese medicine based on molecular docking

Objective: Based on the targets of SARS-CoV-S/ACE2 complex and SARS-CoV-2 Mpro hydrolase, we screened the binding blockers of SARS-CoV-2-ACE2 and inhibitors of SARS-CoV-2 Mpro hydrolase from TCMSP database as precursors to guide the discovery of new drugs from small molecules of traditional Chinese medicine (TCM) against SARS-CoV-2. Methods: According to the literature reports, the active sites of the crystal structure model of SARS-CoV-S/ACE2 complex protein and SARS-CoV-2 Mpro hydrolase were determined, and the small molecular compounds from TCMSP database were virtually screened using LibDock molecular docking technology. The screening results were optimized by combining the LibDock Score with the interaction mode between the compounds and the targeting receptor protein, and then the small molecular compounds of TCM which have the potential activity of anti-SARS-CoV-2 were obtained. Results: ASP38, GLN42, GLN325, GLU329, TYR436, TYR491 on the binding surface of SARS-CoV-S/ACE2 complex protein and THR24, THR25, THR26, LEU27, ASN28, ASN119 in the structure of Mpro hydrolase were identified as the key amino acids for molecular docking. Twenty candidate SARS-CoV-2-ACE2 binding blockers which can form hydrogen bond with key amino acids were screened by molecular docking, and the docking effect of four components mainly from Gardeniae Fructus, Glycyrrhizae Radix Et Rhizoma, Sophorae Tonkinensis Radix Et Rhizoma and Daturae Flos with the targeting protein was better than others. Thirty-four candidate SARS-CoV-2 Mpro hydrolase inhibitors which can form hydrogen bond with key amino acids were also screened, and the docking effect of four components mainly from Zingiberis Rhizoma, Rhizoma Dioscoreae Bulbiferae, Cimicifugae Rhizoma and Capsella Bursa-pastoris with the targeting protein was better than others. Kanzonol E from Glycyrrhizae Radix Et Rhizoma and kryptogenin from Rhizoma Dioscoreae Bulbiferae could interact with the largest number of key amino acids or form the most hydrogen bonds with the targeting protein respectively, and had the best molecular docking effect. Conclusion: Four candidate SARS-CoV-2-ACE2 binding blockers and four candidate SARS-CoV-2 Mpro hydrolase inhibitors from TCM have the potential activity of anti-SARS-CoV-2, among which priority can be given to kanzonol E, a component of Glycyrrhizae Radix Et Rhizoma, and kryptogenin, a component of Rhizoma Dioscoreae Bulbiferae, for further discovery of anti-SARS-CoV-2 new drugs.

Mask crisis during the COVID-19 outbreak.

On December 31, 2019, the World Health Organization (WHO) reported a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. As of February 29, 2020, the National Health Commission of China has reported 79,389 confirmed cases of SARS-CoV-2 infection in 34 provinces. The masks can be used to block respiratory transmission from human to human, and are an effective way to control influenza. It is, therefore, necessary to wear a mask when respiratory infectious diseases are prevalent. China has a population of 1.4 billion. Assuming that two-thirds of the people in China must wear a mask every day, the daily demand for masks will reach 900 million. The Chinese government has taken many measures to solve these problems. Additionally, more measures should be taken to properly dispose of mask garbage. Although the outbreak originated in China, person-to-person transmission of SARS-CoV-2 has been confirmed, which means that it can be spread to anywhere in the world if prevention measures fail. The issues regarding face mask shortages and garbage in China, therefore, deserve worldwide attention.

Dysregulation of immune response in patients with COVID-19 in Wuhan, China ;Clinical Infectious Diseases ;Oxford Academic

Abstract Background In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and rapidly spread throughout China. Methods Demographic and clinical data of all confirmed cases with COVID-19 on admission at Tongji Hospital from January 10 to February 12, 2020, were collected and analyzed. The data of laboratory examinations, including peripheral lymphocyte subsets, were analyzed and compared between severe and non-severe patients. Results Of the 452 patients with COVID-19 recruited, 286 were diagnosed as severe infection. The median age was 58 years and 235 were male. The most common symptoms were fever, shortness of breath, expectoration, fatigue, dry cough and myalgia. Severe cases tend to have lower lymphocytes counts, higher leukocytes counts and neutrophil-lymphocyte-ratio (NLR), as well as lower percentages of monocytes, eosinophils, and basophils. Most of severe cases demonstrated elevated levels of infection-related biomarkers and inflammatory cytokines. The number of T cells significantly decreased, and more hampered in severe cases. Both helper T cells and suppressor T cells in patients with COVID-19 were below normal levels, and lower level of helper T cells in severe group. The percentage of naïve helper T cells increased and memory helper T cells decreased in severe cases. Patients with COVID-19 also have lower level of regulatory T cells, and more obviously damaged in severe cases. Conclusions The novel coronavirus might mainly act on lymphocytes, especially T lymphocytes. Surveillance of NLR and lymphocyte subsets is helpful in the early screening of critical illness, diagnosis and treatment of COVID-19.