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2.
Nat Commun ; 13(1): 959, 2022 02 18.
Article in English | MEDLINE | ID: covidwho-1699459

ABSTRACT

Record rainfall and severe flooding struck eastern China in the summer of 2020. The extreme summer rainfall occurred during the COVID-19 pandemic, which started in China in early 2020 and spread rapidly across the globe. By disrupting human activities, substantial reductions in anthropogenic emissions of greenhouse gases and aerosols might have affected regional precipitation in many ways. Here, we investigate such connections and show that the abrupt emissions reductions during the pandemic strengthened the summer atmospheric convection over eastern China, resulting in a positive sea level pressure anomaly over northwestern Pacific Ocean. The latter enhanced moisture convergence to eastern China and further intensified rainfall in that region. Modeling experiments show that the reduction in aerosols had a stronger impact on precipitation than the decrease of greenhouse gases did. We conclude that through abrupt emissions reductions, the COVID-19 pandemic contributed importantly to the 2020 extreme summer rainfall in eastern China.


Subject(s)
Aerosols/analysis , COVID-19/epidemiology , Greenhouse Gases/analysis , Rain , Vehicle Emissions/analysis , China/epidemiology , Floods , Human Activities/statistics & numerical data , Humans , Pandemics/statistics & numerical data , SARS-CoV-2 , Seasons
3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325222

ABSTRACT

BACKGROUND: Previous study suggested that Chinese Herbal Medicine (CHM) Formula Huashibaidu granule might shorten disease course of Corona Virus Disease 2019 (COVID-19) patients. Our research aims to investigate the early treatment effect of Huashibaidu granule in mild COVID-19 patients under well clinical management.METHODS: An unblended cluster-randomized clinical trial was conducted at the Dongxihu FangCang hospital. 2 cabins were randomly allocated to CHM or control group, with 204 randomly sampled mild COVID-19 patients in each cabin. All participants received a 7-day conventional treatment, and CHM group cabin used additional Huashibaidu granule 10g twice daily. Participants were followed up until they met clinical endpoint. The primary outcome was patient become worsening before clinical endpoint occurred. The secondary outcomes was discharge with cure before clinical endpoint occurred and relief of composite symptoms after 7 days treatment.FINDINGS: All 408 participants were followed up to meet clinical endpoint and included in statistical analysis. The baseline characteristics were comparable between 2 groups. The number of worsening patients in the CHM group was 5 (2.5%), and that in the control group was 16 (7.8%). There was a significant difference between groups (P=0.014). 8 foreseeable mild adverse events occurred without statistical difference between groups.INTERPRETATION: 7-day early treatment with Huashibaidu granule reduced worsening conversion of mild COVID-19 patients. Our study supports Huashibaidu Granule as an active option for early treatment of mild COVID-19 in similar medical locations with well management.TRIAL REGISTRATION: The Chinese Clinical Trial Registry: ChiCTR2000029763.FUNDING: This study was supported by “National Key R&D Program of China” (No.2020YFC0841500).DECLARATION OF INTERESTS: The authors guaranteed that there existed no competing interest in this paper.ETHICS APPROVAL STATEMENT: Ethics Review Committee of Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Approval of Ethical Review Acceptance Number: S2020-001;Approval Number: P20001/PJ01.

4.
Israeli Journal of Aquaculture Bamidgeh ; 73(63949), 2021.
Article in English | CAB Abstracts | ID: covidwho-1503169

ABSTRACT

In 1984, the Fisheries Research Institute of Hubei Province first introduced channel catfish from the US to China. Since then, the production of China's channel catfish has undergone volatile changes. In 2003, as a substitute for Pangasius fillets from Vietnam, the export volume of channel catfish-processed products increased considerably. In recent years, the Chinese channel catfish industry has shifted from dependence on American and European markets to dominance in Chinese markets. It is expected that the continuing impact of the Covid-19 epidemic in China and the development of the global pandemic will significantly affect the channel catfish farming sector in China. This paper outlines China's channel catfish industry's development, markets, costs, and benefits and provides some suggestions for its development.

5.
J Occup Environ Med ; 63(8): e533-e541, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1402737

ABSTRACT

OBJECTIVE: To investigate the epidemiological characteristics of human infection with corona virus disease 2019 (COVID-19) in Moscow, Lima, Kuwait, and Singapore to analyze the effects of climate factors on the incidence of COVID-19. METHODS: Collect the daily incidence of COVID-19 and related climate data in four areas, construct a negative binomial regression model, and analyze the correlation between the incidence of COVID-19 and meteorological factors. RESULTS: AH was the climate factor affecting the incidence of COVID-19 in Moscow, Lima, and Singapore; Ta and RH were the climate factors affecting the incidence of COVID-19 in Kuwait. CONCLUSIONS: The incidence of COVID-19 in four areas were all associated with the humidity, and climate factors should be taken into consideration when epidemic prevention measures are taken, and environment humidification may be a feasible approach to decrease COVID-19 virus transmission.


Subject(s)
COVID-19 , Climate , Humans , Humidity , Models, Statistical , SARS-CoV-2 , Temperature
7.
Gynecologic Oncology ; 162:S279-S280, 2021.
Article in English | Academic Search Complete | ID: covidwho-1366743

ABSTRACT

Poly(ADP-ribose) polymerase inhibitor maintenance (PARPm) therapy is now available to all women with advanced ovarian cancer following response to initial chemotherapy. As the COVID-19 pandemic has resulted in unprecedented challenges for cancer patients, we aimed to evaluate the unique experience for women on maintenance PARP inhibitors. Women with a current or prior diagnosis of ovarian cancer completed an online survey focusing on treatment interruptions and quality of life (QOL). QOL was measured with the Cancer Worry Scale and Hospital Anxiety and Depression Scale. The survey was distributed through survivor networks and social media. The chi-square and ANOVA test were used with a Bonferroni correction to account for multiple comparison testing. Six hundred and three women, from 41 states, visited the survey website between March 30 and April 13, 2020 and 525 (87%) completed the survey and provided information on current treatment status. Sixty-four women (12%) were on PARPm, 153 (29%) on other anti-cancer therapy and 308 (59%) on no treatment. Other anticancer therapies included intravenous chemotherapy (61, 40%), anti-angiogenic (29, 19%), hormonal (25, 16%), oral chemotherapy (12, 8%), immunotherapy (10, 6.5%) and other (16, 10%). There were no differences among women on PARPm, no treatment or other treatment for disease stage, medical comorbidities, COVID-19 symptoms or treatment delays. Women on PARPm were more likely to be self-described as immunocompromised versus women not on treatment (79% vs. 34%, P<0.001) and women on hormonal therapy (79% vs. 40%, P=0.002) and similar to women on oral -anti-cancer therapy (78% vs. 58%, P=0.336). Women on PARPm were more likely to use telemedicine versus women not on treatment (44% vs. 16%, P<0.001) and had similar use of telemedicine compared to all other treatment groups. For women on PARPm, higher cancer worry scores were associated with increased use of telemedicine (used telemedicine - 14.4 vs. did not use telemedicine - 13.3, P=0.007). There were no significant differences in reported cancer worry, anxiety or depression between women on PARPm, other anti-cancer therapy and no treatment. [Display omitted] The COVID-19 crisis is impacting cancer care and it is critical that providers consider and address the unique stressors facing women with ovarian cancer during this challenging time. Women on PARPm, in particular, perceive themselves as immunocompromised, perhaps making them more open to alternative means of care delivery, as demonstrated by their willingness to adopt telemedicine. Women with ovarian cancer on PARPm report similar cancer worry, anxiety and depression to women not on treatment and those on other anti-cancer treatment. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

8.
Gynecologic Oncology ; 162:S198-S198, 2021.
Article in English | Academic Search Complete | ID: covidwho-1366738

ABSTRACT

Collection of an accurate and comprehensive family cancer history (FCH) can help to identify millions of individuals at risk-for familial cancer syndromes. However, there are no formal guidelines for FCH collection and, as a result, there is wide variability in in strategies employed and accuracy of family health history across medical systems. Information technology (IT) provides a promising solution, a tool that has been shown to improve clinical documentation, workflows, quality of care, patient safety, communication and clinical decision support, and that can be completed remotely and safely during a pandemic. The aim of this study is to evaluate the literature on existing strategies whereby medical providers utilize information technology (IT) to assemble FCH. A systematic search of online databases (PubMed, EMBASE, MEDLINE, and the Cochrane Library) between 1980 and 2020 was performed. Meta-analysis was used to estimate pooled results across studies. Statistical heterogeneity was assessed through the chi-square test (i.e., Cochrane Q test) and the inconsistency statistic (I2). A random effects analysis was used to calculate the pooled proportions and means. The comprehensive search produced 4005 publications. Thirty-two peer-reviewed studies met inclusion criteria. Twenty-seven distinct IT tools were evaluated which included the following categories: electronic survey administered prior to visit (21, 65.6%), electronic survey administered via tablet in the medical office (6, 18.8%), electronic survey via kiosk (4, 12.5%) and animated virtual counselor (1, 3.1%). Among the 196,566 included patients, 87.0% completed the FCH tool (electronic survey prior to the visit - 85.0 %;electronic survey in the medical office - 89.0 %). The time required for survey completion was 35.2 minutes (CI 14.3 -56.2). Twelve percent of patients (n=11,093) were referred for genetic assessment based on the output of the FCH tool. Among the studied methods of FCH collection, 7 (21.9%) had the capacity to interface directly with the patient's electronic medical record. [Display omitted] The rapidly advancing field of germline cancer genetics coupled with a growing emphasis on disease prevention and incorporation of technology into medical care algorithms prior to and accelerated by the COVID-19 pandemic make utilization of IT strategies for collection of FCH a promising option. Our systematic review and meta-analysis found that electronic FCH collection can be completed successfully by patients in a time efficient manner. This information may be useful as many healthcare systems continue to restructure the way in which patients interact with their healthcare teams. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

9.
Gynecologic Oncology ; 162:S66-S66, 2021.
Article in English | Academic Search Complete | ID: covidwho-1366720

ABSTRACT

When New York City (NYC) emerged as a COVID-19 epicenter, hospitals and clinicians were forced to quickly change practice models of health care delivery. We sought to determine the impact of COVID-19 on treatment delays that occurred during the peak of the pandemic among low-income gynecologic oncology patients in NYC. Medicaid-insured patients receiving gynecologic oncology care at two affiliated centers between March 15 and April 15, 2020 were identified for telephone interview. Eligible patients included those with precancerous or cancerous gynecologic diseases or hereditary breast and ovarian cancer (HBOC) syndromes. Demographics, clinical characteristics, and reasons for treatment delays were identified through self-report and confirmed with chart review at the time of interview and at 6-month follow up. Outcomes were classified as delays in the following: surgery, adjuvant treatment (chemotherapy/radiation), and surveillance visits. Of the 158 eligible patients identified, 100 completed the interview. A total of 47 patients experienced an average treatment delay of 85.3 days (range: 7-210): surveillance visit (n=33), surgery (n=10), chemotherapy (n=3), radiation (n=1). Within this group, the median age was 58 years (range: 19-86). Self-identified race included: African-American (23.5%), Hispanic (31.9%), non-Hispanic White (17%), Asian (9.1%), Other (8.5%). The majority of patients (80.9%) had an annual income < $40,000. Clinically relevant surveillance delays occurred in 3 patients. A delayed diagnosis of vulvar cancer due to missed biopsy (follow up at 49 days) and 2 patients with delayed diagnosis of recurrent ovarian/primary peritoneal cancer;one died from disease and the other is undergoing chemotherapy. Surgical delays were identified in 10 patients: high grade cervical/vulvar dysplasia (n=3);endometrial intraepithelial neoplasia (EIN) (n=2);endometrial cancer (n=2);risk reducing surgery for HBOC syndromes (n=2);metastatic gastrointestinal adenocarcinoma to the ovary (n=1). Among the patients with endometrial cancer, one procedure delayed by 1 week was able to proceed and one transferred care. No upstaging of cancer diagnosis resulted from delays. Chemotherapy delays occurred in 3 patients with an average delay of 47.7 days. Of these patients, 2 were found to have progression of disease resulting in death (n=1) and decision to pursue hospice (n=1);one had a personal COVID-19 diagnosis. A delay in radiation treatment of 70 days was reported in 2.1% (n=1). A total of 9 patients were lost to follow up. Characteristics of patients lost to follow up include Hispanic/Latino race/ethnicity, essential worker, living with children in a high COVID-positive area (37.5%, n=3) or individuals who experienced a change in employment status (25%;n=2). [Display omitted] COVID-19 resulted in significant treatment delays among Medicaid-insured gynecologic oncology patients. As we continue to minimize clinical encounters, interventions aimed at providing timely oncology care during the COVID-19 pandemic is essential to prevent widening disparities in low-income populations. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

10.
Signal Transduct Target Ther ; 6(1): 300, 2021 08 11.
Article in English | MEDLINE | ID: covidwho-1351933

ABSTRACT

Elderly people and patients with comorbidities are at higher risk of COVID-19 infection, resulting in severe complications and high mortality. However, the underlying mechanisms are unclear. In this study, we investigate whether miRNAs in serum exosomes can exert antiviral functions and affect the response to COVID-19 in the elderly and people with diabetes. First, we identified four miRNAs (miR-7-5p, miR-24-3p, miR-145-5p and miR-223-3p) through high-throughput sequencing and quantitative real-time PCR analysis, that are remarkably decreased in the elderly and diabetic groups. We further demonstrated that these miRNAs, either in the exosome or in the free form, can directly inhibit S protein expression and SARS-CoV-2 replication. Serum exosomes from young people can inhibit SARS-CoV-2 replication and S protein expression, while the inhibitory effect is markedly decreased in the elderly and diabetic patients. Moreover, three out of the four circulating miRNAs are significantly increased in the serum of healthy volunteers after 8-weeks' continuous physical exercise. Serum exosomes isolated from these volunteers also showed stronger inhibitory effects on S protein expression and SARS-CoV-2 replication. Our study demonstrates for the first time that circulating exosomal miRNAs can directly inhibit SARS-CoV-2 replication and may provide a possible explanation for the difference in response to COVID-19 between young people and the elderly or people with comorbidities.


Subject(s)
COVID-19/genetics , Diabetes Mellitus/genetics , MicroRNAs/genetics , Spike Glycoprotein, Coronavirus/genetics , Adult , Age Factors , Aged , COVID-19/blood , COVID-19/pathology , COVID-19/virology , China , Circulating MicroRNA/blood , Circulating MicroRNA/genetics , Cohort Studies , Diabetes Mellitus/blood , Diabetes Mellitus/pathology , Diabetes Mellitus/virology , Exercise , Exosomes/genetics , Exosomes/metabolism , Exosomes/virology , Female , Gene Expression Regulation , HEK293 Cells , Host-Pathogen Interactions/genetics , Humans , Male , MicroRNAs/blood , Middle Aged , SARS-CoV-2/genetics , SARS-CoV-2/growth & development , SARS-CoV-2/metabolism , Spike Glycoprotein, Coronavirus/blood , Virus Replication
13.
Cancer ; 127(14): 2399-2408, 2021 07 15.
Article in English | MEDLINE | ID: covidwho-1287332

ABSTRACT

BACKGROUND: New York City (NYC) emerged as an epicenter of the COVID-19 pandemic, and marginalized populations were affected at disproportionate rates. The authors sought to determine the impact of COVID-19 on cancer treatment, anxiety, and financial distress among low-income patients with gynecologic cancer during the peak of the NYC pandemic. METHODS: Medicaid-insured women who were receiving gynecologic oncology care at 2 affiliated centers were contacted by telephone interviews between March 15 and April 15, 2020. Demographics and clinical characteristics were obtained through self-report and retrospective chart review. Financial toxicity, anxiety, and cancer worry were assessed using modified, validated surveys. RESULTS: In total, 100 patients completed the telephone interview. The median age was 60 years (range, 19-86 years), and 71% had an annual income <$40,000. A change in employment status and early stage cancer (stage I and II) were associated with an increase in financial distress (P < .001 and P = .008, respectively). Early stage cancer and telehealth participation were significantly associated with increased worry about future finances (P = .017 and P = .04, respectively). Lower annual income (<$40,000) was associated with increased cancer worry and anxiety compared with higher annual income (>$40,000; P = .036 and P = .017, respectively). When controlling for telehealth participation, income, primary language, and residence in a high COVID-19 prevalence area, a delay in medical care resulted in a 4-fold increased rate of anxiety (P = .023, 95% CI, 1.278-14.50). Race was not significantly associated with increased financial distress, cancer worry, or anxiety. CONCLUSIONS: Low socioeconomic status was the most common risk factor for increased financial distress, cancer worry, and anxiety. Interventions aimed at improving access to timely oncology care should be implemented during this ongoing pandemic.


Subject(s)
COVID-19/psychology , Financial Stress/epidemiology , Genital Neoplasms, Female/therapy , Pandemics/economics , Adult , Aged , Aged, 80 and over , COVID-19/economics , Female , Financial Stress/etiology , Genital Neoplasms, Female/economics , Genital Neoplasms, Female/psychology , Humans , Medicaid , Mental Health , Middle Aged , New York City , Pilot Projects , Poverty , Surveys and Questionnaires , Telemedicine , United States , Young Adult
14.
SSRN; 2021.
Preprint in English | SSRN | ID: ppcovidwho-9245
15.
Front Physiol ; 12: 630038, 2021.
Article in English | MEDLINE | ID: covidwho-1259363

ABSTRACT

BACKGROUND: Previous studies suggest that coronavirus disease 2019 (COVID-19) is a systemic infection involving multiple systems, and may cause autonomic dysfunction. OBJECTIVE: To assess autonomic function and relate the findings to the severity and outcomes in COVID-19 patients. METHODS: We included consecutive patients with COVID-19 admitted to the 21st COVID-19 Department of the east campus of Renmin Hospital of Wuhan University from February 6 to March 7, 2020. Clinical data were collected. Heart rate variability (HRV), N-terminal pro-B-type natriuretic peptide (NT-proBNP), D-dimer, and lymphocytes and subsets counts were analysed at two time points: nucleic-acid test positive and negative. Psychological symptoms were assessed after discharge. RESULTS: All patients were divided into a mild group (13) and a severe group (21). The latter was further divided into two categories according to the trend of HRV. Severe patients had a significantly lower standard deviation of the RR intervals (SDNN) (P < 0.001), standard deviation of the averages of NN intervals (SDANN) (P < 0.001), and a higher ratio of low- to high-frequency power (LF/HF) (P = 0.016). Linear correlations were shown among SDNN, SDANN, LF/HF, and laboratory indices (P < 0.05). Immune function, D-dimer, and NT-proBNP showed a consistent trend with HRV in severe patients (P < 0.05), and severe patients without improved HRV parameters needed a longer time to clear the virus and recover (P < 0.05). CONCLUSION: HRV was associated with the severity of COVID-19. The changing trend of HRV was related to the prognosis, indicating that HRV measurements can be used as a non-invasive predictor for clinical outcome.

16.
Phenomics ; : 1-11, 2021 May 11.
Article in English | MEDLINE | ID: covidwho-1225094

ABSTRACT

OBJECTIVES: To construct a distribution atlas of coronavirus disease 2019 (COVID-19) pneumonia on computed tomography (CT) and further explore the difference in distribution by location and disease severity through a retrospective study of 484 cases in Jiangsu, China. METHODS: All patients diagnosed with COVID-19 from January 10 to February 18 in Jiangsu Province, China, were enrolled in our study. The patients were further divided into asymptomatic/mild, moderate, and severe/critically ill groups. A deep learning algorithm was applied to the anatomic pulmonary segmentation and pneumonia lesion extraction. The frequency of opacity on CT was calculated, and a color-coded distribution atlas was built. A further comparison was made between the upper and lower lungs, between bilateral lungs, and between various severity groups. Additional lesion-based radiomics analysis was performed to ascertain the features associated with the disease severity. RESULTS: A total of 484 laboratory-confirmed patients with 945 repeated CT scans were included. Pulmonary opacity was mainly distributed in the subpleural and peripheral areas. The distances from the opacity to the nearest parietal/visceral pleura were shortest in the asymptomatic/mild group. More diffused lesions were found in the severe/critically ill group. The frequency of opacity increased with increased severity and peaked at about 3-4 or 7-8 o'clock direction in the upper lungs, as opposed to the 5 or 6 o'clock direction in the lower lungs. Lesions with greater energy, more circle-like, and greater surface area were more likely found in severe/critically ill cases than the others. CONCLUSION: This study constructed a detailed distribution atlas of COVID-19 pneumonia and compared specific patterns in different parts of the lungs at various severities. The radiomics features most associated with the severity were also found. These results may be valuable in determining the COVID-19 sub-phenotype. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43657-021-00011-4.

17.
NPJ Digit Med ; 4(1): 75, 2021 Apr 22.
Article in English | MEDLINE | ID: covidwho-1199320

ABSTRACT

The COVID-19 pandemic overwhelms the medical resources in the stressed intensive care unit (ICU) capacity and the shortage of mechanical ventilation (MV). We performed CT-based analysis combined with electronic health records and clinical laboratory results on Cohort 1 (n = 1662 from 17 hospitals) with prognostic estimation for the rapid stratification of PCR confirmed COVID-19 patients. These models, validated on Cohort 2 (n = 700) and Cohort 3 (n = 662) constructed from nine external hospitals, achieved satisfying performance for predicting ICU, MV, and death of COVID-19 patients (AUROC 0.916, 0.919, and 0.853), even on events happened two days later after admission (AUROC 0.919, 0.943, and 0.856). Both clinical and image features showed complementary roles in prediction and provided accurate estimates to the time of progression (p < 0.001). Our findings are valuable for optimizing the use of medical resources in the COVID-19 pandemic. The models are available here: https://github.com/terryli710/COVID_19_Rapid_Triage_Risk_Predictor .

18.
J Cardiovasc Magn Reson ; 23(1): 14, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1102339

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiovascular magnetic resonance (CMR). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMR METHODS: A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMR examination. The CMR protocol consisted of black blood fat-suppressed T2 weighted imaging, T2 star mapping, left ventricle (LV) cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). LGE were assessed in mixed both recovered COVID-19 patients and healthy controls. The LV and right ventricle (RV) function and LV mass were assessed and compared with healthy controls. RESULTS: A total of 44 recovered COVID-19 patients and 31 healthy controls were studied. LGE was found in 13 (30%) of COVID-19 patients. All LGE lesions were located in the mid myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased LV peak global circumferential strain (GCS), RV peak GCS, RV peak global longitudinal strain (GLS) as compared to non-LGE patients (p < 0.05), while no difference was found between the non-LGE patients and healthy controls. CONCLUSION: Myocardium injury existed in 30% of COVID-19 patients. These patients have depressed LV GCS and peak RV strains at the 3-month follow-up. CMR can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of LV and RV dysfunction.


Subject(s)
COVID-19/complications , Cardiomyopathies/diagnostic imaging , Cardiomyopathies/etiology , Magnetic Resonance Imaging/methods , COVID-19/pathology , Female , Follow-Up Studies , Heart/diagnostic imaging , Humans , Male , Middle Aged , Myocardium/pathology , Prospective Studies , SARS-CoV-2
19.
Ann Surg ; 273(1): 34-40, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1082368

ABSTRACT

OBJECTIVE: To evaluate the perioperative morbidity and mortality of patients with COVID-19 who undergo urgent and emergent surgery. SUMMARY BACKGROUND DATA: Although COVID-19 infection is usually associated with mild disease, it can lead to severe respiratory complications. Little is known about the perioperative outcomes of patients with COVID-19. METHODS: We examined patients who underwent urgent and emergent surgery at 2 hospitals in New York City from March 17 to April 15, 2020. Elective surgical procedures were cancelled throughout and routine, laboratory based COVID-19 screening was instituted on April 1. Mortality, complications, and admission to the intensive care unit were compared between patients with COVID-19 detected perioperatively and controls. RESULTS: Among 468 subjects, 36 (7.7%) had confirmed COVID-19. Among those with COVID-19, 55.6% were detected preoperatively and 44.4% postoperatively. Before the routine preoperative COVID-19 laboratory screening, 7.7% of cases were diagnosed preoperatively compared to 65.2% after institution of screening (P = 0.0008). The perioperative mortality rate was 16.7% in those with COVID-19 compared to 1.4% in COVID-19 negative subjects [aRR = 9.29; 95% confidence interval (CI), 5.68-15.21]. Serious complications were identified in 58.3% of COVID-19 subjects versus 6.0% of controls (aRR = 7.02; 95%CI, 4.96-9.92). Cardiac arrest, sepsis/shock, respiratory failure, pneumonia, acute respiratory distress syndrome, and acute kidney injury were more common in those with COVID-19. The intensive care unit admission rate was 36.1% in those with COVID-19 compared to 16.4% of controls (aRR = 1.34; 95%CI, 0.86-2.09). CONCLUSIONS: COVID-19 is associated with an increased risk for serious perioperative morbidity and mortality. A substantial number of patients with COVID-19 are not identified until after surgery.


Subject(s)
COVID-19/epidemiology , Intensive Care Units/statistics & numerical data , Postoperative Complications/epidemiology , SARS-CoV-2 , Surgical Procedures, Operative/adverse effects , Adult , Aged , Comorbidity , Female , Follow-Up Studies , Humans , Male , Middle Aged , Morbidity/trends , Retrospective Studies , Survival Rate/trends , United States/epidemiology
20.
Cell Host Microbe ; 29(3): 489-502.e8, 2021 03 10.
Article in English | MEDLINE | ID: covidwho-1064930

ABSTRACT

The SARS-CoV-2 virus, the causative agent of COVID-19, is undergoing constant mutation. Here, we utilized an integrative approach combining epidemiology, virus genome sequencing, clinical phenotyping, and experimental validation to locate mutations of clinical importance. We identified 35 recurrent variants, some of which are associated with clinical phenotypes related to severity. One variant, containing a deletion in the Nsp1-coding region (Δ500-532), was found in more than 20% of our sequenced samples and associates with higher RT-PCR cycle thresholds and lower serum IFN-ß levels of infected patients. Deletion variants in this locus were found in 37 countries worldwide, and viruses isolated from clinical samples or engineered by reverse genetics with related deletions in Nsp1 also induce lower IFN-ß responses in infected Calu-3 cells. Taken together, our virologic surveillance characterizes recurrent genetic diversity and identified mutations in Nsp1 of biological and clinical importance, which collectively may aid molecular diagnostics and drug design.


Subject(s)
COVID-19/immunology , COVID-19/virology , Interferon Type I/immunology , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Viral Nonstructural Proteins/genetics , A549 Cells , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Base Sequence , COVID-19/blood , Cell Line , Child , Child, Preschool , Chlorocebus aethiops , Female , Gene Deletion , Genomics , HEK293 Cells , Humans , Infant , Interferon Type I/blood , Interferon-beta/blood , Interferon-beta/metabolism , Male , Middle Aged , Molecular Epidemiology , Reverse Genetics , Vero Cells , Viral Nonstructural Proteins/immunology , Young Adult
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