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2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325397

ABSTRACT

Background: Severe cytokine storm syndrome (CSS) is considered as the cause of death among critically ill COVID-19 cases. Early identification of the high-risk severe cases is crucial to lower the fatality and healthcare costs. Methods: : In this study, we retrospectively analyzed the first and second-week serum levels of IL-6, IL-8, and IL-10 of 50 COVID-19 cases. We calculated the ratios of IL-6/IL-10 and IL-8/IL-10 at 3 rd , 6 th , 9 th , and 12 th days of hospitalization. Results: : We collected 50 COVID-19 cases (male 54%, mean age 51.2, range 18 - 86), including 39 mild cases (78%), 7 severe/recovered cases (14%), and 4 died cases (8%).The ratios of IL 6/IL-10 and IL-8/IL-10 among mild cases were below 27 (the highest, 26.9) along the 4 testing points of two week hospitalization, while we found that the IL-6/IL-10 and IL-8/IL-10 ratios were as high as 187.51 and 225.3 respectively in the death group on 3 rd day with the highest IL-6/IL-10 ratio of 297.28 on the 6 th day of hospitalization. Conclusions: : Our preliminary results suggest that the ratios of IL-6/IL-10 and IL-8/IL-10 at the early stage (the first two weeks) of COVID-19 could be a predictive marker for the disease prognosis, of which the cut-off lines were suggested below 50 for a mild and recoverable severe cases.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310216

ABSTRACT

Background: As an important indicator to measure obesity or underweight, body mass index (BMI) can be used to assess the potential risk for various diseases. The present study systematically examined the relationship between BMI and severity and mortality of patients with coronavirus disease 2019 (COVID-19). Methods We systematically searched PubMed, Embase, Cochrane, and China National Knowledge Infrastructure (CNKI) for studies published as of September 3, 2020 and extracted the relevant data of research endpoints in each study. Results This study included 16 studies with 6087 patients. This study observed a significant increase in BMI on admission in patients with severe COVID-19 compared with those with non-severe COVID-19 (Mean difference [MD] = 1.95, 95% confidence interval [CI], 1.52 − 2.37, I 2  = 33%, P < 0.00001). A significant increase in BMI on admission was observed in patients who died from COVID-19 compared with (MD = 3.01, 95% CI: 1.83 to 4.19, I 2  = 0%, P  < 0.00001). In the intensive care unit (ICU) or geriatric ward, the study observed a significant decrease in BMI in the non-survivor group compared with the survivor group (MD = -1.61, 95% CI: -3.07 to -0.16, I 2  = 72%, P  = 0.03). Conclusions Higher BMI on admission is associated with severity and mortality of patients with COVID-19, but lower BMI is associated with mortality of patients with COVID-19 in the ICU or geriatric ward. Thus, we strongly recommend that clinicians should closely monitor the BMI of patients with COVID-19, especially those from the ICU or geriatric ward.

4.
Nat Med ; 26(6): 845-848, 2020 06.
Article in English | MEDLINE | ID: covidwho-1641979

ABSTRACT

We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.


Subject(s)
Antibodies, Viral/blood , Antibody Formation/drug effects , Betacoronavirus/pathogenicity , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Adult , Aged , Antibody Formation/immunology , Antiviral Agents/therapeutic use , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/immunology , Coronavirus Infections/virology , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/blood , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , SARS-CoV-2
6.
PLoS One ; 16(8): e0254988, 2021.
Article in English | MEDLINE | ID: covidwho-1348363

ABSTRACT

BACKGROUND: During uncertainties associated with the COVID-19 pandemic, effectively improving people's health literacy is more important than ever. Drawing knowledge maps of health literacy research through data mining and visualized measurement technology helps systematically present the research status and development trends in global academic circles. METHODS: This paper uses CiteSpace to carry out a metric analysis of 9,492 health literacy papers included in Web of Science through mapping knowledge domains. First, based on the production theory of scientific knowledge and the data mining of citations, the main bodies (country, institution and author) that produce health literacy knowledge as well as their mutual cooperation (collaboration network) are both clarified. Additionally, based on the quantitative framework of cocitation analysis, this paper introduces the interdisciplinary features, development trends and hot topics of the field. Finally, by using burst detection technology in the literature, it further reveals the research frontiers of health literacy. RESULTS: The results of the BC measures of the global health literacy research collaboration network show that the United States, Australia and the United Kingdom are the major forces in the current international collaboration network on health literacy. There are still relatively very few transnational collaborations between Eastern and Western research institutions. Collaborations in public environmental occupational health, health care science services, nursing and health policy services have been active in the past five years. Research topics in health literacy research evolve over time, mental health has been the most active research field in recent years. CONCLUSIONS: A systematic approach is needed to address the challenges of health literacy, and the network framework of cooperation on health literacy at regional, national and global levels should be strengthened to further promote the application of health literacy research. In the future, we anticipate that this research field will expand in two directions, namely, mental health literacy and eHealth literacy, both of which are closely linked to social development and issues. The results of this study provide references for future applied research in health literacy.


Subject(s)
Data Mining , Global Health , Health Knowledge, Attitudes, Practice , Health Literacy , Bibliometrics , COVID-19/epidemiology , Humans , Public Health
7.
Front Med (Lausanne) ; 8: 684864, 2021.
Article in English | MEDLINE | ID: covidwho-1337651

ABSTRACT

Background: COVID-19 is a global pandemic. The prevention of SARS-CoV-2 infection and the rehabilitation of survivors are currently the most urgent tasks. However, after patients with COVID-19 are discharged from the hospital, how long the antibodies persist, whether the lung lesions can be completely absorbed, and whether cardiopulmonary abnormalities exist remain unclear. Methods: A total of 56 COVID-19 survivors were followed up for 12 months, with examinations including serum virus-specific antibodies, chest CT, and cardiopulmonary exercise testing. Results: The IgG titer of the COVID-19 survivors decreased gradually, especially in the first 6 months after discharge. At 6 and 12 months after discharge, the IgG titer decreased by 68.9 and 86.0%, respectively. The IgG titer in patients with severe disease was higher than that in patients with non-severe disease at each time point, but the difference did not reach statistical significance. Among the patients, 11.8% were IgG negative up to 12 months after discharge. Chest CT scans showed that at 3 and 10 months after discharge, the lung opacity had decreased by 91.9 and 95.5%, respectively, as compared with that at admission. 10 months after discharge, 12.5% of the patients had an opacity percentage >1%, and 18.8% of patients had pulmonary fibrosis (38.5% in the severe group and 5.3% in the non-severe group, P < 0.001). Cardiopulmonary exercise testing showed that 22.9% of patients had FEV1/FVC%Pred <92%, 17.1% of patients had FEV1%Pred <80%, 20.0% of patients had a VO2 AT <14 mlO2/kg/min, and 22.9% of patients had a VE/VCO2 slope >30%. Conclusions: IgG antibodies in most patients with COVID-19 can last for at least 12 months after discharge. The IgG titers decreased significantly in the first 6 months and remained stable in the following 6 months. The lung lesions of most patients with COVID-19 can be absorbed without sequelae, and a few patients in severe condition are more likely to develop pulmonary fibrosis. Approximately one-fifth of the patients had cardiopulmonary dysfunction 6 months after discharge.

8.
Int J Med Sci ; 18(13): 2789-2798, 2021.
Article in English | MEDLINE | ID: covidwho-1296170

ABSTRACT

Coronavirus disease 2019 (COVID-19) has spread widely in the communities in many countries. Although most of the mild patients could be cured by their body's ability to self-heal, many patients quickly progressed to severe disease and had to undergo treatment in the intensive care unit (ICU). Thus, it is very important to effectively predict which patients with mild disease are more likely to progress to severe disease. A total of 72 patients hospitalized with COVID-19 in Shandong Provincial Public Health Clinical Center and 1141 patients included in the published papers were enrolled in this study. We determined that the combination of interleukin-6 (IL-6), Neutrophil (NEUT), and Natural Killer (NK) cells had the highest prediction accuracy (with 75% sensitivity and 95% specificity) for progression of COVID-19 infection. A binomial regression equation that accounted for a multiple risk score for the combination of IL-6, NEUT, and NK was also established. The multiple risk score is a good indicator for early stratification of mild patients into risk categories, which is very important for adjusting the treatment plan and preventing death.


Subject(s)
Biomarkers/analysis , COVID-19/etiology , Aged , Biomarkers/blood , Blood Cell Count , COVID-19/epidemiology , Comorbidity , Disease Progression , Humans , Interleukin-6/blood , Killer Cells, Natural , Middle Aged , Neutrophils , Retrospective Studies
9.
Virol J ; 18(1): 126, 2021 06 12.
Article in English | MEDLINE | ID: covidwho-1266497

ABSTRACT

BACKGROUND: Tens of million cases of coronavirus disease-2019 (COVID-19) have occurred globally. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attacks the respiratory system, causing pneumonia and lymphopenia in infected individuals. The aim of the present study is to investigate the laboratory characteristics of the viral load, lymphocyte subset and cytokines in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19. METHODS: From January 24, 2020, to April 11, 2020, 48 consecutive subjects were enrolled in this study. Viral loads were detected by RT-PCR from throat-swab, sputum and feces samples. Lymphocyte subset levels of CD3 + , CD4 + , and CD8 + T lymphocytes, B cells and NK cells were determined with biological microscope and flow cytometric analysis. Plasma cytokines (IL2, IL4, IL5, IL6, IL8, IL10, TNF-α, IFN-α and IFN-γ) were detected using flow cytometer. Analysis of variance (ANOVA), Chi-square or Fisher's exact test and Pearson's Correlation assay was used for all data. RESULTS: Asymptomatic (AS), mild symptoms (MS) and severe or critical cases (SCS) with COVID-19 were 11 (11/48, 22.9%), 26 (54.2%, 26/48) and 11 cases (11/48, 22.9%), respectively. The mean age of AS group (47.3 years) was lower than SCS group (63.5 years) (P < 0.05). Diabetes mellitus in AS, MS and SCS patients with COVID-19 were 0, 6 and 5 cases, respectively, and there was a significant difference between AS and SCS (P < 0.05). No statistical differences were found in the viral loads of SARS-CoV-2 between AS, MS and SCS groups on admission to hospital and during hospitalization. The concentration of CD 3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), CD3 + CD8 + T cells (P < 0.01), and B cells (P < 0.05) in SCS patients was lower than in AS and MS patients, while the level of IL-5 (P < 0.05), IL-6 (P < 0.05), IL-8 (P < 0.01) and IL-10 (P < 0.01), and TNF-α (P < 0.05) was higher. The age was negatively correlated with CD3 + T cells (P < 0.05), CD3 + CD4 + T cells (P < 0.05), and positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05), and IL-10 (P < 0.05). The viral loads were positively correlated with IL-2 (P < 0.001), IL-5 (P < 0.05), IL-6 (P < 0.05) IL-8 (P < 0.05) and IL-10 (P < 0.05), while negatively correlated with CD 3 + T cells (P < 0.05) and CD3 + CD4 + T cells (P < 0.05). CONCLUSIONS: The viral loads are similar between asymptomatic, mild and severe or critical patients with COVID-19. The severity of COVID-19 may be related to underlying diseases such as diabetes mellitus. Lymphocyte subset and plasma cytokine levels may be as the markers to distinguish severely degrees of disease, and asymptomatic patients may be as an important source of infection for the COVID-19.


Subject(s)
COVID-19/pathology , Cytokines/blood , Lymphocyte Subsets/pathology , SARS-CoV-2 , Viral Load , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Critical Illness , Diabetes Complications/epidemiology , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/pathogenicity , Young Adult
10.
Front Cell Dev Biol ; 9: 578825, 2021.
Article in English | MEDLINE | ID: covidwho-1229166

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has aroused great public health concern worldwide. Currently, COVID-19 epidemic is spreading in many countries and regions around the world. However, the study of SARS-CoV-2 is still in its infancy, and there is no specific therapeutics. Here, we summarize the genomic characteristics of SARS-CoV-2. In addition, we focus on the mechanisms of SARS-CoV-2 infection, including the roles of angiotensin converting enzyme II (ACE2) in cell entry, COVID-19 susceptibility and COVID-19 symptoms, as well as immunopathology such as antibody responses, lymphocyte dysregulation, and cytokine storm. Finally, we introduce the research progress of animal models of COVID-19, aiming at a better understanding of the pathogenesis of COVID-19 and providing new ideas for the treatment of this contagious disease.

12.
Zhongguo Zhong Yao Za Zhi ; 45(6): 1248-1252, 2020 Mar.
Article in Chinese | MEDLINE | ID: covidwho-52710

ABSTRACT

The coronavirus disease 2019(COVID-19) is developing rapidly and posing great threat to public health. There is no specific medicine available for treating the disease. Luckily, traditional Chinese medicine has played a positive role in the fighting against COVID-19. In this paper, We collected and sorted the prescriptions of modern Chinese medicine for COVID-19 released by national government, different provinces, autonomous regions and municipalities, as well as online databases, such as CNKI, WanFang medical network, and VIP database. These prescriptions were combined with the inheritance of traditional Chinese medicine auxiliary V2.5, and the complex system entropy clustering method was used to determine the association rules and frequency of single drug and drug combination in the prescription. In the end, 96 effective prescriptions were included. Among them, the four properties were mainly concentrated in temperature, cold and level, the five tastes were mainly concentrated in bitter, hot and sweet, and the meridians were mainly concentrated in lung, stomach and spleen. The high-frequency drugs were Glycyrrhizae Radix et Rhizoma, Armeniacae Semen Amarum, Gypsum Fibrosum, etc., and the high-frequency combinations are Gypsum Fibrosum-Armeniacae Semen Amarum, Gypsum Fibrosum-Glycyrrhizae Radix et Rhizoma, Armeniacae Semen Amarum-Glycyrrhizae Radix et Rhizoma, the core combinations are Lepidii Semen-Armeniacae Semen Amarum-Gypsum Fibrosum, Pogostemonis Herba-Zingiberis Rhizoma Recens-Magnoliae Officinalis Cortex, Ophiopogonis Radix-Armeniacae Semen Amarum-Scutellariae Radix and so on. Form new prescriptions Lepidii Semen, Armeniacae Semen Amarum, Gypsum Fibrosum, Pogostemonis Herba, Zingiberis Rhizoma Recens, Magnoliae Officinalis Cortex. Ophiopogonis Radix, Armeniacae Semen Amarum, Scutellariae Radix, Schisandrae Sphenantherae Fructus, Panacis Quinquefolii Radix. From the medicinal properties to high-frequency drugs and new prescriptions, it could be seen that the overall treatment of COVID-19 by traditional Chinese medicine was to strengthen body resistance, eliminate pathogenic factors, and give attention to Qi and Yin.


Subject(s)
Coronavirus Infections/drug therapy , Data Mining , Medicine, Chinese Traditional , Pneumonia, Viral/drug therapy , Betacoronavirus , COVID-19 , Drugs, Chinese Herbal/therapeutic use , Humans , Pandemics , SARS-CoV-2
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