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2.
J Infect Dis ; 224(4): 736, 2021 Aug 16.
Article in English | MEDLINE | ID: covidwho-1467349
3.
J Infect Dis ; 2021 Apr 05.
Article in English | MEDLINE | ID: covidwho-1467346
4.
BMC Infect Dis ; 21(1): 737, 2021 Aug 03.
Article in English | MEDLINE | ID: covidwho-1435227

ABSTRACT

BACKGROUND: The serum surfactant protein D (SP-D) level is suggested to be a useful biomarker for acute lung injuries and acute respiratory distress syndrome. Whether the serum SP-D level could identify the severity of coronavirus disease 2019 (COVID-19) in the early stage has not been elucidated. METHODS: We performed an observational study on 39 laboratory-confirmed COVID-19 patients from The Fourth People's Hospital of Yiyang, Hunan, China. Receiver operating characteristic (ROC) curve analysis, correlation analysis, and multivariate logistic regression model analysis were performed. RESULTS: In the acute phase, the serum levels of SP-D were elevated significantly in severe COVID-19 patients than in mild cases (mean value ± standard deviation (SD), 449.7 ± 125.8 vs 245.9 ± 90.0 ng/mL, P<0.001), while the serum levels of SP-D in the recovery period were decreased dramatically than that in the acute phase (mean value ± SD, 129.5 ± 51.7 vs 292.9 ± 130.7 ng/ml, P<0.001), and so were for the stratified patients. The chest CT imaging scores were considerably higher in the severe group compared with those in the mild group (median value, 10.0 vs 9.0, P = 0.011), while markedly lower in the recovery period than those in the acute phase (median value, 2.0 vs 9.0, P<0.001), and so were for the stratified patients. ROC curve analysis revealed that areas under the curve of lymphocyte counts (LYM), C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), and SP-D for severe COVID-19 were 0.719, 0.833, 0.817, 0.837, and 0.922, respectively. Correlation analysis showed that the SP-D levels were negatively correlated with LYM (r = - 0.320, P = 0.047), while positively correlated with CRP (r = 0.658, P<0.001), IL-6 (r = 0.471, P = 0.002), the duration of nucleic acid of throat swab turning negative (r = 0.668, P<0.001), chest CT imaging score on admission (r = 0.695, P<0.001) and length of stay (r = 0.420, P = 0.008). Multivariate logistic regression model analysis showed that age (P = 0.041, OR = 1.093) and SP-D (P = 0.008, OR = 1.018) were risk factors for severe COVID-19. CONCLUSIONS: Elevated serum SP-D level was a potential biomarker for the severity of COVID-19; this may be useful in identifying patients whose condition worsens at an early stage.


Subject(s)
COVID-19 , Pulmonary Surfactant-Associated Protein D , Humans , Prognosis , ROC Curve , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
6.
BMC Infect Dis ; 21(1): 774, 2021 Aug 09.
Article in English | MEDLINE | ID: covidwho-1350142

ABSTRACT

BACKGROUND: The severity of COVID-19 associates with the clinical decision making and the prognosis of COVID-19 patients, therefore, early identification of patients who are likely to develop severe or critical COVID-19 is critical in clinical practice. The aim of this study was to screen severity-associated markers and construct an assessment model for predicting the severity of COVID-19. METHODS: 172 confirmed COVID-19 patients were enrolled from two designated hospitals in Hangzhou, China. Ordinal logistic regression was used to screen severity-associated markers. Least Absolute Shrinkage and Selection Operator (LASSO) regression was performed for further feature selection. Assessment models were constructed using logistic regression, ridge regression, support vector machine and random forest. The area under the receiver operator characteristic curve (AUROC) was used to evaluate the performance of different models. Internal validation was performed by using bootstrap with 500 re-sampling in the training set, and external validation was performed in the validation set for the four models, respectively. RESULTS: Age, comorbidity, fever, and 18 laboratory markers were associated with the severity of COVID-19 (all P values < 0.05). By LASSO regression, eight markers were included for the assessment model construction. The ridge regression model had the best performance with AUROCs of 0.930 (95% CI, 0.914-0.943) and 0.827 (95% CI, 0.716-0.921) in the internal and external validations, respectively. A risk score, established based on the ridge regression model, had good discrimination in all patients with an AUROC of 0.897 (95% CI 0.845-0.940), and a well-fitted calibration curve. Using the optimal cutoff value of 71, the sensitivity and specificity were 87.1% and 78.1%, respectively. A web-based assessment system was developed based on the risk score. CONCLUSIONS: Eight clinical markers of lactate dehydrogenase, C-reactive protein, albumin, comorbidity, electrolyte disturbance, coagulation function, eosinophil and lymphocyte counts were associated with the severity of COVID-19. An assessment model constructed with these eight markers would help the clinician to evaluate the likelihood of developing severity of COVID-19 at admission and early take measures on clinical treatment.


Subject(s)
COVID-19 , Biomarkers , China/epidemiology , Humans , Retrospective Studies , Risk Assessment , SARS-CoV-2
7.
Front Cell Dev Biol ; 9: 659809, 2021.
Article in English | MEDLINE | ID: covidwho-1285273

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through interactions with its receptor, Angiotensin-converting enzyme 2 (ACE2), causing severe acute respiratory syndrome and death in a considerable proportion of people. Patients infected with SARS-CoV-2 experience digestive symptoms. However, the precise protein expression atlas of ACE2 in the gastrointestinal tract remains unclear. In this study, we aimed to explore the ACE2 protein expression pattern and the underlying function of ACE2 in the gastrointestinal tract, including the colon, stomach, liver, and pancreas. Methods: We measured the protein expression of ACE2 in the gastrointestinal tract using immunohistochemical (IHC) staining with an ACE2-specific antibody of paraffin-embedded colon, stomach, liver, and pancreatic tissues. The correlation between the protein expression of ACE2 and the prognosis of patients with gastrointestinal cancers was analyzed by the log-rank (Mantel-Cox) test. The influence of ACE2 on colon, stomach, liver, and pancreatic tumor cell line proliferation was tested using a Cell Counting Kit 8 (CCK-8) assay. Results: ACE2 presented heterogeneous expression patterns in the gastrointestinal tract, and it showed a punctate distribution in hepatic cells. Compared to that in parallel adjacent non-tumor tissues, the protein expression of ACE2 was significantly increased in colon cancer, stomach cancer, and pancreatic cancer tissues but dramatically decreased in liver cancer tissues. However, the expression level of the ACE2 protein was not correlated with the survival of patients with gastrointestinal cancers. Consistently, ACE2 did not affect the proliferation of gastrointestinal cancer cells in vitro. Conclusion: The ACE2 protein is widely expressed in the gastrointestinal tract, and its expression is significantly altered in gastrointestinal tumor tissues. ACE2 is not an independent prognostic marker of gastrointestinal cancers.

8.
Int J Environ Res Public Health ; 18(12)2021 06 10.
Article in English | MEDLINE | ID: covidwho-1264465

ABSTRACT

The purpose of this study was to examine the effect of the COVID-19 pandemic on customer-robot engagement in the Chinese hospitality industry. Analysis of a sample of 589 customers using service robots demonstrated that the perceived risk of COVID-19 has a positive influence on customer-robot engagement. The positive effect is mediated by social distancing and moderated by attitudes towards risk. Specifically, the mediating effect of social distancing between the perceived risk of COVID-19 and customer-robot engagement is stronger for risk-avoiding (vs. risk-seeking) customers. Our results provide insights for hotels when they employ service robots to cope with the shock of COVID-19 pandemic.


Subject(s)
COVID-19 , Robotics , Humans , Pandemics , Perception , SARS-CoV-2
9.
J Infect Dis ; 223(1): 179-180, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1258776
11.
J Infect Dis ; 223(8): 1499-1500, 2021 Apr 23.
Article in English | MEDLINE | ID: covidwho-1244883
12.
Transl Pediatr ; 10(4): 870-881, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1237026

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic brought remarkable disruption to the ways in which healthcare was delivered. This study aimed to examine changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic. Methods: An electronic survey was conducted among 142 hospitals in Hunan Province, China. Using data from January 1 to April 30, 2019 as a reference, the changes in the number of visits for different types of pediatric healthcare between January 1 and April 30, 2020 were calculated. Changes in the number of admissions for infections and injuries were also evaluated. Results: The total number of pediatric healthcare presentations decreased by 53.3% in the first four months of 2020. The most remarkable reductions were observed in the utilization of emergency room (ranging from -45.7% to -94.9% among three hospital levels) and observation room (-55.8% to -77.7%); neonatal inpatient care experienced the smallest decreases (-21.2% to -25.5%). Approximately 85% of the total reduction in the number of pediatric inpatient admissions was attributable to the reduction in admissions for infections. A 13.3% increase in the number of admissions for injuries was observed among third-level hospitals. Conclusions: The utilization of all types of pediatric healthcare services in Hunan Province declined markedly after the outbreak of COVID-19. The reasons, consequences, and responses to these changes should be addressed in future studies and actions.

13.
Appl Intell (Dordr) ; : 1-12, 2021 Feb 15.
Article in English | MEDLINE | ID: covidwho-1120033

ABSTRACT

This paper proposes a susceptible exposed infectious recovered model (SEIR) with isolation measures to evaluate the COVID-19 epidemic based on the prevention and control policy implemented by the Chinese government on February 23, 2020. According to the Chinese government's immediate isolation and centralized diagnosis of confirmed cases, and the adoption of epidemic tracking measures on patients to prevent further spread of the epidemic, we divide the population into susceptible, exposed, infectious, quarantine, confirmed and recovered. This paper proposes an SEIR model with isolation measures that simultaneously investigates the infectivity of the incubation period, reflects prevention and control measures and calculates the basic reproduction number of the model. According to the data released by the National Health Commission of the People's Republic of China, we estimated the parameters of the model and compared the simulation results of the model with actual data. We have considered the trend of the epidemic under different incubation periods of infectious capacity. When the incubation period is not contagious, the peak number of confirmed in the model is 33,870; and when the infectious capacity is 0.1 times the infectious capacity in the infectious period, the peak number of confirmed in the model is 57,950; when the infectious capacity is doubled, the peak number of confirmed will reach 109,300. Moreover, by changing the contact rate in the model, we found that as the intensity of prevention and control measures increase, the peak of the epidemic will come earlier, and the peak number of confirmed will also be significantly reduced. Under extremely strict prevention and control measures, the peak number of confirmed cases has dropped by nearly 50%. In addition, we use the EEMD method to decompose the time series data of the epidemic, and then combine the LSTM model to predict the trend of the epidemic. Compared with the method of directly using LSTM for prediction, more detailed information can be obtained.

14.
Mediterr J Hematol Infect Dis ; 13(1): e2021015, 2021.
Article in English | MEDLINE | ID: covidwho-1045343

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is highly contagious and deadly and is associated with coagulopathy. Pentraxin-3(PTX3) participates in innate resistance to infections and plays a role in thrombogenesis. Purpose: The present study aimed to investigate the role of PTX3 in coagulopathy in patients with COVID-19. Methods: A retrospective study, including thirty-nine COVID-19 patients, enrolled in Hunan, China, were performed. The patients were classified into the D-dimer_L (D-dimer <1mg/L) and D-dimer_H (D-dimer≥1mg/L) groups basing on the plasma D-dimer levels on admission. Serum PTX3 levels were detected by enzyme-linked immunosorbent assays and compared between those two groups, then receiver operating characteristic (ROC) curve analysis, correlation analysis, and linear regression models were performed to analyze the association between PTX3 and D-dimer. Results: Our results showed that serum PTX3 levels (median values, 10.21 vs. 3.36, P<0.001), computerized chest tomography (C.T.) scores (median values, 10.0 vs. 9.0, P<0.05), and length of stay (LOS) (mean values, 16.0 vs. 10.7, P=0.001) in the D-dimer_H group were significantly higher than that in D-dimer_L group. ROC curve analysis revealed that the AUC of white blood corpuscle counts, C-reaction protein, erythrocyte sedimentation rate, and PTX3 for COVID-19 were 0.685, 0.863, 0.846, and 0.985, respectively. Correlation analysis showed that there was a positive relationship between PTX3 and D-dimer (r=0.721, P<0.001), chest CT imaging score (r=0.418, P=0.008), and LOS (r=0.486, P=0.002). Multiple linear regression analysis showed that the coefficient of determination was 0.657 (P < 0.001). Conclusion: Serum level of PTX3 was positively correlated with disease severity and coagulopathy. Detection of serum PTX3 level could help identify severer patients on admission and may be a potential therapeutic target for coagulopathy in patients with COVID-19.

15.
Preprint | SSRN | ID: ppcovidwho-761

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in Wuhan, China in December 2019 and which has subseque

16.
Front Med (Lausanne) ; 7: 485, 2020.
Article in English | MEDLINE | ID: covidwho-732887

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that has spread worldwide. Methods: This was a retrospective case series involving 218 patients admitted to three tertiary hospitals in the Loudi, Shaoyang, and Xiangtan areas of China from January 21 to June 27, 2020, who were confirmed by RT-PCR to have SARS-CoV-2. The patients' clinical characteristics, laboratory results, treatments, and prognoses based on clinical classification were recorded. Poor outcome was defined as admission to an ICU, the use of mechanical ventilation, or death. Results: The patients were classified into four clinical groups based on disease severity, namely mild (10/218, 5%), moderate (146/218, 67%), severe (24/218, 11%), or critical (14/218, 6%); 24 (11%) asymptomatic cases were also included in the study. The most common symptoms were self-reported cough (162/218, 74%), fever (145/218, 67%), sputum production (99/218, 45%), and fatigue (77/218, 35%). Among the 218 patients, 192 (88%) received lopinavir/ritonavir and interferon-alpha inhalation, and 196 (90%) patients received traditional Chinese medicine. Among the severe and critical patients, 25 (11%) were admitted to an ICU with or without mechanical ventilation, and one patient died. The presence of diabetes [relative risk (RR), 3.0; 95% CI, 1.3-6.8; p = 0.007) or other comorbidities (RR, 5.9; 95% CI, 1.9-17.8; p = 0.002) was independently associated with poor outcome. To date, 20 (9%) patients have retested positive for SARS-CoV-2 RNA after recovering and being discharged. Conclusion: The majority of patients in this case series were clinically classified as having moderate COVID-19. Older patients tended to present with greater levels of clinical severity. The prognosis for patients who were elderly or had diabetes or other chronic comorbidities was relatively poor.

17.
J Infect Dis ; 222(6): 894-898, 2020 08 17.
Article in English | MEDLINE | ID: covidwho-613973

ABSTRACT

In a retrospective study of 39 COVID-19 patients and 32 control participants in China, we collected clinical data and examined the expression of endothelial cell adhesion molecules by enzyme-linked immunosorbent assays. Serum levels of fractalkine, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and vascular adhesion protein-1 (VAP-1) were elevated in patients with mild disease, dramatically elevated in severe cases, and decreased in the convalescence phase. We conclude the increased expression of endothelial cell adhesion molecules is related to COVID-19 disease severity and may contribute to coagulation dysfunction.


Subject(s)
Amine Oxidase (Copper-Containing)/blood , Betacoronavirus , Cell Adhesion Molecules/blood , Chemokine CX3CL1/blood , Coronavirus Infections/blood , Intercellular Adhesion Molecule-1/blood , Pneumonia, Viral/blood , Vascular Cell Adhesion Molecule-1/blood , Amine Oxidase (Copper-Containing)/metabolism , Blood Coagulation Disorders/virology , COVID-19 , Cell Adhesion Molecules/metabolism , Chemokine CX3CL1/metabolism , China , Enzyme-Linked Immunosorbent Assay , Female , Humans , Intercellular Adhesion Molecule-1/metabolism , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Vascular Cell Adhesion Molecule-1/metabolism
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