Clinical characteristics of 654 patients with COVID-19 in Dongxihu Shelter Hospital in Wuhan

Objective To analyze the clinical features of patients with coronavirus disease 2019COVID-19in Wuhan, and we provide reference for further prevention and control of the disease. Methods We collected the clinical data of patients with COVID-19 in Dongxihu Shelter Hospital of Wuhan from February 7 to March 6, 2020. The main symptoms, blood test results, lung CT results, and nucleic acid negative conversion were analyzed. Results A total of 654 patients were included, 17526.76%were mild, and 47973.24%were general. There were 344 males (52.60%), and 310 females (47.40%). The patients were with a mean age of49.36+/-10.30years, and 97 patients (14.83%) with a history of hypertension, 51 patients (7.80%) had a history of diabetes. The main clinical symptoms were fever with 547(83.64%) patients, 186 cases (28.44%) had chills, 15 cases (2.29%) had shiver, 342(52.29%) had fatigue symptoms, 413(63.15%) had cough, 137(20.95%) had chest tightness, and 109(16.67%) had diarrhea during the course of the disease. Blood routine tests of 395 patients, the white blood cell count (WBC) was (4.12+/-1.46)x109/L. The total white blood cell count was normal in 378 cases(95.70%), increased in 7(1.77%), and decreased in 10(2.53%). The lymphocyte percentage was (23.10+/-10.02)%, lymphocyte1.06+/-0.37x109/L. The percentage and count of lymphocyte were low. All the 654 cases were examined by CT, 175 cases (26.76%) showed normal lung CT, 422 cases (64.52%) showed patchy or segmental ground-glass opacity, and 57 cases (8.72%) showed multilobar consolidation, ground-glass shadow coexisted with consolidation or streak shadow. The interval between positive nucleic acid test before admission and negative test after admission was as short as 5 days and as long as 24 days, the average was (12.35+/-3.73) days. Conclusion Fever, coughing, and fatigue are the main symptoms in patients with COVID-19. The typical lung CT findings can be used as the basis for clinical diagnosis and disease evaluation. Patients with mild and common type had better prognosis.Copyright © 2021 Editorial Office of Chinese Journal of Schistosomiasis Control. All rights reserved.

NIPGM(1, 1, t.\alpha) Grey Model of COVID-19 Population Prediction Based on Slime Mold Algorithm

The global spread of COVID-19 makes it extremely urgent to study the characteristics of viral transmission. In this paper, the prediction of the cumulative number of infections in COVID-19 was taken as the research object. Aiming at the limitation of GM (1, 1) model, the known data were given exponential weight by using the idea of grey modeling. A new nonlinear power-rate grey model NIPGM (1, 1, \mathrm{t} {\wedge}\alpha) was established by means of a new method of homogeneous exponential accumulation generation. The analytical solution of the model was obtained by theoretical derivation, and the optimal parameters of the model were calculated by slime mold optimization algorithm. Based on the data of Italy's cumulative population of COVID-19 published by the WHO, we predicted the cumulative number of infections in Italy from December 16 to December 30. Compared with the other three representative grey prediction models, the average relative error of NIPGM model is the smallest, and the prediction accuracy is the highest, which provides an effective model reference for the characteristics research of COVID-19 accumulative population. © 2021 IEEE.

A New Fractional Nonlinear Grey Bernoulli Model Based on Artificial Ecological Optimization Algorithm Was Used to Predict the Number of COVID-19 Infections

COVID-19 is a global epidemic which is a serious threat to human health. It is urgent to establish a prediction model for the cumulative number of new coronavirus to explore the transmission mechanism of novel coronavirus and provide theoretical reference for the scientific and effective treatment of the virus. A new fractional nonlinear grey bernoulli model (FANGBM) is established and its analytical solution is derived by using a new adjacent grey accumulation method which weights the old and new information in the process of accumulation. And the optimal parameters of the model were obtained by the artificial ecological optimization algorithm. The effectiveness and practicality of FANGBM were verified by using the data of COVID-19 cumulative population in Spain published by the WHO. The experimental results show that compared with the other three representative grey prediction models, the average absolute percentage error of FANGBM model is the smallest, and the prediction accuracy is the highest, which provides an effective model reference for the characteristics research of COVID-19 accumulative population. © 2021 IEEE.

Comparison of CNN Architecture for Thermal Face Emotion Classification

After the corona pandemic, people's feelings of depression are increasing in most countries. Emotion recognition is an essential technology for the increasing demand for non-face-to-face medical services to reduce the risk of infection. A skin temperature pattern can be used as one of the indicators indicating the emotional state. In this paper, the self-constructed thermal image DB was applied to the existing CNN architecture for facial expression classification and performance evaluation was performed. As a result, it was confirmed that the network in which several kernels are applied in parallel in order to extract various features has good performance. © 2021 IEEE.

Switching from intravenous to subcutaneous infliximab in patients with active inflammatory bowel disease: post-hoc analysis of pre/post switch outcomes from a multicentre, randomised controlled pivotal

Introduction: A subcutaneous (SC) infliximab (IFX), CT-P13 SC, has received regulatory approval from the European Medicines Agency for indications including inflammatory bowel disease.1 In response to the coronavirus disease 2019 (COVID-19) pandemic, clinical guidance has recommended considering switching from intravenous (IV) treatment to SC alternatives to minimise hospital visits.2 Aims & Methods: In this analysis, data from the pivotal randomised controlled trial (NCT02883452) of CT-P13 SC in patients with active Crohn's disease (CD) and ulcerative colitis (UC) were analysed to investigate the clinical impact of switching from IV to SC IFX.3 Patients in the CT-P13 IV arm of the pivotal trial received CT-P13 5 mg/kg IV every 8 weeks from Week (W) 6 until W22. At W30, patients switched to receive CT-P13 SC every 2 weeks up to W54 (dose 120 mg or 240 mg for patients <80 kg or ≥80 kg, respectively).3 This post hoc analysis compared per-patient pairwise data at W30 (pre-switch) and W54 (post-switch) from the CT-P13 IV arm for the following outcomes: trough serum concentration (Ctrough;5 μg/mL was considered to be the target exposure level), clinical response (for CD patients, ≥100-point decrease in Crohn's Disease Activity Index score;for UC patients, ≥2-point decrease in partial Mayo score with accompanying ≥1-point decrease in rectal bleeding subscore or an absolute rectal bleeding subscore of 0 or 1) and immunogenicity (anti-drug antibody [ADA] and neutralising antibody [NAb] positivity;as measured by a drug tolerant assay;ADA negative was regarded as NAb negative). For pairwise comparisons, patients with missing data at either W30 or W54 were excluded from the analysis. Statistical comparisons used Fisher's exact test. The differences are reported in a descriptive manner. Results: Overall, 65 patients (25 CD;40 UC) were included in the CT-P13 IV arm. The proportion of patients with a Ctrough level exceeding target exposure was significantly higher post-switch (36/41, 87.8%) than pre-switch (8/41, 19.5%;p<0.00001) (Table). Clinical response rates were comparable at both pre- and post-switch timepoints (40/49 [81.6%] vs 44/49 [89.8%], respectively;p=0.3873). Positive ADA and NAb rates at pre-switch and post-switch were also comparable, in which some changes were regarded from patients with marginal value (Table). Conclusion: Switching from IV to SC IFX did not detrimentally affect the clinical outcomes of patients with active CD or UC. Further, switching from IV to SC IFX might confer more favourable pharmacokinetic outcomes, although larger comparative studies are warranted. (Table Presented).

L 8F-FDG Uptake in Adipose Tissue Parallels Molecular Markers of the Brown Adipose Tissue Phenotype

Objectives: The COVID-19 pandemic has again shown the vast public health cost of high obesity prevalence in Western countries. Brown adipose tissue (BAT) is an anti-obesity drug target because of its adipokine production and energy consumption. Ongoing human studies are also assessing its role in response to current anti-obesity treatments like bariatric surgery. Therefore, a non-invasive test of brown adipose tissue presence and function is highly valuable. 18F-fluordeoxyglucose-positron emission tomography (FDG-PET) is often used, although the correlation between FDG uptake and the physiologic status of a given fat pad is incompletely understood. In this study, we compare FDG uptake in murine inguinal adipose tissue, a tissue that is sensitive to browning, to tissue-based markers of the brown adipose tissue phenotype following a brown adipose tissue stimulation protocol. Methods: A total of 10 mice (5 treatment/control pairs) were injected with the BAT-activating p3-agonist CL- 316,243 (treatment) or normal saline (control) for 7 days prior to FDG-PET. Mice fasted overnight prior to PET-CT. On the day of scanning, they were briefly anesthetized with isoflurane and injected with 3.7 MBq (0.1 mCi) FDG through the lateral tail vein. After a 1-hour uptake period, they were re-anesthetized and maintained under isoflurane anesthesia for the PET/CT. Manufacturer software was used to co-register CT and PET images and perform image analysis. Small circular regions of interest were drawn in the inguinal fat depots immediately superior the hip on anterior-posterior images using a regional lymph node as a guide and mean standardized uptake values (SUV) determined. In a parallel cohort, 10 additional mice (5 treatment/control pairs) underwent the same BAT-stimulation protocol prior to sacrifice for tissue studies. Mitochondrial oxygen consumption rate, a measure of energy expenditure, was assessed in freshly dissected inguinal adipose tissue with an extracellular flux analyzer. To characterize the inducible brown phenotype, the excised tissues were examined by histology, UCP1 and TOMM40 immunohistochemistry, and Ucpl quantitative polymerase chain reaction. Results: Inguinal WAT demonstrated consistently greater FDG uptake in treated mice than controls (0.20±0.04 vs 0.10±0.05, p=0.01). Basal oxygen consumption rate increased by 7.1±7.8 pmol/min/mg tissue in this fat pad. Interspersed multiloculated adipocytes, indicative of a browning phenotype, were found in histologic sections from CL-316,243-treated animals but not controls. There was increased mitochondrial density and UCP1 content in treated animals relative to controls when assessed by immunohistochemistry. Additionally, there was a 4.8-fold increase (p<0.01) in Ucpl mRNA content in treated versus control animals. Conclusions: FDG uptake by adipose tissue with an induced browning phenotype parallels energy expenditure, changes in cell morphology, and increased mitochondrial density and UCP1 content. These findings are particularly relevant to research with human subjects as metabolically active fat in humans closely resembles the inducible browning phenotype in mice. It is known that FDG-PET imaging does not identify all adipose depots undergoing browning. However, the lower limit of sensitivity of FDG-PET has not been established. This work establishes our model as useful in this regard using gold standard molecular and biochemical assays.

The psychological impact of COVID-19 pandemic in quarantine population

Purpose: Coronavirus disease 2019 (COVID-19) pandemic sweeps across the world. Government policy to control the outbreak is to quarantine. The purpose of this study was to assess the psychological impacts of quarantine during COVID-19 outbreak. Materials and method: Self-report questionnaire was conducted from March 17, 2020, to April 20, 2020 including the outburst period in Daegu, Republic of Korea. Two-thousand and eighty subjects were participated. The online link was sent to the subjects who were now quarantined (NQ) or past-quarantined (PQ). The self-report questionnaire included patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), primary care post-traumatic stress disorder screen for diagnostic and statistical manual-5 (PTSD-PC), state- trait anger expression inventory (STAX-I), and P4 suicidality screener scale(P4). Results: Among 2080 subjects 52.5% (95% CI, 50.3%-54.7%) for PHQ-9, 44.5% (95% CI, 42.4%-46.7%) for GAD-7, 39.4% (95% CI, 37.3%-41.6%) for PTSD-PC, 31.6% (95% CI, 29.6%-33.6%) for STAX-I, and 10.9% (95% CI, 9.6%-12.3%) for P4 exceeded cutoff value. NQ group (n = 608, 29%) show more anger than PQ (n = 1472, 71%) (aORs, 1.417 [95% CI, 1.119-1.796]). Especially subjects who were quarantined for more than 28 days in NQ (n = 238, 39%) had high risk for symptoms of PHQ-9 (aORs, 1.428 [95% CI, 1.081-1.886]), GAD-7 (aORs, 1.326 [95% CI, 1.008-1.744]), PTSD-PC (aORs, 1.427 [95% CI, 1.083-1.879]), and STAX-I (aORs, 1.354 [95% CI, 1.017-1.802] than PQ . Conclusion: Our result suggest that quarantine have negative psychological effects such as depression, anxiety, post-traumatic stress disorder, anger. In particular NQ experiences more anger than PQ and the longer the period, the more depression, anxiety, PTSD, and anger. The result of this study will contribute to identify high risk individuals for mental health during quarantine.

Short-term Changes on Follow-up Chest X-rays of Familial Cluster of COVID-19 Cases

In this study, we report a familial cluster of cases which included five patients and two close contacts who were confirmed to have coronavirus disease 2019 (COVID-19). These participants had received real-time reverse transcription-polymerase chain reaction (RT-PCR) and chest X-rays (CXRs) before diagnosis. The follow-up CXRs of three patients in the family showed significant progression, with COVID-19 pneumonia, clinically worsening in a short period of time. Therefore, the results of follow-up CXRs in the short-term may be an adjunctive diagnostic method for COVID-19 disease diagnosis and its progression. Key Words: Chest X-ray, COVID-19, RT-PCR, Familial clustering.

Behavioural intention of forest therapy tourism in China: based on health belief model and the theory of planned behaviour

The epidemic has aggravated people’s sub-health condition and raised ecological awareness. Forest therapy tourism as a type of natural-based ecotourism and a way to improve health condition deserves more attention. Few studies have combined the health belief model (HBM) and the theory of planned behaviour (TPB) to explore the relationship underlying health beliefs, attitude and behavioural intention of forest therapy tourism. Five hundred and ninety questionnaires were received and the data was analysed by SPSS 24 and Amos. Research results showed that the attitude dimension from TPB was a significant mediator of health beliefs and behavioural intention. Moreover, perceived benefits and perceived severity positively influenced the behavioural intention. Whereas the perceived barriers and perceived susceptibility were not prominent predictors. Marital status and home quarantine partially moderated the relationship among the constructs. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Blood molecular markers associated with COVID-19 immunopathology and multi-organ damage

COVID-19 is characterized by dysregulated immune responses, metabolic dysfunction and adverse effects on the function of multiple organs. To understand host responses to COVID-19 pathophysiology, we combined transcriptomics, proteomics, and metabolomics to identify molecular markers in peripheral blood and plasma samples of 66 COVID-19-infected patients experiencing a range of disease severities and 17 healthy controls. A large number of expressed genes, proteins, metabolites, and extracellular RNAs (exRNAs) exhibit strong associations with various clinical parameters. Multiple sets of tissue-specific proteins and exRNAs varied significantly in both mild and severe patients suggesting a potential impact on tissue function. Chronic activation of neutrophils, IFN-I signaling, and a high level of inflammatory cytokines were observed in patients with severe disease progression. In contrast, COVID-19-infected patients experiencing milder disease symptoms showed robust T-cell responses. Finally, we identified genes, proteins, and exRNAs as potential biomarkers that might assist in predicting the prognosis of SARS-CoV-2 infection. These data refine our understanding of the pathophysiology and clinical progress of COVID-19. SYNOPSIS image Proteomics, metabolomics and RNAseq data map immune responses in COVID-19 patients with different disease severity, revealing molecular makers associated with disease progression and alterations of tissue-specific proteins. A multi-omics profiling of the host response to SARS-CoV2 infection in 66 clinically diagnosed and laboratory confirmed COVID-19 patients and 17 uninfected controls. Significant correlations between multi-omics data and key clinical parameters. Alteration of tissue-specific proteins and exRNAs. Enhanced activation of immune responses is associated with COVID-19 pathogenesis. Biomarkers to predict COVID-19 clinical outcomes pending clinical validation as prospective marker.

Late Breaking Abstract - Multidisciplinary medical team in severe COVID-19 treatment

Background: The pandemic of COVID-19 is emerging. Concomitant comorbidities are major cause of death after SARS-Cov2 infection. Multidisciplinary groups involved intervention should be a great potential for better outcomes in severe COVID-19. Method: A multidisciplinary medical team was allocated from our hospital to assist Wuhan at an emergency. According the local policy and guidelines, a centralized ward with severe COVID-19 patients were charged by this team. Cardiovascular, endocrine, respiratory, nutrition and psychology disorders, as well as infection control and rehabilitation were systematically evaluated and treated. The data of interventional effect were retrospectively reviewed. Results: A total of 90 severe COVID-19 patients were evaluated with high incidence of comorbidities and effectively treated by these comprehensive interventions (Table 1). In the 50 consecutive mission days, most of them survived (n=86, 96%), discharged (n=72, 80%) or transferred into wards where mild cases were treated. Only 2 were transferred into critical care. Conclusion: The astonishing outcomes achieved by the comprehensive intervention warrant more concerns about multidisciplinary treatment in COVID-19 fight policy.

Impact of the 2019-nCoV on the Oral Medical Industry and the Corresponding Strategies

The outbreak of new crown pneumonia has had a great impact on Chinese enterprises. As a highly market-oriented medical vertical segment industry, oral institutions have been impacted and affected unprecedentedly in this epidemic. Through the analysis of the specific impact on the stomatology industry, this paper puts forward and its countermeasures, and provides suggestions for enterprises to eliminate the negative impact of the epidemic on enterprises to the greatest extent and promote the benign development of enterprises. © The Authors, publis ad by EDP Sciences, 2020.

CT characteristics of patients infected with 2019 novel coronavirus: association with clinical type.

AIM: To summarise the features of chest computed tomography (CT) of a series of patients infected with 2019 novel coronavirus (2019-nCov) to speed up recognition and have a better understanding of COVID-19 disease. MATERIALS AND METHODS: The clinical information and chest CT images of 93 patients infected with 2019-nCov from multiple centres were reviewed. RESULTS: Of the 93 cases, abnormalities in 91 cases were located at the subpleural level, presenting with ground-glass opacity (GGO; n=69, 74.2%) and consolidation (n=56, 60.2%) in multiple lobes. Other CT features included vascular dilatation (n=83, 89.2%), interlobular septal thickening (n=29, 31.2%), bronchodilatation (n=44, 47.3%), the crazy-paving sign (n=34, 36.6%), the sieve-hole sign (n=12, 12.9%), pleural thickening (n=21, 22.6%), and pleural effusion (n=8, 8.6%). Multiple lobe involvement, including the presence of consolidation, the crazy-paving sign, interlobular septal thickening, pleural thickening and pleural effusion, was more common in critical patients with heavy/critical infection (p<0.05), whereas the presence of GGO, involvement of one or two lobes, and the halo sign were more common in patients with mild/common-type infections (p<0.05). Moreover, older age, higher body temperature, complaints of chest tightness and breathlessness, and lymphopenia was associated with heavy/critical infections. CONCLUSION: The CT and clinical appearances of COVID-19 are variable and reflect the severity of COVID-19 to some extent.