Changes in the medical-seeking pattern and daily behavior of hematopoietic stem-cell transplant recipients during the COVID-19 epidemic: An online survey in Hubei Province, China

Background To curb the spread of the coronavirus disease 2019 (COVID-19) epidemic, the Chinese government shut down Wuhan city from January 23rd to April 8th, 2020. The COVID-19 epidemic not only leads to widespread illness but also affects the diagnosis and treatment of hematopoietic stem-cell transplant (HSCT) recipients. Objective To investigate the medical-seeking pattern and daily behavior changes in Hubei Province during the COVID-19 epidemic in Hubei Province during the lockdown. Methods We conducted a multicenter, cross-sectional, web-based investigation among 325 HSCT recipients by online questionnaires in Hubei Province during the COVID-19 epidemic. Results A total of 145 complete responses were collected both before and during the epidemic questionnaires. The participants from pre-epidemic group preferred to go to hospital (68.29%) when they experienced influenza-like symptoms. The majority of the patients elected to take oral drugs by themselves (40%) or consulted their attending physicians online or by telephone during the lockdown (23.33%). 64.83% had difficulties in purchasing drugs during the lockdown, which was significantly higher than the proportion of the pre-epidemic group (24.83%) (P < 0.05). The participants preferred to purchase drugs online (23.40%) and decrease or withdraw drugs (18.09%) during the epidemic. The number of participants received regular re-examinations during the epidemic decreased sharply. The proportion of wearing masks and isolating themselves at home increased significantly during the epidemic. No statistic difference was observed in the incidence of graft-versus-host disease (GVHD)complications in participants between the during the epidemic group and the pre-epidemic group. In our study, six patients were confirmed to have COVID-19, and half of them died due to COVID-19-related complications. Conclusion The medical-seeking pattern and daily behavior of HSCT recipients changed during the lockdown;the methods of self-protection, online consultation and drug delivery can help patients receive necessary follow-up and reduce the occurrence of COVID-19.

An ultrasensitive and long-lasting chemiluminescence immunoassay for IP-10 detection based on a 4-bromophenol-reinforced bienzymatic system

The 10-kDa chemokine interferon-gamma-inducible protein 10 (IP-10) is considered one of the most promising biomarkers for diagnosing both tuberculosis and COVID-19 infections. The blood samples of patients at different disease states contain different levels of IP-10, which need to be detected in a rapid, specific and ultrasensitive manner. Here, we report a bienzymatic chemiluminescence sandwich immunoassay (BCSI) assay for the ultrasensitive and stable detection of IP-10. In this assay, IP-10 is first efficiently captured using a double-antibody sandwich strategy. The detection antibody is linked to catalase (CAT) via a streptavidin-biotin signal amplification system to achieve highly efficient conversion of hydrogen peroxide (H2O2) to oxygen and water. In the chemiluminescence (CL) reaction, horseradish peroxidase (HRP) acts as an efficient catalyst, and 4-bromophenol acts as an enhancer for the cyclic transition of HRP, which results in a strong and durable CL signal. The bienzymatic catalysis with CAT and HRP and the potentiation of 4-bromophenol enables the assay to be ultrasensitive and stable. The CL intensity was found to be well correlated with the detection of IP-10 at levels in the range of 0.71 to 125,000 pg/mL, which covers more than 6 orders of magnitude, with a detection limit of 0.63 pg/mL. The coefficient of variation was 1.49%, and the recovery range of IP-10 in serum was 86.21%-104.57%. This assay provides a wide linear range and high sensitivity and may be a promising method for the high-throughput detection of IP-10 in the diagnosis of tuberculosis and COVID-19.

Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center.

Background: Kawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology. After the pandemic of coronavirus disease 2019 (COVID-19), some children infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) showed clinical symptoms similar to KD, indicating a close relationship between KD and SARS-CoV-2. Therefore, we designed this retrospective study to analyze the characteristics of KD patients before and after the COVID-19 pandemic. Methods: We retrospectively collected demographic and laboratory data of KD patients in Yuying Children's Hospital of Wenzhou Medical University from 1 January 2015 to 31 December 2020. Yuying Children's Hospital of Wenzhou Medical University is located in eastern China and is the largest pediatric heart disease center in the region, which includes a population of nearly 10 million. We studied the characteristics of KD patients and analyzed the changes in these characteristics before and after the emergence of SARS-CoV-2 in this area. Results: The analysis revealed the following novel features: (1) Under the influence of the COVID-19 pandemic, the onset age of Kawasaki disease became younger. (2) After the occurrence of COVID-19, the hospitalization days of KD patients were shorter than before the pandemic. (3) After the occurrence of COVID-19, the albumin of KD patients was higher than before the pandemic. (4) The COVID-19 pandemic did not have a significant effect on the incidence of coronary artery lesions (CALs) in Kawasaki disease. Conclusion: After the COVID-19 outbreak, the characteristics of KD patients showed a younger trend of age, shorter hospitalization days and higher levels of albumin, but the incidence of CALs did not change significantly.

Comparisons of the risk of myopericarditis between COVID-19 patients and individuals receiving COVID-19 vaccines: a population-based study (preprint)

Background Both COVID-19 infection and COVID-19 vaccines have been associated with the development of myopericarditis. The objective of this study is to 1) analyze the rates of myopericarditis after COVID-19 infection and COVID-19 vaccination in Hong Kong and 2) compare to the background rates, and 3) compare the rates of myopericarditis after COVID-19 vaccination to those reported in other countries. Methods This was a population-based cohort study from Hong Kong, China. Patients with positive RT-PCR test for COVID-19 between 1 st January 2020 and 30 th June 2021 or individuals who received COVID-19 vaccination until 31 st August were included. The main exposures were COVID-19 positivity or COVID-19 vaccination. The primary outcome was myopericarditis. Results This study included 11441 COVID-19 patients from Hong Kong, of whom four suffered from myopericarditis (rate per million: 350; 95% confidence interval [CI]: 140-900). The rate was higher than the pre-COVID-19 background rate in 2020 (rate per million: 61, 95% CI: 55-67) with a rate ratio of 5.73 (95% CI: 2.23-14.73. Compared to background rates, the rate of myopericarditis among vaccinated subjects in Hong Kong was substantially lower (rate per million: 8.6; 95% CI: 6.4-11.6) with a rate ratio of 0.14 (95% CI: 0.10-0.19). The rates of myocarditis after vaccination in Hong Kong are comparable to those vaccinated in the United States, Israel, and the United Kingdom. Conclusions COVID-19 infection is associated with a higher rate of myopericarditis whereas COVID-19 vaccination is associated with a lower rate of myopericarditis compared to the background.

Genomic monitoring of SARS-CoV-2 uncovers an Nsp1 deletion variant that modulates type I interferon response.

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.

Application Value of Vital Signs Telemetry System for 2019 Novel Coronavirus Disease Suspected Cases in Isolation Wards.

OBJECTIVE: A large number of isolation wards were built to screen suspected patients because of the outbreak of coronavirus disease 2019 (COVID-19). The particularity of the isolation wards would lead to more medical resource consumption and heavier hospital control tasks. Therefore, we adopted a vital signs telemetry system in the isolation wards to improve this situation. MATERIALS AND TECHNOLOGIES: Twenty sets of vital signs telemetry system were installed in the east district of the isolation area and the wards were used as the telemetry system wards (TSWs). The wards in the west district were used as the routine wards (RW). The daily telephone questionnaire was used to collect the frequency and time of ward rounds by medical staff and lasted for one week. RESULTS: Within one-week survey, the average frequency of RW rounds was 3.00 ± 1.00 times per day, and the average time was 93.57 ± 66.25 min. The daily frequency of RW rounds was 0.428 ± 0.394 times per capita, and the time was 7.88 ± 2.36 min. There was a statistically significant difference in the time of ward rounds per capita, which presented that the daily time of TSW rounds per capita was shorter than that of RW rounds. No security events related to telemetry equipment were found throughout the study. CONCLUSION: The application of vital signs telemetry system as an alternative to traditional ward monitoring is considered feasible. The use of telemetry system can significantly reduce the consumption of medical resources, the workload of medical staff along with the administration and labor cost for isolation wards. The telemetry system provides sensitive and reliable real-time monitoring for the key indicators used for disease judgment and can make an accurate warning of the patients with disease aggravation in time. Thus, it is worthy of promotion and wide application.