The impact of the COVID-19 epidemic on tuberculosis control in China.

BACKGROUND: In response to the COVID-19 epidemic, China implemented a series of interventions that impacted tuberculosis (TB) control in the country. METHODS: Based on routine surveillance data and questionnaires, the study analyzed TB notification, follow-up examinations, and treatment outcomes. The data were split into three phases in relation to outbreak, lockdown and reopen when the nationwide COVID-19 response started in 2020: control (11 weeks prior), intensive (11 weeks during and immediately after), and regular (4 additional weeks). Data from 2017-2019 were used as baseline. FINDINGS: The notified number of TB patients decreased sharply in the 1st week of the intensive period but took significantly longer to rebound in 2020 compared with baseline. The percentages of TB patients undergoing sputum examination within one week after 2 months treatment and full treatment course in the intensive period were most affected and decreased by 8% in comparison with control period. 75•2% (221/294) of counties reallocated CDC and primary health care workers to fight the COVID-19 epidemic, 26•9% (725/2694) of TB patients had postponed or missed their follow-up examinations due to travel restrictions and fear of contracting COVID-19. INTERPRETATION: In the short term, the COVID-19 epidemic mostly affected TB notification and follow-up examinations in China, which may lead to a surge of demand for TB services in the near future. To cope with this future challenge, an emergency response mechanism for TB should be established. FUNDING: National Health Commission of China-Bill & Melinda Gates Foundation TB Collaboration project (OPP1137180).

Takotsubo syndrome and respiratory diseases: a systematic review

Takotsubo syndrome (TTS) is a rare cardiovascular condition characterized by reversible ventricular dysfunction and a presentation resembling that of acute myocardial infarction. An increasing number of studies has shown the association of respiratory diseases with TTS. Here, we comprehensively reviewed the literature and examined the available evidence for this association. After searching PubMed, EMBASE, and Cochrane Library databases, two investigators independently reviewed 3117 studies published through May 2021. Of these studies, 99 met the inclusion criteria (n = 108 patients). In patients with coexisting respiratory disease and TTS, the most common TTS symptom was dyspnoea (70.48%), followed by chest pain (24.76%) and syncope (2.86%). The most common type of TTS was apical, accounting for 81.13% of cases, followed by the midventricular (8.49%), basal (8.49%), and biventricular (1.89%) types. Among the TTS cases, 39.82% were associated with obstructive lung disease and 38.89% were associated with pneumonia. Coronavirus disease 2019 (COVID-19), which has been increasingly reported in patients with TTS, was identified in 29 of 42 (69.05%) patients with pneumonia. The overall mortality rate for patients admitted for respiratory disease complicated by TTS was 12.50%. Obstructive lung disease and pneumonia are the most frequently identified respiratory triggers of TTS. Medications and invasive procedures utilized in managing respiratory diseases may also contribute to the development of TTS. Furthermore, the diagnosis of TTS triggered by these conditions can be challenging due to its atypical presentation. Future prospective studies are needed to establish appropriate guidelines for managing respiratory disease with concurrent TTS. Graphical Graphical

The Pivotal Role of SOD1 for Prediction of COVID-19 Progression Revealed by Proteomic and Bioinformatic Strategies (preprint)

Background: Severe acute respiratory distress syndrome-associated coronavirus-2 (SARS-CoV-2) is still threatening the whole human population worldwide. Patients infected with SARS-CoV-2 present diverse symptoms regarding to the severity of the disease. Determining the proteome changes associated with diverse symptoms and in different infection stages is beneficial for clinical diagnosis and management. Methods: We performed a TMT labeling proteomic study on the plasma of healthy controls and COVID-19 patients, including those with asymptomatic infection (NS), mild syndrome (MS), and severe syndrome in the early phase (SSEP) and later phase (SSLP). Bioinformatic and ELISA were used for the data analysis and identification. Findings: Hundreds of proteins were dysregulated in the plasma of COVID-19 patients including all the clinical symptoms. Bioinformatics analysis of the dysregulated proteins revealed that oxidative stress, complement activation and glycolysis-related proteins were affected after infection with SARS-CoV-2. ELISA analysis confirmed that SOD1, PRDX2 and LDHA levels were increased along with severe symptoms and did not change after recovery compared with those in healthy controls. Both GSEA and ROC analysis indicated that SOD1 could be a pivotal player in the progression of COVID-19. Interpretation: Our results indicated that plasma proteome changes differed based on symptoms and disease stages and SOD1 could be an important protein for indicating COVID-19 progression. These results may also provide new understanding for COVID-19 diagnosis and treatment. Funding: This project is supported by Shenzhen Bay Laboratory Opening Fund, Shenzhen Key Medical Discipline Construction Fund, Guangdong Natural Science Foundation, Sanming Project of Medicine in Shenzhen.Declaration of Interests: All the authors declared there are no conflicts of interest exist.Ethics Approval Statement: This research was approved by the ethics committee of the Shenzhen Center for Disease Control and Prevention [Approval number: 2020-025A].

Continuity of services for patients with tuberculosis in China in the COVID-19 era (preprint)

It is crucial to maintain continuity of essential services for people affected by tuberculosis (TB). Efforts to deliver these essential services in many global settings have been complicated by the emergence and global spread of SARS-CoV-2 and the pandemic of COVID-19. Understanding how the COVID-19 pandemic has impacted the availability of TB diagnostic and treatment services is critical for identifying policies that can mitigate disruptions of these essential services. China has a dual burden of TB and COVID-19. We conducted a survey and collected data from 13 provinces in China to evaluate the early impact of COVID-19 on TB services and to document interventions that were adopted to maintain the continuity services for TB patients during the pandemic. We use these data to identify additional opportunities that will improve the ability of TB programs to maintain essential services during this crisis. While health systems and underlying epidemiology differ between countries, we believe that sharing China's experience can inform the design of locally tailored strategies to maintain essential TB services during the COVID-19 pandemic.