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1.
biorxiv; 2023.
Preprint en Inglés | bioRxiv | ID: ppzbmed-10.1101.2023.08.31.555625

RESUMEN

COVID-19 remains a significant public health threat due to the ability of SARS-CoV-2 variants to evade the immune system and cause breakthrough infections. Although pathogenic coronaviruses such as SARS-CoV-2 and MERS-CoV lead to severe respiratory infections, how these viruses affect the chromatin proteomic composition upon infection remains largely uncharacterized. Here we used our recently developed integrative DNA And Protein Tagging (iDAPT) methodology to identify changes in host chromatin accessibility states and chromatin proteomic composition upon infection with pathogenic coronaviruses. SARS-CoV-2 infection induces TP53 stabilization on chromatin, which contributes to its host cytopathic effect. We mapped this TP53 stabilization to the SARS-CoV-2 spike and its propensity to form syncytia, a consequence of cell-cell fusion. Differences in SARS-CoV-2 spike variant-induced syncytia formation modify chromatin accessibility, cellular senescence, and inflammatory cytokine release via TP53. Our findings suggest that differences in syncytia formation alter senescence-associated inflammation, which varies among SARS-CoV-2 variants.


Asunto(s)
Dolor Irruptivo , Infecciones del Sistema Respiratorio , COVID-19 , Inflamación
2.
Medicine (Baltimore) ; 99(44): e22847, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: covidwho-20238619

RESUMEN

Numerous cases of pneumonia from a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China during December 2019.We determined the correlations of patient parameters with disease severity in patients with COVID-19.A total of 132 patients from Wuhan Fourth Hospital who had COVID-19 from February 1 to February 29 in 2020 were retrospectively analyzed.Ninety patients had mild disease, 32 had severe disease, and 10 had critical disease. The severe/critical group was older (P < .05), had a higher proportion of males (P < .05), and had a greater mortality rate (0% vs 61.9%, P < .05). The main symptoms were fever (n = 112, 84.8%) and cough (n = 96, 72.7%). Patients were treated with antiviral agents (n = 94, 71.2%), antibiotics (n = 92, 69.7%), glucocorticoids (n = 46, 34.8%), intravenous immunoglobulin (n = 38, 27.3%), and/or traditional Chinese medicine (n = 40, 30.3%). Patients in the severe/critical group received mechanical ventilation (n = 22, 16.7%) or high-flow nasal can-nula oxygen therapy (n = 6, 4.5%). Chest computed tomography (CT) indicated bilateral pneumonia in all patients. Relative to the mild group, the severe/critical group had higher levels of leukocytes, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, B-type natriuretic peptide (BNP), liver enzymes, and myocardial enzymes (P < .05), and decreased levels of lymphocytes and blood oxygen partial pressure (P < .05).The main clinical symptoms of patients from Wuhan who had COVID-19 were fever and cough. Patients with severe/critical disease were more likely to be male and elderly. Disease severity correlated with increased leukocytes, CRP, PCT, BNP, D-dimer, liver enzymes, and myocardial enzymes, and with decreased lymphocytes and blood oxygen partial pressure.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , COVID-19 , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/terapia , Estudios Retrospectivos , SARS-CoV-2
3.
J Biophotonics ; 2023 Jun 01.
Artículo en Inglés | MEDLINE | ID: covidwho-20241012

RESUMEN

Flow cytometry (FC) is a versatile tool with excellent capabilities to detect and measure multiple characteristics of a population of cells or particles. Notable advancements in in vivo photoacoustic FC, coherent Raman FC, microfluidic FC, and so on, have been achieved in the last two decades, which endows FC with new functions and expands its applications in basic research and clinical practice. Advanced FC broadens the tools available to researchers to conduct research involving cancer detection, microbiology (COVID-19, HIV, bacteria, etc.), and nucleic acid analysis. This review presents an overall picture of advanced flow cytometers and provides not only a clear understanding of their mechanisms but also new insights into their practical applications. We identify the latest trends in this area and aim to raise awareness of advanced techniques of FC. We hope this review expands the applications of FC and accelerates its clinical translation.

4.
Medicine (Baltimore) ; 101(51): e32515, 2022 Dec 23.
Artículo en Inglés | MEDLINE | ID: covidwho-2307751

RESUMEN

INTRODUCTION: The psychological well-being of pregnant women following assisted reproductive has increasingly gained attention in recent years. Anxiety and depression may be associated to pregnancy outcomes. This study aims to determine whether peer support and the WeChat group platform will reduce anxiety and depression among in vitro fertilization and embryo transfer (IVF-ET) women. METHODS AND ANALYSIS: In the present randomized controlled study, 296 patients with confirmed clinical pregnancy following IVF-ET will be randomly assigned to receive standard intervention support or WeChat peer support on a 1:1 basis. The levels of anxiety and depression are the primary endpoints. Assessments will be performed at baseline measurements, first trimester, second trimester, and third trimester, and data will be collected. ETHICS AND DISSEMINATION: This study has been approved as ethical by the affiliated hospital of Shandong University of Traditional Chinese Medicine's Reproductive Ethics Committee. Each patient will sign a written statement of informed permission. All information and biological samples will be legally protected. A peer-reviewed academic journal will publish the findings of this investigation. DISCUSSION: Given the inconvenience of visits due to the current pandemic of COVID-19, this study addresses the patient's visit needs by combining WeChat, the most widely used social software in China, with peer support, while helping improve maternal anxiety, depression, and pregnancy outcomes following IVF-ET.


Asunto(s)
COVID-19 , Mujeres Embarazadas , Femenino , Embarazo , Humanos , Mujeres Embarazadas/psicología , Pandemias , Depresión/epidemiología , Depresión/terapia , Depresión/diagnóstico , COVID-19/epidemiología , Ansiedad/psicología , Resultado del Embarazo , Fertilización In Vitro/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
Water Res ; 235: 119927, 2023 May 15.
Artículo en Inglés | MEDLINE | ID: covidwho-2286181

RESUMEN

Ambroxol hydrochloride (AMB) and bromhexine hydrochloride (BRO) are classic expectorants and bronchosecretolytic pharmaceuticals. In 2022, both AMB and BRO were recommended by medical emergency department of China to alleviate cough and expectoration for symptoms caused by COVID-19. The reaction characteristics and mechanism of AMB/BRO with chlorine disinfectant in the disinfection process were investigated in this study. The reaction of chlorine with AMB/BRO were well described by a second-order kinetics model, first-order in both AMB/BRO and chlorine. The second order rate reaction constant of AMB and BRO with chlorine at pH 7.0 were 1.15 × 102 M-1s-1 and 2.03 × 102 M-1s-1, respectively. During chlorination, a new class of aromatic nitrogenous disinfection by-products (DBPs) including 2-chloro-4, 6-dibromoaniline and 2, 4, 6-tribromoaniline were identified as the intermediate aromatic DBPs by gas chromatography-mass spectrometry. The effect of chlorine dosage, pH, and contact time on the formation of 2-chloro-4, 6-dibromoaniline and 2, 4, 6-tribromoaniline were evaluated. In addition, it was found that bromine in AMB/BRO were vital bromine source to greatly promote the formation of classic brominated DBPs, with the highest Br-THMs yields of 23.8% and 37.8%, respectively. This study inspired that bromine in brominated organic compounds may be an important bromine source of brominated DBPs.


Asunto(s)
Ambroxol , Bromhexina , COVID-19 , Desinfectantes , Contaminantes Químicos del Agua , Purificación del Agua , Humanos , Desinfección/métodos , Halogenación , Expectorantes , Bromo/química , Cloro/química , Purificación del Agua/métodos , Desinfectantes/análisis , Halógenos , Cloruros , Contaminantes Químicos del Agua/química
6.
Influenza Other Respir Viruses ; 2022 Nov 17.
Artículo en Inglés | MEDLINE | ID: covidwho-2231463
7.
Medicine ; 101(51), 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-2167867

RESUMEN

Introduction: The psychological well-being of pregnant women following assisted reproductive has increasingly gained attention in recent years. Anxiety and depression may be associated to pregnancy outcomes. This study aims to determine whether peer support and the WeChat group platform will reduce anxiety and depression among in vitro fertilization and embryo transfer (IVF-ET) women. Methods and Analysis: In the present randomized controlled study, 296 patients with confirmed clinical pregnancy following IVF-ET will be randomly assigned to receive standard intervention support or WeChat peer support on a 1:1 basis. The levels of anxiety and depression are the primary endpoints. Assessments will be performed at baseline measurements, first trimester, second trimester, and third trimester, and data will be collected. Ethics and Dissemination: This study has been approved as ethical by the affiliated hospital of Shandong University of Traditional Chinese Medicine's Reproductive Ethics Committee. Each patient will sign a written statement of informed permission. All information and biological samples will be legally protected. A peer-reviewed academic journal will publish the findings of this investigation. Discussion: Given the inconvenience of visits due to the current pandemic of COVID-19, this study addresses the patient's visit needs by combining WeChat, the most widely used social software in China, with peer support, while helping improve maternal anxiety, depression, and pregnancy outcomes following IVF-ET.

8.
Front Public Health ; 10: 977221, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-2142330

RESUMEN

The epidemic of COVID-19 has a great impact on the life and safety of people around the world. As the main force in the fight against COVID-19, the financial management of public hospitals will provide a strong guarantee for the diagnosis and treatment behavior of medical staff. The financial department needs to recognize the extent of the impact of COVID-19 on hospital finance, quantify and predict the potential risk factors, and develop reasonable financial management strategies. As an important part of assessing the financial health of public hospitals, the capital liquidity can be used as the focus direction of the hospital managers. In this study, we determine the effects of COVID-19 on the finance of public hospitals. Subsequently, we invested the conception, components, risk factors of capital liquidity in public hospitals. In addition, we provided some management strategies of capital liquidity in public hospitals under the epidemic of COVID-19. We deemed that good capital liquidity can ensure that medical staff have enough confidence and mentality to face the risk of death from COVID-19.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Hospitales Públicos
10.
Frontiers in public health ; 10, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-2102039

RESUMEN

The epidemic of COVID-19 has a great impact on the life and safety of people around the world. As the main force in the fight against COVID-19, the financial management of public hospitals will provide a strong guarantee for the diagnosis and treatment behavior of medical staff. The financial department needs to recognize the extent of the impact of COVID-19 on hospital finance, quantify and predict the potential risk factors, and develop reasonable financial management strategies. As an important part of assessing the financial health of public hospitals, the capital liquidity can be used as the focus direction of the hospital managers. In this study, we determine the effects of COVID-19 on the finance of public hospitals. Subsequently, we invested the conception, components, risk factors of capital liquidity in public hospitals. In addition, we provided some management strategies of capital liquidity in public hospitals under the epidemic of COVID-19. We deemed that good capital liquidity can ensure that medical staff have enough confidence and mentality to face the risk of death from COVID-19.

11.
Journal of Tropical Medicine ; 21(9):1119-1124, 2021.
Artículo en Chino | CAB Abstracts | ID: covidwho-2047145

RESUMEN

Objective: To investigate the effects of miR-221-3p on the proliferation and apoptosis of vascular smooth muscle cells (VSMC) in abdominal aortic aneurysm (AAA) by targeting tissue inhibitor of metalloproteinase- 2 (TIMP-2).

12.
Front Med (Lausanne) ; 9: 907727, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-2043474

RESUMEN

Background: We use longitudinal chest CT images to explore the effect of steroids therapy in COVID-19 pneumonia which caused pulmonary lesion progression. Materials and Methods: We retrospectively enrolled 78 patients with severe to critical COVID-19 pneumonia, among which 25 patients (32.1%) who received steroid therapy. Patients were further divided into two groups with severe and significant-severe illness based on clinical symptoms. Serial longitudinal chest CT scans were performed for each patient. Lung tissue was segmented into the five lung lobes and mapped into the five pulmonary tissue type categories based on Hounsfield unit value. The volume changes of normal tissue and pneumonia fibrotic tissue in the entire lung and each five lung lobes were the primary outcomes. In addition, this study calculated the changing percentage of tissue volume relative to baseline value to directly demonstrate the disease progress. Results: Steroid therapy was associated with the decrease of pneumonia fibrotic tissue (PFT) volume proportion. For example, after four CT cycles of treatment, the volume reduction percentage of PFT in the entire lung was -59.79[±12.4]% for the steroid-treated patients with severe illness, and its p-value was 0.000 compared to that (-27.54[±85.81]%) in non-steroid-treated ones. However, for the patient with a significant-severe illness, PFT reduction in steroid-treated patients was -41.92[±52.26]%, showing a 0.275 p-value compared to -37.18[±76.49]% in non-steroid-treated ones. The PFT evolution analysis in different lung lobes indicated consistent findings as well. Conclusion: Steroid therapy showed a positive effect on the COVID-19 recovery, and its effect was related to the disease severity.

13.
biorxiv; 2022.
Preprint en Inglés | bioRxiv | ID: ppzbmed-10.1101.2022.09.13.507833

RESUMEN

Identifying host genes essential for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential to reveal novel drug targets and further our understanding of coronavirus disease 2019 (COVID-19). We previously performed a genome-wide CRISPR/Cas9 screen to identify pro-viral host factors for highly pathogenic human coronaviruses. Very few host factors were required by diverse coronaviruses across multiple cell types, but DYRK1A was one such exception. Although its role in coronavirus infection was completely unknown, DYRK1A encodes Dual Specificity Tyrosine Phosphorylation Regulated Kinase 1A and regulates cell proliferation, and neuronal development, among other cellular processes. Interestingly, individuals with Down syndrome overexpress DYRK1A 1.5-fold and exhibit 5-10x higher hospitalization and mortality rates from COVID-19 infection. Here, we demonstrate that DYRK1A regulates ACE2 and DPP4 transcription independent of its catalytic kinase function to support SARS-CoV, SARS-CoV-2, and MERS-CoV entry. We show that DYRK1A promotes DNA accessibility at the ACE2 promoter and a putative distal enhancer, facilitating transcription and gene expression. Finally, we validate that the pro-viral activity of DYRK1A is conserved across species using cells of monkey and human origin and an in vivo mouse model. In summary, we report that DYRK1A is a novel regulator of ACE2 and DPP4 expression that may dictate susceptibility to multiple highly pathogenic human coronaviruses. Whether DYRK1A overexpression contributes to heightened COVID-19 severity in individuals with Down syndrome through ACE2 regulation warrants further future investigation.


Asunto(s)
Infecciones por Coronavirus , Síndrome Respiratorio Agudo Grave , COVID-19
14.
Frontiers in medicine ; 9, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-1970507

RESUMEN

Background We use longitudinal chest CT images to explore the effect of steroids therapy in COVID-19 pneumonia which caused pulmonary lesion progression. Materials and Methods We retrospectively enrolled 78 patients with severe to critical COVID-19 pneumonia, among which 25 patients (32.1%) who received steroid therapy. Patients were further divided into two groups with severe and significant-severe illness based on clinical symptoms. Serial longitudinal chest CT scans were performed for each patient. Lung tissue was segmented into the five lung lobes and mapped into the five pulmonary tissue type categories based on Hounsfield unit value. The volume changes of normal tissue and pneumonia fibrotic tissue in the entire lung and each five lung lobes were the primary outcomes. In addition, this study calculated the changing percentage of tissue volume relative to baseline value to directly demonstrate the disease progress. Results Steroid therapy was associated with the decrease of pneumonia fibrotic tissue (PFT) volume proportion. For example, after four CT cycles of treatment, the volume reduction percentage of PFT in the entire lung was −59.79[±12.4]% for the steroid-treated patients with severe illness, and its p-value was 0.000 compared to that (−27.54[±85.81]%) in non-steroid-treated ones. However, for the patient with a significant-severe illness, PFT reduction in steroid-treated patients was −41.92[±52.26]%, showing a 0.275 p-value compared to −37.18[±76.49]% in non-steroid-treated ones. The PFT evolution analysis in different lung lobes indicated consistent findings as well. Conclusion Steroid therapy showed a positive effect on the COVID-19 recovery, and its effect was related to the disease severity.

15.
Respir Res ; 23(1): 105, 2022 Apr 29.
Artículo en Inglés | MEDLINE | ID: covidwho-1875011

RESUMEN

BACKGROUND: Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19) and for monitoring its progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19. METHODS: Between February 7 and February 17, 2020, 72 patients with severe COVID-19 were retrospectively enrolled. All 300 chest CT scans from these patients were collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3-7 days); Stage 3 (8-14 days); Stage 4 (15-21 days); and Stage 5 (22-31 days). QCT was performed using a threshold-based quantitative analysis to segment the lung according to different Hounsfield unit (HU) intervals. The primary outcomes were changes in percentage of compromised lung volume (%CL, - 500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders. RESULTS: Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (- 3.27% [95% CI, - 5.86 to - 0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P < 0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P < 0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group (P < 0.05), but not in the low CL group. CONCLUSIONS: Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247.


Asunto(s)
Tratamiento Farmacológico de COVID-19 , Humanos , Pulmón/diagnóstico por imagen , Mediciones del Volumen Pulmonar/métodos , Estudios Retrospectivos , Esteroides/uso terapéutico
16.
Int J Appl Earth Obs Geoinf ; 109: 102774, 2022 May.
Artículo en Inglés | MEDLINE | ID: covidwho-1804408

RESUMEN

The emergence of mutant strains such as Omicron has increased the uncertainty of COVID-19, and all countries have taken strict measures to prevent the spread of the disease. The spread of the disease between countries is of particular concern. However, most COVID-19 research focuses mainly on the country or community, and there is less research on the border areas between two countries. In this study, we analyzed changes in the total nighttime light intensity (TNLI) and total nighttime lit area (TNLA) along the Sino-Burma border and used the data to construct an epidemic pressure input index (PII) model in reference to the Shen potential model. The results show that, as the epidemic became more severe, TNLI on both sides of the border at the Ruili border port increased, while that in areas far from the port decreased. At the same time, increases and decreases in TNLA occurred in areas far from the port, and PII can indicate the areas where imported cases are likely to occur. Along the Sino-Burma border, the PII model showed low PII in the north and south and high PII in the central region. The areas between Dehong and Lincang, especially the Ruili, Wanding, Nansan, and Qingshuihe border ports, had high PII. The results of this study offer a reference for public health officials and decision makers when determining resource allocation and the implementation of stricter quarantine rules. With updated epidemic statistics, PII can be recalculated to support timely monitoring of COVID-19 in border areas.

17.
COVID ; 1(4):784-789, 2021.
Artículo en Inglés | MDPI | ID: covidwho-1580970

RESUMEN

Quick and reliable identification of severe acute respiratory syndrome coronavirus SARS-CoV-2 in the population is required to manage the COVID-19 pandemic. This is a prospective observational study of diagnostic accuracy. Paired swab samples from 317 asymptomatic individuals referring to a drive-in testing facility were tested in parallel by means of the rapid antigen test developed by Jiangsu Bioperfectus Technologies and routine nucleic acid detection. Overall specificity was 100% and sensitivity was 49% but reached 87% at higher viral loads (Ct < 25). In this study, the antigen detection test showed high specificity and good sensitivity in asymptomatic individuals carrying higher viral loads. The assay performance worsened with lower viral loads, making it useful when a rapidly deployable test is essential and to assess a potential risk of immediate transmission in the community, but not recommended for testing asymptomatic individuals.

18.
biorxiv; 2021.
Preprint en Inglés | bioRxiv | ID: ppzbmed-10.1101.2021.12.21.473733

RESUMEN

COVID-19 pathogen SARS-CoV-2 has infected hundreds of millions and caused over 5 million deaths to date. Although multiple vaccines are available, breakthrough infections occur especially by emerging variants. Effective therapeutic options such as monoclonal antibodies (mAbs) are still critical. Here, we report the development, cryo-EM structures, and functional analyses of mAbs that potently neutralize SARS-CoV-2 variants of concern. By high-throughput single cell sequencing of B cells from spike receptor binding domain (RBD) immunized animals, we identified two highly potent SARS-CoV-2 neutralizing mAb clones that have single-digit nanomolar affinity and low-picomolar avidity, and generated a bispecific antibody. Lead antibodies showed strong inhibitory activity against historical SARS-CoV-2 and several emerging variants of concern. We solved several cryo-EM structures at ~3 Angstrom resolution of these neutralizing antibodies in complex with prefusion spike trimer ectodomain, and revealed distinct epitopes, binding patterns, and conformations. The lead clones also showed potent efficacy in vivo against authentic SARS-CoV-2 in both prophylactic and therapeutic settings. We also generated and characterized a humanized antibody to facilitate translation and drug development. The humanized clone also has strong potency against both the original virus and the B.1.617.2 Delta variant. These mAbs expand the repertoire of therapeutics against SARS-CoV-2 and emerging variants.


Asunto(s)
Síndrome Oculocerebrorrenal , Dolor Irruptivo , COVID-19
19.
Chin J Nat Med ; 19(9): 693-699, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-1576003

RESUMEN

A chemical investigation on the fermentation products of Sanghuangporus sanghuang led to the isolation and identification of fourteen secondary metabolites (1-14) including eight sesquiterpenoids (1-8) and six polyphenols (9-14). Compounds 1-3 were sesquiterpenes with new structures which were elucidated based on NMR spectroscopy, high resolution mass spectrometry (HRMS) and electronic circular dichroism (ECD) data. All the isolates were tested for their stimulation effects on glucose uptake in insulin-resistant HepG2 cells, and cellular antioxidant activity. Compounds 9-12 were subjected to molecular docking experiment to primarily evaluate their anti-coronavirus (SARS-CoV-2) activity. As a result, compounds 9-12 were found to increase the glucose uptake of insulin-resistant HepG2 cells by 18.1%, 62.7%, 33.7% and 21.4% at the dose of 50 µmol·L-1, respectively. Compounds 9-12 also showed good cellular antioxidant activities with CAA50 values of 12.23, 23.11, 5.31 and 16.04 µmol·L-1, respectively. Molecular docking between COVID-19 Mpro and compounds 9-12 indicated potential SARS-CoV-2 inhibitory activity of these four compounds. This work provides new insights for the potential role of the medicinal mushroom S. sanghuang as drugs and functional foods.


Asunto(s)
Agaricales , Tratamiento Farmacológico de COVID-19 , Polifenoles , Sesquiterpenos , Antioxidantes/farmacología , Basidiomycota , Glucosa , Humanos , Simulación del Acoplamiento Molecular , Polifenoles/farmacología , SARS-CoV-2 , Sesquiterpenos/farmacología
20.
researchsquare; 2021.
Preprint en Inglés | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-698051.v2

RESUMEN

Background: Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19)and for monitoringits progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19. Methods: Between February 7 and February 17, 2020, 300 chest CT scans from 72 patients with severe COVID-19 were retrospectively collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3–7 days); Stage 3 (8–14 days); Stage 4 (15–21 days); and Stage 5 (22–31 days). QCT was performed using a threshold-based quantitative analysis to segment the lungaccording to different Hounsfield unit (HU) intervals. The primary outcomeswerechanges in percentage of compromised lung volume (%CL, –500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders. Results: Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (-3.27% [95%CI, -5.86 to -0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P <0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P <0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group ( P <0.05), but not inthe low CL group. Conclusions: Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247


Asunto(s)
COVID-19
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