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1.
Curr Psychol ; : 1-16, 2022 Oct 24.
Artículo en Inglés | MEDLINE | ID: covidwho-2260048

RESUMEN

The economic impact caused by the outbreak and dynamic evolution of COVID-19 has reduced employees' psychological security (PS), which not only threatens the physical and mental health of employees but also seriously affects the stable operation and sustainable development of enterprises. PS has been determined to be closely related to daily life experiences. Therefore, the purpose of this article is to examine the types and combinations of life events that improve employees' PS during the pandemic. Cross-sectional data came from 764 enterprise employees in 8 provinces and cities in China during the pandemic period. The participants completed the PS scale to evaluate their PS, and the PS events scale to evaluate the different types of daily life events they experienced. Multiple regression analysis (MRA) and fuzzy-set qualitative comparative analysis (fsQCA) methods were used to test the research hypothesis. The results of MRA suggest that rich leisure activities (RLA), harmonious family relationship (HFR), stable economic order (SEO) and recognition and support from others (RSO) are important life events that enhance employees' PS. The results of fsQCA suggest that the independent role of SEO, the combined role of sound social security system (SSSS), peace and health events (PHE) and HFR, the combined role of PHE, fulfilling work/life status (FWLS), SEO and RSO can substitute for each other to promote employees' high PS. This article reveals the contribution of daily life events to the PS of enterprise employees, and provides an empirical basis for formulating corresponding intervention measures to promote the physical and mental health of enterprise employees and effective enterprise management.

2.
Chaos Solitons Fractals ; 167: 112996, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-2165142

RESUMEN

COVID-19 is the most serious public health event of the 21st century and has had a huge impact across the world. The spatio-temporal pattern analysis and simulation of epidemic spread have become the focus of current research. LSTM model has made a lot of achievements in the prediction of infectious diseases by virtue of its advantages in time prediction, but lacks the spatial expression. CA model plays an important role in epidemic spatial propagation modeling due to its unique evolution characteristics from local to global. However, no existing studies of CA have considered long-term dependence due to the impact of time changes on the evolution of the epidemic, and few have modeled using location data from actual diagnosed patients. Therefore, we proposed a LSTM-CA model to solve above mentioned problems. Base on the advantages of LSTM in temporal level and CA in spatial level, LSTM and CA are integrated from the spatio-temporal perspective of geography based on the fine-grained characteristics of epidemic data. The method divides the study area into regular grids, simulates the spatial interactions between neighborhood cells with the help of CA model, and extracts the parameters affecting the transition probability in CA with the help of LSTM model to assist evolution. Simulations are conducted in Python 3.4 to model the propagation of COVID-19 between Feb, 6 to Mar 20, 2020 in China. Experimental results show that, LSTM-CA performs a higher statistical accuracy than LSTM and spatial accuracy than CA, which could demonstrate the effectiveness of the proposed model. This method could be universal for the temporal and spatial transmission of major public health events. Especially in the early stage of the epidemic, we can quickly understand its development trend and cycle, so as to provide an important reference for epidemic prevention and control and public sentiment counseling.

3.
Frontiers in public health ; 10, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-2093138

RESUMEN

The COVID-19 epidemic has caused more than 6.4 million deaths to date and has become a hot topic of interest in different disciplines. According to bibliometric analysis, more than 340,000 articles have been published on the COVID-19 epidemic from the beginning of the epidemic until recently. Modeling infectious diseases can provide critical planning and analytical tools for outbreak control and public health research, especially from a spatio-temporal perspective. However, there has not been a comprehensive review of the developing process of spatio-temporal dynamic models. Therefore, the aim of this study is to provide a comprehensive review of these spatio-temporal dynamic models for dealing with COVID-19, focusing on the different model scales. We first summarized several data used in the spatio-temporal modeling of the COVID-19, and then, through literature review and summary, we found that the existing COVID-19 spatio-temporal models can be divided into two categories: macro-dynamic models and micro-dynamic models. Typical representatives of these two types of models are compartmental and metapopulation models, cellular automata (CA), and agent-based models (ABM). Our results show that the modeling results are not accurate enough due to the unavailability of the fine-grained dataset of COVID-19. Furthermore, although many models have been developed, many of them focus on short-term prediction of disease outbreaks and lack medium- and long-term predictions. Therefore, future research needs to integrate macroscopic and microscopic models to build adaptive spatio-temporal dynamic simulation models for the medium and long term (from months to years) and to make sound inferences and recommendations about epidemic development in the context of medical discoveries, which will be the next phase of new challenges and trends to be addressed. In addition, there is still a gap in research on collecting fine-grained spatial-temporal big data based on cloud platforms and crowdsourcing technologies to establishing world model to battle the epidemic.

4.
Current psychology (New Brunswick, N.J.) ; : 1-16, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-2083641

RESUMEN

The economic impact caused by the outbreak and dynamic evolution of COVID-19 has reduced employees’ psychological security (PS), which not only threatens the physical and mental health of employees but also seriously affects the stable operation and sustainable development of enterprises. PS has been determined to be closely related to daily life experiences. Therefore, the purpose of this article is to examine the types and combinations of life events that improve employees’ PS during the pandemic. Cross-sectional data came from 764 enterprise employees in 8 provinces and cities in China during the pandemic period. The participants completed the PS scale to evaluate their PS, and the PS events scale to evaluate the different types of daily life events they experienced. Multiple regression analysis (MRA) and fuzzy-set qualitative comparative analysis (fsQCA) methods were used to test the research hypothesis. The results of MRA suggest that rich leisure activities (RLA), harmonious family relationship (HFR), stable economic order (SEO) and recognition and support from others (RSO) are important life events that enhance employees’ PS. The results of fsQCA suggest that the independent role of SEO, the combined role of sound social security system (SSSS), peace and health events (PHE) and HFR, the combined role of PHE, fulfilling work/life status (FWLS), SEO and RSO can substitute for each other to promote employees’ high PS. This article reveals the contribution of daily life events to the PS of enterprise employees, and provides an empirical basis for formulating corresponding intervention measures to promote the physical and mental health of enterprise employees and effective enterprise management.

5.
Nat Commun ; 13(1): 3106, 2022 06 03.
Artículo en Inglés | MEDLINE | ID: covidwho-1931406

RESUMEN

Non-pharmaceutical interventions (NPIs) and vaccination are two fundamental approaches for mitigating the coronavirus disease 2019 (COVID-19) pandemic. However, the real-world impact of NPIs versus vaccination, or a combination of both, on COVID-19 remains uncertain. To address this, we built a Bayesian inference model to assess the changing effect of NPIs and vaccination on reducing COVID-19 transmission, based on a large-scale dataset including epidemiological parameters, virus variants, vaccines, and climate factors in Europe from August 2020 to October 2021. We found that (1) the combined effect of NPIs and vaccination resulted in a 53% (95% confidence interval: 42-62%) reduction in reproduction number by October 2021, whereas NPIs and vaccination reduced the transmission by 35% and 38%, respectively; (2) compared with vaccination, the change of NPI effect was less sensitive to emerging variants; (3) the relative effect of NPIs declined 12% from May 2021 due to a lower stringency and the introduction of vaccination strategies. Our results demonstrate that NPIs were complementary to vaccination in an effort to reduce COVID-19 transmission, and the relaxation of NPIs might depend on vaccination rates, control targets, and vaccine effectiveness concerning extant and emerging variants.


Asunto(s)
COVID-19 , Teorema de Bayes , COVID-19/epidemiología , COVID-19/prevención & control , Humanos , Pandemias/prevención & control , SARS-CoV-2 , Vacunación
6.
Sci Adv ; 8(6): eabk2691, 2022 02 11.
Artículo en Inglés | MEDLINE | ID: covidwho-1685473

RESUMEN

Upon virus infection, CD8+ T cell accumulation is tightly controlled by simultaneous proliferation and apoptosis. However, it remains unclear how TCR signal coordinates these events to achieve expansion and effector cell differentiation. We found that T cell-specific deletion of nuclear helicase Dhx9 led to impaired CD8+ T cell survival, effector differentiation, and viral clearance. Mechanistically, Dhx9 acts as the key regulator to ensure LCK- and CD3ε-mediated ZAP70 phosphorylation and ERK activation to protect CD8+ T cells from apoptosis before proliferative burst. Dhx9 directly regulates Id2 transcription to control effector CD8+ T cell differentiation. The DSRM and OB_Fold domains are required for LCK binding and Id2 transcription, respectively. Dhx9 expression is predominantly increased in effector CD8+ T cells of COVID-19 patients. Therefore, we revealed a previously unknown regulatory mechanism that Dhx9 protects activated CD8+ T cells from apoptosis and ensures effector differentiation to promote antiviral immunity independent of nuclear sensor function.


Asunto(s)
Antivirales/farmacología , Infecciones por Arenaviridae/prevención & control , Linfocitos T CD8-positivos/inmunología , COVID-19/prevención & control , ARN Helicasas DEAD-box/metabolismo , Inmunidad Innata , Proteínas de Neoplasias/metabolismo , Animales , Infecciones por Arenaviridae/inmunología , Infecciones por Arenaviridae/metabolismo , Infecciones por Arenaviridae/patología , COVID-19/inmunología , COVID-19/metabolismo , COVID-19/patología , Diferenciación Celular , ARN Helicasas DEAD-box/genética , Humanos , Activación de Linfocitos , Virus de la Coriomeningitis Linfocítica/fisiología , Ratones , Proteínas de Neoplasias/genética , SARS-CoV-2/fisiología , Replicación Viral
7.
Complexity ; 2022, 2022.
Artículo en Inglés | ProQuest Central | ID: covidwho-1662357

RESUMEN

The epidemic spreading is closely related to the spread of information, and it will coevolve with the information transmission. Considering that the network structure has a significant impact on network dynamics and the virtual contact networks have obvious community structures in reality, in this article, we built a multiplex network, which contains a community structure to explore the interplay of the coupled spread dynamics. We first use a microscopic Markov chain approach to characterize the coupled disease-awareness dynamics and then analyze the effect of different factors on the coevolution of information dissemination and epidemic spreading based on the Monte Carlo simulation. The simulation results show that promoting the dissemination of information is indeed conducive to suppressing the spread of disease, but changing the process of disease transmission has no obvious effect on the information dissemination. The analysis also reveals that increasing the information transmission rate or decreasing the information recovery rate can promote the spread of information and inhibit the spread of diseases. In addition, taking preventive behaviors or decreasing the long-distance jump also helps slow the epidemic spreading.

8.
Int J Appl Earth Obs Geoinf ; 106: 102649, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-1561473

RESUMEN

Governments worldwide have rapidly deployed non-pharmaceutical interventions (NPIs) to mitigate the COVID-19 pandemic. However, the effect of these individual NPI measures across space and time has yet to be sufficiently assessed, especially with the increase of policy fatigue and the urge for NPI relaxation in the vaccination era. Using the decay ratio in the suppression of COVID-19 infections and multi-source big data, we investigated the changing performance of different NPIs across waves from global and regional levels (in 133 countries) to national and subnational (in the United States of America [USA]) scales before the implementation of mass vaccination. The synergistic effectiveness of all NPIs for reducing COVID-19 infections declined along waves, from 95.4% in the first wave to 56.0% in the third wave recently at the global level and similarly from 83.3% to 58.7% at the USA national level, while it had fluctuating performance across waves on regional and subnational scales. Regardless of geographical scale, gathering restrictions and facial coverings played significant roles in epidemic mitigation before the vaccine rollout. Our findings have important implications for continued tailoring and implementation of NPI strategies, together with vaccination, to mitigate future COVID-19 waves, caused by new variants, and other emerging respiratory infectious diseases.

9.
Sci Rep ; 11(1): 17421, 2021 08 31.
Artículo en Inglés | MEDLINE | ID: covidwho-1380913

RESUMEN

Corona Virus Disease 2019 (COVID-19) has spread rapidly to countries all around the world from the end of 2019, which caused a great impact on global health and has had a huge impact on many countries. Since there is still no effective treatment, it is essential to making effective predictions for relevant departments to make responses and arrangements in advance. Under the limited data, the prediction error of LSTM model will increase over time, and its prone to big bias for medium- and long-term prediction. To overcome this problem, our study proposed a LSTM-Markov model, which uses Markov model to reduce the prediction error of LSTM model. Based on confirmed case data in the US, Britain, Brazil and Russia, we calculated the training errors of LSTM and constructed the probability transfer matrix of the Markov model by the errors. And finally, the prediction results were obtained by combining the output data of LSTM model with the prediction errors of Markov Model. The results show that: compared with the prediction results of the classical LSTM model, the average prediction error of LSTM-Markov is reduced by more than 75%, and the RMSE is reduced by more than 60%, the mean [Formula: see text] of LSTM-Markov is over 0.96. All those indicators demonstrate that the prediction accuracy of proposed LSTM-Markov model is higher than that of the LSTM model to reach more accurate prediction of COVID-19.


Asunto(s)
COVID-19/epidemiología , Brasil/epidemiología , Aprendizaje Profundo , Humanos , Cadenas de Markov , Redes Neurales de la Computación , Proyectos de Investigación , Federación de Rusia/epidemiología , Reino Unido/epidemiología , Estados Unidos
10.
Geriatr Nurs ; 42(5): 1105-1108, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1284099

RESUMEN

The purpose of this study was to assess the effectiveness of Pfizer-BioNTech COVID19 vaccine among nursing home residents by exploring the outcomes of a major COVID-19 outbreak following COVID-19 vaccination in a nursing home located at a metropolitan area of South-Central Texas. 91 residents resided in this nursing home during the outbreak, and 86 residents received the 1st dose of COVID-19 vaccine on January 4th, 2021. A retrospective chart review explored outcomes of this outbreak by accessing the electronic medical records from January 4th, 2021 thru February 28th, 2021. Residents partially vaccinated with COVID-19 vaccine were found less likely to be symptomatic during this outbreak. The risk of SARS-CoV-2 infection was significantly lower among residents who received both doses of the COVID-19 vaccine. Completion of both doses of COVID vaccination for all nursing home residents is essential and can prevent future COVID-19 outbreaks in nursing homes.


Asunto(s)
COVID-19 , Vacunas , Vacunas contra la COVID-19 , Brotes de Enfermedades/prevención & control , Humanos , Casas de Salud , Estudios Retrospectivos , SARS-CoV-2
11.
World J Clin Cases ; 9(12): 2731-2738, 2021 Apr 26.
Artículo en Inglés | MEDLINE | ID: covidwho-1215740

RESUMEN

BACKGROUND: Emerging infectious diseases are a constant threat to the public's health and health care systems around the world. Coronavirus disease 2019 (COVID-2019), which was defined by the World Health Organization as pandemic, has rapidly emerged as a global health threat. Outbreak evolution and prevention of international implications require substantial flexibility of frontline health care facilities in their response. AIM: To explore the effect of the implementation and management strategy of pre-screening triage in children during COVID-19. METHODS: The standardized triage screening procedures included a standardized triage screening questionnaire, setup of pre-screening triage station, multi-point temperature monitoring, extensive screenings, and two-way protection. In order to ensure the implementation of the pre-screening triage, the prevention and control management strategies included training, emergency exercise, and staff protection. Statistical analysis was performed on the data from all the children hospitalized from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. Data were obtained from questionnaires and electronic medical record systems. RESULTS: A total of 17561 children, including 2652 who met the criteria for screening, 192 suspected cases, and two confirmed cases without omission, were screened from January 20, 2020 to March 20, 2020 at solstice during the pandemic period. There was zero transmission of the infection to any medical staff. CONCLUSION: The effective strategies for pre-screening triage have an essential role in the prevention and control of hospital infection.

12.
Computers, Materials, & Continua ; 67(3):3311-3327, 2021.
Artículo | ProQuest Central | ID: covidwho-1112964

RESUMEN

With COVID-19 continuing to rage around the world, there is a spread of epidemic-related information on social networking platforms. This phenomenon may inhibit or promote the scale of epidemic transmission. This study constructed a double-layer epidemic spreading–information dissemination network based on the movements of individuals across regions to analyze the dynamic evolution and coupling mechanism of information dissemination and epidemic transmission. We also proposed measures to control the spread of the epidemic by analyzing the factors affecting dynamic transmission. We constructed a state probability equation based on Markov chain theory and performed Monte Carlo simulations to demonstrate the interaction between information dissemination and epidemic transmission. The simulation results showed that the higher the information dissemination rate, the larger the scale of information dissemination and the smaller the scale of epidemic transmission. In addition, the higher the recovery rate of the epidemic or the lower the infection rate of the epidemic, the smaller the scale of information dissemination and the smaller the scale of epidemic transmission. Moreover, the greater the probability of individuals moving across regions, the larger the spread of the epidemic and information. Finally, the higher the probability of an individual taking preventive behavior, the smaller the spread of the epidemic and information. Therefore, it is possible to suppress epidemic spread by increasing the information dissemination rate, epidemic recovery rate, and probability of individuals taking preventive behavior, while also reducing the infection rate of the epidemic and appropriately implementing regional blockades.

13.
Ann Med ; 53(1): 391-401, 2021 12.
Artículo en Inglés | MEDLINE | ID: covidwho-1096398

RESUMEN

BACKGROUND: There are few effective therapies for coronavirus disease 2019 (COVID-19) upon the outbreak of the pandemic. To compare the effectiveness of a novel genetically engineered recombinant super-compound interferon (rSIFN-co) with traditional interferon-alpha added to baseline antiviral agents (lopinavir-ritonavir or umifenovir) for the treatment of moderate-to-severe COVID-19. METHOD: In this multicenter randomized (1:1) trial, patients hospitalized with moderate-to-severe COVID-19 received either rSIFN-co nebulization or interferon-alpha nebulization added to baseline antiviral agents for no more than 28 days. The primary endpoint was the time to clinical improvement. Secondary endpoints included the overall rate of clinical improvement assessed on day 28, the time to radiological improvement and virus nucleic acid negative conversion. RESULTS: A total of 94 patients were included in the safety set (46 patients assigned to rSIFN-co group, 48 to interferon-alpha group). The time to clinical improvement was 11.5 days versus 14.0 days (95% CI 1.10 to 2.81, p = .019); the overall rate of clinical improvement on day 28 was 93.5% versus 77.1% (difference, 16.4%; 95% CI 3% to 30%); the time to radiological improvement was 8.0 days versus 10.0 days (p = .002), the time to virus nucleic acid negative conversion was 7.0 days versus 10.0 days (p = .018) in the rSIFN-co and interferon alpha arms, respectively. Adverse events were balanced with no deaths among groups. CONCLUSIONS AND RELEVANCE: rSIFN-co was associated with a shorter time of clinical improvement than traditional interferon-alpha in the treatment of moderate-to-severe COVID-19 when combined with baseline antiviral agents. rSIFN-co therapy alone or combined with other antiviral therapy is worth to be further studied.Key messagesThere are few effective therapies for coronavirus disease 2019 (COVID-19) upon the outbreak of the pandemic. Interferon alphas, by inducing both innate and adaptive immune responses, have shown clinical efficacy in treating severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus.In this multicenter, head-to-head, randomized, clinical trial which included 94 participants with moderate-to-severe COVID-19, the rSIFN-co plus antiviral agents (lopinavir-ritonavir or umifenovir) was associated with a shorter time of clinical improvement than interferon-alpha plus antiviral agents.


Asunto(s)
Antivirales/uso terapéutico , Tratamiento Farmacológico de COVID-19 , COVID-19/dietoterapia , Interferon beta-1b/uso terapéutico , Interferón-alfa/uso terapéutico , Adulto , COVID-19/epidemiología , Protocolos Clínicos , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/uso terapéutico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
14.
J Comput Aided Mol Des ; 34(12): 1237-1259, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-841071

RESUMEN

Computational protein-ligand docking is well-known to be prone to inaccuracies in input receptor structures, and it is challenging to obtain good docking results with computationally predicted receptor structures (e.g. through homology modeling). Here we introduce a fragment-based docking method and test if it reduces requirements on the accuracy of an input receptor structures relative to non-fragment docking approaches. In this method, small rigid fragments are docked first using AutoDock Vina to generate a large number of favorably docked poses spanning the receptor binding pocket. Then a graph theory maximum clique algorithm is applied to find combined sets of docked poses of different fragment types onto which the complete ligand can be properly aligned. On the basis of these alignments, possible binding poses of complete ligand are determined. This docking method is first tested for bound docking on a series of Cytochrome P450 (CYP450) enzyme-substrate complexes, in which experimentally determined receptor structures are used. For all complexes tested, ligand poses of less than 1 Å root mean square deviations (RMSD) from the actual binding positions can be recovered. Then the method is tested for unbound docking with modeled receptor structures for a number of protein-ligand complexes from different families including the very recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) protease. For all complexes, poses with RMSD less than 3 Å from actual binding positions can be recovered. Our results suggest that for docking with approximately modeled receptor structures, fragment-based methods can be more effective than common complete ligand docking approaches.


Asunto(s)
Betacoronavirus/enzimología , Infecciones por Coronavirus/tratamiento farmacológico , Cisteína Endopeptidasas/efectos de los fármacos , Simulación del Acoplamiento Molecular , Pandemias , Neumonía Viral/tratamiento farmacológico , Proteínas no Estructurales Virales/efectos de los fármacos , ATPasas Asociadas con Actividades Celulares Diversas/química , ATPasas Asociadas con Actividades Celulares Diversas/metabolismo , COVID-19 , Proteasas 3C de Coronavirus , Cisteína Endopeptidasas/química , Cisteína Endopeptidasas/metabolismo , Sistema Enzimático del Citocromo P-450/química , Sistema Enzimático del Citocromo P-450/metabolismo , Proteínas de Unión al ADN/química , Proteínas de Unión al ADN/metabolismo , Humanos , Ligandos , Modelos Químicos , Modelos Moleculares , Chaperonas Moleculares/química , Chaperonas Moleculares/metabolismo , Fragmentos de Péptidos/química , Fragmentos de Péptidos/metabolismo , Unión Proteica , Conformación Proteica , Receptores Acoplados a Proteínas G/química , Receptores Acoplados a Proteínas G/metabolismo , SARS-CoV-2 , Factores de Transcripción/química , Factores de Transcripción/metabolismo , Proteínas no Estructurales Virales/química , Proteínas no Estructurales Virales/metabolismo
16.
Chaos Solitons Fractals ; 140: 110123, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-650411

RESUMEN

COVID-19 blocked Wuhan in China, which was sealed off on Chinese New Year's Eve. During this period, the research on the relevant topics of COVID-19 and emotional expressions published on social media can provide decision support for the management and control of large-scale public health events. The research assisted the analysis of microblog text topics with the help of the LDA model, and obtained 8 topics ("origin", "host", "organization", "quarantine measures", "role models", "education", "economic", "rumor") and 28 interactive topics. Obtain data through crawler tools, with the help of big data technology, social media topics and emotional change characteristics are analyzed from spatiotemporal perspectives. The results show that: (1) "Double peaks" feature appears in the epidemic topic search curve. Weibo on the topic of the epidemic gradually reduced after January 24. However, the proportion of epidemic topic searches has gradually increased, and a "double peaks" phenomenon appeared within a week; (2) The topic changes with time and the fluctuation of the topic discussion rate gradually weakens. The number of texts on different topics and interactive topics changes with time. At the same time, the discussion rate of epidemic topics gradually weakens; (3) The political and economic center is an area where social media is highly concerned. The areas formed by Beijing, Shanghai, Guangdong, Sichuan and Hubei have published more microblog texts. The spatial division of the number of Weibo social media texts has a high correlation with the economic zone division; (4) The existence of the topic of "rumor" will enable people to have more communication and discussion. The interactive topics of "rumors" always have higher topic popularity and low emotion text expressions. Through the analysis of media information, it helps relevant decision makers to grasp social media topics from spatiotemporal characteristics, so that relevant departments can accurately grasp the public's subjective ideas and emotional expressions, and provide decision support for macro-control response strategies and measures and risk communication.

17.
J Thromb Haemost ; 18(6): 1324-1329, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-600185

RESUMEN

BACKGROUND: The outbreak of the coronavirus disease 2019 (Covid-19) has shown a global spreading trend. Early and effective predictors of clinical outcomes are urgently needed to improve management of Covid-19 patients. OBJECTIVE: The aim of the present study was to evaluate whether elevated D-dimer levels could predict mortality in patients with Covid-19. METHODS: Patients with laboratory confirmed Covid-19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020, to March 15, 2020. D-dimer levels on admission and death events were collected to calculate the optimum cutoff using receiver operating characteristic curves. According to the cutoff, the subjects were divided into two groups. Then the in-hospital mortality between two groups were compared to assess the predictive value of D-dimer level. RESULTS: A total of 343 eligible patients were enrolled in the study. The optimum cutoff value of D-dimer to predict in-hospital mortality was 2.0 µg/mL with a sensitivity of 92.3% and a specificity of 83.3%. There were 67 patients with D-dimer ≥2.0 µg/mL, and 267 patients with D-dimer <2.0 µg/mL on admission. 13 deaths occurred during hospitalization. Patients with D-dimer levels ≥2.0 µg/mL had a higher incidence of mortality when comparing with those who with D-dimer levels <2.0 µg/mL (12/67 vs 1/267, P < .001; hazard ratio, 51.5; 95% confidence interval, 12.9-206.7). CONCLUSIONS: D-dimer on admission greater than 2.0 µg/mL (fourfold increase) could effectively predict in-hospital mortality in patients with Covid-19, which indicated D-dimer could be an early and helpful marker to improve management of Covid-19 patients. (Chinese Clinical Trial Registry: ChiCTR2000031428).


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Mortalidad Hospitalaria , Admisión del Paciente , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Anciano , Biomarcadores/sangre , COVID-19 , China , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , SARS-CoV-2 , Factores de Tiempo
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