Mechanistic investigation of direct photodegradation of chloroquine phosphate under simulated sunlight.

Chloroquine phosphate (CQ) is an antiviral drug for Coronavirus Disease 2019 and an old drug for treatment of malaria, which has been detected in natural waters. Despite its prevalence, the environmental fate of CQ remains unclear. In this study, the direct photodegradation of CQ under simulated sunlight was investigated. The effect of various parameters such as pH, initial concentration and environmental matrix were examined. The photodegradation quantum yield of CQ (4.5 × 10-5-0.025) increased with the increasing pH value in the range of 6.0-10.0. The electron spin resonance (ESR) spectrometry and quenching experiments verified that the direct photodegradation of CQ was primarily associated with excited triplet states of CQ (3CQ*). The common ions had negligible effect and humic substances exhibited a negative effect on CQ photodegradation. The photoproducts were identified using high-resolution mass spectrometry and the photodegradation pathway of CQ was proposed. The direct photodegradation of CQ involved the cleavage of the C-Cl bond and substitution of the hydroxyl group, followed by further oxidation to yield carboxylic products. The photodegradation processes were further confirmed by the density functional theory (DFT) computation for the energy barrier of CQ dichlorination. The findings contribute to the assessment of the ecological risk associated with the overuse of Coronavirus drugs during global public health emergencies.

Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19.

Despite the well-known benefits of breastfeeding and the World Health Organization's breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk's protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.

Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19

Despite the well-known benefits of breastfeeding and the World Health Organization's breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk's protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.

Chest CT study of fifteen COVID-19 patients with positive RT-PCR retest results after discharge.

BACKGROUND: Our hospital is a designated institution for COVID-19 patients in Chengdu, China. This study aimed to analyze the clinical and chest CT features of 15 COVID-19 patients with positive reverse transcription-polymerase chain reaction (RT-PCR) retest results after discharge. Patients who met the current standards of discharge could still carry the SARS-CoV-2 virus. METHODS: Clinical manifestations, laboratory data, and chest CT images were retrospectively reviewed and analyzed. RESULTS: The most common symptoms at Covid-19COVID-19 initial onset were fever (12/15, 80%) and cough (11/15, 73.3%). Most of the patients had a normal white blood cells (12/15, 80%), neutrophils (12/15, 80%), and lymphocytes count (13/15, 86.7%); some patients had increased C-reactive protein (CRP) (5/15, 33.3%), and increased lactate dehydrogenase (LDH) (4/15, 26.7%) during first admission. Five patients (33.3%) had a cough before their first discharge. The average interval from the first discharge to re-admission was 17 days (range, 9-30 days). At re-admission, two (13.3%) patients presented with cough, and one (6.6%) had chest pain with anxiety. At re-admission, all patients had normal clinical results except five (33.3%) patients had increased CRP compared with first discharging, two (13.3%) patients had increased neutrophils count, and one (6.6%) had increased CRP. The majority of patients had normal procalcitonin. Ground glass opacities (GGOs) and reticulation in the peripheral and subpleural areas were the most common CT manifestations, and six patients (40%) showed a transformation from reticulation to GGOs when re-admitted. CONCLUSIONS: There may be no specific clinical characteristics to predict the re-detectability of the virus. A regular medical observation and a bi-monthly follow-up is recommended.

A 3-month-old child with COVID-19: A case report.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is pandemic and is a medical issue. However, children account for a small portion of those with the disease, and there are few published reports of COVID-19 in children. The patient reported in this case report is the youngest case reported in Chengdu, China to date. PATIENT CONCERNS: A 3-month-old male infant presented with cough and rhinorrhea. DIAGNOSIS: Family members from Wuhan, the epicenter of the epidemic came to stay in the patient's home 16 days before the onset of his disease, and his mother had been diagnosed with COVID-19. He was diagnosed with COVID-19 based on a history of exposure and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected using reverse transcription polymerase chain reaction (RT-PCR). INTERVENTIONS: The patient was admitted to hospital and treated symptomatically with oral medication. OUTCOMES: The patient recovered completely and was discharged after one month of hospitalization. He tested negative for SARS-CoV-2 using RT-PCR and a chest CT performed 4 weeks after admission showed marked improvement prior to discharge. CONCLUSION: Clinicians must be aware of the presentation of COVID-19 in children because it differs from that in adults.

[Clinical Study and CT Findings of a Familial Cluster of Pneumonia with Coronavirus Disease 2019 (COVID-19)].

We studied the epidemiological and clinical data collected from a family with 5 people, in which there were 3 family member diagnosed as coronavirus disease 2019 (COVID-19). We found that the first patient in this family had Wuhan city travel history. Close contact in daily life was the route of infection. The most common symptoms were fever, cough and weakness. Characteristic imaging changes were found with grass opacity (GGO), consolidation and septal thickening mainly distributed in peripheral and posterior area by thoracic CT scan in the 3 patients. The abnormality in laborotary test included lower white blood cell count, neutrophil count and lymphocyte count，increasing fibrinogen and C-reactive protein，decreasing myohaemoglobin and increasing lactate dehydrogenase. The epidemiological and clinical features could provide quicker diagnosis and better management for the COVID-19 infected patients.

Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records.

BACKGROUND: Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection. METHODS: Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation. FINDINGS: All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 109 cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8-9 and a 5-min Apgar score of 9-10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus. INTERPRETATION: The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy. FUNDING: Hubei Science and Technology Plan, Wuhan University Medical Development Plan.