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Objective: The aim of the study was to analyze the clinical features of elderly patients with coronavirus disease 2019 (COVID-19) and to explore the relationship between COVID-19 patients and kidney injury. Methods: A total of 188 elderly patients with confirmed COVID-19 enrolled in this study were hospitalized for at least 1 week in the Central Theater Command General Hospital of Chinese People's Liberation Army from January 3, 2020 to March 14, 2020. The recorded information included clinical data and results of kidney-related laboratory tests. Retrospective analysis was performed. Results: The median age of the patients was 69 years (interquartile range 65–78, range: 60–97 years);31.4% were 60–74 years old, and 68.6% were over 75 years old. A total of 12.8% and 18.6% of the patients were in critical and severe stages of COVID-19, respectively. The proportions of patients using mechanical ventilators and deaths were 9.5% and 8.5%, respectively. A total of 26.1% and 8.5% of the patients showed mild elevation of blood urea nitrogen (BUN) and serum creatinine (SCr) levels at admission. A total of 18.6% and 5.9% of the patients had elevated BUN and SCr 1 week after admission, respectively. A total of 3.1% of the patients were diagnosed with acute kidney injury, and 75% of those patients had chronic kidney disease before admission. Compared with the patients aged 60–74 years, those over 75 years exhibited significantly increased proportions of elevated BUN levels, critical illness, use of mechanical ventilated, and death. Multivariate logistic regression analysis revealed that an elevated BUN level at admission and 1 week after admission were independent risk factors for death in the elderly patients with COVID-19. Conclusion: There were more critical cases and a high mortality in elderly patients with COVID-19. An increased BUN level was an independent risk factor for death in elderly patients with COVID-19.
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We wished to explore the interference factors causing false-positive results for immunoglobulin M (IgM) and IgG antibodies in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detected by the gold immunochromatography assaym (GICA). In this way, we wanted to improve the detection method and scheme of laboratory detection. Seventy-four serum samples from outpatients and inpatients from the Affiliated Hospital of North Sichuan Medical College and Nanchong Central Hospital in China from 2 January 2020 to 5 March 2020 were collected 19 patients with the nucleic acids of SARS-CoV-2;10 cases with IgM antibodies against other respiratory viruses;10 patients with IgM antibodies against hepatitis viruses;20 patients with IgM antibodies against rheumatoid factor (RF);15 patients with antinuclear antibody (ANA). Colloidal GICA (kit A and kit B) was used to detect IgM and IgG antibodies against SARS-CoV-2 in patient sera. Positive results of SARS-CoV-2 IgM or SARS-CoV -2 IgG antibodies were analyzed, and possible factors causing false-positive results were found. Then, the sera of SARS- CoV - 2 IgM/IgG positive and 3 early coronavirus disease 2019 (COVID-19) patients were dissociated with an appropriate concentration of urea, and levels of IgM and IgG antibodies against SARS-CoV-2 were redetermined. SPSS v19.0 was used to analyze data. In the sera of 19 patients with SARS-CoV-2 infection 15 of SARS -CoV-2 IgM antibodies and 18 cases SARS-CoV-2 IgG antibodies were detected in kit A;12 cases of SARS-CoV-2 IgM antibodies and 12 cases of SARS-CoV-2 IgG antibodies were detected in kit B;16 cases of SARS-CoV-2 IgM antibodies and 14 cases of SARS-CoV -2 IgG antibodies were detected in 20 patients who had IgM antibodies against RF. In the sera of 15 patients with high - titer ANA, SARS-CoV- 2 IgG antibodies were detected in four cases using kit B. When the urea dissociation concentration was 2 mol/L, 14 of 16 RF- IgM - positive sera detected using kit A turned negative, 13 of 14 SARS- CoV- 2 IgG antibodies turned negative, but patients with COVID-19 detected by kit A did not show negative conversion of IgM or IgG antibodies. When the urea dissociation concentration was 4 mol/L, ANA -positive serum detected by kit B turned negative in four cases, whereas SARS-CoV-2 IgM and IgG antibodies in patients with COVID-19 did not turn negative. After urea dissociation, the SARS-CoV- 2 IgM antibodies detected by kit A and kit B in the sera of three patients with early COVID- 19 did not turn negative. RF could cause false-positive results for SARS-CoV-2 IgM and IgG antibodies detected by kit A, and a high titer of ANA could cause false-positive results of SARS-CoV-2 IgG antibodies detected by kit B. Urea dissociation could be helpful for reducing the probability of false-positive results of SARS-CoV-2 IgM and IgG antibodies. The effect of urea dissociation on the detection sensitivity of early COVID-19 merits further study.
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The increasing use of raw carbon-based nanomaterials (CBNs) will inevitably affect wastewater treatment systems. Constructed wetlands (CWs) are ecological wastewater treatment facilities and can intercept the vast particles pollutant, including CBNs. However, the impacts of CBNs on the treatment performance of CWs have no available knowledge. Therefore, we systematically inspected the effects of single-walled and multi-walled carbon nanotubes (SWCNTs and MWCNTs) and fullerene nanoparticles (C60) on CW performance under 180-day exposure to 0, 10 and 1000 µg/L concentrations. The results showed that CBNs had marginally adverse impacts on chemical oxygen demand (COD) and total phosphorus (TP) removal, whereas nitrogen removal declined by 24.1 %-42.7 % following long-term exposure to CBNs. MWCNTs had the greatest inhibition effect on nitrogen removal, followed by SWCNTs and C60. The CBNs also induced reactive oxygen species (ROS) overproduction as the increasing concentration, which confirmed that CBNs have biotoxic effects in CWs. The variation of functional microbial community and the inhibition of enzyme activities were the dominant reasons for the decline in nitrogen removal efficiency. Furthermore, predictive functional profiling showed that CBNs affected functional gene abundance, and caused a decline in the enzymes abundance connected to nitrogen removal by the end of the 180-day exposure period.
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Background: Current information is not enough to recognize the risk factors of clinical deterioration and to make medical decisions in COVID-19 patients. Methods: A retrospective study was performed, with collecting data from medical records of COVID-19 patients in three designated hospitals from January 8, 2020 to May 6, 2020. Clinical data were analyzed between the deteriorated and the non-deteriorated patients, which was defined as either a increase of 2 categories on the modified 6-category ordinal scale, or a decline of PaO2-to-FIO2 ratio more than 100mmHg. Results: Total 238 patients with COVID-19 were selected, where 31 were deteriorated and 207 were non-deteriorated. In the deterioration group, the case fatality rate was up to 41.9%. Compared with non-deteriorated patients, the deteriorated were older (65.8[IQR 54.3-72.3] vs 54.4[41.0-66.1], p=0.004) and were more likely to have chronic medical illnesses (17[54.8%]) vs 92[44.4%]). Multivariable regression showed that three variables, neutrophil-lymphocyte ratio (NLR)≥3.66 (OR, 9.85; 95% CI, 1.68-57.57), hyponatremia (OR, 8.35; 95% CI, 1.74-40.16), and presence of ground-glass opacities with consolidation (OR, 5.84; 95% CI, 1.24-27.49) were associated with increased odds of clinical deterioration. The variable that inspiring air or traditional oxygen therapy only within 72 hours after admission, indicated a decreased odd of illness progression (OR, 0.075; 95% CI, 0.012–0.465).Conclusions: COVID-19 patients with clinical deterioration had more common extra-pulmonary organ impair in early stage and high case fatality rate. Three factors, NLR ≥3.66, hyponatremia and presence of ground-glass opacities with consolidation were determined as high risk factors in deterioration.
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COVID-19 , HiponatremiaRESUMEN
The unprecedented coronavirus disease 2019 (COVID-19) epidemic has created a worldwide public health emergency, and there is an urgent need to develop an effective vaccine to control this severe infectious disease. Here, we found that a single vaccination with a replication-defective human type 5 adenovirus encoding the SARS-CoV-2 spike protein (Ad5-nCoV) protected mice completely against SARS-CoV-2 infection in the upper and lower respiratory tracts. Additionally, a single vaccination with Ad5-nCoV protected ferrets from SARS-CoV-2 infection in the upper respiratory tract. This study suggested that a combination of intramuscular and mucosal vaccination maybe provide a desirable protective efficacy and different Ad5-nCoV delivery modes are worth further investigation in human clinical trials.
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COVID-19 , Enfermedades TransmisiblesRESUMEN
Background: Coronavirus disease 2019 (COVID-19) is a current global pandemic. However, impact of recent influenza A virus infection on the clinical course and outcomes of severe COVID-19 adult inpatients needs to be further explored.Methods: In this retrospective cohort study, severe, laboratory confirmed COVID-19 adult patients from Wuhan Tongji Hospital were included. Data were obtained from electronic medical records and compared between patients with and without recent influenza A virus infection.Results: 200 patients were included, 51.5% with recent influenza A virus infection. Recent influenza A virus infection group presented with longer persistence of cough and sputum from illness onset (35.0 vs. 27.0 days, P = 0.018) and (33.0 vs. 26.0 days, P = 0.015), respectively. Median time of progression to critical illness from illness onset was shorter (day 11.5 vs. day 16.0, P = 0.034). Time to clinical improvement and length of hospital stay were longer in recent infection group (23.0 vs. 19.0 days, P = 0.044) and (22.0 vs. 18.0 days, P = 0.030), respectively.Conclusions: Patients with recent influenza A virus infection showed a delay in time to clinical improvement and increased length of hospital stay. There is a high clinical need to improve the detection of common respiratory pathogens to identify co-infection during the epidemic of COVID-19.