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1.
Journal of Urban History ; 49(4):723-744, 2023.
Artículo en Inglés | Academic Search Complete | ID: covidwho-20238637

RESUMEN

COVID-19 calls for a new understanding of urban landscape and associated living. As an emerging topic, lockdown urbanism involves an unpredictable future where lockdown or quarantine may be a come and go new normal for everyday practice, but the topic itself seems to have escaped historical inquiry. This paper attempts to answer why the strict lockdown is suitable for China by revealing a long and complex history of urbanization and its social and administrative organization. The urban fabric is characterized by a system of urban patterns: enclosed communities, the spatial layout and service distribution of the neighborhood, and the formation of the center. It was also animated by daily ritualistic practices, such as the control of time, quotidian lockdown practice (yejin), and individual ties within the enclosed neighborhood. This paper contributes to a better understanding of the deep history of urban form and the order and logic behind lockdown urbanism. [ FROM AUTHOR] Copyright of Journal of Urban History is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

2.
Poult Sci ; 102(6): 102661, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-20244886

RESUMEN

Avian infectious bronchitis (IB) is a highly contagious disease caused by infectious bronchitis virus (IBV). Vaccination is an effective approach for controlling IBV. Therefore, reliable immune monitoring for IB is critical for poultry. In this study, a novel peptide derived from S2 protein was used to develop an enzyme-linked immunosorbent assay (ELISA) for the detection of broadly cross-reactive antibodies against IBV. The peptide-based ELISA (pELISA) showed good specificity and sensitivity in detecting IBV antibodies against different serotypes. A semilogarithmic regression method for determining IBV antibody titers was also established. Antibody titers detected by pELISA and calculated with this equation were statistically similar to those evaluated by indirect fluorescence assay (IFA). Moreover, the comparison analysis showed a 96.07% compatibility between the pELISA and IDEXX ELISA. All these data demonstrate that the pELISA generated here can be as a rapid and reliable serological surveillance tool for monitoring IBV infection or vaccination.


Asunto(s)
Infecciones por Coronavirus , Virus de la Bronquitis Infecciosa , Enfermedades de las Aves de Corral , Animales , Pollos , Anticuerpos Antivirales/análisis , Ensayo de Inmunoadsorción Enzimática/veterinaria , Ensayo de Inmunoadsorción Enzimática/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/veterinaria , Péptidos , Enfermedades de las Aves de Corral/diagnóstico , Enfermedades de las Aves de Corral/prevención & control
3.
Small ; : e2208198, 2023 Apr 12.
Artículo en Inglés | MEDLINE | ID: covidwho-2298827

RESUMEN

The rapid and sensitive detection of trace-level viruses in a simple and reliable way is of great importance for epidemic prevention and control. Here, a multi-functionalized floating gate carbon nanotube field effect transistor (FG-CNT FET) based biosensor is reported for the single virus level detection of SARS-CoV-2 virus antigen and RNA rapidly with a portable sensing platform. The aptamers functionalized sensors can detect SARS-CoV-2 antigens from unprocessed nasopharyngeal swab samples within 1 min. Meanwhile, enhanced by a multi-probe strategy, the FG-CNT FET-based biosensor can detect the long chain RNA directly without amplification down to single virus level within 1 min. The device, constructed with packaged sensor chips and a portable sensing terminal, can distinguish 10 COVID-19 patients from 10 healthy individuals in clinical tests both by the RNAs and antigens by a combination detection strategy with an combined overall percent agreement (OPA) close to 100%. The results provide a general and simple method to enhance the sensitivity of FET-based biochemical sensors for the detection of nucleic acid molecules and demonstrate that the CNT FG FET biosensor is a versatile and reliable integrated platform for ultrasensitive multibiomarker detection without amplification and has great potential for point-of-care (POC) clinical tests.

4.
Protein Cell ; 14(1): 37-50, 2023 01.
Artículo en Inglés | MEDLINE | ID: covidwho-2222720

RESUMEN

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.


Asunto(s)
Antivirales , Virus de la Hepatitis B , Ribonucleoproteína Heterogénea-Nuclear Grupo A-B , SARS-CoV-2 , Animales , Ratones , Antivirales/farmacología , COVID-19 , Interferón Tipo I/metabolismo , SARS-CoV-2/efectos de los fármacos , Ribonucleoproteína Heterogénea-Nuclear Grupo A-B/antagonistas & inhibidores
5.
Blood Press ; 32(1): 6-15, 2023 12.
Artículo en Inglés | MEDLINE | ID: covidwho-2160599

RESUMEN

PURPOSE: We investigated plasma angiotensin-converting enzyme 2 (ACE2) concentration in a population sample and the ACE2 expression quantitated with the diaminobenzidine mean intensity in the lung tissue in patients who underwent lung surgery. MATERIALS AND METHODS: The study participants were recruited from a residential area in the suburb of Shanghai for the plasma ACE2 concentration study (n = 503) and the lung tissue samples were randomly selected from the storage in Ruijin Hospital (80 men and 78 age-matched women). RESULTS: In analyses adjusted for covariables, men had a significantly higher plasma ACE2 concentration (1.21 vs. 0.98 ng/mL, p = 0.027) and the mean intensity of ACE2 in the lung tissue (55.1 vs. 53.9 a.u., p = 0.037) than women. With age increasing, plasma ACE2 concentration decreased (p = 0.001), while the mean intensity of ACE2 in the lung tissue tended to increase (p = 0.087). Plasma ACE2 concentration was higher in hypertension than normotension, especially treated hypertension (1.23 vs. 0.98 ng/mL, p = 0.029 vs. normotension), with no significant difference between users of RAS inhibitors and other classes of antihypertensive drugs (p = 0.64). There was no significance of the mean intensity of ACE2 in the lung tissue between patients taking and those not taking RAS inhibitors (p = 0.14). Neither plasma ACE2 concentration nor the mean intensity of ACE2 in the lung tissue differed between normoglycemia and diabetes (p ≥ 0.20). CONCLUSION: ACE2 in the plasma and lung tissue showed divergent changes according to several major characteristics of patients.Plain language summary What is the context? • The primary physiological function of ACE2 is the degradation of angiotensin I and II to angiotensin 1-9 and 1-7, respectively. • ACE2 was found to behave as a mediator of the severe acute respiratory syndrome coronavirus (SARS) infection. • There is little research on ACE2 in humans, especially in the lung tissue. • In the present report, we investigated plasma ACE2 concentration and the ACE2 expression quantitated with the diaminobenzidine mean intensity in the lung tissue respectively in two study populations. What is new? • Our study investigated both circulating and tissue ACE2 in human subjects. The main findings were: • In men as well as women, plasma ACE2 concentration was higher in younger than older participants, whereas the mean intensity of ACE2 in the lung tissue increase with age increasing. • Compared with normotension, hypertensive patients had higher plasma ACE2 concentration but similar mean intensity of ACE2 in the lung tissue. • Neither plasma ACE2 concentration nor lung tissue ACE2 expression significantly differed between users of RAS inhibitors and other classes of antihypertensive drugs. What is the impact? • ACE2 in the plasma and lung tissue showed divergent changes according to several major characteristics, such as sex, age, and treated and untreated hypertension. • A major implication is that plasma ACE2 concentration might not be an appropriate surrogate for the ACE2 expression in the lung tissue, and hence not a good predictor of SARS-COV-2 infection or fatality.


Asunto(s)
COVID-19 , Hipertensión , Masculino , Humanos , Femenino , Enzima Convertidora de Angiotensina 2/metabolismo , Enzima Convertidora de Angiotensina 2/farmacología , SARS-CoV-2/metabolismo , Peptidil-Dipeptidasa A/metabolismo , Peptidil-Dipeptidasa A/farmacología , Antihipertensivos/farmacología , Sistema Renina-Angiotensina , China , Angiotensina I , Pulmón
6.
Soc Sci Med ; 311: 115301, 2022 Aug 29.
Artículo en Inglés | MEDLINE | ID: covidwho-2004525

RESUMEN

RATIONALE: Parenting is a demanding task associated with parents' mental health, which is likely exacerbated by the COVID-19 pandemic lockdown. The present study investigated daily parenting hassles and their effects on parents' mental health during this period. METHODS: A total of 7314 parents with children aged 3-14 years old completed a sociodemographic questionnaire and reported on their perceived daily parenting hassles, mental health, family support, and co-parenting during the COVID-19 school closure. RESULTS: Most parents (73.4%) showed different degrees of daily hassles, and a relatively higher prevalence of depression (18.7%), anxiety (22.4%), and stress (12.1%) were found. Motherhood, parents' younger ages, lower education parents, job loss, and having younger children, boys, and multiple children were associated with elevated daily parenting hassles and mental health issues. Importantly, daily parenting hassles were uniquely associated with mental health problems after controlling for various sociodemographic characteristics, family support, and co-parenting. Furthermore, family support and co-parenting can attenuate daily parenting hassles, which, in turn, protect parents' mental health. CONCLUSIONS: The findings of the present study underscore the critical need to consider daily parenting hassles and their effects on the mental health of parents during the COVID-19 lockdown. The present study also outlines potential factors (family support and co-parenting) that attenuate parents' daily parenting hassles and protect their mental health during the COVID-19 lockdown.

7.
Infect Dis Ther ; 11(4): 1661-1682, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-2000143

RESUMEN

INTRODUCTION: Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX) is the first direct-acting antiviral (DAA) therapy approved for patients who have previously failed a DAA-containing regimen including NS5A inhibitors. In clinical trials, SOF/VEL/VOX was associated with high rates of sustained virologic response at post-treatment week 12 (SVR12) and was well tolerated. However, the effectiveness and safety of SOF/VEL/VOX in the real world remained uncertain. We aimed to perform a systematic review and meta-analysis to assess the real world effectiveness and safety of SOF/VEL/VOX. METHODS: We systematically searched the PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases for relevant real world studies published before January 28, 2022. Patients with previous treatment failure who received SOF/VEL/VOX were included. The primary outcome was the percentage of patients achieving SVR12. Secondary outcome included adverse events (AEs) during treatment. RESULTS: Fifteen studies with a total of 1796 HCV-infected patients with previous treatment failure were included. SVR12 rates were 93% (95% CI 91-95) in the ITT populations (n = 1517, 11 cohorts) and 96% (95% CI 95-97) in the PP populations (n = 1187, 10 cohorts). SVR12 rates were significantly higher in non-GT3-infected patients (OR = 2.29, 95% CI 1.23-4.27, P = 0.009) and non-cirrhotic patients (OR = 2.22, 95% CI 1.07-4.60, P = 0.03) than in GT3-infected patients and cirrhotic patients. Furthermore, the SVR12 rates of previous treatment of SOF/VEL were significantly lower than those of other regimens in both ITT and PP populations (P ≤ 0.001). Adverse events (AEs) were reported in 30% (228/760) of patients. Serious AEs (SAEs) were reported in 3.82% (29/760) of patients. The most frequently reported AEs were headache, asthenia, nausea, fatigue, and diarrhea, which were mostly mild in severity. AE-related treatment discontinuations were reported in 0.66% (5/760) of patients. CONCLUSIONS: Consistent with clinical trials, the real world evidence indicates that SOF/VEL/VOX is a well-tolerated and highly effective salvage therapy for HCV-infected patients with previous treatment failure. However, there may still be a risk of treatment failure for patients with GT3 infection, cirrhosis, or SOF/VEL treatment failure. The protocol of this study was registered at PROSPERO, registration no. CRD 42022306828.

8.
Appl Spat Anal Policy ; 15(2): 557-571, 2022.
Artículo en Inglés | MEDLINE | ID: covidwho-1844463

RESUMEN

The identification of seriously infected areas across a city, region, or country can inform policies and assist in resources allocation. Concentration of coronavirus infection can be identified through applying cluster detection methods to coronavirus cases over space. To enhance the identification of seriously infected areas by relevant studies, this study focused on coronavirus infection by small area across a city during the second wave. Specifically, we firstly explored spatiotemporal patterns of new coronavirus cases. Subsequently, we detected spatial clusters of new coronavirus cases by small area. Empirically, we used the London-wide small-area coronavirus infection data aggregately collected. Methodologically, we applied a fast Bayesian model-based detection method newly developed to new coronavirus cases by small area. As empirical evidence on the association of socioeconomic factors and coronavirus spread have been found, spatial patterns of coronavirus infection are arguably associated with socioeconomic and built environmental characteristics. Therefore, we further investigated the socioeconomic and built environmental characteristics of the clusters detected. As a result, the most significant clusters of new cases during the second wave are likely to occur around the airports. And, lower income or lower healthcare accessibility is associated with concentration of coronavirus infection across London.

10.
BMJ Open ; 12(3): e055365, 2022 03 28.
Artículo en Inglés | MEDLINE | ID: covidwho-1769912

RESUMEN

OBJECTIVES: We aimed to provide an insight into the life of survivors of critical COVID-19 in China. METHODS: We conducted an online survey and qualitative interviews among intensive care unit survivors of critical COVID-19 between November and December 2020 in Wuhan, China. Eligible participants were asked to complete the EQ-5D-5L and the Short Form 36-Item Survey, and invited to participate in a semistructured face-to-face interview. Descriptive analyses and phenomenological approach were adopted to analyse quantitative and qualitative data, respectively. RESULTS: Of 10 survivors who completed the questionnaire, 8 participated in the interview. The mean scores±SD of EuroQol-5 Dimensions-5 Level utility and EuroQol-Visual Analogue Scale were 0.88±0.15 and 80.9±14.2, respectively. The qualitative interview identified four themes, namely poor physical health, post-traumatic stress, social stigma and family support. CONCLUSIONS: COVID-19 survivors continue fighting physical and psychological impacts. Despite strong family support, these patients are struggling with social stigma. It is a long, challenging journey to recovery for patients and society.


Asunto(s)
COVID-19 , COVID-19/epidemiología , China/epidemiología , Humanos , Unidades de Cuidados Intensivos , Investigación Cualitativa , Sobrevivientes/psicología
11.
Mol Med ; 27(1): 151, 2021 12 03.
Artículo en Inglés | MEDLINE | ID: covidwho-1551198

RESUMEN

BACKGROUND: We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality. METHODS: The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed. RESULTS: The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan-Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors. CONCLUSIONS: COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19.


Asunto(s)
COVID-19/sangre , COVID-19/terapia , Endotelio/metabolismo , Glicocálix/metabolismo , Sindecano-1/sangre , Anciano , Biomarcadores/sangre , Coagulación Sanguínea , COVID-19/mortalidad , China/epidemiología , Citocinas/metabolismo , Endotelio Vascular/patología , Femenino , Humanos , Inflamación , Unidades de Cuidados Intensivos , Interleucina-6/sangre , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Oxígeno , Curva ROC , SARS-CoV-2 , Trombomodulina/sangre , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/sangre
12.
Infect Dis Poverty ; 10(1): 119, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: covidwho-1496233

RESUMEN

BACKGROUND: The incubation period is a crucial index of epidemiology in understanding the spread of the emerging Coronavirus disease 2019 (COVID-19). In this study, we aimed to describe the incubation period of COVID-19 globally and in the mainland of China. METHODS: The searched studies were published from December 1, 2019 to May 26, 2021 in CNKI, Wanfang, PubMed, and Embase databases. A random-effect model was used to pool the mean incubation period. Meta-regression was used to explore the sources of heterogeneity. Meanwhile, we collected 11 545 patients in the mainland of China outside Hubei from January 19, 2020 to September 21, 2020. The incubation period fitted with the Log-normal model by the coarseDataTools package. RESULTS: A total of 3235 articles were searched, 53 of which were included in the meta-analysis. The pooled mean incubation period of COVID-19 was 6.0 days (95% confidence interval [CI] 5.6-6.5) globally, 6.5 days (95% CI 6.1-6.9) in the mainland of China, and 4.6 days (95% CI 4.1-5.1) outside the mainland of China (P = 0.006). The incubation period varied with age (P = 0.005). Meanwhile, in 11 545 patients, the mean incubation period was 7.1 days (95% CI 7.0-7.2), which was similar to the finding in our meta-analysis. CONCLUSIONS: For COVID-19, the mean incubation period was 6.0 days globally but near 7.0 days in the mainland of China, which will help identify the time of infection and make disease control decisions. Furthermore, attention should also be paid to the region- or age-specific incubation period.


Asunto(s)
COVID-19 , Salud Global , Periodo de Incubación de Enfermedades Infecciosas , Adolescente , Adulto , COVID-19/epidemiología , China/epidemiología , Bases de Datos Factuales , Femenino , Salud Global/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estudios Observacionales como Asunto , Adulto Joven
13.
Journal of Urban History ; : 1, 2021.
Artículo en Inglés | Academic Search Complete | ID: covidwho-1443719

RESUMEN

COVID-19 calls for a new understanding of urban landscape and associated living. As an emerging topic, lockdown urbanism involves an unpredictable future where lockdown or quarantine may be a come and go new normal for everyday practice, but the topic itself seems to have escaped historical inquiry. This paper attempts to answer why the strict lockdown is suitable for China by revealing a long and complex history of urbanization and its social and administrative organization. The urban fabric is characterized by a system of urban patterns: enclosed communities, the spatial layout and service distribution of the neighborhood, and the formation of the center. It was also animated by daily ritualistic practices, such as the control of time, quotidian lockdown practice (yejin), and individual ties within the enclosed neighborhood. This paper contributes to a better understanding of the deep history of urban form and the order and logic behind lockdown urbanism. [ABSTRACT FROM AUTHOR] Copyright of Journal of Urban History is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

14.
Drug Evaluation Research ; 43(4):606-612, 2020.
Artículo en Chino | CAB Abstracts | ID: covidwho-1352919

RESUMEN

Since the initial cases of the Coronavirus Disease in 2019 (COVID-19) occurred in Wuhan in December 2019, more and more cases have been found and confirmed, not only in central China but also in other countries. Given there are still no effective drugs many approved "old drugs" are in clinical test for treating COVID-19 at present. Artemisinin, a first-line antimalarial drug recommended by WHO, has been validated to possess a variety of pharmacological effects, including, without limitation, antiinflammatory, immune regulation, anti-pulmonary fibrosis, antibacterial, antiviral and cardiovascular effects, and the like. In this paper, various pharmacological effects of Artemisinin and its derivatives have been summarized, with the emphasis on the mechanism of action, so as to explore its potential medicinal value, especially for treating COVID-19.

15.
Drug Evaluation Research ; 43(4):591-600, 2020.
Artículo en Chino | CAB Abstracts | ID: covidwho-1352917

RESUMEN

Objective: To study the potential mechanism of Tankejing in the treatment of respiratory system based on network pharmacology, and to evaluate the possibility of Tankejing in the prevention and treatment of COVID-19 pneumonia.

16.
Sustainability ; 13(12):6806, 2021.
Artículo en Inglés | MDPI | ID: covidwho-1273508

RESUMEN

Since the outbreak of the Novel Coronavirus Pneumonia in 2019, several cities have been blocked to prevent the expansion of the infection. This qualitative study aimed to determine the motives of urban residents for visiting urban green spaces during the epidemic (especially within the context of the city blockade), and what might weaken these motives. In total, 47 residents (17 men and 30 women) were recruited from Chengdu, in China, to participate in interviews. A thematic analysis was used to analyze the interview data. According to the results, the motives of the respondents were divided into strong motives and weak motives. These strong motives for visiting UGS can be divided into four themes: “A place for health”, “Escape”, “Social support”, and “A safe and important place for outdoor activities”. Residents classified as the weak motive primarily considered the reasons of “Keep distance with others”, “Potential infection risk” and “Seek compensation”. The results of this study are significant for current and future urban management, green space planning, and social well-being.

17.
Curr Med Res Opin ; 37(6): 917-927, 2021 06.
Artículo en Inglés | MEDLINE | ID: covidwho-1137872

RESUMEN

BACKGROUND: To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. METHODS: 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. RESULTS: Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90-0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93-23.71; p < .0001). The predictive performance, specificity, and sensitivity of the score were validated in three independent cohorts. CONCLUSIONS: The OURMAPCN score is a risk assessment tool to determine the mortality rate in COVID-19 patients based on a limited number of baseline parameters. This tool can assist physicians in optimizing the clinical management of COVID-19 patients with limited hospital resources.


Asunto(s)
COVID-19 , Medición de Riesgo/métodos , COVID-19/epidemiología , COVID-19/mortalidad , China , Hospitalización/estadística & datos numéricos , Humanos , Italia , Factores de Riesgo
18.
Ann Transl Med ; 9(4): 276, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-1134638

RESUMEN

BACKGROUND: Many studies have revealed several risk factors associated with the prognosis of patients with coronavirus disease 2019 (COVID-19), but the risk factors associated with death in critically ill COVID-19 patients still needs to be fully elucidated. Therefore, we analyzed clinical characteristics and laboratory data of ICU patients to identify risk factors associated with COVID-19 death. METHODS: Patients with COVID-19 from the ICU in the Sino-French New City Branch of Tongji Hospital Wuhan, China, between February 4 and February 29, 2020, were enrolled in this study. The final date of follow-up was April 4, 2020. Clinical manifestations, laboratory tests, treatment, and outcome of participants before and during the ICU stay were retrospectively collected and analyzed. RESULTS: A total of 92 patients were admitted or transferred to the ICU from February 4 to February 29, 2020. Compared to survivors, the majority of non-survivors (73.8%) presented with dyspnea. A random forest classifier and ROC curve were used to develop a predictive model. IL-6, D-dimer, lymphocytes, and albumin achieved good performance with AUCs of 0.9476, 0.9165, 0.8994, and 0.9251, respectively, which were consistent with clinical observations, such as inflammation, lymphopenia, and coagulation dysfunction. Combining IL-6 and D-dimer improved the performance of this model with an excellent AUC (0.997). CONCLUSIONS: Mortality in COVID-19 was not rare in critically ill patients. The model that combined IL-6 and D-dimer was valuable for predicting the mortality of patients with COVID-19 with excellent performance. This model needs to be further optimized by adding more indicators and then evaluated with a multicenter study.

19.
Med (N Y) ; 2(4): 435-447.e4, 2021 04 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1057073

RESUMEN

BACKGROUND: To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC). METHODS: We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with ≥2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM). FINDINGS: Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92-0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions. CONCLUSIONS: The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients. FUNDING: This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006).


Asunto(s)
COVID-19 , Recuento de Células Sanguíneas , Mortalidad Hospitalaria , Humanos , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2
20.
Hypertension ; 76(4): 1104-1112, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-992137

RESUMEN

The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60-11.03] P<0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50-7.47] P<0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33-7.09] P<0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18-6.36] P<0.001), and CK was 3.56 ([95% CI, 2.53-5.02] P<0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%-50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19-associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.


Asunto(s)
Infecciones por Coronavirus , Forma MB de la Creatina-Quinasa/sangre , Cardiopatías , Péptido Natriurético Encefálico/sangre , Pandemias , Fragmentos de Péptidos/sangre , Neumonía Viral , Troponina I/sangre , Betacoronavirus/aislamiento & purificación , Biomarcadores/sangre , COVID-19 , China/epidemiología , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Femenino , Cardiopatías/sangre , Cardiopatías/mortalidad , Cardiopatías/virología , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Evaluación de Resultado en la Atención de Salud , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , SARS-CoV-2
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