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1.
World J Gastroenterol ; 28(46): 6599-6618, 2022 Dec 14.
Artículo en Inglés | MEDLINE | ID: covidwho-2296320

RESUMEN

BACKGROUND: There is growing evidence that patients with coronavirus disease 2019 (COVID-19) frequently present with liver impairment. Hepatitis B virus (HBV) remains a major public health threat in current society. Both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HBV can cause liver damage, and current findings on whether HBV infection increases disease severity in COVID-19 patients are inconsistent, and whether SARS-CoV-2 infection accelerates hepatitis B progression or leads to a worse prognosis in hepatitis B patients has not been adequately elucidated. AIM: To explore the complex relationship between COVID-19 and hepatitis B in order to inform the research and management of patients co-infected with SARS-CoV-2 and HBV. METHODS: An experienced information specialist searched the literature in the following online databases: PubMed, China National Knowledge Infrastructure, Google Scholar, Scopus, Wiley, Web of Science, Cochrane, and ScienceDirect. The literature published from December 2019 to September 1, 2022 was included in the search. We also searched medRxiv and bioRxiv for gray literature and manually scanned references of included articles. Articles reporting studies conducted in humans discussing hepatitis B and COVID-19 were included. We excluded duplicate publications. News reports, reports, and other gray literature were included if they contained quantifiable evidence (case reports, findings, and qualitative analysis). Some topics that included HBV or COVID-19 samples but did not have quantitative evidence were excluded from the review. RESULTS: A total of 57 studies were eligible and included in this review. They were from 11 countries, of which 33 (57.9%) were from China. Forty-two of the 57 studies reported abnormalities in liver enzymes, three mainly reported abnormalities in blood parameters, four indicated no significant liver function alterations, and another eight studies did not provide data on changes in liver function. Fifty-seven studies were retrospective and the total number of co-infections was 1932, the largest sample size was 7723, and the largest number of co-infections was 353. Most of the studies suggested an interaction between hepatitis B and COVID-19, while 12 studies clearly indicated no interaction between hepatitis B and COVID-19. Six of the 57 studies clearly reported HBV activation. Six studies were related to liver transplant patients. CONCLUSION: There is some association between COVID-19 and hepatitis B. Future high-quality randomized trials are needed to further elucidate the interaction between COVID-19 and hepatitis B.


Asunto(s)
COVID-19 , Coinfección , Hepatitis B , Humanos , SARS-CoV-2 , Estudios Retrospectivos , Hepatitis B/complicaciones , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Virus de la Hepatitis B
2.
Brain Behav ; 13(5): e2977, 2023 05.
Artículo en Inglés | MEDLINE | ID: covidwho-2277216

RESUMEN

BACKGROUND: Intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) is a time-dependent treatment with a narrow therapeutic time window, in which the time delay could result from the deadline effect. METHODS: One hospital-based cohort was recruited to detect the factors contributing to the deadline effect, where patients with the deadline effect were defined as those who were presented with the onset-to-door time (ODT) in the first 50%, while the door-to-needle time (DNT) was in the last quartile. DNT (in-hospital delay) was further subdivided into several time intervals [door-to-examination time (DET), door-to-imaging time (DIT), door-to-laboratory time (DLT), and decision-making time (DMT) of the patients or their proxies. RESULTS: A total of 186 IVT cases were enrolled, of which 17.2% (32/186) suffered a delay of the deadline effect. The median age was 66 years, and 35.5% were female. Baseline characteristics were similar between the two groups (all p > .05). For the comparisons of the time intervals, DIT (26 versus 15 min, p = .001) was significantly longer in the group with deadline effect, while the differences of DET, DLT, DMT, and ONT did not reach statistical significance (all p > .05). Upon multivariable adjustment in the binary logistic regression model, longer DIT [odds ratio (OR), 1.076; 95% confidence interval (CI), 1.036-1.118; p < .001], and history of coronary heart disease (OR, 3.898; 95%CI, 1.415-10.735; p = .008) were independently associated with deadline effect in the binary logistic regression model, while admitted in the working day (OR, 0.674; 95%CI, 0.096-0.907; p = .033), and having medical insurance (OR, 0.350; 95% CI, 0.132-0.931; p = .035) were negatively associated with the deadline effect. CONCLUSIONS: A speed-safety tradeoff phenomenon from the deadline effect was observed in 17.2% of IVT cases during the COVID-19 pandemic, where longer DIT contributed a lot to this time delay. Patients without medical insurance, or admitted in official holidays were more likely to experience a delay of the deadline effect.


Asunto(s)
Isquemia Encefálica , COVID-19 , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Trombosis , Humanos , Femenino , Anciano , Masculino , Accidente Cerebrovascular/terapia , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , Terapia Trombolítica/métodos , Pandemias , Fibrinolíticos/uso terapéutico , Isquemia Encefálica/tratamiento farmacológico , Resultado del Tratamiento
3.
J Biomol Struct Dyn ; : 1-12, 2022 Nov 14.
Artículo en Inglés | MEDLINE | ID: covidwho-2106894

RESUMEN

Since the main protease (Mpro) is crucial for the COVID-19 virus replication and transcription, searching for Mpro inhibitors is one possible treatment option. In our study, 258 small molecules were collected from lung-related herbal medicines, and their structures were optimized with the B3LYP-D3/6-31G* method. After the molecular docking with Mpro, we selected the top 20 compounds for the further geometry optimization with the larger basis sets. After the further molecular docking, the top eight compounds were screened out. Then we performed molecular dynamics simulations and binding free energy calculations to determine stability of the complexes. Our results show that mulberrofuran G, Xambioona, and kuwanon D can bind Mpro well. In quantum chemistry studies, such as ESP and CDFT analyses, the compounds properties are predicted. Additionally, the drug-likeness analyses and ADME studies on these three candidate compounds verified that all of them conform to Libinski's rule and may be drug-like compounds.

4.
Antibiotics (Basel) ; 11(11)2022 Nov 03.
Artículo en Inglés | MEDLINE | ID: covidwho-2099294

RESUMEN

There are growing concerns that the coronavirus disease of 2019 (COVID-19) pandemic may change antibiotic use patterns and accelerate antibiotic resistance, but evidence from the community level is lacking. This study aims to estimate the impact of the COVID-19 outbreak on the antibiotic use patterns among a community population in Eastern China. A self-administered medicine diary was used to collect information on antibiotic use from July 2019 to June 2021 among a rural community in Eastern China. We analyzed the changes in antibiotic use patterns over five months from August to December 2019 and the corresponding months in 2020. The risk of antibiotic use and its changes were measured with the incidence rate (IR) and relative risk (RR). In total, 1111 participants were eligible for the final analysis (440 in 2019 and 671 in 2020). After the COVID-19 outbreak, antibiotic use increased by 137% (5.43 per 100 person months in the 2019 vs. 12.89 per 100 person months in the 2020), and after the adjustment of covariates, the adjusted RR was 1.72 (95% CI: 1.10~2.34). It was higher among those who were women (RR = 2.62), aged 35-59 years old (RR = 2.72), non-farmers (RR = 2.75), had less than six years of education (RR = 2.61), had an annual household income over CNY 100,000 (USD 14,940) (RR = 2.60), and had no history of chronic diseases (RR = 2.61) (all p < 0.05). The proportion of cephalosporins consumed increased from 54.29% in 2019 to 64.92% in 2020 (p = 0.011). Among those aged 35 years and older, the proportion of antibiotics obtained from medical facilities increased, while the proportion obtained from retail pharmacies, homes, and other sources decreased (all p < 0.05). The COVID-19 outbreak changed antibiotic use patterns in this study population (Eastern China) significantly. More efforts to monitor and enhance antibiotic stewardship activities at the community level are needed in future.

5.
Vis Comput ; : 1-17, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: covidwho-2048229

RESUMEN

With the worldwide spread of the COVID-19 pandemic, the demand for medical syringes has increased dramatically. Scale defect, one of the most common defects on syringes, has become a major barrier to boosting syringe production. Existing methods for scale defect detection suffer from large volumes of data requirements and the inability to handle diverse and uncertain defects. In this paper, we propose a robust scale defects detection method with only negative samples and favorable detection performance to solve this problem. Different from conventional methods that work in a batch-mode defects detection manner, we propose to locate the defects on syringes with a two-stage framework, which consists of two components, that is, the scale extraction network and the scale defect discriminator. Concretely, the SeNet is first built to utilize the convolutional neural network to extract the main structure of the scale. After that, the scale defect discriminator is designed to detect and label the scale defects. To evaluate the performance of our method, we conduct experiments on one real-world syringe dataset. The competitive results, that is, 99.7% on F1, prove the effectiveness of our method.

6.
China Review ; 22(3):365-367, 2022.
Artículo en Inglés | ProQuest Central | ID: covidwho-2012908

RESUMEN

Law enforcement officers beat citizens who were not wearing face masks and shamed them by parading them in public. There were also louder forms of public resistance, in some cases literally, as some citizens shouted out their frustrations at the government staff, while others noisily banged their pots and pans to attract public attention and protest the strict coronavirus rules (p. 56). [...]we are not clearly provided the social class backgrounds and other demographic characteristics of the diarists, nor do we get information about how much the book describes can represent a wider population.

7.
Biosens Bioelectron ; 215: 114563, 2022 Nov 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1936099

RESUMEN

Ultrasensitive, specific, and early identification of Coronavirus Disease (2019) (COVID-19) infection is critical to control virus spread and remains a global public health problem. Herein, we present a novel solid-state electrochemiluminescence (ECL) platform targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody with rapidity and ultrahigh sensitivity, in which a bipolar silica nanochannel array (bp-SNA) is fabricated on indium tin oxide (ITO) electrode for the first time to stably confine the ECL probe of tris(2,2'-bipyridyl) ruthenium (Ru(bpy)32+) under dual electrostatic force. The bp-SNA consists of tightly packed bilayer silica nanochannel array (SNA) with asymmetric surface charges, namely an inner negatively charged SNA (n-SNA) and an outer positively charged SNA (p-SNA), serving as an "electrostatic lock" to enrich and stabilize the cationic Ru(bpy)32+ probe without leakage from the electrode surface. The detection of SARS-CoV-2 IgG antibody could be realized via immobilization of SARS-CoV-2 spike protein on the utmost of Ru(bpy)32+-confined solid-state ECL platform (Ru@bp-SNA). Upon the capture of target SARS-CoV-2 IgG by immune recognition, the formed immunocomplex will block the nanochannel, leading to the hindered diffusion of the co-reactant (tri-n-propylamine, TPrA) and further producing a decreased ECL signal. The developed solid-stated ECL immunosensor is able to determine SARS-CoV-2 IgG with a wide linear range (5 pg mL-1 to 1 µg mL-1), a low limit-of-detection (2.9 pg mL-1), and a short incubation time (30 min). Furthermore, accurate analysis of SARS-CoV-2 IgG in real serum samples is also obtained by the sensor.


Asunto(s)
Técnicas Biosensibles , COVID-19 , COVID-19/diagnóstico , Técnicas Electroquímicas , Humanos , Inmunoensayo , Inmunoglobulina G , Mediciones Luminiscentes , SARS-CoV-2 , Dióxido de Silicio , Glicoproteína de la Espiga del Coronavirus
8.
Adv Sci (Weinh) ; 9(18): e2105792, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-1898522

RESUMEN

Piezoelectric semiconductors have emerged as redox catalysts, and challenges include effective conversion of mechanical energy to piezoelectric polarization and achieving high catalytic activity. The catalytic activity can be enhanced by simultaneous irradiation of ultrasound and light, but the existing piezoelectric semiconductors have trouble absorbing visible light. A piezoelectric catalyst is designed and tested for the generation of hydrogen peroxide (H2 O2 ). It is based on Nb-doped tetragonal BaTiO3 (BaTiO3 :Nb) and is sensitized by carbon quantum dots (CDs). The photosensitizer injects electrons into the conduction band of the semiconductor, while the piezoelectric polarization directed electrons to the semiconductor surface, allowing for a high-rate generation of H2 O2 . The piezoelectric polarization field restricts the recombination of photoinduced electron-hole pairs. A production rate of 1360 µmol gcatalyst -1  h-1  of H2 O2  is achieved under visible light and ultrasound co-irradiation. Individual piezo- and photocatalysis yielded lower production rates. Furthermore, the CDs enhance the piezocatalytic activity of the BaTiO3 :Nb. It is noted that moderating the piezoelectricity of BaTiO3 :Nb via microstructure modulation influences the piezophotocatalytic activity. This work shows a new methodology for synthesizing H2 O2  by using visible light and mechanical energy.

9.
Aging Dis ; 13(3): 641-646, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-1870134
10.
Sci Total Environ ; 837: 155720, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1819602

RESUMEN

Harmful microorganism (e.g., new coronavirus) based infection is the most important security concern in life sciences and healthcare. This article aims to provide a state-of-the-art review on the development of advanced technology based on nanomaterial disinfection/sterilization techniques (NDST) for the first time including the nanomaterial types, disinfection techniques, bactericidal devices, sterilization products, and application scenarios (i.e., water, air, medical healthcare), with particular brief account of bactericidal behaviors referring to varied systems. In this emerging research area spanning the years from 1998 to 2021, total of ~200 publications selected for the type of review paper and research articles were reviewed. Four typical functional materials (namely type of metal/metal oxides, S-based, C-based, and N-based) with their development progresses in disinfection/sterilization are summarized with a list of synthesis and design. Among them, the widely used silver nanoparticles (AgNPs) are considered as the most effective bacterial agents in the type of nanomaterials at present and has been reported for inactivation of viruses, fungi, protozoa. Some methodologies against (1) disinfection by-products (DBPs) in traditional sterilization, (2) noble metal nanoparticles (NPs) agglomeration and release, (3) toxic metal leaching, (4) solar spectral response broadening, and (5) photogenerated e-/h+ pairs recombination are reviewed and discussed in this field, namely (1) alternative techniques and nanomaterials, (2) supporter anchoring effect, (3) nonmetal functional nanomaterials, (4) element doping, and (5) heterojunction constructing. The feasible strategies in the perspective of NDST are proposed to involve (1) non-noble metal disinfectors, (2) multi-functional nanomaterials, (3) multi-component nanocomposite innovation, and (4) hybrid techniques for disinfection/sterilization system. It is promising to achieve 100% bactericidal efficiency for 108 CFU/mL within a short time of less than 30 min.


Asunto(s)
Nanopartículas del Metal , Nanocompuestos , Antibacterianos , Desinfección/métodos , Óxidos , Plata , Tecnología
11.
RSC advances ; 12(9):5357-5368, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-1787287

RESUMEN

Recent outbreaks of coronavirus have brought serious challenges to public health around the world, and it is essential to find effective treatments. In this study, the 3C-like proteinase (3CLpro) of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been considered as an important drug target because of its role in viral replication. We initially optimized 251 compounds at the PM7 level of theory for docking with 3CLpro, and then we selected the top 12 compounds for further optimization with the B3LYP-D3/6-311G** method and obtained the top four compounds by further molecular docking. Quantum chemistry calculations were performed to predict molecular properties, such as the electrostatic potential and some CDFT descriptors. We also performed molecular dynamics simulations and free energy calculations to determine the relative stability of the selected four potential compounds. We have identified key residues controlling the 3CLpro/ligand binding from per-residue based decomposition of the binding free energy. Convincingly, the comprehensive results support the conclusion that the compounds have the potential to become a candidate for anti-coronavirus treatment. The combination of molecular dynamics simulations and quantitative calculations as a powerful tool for screening molecules.

12.
Ann Rheum Dis ; 81(8): 1189-1193, 2022 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1741595

RESUMEN

OBJECTIVES: COVID-19 vaccination often triggers a constellation of transitory inflammatory symptoms. Gout is associated with several comorbidities linked to poor outcomes in COVID-19, and gout flares can be triggered by some vaccinations. We analysed the risk of gout flares in the first 3 months after COVID-19 vaccination with inactivated virus, and whether colchicine can prevent gout flares following post-COVID-19 vaccination. METHODS: A clinical delivery population-based cross-sectional study was conducted in the Gout Clinic at the Affiliated Hospital of Qingdao University between February and October 2021. Study participants were selected using a systematic random sampling technique among follow-up patients with gout. We collected data, including vaccinations and potential risk factors, using a combination of interviews, health QR codes and medical records. Logistic regression was used to adjust for covariates. RESULTS: We enrolled 549 gout participants (median age 39 years, 84.2% vaccinated). For the 462 patients who received COVID-19 vaccine, 203 (43.9%) developed at least one gout flare in the 3 months after vaccination. Most of these flares were experienced within 1 month after the first (99/119 (83.2%)) or second (70/115 (60.9%)) dose of vaccine. Compared with unvaccinated participants, COVID-19 vaccination was associated with higher odds of gout flare within 3 months (adjusted OR 6.02; 95% CI 3.00 to 12.08). Colchicine use was associated with 47% less likelihood of postvaccine gout flare. CONCLUSION: COVID-19 vaccination was associated with increased odds of gout flare, which developed mainly in month 1 after each vaccine dose, and was negatively associated with colchicine prophylaxis.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Colchicina , Supresores de la Gota , Gota , Brote de los Síntomas , Adulto , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Colchicina/uso terapéutico , Estudios Transversales , Gota/tratamiento farmacológico , Supresores de la Gota/uso terapéutico , Humanos , Vacunación , Vacunas/uso terapéutico
13.
Applied Intelligence ; : 1-17, 2022.
Artículo en Inglés | EuropePMC | ID: covidwho-1610583

RESUMEN

In addition to the almost five million lives lost and millions more than that in hospitalisations, efforts to mitigate the spread of the COVID-19 pandemic, which that has disrupted every aspect of human life deserves the contributions of all and sundry. Education is one of the areas most affected by the COVID-imposed abhorrence to physical (i.e., face-to-face (F2F)) communication. Consequently, schools, colleges, and universities worldwide have been forced to transition to different forms of online and virtual learning. Unlike F2F classes where the instructors could monitor and adjust lessons and content in tandem with the learners’ perceived emotions and engagement, in online learning environments (OLE), such tasks are daunting to undertake. In our modest contribution to ameliorate disruptions to education caused by the pandemic, this study presents an intuitive model to monitor the concentration, understanding, and engagement expected of a productive classroom environment. The proposed apposite OLE (i.e., AOLE) provides an intelligent 3D visualisation of the classroom atmosphere (CA), which could assist instructors adjust and tailor both content and instruction for maximum delivery. Furthermore, individual learner status could be tracked via visualisation of his/her emotion curve at any stage of the lesson or learning cycle. Considering the enormous emotional and psychological toll caused by COVID and the attendant shift to OLE, the emotion curves could be progressively compared through the duration of the learning cycle and the semester to track learners’ performance through to the final examinations. In terms of learning within the CA, our proposed AOLE is assessed within a class of 15 students and three instructors. Correlation of the outcomes reported with those from administered questionnaires validate the potential of our proposed model as a support for learning and counselling during these unprecedentedtimes that we find ourselves.

14.
Vaccine ; 39(52): 7584-7589, 2021 12 20.
Artículo en Inglés | MEDLINE | ID: covidwho-1569117

RESUMEN

OBJECTIVE: To conduct a nationwide evaluation of vaccine bidding, procurement and distribution management for understanding and improving the current situation well in mainland China. METHODS: An institution survey was carried out to collect information on tendering, procurement, distribution and related issues to vaccines by structured questionnaires administered to 31 provinces in mainland China from April to July 2019. RESULTS: In 13 (41.9%) of 31 provinces, centralized bidding of National Immunization Program (NIP) vaccines was accomplished, and others conducted independent tendering and purchasing in 2018. For non-NIP vaccines, all provinces implemented unified bidding at the provincial level and over half (18, 58.1%) of them chose provincial public resource trading platforms, but their modes varied over provinces. Then procurement was undertaken by the district-level centers for disease control and prevention (CDC) while they were unable to choose the best option of too many vaccines targeted by the province-level CDC for local populations. The distribution modes of NIP and non-National Immunization Program (non-NIP) vaccines were similar overall in a province but very different over provinces. Main mode was that CDCs at different levels delivered about two thirds (64.5%) of NIP vaccines distribution and more than one third (35.5%) of non-NIP vaccines. Another distribution mode was occupied as fully buying the service from third parties in 3 municipalities. Some provinces mixed both modes, too. The total distribution volume of vaccines was 430.7 million doses in 2018. The top five non-NIP vaccines delivered in 2018 were human rabies vaccine, varicella vaccine, EV71 hand foot mouth disease vaccine, hepatitis B vaccine and influenza vaccine. CONCLUSION: The vaccine biding, procurement and distribution management varied over provinces in mainland China in 2018, especially for non-NIP vaccines. Specific policies and measures should be developed for different regions to improve the immunization management better.


Asunto(s)
Enfermedad de Boca, Mano y Pie , Programas de Inmunización , China , Vacunas contra Hepatitis B , Humanos , Vacunación
15.
Security and Communication Networks ; 2021, 2021.
Artículo en Inglés | ProQuest Central | ID: covidwho-1378088

RESUMEN

Loneliness and isolation are on the rise worldwide, threatening human well-being and the wellness of different age groups and backgrounds. Notably, global social distancing measures during the COVID-19 crisis have exacerbated this problem, resulting in various psychological and physiological ailments. Within both the categories of social and medical robots, companion robots are capable of engaging emotionally with users and providing continuous monitoring and assessment of their health. In this study, we propose a framework for modeling the emotion space of companion robots to facilitate their emotion generation and transition based on Plutchik’s wheel of emotions and reversible quantum circuit schemes. Superposition encodings allow fewer computing resources for the generation and storage of emotional states, and by using unitary operations, they facilitate easier emotion transition and recovery over different intervals. Further, an encryption strategy is designed based on the emotion communication architecture to secure the emotion-related data in human-robot interaction. It is hoped that such an integrative framework and research agenda exploring the role of companion robots will be useful to care for users’ social health by mitigating their negative emotions, especially during difficult times.

16.
Nat Commun ; 12(1): 897, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1075219

RESUMEN

The dynamics, duration, and nature of immunity produced during SARS-CoV-2 infection are still unclear. Here, we longitudinally measured virus-neutralising antibody, specific antibodies against the spike (S) protein, receptor-binding domain (RBD), and the nucleoprotein (N) of SARS-CoV-2, as well as T cell responses, in 25 SARS-CoV-2-infected patients up to 121 days post-symptom onset (PSO). All patients seroconvert for IgG against N, S, or RBD, as well as IgM against RBD, and produce neutralising antibodies (NAb) by 14 days PSO, with the peak levels attained by 15-30 days PSO. Anti-SARS-CoV-2 IgG and NAb remain detectable and relatively stable 3-4 months PSO, whereas IgM antibody rapidly decay. Approximately 65% of patients have detectable SARS-CoV-2-specific CD4+ or CD8+ T cell responses 3-4 months PSO. Our results thus provide critical evidence that IgG, NAb, and T cell responses persist in the majority of patients for at least 3-4 months after infection.


Asunto(s)
Anticuerpos Antivirales/inmunología , COVID-19/inmunología , COVID-19/virología , SARS-CoV-2/fisiología , Linfocitos T/inmunología , Adulto , Anticuerpos Neutralizantes/sangre , Anticuerpos Neutralizantes/inmunología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , COVID-19/sangre , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Memoria Inmunológica , Interferón gamma/metabolismo , Cinética , Antígenos Comunes de Leucocito/metabolismo , Masculino , Persona de Mediana Edad , Fenotipo , Receptores CCR7/metabolismo
17.
BMJ Glob Health ; 5(11)2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-922569

RESUMEN

INTRODUCTION: The COVID-19 pandemic caused a healthcare crisis in China and continues to wreak havoc across the world. This paper evaluated COVID-19's impact on national and regional healthcare service utilisation and expenditure in China. METHODS: Using a big data approach, we collected data from 300 million bank card transactions to measure individual healthcare expenditure and utilisation in mainland China. Since the outbreak coincided with the 2020 Chinese Spring Festival holiday, a difference-in-difference (DID) method was employed to compare changes in healthcare utilisation before, during and after the Spring Festival in 2020 and 2019. We also tracked healthcare utilisation before, during and after the outbreak. RESULTS: Healthcare utilisation declined overall, especially during the post-festival period in 2020. Total healthcare expenditure and utilisation declined by 37.8% and 40.8%, respectively, while per capita expenditure increased by 3.3%. In a subgroup analysis, we found that the outbreak had a greater impact on healthcare utilisation in cities at higher risk of COVID-19, with stricter lockdown measures and those located in the western region. The DID results suggest that, compared with low-risk cities, the pandemic induced a 14.8%, 26.4% and 27.5% reduction in total healthcare expenditure in medium-risk and high-risk cities, and in cities located in Hubei province during the post-festival period in 2020 relative to 2019, an 8.6%, 15.9% and 24.4% reduction in utilisation services; and a 7.3% and 18.4% reduction in per capita expenditure in medium-risk and high-risk cities, respectively. By the last week of April 2020, as the outbreak came under control, healthcare utilisation gradually recovered, but only to 79.9%-89.3% of its pre-outbreak levels. CONCLUSION: The COVID-19 pandemic had a significantly negative effect on healthcare utilisation in China, evident by a dramatic decline in healthcare expenditure. While the utilisation level has gradually increased post-outbreak, it has yet to return to normal levels.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Gastos en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Aceptación de la Atención de Salud/estadística & datos numéricos , Neumonía Viral/epidemiología , Betacoronavirus , COVID-19 , China/epidemiología , Humanos , Pandemias , SARS-CoV-2
19.
World J Clin Cases ; 8(11): 2325-2331, 2020 Jun 06.
Artículo en Inglés | MEDLINE | ID: covidwho-602207

RESUMEN

BACKGROUND: Since December 2019, many cases of pneumonia caused by novel coronavirus have been discovered in Wuhan, China, and such cases have spread nationwide quickly. At present, coronavirus disease 2019 (COVID-19) is a worldwide pandemic. What are the clinical features of this disease? What is the clinical diagnosis and how should such patients be treated? As a clinician, mastery of the clinical characteristics, basic diagnosis, and treatment methods of COVID-19 are required to provide help to patients. CASE SUMMARY: A 42-year-old male patient with a cough lasting 6 d without obvious cause, as well as fever and fatigue for 1 d, was admitted to Hankou Hospital on January 22, 2020 and transferred to Huoshenshan Hospital on February 4. The main clinical symptoms were dry cough, fatigue, and fever. He was diagnosed with COVID-19. From the 4th d of admission, the patient's condition gradually worsened, with increased respiratory rate and body temperature. Peripheral blood lymphocytes decreased progressively. On the 8th d of admission, the patient's highest temperature was 40.7 °C, and oxygen saturation was 83% despite high-flow oxygen inhalation. Chest computed tomography results showed that the virus progressed rapidly. The number of lesions significantly increased with expanded scope and increased density. The distribution of lesions advanced from peripheral to central. In addition to nasal catheter oxygen inhalation and symptomatic support, antiviral drugs were used throughout the treatment. On January 22, oseltamivir phosphate capsules were given orally (75 mg, twice daily) for 6 d. On January 24, three tablets of lopinavir and ritonavir were added orally (twice daily). After 6 d, this was changed to 0.2 g (two tablets) arbidol, taken orally (three times daily) for 5 d. During the severe stage, methylprednisolone was given (40 mg) once every 12 h, immunoglobulin (20 g) was administered by intravenous drip infusion once daily, and thymosin (1.6 mg) was injected subcutaneously once daily combined with immunotherapy. On February 2, symptoms decreased, various indicators improved, and pulmonary inflammation was obviously reduced. Throat swabs on February 4 and 9 were negative for novel coronavirus nucleic acid. After 19 d in the hospital, the patient was successfully treated and discharged. CONCLUSION: COVID-19 in young adults can be successfully treated with active treatment. We report a typical case of COVID-19, analyze its clinical characteristics, summarize its clinical diagnosis and treatment experience, and provide a reference for clinical colleagues.

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