Efficacy and safety of interleukin-6 receptor antagonists in adult patients admitted to intensive care unit with COVID-19: A systematic review and meta-analysis of randomized controlled trials.

The purpose of the systematic review was to evaluate the efficacy and safety of interleukin-6 receptor (IL-6) antagonists (tocilizumab, sarilumab) in adult patients with severe or critical COVID-19. A systematic review of the literature was conducted in Medline, Cochrane and Embase databases, and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov from the inception dates to10 January 2023. Randomized clinical trials comparing IL-6 receptor antagonists (tocilizumab, sarilumab) with a placebo or usual care treatment for adult patients with severe or critical COVID-19 were identified. Two independent reviewers performed the assessment and selection of eligible studies, assessed study quality and extracted data. Relative risk (RR), mean difference (MD), and 95% confidence interval (CI) with random-effects models was performed in meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the quality of the evidence. The search retrieved a total of 11 RCTs involving 5028 participants were eligible for meta-analysis. Our findings suggest that as the new drug used in adult patients with severe or critical COVID-19, IL-6 antagonists (tocilizumab, sarilumab) may reduce the length of ICU stay and hospital stay. However, they did not significantly increase the risks of serious adverse events and did not reduce all-cause mortality (28-day, 14-day, and 7-day).

Understanding metabolic alterations after SARS-CoV-2 infection: insights from the patients' oral microenvironmental metabolites.

BACKGROUND: Coronavirus disease 2019 is a type of acute infectious pneumonia and frequently confused with influenza since the initial symptoms. When the virus colonized the patient's mouth, it will cause changes of the oral microenvironment. However, few studies on the alterations of metabolism of the oral microenvironment affected by SARS-CoV-2 infection have been reported. In this study, we explored metabolic alterations of oral microenvironment after SARS-CoV-2 infection. METHODS: Untargeted metabolomics (UPLC-MS) was used to investigate the metabolic changes between oral secretion samples of 25 COVID-19 and 30 control participants. To obtain the specific metabolic changes of COVID-19, we selected 25 influenza patients to exclude the metabolic changes caused by the stress response of the immune system to the virus. Multivariate analysis (PCA and PLS-DA plots) and univariate analysis (students' t-test) were used to compare the differences between COVID-19 patients and the controls. Online hiplot tool was used to perform heatmap analysis. Metabolic pathway analysis was conducted by using the MetaboAnalyst 5.0 web application. RESULTS: PLS-DA plots showed significant separation of COVID-19 patients and the controls. A total of 45 differential metabolites between COVID-19 and control group were identified. Among them, 35 metabolites were defined as SARS-CoV-2 specific differential metabolites. Especially, the levels of cis-5,8,11,14,17-eicosapentaenoic acid and hexanoic acid changed dramatically based on the FC values. Pathway enrichment found the most significant pathways were tyrosine-related metabolism. Further, we found 10 differential metabolites caused by the virus indicating the body's metabolism changes after viral stimulation. Moreover, adenine and adenosine were defined as influenza virus-specific differential metabolites. CONCLUSIONS: This study revealed that 35 metabolites and tyrosine-related metabolism pathways were significantly changed after SARS-CoV-2 infection. The metabolic alterations of oral microenvironment in COVID-19 provided new insights into its molecular mechanisms for research and prognostic treatment.

Exploratory Research on Satisfaction Degree in Distance Education

In order to solve the education problems caused by teachers and students' unavoidable absence in school during the COVID-19 pandemic, a series of online education activities were carried out by Nanjing University of Posts and Telecommunication in early March. To explore students and teachers' degree of satisfaction with distance education, this paper investigates multiple dimensions such as students' degree of satisfaction with teachers, the regional living standard, educational resources and negative factors that reduce the students' degree of satisfaction, etc. Furthermore, the attitude of teachers toward distance education may be partially reflected by the arrangement of live classes. All of the statistics are analyzed by comparing the distribution of votes. The results show that the degree of satisfaction by students and teachers with distance education is generally high but varies in areas with different living standards. In addition, we find that students are more sensitive to the lack of a learning atmosphere.

Analysis on the influencing factors of residents dispose of discarded masks base on Probit regression model

Objective Understanding the influencing factors of discarded masks disposed by residents in Dongguan City during the period of COVID-19 epidemic, so as to provide basis for avoiding the environmental pollution caused by discarded masks in the future. Methods Using random sampling way to make an Internet questionnaire survey among 1042 permanent residents in Dongguan city and using Probit regression model to analyze the current situation and influencing factors of disposing the discarded masks. Results The installation of disposal bins, residents’ environmental concern level and education level positively influenced the residents’ disposal behavior, while the residents’ age and total household size negatively influenced the residents’ willingness to dispose. These influencing factors are basically consistent with those derived from other scholars’ studies on residents’ willingness to dispose of household waste, it shows that residents do not treat the disposal of discarded masks differently from other household waste and ignore the potential environmental hazards of discarded masks. Conclusion In order to motivate residents to properly dispose of discarded masks, it is necessary to clarify and standardize the requirements for discarded mask disposal and increase publicity to enhance the public’s awareness of environmental concerns and hygiene. To avoid environmental problems such as microplastics brought by discarded masks, disposable masks should be replaced by reusable elastic respirators;the use of polypropylene in masks should be reduced;new mask materials should be developed.

Correlation between vaccine coverage and the COVID-19 pandemic throughout the world: Based on real-world data.

The aim of the study was to examine the correlation between COVID-19 vaccine coverage rates and outcomes of the COVID-19 epidemic in the case of COVID-19 variants based on real-world data. The data came from Our World in Data, which is building the international COVID-19 vaccination data set and is an open-source data set for everyone to use. The vaccination data set uses the most recent official numbers from governments and health ministries worldwide. We assessed the correlation between COVID-19 vaccine coverage rates and outcomes of the COVID-19 epidemic with existing variants by performing temporal analysis and spatial analysis. Overall, new cases per million population, the reproduction rate of COVID-19, new deaths from all causes per million population, excess mortality attributed to COVID-19 pandemic, and hospital patients or intensive care unit (ICU) patients per million population were not decreased with the time course. However, at the same time point, new cases per million population, the reproduction rate of COVID-19, new deaths per million population, and hospital patients or ICU patients per million population gradually decreased as the rate of vaccination coverage increased. High coverage percentages of COVID-19 vaccination were negatively correlated with the reproduction rate of COVID-19 (correlation coefficient -0.116) and ICU patients per million of the local population (correlation coefficient -0.055). Currently, there is no effective treatment for the COVID-19 pandemic, and prevention of the COVID-19 pandemic mainly depends on vaccines, especially when the rate of COVID-19 vaccine coverage is over 60%. The benefits of preventing severe disease and preventing transmission of infection are likely to be obvious.

Identification of natural compounds as SARS-CoV-2 entry inhibitors by molecular docking-based virtual screening with bio-layer interferometry.

Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which enter the host cells through the interaction between its receptor binding domain (RBD) of spike glycoprotein with angiotensin-converting enzyme 2 (ACE2) receptor on the plasma membrane of host cell. Neutralizing antibodies and peptide binders of RBD can block viral infection, however, the concern of accessibility and affordability of viral infection inhibitors has been raised. Here, we report the identification of natural compounds as potential SARS-CoV-2 entry inhibitors using the molecular docking-based virtual screening coupled with bilayer interferometry (BLI). From a library of 1871 natural compounds, epigallocatechin gallate (EGCG), 20(R)-ginsenoside Rg3 (RRg3), 20(S)-ginsenoside Rg3 (SRg3), isobavachalcone (Ibvc), isochlorogenic A (IscA) and bakuchiol (Bkc) effectively inhibited pseudovirus entry at concentrations up to 100 µM. Among these compounds, four compounds, EGCG, Ibvc, salvianolic acid A (SalA), and isoliensinine (Isl), were effective in inhibiting SARS-CoV-2-induced cytopathic effect and plaque formation in Vero E6 cells. The EGCG was further validated with no observable animal toxicity and certain antiviral effect against SARS-CoV-2 pseudovirus mutants (D614G, N501Y, N439K & Y453F). Interestingly, EGCG, Bkc and Ibvc bind to ACE2 receptor in BLI assay, suggesting a dual binding to RBD and ACE2. Current findings shed some insight into identifications and validations of SARS-CoV-2 entry inhibitors from natural compounds.

Perinatal Depression of Exposed Maternal Women in the COVID-19 Pandemic in Wuhan, China.

Objective: This study aims to investigate perinatal depression in women who gave birth during the COVID-19 pandemic in Wuhan, and to evaluate the effect of the pandemic on perinatal depression prevalence. Methods: A cross-sectional investigation was conducted into women hospitalized for delivery in Hubei Maternity and Child Healthcare Hospital from December 31, 2019 to March 22, 2020, a period which encompasses the entire time frame of the COVID-19 pandemic in Wuhan. The Edinburgh Postnatal Depression Scale (EPDS) was adopted to evaluate perinatal depression status. A Chi-square test and logistic regression model were utilized for data analysis. Results: A total of 2,883 participants were included, 33.71% of whom were found to suffer from depressive symptoms. In detail, 27.02%, 5.24%, and 1.46% were designated as having mild, moderate, and severe depressive symptoms, respectively. The perinatal depression prevalence increased as the COVID-19 pandemic worsened. Compared to the period from December 31, 2019 to January 12, 2020, perinatal depression risk significantly decreased within the 3 weeks of March 2-22, 2020 (1st week: OR = 0.39, 95% CI: 0.20, 0.78; 2nd week: OR = 0.35, 95% CI: 0.17, 0.73; and 3rd week: OR = 0.48, 95% CI: 0.25, 0.94); and the postnatal depression risk significantly rose within the four weeks of January 27-February 23, 2020 (1st week: OR = 1.78, 95% CI: 1.18, 2.68; 2nd week: OR = 2.03, 95% CI: 1.35, 3.04; 3rd week: OR = 1.48, 95% CI: 1.02, 2.14; and 4th week: OR = 1.73, 95% CI: 1.20, 2.48). Conclusion: The dynamic change of perinatal depression was associated with the progression of the COVID-19 pandemic among new mothers who were exposed to the pandemic. An elevated risk of postnatal depression was also observed during the COVID-19 pandemic.