Résumé
The theoretical model of the relationship among dose-response function parameters, quantum emission rate, and basic reproductive number for SARS-CoV-2 was constructed. Then, using this model, infection fields and pathways for SARS-CoV-2 and its variant were estimated. The parameters of the time activity, the number of contacts by the microenvironments and groups, and the COVID-19 risk from multiple pathways in near and far fields were used. Consequently, in lower transmissibility, droplet spray transmission in the near field was dominant, whereas in higher transmissibility, transmission from inhalation of smaller aerosols in the far field was dominant. Moreover, it was suggested that transmission from droplet spray, indirect contacts, and inhalation of smaller aerosols in the near field and inhalation of smaller aerosols in the far field was dominant for the wild-type strain, while transmission from inhalation of smaller aerosols in the far field were dominant for the Delta variant. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
Résumé
OBJECTIVE: To describe the longitudinal changes in liver function tests, and their association with illness severity and mortality in patients with COVID-19. METHODS: A retrospective cohort study of 1003 hospitalized patients with COVID-19 was conducted. Longitudinal liver function tests and clinical outcomes were analyzed. RESULTS: Abnormal liver function parameters were observed, both at admission (ALT 13.2%, AST 8.5%, ALP 2.0%, GGT 7.4%, LDH 37.6%, TBIL 4.0%, DBIL 7.8%, Albumin 10.1%) and peak hospitalization (ALT 29.4%, AST 17.5%, ALP 2.6%, GGT 13.4%, LDH 49.4%, TBIL 10.1%, DBIL 18.0%, Albumin 30.6%) in patients with COVID-19. Compared with non-severe patients, severe patients had markedly higher liver function parameters from baseline to 30 days after hospital admission. Abnormal ALT and LDH at hospital admission and some medications use (Hydroxychloroquine, Lopinavir/Ritonavir, and Traditional Chinese medicines) were associated with peak hospitalization ALT > 5× the upper limit unit of normal (ULN). On multivariate analysis, age >60 years, male, obesity, comorbidity, abnormal LDH and albumin at hospital admission and peak hospitalization were associated with progression to severe COVID-19 (OR > 1; p < 0.05). COX analysis revealed that ALT > 2 ULN (HR=7.0, p=0.011), AST > 2 ULN (HR=34.7, p < 0.001), and TBIL > 2 ULN (HR=54.6, p < 0.001) were associated with a higher mortality. CONCLUSION: Dynamic abnormalities of liver function parameters are common in hospitalized patients with COVID-19, and associated with illness severity and mortality.