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BackgroundLittle is known regarding long-term outcomes of patients hospitalized with COVID-19. MethodsWe conducted a prospective study of 6-month outcomes of hospitalized COVID-19 patients. Patients with new neurological complications during hospitalization who survived were propensity score-matched to COVID-19 survivors without neurological complications hospitalized during the same period. The primary 6-month outcome was multivariable ordinal analysis of the modified Rankin Scale(mRS) comparing patients with or without neurological complications. Secondary outcomes included: activities of daily living (ADLs;Barthel Index), telephone Montreal Cognitive Assessment and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. ResultsOf 606 COVID-19 patients with neurological complications, 395 survived hospitalization and were matched to 395 controls; N=196 neurological patients and N=186 controls completed follow-up. Overall, 346/382 (91%) patients had at least one abnormal outcome: 56% had limited ADLs, 50% impaired cognition, 47% could not return to work and 62% scored worse than average on [≥]1 Neuro-QoL scale (worse anxiety 46%, sleep 38%, fatigue 36%, and depression 25%). In multivariable analysis, patients with neurological complications had worse 6-month mRS (median 4 vs. 3 among controls, adjusted OR 2.03, 95%CI 1.22-3.40, P=0.01), worse ADLs (aOR 0.38, 95%CI 0.29-0.74, P=0.01) and were less likely to return to work than controls (41% versus 64%, P=0.04). Cognitive and Neuro-QOL metrics were similar between groups. ConclusionsAbnormalities in functional outcomes, ADLs, anxiety, depression and sleep occurred in over 90% of patients 6-months after hospitalization for COVID-19. In multivariable analysis, patients with neurological complications during index hospitalization had significantly worse 6-month functional outcomes than those without.
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Objective To investigate the effect of FK506 on the in vitro ostengenic potential of rat bone marrow-derived mesenchymal stem cells(MSCs)and the dose-response effect of FK506(5-5000 nmol/ L)on the ostengenic potential of MSCs in vitro.Methods MSCs derived from primary culture were sub- cultured for 16 days under four conditions:(1)?-MEM containing L-ascorbicacid-2-phosphate(AsAP)and?-glycemphosphate(?-GP)(basic culture medium)as a control;(2) AsAP and?-GP(basic culture medi- um) plus dexamethasone;(3)AsAP and?-GP(basic culture medium)plus FK506,(4)AsAP and?-GP (basic culture medium)plus FK506 and dexamethasone.Osteogenie potential was determined by testing os- teoblastic morphology,cell proliferation,alkaline phosphatase(APase)activity,bone nodule formation and the expression of osteocalcin mRNA.Results FK506 promoted the proliferation of MSCs,induced mineral- izing bone-like nodule formation,and increased APase activity and the expression of osteocalcin mRNA.The data also showed that the efficacy of FK506 was greater when used in combination with dexamethasone.Opti- mal ostengenesis was achieved with?-MEM containing 0.25mmol/L AsAP,10mmol/L?-GP,10nmol/L dexa- methasone and 50nmol/L FK506.Conclusion FK506 has powerful ostengenic ablility.It can be consid- ered as an osteogenic agent to repair bone defects.
