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Hu C, Liu YK, Sun QD, Du Z, Fang YQ, Guo F, Wang YB, He Y, Cen Y, Zeng F. Clinical characteristics and risk factors for a prolonged length of stay of patients with asymptomatic and mild COVID-19 during the wave of Omicron from Shanghai, China. BMC Infect Dis 2022; 22:947. [PMID: 36526990 PMCID: PMC9756685 DOI: 10.1186/s12879-022-07935-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study aims to investigate the clinical characteristics and the length of hospital stay (LOS), as well as risk factors for prolonged LOS in a cohort of asymptomatic and mild COVID-19 patients infected with the Omicron variant. METHODS A total of 1166 COVID-19 patients discharged from the inpatient ward of the largest makeshift hospital (May 8-10, 2022) in Shanghai, China, were included. The demographics, medical history, and the lowest and admission cycle threshold (Ct) values of the RT-PCR tests for SARS-CoV-2 genes of the open reading frame 1ab (Ct-ORF) and the nucleocapsid protein (Ct-N) during hospitalization were recorded. Patients with LOS > 7 days, or LOS ≤ 7 days were included in the Prolonged group or the Control group, separately. The clinical characteristics and LOS of the participants in the two groups were described and compared. Multivariate Logistic and linear regression analyses were applied to explore the risk factors for prolonged LOS. The diagnostic efficacy of the lowest and admission Ct values for the Prolonged group was tested via the receiver operating characteristic (ROC) curve analysis. RESULTS The median LOS was 6 days in the total study population. The age was older (45.52 ± 14.78 vs. 42.54 ± 15.30, P = 0.001), while both the lowest and admission Ct-ORF (27.68 ± 3.88 vs. 37.00 ± 4.62, P < 0.001; 30.48 ± 5.03 vs. 37.79 ± 3.81, P < 0.001) and Ct-N (25.79 ± 3.60 vs. 36.06 ± 5.39, P < 0.001; 28.71 ± 4.95 vs. 36.95 ± 4.59, P < 0.001) values were significantly lower in the Prolonged group. There were more mild cases in the Prolonged group (23.8% vs. 11.5%, P < 0.001). The symptom spectrum differed between the two groups. In multivariate analyses, age, disease category, and the lowest Ct-N values were shown to be associated with prolonged LOS. Besides, both the lowest and admission Ct-ORF (AUC = 0.911 and 0.873) and Ct-N (AUC = 0.912 and 0.874) showed robust diagnostic efficacy for prolonged LOS. CONCLUSIONS Our study firstly reports the clinical characteristics and risk factors for prolonged LOS during the wave of the Omicron epidemic in Shanghai, China. These findings provide evidence for the early identification of asymptomatic and mild COVID-19 patients at a high risk of prolonged hospitalization who may require early intervention, and long-term monitoring and management.
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Affiliation(s)
- Chen Hu
- Department of Respiratory Disease, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Yu-Kai Liu
- Department of Cardiology, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Qi-Di Sun
- Department of Medical Education, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Zheng Du
- Department of Intensive Care Unit, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu-Qiang Fang
- Department of Cardiology, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Fei Guo
- Department of Medical Education, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Yu-Bo Wang
- Department of Respiratory Disease, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Yong He
- Department of Respiratory Disease, Daping Hospital, Army Medical University, Chongqing, China
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China
| | - Yuan Cen
- Department of Orthopedics, Daping Hospital, Army Medical University, Changjiang Branch Road 10, Chongqing, 400042, China.
| | - Fan Zeng
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Army Medical University, Changjiang Branch Road 10, Chongqing, 400042, China.
- National Exhibition and Convention Center Makeshift Hospital, Shanghai, China.
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Zhang X, Zhang X, Xu A, Yu M, Xu Y, Xu Y, Wang C, Yang G, Song C, Wu X, Lu Y. Aptamer-Gated Mesoporous Silica Nanoparticles for N Protein Triggered Release of Remdesivir and Treatment of Novel Coronavirus (2019-nCoV). BIOSENSORS 2022; 12:950. [PMID: 36354459 PMCID: PMC9688528 DOI: 10.3390/bios12110950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Since the 2019-nCoV outbreak was first reported, hundreds of millions of people all over the world have been infected. There is no doubt that improving the cure rate of 2019-nCoV is one of the most effective means to deal with the current serious epidemic. At present, Remdesivir (RDV) has been clinically proven to be effective in the treatment of SARS-CoV-2. However, the uncertain side effects make it important to reduce the use of drugs while ensuring the self-healing effect. We report an approach here with targeted therapy for the treatment of SARS-CoV-2 and other coronaviruses illness. In this study, mesoporous silica was used as the carrier of RDV, the nucleocapsid protein (N protein) aptamer was hybridized with the complementary chain, and the double-stranded DNA was combined with gold nanoparticles as the gates of mesoporous silica pores. When the RDV-loaded mesoporous silica is incubated with the N protein, aptamer with gold nanoparticles dissociate from the complementary DNA oligonucleotide on the mesoporous silica surface and bind to the N protein. The releasing of RDV was determined by detecting the UV-vis absorption peak of RDV in the solution. These results show that the RDV delivery system designed in this work has potential clinical application for the treatment of 2019-nCoV.
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Affiliation(s)
- Xiaohui Zhang
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Xin Zhang
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Aoqiong Xu
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Mengdi Yu
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Yu Xu
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Ying Xu
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Chao Wang
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Gege Yang
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
| | - Chunxia Song
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
- Key Laboratory of Agricultural Sensors, Ministry of Agriculture and Rural Affairs, Anhui Agricultural University, Hefei 230036, China
| | - Xiangwei Wu
- Key Laboratory of Agri-Food Safety of Anhui Province, College of Resources and Environment, Anhui Agricultural University, Hefei 230036, China
| | - Ying Lu
- Department of Applied Chemistry, Anhui Agricultural University, Hefei 230036, China
- Key Laboratory of Agricultural Sensors, Ministry of Agriculture and Rural Affairs, Anhui Agricultural University, Hefei 230036, China
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Pastorio C, Zech F, Noettger S, Jung C, Jacob T, Sanderson T, Sparrer KMJ, Kirchhoff F. Determinants of Spike infectivity, processing, and neutralization in SARS-CoV-2 Omicron subvariants BA.1 and BA.2. Cell Host Microbe 2022; 30:1255-1268.e5. [PMID: 35931073 PMCID: PMC9289044 DOI: 10.1016/j.chom.2022.07.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 12/02/2022]
Abstract
SARS-CoV-2 Omicron rapidly outcompeted other variants and currently dominates the COVID-19 pandemic. Its enhanced transmission and immune evasion are thought to be driven by numerous mutations in the Omicron Spike protein. Here, we systematically introduced BA.1 and/or BA.2 Omicron Spike mutations into the ancestral Spike protein and examined the impacts on Spike function, processing, and susceptibility to neutralization. Individual mutations of S371F/L, S375F, and T376A in the ACE2-receptor-binding domain as well as Q954H and N969K in the hinge region 1 impaired infectivity, while changes to G339D, D614G, N764K, and L981F moderately enhanced it. Most mutations in the N-terminal region and receptor-binding domain reduced the sensitivity of the Spike protein to neutralization by sera from individuals vaccinated with the BNT162b2 vaccine and by therapeutic antibodies. Our results represent a systematic functional analysis of Omicron Spike adaptations that have allowed this SARS-CoV-2 variant to dominate the current pandemic.
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Affiliation(s)
- Chiara Pastorio
- Institute of Molecular Virology, Ulm University Medical Centre, 89081 Ulm, Germany
| | - Fabian Zech
- Institute of Molecular Virology, Ulm University Medical Centre, 89081 Ulm, Germany
| | - Sabrina Noettger
- Institute of Molecular Virology, Ulm University Medical Centre, 89081 Ulm, Germany
| | - Christoph Jung
- Institute of Electrochemistry, Ulm University, 89081 Ulm, Germany; Electrochemical Energy Storage, Helmholtz-Institute-Ulm (HIU), 89081 Ulm, Germany; Karlsruhe Institute of Technology (KIT), 76344 Karlsruhe, Germany
| | - Timo Jacob
- Institute of Electrochemistry, Ulm University, 89081 Ulm, Germany
| | | | | | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Centre, 89081 Ulm, Germany.
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