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Beesiga B, Marson K, Fatch R, Emenyonu NI, Adong J, Kekibiina A, Puryear S, Lodi S, McDonell MG, Muyindike WR, Kamya MR, Hahn JA, Chamie G. Effects of a COVID-19 Public Health Lockdown on Drinking and Health Behavior Among Persons with HIV and with Unhealthy Alcohol use in Uganda. AIDS Behav 2023; 27:3213-3222. [PMID: 37000383 PMCID: PMC10063928 DOI: 10.1007/s10461-023-04042-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 04/01/2023]
Abstract
To better understand the impact of Uganda's initial COVID-19 lockdown on alcohol use, we conducted a cross-sectional survey (August 2020-September 2021) among persons with HIV (PWH) with unhealthy alcohol use (but not receiving an alcohol intervention), enrolled in a trial of incentives to reduce alcohol use and improve isoniazid preventive therapy. We examined associations between bar-based drinking and decreased alcohol use, and decreased alcohol use and health outcomes (antiretroviral therapy [ART] access, ART adherence, missed clinic visits, psychological stress and intimate partner violence), during lockdown. Of 178 adults surveyed whose data was analyzed, (67% male, median age: 40), 82% reported bar-based drinking at trial enrollment; 76% reported decreased alcohol use during lockdown. In a multivariate analysis, bar-based drinking was not associated with greater decreases in alcohol use during lockdown compared to non-bar-based drinking (OR = 0.81, 95% CI: 0.31-2.11), adjusting for age and sex. There was a significant association between decreased alcohol use and increased stress during lockdown (adjusted β = 2.09, 95% CI: 1.07-3.11, P < 0.010), but not other health outcomes.
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Affiliation(s)
- Brian Beesiga
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | - Kara Marson
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Robin Fatch
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Nneka I Emenyonu
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Julian Adong
- Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Allen Kekibiina
- Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sarah Puryear
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sara Lodi
- Boston University School of Public Health, Boston, MA, USA
| | - Michael G McDonell
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Winnie R Muyindike
- Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
- Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Moses R Kamya
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Judith A Hahn
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Gabriel Chamie
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, 94110, USA.
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Reiner MF, Schmidt D, Frischknecht L, Ruschitzka F, Duru F, Saguner AM. Case report of long-term postural tachycardia syndrome in a patient after messenger RNA coronavirus disease-19 vaccination with mRNA-1273. Eur Heart J Case Rep 2023; 7:ytad390. [PMID: 37650075 PMCID: PMC10464593 DOI: 10.1093/ehjcr/ytad390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
Background Postural tachycardia syndrome (POTS) is characterized by orthostatic intolerance and heart rate increase in an upright position without orthostatic hypotension. It has been described after coronavirus disease-19 (COVID-19) as well as after COVID-19 vaccination. Case summary A 54-year-old female patient presented with a 9-months history of severe orthostatic intolerance since COVID-19 vaccination with messenger RNA (mRNA)-1273 (Spikevax, Moderna). Except for diet-controlled coeliac disease, the patient was healthy, had no allergies, and did not take regular medication. Tilt table testing revealed a significant heart rate increase to 168 bpm without orthostatic hypotension accompanied by light-headedness, nausea, and syncope, findings consistent with POTS. Potential underlying causes including anaemia, thyroid dysfunction, adrenal insufficiency, pheochromocytoma, (auto)-immune disease, chronic inflammation as well as neurological causes were ruled out. Echocardiography and cardiac stress magnetic resonance imaging (MRI) did not detect structural or functional heart disease or myocardial ischaemia. Forty-eight-hour-electrocardiogram (ECG) showed no tachycardias other than sinus tachycardia. Finally, genomic analysis did not detect an inherited arrhythmia syndrome. Serologic analysis revealed adequate immune response to mRNA-1273 vaccination without signs of previous severe acute respiratory syndrome-coronavirus-2 infection. While ivabradine was not tolerated and metoprolol extended release only slightly improved symptoms, physical exercise reduced orthostatic intolerance moderately. At a 5-months follow-up, the patient remained dependant on assistance for activities of daily living. Discussion The temporal association of POTS with the COVID-19 vaccination in a previously healthy patient and the lack of evidence of an alternative aetiology suggests COVID-19 vaccination is the potential cause of POTS in this patient. To our knowledge, this is the first case reporting severe, long-term, and treatment-refractory POTS following COVID-19 vaccination with mRNA1273.
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Affiliation(s)
- Martin F Reiner
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Dörthe Schmidt
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Lukas Frischknecht
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Firat Duru
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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Liu Q, Ma F, Zhong Y, Wang G, Hu L, Zhang Y, Xie J. Efficacy and safety of human umbilical cord-derived mesenchymal stem cells for COVID-19 pneumonia: a meta-analysis of randomized controlled trials. Stem Cell Res Ther 2023; 14:118. [PMID: 37143167 PMCID: PMC10159228 DOI: 10.1186/s13287-023-03286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Elevated levels of inflammatory factors are associated with poor prognosis in coronavirus disease-19 (COVID-19). However, mesenchymal stem cells (MSCs) have immunomodulatory functions. Accordingly, this meta-analysis aimed to determine the efficacy and safety of MSC-based therapy in patients with COVID-19 pneumonia. METHODS Online global databases were used to find relevant studies. Two independent researchers then selected and evaluated the studies for suitability while the Cochrane risk of bias tool determined the quality of all articles and Cochran's Q test and I2 index assessed the degree of heterogeneity in the principal studies. Statistical analysis was performed using Review Manager software, and the effect of each study on the overall estimate was evaluated by sensitivity analysis. RESULTS Seven studies were included in the meta-analysis, and all MSCs used in the trials were acquired from the umbilical cord. The results of these studies (n = 328) indicated that patients with COVID-19 pneumonia who received MSCs had a 0.58 risk of death compared with controls (95% CI = 0.38, 0.87; P = 0.53; I2 = 0%). In terms of inflammatory biomarkers, MSCs reduced the levels of C-reactive protein (n = 88; MD = - 32.49; 95% CI = - 48.43, - 16.56; P = 0.46; I2 = 0%) and interferon-gamma (n = 44; SMD = - 1.23; 95% CI = - 1.89, - 0.57; P = 0.37; I2 = 0%) in severe COVID-19 patients but had no significant effect on interleukin-6 (n = 185; MD = - 0.75; 95% CI = - 7.76, 6.27; P = 0.57; I2 = 0%). A summary of the data revealed no significant differences in adverse events (n = 287) or serious adverse events (n = 229) between the MSC and control groups. CONCLUSIONS Infusion of umbilical cord-derived MSCs is an effective strategy for treating patients with COVID-19 pneumonia, with no noticeable adverse effects.
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Affiliation(s)
- Qinxue Liu
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China
| | - Fengjie Ma
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China
| | - Yizhi Zhong
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China
| | - Gaojian Wang
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China
| | - Li Hu
- Department of Anesthesiology, Second Affiliated Hospital of Jiaxing University, No.1518 North Huancheng Road, Nanhu District, Jiaxing, 314000, China
| | - Yaping Zhang
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China
| | - Junran Xie
- Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No.3 East Qingchun Road, Jianggan District, Hangzhou, 310016, China.
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Yao W, Dong H, Qi J, Zhang Y, Shi L. Safety and efficacy of mesenchymal stem cells in severe/critical patients with COVID-19: A systematic review and meta-analysis. EClinicalMedicine 2022; 51:101545. [PMID: 35844767 PMCID: PMC9270852 DOI: 10.1016/j.eclinm.2022.101545] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aims to better understand the efficacy and safety of mesenchymal stromal cells (MSCs) in treating severe/critical patients with COVID-19. METHODS PubMed, the Cochrane Library, and the Chinese electronic database CNKI were searched from inception up to Dec 19, 2021. Original comparative studies for MSC treatment + standard treatment for severe/critical patients with COVID-19, with placebo or standard treatment as the control group, were included. The primary outcomes were in-hospital mortality and adverse events (AEs). A meta-analysis was performed to compare the mortality rates between the two groups. Then, a subgroup analysis was performed according to the category of the disease (severe or critical) and MSC dose. Afterwards, a descriptive analysis was performed for AEs and secondary outcomes. The funnel plot and Egger's test were used for the publication bias assessment. FINDINGS Compared to placebo or standard care, MSCs provide significant benefit in the treatment of patients with severe/critical COVID-19, in terms of in-hospital mortality rate (odds ratio: 0.52, 95% CI 0.32-0.84), with very low heterogeneity (P=0.998 [Q test], I 2=0.0%) and less AEs. No significant difference was found in mortality rate due to the different disease categories or MSC doses. Furthermore, no publication bias was found. INTERPRETATION The present study demonstrates that MSCs are highly likely to reduce mortality and are safe to use for patients with severe or critical COVID-19, regardless of whether 1-3 doses are applied. However, due to the small sample size of the included studies, further high-quality, large-scale trials are needed to confirm this statement in the future. FUNDING The National Key Research and Development Program of China (No. 2020YFC0860900), the Science and Technology Project of Wuhan (No. 2020020602012112), the Tianjin Science and Technology Research Program (18PTSYJC00070 and 16PTWYHZ00030), Haihe Laboratory of Cell Ecosystem Innovation Fund (HH22KYZX0046), and the Tianjin Free Trade Zone Innovation Development Project (ZMCY-03-2021002-01) funded the study. We are also grateful for the support from the 3551 Talent Plan of China Optics Valley.
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Affiliation(s)
- Weiqi Yao
- Department of Hematology, Union Hospital, Tong Ji Medical College, Hua Zhong University of Science and Technology, Hubei, China
- School of Biological Engineering and Food, Hubei University of Technology, Wuhan, Hubei, China
- Wuhan Optics Valley Vcanbio Cell & Gene Technology Co., Ltd., Hubei, China
- Wuhan Optics Valley Zhongyuan Pharmaceutical Co., Ltd., Hubei, China
- Hubei Engineering Research Center for Human Stem Cell Preparation, Application and Resource Preservation, Wuhan, China
| | - Haibo Dong
- Wuhan Optics Valley Vcanbio Cell & Gene Technology Co., Ltd., Hubei, China
- Wuhan Optics Valley Zhongyuan Pharmaceutical Co., Ltd., Hubei, China
- Hubei Engineering Research Center for Human Stem Cell Preparation, Application and Resource Preservation, Wuhan, China
| | - Ji Qi
- Wuhan Optics Valley Zhongyuan Pharmaceutical Co., Ltd., Hubei, China
| | - Yu Zhang
- Wuhan Optics Valley Vcanbio Cell & Gene Technology Co., Ltd., Hubei, China
- Wuhan Optics Valley Zhongyuan Pharmaceutical Co., Ltd., Hubei, China
- Hubei Engineering Research Center for Human Stem Cell Preparation, Application and Resource Preservation, Wuhan, China
- VCANBIO Cell & Gene Engineering Corp., Ltd., No. 12 Meiyuan Road, Tianjin, China
- State Industrial Base for Stem Cell Engineering Products, Tianjin, China
- Corresponding authors.
| | - Lei Shi
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, No. 100 Xi Si Huan Middle Road, Fengtai District, Beijing, China
- Corresponding authors.
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Ferreira FAF, Kannan D, Meidutė-Kavaliauskienė I, Vale IMT. A sociotechnical approach to vaccine manufacturer selection as part of a global immunization strategy against epidemics and pandemics. Ann Oper Res 2022:1-30. [PMID: 35068642 PMCID: PMC8760108 DOI: 10.1007/s10479-021-04347-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 05/27/2023]
Abstract
These are unprecedented times while the world weathers the highly infectious respiratory pandemic caused by coronavirus disease-19 (COVID-19). Humanity has experienced other cataclysmic events, but something as novel as this pandemic cannot be easily described. A safe COVID-19 vaccine is often hailed as the only effective public health method to prevent the further spread of this virus. New vaccines' cost has increased even as policymakers struggle with limited resources and budget constraints. Thus, more decision-support tools are needed to facilitate the selection of vaccine manufacturers as part of a global immunization strategy against COVID-19 or other epidemics and pandemics. This study sought to address this issue by combining three well-established operational research methods (i.e., cognitive mapping, decision-making trial and evaluation laboratory, and the Choquet integral). Based on the insights provided by a panel of experts on vaccination and infectious diseases, a vaccine manufacturer selection mechanism was developed that incorporates the World Health Organization's guidelines. This approach facilitated the identification of multiple selection criteria regarding vaccine manufacturers, their allocation into six major clusters (i.e., soundness of scientific approach and technology used; speed of delivery; cost; liability and risk sharing; ability to supply sufficient quantities through production capacity development; and global solidarity), and subsequent analysis of the respective cause-and-effect relationships. The results of a real-life application of the proposed selection system were further consolidated by a member of Saint Francisco Xavier Hospital Infectious Diseases Unit in Lisbon, Portugal. The mechanism's advantages and limitations are also discussed.
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Affiliation(s)
- Fernando A. F. Ferreira
- ISCTE Business School, BRU-IUL, University Institute of Lisbon, Avenida das Forças Armadas, 1649-026 Lisbon, Portugal
- Fogelman College of Business and Economics, University of Memphis, Memphis, TN 38152-3120 USA
| | - Devika Kannan
- Centre for Sustainable Supply Chain Engineering, Department of Technology and Innovation, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- China Institute of FTZ Supply Chain, Shanghai Maritime University, Shanghai, 201306 China
| | - Ieva Meidutė-Kavaliauskienė
- Faculty of Business Management, Vilnius Gediminas Technical University, Saulėtekio al. 11, 10223 Vilnius, Lithuania
- Business Research center, University Institute of Lisbon, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Inês M. T. Vale
- ISCTE Business School, University Institute of Lisbon, Avenida das Forças Armadas, 1649-026 Lisbon, Portugal
- BIAL Pharmaceutical Group S.A., Av. da Siderurgia Nacional, 745-457 S. Mamede do Coronado, Portugal
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Tanal M, Celayir MF, Kale ZS. Unexpected tendency to bleeding in COVID-19 patients: A case of spontaneous retroperitoneal hematoma. SAGE Open Med Case Rep 2022; 9:2050313X211067907. [PMID: 34987821 PMCID: PMC8721400 DOI: 10.1177/2050313x211067907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/02/2021] [Indexed: 11/28/2022] Open
Abstract
While COVID-19 pandemic has become an enormous and devastating pandemic for today’s world, studies on the morbidity of the disease mainly show the disease’s progress with pneumonia and thromboembolic pathologies. In this disease with a predisposition to thromboembolism, findings of nontraumatic focused hemorrhages are unexpected. As spontaneous retroperitoneal hematoma is a serious condition with the absence of symptoms, creating a challenge for diagnosis, it should also be considered in COVID-19 which is thought to be predisposed to thromboembolism. Here, a 47-year-old woman with COVID-19 pneumonia diagnosis (diagnosed by computed tomography (CT) scan and approved by nasopharyngeal swab test) is presented with spontaneous retroperitoneal hematoma, and its management is reported. This case highlights the importance of considering both thromboembolic events and bleeding in cases with COVID-19 positivity. The balance between two sides of clotting mechanisms needs to be understood with novel research.
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Affiliation(s)
- Mert Tanal
- Department of General Surgery, Tekirdag Ismail Fehmi Cumalioglu State Hospital, Tekirdag, Turkey
| | - Mustafa Fevzi Celayir
- Department of General Surgery, Hamidiye Etfal Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zulfiye Sumeyye Kale
- Department of General Surgery, Hamidiye Etfal Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
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Thoms BL, Gosselin J, Libman B, Littenberg B, Budd RC. Efficacy of Combination Therapy with the JAK Inhibitor Baricitinib in the Treatment of COVID-19. SN Compr Clin Med 2022; 4:42. [PMID: 35079694 PMCID: PMC8776555 DOI: 10.1007/s42399-022-01121-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 01/08/2023]
Abstract
Coronavirus disease-19 (COVID-19), resulting from infection with SARS-CoV-2, spans a wide spectrum of illness. In severely ill patients, highly elevated serum levels of certain cytokines and considerable cytolytic T cell infiltrates in the lungs have been observed. These same patients may bear low to negligible viral burdens suggesting that an overactive immune response, often termed cytokine storm, contributes to the severity of COVID-19. We report the safety and efficacy of baricitinib combined with remdesivir and dexamethasone in a retrospective review of 45 hospitalized patients with COVID-19 pneumonia at a tertiary academic medical center. Patients received 7-day course of baricitinib, 5-day course of remdesivir, and 10-day course of dexamethasone. Clinical status and biomarkers were obtained daily. Outcomes assessed include mortality, duration of hospitalization, presence of shock, need for supplemental oxygen, need for non-invasive ventilation, need for mechanical ventilation, and development of thrombosis. Obesity and multiple medical comorbidities were associated with hospitalization in the setting of COVID-19. Treated patients demonstrated rapid declines of C-reactive protein (CRP), ferritin and D-dimer with gradual improvement in hemoglobin, platelet counts, and clinical status. Only 2 of 45 (4.4%) treated patients required mechanical ventilation after initiating treatment, and there were six deaths (13.3%). Only 2 of 45 (4.4%) treated patients required mechanical ventilation after initiating treatment. There were six deaths (13.3%) and these were associated with lower BMI. These findings support the utility of immunosuppression via JAK inhibition in moderate to severe COVID-19 pneumonia. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-022-01121-4.
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Affiliation(s)
- Brendan L. Thoms
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 USA
| | - Jeanne Gosselin
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 USA
| | - Bonita Libman
- Rheumatology and Clinical Immunology Division, Department of Medicine, The Larner College of Medicine at the University of Vermont, Burlington, VT 05405 USA
| | - Benjamin Littenberg
- Division of General Internal Medicine Research, Department of Medicine, The University of Vermont Larner College of Medicine, Burlington, VT 05405 USA
| | - Ralph C. Budd
- Rheumatology and Clinical Immunology Division, Department of Medicine, The Larner College of Medicine at the University of Vermont, Burlington, VT 05405 USA ,Vermont Center for Immunology and Infectious Diseases, The University of Vermont Larner College of Medicine, Burlington, VT 05405 USA
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8
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Hammam N, Tharwat S, Shereef RRE, Elsaman AM, Khalil NM, Fathi HM, Salem MN, El-Saadany HM, Samy N, El-Bahnasawy AS, Abdel-Fattah YH, Amer MA, ElShebini E, El-Shanawany AT, El-Hammady DH, Noor RA, ElKhalifa M, Ismail F, Fawzy RM, El-Najjar AR, Selim ZI, Abaza NM, Radwan AR, Elazeem MIA, Mohsen WA, Moshrif AH, Mohamed EF, Aglan LI, Senara S, Ibrahim ME, Khalifa I, Owaidy RE, Fakharany NE, Mohammed RHA, Gheita TA. Rheumatology university faculty opinion on coronavirus disease-19 (COVID-19) vaccines: the vaXurvey study from Egypt. Rheumatol Int 2021; 41:1607-1616. [PMID: 34244818 PMCID: PMC8269986 DOI: 10.1007/s00296-021-04941-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of the present work was to explore the perspectives of Egyptian Rheumatology staff members as regards the coronavirus disease-19 (COVID-19) vaccine. METHODS The survey is composed of 25 questions. Some questions were adapted from the global rheumatology alliance COVID-19 survey for patients. RESULTS 187 rheumatology staff members across Egypt from 18 universities and authorizations actively participated with a valid response. The mean time needed to complete the survey was 17.7 ± 13 min. Participants were 159 (85%) females (F:M 5.7:1). One-third agreed that they will be vaccinated once available, 24.6% have already received at least one dose, 29.4% are unsure while 16% will not take it. Furthermore, 70.1% agreed that they will recommend it to the rheumatic diseases (RD) patients once available, 24.1% are not sure while 5.9% will not recommend it. RD priority to be vaccinated against COVID-19 in descending order include SLE (82.9%), RA (55.1%), vasculitis (51.3%), systemic sclerosis (39.6%), MCTD (31.6%), Behcet's disease (28.3%). The most common drugs to be avoided before vaccination included biologics (71.7%), DMARDs (44.4%), biosimilars (26.7%), IVIg (17.1%) and NSAIDs (9.1%). CONCLUSIONS The results of the study and specifically the low rate of acceptability are alarming to Egyptian health authorities and should stir further interventions to reduce the levels of vaccine hesitancy. As rheumatic disease patients in Egypt were not systematically provided with the vaccine till present, making the vaccine available could as well enhance vaccine acceptance. Further studies to investigate any possible side effects, on a large scale of RD patients are warranted.
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Affiliation(s)
- Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
- Rheumatology Department, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Samar Tharwat
- Rheumatology Unit, Internal Medicine, Mansoura University, Dakahlia, Egypt
| | - Rawhya R El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmed M Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Gharbia, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amany S El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Emad ElShebini
- Internal Medicine Department, Rheumatology Unit, Menoufia University, Menoufia, Egypt
| | - Amira T El-Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Dina H El-Hammady
- Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Marwa ElKhalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Rasha M Fawzy
- Rheumatology Department, Faculty of Medicine, Benha University, Kalubia, Egypt
| | - Amany R El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Zahraa I Selim
- Rheumatology Department, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Nouran M Abaza
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed R Radwan
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mervat IAbd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Wael Abdel Mohsen
- Rheumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abdel Hafeez Moshrif
- Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
| | - Loay I Aglan
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Maha E Ibrahim
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Iman Khalifa
- Pediatrics Department, Rheumatology and Nephrology Unit, Helwan University, Cairo, Egypt
| | - Rasha El Owaidy
- Pediatrics Department, Rheumatology Unit, Ain Shams University, Cairo, Egypt
| | - Noha El Fakharany
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Todorov SD, Tagg JR, Ivanova IV. Could Probiotics and Postbiotics Function as "Silver Bullet" in the Post-COVID-19 Era? Probiotics Antimicrob Proteins 2021. [PMID: 34386940 DOI: 10.1007/s12602-021-09833-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 12/14/2022]
Abstract
We are currently experiencing the realities of the most severe pandemic within living memory, with major impacts on the health and economic well-being of our planet. The scientific community has demonstrated an unprecedented mobilization capability, with the rapid development of vaccines and drugs targeting the protection of human life and palliative measures for infected individuals. However, are we adequately prepared for ongoing defense against COVID-19 and its variants in the post-pandemic world? Moreover, are we equipped to provide a satisfactory quality of life for individuals who are recovering from COVID-19 disease? What are the possibilities for the acceleration of the recovery process? Here, we give special consideration to the potential and already-demonstrated role of probiotics and traditional medical approaches to the management of current and potential future encounters with our major virus adversaries.
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Malka M, Gropp C, Jaworowski S, Oberbaum M, Katz DE. Telepsychiatry for Patients with Post-traumatic Stress Disorder During the COVID-19 Outbreak. ACTA ACUST UNITED AC 2021;:1-8. [PMID: 34377626 DOI: 10.1007/s40501-021-00245-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/21/2022]
Abstract
Purpose The novel coronavirus, SARS-CoV-2, emerged from Wuhan, China, causing a pandemic. Access to outpatient psychiatric care was limited. We conducted a pilot study of telepsychiatry during a national shutdown. Adult patients with post-traumatic stress disorder (PTSD) participated via Zoom. Patient preference comparing televisits to face-to-face visits was assessed. Recent findings Telemedicine has emerged as new technological tool in the evolution of the patient-physician relationship, changing the way we interact. Physicians and patients now have access to the electronic medical record, remote point-of-care testing, and each other. The present epidemic allows us to test the limits of technology in combating limited access to care for patients with psychiatric illness. Summary Twenty (90% male) patients with PTSD participated. Most (90 %) were moderately to severely depressed, and 50% used medical cannabis and increased their dosage during the study period. Patients preferred face-to-face meetings for its ease of use (p < .01) and general satisfaction from therapy (p < .01). However, given continued outbreak-limiting access to care, most patients stated they would continue with telepsychiatry. While most patients preferred face-to-face visits, telepsychiatry can be used during times of outbreak-limiting access to care. Future research and development should be directed at improving technological ease of use.
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Oshiro S, Tabe Y, Funatogawa K, Saito K, Tada T, Hishinuma T, Mizutani N, Akiwa M, Sekiguchi JI, Miida T, Kirikae T. Development of an immunochromatographic kit to detect severe acute respiratory syndrome coronavirus 2. J Virol Methods 2021; 294:114183. [PMID: 33984393 PMCID: PMC8110331 DOI: 10.1016/j.jviromet.2021.114183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022]
Abstract
Background The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the worldwide coronavirus disease-19 (COVID-19) pandemic, starting in late 2019. The standard diagnostic methods to detect SARS-CoV-2 are PCR-based genetic assays. Antigen-antibody-based immunochromatographic assays are alternative methods of detecting this virus. Rapid diagnosis kits to detect SARS-CoV-2 are urgently needed. Study design Three monoclonal antibodies against SARS-CoV-2 nucleocapsid (N) protein were used to develop an antigen-antibody-based immunochromatographic kit to detect SARS-CoV-2. These assays were evaluated using nasopharyngeal swab specimens collected from patients suspected of having COVID-19. Results These assays detected recombinant SARS-CoV-2 N protein at concentrations >0.2 ng/mL within 10 min after protein loading, but did not detect the N proteins of Middle East respiratory syndrome coronavirus (MERS-CoV), human coronaviruses OC43 (HCoV-OC43) and 299E (HCoV-229E) and other pathogens causing respiratory infections. Nasopharyngeal swab specimens obtained 1~3, 4~9, and ≥ 10 days after symptom onset from COVID-19 patients diagnosed by RT-PCR showed positivity rates of 100 %, >80 %, and <30 %, respectively. Conclusions Kits using this immunochromatographic assay may be a rapid and useful tool for point-of-care diagnosis of COVID-19 when samples are obtained from patients 1~9 days after symptom onset.
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Affiliation(s)
- Satoshi Oshiro
- Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoko Tabe
- Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiji Funatogawa
- Tochigi Prefectural Institute of Public Health and Environmental Science, Utsunomiya, Tochigi, Japan
| | - Kaori Saito
- Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Tatsuya Tada
- Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomomi Hishinuma
- Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Naeko Mizutani
- Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Makoto Akiwa
- Microbiology Research Division, Kohjin Bio Co., Ltd., Saitama, Japan
| | | | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Teruo Kirikae
- Department of Microbiology, Juntendo University School of Medicine, Tokyo, Japan.
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Yasmin F, Shujauddin SM, Naeem A, Jabeen A, Shah SMI, Ochani RK, Mohiuddin O, Khan AA, Jalees S, Razzack AA, Salman S, Khan SAK, Mustafa A, Lak HM. Exploring the impact of the COVID-19 pandemic on provision of cardiology services: a scoping review. Rev Cardiovasc Med 2021; 22:83-95. [PMID: 33792250 DOI: 10.31083/j.rcm.2021.01.241] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/30/2020] [Accepted: 01/03/2020] [Indexed: 11/06/2022] Open
Abstract
The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported. A similar reduction in the patient presentation is seen for ischemic heart disease, decompensated heart failure, and endocarditis. Cardiovascular services, including catheterization, primary percutaneous coronary intervention (PPCI), cardiac investigations such as electrocardiograms (ECGs), exercise tolerance test (ETT), dobutamine stress test, computed tomography (CT) angiography, transesophageal echocardiography (TOE) have been reported to have declined and performed on a priority basis. The long-term implications of this decline have been discussed with major concerns of severe cardiac complications and vulnerabilities in cardiac patients. The pandemic has also had psychological impacts on patients causing them to avoid seeking medical help. This review discusses the effects of the COVID-19 pandemic on the provision of various cardiology services and aims to provide strategies to restore cardiovascular services including structural changes in the hospital to make up for the reduced staff personnel, the use of personal protective equipment in healthcare workers, and provides alternatives for high-risk cardiac imaging, cardiac interventions, and procedures. Implementation of the triage system, risk assessment scores, and telemedicine services in patients and their adaptation to the cardiovascular department have been discussed.
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Affiliation(s)
- Farah Yasmin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Syed Muhammad Shujauddin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Aisha Naeem
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Adina Jabeen
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | | | - Rohan Kumar Ochani
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Osama Mohiuddin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Anosh Aslam Khan
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Sumeen Jalees
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | | | - Shiza Salman
- Department of Internal Medicine, Dow International Medical College, 247000 Karachi, Pakistan
| | - Shuja Abdul Karim Khan
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
| | - Ahmad Mustafa
- Department of Internal Medicine, Staten Island University Hospital, NY 10001, USA
| | - Hassan Mehmood Lak
- Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, USA
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YORMAZ B, ERGÜN D, TÜLEK B, ERGÜN R, ARSLAN U, KANAT F. Impact of low molecular weight heparin administration on the clinical course of the COVID-19 disease. Turk J Med Sci 2021; 51:28-38. [PMID: 32892540 PMCID: PMC7991848 DOI: 10.3906/sag-2006-184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023] Open
Abstract
Background Lymphopenia is the most important criterion of mortality and discharging feature for patients infected with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical impact of a low molecular weight heparin (LMWH) treatment on the clinical course of COVID-19. Materials and methods Patients’ clinical symptoms, radiologic outcomes, hematologic, biochemical, D-dimer, and C-reactive protein (CRP) results were obtained from their medical records. Participants were separated into 2 groups: one was treated with LMWH and the other was not. Improvement in the patients was compared before and after treatment. Results Ninety-six patients who were diagnosed with COVID-19 between April and May 2020 were retrospectively analyzed. The multivariable analysis showed that the count of lymphocytes, D-dimer, and CRP levels were significantly improved in the LMWH group, as compared to the control group (OR, (95% CI) 0.628 (0.248–0.965), P < 0.001); OR, (95% CI) 0.356 (0.089–0.674), P < 0.001, respectively). The area under the receiver operating characteristic (ROC) curve analysis was AUC: 0.679 ± 0.055, 0.615 ± 0.058, and 0.633 ± 0.057, respectively; the β-value was found to be –1.032, –0.026, and –0.465, respectively. Conclusion The LMWH treatment group demonstrated better laboratory findings, including recovery in the lymphocyte count, CRP, and D-dimer results.
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Affiliation(s)
- Burcu YORMAZ
- Department of Pulmonology, Faculty of Medicine, Selçuk University, KonyaTurkey
| | - Dilek ERGÜN
- Department of Pulmonology, Faculty of Medicine, Selçuk University, KonyaTurkey
| | - Baykal TÜLEK
- Department of Pulmonology, Faculty of Medicine, Selçuk University, KonyaTurkey
| | - Recai ERGÜN
- Department of Pulmonology, Faculty of Medicine, Selçuk University, KonyaTurkey
| | - Uğur ARSLAN
- Department of Microbiology, Faculty of Medicine, Selçuk University, KonyaTurkey
| | - Fikret KANAT
- Department of Pulmonology, Faculty of Medicine, Selçuk University, KonyaTurkey
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Xian J, Pei X, Lu W, Zhong H, Lin Y, Jin H, Su Z. The clinical value of bedside ultrasound in predicting the severity of coronavirus disease-19 (COVID-19). Ann Transl Med 2021; 9:336. [PMID: 33708963 PMCID: PMC7944274 DOI: 10.21037/atm-20-7944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background To summarise the ultrasound manifestations of coronavirus disease-19 (COVID-19) patients with lung lesions and explore the clinical value of bedside ultrasound in the identification of patients at risk of progression to severe disease. Methods This retrospective study enrolled 31 patients with COVID-19 who were admitted to our hospital from January 18 to February 5, 2020. Lung ultrasounds were performed in all cases to evaluate the ultrasound manifestations of the patient’s lung lesions and to determine the lung ultrasound scores (LUS). The Cox proportional hazards regression model was used for the multifactor analysis of 7 candidate parameters, including the LUS and the oxygenation index (PaO2/FiO2). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of the LUS. Results Lung ultrasound images of COVID-19 patients mainly reflected the presence of interstitial pulmonary lesions (90.3%, 28/31). The lung lesions were primarily distributed in the subpleural and peripheral pulmonary zones. Multivariate analyses identified the oxygenation index, the LUS, and the lymphocyte count as factors related to the progression to severe-critical disease in COVID-19 patients (P<0.05). With a cut-off value of 9.5, the area under the ROC curve was 0.910. The LUS showed a sensitivity and specificity of 81.3% and 93.0%, respectively (P≤0.001), with an overall accuracy of 75%. Conclusions The lung ultrasound findings in COVID-19 patients were mainly and specifically manifested as interstitial lesions involving the peripheral zones of the lung. In addition, ultrasound imaging could predict the likelihood of COVID-19 patients progressing to severe disease, thereby allowing for early intervention. Thus, lung ultrasounds have great clinical value in monitoring and evaluating COVID-19 patients.
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Affiliation(s)
- Jianzhong Xian
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xiaofeng Pei
- Department of Thoracic Oncology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wuzhu Lu
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Haihong Zhong
- Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yuhong Lin
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hongjun Jin
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongzhen Su
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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15
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Abstract
BACKGROUND The COVID-19 pandemic, which broke out in Wuhan in 2019, has become the global health crisis of our time. Elderly patients with certain fundamental diseases are more likely to develop severe cases. The secondary lesion following viral infection have only rarely been reported. CASE PRESENTATION We here report two cases of coronavirus-infected pneumonia with acute ischemic stroke in middle-aged patients. In both COVID-19 cases, neurological physical examinations showed normal results before infection. Lymphocytopenia, accompanied by elevated cytokines and D-dimers, were found from serum clinical laboratory examination at admission. Dysarthria and limb muscle weakness are initial manifestations, occurring one week after infect-causative pathogen, SARS-CoV-2. The head CT and head/neck arterial CTA showed small-vessel occlusion. The patients were diagnosed with coronavirus diseases with secondary acute ischemic stroke. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. CONCLUSIONS These cases suggested that secondary ischemic stroke, mainly manifested as small-vessel occlusion, should be considered for COVID-19 patients and diagnosed and treated promptly.
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Affiliation(s)
- Bin Fu
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Hubei University of Chinese Medicine, 430000, Wuhan, China.
| | - Yun Chen
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Hubei University of Chinese Medicine, 430000, Wuhan, China
| | - Ping Li
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Hubei University of Chinese Medicine, 430000, Wuhan, China.
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Ying W, Qian Y, Kun Z. Drugs supply and pharmaceutical care management practices at a designated hospital during the COVID-19 epidemic. Res Social Adm Pharm 2021; 17:1978-1983. [PMID: 32317153 PMCID: PMC7136878 DOI: 10.1016/j.sapharm.2020.04.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 11/06/2022]
Abstract
The coronavirus disease-19 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus that was first detected at the end of December 2019. The epidemic has affected various regions of China in different degrees. As the situations evolve, the COVID-19 had been confirmed in many countries, and made a assessment that it can be characterized as a pandemic by the World Health Organization on March 11, 2020. Drugs are the main treatment of COVID-19 patients. Pharmaceutical service offers drug safety ensurance for COVID-19 patients. According to COVID-19 prevention and control policy and requirements, combined with series of diagnosis and treatment plans, pharmacists in the first provincial-level COVID-19 diagnosis and treatment unit in Jilin Province in Northeast China have established the management practices of drug supply and pharmaceutical care from four aspects: personnel, drugs supply management, off-label drug use management and pharmaceutical care. During the outbreak, the pharmaceutical department of THJU completed its assigned workload to ensure drug supply. So far, no nosocomial infections and medication errors have occurred, which has stabilized the mood of the staff and boosted the pharmacists' confidence in fighting the epidemic. For the treatment of COVID-19, pharmacists conducted adverse reaction monitoring and participated in the multidisciplinary consultation of COVID-19. Up to now, the COVID-19 patients admitted to THJU have not shown any new serious adverse reactions and been cured finally. The hospital pharmacy department timely adjusted the work mode, and the formed management practices is a powerful guarantee for the prevention and control of the COVID-19 epidemic. This paper summarized the details and practices of drug supply and pharmaceutical services management to provide experience for the people who involving in COVID-19 prevention and contain in other abroad epidemic areas.
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Affiliation(s)
- Wang Ying
- Department of Pharmacy, The Third Hospital of Jilin University, Jilin University, Changchun, 130033, Jilin, China
| | - Yu Qian
- Department of Pharmacy, The Third Hospital of Jilin University, Jilin University, Changchun, 130033, Jilin, China
| | - Zhu Kun
- Department of Pharmacy, The Third Hospital of Jilin University, Jilin University, Changchun, 130033, Jilin, China.
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17
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Zhang RX, Chen DM, Qian Y, Sun Y, Zhu RN, Wang F, Ding YX, Guo Q, Zhou YT, Qu D, Cao L, Zhu CM, Zhao LQ. Surges of hospital-based rhinovirus infection during the 2020 coronavirus disease-19 (COVID-19) pandemic in Beijing, China. World J Pediatr 2021; 17:590-6. [PMID: 34713393 DOI: 10.1007/s12519-021-00477-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/17/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND A series of public health preventive measures has been widely implemented in Beijing to control the coronavirus disease-19 (COVID-19) pandemic since January 2020. An evaluation of the effects of these preventive measures on the spread of other respiratory viruses is necessary. METHODS Respiratory specimens collected from children with acute respiratory infections were tested by NxTAG™ respiratory pathogen panel assays during January 2017 and December 2020. Specimens characterized as rhinoviruses (RVs) were sequenced to identify the RV species and types. Then, the epidemiology results of respiratory pathogens in 2020 were compared with those from 2017 to 2019 using SPSS statistics 22.0. RESULTS The positive rates of adenovirus (ADV), influenza virus (flu), RVs, and respiratory syncytial virus (RSV) dropped abruptly by 86.31%, 94.67%, 94.59%, and 92.17%, respectively, from February to May 2020, compared with the average level in the same period during 2017-2019. Positive rates of RVs then steeply increased from June 2020 (13.77%), to an apex (37.25%) in August 2020, significantly higher than the average rates (22.51%) in August 2017-2019 (P = 0.005). The increase, especially in group ≥ 3 years, was accompanied by the reopening of schools and kindergartens after the 23rd and 24th week of 2020 in Beijing. CONCLUSIONS Whereas the abrupt drop in viral pathogen positive rates from February to May 2020 revealed the remarkable effects of the COVID-19 preventive measures, the sharp increase in positive rates of RVs from the 23rd week of 2020 might be explained by the reopening of schools and kindergartens in Beijing.
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18
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Satake S, Kinoshita K, Arai H. More Active Participation in Voluntary Exercise of Older Users of Information and Communicative Technology even during the COVID-19 Pandemic, Independent of Frailty Status. J Nutr Health Aging 2021; 25:516-519. [PMID: 33786570 PMCID: PMC7847235 DOI: 10.1007/s12603-021-1598-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to examine whether older users of information and communicative technology (ICT) participate in active behaviors, such as voluntary exercise, to maintain health, even under community containment to suppress the coronavirus disease 2019 (COVID-19) pandemic. DESIGN Cross-sectional study. SETTING Community setting. PARTICIPANTS Independent community-dwelling older residents aged ≥75 years. MEASUREMENTS The municipality sent the Kihon Checklist (KCL) and Simplified Nutritional Appetite Questionnaire (SNAQ) with several questions on lifestyle and health conditions under social restriction. RESULTS Among 3199 responders (72.1%), we analyzed the data of 2304 residents who provided complete answers to the KCL and SNAQ and on ICT use, voluntary exercise, polypharmacy, and families. The mean age was 79.7 years (51.3% male). The percentages of frailty assessed by the KCL, voluntary exercise, and low SNAQ scores (≤14) were 16.0%, 61.4%, and 43.8% in 808 ICT users and 30.3%, 47.2%, and 54.1% in 1496 ICT non-users, respectively (p<0.001). ICT use was significantly associated with voluntary exercise even during social restriction, independent of age, sex, polypharmacy, low SNAQ scores, and frailty status (odds ratio, 1.503; 95% confidential interval, 1.246-1.813). CONCLUSION Older ICT users are more active to maintain health even during social restriction, independent of frailty status.
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Affiliation(s)
- S Satake
- Shosuke Satake, MD, PhD, Section of Frailty Prevention, Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi 474-8511, Japan, Phone: +81-562-46-2311, FAX: +81-562-44-8518, e-mail address:
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19
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Qian F, Gao G, Song Y, Xu Y, Wang A, Wang S, Hao Y, Chen M, Ma X, Zhao T, Guo X, Chen Z, Zhang F. Specific dynamic variations in the peripheral blood lymphocyte subsets in COVID-19 and severe influenza A patients: a retrospective observational study. BMC Infect Dis 2020; 20:910. [PMID: 33261583 PMCID: PMC7705851 DOI: 10.1186/s12879-020-05637-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023] Open
Abstract
Background Both COVID-19 and influenza A contribute to increased mortality among the elderly and those with existing comorbidities. Changes in the underlying immune mechanisms determine patient prognosis. This study aimed to analyze the role of lymphocyte subsets in the immunopathogenesisof COVID-19 and severe influenza A, and examined the clinical significance of their alterations in the prognosis and recovery duration. Methods By retrospectively reviewing of patients in four groups (healthy controls, severe influenza A, non-severe COVID-19 and severe COVID-19) who were admitted to Ditan hospital between 2018 to 2020, we performed flow cytometric analysis and compared the absolute counts of leukocytes, lymphocytes, and lymphocyte subsets of the patients at different time points (weeks 1–4). Results We reviewed the patients’ data of 94 healthy blood donors, 80 Non-severe-COVID-19, 19 Severe-COVID-19 and 37 severe influenza A. We found total lymphocytes (0.81 × 109/L vs 1.74 × 109/L, P = 0.001; 0.87 × 109/L vs 1.74 × 109/L, P < 0.0001, respectively) and lymphocyte subsets (T cells, CD4+ and CD8+ T cell subsets) of severe COVID-19 and severe influenza A patients to be significantly lower than those of healthy donors at early infection stages. Further, significant dynamic variations were observed at different time points (weeks 1–4). Conclusions Our study suggests the plausible role of lymphocyte subsets in disease progression, which in turn affects prognosis and recovery duration in patients with severe COVID-19 and influenza A. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05637-9.
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Affiliation(s)
- Fang Qian
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Guiju Gao
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Yangzi Song
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Yanli Xu
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Aibin Wang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Sa Wang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Yiwei Hao
- Department of Medical Records and Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Meiling Chen
- Department of Medical Records and Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xiaoyang Ma
- Department of Neurology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tianwei Zhao
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China
| | - Xiaodi Guo
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China.
| | - Fujie Zhang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No.8, Jing shun Dong jie, Chaoyang, 100015, District Beijing, China.
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Wu J, Cheng J, Shi X, Liu J, Huang B, Zhao X, Qiu Y, Yu J, Cao H, Li L. Recurrence of SARS-CoV-2 nucleic acid positive test in patients with COVID-19: a report of two cases. BMC Pulm Med 2020; 20:308. [PMID: 33225932 PMCID: PMC7681189 DOI: 10.1186/s12890-020-01348-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The recurrence of positive SARS-CoV-2 nucleic acid test results in patients with COVID-19 is becoming more important and warrants more attention. CASE PRESENTATION This study reports 2 cases, a child with mild COVID-19 and an adult female with moderate COVID-19, who were discharged after three consecutive negative nucleic acid tests and were later readmitted to the hospital for recurrence of SARS-CoV-2 nucleic acid positivity. By tracking the patients' symptoms, serum antibodies, and imaging manifestations after readmission, we found that they showed a trend of gradual improvement and recovery throughout treatment. They were cured without additional treatment, with the appearance of antibodies and the recovery of immune functions. CONCLUSIONS It is deemed extremely necessary to improve the discharge standard of care. At the same time, nucleic acid detection is recommended to increase the dynamic monitoring of serum antibodies and imaging, strengthen the management of discharged patients, and appropriately extend the home or centralized isolation time.
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Affiliation(s)
- Jian Wu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou, 310003, China.,Department of Laboratory Medicine, Yancheng Clinical Medical College of Nanjing Medical University, Yancheng, 224001, China
| | - Juan Cheng
- Department of Infectious Disease, The Second People's Hospital of Yancheng City, Yancheng, 224005, China
| | - Xiaowei Shi
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou, 310003, China
| | - Jun Liu
- Department of Laboratory Medicine, The Fifth People's Hospital of Wuxi, Wuxi, 214005, China
| | - Biao Huang
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Xinguo Zhao
- Department of Respiration, The Fifth People's Hospital of Wuxi, Wuxi, 214005, China
| | - Yuanwang Qiu
- Department of Infectious Diseases, The Fifth People's Hospital of Wuxi, Wuxi, 214005, China
| | - Jiong Yu
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou, 310003, China
| | - Hongcui Cao
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou, 310003, China. .,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, 79 Qingchun Rd, Hangzhou, 310003, China.
| | - Lanjuan Li
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou, 310003, China
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21
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Chen Z, Zhang F, Hu W, Chen Q, Li C, Wu L, Zhang Z, Li B, Ye Q, Mei J, Yue J. Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective study. J Clin Lab Anal 2020; 35:e23644. [PMID: 33112011 PMCID: PMC7645968 DOI: 10.1002/jcla.23644] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To investigate laboratory markers for COVID-19 progression in patients with different medical conditions. METHODS We performed a multicenter retrospective study of 836 cases in Hubei. To avoid the collinearity among the indicators, principal component analysis (PCA) followed by partial least squares discriminant analysis (PLS-DA) was performed to obtain an overview of laboratory assessments. Multivariable logistic regression analysis and multivariable Cox proportional hazards regression analysis were respectively used to explore risk factors associated with disease severity and mortality. Survival analysis was performed in patients with the most common comorbidities. RESULTS Lactate dehydrogenase (LDH) and prealbumin were associated with disease severity in patients with or without comorbidities, indicated by both PCA/PLS-DA and multivariable logistic regression analysis. The mortality risk was associated with age, LDH, C-reactive protein (CRP), D-dimer, and lymphopenia in patients with comorbidities. CRP was a risk factor associated with short-term mortality in patients with hypertension, but not liver diseases; additionally, D-dimer was a risk factor for death in patients with liver diseases. CONCLUSIONS Lactate dehydrogenase was a reliable predictor associated with COVID-19 severity and mortality in patients with different medical conditions. Laboratory biomarkers for mortality risk were not identical in patients with comorbidities, suggesting multiple pathophysiological mechanisms following COVID-19 infection.
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Affiliation(s)
| | - Furong Zhang
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, China
| | - Weihua Hu
- Jingzhou First People's Hospital, Jingzhou, China
| | - Qijian Chen
- Emergency Department, Fifth Hospital in Wuhan, Wuhan, China
| | - Chang Li
- Hubei No.3 People's Hospital of Jianghan University, Wuhan, China
| | - Longlong Wu
- People's Hospital of Nanzhang County, Xiangyang, China
| | - Zhuheng Zhang
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, China
| | - Bin Li
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, China
| | - Qifa Ye
- Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Wuhan, China
| | - Jin Mei
- Central Laboratory, Ningbo First Hospital, Zhejiang University, Ningbo, China
| | - Jiang Yue
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan, China.,Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, China
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22
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Zhang H, Shang W, Liu Q, Zhang X, Zheng M, Yue M. Clinical characteristics of 194 cases of COVID-19 in Huanggang and Taian, China. Infection 2020; 48:687-694. [PMID: 32390091 PMCID: PMC7211492 DOI: 10.1007/s15010-020-01440-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/04/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE We aimed to report the clinical characteristics of 194 cases coronavirus disease-19 (COVID-19) in Huanggang, Hubei and Taian, Shandong. METHODS We retrospectively investigated the clinical, laboratory characteristics and CT imaging of confirmed cases of COVID-19 from January 22 to February 28, 2020 in Huanggang Central Hospital and The Second Affiliated Hospital of Shandong First Medical University. Real time PCR was used to detect the new coronavirus in respiratory samples. Immunohistochemical staining was used to detect the expressions of ACE2 in tissues. RESULTS Among the 194 patients infected with COVID-19, 108 patients were male, with a median age of 48.3 years. The average preclinical period was 7.44 day. Except for 37 severe or critically ill patients, the rest of the 157 patients exhibited mild or moderate symptoms. 190 (97.94%) patients were confirmed during the three times nucleic acid test. The main clinical symptom of the patients were fever, sore throat and cough, which accounted for 146 cases (75.26%), 98 (50.52%) and 86 cases (44.33%), respectively. 30 patients (15.46%) showed liver dysfunction. Imaging examination showed that 141 patients (72.68%) showed abnormal density shadow, while 53 cases (27.32%) had no obvious abnormality in the parenchyma of both lungs. Up to now, 109 cases have been discharged from the hospital, and 9 patients died. The ACE2 expression levels were up-regulated in patients of severe type and critically ill type. CONCLUSION Clinical symptoms, laboratory tests and CT imaging should be combined for comprehensive analysis to diagnose COVID-19. ACE2 may be the receptor of COVID-19.
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Affiliation(s)
- Hong Zhang
- Department of Hematopathology, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, China
| | - Wenli Shang
- Department of Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 706 Taishan Road, Taian, 271000, China
| | - Qinghua Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, China
| | - Xuejing Zhang
- Taian Daiyue Maternal and Child Care Service Centre, Taian, 271000, China
| | - Maochuan Zheng
- Department of Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 706 Taishan Road, Taian, 271000, China
| | - Maokui Yue
- Department of Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 706 Taishan Road, Taian, 271000, China.
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23
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Subir R, Jagat J M, Kalyan K G. Pros and cons for use of statins in people with coronavirus disease-19 (COVID-19). Diabetes Metab Syndr 2020; 14:1225-1229. [PMID: 32683320 PMCID: PMC7352102 DOI: 10.1016/j.dsx.2020.07.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND AIMS Morbidity and mortality from coronavirus disease 2019 (COVID-19) is higher among people with diabetes mellitus (DM), hypertension, and cardiovascular disease (CVD). Statins are used in the majority of people with DM and CVD. This mini-review discusses the current understanding of benefit-risk ratio of use of statins in COVID-19. METHODS We searched PubMed database using specific keywords related to our aims till June 12, 2020. Full text of relevant articles published in English language were retrieved and reviewed. RESULTS Statins, with their immunomodulatory, anti-inflammatory, anti-thrombotic, and anti-oxidant properties, have the potential to reduce severity of lung injury in, and mortality from, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infections. Statin-induced upregulation of angiotensin-converting enzyme-2 (ACE2) has the potential to reduce lung injury from excess angiotensin II. By disrupting lipid rafts, statins have the potential to reduce viral entry into cells. However, benefit-risk ratio of its complex interaction with MYD88 gene expression on outcomes in COVID-19, and the putative role of low serum LDL cholesterol in increasing severity of SARS-CoV2 infection need further clarification. CONCLUSIONS People with COVID-19, who are already on statins for an underlying co-morbid condition, should continue on it unless there are specific contraindications. De-novo use of statins in people with COVID-19 with no underlying co-morbidity might be beneficial but awaits substantiation in clinical trials; till that time, de novo use of statins in COVID 19 should be limited to a clinical trial setting.
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Affiliation(s)
- Ray Subir
- Department of Endocrinology and Diabetes, Apollo Gleneagles Hospitals, Kolkata, India
| | - Mukherjee Jagat J
- Department of Endocrinology and Diabetes, Apollo Gleneagles Hospitals, Kolkata, India
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24
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Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis. Int J Infect Dis 2020; 98:180-186. [PMID: 32562846 PMCID: PMC7832751 DOI: 10.1016/j.ijid.2020.06.052] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is characterized by an unpredictable disease course, ranging from asymptomatic to severe, life-threatening infections. Asymptomatic COVID-19 infections have been described, and the aim of this systematic review was to summarise their presentation forms. METHODS We searched PubMed® and Google® (1 December 2019 to 29 March 2020) and extracted age, laboratory findings, and computed tomography (CT) scans. Pooled incidence rates of clinical characteristics were analyzed using random-effect models. RESULTS In total, 506 patients from 34 studies (68 single cases and 438 from case-series) with an asymptomatic course were identified. Patients with normal radiology were younger (19.59 ± 17.17 years) than patients with abnormal radiology (39.14 ± 26.70 years) (p-value = 0.013). Despite being asymptomatic, CT investigations revealed abnormalities in 62.2% of the cases; ground-glass opacities were most frequently observed (43.09% by meta-analysis). Most studies reported normal laboratory findings (61.74% by meta-analysis). CONCLUSIONS More than half of the patients without any symptoms present with CT abnormalities. Asymptomatic patients may be contagious and thus a potential source of transmission of COVID-19.
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Affiliation(s)
- Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
| | - Daniela Kresse
- Department of Internal Medicine, St. Johann County Hospital, St. Johann in Tirol, Austria
| | - Sojung Yoon
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Maria Effenberger
- Department of Internal Medicine I (Gastroenterology, Hepatology, Endocrinology & Metabolism), Medical University Innsbruck, Innsbruck, Austria
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
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25
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Shu L, Niu C, Li R, Huang T, Wang Y, Huang M, Ji N, Zheng Y, Chen X, Shi L, Wu M, Deng K, Wei J, Wang X, Cao Y, Yan J, Feng G. Treatment of severe COVID-19 with human umbilical cord mesenchymal stem cells. Stem Cell Res Ther 2020; 11:361. [PMID: 32811531 PMCID: PMC7432540 DOI: 10.1186/s13287-020-01875-5] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 is a highly infectious respiratory disease. No therapeutics have yet been proven effective for treating severe COVID-19. Objectives To determine whether human umbilical cord mesenchymal stem cell infusion may be effective and safe for the treatment of severe COVID-19. Methods Patients with severe COVID-19 were randomly divided into 2 groups: the standard treatment group and the standard treatment plus hUC-MSC infusion group. The incidence of progression from severe to critical illness, 28-day mortality, clinical symptom improvement, time to clinical symptom improvement, hematologic indicators including C-reactive protein, lymphocyte number, and interleukin 6, and imaging changes were observed and compared between the two groups. Measurements and main results The incidence of progression from severe to critical illness and the 28-day mortality rate were 0 in the hUC-MSC treatment group, while 4 patients in the control group deteriorated to critical condition and received invasive ventilation; 3 of them died, and the 28-day mortality rate was 10.34%. In the hUC-MSC treatment group, the time to clinical improvement was shorter than that in the control group. Clinical symptoms of weakness and fatigue, shortness of breath, and low oxygen saturation obviously improved beginning on the third day of stem cell infusion and reached a significant difference on day 7. CRP and IL-6 levels were significantly lower from day 3 of infusion, the time for the lymphocyte count to return to the normal range was significantly faster, and lung inflammation absorption was significantly shorter on CT imaging in the hUC-MSC group than in the control group. Conclusions Intravenous transplantation of hUC-MSCs is a safe and effective method that can be considered a salvage and priority treatment option for severe COVID-19. Trial registration Chinese Clinical Trial Registration; ChiCTR2000031494; Registered on 2 April 2020; http://www.medresman.org
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Affiliation(s)
- Lei Shu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.,Department of Respiratory Medicine, the Second Clinical Medical School of Nanjing Medical University, Nanjing, 210011, Jiangsu, China
| | - Changming Niu
- Department of Critical Care Medicine, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, Jiangsu, China
| | - Ruyou Li
- Department of Respiratory Medicine, Huangshi Central Hospital, Hangshi, 435000, Hubei, China
| | - Tingrong Huang
- Department of Nephrology, Huangshi Hospital of Traditional Chinese Medicine, Hangshi, 435000, Hubei, China
| | - Yan Wang
- Jiangsu Cell Tech Medical Research Institute, Nanjing, 211166, Jiangsu, China
| | - Mao Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Ningfei Ji
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - You Zheng
- Department of Nephrology, Huangshi Hospital of Traditional Chinese Medicine, Hangshi, 435000, Hubei, China
| | - Xiaolin Chen
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Lei Shi
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Mingjing Wu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Kaili Deng
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jing Wei
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Xueli Wang
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yang Cao
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jiaxin Yan
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Ganzhu Feng
- Department of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Nanjing Medical University, Address: No. 121 Jiangjiayuan Rd, Gulou District, Nanjing, 210011, Jiangsu, China.
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26
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Balanchivadze N, Kudirka AA, Askar S, Almadhoun K, Kuriakose P, Fadel R, Dabak V. Impact of COVID-19 Infection on 24 Patients with Sickle Cell Disease. One Center Urban Experience, Detroit, MI, USA. Hemoglobin 2020; 44:284-289. [PMID: 32722950 DOI: 10.1080/03630269.2020.1797775] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The city of Detroit has a large population of individuals with sickle cell disease, and hospitals in Detroit have seen some of the highest numbers of cases of coronavirus disease-19 (COVID-19) in 2020. The purpose of this study was to examine the pathophysiological characteristics of COVID-19 in patients with sickle cell disease or trait to determine whether these patients have unique manifestations that might require special consideration. This retrospective analysis included 24 patients with confirmed COVID-19 and sickle cell disease or trait who were seen at the Henry Ford Hospital, Detroit, MI, USA, between March 1 and April 15 2020. Of the 24 patients, 18 (75.0%) had heterozygous sickle cell trait, one (4.0%) was a double heterozygote for Hb S (HBB: c.20A>T)/β+-thalassemia (β+-thal), four had sickle cell anemia (βS/βS) and one (4.0%) had Hb S/Hb C (HBB: c.19G>A) disease. A total of 13 (54.0%) patients required hospitalization. All four patients with sickle cell anemia, developed acute pain crisis. We observed one patient who developed acute pulmonary embolism and no patients developed other sickle cell associated complications. Additionally, three (13.0%) patients required packed red blood cell transfusion without the need of exchange transfusion, and one patient required admission to the intensive care unit (ICU), mechanical ventilation and subsequently died. Patients with sickle cell disease or trait and laboratory-confirmed COVID-19 had a generally mild, or unremarkable, course of disease, with lower chances of intubation, ICU admission and death, but with a slightly longer hospitalization.
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Affiliation(s)
- Nino Balanchivadze
- Department of Hematology and Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Adam A Kudirka
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Sally Askar
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Khaled Almadhoun
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Philip Kuriakose
- Department of Hematology and Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Raef Fadel
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Vrushali Dabak
- Department of Hematology and Oncology, Henry Ford Health System, Detroit, MI, USA
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