Objective:To determine the change in the quality of life(QoL)of patients who applied to a tertiary outpatient clinic according to their COVID-19 status.Methods:This cross-sectional study comprised 1370 participants.Sh...Objective:To determine the change in the quality of life(QoL)of patients who applied to a tertiary outpatient clinic according to their COVID-19 status.Methods:This cross-sectional study comprised 1370 participants.Short form-12(SF-12),which includes Physical Component Summary(PCS)and Mental Component Summary(MCS)domains,was used to evaluate the QoL.Different linear regression models created using PCS-12 and MCS-12 were dependent variables.Results:A total of 19.2% of participants had acute COVID-19,and 8.4%had long COVID-19.The most common sypmtoms were fatigue(72.6%),headache(42.5%),and joint pain(39.8%)in patients with long COVID-19.The model including all participants showed that long COVID-19 reduced the QoL in multivariate analysis for both MCS and PCS,while acute COVID-19 had no significant effect on the QoL comparing with those without COVID-19.Model that included participants with COVID-19 showed that long COVID-19 negatively affected the QoL in the multivariate model for PCS-12 and MCS-12.Variables that were significant in the multivariate model for those who had long COVID-19 were having a chronic disease and presence of ongoing symptoms.Females were disadvantaged for PCS-12 and MCS-12 in the multivariate models including all participants,and models including participants who have had COVID-19.Low educational group were disadvantaged for PCS-12 in the multivariate model including all participants.This group were also disadvantaged for PCS-12 and MCS-12 in the multivariate models including participants who had COVID-19.Conclusions:In studies,acute COVID-19 and long COVID-19 should be treated as separate categories.The effects of long COVID-19 should be considered when providing and planning health services.The effect of gender,and education,on QoL shows that health inequalities continue to be effective during the pandemic period.展开更多
We have been experiencing multiple waves of the coronavirus disease 2019(COVID-19)pandemic.With these unprecedented waves,we have entered into an era of‘new normal’.This pandemic has enforced us to rethink the very ...We have been experiencing multiple waves of the coronavirus disease 2019(COVID-19)pandemic.With these unprecedented waves,we have entered into an era of‘new normal’.This pandemic has enforced us to rethink the very basics of childhood learning:Habits,health etiquette,and hygiene.Rehabilitation has immense importance during this pandemic considering a few aspects.Multidisciplinary COVID-19 rehabilitation clinics are essential to address the demand.The equitable distribution of COVID-19 rehabilitation services for differently-abled individuals during the pandemic is an important aspect.Rehabilitation needs identification and further studies on various rehabilitation interventions are among the key unmet future research needs.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-1...BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-19 infection,but musculoskeletal complications in long COVID-19 are underreported.However,post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue,myalgia,arthralgia,arthritis,muscle weakness,etc in clinical practice.The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.AIM To determine the musculoskeletal complications in long COVID.METHODS We performed a systematic review of‘systematic reviews and meta-analyses’.RESULTS Of the 63 articles screened,24 articles were included.Two articles specifically discussed children and adolescents.One article discussed rehabilitation intervention.No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular.Fatigue was the most common musculoskeletal complication.CONCLUSION Fatigue is found to be very common along with myalgia and arthralgia.There were no studies on rehabilitation intervention in musculoskeletal complications specifically.Considering the lacuna in literature and the needs of the current situation,further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications.More homogenous studies are needed.Studies on functional impairment due to musculoskeletal involvement are essential.展开更多
Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotion...Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.展开更多
BACKGROUND According to the population statistics in 2023,there were 110000 people aged over 100 years in China,and the experience of using Paxlovid(nirmatrelvir/ritonavir)for centenarians is particularly valuable.Thi...BACKGROUND According to the population statistics in 2023,there were 110000 people aged over 100 years in China,and the experience of using Paxlovid(nirmatrelvir/ritonavir)for centenarians is particularly valuable.This article reports our experience of using Paxlovid in a centenarian with the novel coronavirus disease 2019(COVID-19)infection.CASE SUMMARY A 103-year-old female with mild COVID-19 and renal insufficiency was given sufficient Paxlovid for 2 days and a half dose for 3 days.During treatment,the patient was complicated with lung infection and heart failure,and nucleic acid remained positive.After expert consultation,a full dose of Paxlovid was given again on the 9th day of admission for 2 days and a half dose for 3 days.Meanwhile,anti-heart failure and antibiotics were administered;the heart failure and pulmonary infection were improved.Finally,on the 33^(th) day of admission,nucleic acid turned negative,body temperature returned to normal,cough and sputum,fatigue,poor appetite and other symptoms basically improved.The patient was given Paxlovid via nasal feeding for 2 courses without deterioration of liver and kidney function,diarrhea,nausea and vomiting,myalgia,chest tightness and other side effects,and was discharged from hospital with good recovery.CONCLUSION This case suggests that Paxlovid can be used cautiously in centenarians with renal insufficiency and two courses of treatment can be considered in patients with persistent positive nucleic acid.展开更多
BACKGROUND QTc interval prolongation with an increased risk of torsade de pointes(Tsd)has been described in coronavirus disease 2019(COVID-19)patients treated with hydroxychloroquine(HCQ)and azithromycin(AZI)in Wester...BACKGROUND QTc interval prolongation with an increased risk of torsade de pointes(Tsd)has been described in coronavirus disease 2019(COVID-19)patients treated with hydroxychloroquine(HCQ)and azithromycin(AZI)in Western countries.In the DR Congo,few studies have evaluated the safety of this association or proposed new molecules.AIM To determine the incidence of QTc prolongation and Tsd in COVID-19 patients treated with HCQ-AZIs vs doubase C(new molecule).METHODS In present randomized clinical trial,we have included patients with mild or moderate COVID-19 treated with either HCQ-AZI or doubase C.Electrocardiogram(ECG)changes on day 14 of randomization were determined based on pretreatment tracing.Prolonged QTc was defined as≥500 ms on day 14 or an increase of≥80 ms compared to pretreatment tracing.Patients with cardiac disease,those undergoing other treatments likely to prolong QTc,and those with disturbed ECG tracings were excluded from the study.RESULTS The study included 258 patients(mean age 41±15 years;52%men;3.4%diabetics,11.1%hypertensive).Mild and moderate COVID-19 were found in 93.5%and 6.5%of patients,respectively.At baseline,all patients had normal sinus rhythm,a mean heart rate 78±13/min,mean PR space 170±28 ms,mean QRS 76±13 ms,and mean QTc 405±30 ms.No complaints suggesting cardiac involvement were reported during or after treatment.Only four patients(1.5%)experienced QTc interval prolongation beyond 500 ms.Similarly,only five patients(1.9%)had an increase in the QTc interval of more than 80 ms.QTc prolongation was more significant in younger patients,those with high viral load at baseline,and those receiving HCQ-AZI(P<0.05).None of the patients developed Tsd.CONCLUSION QTc prolongation without Tsd was observed at a lower frequency in patients treated with HCQ-AZI vs doubase C.The absence of comorbidities and concurrent use of other products that are likely to cause arrhythmia may explain our results.展开更多
Background Coronavirus disease 2019(COVID-19)can involve persistence,sequelae,and other clinical complications that last weeks to months to evolve into long COVID-19.Exploratory studies have suggested that interleukin...Background Coronavirus disease 2019(COVID-19)can involve persistence,sequelae,and other clinical complications that last weeks to months to evolve into long COVID-19.Exploratory studies have suggested that interleukin-6(IL-6)is related to COVID-19;however,the correlation between IL-6 and long COVID-19 is unknown.We designed a systematic review and meta-analysis to assess the relationship between IL-6 levels and long COVID-19.Methods Databases were systematically searched for articles with data on long COVID-19 and IL-6 levels published before September 2022.A total of 22 published studies were eligible for inclusion following the PRISMA guidelines.Analysis of data was undertaken by using Cochran's Q test and the Higgins I-squared(I2)statistic for heterogeneity.Random-effect meta-analyses were conducted to pool the IL-6 levels of long COVID-19 patients and to compare the differences in IL-6 levels among the long COVID-19,healthy,non-postacute sequelae of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection(non-PASC),and acute COVID-19 populations.The funnel plot and Egger's test were used to assess potential publication bias.Sensitivity analysis was used to test the stability of the results.Results An increase in IL-6 levels was observed after SARS-CoV-2 infection.The pooled estimate of IL-6 revealed a mean value of 20.92 pg/ml(95%CI=9.30–32.54 pg/ml,I2=100%,P<0.01)for long COVID-19 patients.The forest plot showed high levels of IL-6 for long COVID-19 compared with healthy controls(mean difference=9.75 pg/ml,95%CI=5.75–13.75 pg/ml,I2=100%,P<0.00001)and PASC category(mean difference=3.32 pg/ml,95%CI=0.22–6.42 pg/ml,I2=88%,P=0.04).The symmetry of the funnel plots was not obvious,and Egger’s test showed that there was no significant small study effect in all groups.Conclusions This study showed that increased IL-6 correlates with long COVID-19.Such an informative revelation suggests IL-6 as a basic determinant to predict long COVID-19 or at least inform on the“early stage”of long COVID-19.展开更多
目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSvie...目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。展开更多
目的分析COVID-19疫情暴发前后不同国家经季节和日历调整后的生育率(seasonally and calendar adjusted fertility rate,SAFR)趋势的变化及其影响因素。方法使用国际人类生育力数据库(Human Fertility Database,HFD)中28个国家自2012年...目的分析COVID-19疫情暴发前后不同国家经季节和日历调整后的生育率(seasonally and calendar adjusted fertility rate,SAFR)趋势的变化及其影响因素。方法使用国际人类生育力数据库(Human Fertility Database,HFD)中28个国家自2012年1月至2022年12月的月度SAFR数据,以2020年12月(2020年3月疫情暴发起点加9个月妊娠过程)为节点划分为疫情前(2012.1-2020.11)和疫情后(2020.12-2022.12)进行比较,使用中断时间序列方法分析各国疫情前后的SAFR趋势(短期波动和长期趋势)是否发生变化,使用秩和检验分析疫情前SAFR、人均GDP、公共卫生和社会措施(public health and social measures,PHSM)和失业率是否与SAFR趋势变化有关。结果疫情后28个国家中19个国家的SAFR出现短期下降,随后反弹。对于长期趋势,2个国家由下降趋势转为上升趋势,8个国家由上升趋势转为下降趋势,6个国家的SAFR保持不变。SAFR变化率下降主要集中在部分中欧国家以及地中海西岸的国家,而SAFR变化率增加的国家主要分布在北欧以及西欧地区。SAFR无短期波动的国家疫情前的SAFR低于有短期波动的国家(P=0.041),SAFR变化率下降国家的疫情前SAFR(P=0.005)与人均GDP(P=0.027)均低于SAFR变化率上升国家。未发现SAFR短期波动或长期趋势与PHSM严重程度指数或失业率存在关联。结论COVID-19疫情对28个国家的SAFR造成了不同的短期和长期影响,特别是经济水平和疫情前SAFR相对较低的国家可能更易遭到进一步打击。COVID-19疫情对各国人口的更长期影响值得进一步关注。展开更多
BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from...BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.展开更多
BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and fibrosis.Liver injury(LI)i...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and fibrosis.Liver injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated cholangiopathy.Mechanisms of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell invasion.AIM To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe COVID-19.METHODS ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel classifiers.RESULTS ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct cholangiocytes.Strikingly,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in cirrhosis.ACE2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD spectrum.Hepatic ACE2 levels are also increased in COVID-19 patients,especially those showing evidence of LI,but are not correlated with the presence of SARS-CoV-2 virus in the liver.However,there is a clear association between the hepatic lipid droplet content and the presence of the virus,suggesting a possible functional link.CONCLUSION Hepatic ACE2 levels were elevated in nonfibrotic MASH and COVID-19 patients with LI,while lipid accumulation may promote intra-hepatic SARS-CoV-2 replication,accelerating MASLD progression and COVID-19-mediated liver damage.展开更多
Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome corona...Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related complications.Therefore,COVID-19 vaccination has been recommended to be administered as early as possible in LTRs.Data sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in PubMed.Results:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of vaccination.Although the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained unresponsive.Furthermore,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver injury.Conclusions:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.展开更多
The distribution of the immune system throughout the body complicates in vitro assessments of coronavirus disease 2019(COVID-19)immunobiology,often resulting in a lack of reproducibility when extrapolated to the whole...The distribution of the immune system throughout the body complicates in vitro assessments of coronavirus disease 2019(COVID-19)immunobiology,often resulting in a lack of reproducibility when extrapolated to the whole organism.Consequently,developing animal models is imperative for a comprehensive understanding of the pathology and immunology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.This review summarizes current progress related to COVID-19 animal models,including non-human primates(NHPs),mice,and hamsters,with a focus on their roles in exploring the mechanisms of immunopathology,immune protection,and long-term effects of SARS-CoV-2 infection,as well as their application in immunoprevention and immunotherapy of SARS-CoV-2 infection.Differences among these animal models and their specific applications are also highlighted,as no single model can fully encapsulate all aspects of COVID-19.To effectively address the challenges posed by COVID-19,it is essential to select appropriate animal models that can accurately replicate both fatal and non-fatal infections with varying courses and severities.Optimizing animal model libraries and associated research tools is key to resolving the global COVID-19 pandemic,serving as a robust resource for future emerging infectious diseases.展开更多
文摘Objective:To determine the change in the quality of life(QoL)of patients who applied to a tertiary outpatient clinic according to their COVID-19 status.Methods:This cross-sectional study comprised 1370 participants.Short form-12(SF-12),which includes Physical Component Summary(PCS)and Mental Component Summary(MCS)domains,was used to evaluate the QoL.Different linear regression models created using PCS-12 and MCS-12 were dependent variables.Results:A total of 19.2% of participants had acute COVID-19,and 8.4%had long COVID-19.The most common sypmtoms were fatigue(72.6%),headache(42.5%),and joint pain(39.8%)in patients with long COVID-19.The model including all participants showed that long COVID-19 reduced the QoL in multivariate analysis for both MCS and PCS,while acute COVID-19 had no significant effect on the QoL comparing with those without COVID-19.Model that included participants with COVID-19 showed that long COVID-19 negatively affected the QoL in the multivariate model for PCS-12 and MCS-12.Variables that were significant in the multivariate model for those who had long COVID-19 were having a chronic disease and presence of ongoing symptoms.Females were disadvantaged for PCS-12 and MCS-12 in the multivariate models including all participants,and models including participants who have had COVID-19.Low educational group were disadvantaged for PCS-12 in the multivariate model including all participants.This group were also disadvantaged for PCS-12 and MCS-12 in the multivariate models including participants who had COVID-19.Conclusions:In studies,acute COVID-19 and long COVID-19 should be treated as separate categories.The effects of long COVID-19 should be considered when providing and planning health services.The effect of gender,and education,on QoL shows that health inequalities continue to be effective during the pandemic period.
文摘We have been experiencing multiple waves of the coronavirus disease 2019(COVID-19)pandemic.With these unprecedented waves,we have entered into an era of‘new normal’.This pandemic has enforced us to rethink the very basics of childhood learning:Habits,health etiquette,and hygiene.Rehabilitation has immense importance during this pandemic considering a few aspects.Multidisciplinary COVID-19 rehabilitation clinics are essential to address the demand.The equitable distribution of COVID-19 rehabilitation services for differently-abled individuals during the pandemic is an important aspect.Rehabilitation needs identification and further studies on various rehabilitation interventions are among the key unmet future research needs.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has crippled humanity since early 2020.Various sequelae of COVID-19 have been reported in different body systems.Musculoskeletal symptoms are widely reported during COVID-19 infection,but musculoskeletal complications in long COVID-19 are underreported.However,post-COVID-19 survivors have reported complaints of persisting or new-onset fatigue,myalgia,arthralgia,arthritis,muscle weakness,etc in clinical practice.The well-known detrimental effects of steroids on the musculoskeletal system coupled with their over-the-counter availability can also be anticipated since they were the cornerstone of life-saving management in this pandemic.AIM To determine the musculoskeletal complications in long COVID.METHODS We performed a systematic review of‘systematic reviews and meta-analyses’.RESULTS Of the 63 articles screened,24 articles were included.Two articles specifically discussed children and adolescents.One article discussed rehabilitation intervention.No article addressed rehabilitation of musculoskeletal issues in long COVID-19 in particular.Fatigue was the most common musculoskeletal complication.CONCLUSION Fatigue is found to be very common along with myalgia and arthralgia.There were no studies on rehabilitation intervention in musculoskeletal complications specifically.Considering the lacuna in literature and the needs of the current situation,further studies are warranted to standardize effective rehabilitation interventions in musculoskeletal complications.More homogenous studies are needed.Studies on functional impairment due to musculoskeletal involvement are essential.
基金the Tianjin Philosophy and Social Science Planning Project“Research on Value-Added Evaluation of Career Adaptability for Engineering Students Oriented towards Outstanding Engineers”,Grant Number TJJXQN22-001.
文摘Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.
文摘BACKGROUND According to the population statistics in 2023,there were 110000 people aged over 100 years in China,and the experience of using Paxlovid(nirmatrelvir/ritonavir)for centenarians is particularly valuable.This article reports our experience of using Paxlovid in a centenarian with the novel coronavirus disease 2019(COVID-19)infection.CASE SUMMARY A 103-year-old female with mild COVID-19 and renal insufficiency was given sufficient Paxlovid for 2 days and a half dose for 3 days.During treatment,the patient was complicated with lung infection and heart failure,and nucleic acid remained positive.After expert consultation,a full dose of Paxlovid was given again on the 9th day of admission for 2 days and a half dose for 3 days.Meanwhile,anti-heart failure and antibiotics were administered;the heart failure and pulmonary infection were improved.Finally,on the 33^(th) day of admission,nucleic acid turned negative,body temperature returned to normal,cough and sputum,fatigue,poor appetite and other symptoms basically improved.The patient was given Paxlovid via nasal feeding for 2 courses without deterioration of liver and kidney function,diarrhea,nausea and vomiting,myalgia,chest tightness and other side effects,and was discharged from hospital with good recovery.CONCLUSION This case suggests that Paxlovid can be used cautiously in centenarians with renal insufficiency and two courses of treatment can be considered in patients with persistent positive nucleic acid.
文摘BACKGROUND QTc interval prolongation with an increased risk of torsade de pointes(Tsd)has been described in coronavirus disease 2019(COVID-19)patients treated with hydroxychloroquine(HCQ)and azithromycin(AZI)in Western countries.In the DR Congo,few studies have evaluated the safety of this association or proposed new molecules.AIM To determine the incidence of QTc prolongation and Tsd in COVID-19 patients treated with HCQ-AZIs vs doubase C(new molecule).METHODS In present randomized clinical trial,we have included patients with mild or moderate COVID-19 treated with either HCQ-AZI or doubase C.Electrocardiogram(ECG)changes on day 14 of randomization were determined based on pretreatment tracing.Prolonged QTc was defined as≥500 ms on day 14 or an increase of≥80 ms compared to pretreatment tracing.Patients with cardiac disease,those undergoing other treatments likely to prolong QTc,and those with disturbed ECG tracings were excluded from the study.RESULTS The study included 258 patients(mean age 41±15 years;52%men;3.4%diabetics,11.1%hypertensive).Mild and moderate COVID-19 were found in 93.5%and 6.5%of patients,respectively.At baseline,all patients had normal sinus rhythm,a mean heart rate 78±13/min,mean PR space 170±28 ms,mean QRS 76±13 ms,and mean QTc 405±30 ms.No complaints suggesting cardiac involvement were reported during or after treatment.Only four patients(1.5%)experienced QTc interval prolongation beyond 500 ms.Similarly,only five patients(1.9%)had an increase in the QTc interval of more than 80 ms.QTc prolongation was more significant in younger patients,those with high viral load at baseline,and those receiving HCQ-AZI(P<0.05).None of the patients developed Tsd.CONCLUSION QTc prolongation without Tsd was observed at a lower frequency in patients treated with HCQ-AZI vs doubase C.The absence of comorbidities and concurrent use of other products that are likely to cause arrhythmia may explain our results.
文摘Background Coronavirus disease 2019(COVID-19)can involve persistence,sequelae,and other clinical complications that last weeks to months to evolve into long COVID-19.Exploratory studies have suggested that interleukin-6(IL-6)is related to COVID-19;however,the correlation between IL-6 and long COVID-19 is unknown.We designed a systematic review and meta-analysis to assess the relationship between IL-6 levels and long COVID-19.Methods Databases were systematically searched for articles with data on long COVID-19 and IL-6 levels published before September 2022.A total of 22 published studies were eligible for inclusion following the PRISMA guidelines.Analysis of data was undertaken by using Cochran's Q test and the Higgins I-squared(I2)statistic for heterogeneity.Random-effect meta-analyses were conducted to pool the IL-6 levels of long COVID-19 patients and to compare the differences in IL-6 levels among the long COVID-19,healthy,non-postacute sequelae of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection(non-PASC),and acute COVID-19 populations.The funnel plot and Egger's test were used to assess potential publication bias.Sensitivity analysis was used to test the stability of the results.Results An increase in IL-6 levels was observed after SARS-CoV-2 infection.The pooled estimate of IL-6 revealed a mean value of 20.92 pg/ml(95%CI=9.30–32.54 pg/ml,I2=100%,P<0.01)for long COVID-19 patients.The forest plot showed high levels of IL-6 for long COVID-19 compared with healthy controls(mean difference=9.75 pg/ml,95%CI=5.75–13.75 pg/ml,I2=100%,P<0.00001)and PASC category(mean difference=3.32 pg/ml,95%CI=0.22–6.42 pg/ml,I2=88%,P=0.04).The symmetry of the funnel plots was not obvious,and Egger’s test showed that there was no significant small study effect in all groups.Conclusions This study showed that increased IL-6 correlates with long COVID-19.Such an informative revelation suggests IL-6 as a basic determinant to predict long COVID-19 or at least inform on the“early stage”of long COVID-19.
文摘目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。
文摘目的分析COVID-19疫情暴发前后不同国家经季节和日历调整后的生育率(seasonally and calendar adjusted fertility rate,SAFR)趋势的变化及其影响因素。方法使用国际人类生育力数据库(Human Fertility Database,HFD)中28个国家自2012年1月至2022年12月的月度SAFR数据,以2020年12月(2020年3月疫情暴发起点加9个月妊娠过程)为节点划分为疫情前(2012.1-2020.11)和疫情后(2020.12-2022.12)进行比较,使用中断时间序列方法分析各国疫情前后的SAFR趋势(短期波动和长期趋势)是否发生变化,使用秩和检验分析疫情前SAFR、人均GDP、公共卫生和社会措施(public health and social measures,PHSM)和失业率是否与SAFR趋势变化有关。结果疫情后28个国家中19个国家的SAFR出现短期下降,随后反弹。对于长期趋势,2个国家由下降趋势转为上升趋势,8个国家由上升趋势转为下降趋势,6个国家的SAFR保持不变。SAFR变化率下降主要集中在部分中欧国家以及地中海西岸的国家,而SAFR变化率增加的国家主要分布在北欧以及西欧地区。SAFR无短期波动的国家疫情前的SAFR低于有短期波动的国家(P=0.041),SAFR变化率下降国家的疫情前SAFR(P=0.005)与人均GDP(P=0.027)均低于SAFR变化率上升国家。未发现SAFR短期波动或长期趋势与PHSM严重程度指数或失业率存在关联。结论COVID-19疫情对28个国家的SAFR造成了不同的短期和长期影响,特别是经济水平和疫情前SAFR相对较低的国家可能更易遭到进一步打击。COVID-19疫情对各国人口的更长期影响值得进一步关注。
基金the Researchers Supporting Project number,King Saud University,Riyadh,Saudi Arabia,No.RSPD2024R919.
文摘BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.
基金Supported by University of Edinburgh Hepatology Laboratory Internal Fundingthe Liver Endowment Funds of the Edinburgh&Lothian Health Foundation.
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and fibrosis.Liver injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated cholangiopathy.Mechanisms of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell invasion.AIM To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe COVID-19.METHODS ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel classifiers.RESULTS ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct cholangiocytes.Strikingly,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in cirrhosis.ACE2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD spectrum.Hepatic ACE2 levels are also increased in COVID-19 patients,especially those showing evidence of LI,but are not correlated with the presence of SARS-CoV-2 virus in the liver.However,there is a clear association between the hepatic lipid droplet content and the presence of the virus,suggesting a possible functional link.CONCLUSION Hepatic ACE2 levels were elevated in nonfibrotic MASH and COVID-19 patients with LI,while lipid accumulation may promote intra-hepatic SARS-CoV-2 replication,accelerating MASLD progression and COVID-19-mediated liver damage.
基金the National Natural Science Foundation of China(82103662).
文摘Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related complications.Therefore,COVID-19 vaccination has been recommended to be administered as early as possible in LTRs.Data sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in PubMed.Results:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of vaccination.Although the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained unresponsive.Furthermore,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver injury.Conclusions:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.
基金National Key Research and Development Program of China(2022YFC2303700,2021YFC2301300)Yunnan Key Research and Development Program(202303AC100026)+2 种基金National Natural Science Foundation of China(82302002,82341069)Yunnan Fundamental Research Project(202201AS070047)Strategic Priority Research Program of the Chinese Academy of Sciences(XDB0490000)。
文摘The distribution of the immune system throughout the body complicates in vitro assessments of coronavirus disease 2019(COVID-19)immunobiology,often resulting in a lack of reproducibility when extrapolated to the whole organism.Consequently,developing animal models is imperative for a comprehensive understanding of the pathology and immunology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.This review summarizes current progress related to COVID-19 animal models,including non-human primates(NHPs),mice,and hamsters,with a focus on their roles in exploring the mechanisms of immunopathology,immune protection,and long-term effects of SARS-CoV-2 infection,as well as their application in immunoprevention and immunotherapy of SARS-CoV-2 infection.Differences among these animal models and their specific applications are also highlighted,as no single model can fully encapsulate all aspects of COVID-19.To effectively address the challenges posed by COVID-19,it is essential to select appropriate animal models that can accurately replicate both fatal and non-fatal infections with varying courses and severities.Optimizing animal model libraries and associated research tools is key to resolving the global COVID-19 pandemic,serving as a robust resource for future emerging infectious diseases.
