BACKGROUND Over the last few decades,3 pathogenic pandemics have impacted the global population;severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV)and SARS-Co...BACKGROUND Over the last few decades,3 pathogenic pandemics have impacted the global population;severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV)and SARS-CoV-2.The global disease burden has attributed to millions of deaths and morbidities,with the majority being attributed to SARS-CoV-2.As such,the evaluation of the mental health(MH)impact across healthcare professionals(HCPs),patients and the general public would be an important facet to evaluate to better understand short,medium and long-term exposures.AIM To identify and report:(1)MH conditions commonly observed across all 3 pandemics;(2)Impact of MH outcomes across HCPs,patients and the general public associated with all 3 pandemics;and(3)The prevalence of the MH impact and clinical epidemiological significance.METHODS A systematic methodology was developed and published on PROSPERO(CRD42021228697).The databases PubMed,EMBASE,ScienceDirect and the Cochrane Central Register of Controlled Trials were used as part of the data extraction process,and publications from January 1,1990 to August 1,2021 were searched.MeSH terms and keywords used included Mood disorders,PTSD,Anxiety,Depression,Psychological stress,Psychosis,Bipolar,Mental Health,Unipolar,Self-harm,BAME,Psychiatry disorders and Psychological distress.The terms were expanded with a‘snowballing’method.Cox-regression and the Monte-Carlo simulation method was used in addition to I2 and Egger’s tests to determine heterogeneity and publication bias.RESULTS In comparison to MERS and SARS-CoV,it is evident SAR-CoV-2 has an ongoing MH impact,with emphasis on depression,anxiety and post-traumatic stress disorder.CONCLUSION It was evident MH studies during MERS and SARS-CoV was limited in comparison to SARS-CoV-2,with much emphasis on reporting symptoms of depression,anxiety,stress and sleep disturbances.The lack of comprehensive studies conducted during previous pandemics have introduced limitations to the“know-how”for clinicians and researchers to better support patients and deliver care with limited healthcare resources.展开更多
Viral infectious diseases have become an increased public health issue in the past 20 years.The outbreaks of severe acute respiratory syndrome coronavirus(SARSCoV-1)in 2002,influenza H1N1 in 2009,Middle East respirato...Viral infectious diseases have become an increased public health issue in the past 20 years.The outbreaks of severe acute respiratory syndrome coronavirus(SARSCoV-1)in 2002,influenza H1N1 in 2009,Middle East respiratory syndrome-CoV in 2012,and the current new coronavirus SARS-CoV-2 have shown that viral infectious diseases are a major concern in the 21st century.As the world lives under the pandemic of a new coronavirus(COVID-19),knowing the clinical characteristics from those past diseases and their long-term outcomes is important to understand the current coronavirus pandemic and its complications and consequences better and plan for possible future outbreaks.Several long-term complications have been described with these respiratory viral diseases,such as decreased pulmonary function,pulmonary fibrosis,chronic fatigue syndrome,avascular necrosis of bone,polyneuropathy,encephalitis,posttraumatic stress disorder,depression,and anxiety.This article summarizes several studies describing chronic complications and long-term outcomes of patients recovered from these viral syndromes.展开更多
Background:The ongoing transmission of the Middle East respiratory syndrome coronavirus(MERS-CoV)in the Middle East and its expansion to other regions are raising concerns of a potential pandemic.An in-depth analysis ...Background:The ongoing transmission of the Middle East respiratory syndrome coronavirus(MERS-CoV)in the Middle East and its expansion to other regions are raising concerns of a potential pandemic.An in-depth analysis about both population and molecular epidemiology of this pathogen is needed.Methods:MERS cases reported globally as of June 2020 were collected mainly from World Health Organization official reports,supplemented by other reliable sources.Determinants for case fatality and spatial diffusion of MERS were assessed with Logistic regressions and Cox proportional hazard models,respectively.Phylogenetic and phylogeographic analyses were performed to examine the evolution and migration history of MERS-CoV.Results:A total of 2562 confirmed MERS cases with 150 case clusters were reported with a case fatality rate of 32.7%(95%Cl:30.9-34.6%).Saudi Arabia accounted for 83.6%of the cases.Age of>65 years old,underlying conditions and>5 days delay in diagnosis were independent risk factors for death.However,a history of animal contact was associated with a higher risk(adjusted OR=297,95%Cl:1」0-7.98)among female cases<65 years but with a lower risk(adjusted OR=0.31,95%Cl:0.18-0.51)among male cases>65 years old.Diffusion of the disease was fastest from its origin in Saudi Arabia to the east,and was primarily driven by the transportation network.The most recent subclade C5.1(since 2013)was associated with non-synonymous mutations and a higher mortality rate.Phylogeographic analyses pointed to Riyadh of Saudi Arabia and Abu Dhabi of the United Arab Emirates as the hubs for both local and international spread of MERS-CoV.Conclusions:MERS-CoV remains primarily locally transmitted in the Middle East,with opportunistic exportation to other continents and a potential of causing transmission clusters of human cases.Animal contact is associated with a higher risk of death,but the association differs by age and sex.Transportation network is the leading driver for the spatial diffusion ofthe disease.These findings how this pathogen spread are helpful for targeting public health surveillance and interventions to control endemics and to prevent a potential pandemic.展开更多
South Korea was free of the Middle East Respiratory Syndrome(MERS)until 2015.The MERS outbreak in South Korea during 2015 was the largest outbreak of the Coronavirus outside the Middle East.The major characteristic of...South Korea was free of the Middle East Respiratory Syndrome(MERS)until 2015.The MERS outbreak in South Korea during 2015 was the largest outbreak of the Coronavirus outside the Middle East.The major characteristic of this outbreak is inter-or intra-hospital transmission.This recent MERS outbreak in South Korea is examined and assessed in this paper.The main objectives of the study is to characterize the pattern of the MERS outbreak in South Korea based on a basic reproductive ratio,the probability of ultimate extinction of the disease,and the spatio-temporal proximity of occurrence between patients.The survival function method and stochastic branching process model are adapted to calculate the basic reproductive ratio and the probability of ultimate extinction of the disease.We further investigate the occurrence pattern of the outbreak using a spatio-temporal autocorrelation function.展开更多
The recent problem on Middle East respiratory syndrome is a very interesting new infection emerging from the Gulf area. For practitioners in intensive care medicine, knowledge update on this new emerging infection is ...The recent problem on Middle East respiratory syndrome is a very interesting new infection emerging from the Gulf area. For practitioners in intensive care medicine, knowledge update on this new emerging infection is needed. Preparation for diagnostic tool and antiviral drug to cope with possible outbreak is suggested. In addition, the consideration of ecological factors of this new disease is important. The consideration of not only ecological but also humanistic background can be useful to manage the new disease, Middle East respiratory syndrome as well. Finally, how to improve medical service for underserved population is a big issue. The local health department must play an important role.展开更多
As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, ...As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, diabetes and diseases that may contribute to the severity and risk factor of diabetes in individuals and this impact on COVID-19 and the mortality rate. These diseases include respiratory diseases, cardiovascular diseases, and obesity. Equally significant is the statistical analysis on ethnicity, age, and sex on COVID-19 infection as well as mortality rate. Their possible contributions to increasing the severity and risk factor of diabetes as a risk to mortality to individuals who have COVID-19. Objectives: The ultimate objectives of this investigation are as follow: 1) Is there a risk factor of diabetes on COVID-19 infection and increasing mortality rate? 2) To what extent do other disease conditions that include, obesity, heart failure, and respiratory diseases influence the severity and risk factor of diabetes on increasing COVID-19 infection and mortality rate? 3) To what extent does age, race, and gender increase the mortality of COVID-19 and increase the severity and risk factor of diabetes on COVID-19 mortality rate? 4) How and why COVID-19 virus increases the risk of diabetes in children? 5) Diabetes and COVID-19: Who is most at Risk? Lastly, understanding the misconception of COVID-19 and diabetes.展开更多
Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electr...Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19,SARS and MERS pneumonia respectively.Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists.Vote-counting method was employed to include cases of each group.Data of patients’manifestations in early chest CT including lesion patterns,distribution of lesions and specific imaging signs for the three groups were extracted and recorded.Data were compared and analyzed using SPSS 22.0.Results A total of 24 studies were included,composing of 10 studies of COVID-19,5 studies of MERS and 9 studies of SARS.The included CT exams were 147,40,and 122 respectively.For the early CT features of the 3 pneumonias,the basic lesion pattern with respect to"mixed ground glass opacity(GGO)and consolidation,GGO mainly,or consolidation mainly"was similar among the 3 groups(χ^2=7.966,P>0.05).There were no significant differences on the lesion distribution(χ^2=13.053,P>0.05)and predominate involvement of the subpleural area of bilateral lower lobes(χ^2=4.809,P>0.05)among the 3 groups.The lesions appeared more focal in COVID-19 pneumonia at early phase(χ^2=23.509,P<0.05).The proportions of crazy-paving pattern(χ^2=23.037,P<0.001),organizing pneumonia pattern(P<0.05)and pleural effusions(P<0.001)in COVID-19 pneumonia were significantly lower than the other two.Although rarely shown in the early CT findings of all three viral pneumonias,the fibrotic changes were more frequent in SARS than COVID-19 and MERS(χ^2=6.275,P<0.05).For other imaging signs,only the MERS pneumonia demonstrated tree-in-buds,cavitation,and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia(χ^2=22.412,P<0.05).No pneumothorax,pneumomediastinum and lymphadenopathy was present for each group.Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns,including GGO and consolidation,bilateral distribution,and predominant involvement of the subpleural area and the lower lobes.Early signs of COVID-19 pneumonia showed less severity of inflammation.Early fibrotic changes appeared in SARS only.MERS had more severe inflammatory changes including cavitation and pleural effusion.The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.展开更多
At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effect...At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effective antiviral treatment for this infectious disease is absent.At the beginning of the epidemic,relevant cellular and animal experiments of antiviral treatment for SARS-CoV-2 were conducted based on the prior studies of SARS-CoV and Middle East respiratory syndrome coronavirus.Some antivirals were preliminarily validated to be potentially effective in the clinical settings.But as the epidemic continued and more studies were carried out,the efficacy of these antiviral drugs became controversial.This paper reviews the pharmacology and application of interferon,lopinavir/ritonavir,ribavirin,chloroquine,arbidol,favipiravir,remdesivir,and thymosinα1 in coronavirus disease 2019.The actual effect of these drugs remains controversial.Meanwhile,the efficacy and safety of these drugs for patients with coronavirus disease 2019 still need to be explored.展开更多
BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and c...BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and coronavirus infections.Despite the large amount of data concerning the use of ribavirin alone or in combination for measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and coronavirus disease 2019(COVID-19)outbreaks,the conclusions of these studies have been contradictory.Underlying reasons for these discrepancies include possible study design inaccuracies and failures and misinterpretations of data,and these potential confounds should be addressed.AIM To determine the confounding factors of ribavirin treatment studies and propose a therapeutic scheme for COVID-19.METHODS PubMed database was searched over a period of five decades utilizing the terms“ribavirin”alone or combined with other compounds in measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and COVID-19 infections.The literature search was performed and described according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Articles were considered eligible when they reported on ribavirin dose regimens and/or specified outcomes concerning its efficacy and/or possible adverseeffects.In vitro and animal studies were also retrieved.A chapter on ribavirin’s pharmacology was included as well.RESULTS In addition to the difficulties and pressures of an emerging pandemic,there is the burden of designing and conducting well-organized,double-blind,randomized controlled trials.Many studies have succumbed to specific pitfalls,one of which was identified in naturally ribavirin-resistant Vero cell lines in in vitro studies.Other pitfalls include study design inconsistent with the well-established clinical course of disease;inappropriate pharmacology of applied treatments;and the misinterpretation of study results with misconceived generalizations.A comprehensive treatment for COVID-19 is proposed,documented by thorough,longterm investigation of ribavirin regimens in coronavirus infections.CONCLUSION A comprehensive treatment strictly tailored to distinct disease stages was proposed based upon studies on ribavirin and coronavirus infections.展开更多
Coronaviruses are a family of viruses that can be transmitted from one person to another.Earlier strains have only been mild viruses,but the current form,known as coronavirus disease 2019(COVID-19),has become a deadly...Coronaviruses are a family of viruses that can be transmitted from one person to another.Earlier strains have only been mild viruses,but the current form,known as coronavirus disease 2019(COVID-19),has become a deadly infection.The outbreak originated in Wuhan,China,and has since spread worldwide.The symptoms of COVID-19 include a dry cough,sore throat,fever,and nasal congestion.Antimicrobial drugs,pathogen–host interaction,and 2 weeks of isolation have been recommended for the treatment of the infection.Safe operating procedures,such as the use of face masks,hand sanitizer,handwashing with soap,and social distancing,are also suggested.Moreover,travel bans for cities,states,and countries have been put in place,along with lockdowns to control the outbreak.Travel restrictions,mask use,sanitizer or soap use,and avoidance of touching the face and nose have produced encouraging results,whereas the effectiveness of antibiotics has not been proved.The results of isolation for the recovery of infected people have also been promising.Travel bans and lockdowns have caused a slump in economies,and unemployment has risen sharply,resulting in an increase in mental health cases globally.To date,vaccines have been developed and are in use in certain countries,but following standard operating procedures remain critical.The countries following the guidelines can eradicate this virus.New Zealand was the rst country to eliminate the virus from their territory.展开更多
SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and th...SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and the numbers are still rising.Current evidence shows that COVID-19 is lower than severe acute respiratory syndrome and Middle East respiratory syndrome in terms of severity and mortality risk,although the infections are particularly more severe in patients with underlying medical conditions.The bulk of COVID-19 patients had close contact with confirmed cases,but an exact origin and specific transmission for COVID-19 are still unknown.As there is no approved antiviral treatment for COVID-19 infection,proper prevention and control practices are essential to control the infection.To have an insight view of COVID-19,we summarized and compared the etiology,clinical manifestations,diagnosis,treatment,and prevention measures of COVID-19,severe acute respiratory syndrome,and Middle East respiratory syndrome.展开更多
The Middle East respiratory syndrome(MERS)outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented.Strict infection control measures were taken in the hospital where an...The Middle East respiratory syndrome(MERS)outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented.Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative.Infection control in healthcare settings,in which patients with emerging infectious diseases such as MERS,Ebola virus disease,and the severe acute respiratory syndrome(SARS)are diagnosed and treated,are often imperfect.When it comes to emerging or unknown infectious diseases,before the imported case was finally identified or community transmission was reported,cases have often occurred in clusters in healthcare settings.Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.展开更多
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)belongs to the family coronaviridae.It is spherical and possesses proteins called spikes,which can clamp onto the human cells.Once in close interaction with t...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)belongs to the family coronaviridae.It is spherical and possesses proteins called spikes,which can clamp onto the human cells.Once in close interaction with the human cells,these viruses undergo structural change and can fuse with the cell membrane.The virus enters the host and starts the process of translation and transcription in the cells and uncoated genome,respectively.Due to the rapid transmittable nature of the virus,extant actions should be taken.The fatty acids administrated orally,or intravenously,could help us gear things up in providing resistance and preventing infection.Hence,the multiplication of the virus could be hindered by arachidonic acid,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA).In that context,the current review highlights the role of these unsaturated fatty acids and their derivatives such as lipoxins and resolvins in the inactivation of the enveloped coro-navirus disease 2019(COVID-19).展开更多
The novel coronavirus disease 2019(COVID-19)in human caused by novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is currently rampant across the world,causing an international concern for public health ...The novel coronavirus disease 2019(COVID-19)in human caused by novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is currently rampant across the world,causing an international concern for public health emergency.At the time of July,2020,about 8380000 confirmed cases and more than 450000 deaths have been reported worldwide.This is the third outbreak of severe coronavirus family after the Middle East respiratory syndrome(MERS)and severe acute respiratory syndrome(SARS).Young victims(<12 years)in clinical course and prognosis of pediatric COVID-19 appear symptomatically milder than do teenage and adult patients,and many children with asymptomatic infections or showing only mild symptoms may be transmitter as well.Thus,the children with COVID-19 infection deserve more attention.This review is cautiously designed to report the clinical characteristics and symptoms of three kinds of coronaviruses(SARS-CoV,MERS-CoV,and SARS-CoV-2)in children and to summarize some recommended tactics to reduce COVID-19 transmission and/or to attain improved prevention in children.展开更多
Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for...Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for a user-friendly system for rapid drug screening.In this study,we constructed a MERS-CoV replicon containing the Renilla luciferase(Rluc)reporter gene and a stable luciferase replicon-carrying cell line.Using this cell line,we showed that MERS-CoV replication was inhibited by combined application of lopinavir and ritonavir,indicating that this cell line can be used to screen inhibitors of MERS-CoV replication.Importantly,the MERS-replicon cell line can be used for high-throughput screening of antiviral drugs without the need for live virus handling,providing an effective and safe tool for the discovery of antiviral drugs against MERS-CoV.展开更多
基金Supported by Southern Health NHS Foundation Trust.
文摘BACKGROUND Over the last few decades,3 pathogenic pandemics have impacted the global population;severe acute respiratory syndrome coronavirus(SARS-CoV),Middle East respiratory syndrome coronavirus(MERS-CoV)and SARS-CoV-2.The global disease burden has attributed to millions of deaths and morbidities,with the majority being attributed to SARS-CoV-2.As such,the evaluation of the mental health(MH)impact across healthcare professionals(HCPs),patients and the general public would be an important facet to evaluate to better understand short,medium and long-term exposures.AIM To identify and report:(1)MH conditions commonly observed across all 3 pandemics;(2)Impact of MH outcomes across HCPs,patients and the general public associated with all 3 pandemics;and(3)The prevalence of the MH impact and clinical epidemiological significance.METHODS A systematic methodology was developed and published on PROSPERO(CRD42021228697).The databases PubMed,EMBASE,ScienceDirect and the Cochrane Central Register of Controlled Trials were used as part of the data extraction process,and publications from January 1,1990 to August 1,2021 were searched.MeSH terms and keywords used included Mood disorders,PTSD,Anxiety,Depression,Psychological stress,Psychosis,Bipolar,Mental Health,Unipolar,Self-harm,BAME,Psychiatry disorders and Psychological distress.The terms were expanded with a‘snowballing’method.Cox-regression and the Monte-Carlo simulation method was used in addition to I2 and Egger’s tests to determine heterogeneity and publication bias.RESULTS In comparison to MERS and SARS-CoV,it is evident SAR-CoV-2 has an ongoing MH impact,with emphasis on depression,anxiety and post-traumatic stress disorder.CONCLUSION It was evident MH studies during MERS and SARS-CoV was limited in comparison to SARS-CoV-2,with much emphasis on reporting symptoms of depression,anxiety,stress and sleep disturbances.The lack of comprehensive studies conducted during previous pandemics have introduced limitations to the“know-how”for clinicians and researchers to better support patients and deliver care with limited healthcare resources.
文摘Viral infectious diseases have become an increased public health issue in the past 20 years.The outbreaks of severe acute respiratory syndrome coronavirus(SARSCoV-1)in 2002,influenza H1N1 in 2009,Middle East respiratory syndrome-CoV in 2012,and the current new coronavirus SARS-CoV-2 have shown that viral infectious diseases are a major concern in the 21st century.As the world lives under the pandemic of a new coronavirus(COVID-19),knowing the clinical characteristics from those past diseases and their long-term outcomes is important to understand the current coronavirus pandemic and its complications and consequences better and plan for possible future outbreaks.Several long-term complications have been described with these respiratory viral diseases,such as decreased pulmonary function,pulmonary fibrosis,chronic fatigue syndrome,avascular necrosis of bone,polyneuropathy,encephalitis,posttraumatic stress disorder,depression,and anxiety.This article summarizes several studies describing chronic complications and long-term outcomes of patients recovered from these viral syndromes.
基金supported by China Mega-Project on Infectious Disease Prevention(No.2017ZX10303401,2018ZX10713002,2018ZX10101003 and 2018ZX10201001)National Natural Science Foundation of China(No.81825019),and the National Institutes of Health of United States(R01 All 39761 and R01 AI116770)YY was supported by US National Institutes of Health grants R01 Al 139761 and R56 Al 148284.
文摘Background:The ongoing transmission of the Middle East respiratory syndrome coronavirus(MERS-CoV)in the Middle East and its expansion to other regions are raising concerns of a potential pandemic.An in-depth analysis about both population and molecular epidemiology of this pathogen is needed.Methods:MERS cases reported globally as of June 2020 were collected mainly from World Health Organization official reports,supplemented by other reliable sources.Determinants for case fatality and spatial diffusion of MERS were assessed with Logistic regressions and Cox proportional hazard models,respectively.Phylogenetic and phylogeographic analyses were performed to examine the evolution and migration history of MERS-CoV.Results:A total of 2562 confirmed MERS cases with 150 case clusters were reported with a case fatality rate of 32.7%(95%Cl:30.9-34.6%).Saudi Arabia accounted for 83.6%of the cases.Age of>65 years old,underlying conditions and>5 days delay in diagnosis were independent risk factors for death.However,a history of animal contact was associated with a higher risk(adjusted OR=297,95%Cl:1」0-7.98)among female cases<65 years but with a lower risk(adjusted OR=0.31,95%Cl:0.18-0.51)among male cases>65 years old.Diffusion of the disease was fastest from its origin in Saudi Arabia to the east,and was primarily driven by the transportation network.The most recent subclade C5.1(since 2013)was associated with non-synonymous mutations and a higher mortality rate.Phylogeographic analyses pointed to Riyadh of Saudi Arabia and Abu Dhabi of the United Arab Emirates as the hubs for both local and international spread of MERS-CoV.Conclusions:MERS-CoV remains primarily locally transmitted in the Middle East,with opportunistic exportation to other continents and a potential of causing transmission clusters of human cases.Animal contact is associated with a higher risk of death,but the association differs by age and sex.Transportation network is the leading driver for the spatial diffusion ofthe disease.These findings how this pathogen spread are helpful for targeting public health surveillance and interventions to control endemics and to prevent a potential pandemic.
文摘South Korea was free of the Middle East Respiratory Syndrome(MERS)until 2015.The MERS outbreak in South Korea during 2015 was the largest outbreak of the Coronavirus outside the Middle East.The major characteristic of this outbreak is inter-or intra-hospital transmission.This recent MERS outbreak in South Korea is examined and assessed in this paper.The main objectives of the study is to characterize the pattern of the MERS outbreak in South Korea based on a basic reproductive ratio,the probability of ultimate extinction of the disease,and the spatio-temporal proximity of occurrence between patients.The survival function method and stochastic branching process model are adapted to calculate the basic reproductive ratio and the probability of ultimate extinction of the disease.We further investigate the occurrence pattern of the outbreak using a spatio-temporal autocorrelation function.
文摘The recent problem on Middle East respiratory syndrome is a very interesting new infection emerging from the Gulf area. For practitioners in intensive care medicine, knowledge update on this new emerging infection is needed. Preparation for diagnostic tool and antiviral drug to cope with possible outbreak is suggested. In addition, the consideration of ecological factors of this new disease is important. The consideration of not only ecological but also humanistic background can be useful to manage the new disease, Middle East respiratory syndrome as well. Finally, how to improve medical service for underserved population is a big issue. The local health department must play an important role.
文摘As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, diabetes and diseases that may contribute to the severity and risk factor of diabetes in individuals and this impact on COVID-19 and the mortality rate. These diseases include respiratory diseases, cardiovascular diseases, and obesity. Equally significant is the statistical analysis on ethnicity, age, and sex on COVID-19 infection as well as mortality rate. Their possible contributions to increasing the severity and risk factor of diabetes as a risk to mortality to individuals who have COVID-19. Objectives: The ultimate objectives of this investigation are as follow: 1) Is there a risk factor of diabetes on COVID-19 infection and increasing mortality rate? 2) To what extent do other disease conditions that include, obesity, heart failure, and respiratory diseases influence the severity and risk factor of diabetes on increasing COVID-19 infection and mortality rate? 3) To what extent does age, race, and gender increase the mortality of COVID-19 and increase the severity and risk factor of diabetes on COVID-19 mortality rate? 4) How and why COVID-19 virus increases the risk of diabetes in children? 5) Diabetes and COVID-19: Who is most at Risk? Lastly, understanding the misconception of COVID-19 and diabetes.
文摘Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19,SARS and MERS pneumonia respectively.Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists.Vote-counting method was employed to include cases of each group.Data of patients’manifestations in early chest CT including lesion patterns,distribution of lesions and specific imaging signs for the three groups were extracted and recorded.Data were compared and analyzed using SPSS 22.0.Results A total of 24 studies were included,composing of 10 studies of COVID-19,5 studies of MERS and 9 studies of SARS.The included CT exams were 147,40,and 122 respectively.For the early CT features of the 3 pneumonias,the basic lesion pattern with respect to"mixed ground glass opacity(GGO)and consolidation,GGO mainly,or consolidation mainly"was similar among the 3 groups(χ^2=7.966,P>0.05).There were no significant differences on the lesion distribution(χ^2=13.053,P>0.05)and predominate involvement of the subpleural area of bilateral lower lobes(χ^2=4.809,P>0.05)among the 3 groups.The lesions appeared more focal in COVID-19 pneumonia at early phase(χ^2=23.509,P<0.05).The proportions of crazy-paving pattern(χ^2=23.037,P<0.001),organizing pneumonia pattern(P<0.05)and pleural effusions(P<0.001)in COVID-19 pneumonia were significantly lower than the other two.Although rarely shown in the early CT findings of all three viral pneumonias,the fibrotic changes were more frequent in SARS than COVID-19 and MERS(χ^2=6.275,P<0.05).For other imaging signs,only the MERS pneumonia demonstrated tree-in-buds,cavitation,and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia(χ^2=22.412,P<0.05).No pneumothorax,pneumomediastinum and lymphadenopathy was present for each group.Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns,including GGO and consolidation,bilateral distribution,and predominant involvement of the subpleural area and the lower lobes.Early signs of COVID-19 pneumonia showed less severity of inflammation.Early fibrotic changes appeared in SARS only.MERS had more severe inflammatory changes including cavitation and pleural effusion.The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.
基金Supported by the 345 Talent Project of Shengjing Hospital of China Medical University。
文摘At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effective antiviral treatment for this infectious disease is absent.At the beginning of the epidemic,relevant cellular and animal experiments of antiviral treatment for SARS-CoV-2 were conducted based on the prior studies of SARS-CoV and Middle East respiratory syndrome coronavirus.Some antivirals were preliminarily validated to be potentially effective in the clinical settings.But as the epidemic continued and more studies were carried out,the efficacy of these antiviral drugs became controversial.This paper reviews the pharmacology and application of interferon,lopinavir/ritonavir,ribavirin,chloroquine,arbidol,favipiravir,remdesivir,and thymosinα1 in coronavirus disease 2019.The actual effect of these drugs remains controversial.Meanwhile,the efficacy and safety of these drugs for patients with coronavirus disease 2019 still need to be explored.
文摘BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and coronavirus infections.Despite the large amount of data concerning the use of ribavirin alone or in combination for measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and coronavirus disease 2019(COVID-19)outbreaks,the conclusions of these studies have been contradictory.Underlying reasons for these discrepancies include possible study design inaccuracies and failures and misinterpretations of data,and these potential confounds should be addressed.AIM To determine the confounding factors of ribavirin treatment studies and propose a therapeutic scheme for COVID-19.METHODS PubMed database was searched over a period of five decades utilizing the terms“ribavirin”alone or combined with other compounds in measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and COVID-19 infections.The literature search was performed and described according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Articles were considered eligible when they reported on ribavirin dose regimens and/or specified outcomes concerning its efficacy and/or possible adverseeffects.In vitro and animal studies were also retrieved.A chapter on ribavirin’s pharmacology was included as well.RESULTS In addition to the difficulties and pressures of an emerging pandemic,there is the burden of designing and conducting well-organized,double-blind,randomized controlled trials.Many studies have succumbed to specific pitfalls,one of which was identified in naturally ribavirin-resistant Vero cell lines in in vitro studies.Other pitfalls include study design inconsistent with the well-established clinical course of disease;inappropriate pharmacology of applied treatments;and the misinterpretation of study results with misconceived generalizations.A comprehensive treatment for COVID-19 is proposed,documented by thorough,longterm investigation of ribavirin regimens in coronavirus infections.CONCLUSION A comprehensive treatment strictly tailored to distinct disease stages was proposed based upon studies on ribavirin and coronavirus infections.
文摘Coronaviruses are a family of viruses that can be transmitted from one person to another.Earlier strains have only been mild viruses,but the current form,known as coronavirus disease 2019(COVID-19),has become a deadly infection.The outbreak originated in Wuhan,China,and has since spread worldwide.The symptoms of COVID-19 include a dry cough,sore throat,fever,and nasal congestion.Antimicrobial drugs,pathogen–host interaction,and 2 weeks of isolation have been recommended for the treatment of the infection.Safe operating procedures,such as the use of face masks,hand sanitizer,handwashing with soap,and social distancing,are also suggested.Moreover,travel bans for cities,states,and countries have been put in place,along with lockdowns to control the outbreak.Travel restrictions,mask use,sanitizer or soap use,and avoidance of touching the face and nose have produced encouraging results,whereas the effectiveness of antibiotics has not been proved.The results of isolation for the recovery of infected people have also been promising.Travel bans and lockdowns have caused a slump in economies,and unemployment has risen sharply,resulting in an increase in mental health cases globally.To date,vaccines have been developed and are in use in certain countries,but following standard operating procedures remain critical.The countries following the guidelines can eradicate this virus.New Zealand was the rst country to eliminate the virus from their territory.
文摘SARS-CoV-2 is the causative agent of COVID-19.Since its outbreak in December 2019,COVID-19 has swept the globe.By 17 July 2020,the World Health Organization(WHO)had confirmed 13?119?239 cases and 573?752 deaths,and the numbers are still rising.Current evidence shows that COVID-19 is lower than severe acute respiratory syndrome and Middle East respiratory syndrome in terms of severity and mortality risk,although the infections are particularly more severe in patients with underlying medical conditions.The bulk of COVID-19 patients had close contact with confirmed cases,but an exact origin and specific transmission for COVID-19 are still unknown.As there is no approved antiviral treatment for COVID-19 infection,proper prevention and control practices are essential to control the infection.To have an insight view of COVID-19,we summarized and compared the etiology,clinical manifestations,diagnosis,treatment,and prevention measures of COVID-19,severe acute respiratory syndrome,and Middle East respiratory syndrome.
基金This publication was made possible by research grants from the National Ministry of Health(201306015)the Department of Health of Guangdong Province(2012-501)。
文摘The Middle East respiratory syndrome(MERS)outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented.Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative.Infection control in healthcare settings,in which patients with emerging infectious diseases such as MERS,Ebola virus disease,and the severe acute respiratory syndrome(SARS)are diagnosed and treated,are often imperfect.When it comes to emerging or unknown infectious diseases,before the imported case was finally identified or community transmission was reported,cases have often occurred in clusters in healthcare settings.Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.
基金This work was supported by the Department of Biotechnology(DBT),New Delhi,India,under Project Grant No.BT/PR/15650/AAQ/3/815/2016.
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)belongs to the family coronaviridae.It is spherical and possesses proteins called spikes,which can clamp onto the human cells.Once in close interaction with the human cells,these viruses undergo structural change and can fuse with the cell membrane.The virus enters the host and starts the process of translation and transcription in the cells and uncoated genome,respectively.Due to the rapid transmittable nature of the virus,extant actions should be taken.The fatty acids administrated orally,or intravenously,could help us gear things up in providing resistance and preventing infection.Hence,the multiplication of the virus could be hindered by arachidonic acid,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA).In that context,the current review highlights the role of these unsaturated fatty acids and their derivatives such as lipoxins and resolvins in the inactivation of the enveloped coro-navirus disease 2019(COVID-19).
基金Supported by the National Natural Science Foundation of China(31570203)。
文摘The novel coronavirus disease 2019(COVID-19)in human caused by novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is currently rampant across the world,causing an international concern for public health emergency.At the time of July,2020,about 8380000 confirmed cases and more than 450000 deaths have been reported worldwide.This is the third outbreak of severe coronavirus family after the Middle East respiratory syndrome(MERS)and severe acute respiratory syndrome(SARS).Young victims(<12 years)in clinical course and prognosis of pediatric COVID-19 appear symptomatically milder than do teenage and adult patients,and many children with asymptomatic infections or showing only mild symptoms may be transmitter as well.Thus,the children with COVID-19 infection deserve more attention.This review is cautiously designed to report the clinical characteristics and symptoms of three kinds of coronaviruses(SARS-CoV,MERS-CoV,and SARS-CoV-2)in children and to summarize some recommended tactics to reduce COVID-19 transmission and/or to attain improved prevention in children.
基金This study was supported by the strategic priority research program of the Chinese academy of sciences(XDB29010101).
文摘Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for a user-friendly system for rapid drug screening.In this study,we constructed a MERS-CoV replicon containing the Renilla luciferase(Rluc)reporter gene and a stable luciferase replicon-carrying cell line.Using this cell line,we showed that MERS-CoV replication was inhibited by combined application of lopinavir and ritonavir,indicating that this cell line can be used to screen inhibitors of MERS-CoV replication.Importantly,the MERS-replicon cell line can be used for high-throughput screening of antiviral drugs without the need for live virus handling,providing an effective and safe tool for the discovery of antiviral drugs against MERS-CoV.
