The ongoing Coronavirus disease 19 pandemic has likely changed the world in ways not seen in the past.Neutralizing antibody(NAb)assays play an important role in the management of the severe acute respiratory syndrome ...The ongoing Coronavirus disease 19 pandemic has likely changed the world in ways not seen in the past.Neutralizing antibody(NAb)assays play an important role in the management of the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)outbreak.Using these tools,we can assess the presence and duration of antibody-mediated protection in naturally infected individuals,screen convalescent plasma preparations for donation,test the efficacy of immunotherapy,and analyze NAb titers and persistence after vaccination to predict vaccine-induced protective effects.This review briefly summarizes the various methods used for the detection of SARS-CoV-2 NAbs and compares their advantages and disadvantages to facilitate their development and clinical application.展开更多
Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-p...Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.展开更多
Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019(COVID-19).Here we propose two new perspectives through which cardiorespiratory fitness may prote...Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019(COVID-19).Here we propose two new perspectives through which cardiorespiratory fitness may protect against severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).Physical exercise-activated adenosine monophosphate(AMP)-activated protein kinase(AMPK)signaling induces endothelial nitric oxide(NO)synthase(eNOS),increases NO bio-availability,and inhibits palmitoylation,leading to specific and immediate SARS-CoV-2 protection.AMPK signaling also induces angiotensin 1-7 release and enhances eNOS activation thus further mediating cardio-and renoprotection.Irisin,a myokine released from skeletal muscles during aerobic exercise,also participates in the AMPK/Akt-eNOS/NO pathway,protects mitochondrial functions in endothelial cells,and antagonizes renin angiotensin system proinflammatory action leading to reductions in genes associated with severe COVID-19 outcomes.Collectively,all the above findings point to the fact that increased AMPK and irisin activity through exercise training greatly benefits molecular processes that mediate specific,immediate,and delayed SARS-CoV-2 protection.Maintaining regular physical activity levels is a safe and affordable lifestyle strategy against the current and future pandemics and may also mitigate against obesity and cardiometabolic disease syndemics.Move more because a moving target is harder to kill.展开更多
Coronavirus belonging to family Coronaviridae is a large group of viruses causing respiratory and gastrointestinal diseases.The outbreak of 2019-novel coronavirus has created panic in the whole world after being trans...Coronavirus belonging to family Coronaviridae is a large group of viruses causing respiratory and gastrointestinal diseases.The outbreak of 2019-novel coronavirus has created panic in the whole world after being transmitted from Wuhan,China in December 2019.A large number of people are affected throughout the world that forced a solitary situation in the affected areas confining common people to their homes to prevent its spread.Cellular receptors in humans for 2019-novel coronavirus are found to be same as for severe acute respiratory syndrome coronavirus,the first human pandemic of 21st century,however,2019-novel coronavirus is highly contagious,virulent and mutable than the severe acute respiratory syndrome coronavirus.The most attractive site for vaccine development against 2019-novel coronavirus is the spike glycoprotein which is crucial for receptor binding,membrane fusion via conformational changes,virus internalization,and host tissue tropism or spike inactivation through antibody induced destabilization.First outbreak was in December 2019,later on at the end of 2020,the mortality ratio decreased that created a sigh of temporary relief in the globe.Summer season was considered as one of the sources combating infection and preventing spread of virus.However,for the last few months,suddenly a huge outrage of new variants of coronavirus disease 2019 are capturing attention of the entire population of earth endangering lives of people irrespective of their ages and communities.Researchers must focus on the inventions and discoveries of either preventive or therapeutic medicines that precisely target the spike proteins that enable the severe acute respiratory syndrome coronavirus-2’s entry into a host cell.In this article,we have highlighted various vaccines being approved for emergency use by Federal Investigating Agency to combat the disastrous effects of pandemic on humanity.Mutated variants have created an alarming situation for the health care workers,researchers and scientists to consider the possible mutants and their threat to humanity in the coming years.Further,we have tried to create awareness for developing a global internet community to promote a barrier-free connectivity among all corners of the world to facilitate humanity in case of a category 5 coronavirus disease-hurricane,a term used by researchers for future threats of pandemic.展开更多
目的评估指南推荐疗法治疗严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和其他β冠状病毒相关呼吸道疾病的安全性。方法系统检索PubMed、Embase、Web of Science、Cochrane library、SinoMed、中国知网、万方数据库2003—2020年6月公开发...目的评估指南推荐疗法治疗严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和其他β冠状病毒相关呼吸道疾病的安全性。方法系统检索PubMed、Embase、Web of Science、Cochrane library、SinoMed、中国知网、万方数据库2003—2020年6月公开发表的关于β-冠状病毒治疗措施的随机对照试验(RCT)、类试验和队列研究。双人独立筛选文献、提取资料,并对符合入选标准的文献采用Cochrane偏倚评价工具进行质量评价后,使用Stata 14.0版软件进行Meta分析。结果最终纳入59项研究,共计9598例。其中49项研究关于SARS-CoV-2,包括27项RCT,19项队列和3项类试验,9项研究关于SARS-CoV,1项队列关于中东呼吸综合征冠状病毒(MERS-CoV)。所有研究中显著性结果如下:在SARS-CoV-2患者中,两项关于洛匹那韦/利托那韦的队列和一项关于大剂量羟氯喹或氯喹的RCT比标准治疗有更多的整体不良反应事件发生[RR=2.68,95%CI(1.48,4.85),I^(2)=34.3%,采用建议分级评估、开发和评价准则(GRADE)评级为:低;RR=3.43,95%CI(1.55,7.58),GRADE评级:中]。而在一项RCT和一项非随机对照试验中,应用洛匹那韦/利托那韦和皮质类固醇激素相比标准治疗发生急性呼吸窘迫综合征的发生率更低[RR=0.46,95%CI(0.25,0.86),GRADE评级:低;RR=0.65,95%CI(0.44,0.98),GRADE评级:极低]。两项应用瑞德昔韦治疗10 d的RCT[RR=0.94,95%CI(0.80,1.11),I^(2)=28.8%,GRADE评级:中]和11项应用中药治疗的RCT[RR=0.77,95%CI(0.53,1.10),I^(2)=0.0%,GRADE评级:低]的安全性与标准治疗相比差异无统计学意义。在SARS-CoV患者中,6项应用中药治疗的RCT相比标准治疗的总体不良反应发生率更低[RR=0.38,95%CI(0.21,0.71),I^(2)=0.0%,GRADE评级:低]。结论洛匹那韦/利托那韦和大剂量羟基氯喹或氯喹治疗SARS-CoV-2的总体不良反应发生率更高,而瑞德西韦和中药相对安全。展开更多
BACKGROUND The global outbreak of coronavirus disease 2019(COVID-19)leads to the development of accessible and cost-effective rapid antigen-detection tests(RATs),as quick and accurate diagnosis is crucial to curb the ...BACKGROUND The global outbreak of coronavirus disease 2019(COVID-19)leads to the development of accessible and cost-effective rapid antigen-detection tests(RATs),as quick and accurate diagnosis is crucial to curb the pandemic.AIM To evaluate the Humasis COVID-19 Ag Test(Humasis Co.,Ltd.,Gyeonggi-do,Republic of Korea)in the diagnosis of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).METHODS This retrospective study was carried out at the Croatian Institute of Public Health and included patients with clinical symptoms of COVID-19 lasting no longer than 5 d prior to testing,whose nasopharyngeal swabs were primarily tested with RAT.Negative RAT samples underwent confirmatory real-time reverse transcription-polymerase chain reaction(RT-PCR).Diagnostic efficacy was determined compared to RT-PCR.The patients were divided into three age groups(<18,19-65,>65 years).Statistical analysis was performed with the significance level set at P<0.05.RESULTSIn total,2490 symptomatic patients were tested;953 samples were positive on RAT,and 1537 werenegative.All negative RAT samples were subjected to RT-PCR;266 samples were positive andmarked as false-negative results on RAT.The calculated negative predictive value as a measure ofRAT efficacy was 82.69%.The χ^(2) test and Kruskal-Wallis test showed a significant difference in theproportion of false negatives(P<0.001)and RT-PCR cycle(Ct)values for false-negative RATs(P=0.012)among the age groups.The young age group was significantly less likely to be falsenegative,whereas the false negatives from the elderly group experienced significantly lower Ctvalues than the other two age groups.CONCLUSIONEvaluated RAT demonstrated satisfactory performance with more reliable results in youngerpatients.Humasis COVID-19 Ag RAT is potentially a valuable tool in areas where access tomolecular methods is limited;however,RT-PCR remains a gold standard for SARS-CoV-2detection.展开更多
The current epidemic situation of the COVID-19 is still serious.As a designated unit for the diagnosis of COVID-19 in Hainan Province,We,The Second Affiliated Hospital of Hainan Medical University,established a multid...The current epidemic situation of the COVID-19 is still serious.As a designated unit for the diagnosis of COVID-19 in Hainan Province,We,The Second Affiliated Hospital of Hainan Medical University,established a multidisciplinary integrated individualized treatment team.We emphasized early improvement of relevant examinations,early antiviral treatment,dynamic monitoring of inflammatory markers and imaging changes.In addition,nutritional support,psychological intervention,and Chinese medicine treatment also play an important role.We summarized the experience in the diagnosis and treatment process for the reference of clinicians.展开更多
Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2 has become a worldwide public health crisis.Studies have demonstrated that diabetes and dyslipidaemia are common comorbiditie...Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2 has become a worldwide public health crisis.Studies have demonstrated that diabetes and dyslipidaemia are common comorbidities and could be high-risk factors for severe COVID-19.Vitamin D,a group of fatsoluble compounds responsible for intestinal absorption of calcium,magnesium,and phosphate,has been widely used as a dietary supplement for the prevention and treatment of numerous diseases,including infectious and non-infectious diseases,due to its high cost-effectiveness;safety;tolerability;and anti-thrombotic,anti-inflammatory,antiviral,and immunomodulatory properties.In this letter to the editor,we mainly discuss the potential role of vitamin D in patients with diabetes,dyslipidaemia,and COVID-19.展开更多
Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementat...Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementation,isolated case reports about myocarditis as a potential adverse reaction started coming.As of November 12,2021,Centers for Disease Control and Prevention(CDC)has reported 1793 cases of myocarditis or pericarditis among young people with age 12-29 years,most cases have been reported in the male adolescent age group after the second dose of mRNA COVID-19 vaccines.It is very important to monitor the safety standards and adverse reactions of vaccines to effectively implement the vaccination policies.The CDC and the United States Food and Drug Administration actively monitor vaccine-associated adverse reactions a well-known platform such as Vaccine Adverse Event Reporting System.CDC continues to recommend COVID-19 vaccines and booster doses for eligible individuals(age limit according to the type of vaccine)after careful consideration from risk-benefit assessment and favorable outcomes from vaccination.Mechanisms behind COVID-19 vaccine-induced myocarditis are not clear yet but several possibilities such as molecular mimicry between the spike protein of SARS-CoV-2 and self-antigens,immune response to mRNA,and activation of host immunological system,trigger of the pre-existing dysregulated immunological system have been documented in the literature.Overall,data suggests a good prognosis,especially in young patients.In this review article,we cover currently available data on COVID-19 vaccine-related myocarditis incidence,concerns,possible mechanisms of myocarditis,current treatment,and outcome trends,risk vs benefit assessment of COVID-19 vaccination in this current pandemic.展开更多
<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home...<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home orders could be a main factor affecting the time individuals spent outdoors, the progression of COVID-19 in countries that mandated the most stringent lock-downs and stay-at-home orders was compared to countries in the same hemisphere that did not order their citizens to remain at home. <u>Methods</u>: Infections attributed to COVID-19 per million inhabitants, deaths per infections × 100, and deaths per million inhabitants from different countries were analyzed utilizing national reports registered in the Johns’ Hopkins database together with the most recent world population data. The null hypothesis (no difference between countries with and without lock-downs) was tested (two tailed test, p < 0.01) for each paired set of data according to well established statistical analysis. <u>Results</u>: The shift of highest infection rates from countries in the northern-towards countries in the southern-hemisphere during early 2020 and the reverse in December of the same year correlates with the seasonal variation in the flux of germicidal sunlight. Mortality rate for the same virus among different countries did not show a seasonal component. COVID-19 infection mortality rate was considerably lower in developing countries of South America (11 of the largest countries) than in several (at least 8) developed European countries. <u>Discussion</u>: COVID-19 resulted in higher infections during winter than in summer. The finding of a seasonal component, correlating the progression of the pandemic with local solar flux, demonstrates that infectious virus in the environment plays a role in the pandemic since direct person-to-person transmission would afford little time for solar inactivation. Similar epidemiological data amongst “locked” and “unlocked” countries demonstrates that lock-downs and similar confining measures had no effect on the chances of healthy individuals becoming infected with SARS-CoV-2 or dying of COVID-19.展开更多
Background and Aims:Coronavirus disease 2019(COVID-19)is a new respiratory infectious disease caused by severe acute respiratory syndrome coronavirus-2(commonly known as SARS-CoV-2)with multiple organ injuries.The aim...Background and Aims:Coronavirus disease 2019(COVID-19)is a new respiratory infectious disease caused by severe acute respiratory syndrome coronavirus-2(commonly known as SARS-CoV-2)with multiple organ injuries.The aim of this study was to analyze COVID-19-associated liver dysfunction(LD),its association with the risk of death and prognosis after discharge.Methods:Three-hundred and fifty-five COVID-19 patients were recruited.Clinical data were collected from electronic medical records.LD was evaluated and its prognosis was tracked.The association between LD and the risk of death was analyzed.Results:Of the 355 COVID-19 patients,211 had mild disease,88 had severe disease,and 51 had critically ill disease.On admission,223(62.8%)patients presented with hypoproteinemia,151(42.5%)with cholestasis,and 101(28.5%)with hepatocellular injury.As expected,LD was more common in critically ill patients.By multivariate logistic regression,male sex,older age and lymphopenia were three important independent risk factors predicting LD among COVID-19 patients.Risk of death analysis showed that the fatality rate was higher in patients with hypoproteinemia than in those without hypoproteinemia(relative risk=9.471,p<0.01).Moreover,the fatality rate was higher in patients with cholestasis than those without cholestasis(relative risk=2.182,p<0.05).Follow-up observation found that more than one hepatic functional index of two-third patients remained abnormal at 14 days after discharge.Conclusions:LD at early disease stage elevates the risk of death of COVID-19 patients.COVID-19-associated LD does not recover completely by 14 days after discharge.展开更多
Antiviral therapy with antiviral agents is a very important component of treatment for the 2019 novel coronavirus disease(COVID-19)caused by the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).It is import...Antiviral therapy with antiviral agents is a very important component of treatment for the 2019 novel coronavirus disease(COVID-19)caused by the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).It is important to clarify how to evaluate efficacy and safety of antiviral agents in treatment of COVID-19 during the pandemic of this disease.We need to answer the following questions:do we still need to use rigorously designed randomized controlled clinical trials(RCTs)?Or,will it be enough if we use loosened criteria,observational studies or even retrospective case series and case reports?The answer is"No,we still need to use the strictly designed preferably blinded multicenter RCTs to evaluate the antiviral agents."In this article,we reviewed almost all the RCT reports on monotherapies and combined therapies with antiviral agents for COVID-19,and found that among the reports on monotherapies,only remdesivir,and among combined antiviral agents,only the combined regimen with interferon-β1b,lopinavir-ritonavir and ribavirin were effective and safe based on evidences from RCTs.The results of five RCTs for chloroquine or hydroxychloroquine consistently showed that they were ineffective and unsafe in the treatment of COVID-19,especially at larger doses.Many aspects in the design of the clinical trials may be related to success or failure of a trial and the relevant factors need to be analyzed,discussed and emphasized from the specific requirements and considerations of antiviral therapies.We hope such discussions be of certain use in designing clinical trials for pediatric antiviral therapies.展开更多
The SARS-CoV-2 virus causes the disease COVID-19,and has caused high morbidity and mortality worldwide.Empirical models are useful tools to predict future trends of disease progression such as COVID-19 over the near-t...The SARS-CoV-2 virus causes the disease COVID-19,and has caused high morbidity and mortality worldwide.Empirical models are useful tools to predict future trends of disease progression such as COVID-19 over the near-term.A modified Incidence Decay and Exponential Adjustment(m-IDEA)model was developed to predict the progression of infectious disease outbreaks.The modification allows for the production of precise daily estimates,which are critical during a pandemic of this scale for planning purposes.The m-IDEA model was employed using a range of serial intervals given the lack of knowledge on the true serial interval of COVID-19.Both deterministic and stochastic approaches were applied.Model fitting was accomplished through minimizing the sum-of-square differences between predicted and observed daily incidence case counts,and performance was retrospectively assessed.The performance of the m-IDEA for projection cases in the nearterm was improved using shorter serial intervals(1e4 days)at early stages of the pandemic,and longer serial intervals at mid-to late-stages(5e9 days)thus far.This,coupled with epidemiological reports,suggests that the serial interval of COVID-19 might increase as the pandemic progresses,which is rather intuitive:Increasing serial intervals can be attributed to gradual increases in public health interventions such as facility closures,public caution and social distancing,thus increasing the time between transmission events.In most cases,the stochastic approach captured the majority of future reported incidence data,because it accounts for the uncertainty around the serial interval of COVID-19.As such,it is the preferred approach for using the m-IDEA during dynamic situation such as in the midst of a major pandemic.展开更多
基金supported by grants from the Applied Basic Research Key Project of Wuhan Municipal Bureau of Science and Technology(2020020601012218)the Fundamental Research Funds for the Central Universities(HUST COVID-19 Rapid Response Call No.2020kfyXGYJ040).
文摘The ongoing Coronavirus disease 19 pandemic has likely changed the world in ways not seen in the past.Neutralizing antibody(NAb)assays play an important role in the management of the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)outbreak.Using these tools,we can assess the presence and duration of antibody-mediated protection in naturally infected individuals,screen convalescent plasma preparations for donation,test the efficacy of immunotherapy,and analyze NAb titers and persistence after vaccination to predict vaccine-induced protective effects.This review briefly summarizes the various methods used for the detection of SARS-CoV-2 NAbs and compares their advantages and disadvantages to facilitate their development and clinical application.
文摘Due to the disease's broad clinical spectrum,it is currently unclear how to predict the future prognosis of patients at the time of diagnosis of coronavirus disease 2019(COVID-19).Real-time reverse transcription-polymerase chain reaction(RTPCR)is the gold standard molecular technique for diagnosing COVID-19.The number of amplification cycles necessary for the target genes to surpass a threshold level is represented by the RT-PCR cycle threshold(Ct)values.Ct values were thought to be an adequate proxy for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral load.A body of evidence suggests that SARS-CoV-2 viral load is a possible predictor of COVID-19 severity.The link between SARS-CoV-2 viral load and the likelihood of severe disease development in COVID-19 patients is not clearly elucidated.In this review,we describe the scientific data as well as the important findings from many clinical studies globally,emphasizing how viral load may be related to disease severity in COVID-19 patients.Most of the evidence points to the association of SARS-CoV-2 viral load and disease severity in these patients,and early anti-viral treatment will reduce the severe clinical outcomes.
文摘Several mechanisms may explain how exercise training mechanistically confers protection against coronavirus disease 2019(COVID-19).Here we propose two new perspectives through which cardiorespiratory fitness may protect against severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).Physical exercise-activated adenosine monophosphate(AMP)-activated protein kinase(AMPK)signaling induces endothelial nitric oxide(NO)synthase(eNOS),increases NO bio-availability,and inhibits palmitoylation,leading to specific and immediate SARS-CoV-2 protection.AMPK signaling also induces angiotensin 1-7 release and enhances eNOS activation thus further mediating cardio-and renoprotection.Irisin,a myokine released from skeletal muscles during aerobic exercise,also participates in the AMPK/Akt-eNOS/NO pathway,protects mitochondrial functions in endothelial cells,and antagonizes renin angiotensin system proinflammatory action leading to reductions in genes associated with severe COVID-19 outcomes.Collectively,all the above findings point to the fact that increased AMPK and irisin activity through exercise training greatly benefits molecular processes that mediate specific,immediate,and delayed SARS-CoV-2 protection.Maintaining regular physical activity levels is a safe and affordable lifestyle strategy against the current and future pandemics and may also mitigate against obesity and cardiometabolic disease syndemics.Move more because a moving target is harder to kill.
文摘Coronavirus belonging to family Coronaviridae is a large group of viruses causing respiratory and gastrointestinal diseases.The outbreak of 2019-novel coronavirus has created panic in the whole world after being transmitted from Wuhan,China in December 2019.A large number of people are affected throughout the world that forced a solitary situation in the affected areas confining common people to their homes to prevent its spread.Cellular receptors in humans for 2019-novel coronavirus are found to be same as for severe acute respiratory syndrome coronavirus,the first human pandemic of 21st century,however,2019-novel coronavirus is highly contagious,virulent and mutable than the severe acute respiratory syndrome coronavirus.The most attractive site for vaccine development against 2019-novel coronavirus is the spike glycoprotein which is crucial for receptor binding,membrane fusion via conformational changes,virus internalization,and host tissue tropism or spike inactivation through antibody induced destabilization.First outbreak was in December 2019,later on at the end of 2020,the mortality ratio decreased that created a sigh of temporary relief in the globe.Summer season was considered as one of the sources combating infection and preventing spread of virus.However,for the last few months,suddenly a huge outrage of new variants of coronavirus disease 2019 are capturing attention of the entire population of earth endangering lives of people irrespective of their ages and communities.Researchers must focus on the inventions and discoveries of either preventive or therapeutic medicines that precisely target the spike proteins that enable the severe acute respiratory syndrome coronavirus-2’s entry into a host cell.In this article,we have highlighted various vaccines being approved for emergency use by Federal Investigating Agency to combat the disastrous effects of pandemic on humanity.Mutated variants have created an alarming situation for the health care workers,researchers and scientists to consider the possible mutants and their threat to humanity in the coming years.Further,we have tried to create awareness for developing a global internet community to promote a barrier-free connectivity among all corners of the world to facilitate humanity in case of a category 5 coronavirus disease-hurricane,a term used by researchers for future threats of pandemic.
文摘BACKGROUND The global outbreak of coronavirus disease 2019(COVID-19)leads to the development of accessible and cost-effective rapid antigen-detection tests(RATs),as quick and accurate diagnosis is crucial to curb the pandemic.AIM To evaluate the Humasis COVID-19 Ag Test(Humasis Co.,Ltd.,Gyeonggi-do,Republic of Korea)in the diagnosis of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).METHODS This retrospective study was carried out at the Croatian Institute of Public Health and included patients with clinical symptoms of COVID-19 lasting no longer than 5 d prior to testing,whose nasopharyngeal swabs were primarily tested with RAT.Negative RAT samples underwent confirmatory real-time reverse transcription-polymerase chain reaction(RT-PCR).Diagnostic efficacy was determined compared to RT-PCR.The patients were divided into three age groups(<18,19-65,>65 years).Statistical analysis was performed with the significance level set at P<0.05.RESULTSIn total,2490 symptomatic patients were tested;953 samples were positive on RAT,and 1537 werenegative.All negative RAT samples were subjected to RT-PCR;266 samples were positive andmarked as false-negative results on RAT.The calculated negative predictive value as a measure ofRAT efficacy was 82.69%.The χ^(2) test and Kruskal-Wallis test showed a significant difference in theproportion of false negatives(P<0.001)and RT-PCR cycle(Ct)values for false-negative RATs(P=0.012)among the age groups.The young age group was significantly less likely to be falsenegative,whereas the false negatives from the elderly group experienced significantly lower Ctvalues than the other two age groups.CONCLUSIONEvaluated RAT demonstrated satisfactory performance with more reliable results in youngerpatients.Humasis COVID-19 Ag RAT is potentially a valuable tool in areas where access tomolecular methods is limited;however,RT-PCR remains a gold standard for SARS-CoV-2detection.
基金Hainan Provincial Natural Science Foundation of China(NO.819QN360)Special Program for Novel Coronavirus(2019-nCoV)of Hainan Medical University(No.XGZX2020004)
文摘The current epidemic situation of the COVID-19 is still serious.As a designated unit for the diagnosis of COVID-19 in Hainan Province,We,The Second Affiliated Hospital of Hainan Medical University,established a multidisciplinary integrated individualized treatment team.We emphasized early improvement of relevant examinations,early antiviral treatment,dynamic monitoring of inflammatory markers and imaging changes.In addition,nutritional support,psychological intervention,and Chinese medicine treatment also play an important role.We summarized the experience in the diagnosis and treatment process for the reference of clinicians.
文摘Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2 has become a worldwide public health crisis.Studies have demonstrated that diabetes and dyslipidaemia are common comorbidities and could be high-risk factors for severe COVID-19.Vitamin D,a group of fatsoluble compounds responsible for intestinal absorption of calcium,magnesium,and phosphate,has been widely used as a dietary supplement for the prevention and treatment of numerous diseases,including infectious and non-infectious diseases,due to its high cost-effectiveness;safety;tolerability;and anti-thrombotic,anti-inflammatory,antiviral,and immunomodulatory properties.In this letter to the editor,we mainly discuss the potential role of vitamin D in patients with diabetes,dyslipidaemia,and COVID-19.
文摘Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementation,isolated case reports about myocarditis as a potential adverse reaction started coming.As of November 12,2021,Centers for Disease Control and Prevention(CDC)has reported 1793 cases of myocarditis or pericarditis among young people with age 12-29 years,most cases have been reported in the male adolescent age group after the second dose of mRNA COVID-19 vaccines.It is very important to monitor the safety standards and adverse reactions of vaccines to effectively implement the vaccination policies.The CDC and the United States Food and Drug Administration actively monitor vaccine-associated adverse reactions a well-known platform such as Vaccine Adverse Event Reporting System.CDC continues to recommend COVID-19 vaccines and booster doses for eligible individuals(age limit according to the type of vaccine)after careful consideration from risk-benefit assessment and favorable outcomes from vaccination.Mechanisms behind COVID-19 vaccine-induced myocarditis are not clear yet but several possibilities such as molecular mimicry between the spike protein of SARS-CoV-2 and self-antigens,immune response to mRNA,and activation of host immunological system,trigger of the pre-existing dysregulated immunological system have been documented in the literature.Overall,data suggests a good prognosis,especially in young patients.In this review article,we cover currently available data on COVID-19 vaccine-related myocarditis incidence,concerns,possible mechanisms of myocarditis,current treatment,and outcome trends,risk vs benefit assessment of COVID-19 vaccination in this current pandemic.
文摘<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home orders could be a main factor affecting the time individuals spent outdoors, the progression of COVID-19 in countries that mandated the most stringent lock-downs and stay-at-home orders was compared to countries in the same hemisphere that did not order their citizens to remain at home. <u>Methods</u>: Infections attributed to COVID-19 per million inhabitants, deaths per infections × 100, and deaths per million inhabitants from different countries were analyzed utilizing national reports registered in the Johns’ Hopkins database together with the most recent world population data. The null hypothesis (no difference between countries with and without lock-downs) was tested (two tailed test, p < 0.01) for each paired set of data according to well established statistical analysis. <u>Results</u>: The shift of highest infection rates from countries in the northern-towards countries in the southern-hemisphere during early 2020 and the reverse in December of the same year correlates with the seasonal variation in the flux of germicidal sunlight. Mortality rate for the same virus among different countries did not show a seasonal component. COVID-19 infection mortality rate was considerably lower in developing countries of South America (11 of the largest countries) than in several (at least 8) developed European countries. <u>Discussion</u>: COVID-19 resulted in higher infections during winter than in summer. The finding of a seasonal component, correlating the progression of the pandemic with local solar flux, demonstrates that infectious virus in the environment plays a role in the pandemic since direct person-to-person transmission would afford little time for solar inactivation. Similar epidemiological data amongst “locked” and “unlocked” countries demonstrates that lock-downs and similar confining measures had no effect on the chances of healthy individuals becoming infected with SARS-CoV-2 or dying of COVID-19.
基金upported by the National Natural Science Foundation of China(Grant Number:81630084)the National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University(Grant Number:2019GQFY06).
文摘Background and Aims:Coronavirus disease 2019(COVID-19)is a new respiratory infectious disease caused by severe acute respiratory syndrome coronavirus-2(commonly known as SARS-CoV-2)with multiple organ injuries.The aim of this study was to analyze COVID-19-associated liver dysfunction(LD),its association with the risk of death and prognosis after discharge.Methods:Three-hundred and fifty-five COVID-19 patients were recruited.Clinical data were collected from electronic medical records.LD was evaluated and its prognosis was tracked.The association between LD and the risk of death was analyzed.Results:Of the 355 COVID-19 patients,211 had mild disease,88 had severe disease,and 51 had critically ill disease.On admission,223(62.8%)patients presented with hypoproteinemia,151(42.5%)with cholestasis,and 101(28.5%)with hepatocellular injury.As expected,LD was more common in critically ill patients.By multivariate logistic regression,male sex,older age and lymphopenia were three important independent risk factors predicting LD among COVID-19 patients.Risk of death analysis showed that the fatality rate was higher in patients with hypoproteinemia than in those without hypoproteinemia(relative risk=9.471,p<0.01).Moreover,the fatality rate was higher in patients with cholestasis than those without cholestasis(relative risk=2.182,p<0.05).Follow-up observation found that more than one hepatic functional index of two-third patients remained abnormal at 14 days after discharge.Conclusions:LD at early disease stage elevates the risk of death of COVID-19 patients.COVID-19-associated LD does not recover completely by 14 days after discharge.
文摘Antiviral therapy with antiviral agents is a very important component of treatment for the 2019 novel coronavirus disease(COVID-19)caused by the severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).It is important to clarify how to evaluate efficacy and safety of antiviral agents in treatment of COVID-19 during the pandemic of this disease.We need to answer the following questions:do we still need to use rigorously designed randomized controlled clinical trials(RCTs)?Or,will it be enough if we use loosened criteria,observational studies or even retrospective case series and case reports?The answer is"No,we still need to use the strictly designed preferably blinded multicenter RCTs to evaluate the antiviral agents."In this article,we reviewed almost all the RCT reports on monotherapies and combined therapies with antiviral agents for COVID-19,and found that among the reports on monotherapies,only remdesivir,and among combined antiviral agents,only the combined regimen with interferon-β1b,lopinavir-ritonavir and ribavirin were effective and safe based on evidences from RCTs.The results of five RCTs for chloroquine or hydroxychloroquine consistently showed that they were ineffective and unsafe in the treatment of COVID-19,especially at larger doses.Many aspects in the design of the clinical trials may be related to success or failure of a trial and the relevant factors need to be analyzed,discussed and emphasized from the specific requirements and considerations of antiviral therapies.We hope such discussions be of certain use in designing clinical trials for pediatric antiviral therapies.
基金I would like to thank the Knowledge Synthesis team members within the Public Health Risk Sciences Division of Public Health Agency of Canada.Their daily literature scans and summarization of Sars-CoV-2 publications contributed to the quick preparation of the work presented here.Thanks to Charly Phillips(Public Health Risk Sciences Division of Public Health Agency of Canada)for her assistance summarizing serial interval values from the literature.
文摘The SARS-CoV-2 virus causes the disease COVID-19,and has caused high morbidity and mortality worldwide.Empirical models are useful tools to predict future trends of disease progression such as COVID-19 over the near-term.A modified Incidence Decay and Exponential Adjustment(m-IDEA)model was developed to predict the progression of infectious disease outbreaks.The modification allows for the production of precise daily estimates,which are critical during a pandemic of this scale for planning purposes.The m-IDEA model was employed using a range of serial intervals given the lack of knowledge on the true serial interval of COVID-19.Both deterministic and stochastic approaches were applied.Model fitting was accomplished through minimizing the sum-of-square differences between predicted and observed daily incidence case counts,and performance was retrospectively assessed.The performance of the m-IDEA for projection cases in the nearterm was improved using shorter serial intervals(1e4 days)at early stages of the pandemic,and longer serial intervals at mid-to late-stages(5e9 days)thus far.This,coupled with epidemiological reports,suggests that the serial interval of COVID-19 might increase as the pandemic progresses,which is rather intuitive:Increasing serial intervals can be attributed to gradual increases in public health interventions such as facility closures,public caution and social distancing,thus increasing the time between transmission events.In most cases,the stochastic approach captured the majority of future reported incidence data,because it accounts for the uncertainty around the serial interval of COVID-19.As such,it is the preferred approach for using the m-IDEA during dynamic situation such as in the midst of a major pandemic.
