The impact of COVID-19 on a Southern Chinese cohort with neuromyelitis optica spectrum disorders.

BACKGROUND: There are few studies on risk factors for coronavirus disease 2019 (COVID-19) infection in patients with Neuromyelitis Optica Spectrum Disorders (NMOSD). The relationship between NMOSD relapse and COVID-19 needs to be evaluated. The objective of our study is to identify the risk factors of COVID-19 infection and NMOSD relapse among NMOSD patients with COVID-19. METHOD: A total of 379 NMOSD patients registered in a NMOSD database were included in this case-control study after the end of the COVID-19 quarantine and restriction policies on December 6, 2022 in China. Data were obtained from the database. Additional information was obtained by questionnaires and the Neurology out-patient clinic. The clinical characteristics of NMOSD patients with COVID-19 were described. Risk factors associated with COVID-19 infection and outcome among patients with NMOSD were analyzed. Risk factors associated with relapse in NMOSD patients with COVID-19 were also identified. RESULTS: 239 (63.1%) NMOSD patients were infected with COVID-19. Patients with NMOSD who were infected with COVID-19, in comparison to those without COVID-19, were younger at the time of interview (median [IQR] age: 43.00 [32.00-55.00] vs 49.50 [35.25-56.00] years, P = 0.029), younger at NMOSD onset (median [IQR] age: 38.00 [27.00-51.00] vs 45.00 [32.00-52.75] years, P = 0.013), had abnormal visual evoked potentials before infection (73.4% vs 54.3% P = 0.029), had lower baseline Activities of Daily Living Scale (ADL) scores (median [IQR] ADL: 14.00 [14.00-16.00] vs 14.00 [14.00-19.00], P = 0.014) or lower baseline modified Rankin Scale (mRS) scores (1.12±0.749 vs 1.33±0.991, P = 0.037), and were less frequently treated with more than 10 mg prednisone or 8 mg methylprednisolone (25.0% vs 36.0%,p = 0.026). All 9 NMOSD patients who had symptomatic cerebral syndrome developed moderate/severe COVID-19. A higher percentage of patients with moderate/severe COVID-19 experienced more than one core clinical NMOSD symptoms (61.5% vs 55.1%, p = 0.044), compared to patients with mild COVID-19. Higher risk of NMOSD relapse among NMOSD patients with COVID-19 was associated with higher Expanded Disability Status Scale (EDSS) scores (median[IQR] EDSS: 2.00 [1.00-3.00] vs 1.50 [1.00-2.25], P = 0.037) and drug treatments disruption (21.6% vs 5.0% P<0.001). CONCLUSIONS: NMOSD patients with younger age, lower baseline ADL or mRS had higher incidence of being diagnosed with COVID-19 during pandemic. Glucocorticoid use may decrease the risk of COVID-19. NMOSD patients with symptomatic cerebral syndrome before the COVID-19 pandemic are associated with worse COVID-19 outcomes. Drug treatment disruption may result in relapse among NMOSD patients with COVID-19.

Clinical Characteristics of Myasthenia Gravis Patients with COVID-19 in Guangxi, China: A Case-Control Study.

Purpose: With the adjustment of prevention strategies in December 2022, coronavirus disease 2019 (COVID-19) became widely prevalent in China. This study is aimed to describe the clinical characteristics of myasthenia gravis (MG) patients with COVID-19 and identify risk factors of exacerbation in MG patients with COVID-19 in Guangxi. Patients and Methods: A total of 489 MG patients and 587 control subjects in Guangxi during the COVID-19 pandemic were enrolled in this case-control study. After contacting the participants, the clinical data of MG patients and the control group were analyzed. The clinical characteristics of MG patients with COVID-19 were described. Multivariable logistic regression analysis was used for discovering independent risk factors of MG exacerbation in the patients with MG and COVID-19. Results: A total of 311 (75.30%) MG patients and 428 (72.91%) control subjects were infected with COVID-19, and 64.31% of MG patients with COVID-19 were women. The median age at the time of interview was 41 (IQR: 28, 54) years old, and median onset age was 36 (IQR: 24, 51), both of which were lower than those in MG patients without COVID-19. MG duration was 24 (IQR: 9, 72) months. About 44.69% of patients were generalized MG (GMG). About 11.90% of MG patients with COVID-19 showed severe COVID-19 symptoms and the duration of symptomatic COVID-19 was 9.57 ± 6.79 days, higher than those in the control group. About 35.69% MG patients with immunosuppressive drugs were infected with COVID-19, which is higher than those in the non-infected MG patients (21.57%). A total of 120 (38.59%) MG patients with COVID-19 had comorbidities. About 21 (20.19%) of the 104 MG patients without vaccination showed severe COVID-19 symptoms. Multivariable logistic regression analysis showed that baseline MG activities of daily living profile (MG-ADL, OR 1.280, 95% CI: 1.010-1.621, p = 0.041), duration of COVID-19 (OR 1.158, 95% CI: 1.100-1.220, p < 0.001), GMG (OR 2.331, 95% CI: 1.228, 4.426, p = 0.010), and lack of COVID vaccination (OR 2.075, 95% CI: 1.152, 3.738, p = 0.015) were independent factors of exacerbation in MG patients with COVID-19. Conclusion: MG patients with immunosuppressive drugs, younger onset, longer MG duration, or comorbidities are more susceptible to COVID-19. The baseline MG-ADL, duration of symptomatic COVID-19, GMG, and lack of COVID-19 vaccination are independent risk factors of exacerbation in MG patients with COVID-19.

Ozonation catalysed by ferrosilicon for the degradation of ibuprofen in water.

The search for optimal catalysts to improve the working efficiency of ozonation has always been an important issue in the research field of advanced oxidation processes. In this study, a novel catalyst, ferrosilicon, was selected as the catalyst in heterogeneous catalytic ozonation to degrade ibuprofen (IBP) in water and treat real pharmaceutical wastewater. During the procedure, 45#ferrosilicon exhibited the best catalytic activity. Under the optimized experimental conditions, the IBP removal reached 75%, which was a great improvement compared to the 37% removal by ozone alone. The 45#-ferrosilicon-catalysed ozonation also achieved 68% TOC removal for real pharmaceutical wastewater, which was 31% higher than that by ozone alone. The degradation pathway of IBP was proposed using GC/MS. The EPR test proved that the main active species in the system were free active radicals •OH, and the measured accumulative •OH amount was 102 µmol. The characterization results show that the nascent metallic oxides, hydroxides, and hydroxyoxides on the ferrosilicon surface facilitated the decomposition of ozone molecules and generation of free active radicals. The removal of target organic contaminants in the water was mainly attributed to the oxidization of these highly active species.

Iron foam combined ozonation for enhanced treatment of pharmaceutical wastewater.

In this study, iron foam combined ozonation was employed as an advanced oxidation process to treat the organic contaminants in real pharmaceutical wastewater. It was found that this procedure worked well in a wide range of pH, the existence of iron foam in ozonation system markedly elevated the mineralization level of organic contaminants. Within the reaction time of 120 min, iron foam combined ozonation achieved 53% of DOC removal percentage, which was 21% higher than that of ozone alone. Meanwhile, the biodegradability of the pharmaceutical wastewater was improved, a large part of the organic pollutants containing benzene rings and amino groups were effectively degraded, and a certain amount of phosphate and nitrogen also get removed. In iron foam combined ozonation, zero valent iron played the role as an activator. It was oxidized into iron oxides and oxyhydroxides, the electrons transferring among different valences of iron stimulated the decomposition of ozone and the generation of hydroxyl radicals, which accounted for most of the organic contaminants degradation.

Ni-Fe layered double hydroxides catalized ozonation of synthetic wastewater containing Bisphenol A and municipal secondary effluent.

Ni-Fe Layered Double Hydroxides (Ni-Fe LDHs) was prepared, characterized and used as catalyst in heterogeneous catalytic ozonation of Bisphenol A (BPA) and other organic compounds in secondary effluent. The characterization and ozonation results revealed that the Ni-Fe LDHs possessing a Ni: Fe ratio of 3:1 had the best crystalline and the highest affinity for ozone. Under the optimized conditions, the final TOC and COD removal achieved was 56% and 68%, respectively. BPA in the secondary effluent could be removed completely by Ni3-Fe LDH catalyzed ozonation. The organic compounds removal was mainly attributed to the oxidation by free active radicals such as hydroxyl radicals (OH). In this research the accumulative ·OH in the reaction system was determined to be 28.2 µmol at the reaction time of 60 min. The free active radicals were mostly generated through the electron transfer among different valences of metals on Ni-Fe LDHs surface, and subsequently diffused into bulk solution to oxidize the target organic compounds there.