An analysis model of diagnosis and treatment for COVID-19 pandemic based on medical information fusion.

Exploring the complicated relationships underlying the clinical information is essential for the diagnosis and treatment of the Coronavirus Disease 2019 (COVID-19). Currently, few approaches are mature enough to show operational impact. Based on electronic medical records (EMRs) of 570 COVID-19 inpatients, we proposed an analysis model of diagnosis and treatment for COVID-19 based on the machine learning algorithms and complex networks. Introducing the medical information fusion, we constructed the heterogeneous information network to discover the complex relationships among the syndromes, symptoms, and medicines. We generated the numerical symptom (medicine) embeddings and divided them into seven communities (syndromes) using the combination of Skip-Gram model and Spectral Clustering (SC) algorithm. After analyzing the symptoms and medicine networks, we identified the key factors using six evaluation metrics of node centrality. The experimental results indicate that the proposed analysis model is capable of discovering the critical symptoms and symptom distribution for diagnosis; the key medicines and medicine combinations for treatment. Based on the latest COVID-19 clinical guidelines, this model could result in the higher accuracy results than the other representative clustering algorithms. Furthermore, the proposed model is able to provide tremendously valuable guidance and help the physicians to combat the COVID-19.

Add-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries.

Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, [Formula: see text] = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, [Formula: see text] = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.

Clinical features and the traditional Chinese medicine therapeutic characteristics of 293 COVID-19 inpatient cases.

Coronavirus disease 2019 (COVID-19) is now pandemic worldwide and has heavily overloaded hospitals in Wuhan City, China during the time between late January and February. We reported the clinical features and therapeutic characteristics of moderate COVID-19 cases in Wuhan that were treated via the integration of traditional Chinese medicine (TCM) and Western medicine. We collected electronic medical record (EMR) data, which included the full clinical profiles of patients, from a designated TCM hospital in Wuhan. The structured data of symptoms and drugs from admission notes were obtained through an information extraction process. Other key clinical entities were also confirmed and normalized to obtain information on the diagnosis, clinical treatments, laboratory tests, and outcomes of the patients. A total of 293 COVID-19 inpatient cases, including 207 moderate and 86 (29.3%) severe cases, were included in our research. Among these cases, 238 were discharged, 31 were transferred, and 24 (all severe cases) died in the hospital. Our COVID-19 cases involved elderly patients with advanced ages (57 years on average) and high comorbidity rates (61%). Our results reconfirmed several well-recognized risk factors, such as age, gender (male), and comorbidities, as well as provided novel laboratory indications (e.g., cholesterol) and TCM-specific phenotype markers (e.g., dull tongue) that were relevant to COVID-19 infections and prognosis. In addition to antiviral/antibiotics and standard supportive therapies, TCM herbal prescriptions incorporating 290 distinct herbs were used in 273 (93%) cases. The cases that received TCM treatment had lower death rates than those that did not receive TCM treatment (17/273 = 6.2% vs. 7/20= 35%, P = 0.0004 for all cases; 17/77= 22% vs. 7/9= 77.7%, P = 0.002 for severe cases). The TCM herbal prescriptions used for the treatment of COVID-19 infections mainly consisted of Pericarpium Citri Reticulatae, Radix Scutellariae, Rhizoma Pinellia, and their combinations, which reflected the practical TCM principles (e.g., clearing heat and dampening phlegm). Lastly, 59% of the patients received treatment, including antiviral, antibiotics, and Chinese patent medicine, before admission. This situation might have some effects on symptoms, such as fever and dry cough. By using EMR data, we described the clinical features and therapeutic characteristics of 293 COVID-19 cases treated via the integration of TCM herbal prescriptions and Western medicine. Clinical manifestations and treatments before admission and in the hospital were investigated. Our results preliminarily showed the potential effectiveness of TCM herbal prescriptions and their regularities in COVID-19 treatment.

[Detecting int I 1 gene expression of Pseudomonas aeruginosa with fluorescent quantitative PCR assay].

OBJECTIVE: In order to understand the role of integron, fluorescent quantitative polymerase chain reaction (FQ-PCR)was developed to measure the changes in int I 1 gene expression of Pseudomonas Aeruginosa in biofilm and planktonic cells. METHODS: Three clinical strains of P. aeruginosa with int I 1 gene (SW07, R07 and TH12) were cultured in planktonic cells and biofilm cells. The total RNA of these cultured bacteria were extracted by the conventional method. The FQ-PCR was developed to measure the changes in int I 1 mRNA expression of the P. aeruginosa with bacterial 16s rRNA as an internal control. RESULTS: The three clinical strains of P. aeruginosa expressed int I 1 mRNA in both biofilm and planktonic cells, but with different levels. The int 1 mRNA expressed by the RO7, SW07 and TH12 strains in the biofilm cells were 1.4, 5.7 and 128 times higher than in the planktonic cells, respectively. CONCLUSION: The int I 1 gene expression of P. aeruginosa in the biofilm is up-regulated at mRNA level. The integron may capture and accumulate drug resistance gene cassettes more effectively in the biofilm condition.