Hypoproteinemia is an independent risk factor for the prognosis of severe COVID-19 patients.

Severe patients of the coronavirus disease 2019 (COVID-19) may progress rapidly to critical stage. This study aimed to identify factors useful for predicting the progress. 33 severe COVID-19 patients at the intensive care unit were included in this study. During treatment, 13 patients deteriorated and required further treatment for supporting organ function. The remaining 20 patients alleviated and were transferred to the general wards. The multivariate COX regression analyses showed that hypoproteinemia was an independent risk factor associated with deterioration of severe patients (HR, 0.763; 95% CI, 0.596 to 0.978; p = 0.033). The restricted cubic spline indicated that when HR = 1, the corresponding value of albumin is 29.6 g/L. We used the cutoff of 29.6 g/L to divide these patients. Kaplan-Meier curves showed that the survival rate of the high-albumin group was higher than that of the low-albumin group. Therefore, hypoalbuminemia may be an independent risk factor to evaluate poor prognosis of severely patients with COVID-19, especially when albumin levels were below 29.6 g/L.

Effects of high temperature on photosynthesis and related gene expression in poplar.

BACKGROUND: High temperature, whether transitory or constant, causes physiological, biochemical and molecular changes that adversely affect tree growth and productivity by reducing photosynthesis. To elucidate the photosynthetic adaption response and examine the recovery capacity of trees under heat stress, we measured gas exchange, chlorophyll fluorescence, electron transport, water use efficiency, and reactive oxygen-producing enzyme activities in heat-stressed plants. RESULTS: We found that photosynthesis could completely recover after less than six hours of high temperature treatment, which might be a turning point in the photosynthetic response to heat stress. Genome-wide gene expression analysis at six hours of heat stress identified 29,896 differentially expressed genes (15,670 up-regulated and 14,226 down-regulated), including multiple classes of transcription factors. These interact with each other and regulate the expression of photosynthesis-related genes in response to heat stress, controlling carbon fixation and changes in stomatal conductance. Heat stress of more than twelve hours caused reduced electron transport, damaged photosystems, activated the glycolate pathway and caused H2O2 production; as a result, photosynthetic capacity did not recover completely. CONCLUSIONS: This study provides a systematic physiological and global gene expression profile of the poplar photosynthetic response to heat stress and identifies the main limitations and threshold of photosynthesis under heat stress. It will expand our understanding of plant thermostability and provides a robust dataset for future studies.

Association of uric acid with the decline in estimated glomerular filtration rate in middle-aged and elderly populations: evidence based on the China Health and Retirement Longitudinal Study.

OBJECTIVE: Whether uric acid (UA) has an effect on renal function remains controversial. We aimed to investigate the association between serum UA with the decline in estimated glomerular filtration rate (eGFR) in middle-aged and elderly populations in the China Health and Retirement Longitudinal Study (CHARLS). DESIGN: Longitudinal cohort study. SETTING: This was a second analysis of a public dataset (CHARLS). PARTICIPANTS: In this study, 4538 middle-aged and elderly individuals were screened after removing individuals younger than 45 years old, with kidney disease, malignant tumour and missing values. OUTCOME MEASURES: Blood tests were performed both in 2011 and 2015. Decline in eGFR was defined as an eGFR decrease of more than 25% or deterioration of the eGFR stage during the 4-year follow-up period. Logistic models corrected for multiple covariables were used to analyse the association of UA with the decline in eGFR. RESULTS: The median (IQR) concentrations of serum UA grouped by quartiles were 3.1 (0.6), 3.9 (0.3), 4.6 (0.4) and 5.7 (1.0) mg/dL, respectively. After multivariable adjustment, the OR of the decline in eGFR was higher for quartile 2 (3.5-<4.2 mg/dL: OR 1.44; 95% CI 1.07 to 1.64; p<0.01), quartile 3 (4.2-<5.0 mg/dL: OR 1.72; 95% CI 1.36 to 2.18; p<0.001) and quartile 4 (≥5.0 mg/dL: OR 2.04; 95% CI 1.58 to 2.63; p<0.001) when compared with quartile 1 (<3.5 mg/dL), and the p value for the trend was <0.001. CONCLUSIONS: Over a 4-year follow-up period, we found that elevated UA was associated with a decline in eGFR in the middle-aged and elderly individuals with normal renal function.

COVID-19: risk factors for severe cases of the Delta variant.

BACKGROUND: Since April 2021, the SARS-CoV-2 (B.1.167) Delta variant has been rampant worldwide. Recently, this variant has spread in Guangzhou, China. Our objective was to characterize the clinical features and risk factors of severe cases of the Delta variant in Guangzhou. METHODS: A total of 144 patients with the Delta variant were enrolled, and the data between the severe and non-severe groups were compared. Logistic regression methods and Cox multivariate regression analysis were used to investigate the risk factors of severe cases. RESULTS: The severity of the Delta variant was 11.1%. Each 1-year increase in age (OR, 1.089; 95% CI, 1.035-1.147; P = 0.001) and each 1-µmol/L increase in total bilirubin (OR, 1.198; 95% CI, 1.021-1.406; P = 0.039) were risk factors for severe cases. Moreover, the risk of progression to severe cases increased 13.444-fold and 3.922-fold when the age was greater than 58.5 years (HR, 13.444; 95% CI, 2.989-60.480; P = 0.001) or the total bilirubin level was greater than 7.23 µmol/L (HR, 3.922; 95% CI, 1.260-12.207; P = 0.018), respectively. CONCLUSION: Older age and elevated total bilirubin were independent risk factors for severe cases of the Delta variant in Guangzhou, especially if the age was greater than 58.5 years or the total bilirubin level was greater than 7.23 µmol/L.

Prey partitioning and livestock consumption in the world's richest large carnivore assemblage.

Large mammalian carnivores have undergone catastrophic declines during the Anthropocene across the world. Despite their pivotal roles as apex predators in food webs and ecosystem dynamics, few detailed dietary datasets of large carnivores exist, prohibiting deep understanding of their coexistence and persistence in human-dominated landscapes. Here, we present fine-scaled, quantitative trophic interactions among sympatric carnivores from three assemblages in the Mountains of Southwest China, a global biodiversity hotspot harboring the world's richest large-carnivore diversity, derived from DNA metabarcoding of 1,097 fecal samples. These assemblages comprise a large-carnivore guild ranging from zero to five species along with two mesocarnivore species. We constructed predator-prey food webs for each assemblage and identified 95 vertebrate prey taxa and 260 feeding interactions in sum. Each carnivore species consumed 6-39 prey taxa, and dietary diversity decreased with increased carnivore body mass across guilds. Dietary partitioning was more evident between large-carnivore and mesocarnivore guilds, yet different large carnivores showed divergent proportional utilization of different-sized prey correlating with their own body masses. Large carnivores particularly selected livestock in Tibetan-dominated regions, where the indigenous people show high tolerance toward wild predators. Our results suggest that dietary niche partitioning and livestock subsidies facilitate large-carnivore sympatry and persistence and have key implications for sustainable conservation promoting human-carnivore coexistence.

Successful recovery of recurrence of positive SARS-CoV-2 RNA in COVID-19 patient with systemic lupus erythematosus: a case report and review.

COVID-19 has become a global concern. A large number of reports have explained the clinical characteristics and treatment strategies of COVID-19, but the characteristics and treatment of COVID-19 patient with systemic lupus erythematosus (SLE) are still unclear. Here, we report the clinical features and treatment of the first SLE patient with confirmed COVID-19 pneumonia. This was a 39-year-old woman, diagnosed with SLE 15 years ago, whose overall clinical characteristics (symptoms, laboratory tests, and chest CTs) were similar to those of the general COVID-19 patients. She continued to take the previous SLE drugs (doses of glucocorticoids, hydroxychloroquine, and immunosuppressive agents were not reduced) and was treated with strict antiviral and infection prevention treatment. After the first discharge, she got a recurrence of COVID-19 during her home isolation, and then returned to hospital and continued the previous therapy. Finally, this long-term immune suppressive patient's COVID-19 was successfully cured. The successful recovery of this case has significant reference value for the future treatment of COVID-19 patients with SLE. Key Points • COVID-19 patients with SLE is advocated to continue the medical treatment for SLE. • Hydroxychloroquine may have potential benefits for COVID-19 patients with SLE. • COVID-19 patients with SLE is prone to relapse, and multiple follow-ups are necessary.

Clinical Features and Risk Factors of ICU Admission for COVID-19 Patients with Diabetes.

INTRODUCTION: Previous studies of coronavirus disease 2019 (COVID-19) have focused on the general population. However, diabetes (DM) as one of the most common comorbidities is rarely studied in detail. This study is aimed at describing clinical characteristics and determining risk factors of ICU admission for COVID-19 patients with DM. METHODS: Data were extracted from 288 adult patients with laboratory-confirmed COVID-19 from Guangzhou Eighth People's Hospital. Demographic characteristics, laboratory results, radiographic findings, complications, and treatments were collected and compared between DM and non-DM groups. Binary logistic regression was used to identify the risk factors associated with ICU admission for COVID-19 patients with DM or non-DM. RESULTS: COVID-19 patients with DM showed as older ages, higher levels of C-reactive protein (CRP), myoglobin, alanine transaminase (ALT), and aspartate transaminase (AST). They were also more prone to transfer to the intensive care unit (ICU) for treatment. Multiple regression analysis showed that the following were the independent risk factors for COVID-19 patients with DM that received ICU admission: each 1-year increase in age (odds ratio (OR), 1.07; 95% CI, 1.02-1.13; P = 0.007), respiratory rate over 24 times per minute (OR, 5.22; 95% CI, 2.26-16.58; P = 0.016), HbA1c greater than 7% (OR, 4.58; 95% CI, 1.82-10.55; P = 0.012), and AST higher than 40 U/L (OR, 2.96; 95% CI, 1.58-8.85; P = 0.022). In addition, each 1-year increase in age (OR, 1.05; 95% CI, 1.01-1.10; P = 0.006), diarrhea (OR, 4.62; 95% CI, 2.01-9.36; P = 0.022), respiratory rate over 24 times per minute (OR, 5.13; 95% CI, 1.18-16.82; P = 0.035), CRP greater than 10 mg/L (OR, 5.19; 95% CI, 1.37-13.25, P = 0.009), and TnI higher than 0.03 µg/L (OR, 6.48; 95% CI, 1.17-21.38; P = 0.036) were risk factors for ICU admission of COVID-19 patients with non-DM. CONCLUSIONS: The older age, respiratory rate over 24 times per minute, HbA1c greater than 7%, and AST higher than 40 U/L were risk factors of ICU admission for COVID-19 patients with diabetes. Investigating and monitoring these factors could assist in the risk stratification of COVID-19 patients with DM at an early stage.

Risk factors for severe cases of COVID-19: a retrospective cohort study.

BACKGROUND: SARS-CoV-2 has raged around the world since March, 2020. We aim to describe the clinical characteristics and risk factors of severe patients with COVID-19 in Guangzhou. RESULTS: The severity and mortality of COVID-19 was 10.4% and 0.3% respectively. And each 1-year increase in age (OR, 1.057; 95% CI, 1.018-1.098; P=0.004), Wuhan exposure history greater than 2 weeks (OR, 2.765; 95% CI, 1.040-7.355; P=0.042), diarrhea (OR, 24.349; 95% CI, 3.580-165.609; P=0.001), chronic kidney disease (OR, 6.966; 95% CI, 1.310-37.058; P = 0.023), myoglobin higher than 106 µg/L (OR, 8.910; 95% CI, 1.225-64.816; P=0.031), white blood cell higher than 10×109/L (OR, 5.776; 95% CI, 1.052-31.722; P=0.044), and C-reactive protein higher than 10 mg/L (OR, 5.362; 95% CI, 1.631-17.626; P=0.006) were risk factors for severe cases. CONCLUSION: Older age, Wuhan exposure history, diarrhea, chronic kidney disease, elevated myoglobin, elevated white blood cell and C-reactive protein were independent risk factors for severe patients with COVID-19 in Guangzhou. METHODS: We included 288 adult patients with COVID-19 and compared the data between severe and non-severe group. We used univariate and multivariate logistic regression methods to explore risk factors of severe cases.

Molecular dietary analysis of two sympatric felids in the Mountains of Southwest China biodiversity hotspot and conservation implications.

Dietary information is lacking in most of small to mid-sized carnivores due to their elusive predatory behaviour and versatile feeding habits. The leopard cat (LPC; Prionailurus bengalensis) and the Asiatic golden cat (AGC; Catopuma temminckii) are two important yet increasingly endangered carnivore species in the temperate mountain forest ecosystem in Southwest China, a global biodiversity hotspot and a significant reservoir of China's endemic species. We investigated the vertebrate prey of the two sympatric felids using faecal DNA and a next-generation sequencing (NGS)/metabarcoding approach. Forty vertebrate prey taxa were identified from 93 LPC and 10 AGC faecal samples; 37 taxa were found in the LPC diet, and 20 were detected in the AGC diet. Prey included 27 mammalian taxa, 11 birds, one lizard and one fish, with 73% (29/40) of the taxa assigned to the species level. Rodents and pikas were the most dominant LPC prey categories, whereas rodents, pheasant, fowl and ungulates were the main AGC prey. We also analysed the seasonal and altitudinal variations in the LPC diet. Our results provide the most comprehensive dietary data for these felids and valuable information for their conservation planning.