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2.
Nat Med ; 27(11): 2012-2024, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1526091

ABSTRACT

The efficacy of convalescent plasma for coronavirus disease 2019 (COVID-19) is unclear. Although most randomized controlled trials have shown negative results, uncontrolled studies have suggested that the antibody content could influence patient outcomes. We conducted an open-label, randomized controlled trial of convalescent plasma for adults with COVID-19 receiving oxygen within 12 d of respiratory symptom onset ( NCT04348656 ). Patients were allocated 2:1 to 500 ml of convalescent plasma or standard of care. The composite primary outcome was intubation or death by 30 d. Exploratory analyses of the effect of convalescent plasma antibodies on the primary outcome was assessed by logistic regression. The trial was terminated at 78% of planned enrollment after meeting stopping criteria for futility. In total, 940 patients were randomized, and 921 patients were included in the intention-to-treat analysis. Intubation or death occurred in 199/614 (32.4%) patients in the convalescent plasma arm and 86/307 (28.0%) patients in the standard of care arm-relative risk (RR) = 1.16 (95% confidence interval (CI) 0.94-1.43, P = 0.18). Patients in the convalescent plasma arm had more serious adverse events (33.4% versus 26.4%; RR = 1.27, 95% CI 1.02-1.57, P = 0.034). The antibody content significantly modulated the therapeutic effect of convalescent plasma. In multivariate analysis, each standardized log increase in neutralization or antibody-dependent cellular cytotoxicity independently reduced the potential harmful effect of plasma (odds ratio (OR) = 0.74, 95% CI 0.57-0.95 and OR = 0.66, 95% CI 0.50-0.87, respectively), whereas IgG against the full transmembrane spike protein increased it (OR = 1.53, 95% CI 1.14-2.05). Convalescent plasma did not reduce the risk of intubation or death at 30 d in hospitalized patients with COVID-19. Transfusion of convalescent plasma with unfavorable antibody profiles could be associated with worse clinical outcomes compared to standard care.

3.
Nat Commun ; 12(1): 6304, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500462

ABSTRACT

Accumulating mutations in the SARS-CoV-2 Spike (S) protein can increase the possibility of immune escape, challenging the present COVID-19 prophylaxis and clinical interventions. Here, 3 receptor binding domain (RBD) specific monoclonal antibodies (mAbs), 58G6, 510A5 and 13G9, with high neutralizing potency blocking authentic SARS-CoV-2 virus display remarkable efficacy against authentic B.1.351 virus. Surprisingly, structural analysis has revealed that 58G6 and 13G9 both recognize the steric region S470-495 on the RBD, overlapping the E484K mutation presented in B.1.351. Also, 58G6 directly binds to another region S450-458 in the RBD. Significantly, 58G6 and 510A5 both demonstrate prophylactic efficacy against authentic SARS-CoV-2 and B.1.351 viruses in the transgenic mice expressing human ACE2 (hACE2), protecting weight loss and reducing virus loads. Together, we have evidenced 2 potent neutralizing Abs with unique mechanism targeting authentic SARS-CoV-2 mutants, which can be promising candidates to fulfill the urgent needs for the prolonged COVID-19 pandemic.


Subject(s)
Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/prevention & control , SARS-CoV-2/immunology , Animals , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/administration & dosage , Antibodies, Neutralizing/chemistry , Antibodies, Viral/administration & dosage , Antibodies, Viral/chemistry , Binding Sites , COVID-19/pathology , COVID-19/virology , Epitopes , Humans , Mice , Mice, Transgenic , Mutation , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Viral Load/drug effects , Weight Loss/drug effects
4.
Front Med (Lausanne) ; 8: 715519, 2021.
Article in English | MEDLINE | ID: covidwho-1477836

ABSTRACT

Background: Secondary infections pose tremendous challenges in Coronavirus disease 2019 (COVID-19) treatment and are associated with higher mortality rates. Clinicians face of the challenge of diagnosing viral infections because of low sensitivity of available laboratory tests. Case Presentation: A 66-year-old woman initially manifested fever and shortness of breath. She was diagnosed as critically ill with COVID-19 using quantitative reverse transcription PCR (RT-qPCR) and treated with antiviral therapy, ventilator and extracorporeal membrane oxygenation (ECMO). However, after the condition was relatively stabled for a few days, the patient deteriorated with fever, frequent cough, increased airway secretions, and increased exudative lesions in the lower right lung on chest X-rays, showing the possibility of a newly acquired infection, though sputum bacterial and fungal cultures and smears showed negative results. Using metagenomic next-generation sequencing (mNGS), we identified a reactivation of latent human herpes virus type 1 (HHV-1) in the respiratory tract, blood and gastrointestinal tract, resulting in a worsened clinical course in a critically ill COVID-19 patient on ECMO. Anti-HHV-1 therapy guided by these sequencing results effectively decreased HHV-1 levels, and improved the patient's clinical condition. After 49 days on ECMO and 67 days on the ventilator, the 66-year-old patient recovered and was discharged. Conclusions: This case report demonstrates the potential value of mNGS for evidence-based treatment, and suggests that potential reactivation of latent viruses should be considered in critically ill COVID-19 patients.

5.
Biotechnology Law Report ; 40(5):334-338, 2021.
Article in English | Mary Ann Liebert | ID: covidwho-1465217
6.
Nano Today ; 41: 101308, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1446977

ABSTRACT

A once-in-a-century global public health crisis, the COVID-19 pandemic has damaged human health and world economy greatly. To help combat the virus, we report a self-resetting molecular probe capable of repeatedly detecting SARS-CoV-2 RNA, developed by orchestrating a fuel dissipative system via DNA nanotechnology. A set of simulation toolkits was utilized to design the probe, permitting highly consistent signal amplitudes across cyclic detections. Uniquely, full width at half maximum regulated by dissipative kinetics exhibits a fingerprint signal suitable for high confidential identifications of single-nucleotide variants. Further examination on multiple human-infectious RNA viruses, including ZIKV, MERS-CoV, and SARS-CoV, demonstrates the generic detection capability and superior orthogonality of the probe. It also correctly classified all the clinical samples from 55 COVID-19 patients and 55 controls. Greatly enhancing the screening capability for COVID-19 and other infectious diseases, this probe could help with disease control and build a broader global public health agenda.

7.
One Health ; 13: 100332, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1433701

ABSTRACT

The emerging coronavirus diseases such as COVID-19, MERS, and SARS indicated that animal coronaviruses (CoVs) spillover to humans are a huge threat to public health. Therefore, we needed to understand the CoVs carried by various animals. Wild hedgehogs were collected from rural areas in Wuhan and Xianning cities in Hubei Province for analysis of CoVs. PCR results showed that 5 out of 51 (9.8%) hedgehogs (Erinaceus amurensis) were positive to CoVs in Hubei Province with 3 samples from Wuhan City and 2 samples from Xianning City. Phylogenetic analysis based on the partial sequence of RNA-dependent RNA polymerase showed that the CoVs from hedgehogs are classified into Merbecovirus of the genus Betacoronavirus; the hedgehog CoVs formed a phylogenetic sister cluster with human MERS-CoVs and bat MERS-related CoVs. Among the 12 most critical residues of receptor binding domain in MERS-CoV for binding human Dipeptidyl peptidase 4, 3 residuals were conserved between the hedgehog MERS-related CoV obtained in this study and the human MERS-CoV. We concluded that hedgehogs from Hubei Province carried MERS-related CoVs, indicating that hedgehogs might be important in the evolution and transmission of MERS-CoVs, and continuous surveillance of CoVs in hedgehogs was important.

8.
Nanophotonics ; 10(8):1941-1942, 2020.
Article in English | ProQuest Central | ID: covidwho-1430574
9.
Lancet Infect Dis ; 2021 Sep 15.
Article in English | MEDLINE | ID: covidwho-1414105

ABSTRACT

BACKGROUND: Although SARS-CoV-2 infection often causes milder symptoms in children and adolescents, young people might still play a key part in SARS-CoV-2 transmission. An efficacious vaccine for children and adolescents could therefore assist pandemic control. For further evaluation of the inactivated COVID-19 vaccine candidate BBIBP-CorV, we assessed the safety and immunogenicity of BBIBP-CorV in participants aged 3-17 years. METHODS: A randomised, double-blind, controlled, phase 1/2 trial was done at Shangqiu City Liangyuan District Center for Disease Control and Prevention in Henan, China. In phases 1 and 2, healthy participants were stratified according to age (3-5 years, 6-12 years, or 13-17 years) and dose group. Individuals with a history of SARS-CoV-2 or SARS-CoV infection were excluded. All participants were randomly assigned, using stratified block randomisation (block size eight), to receive three doses of 2 µg, 4 µg, or 8 µg of vaccine or control (1:1:1:1) 28 days apart. The primary outcome, safety, was analysed in the safety set, which consisted of participants who had received at least one vaccination after being randomly assigned, and had any safety evaluation information. The secondary outcomes were geometric meant titre (GMT) of the neutralising antibody against infectious SARS-CoV-2 and were analysed based on the full analysis set. This study is registered with www.chictr.org.cn, ChiCTR2000032459, and is ongoing. FINDINGS: Between Aug 14, 2020, and Sept 24, 2020, 445 participants were screened, and 288 eligible participants were randomly assigned to vaccine (n=216, 24 for each dose level [2/4/8 µg] in each of three age cohorts [3-5, 6-12, and 13-17 years]) or control (n=72, 24 for each age cohort [3-5, 6-12, and 13-17 years]) in phase 1. In phase 2, 810 participants were screened and 720 eligible participants were randomly assigned and allocated to vaccine (n=540, 60 for each dose level [2/4/8 µg] in each of three age cohorts [3-5, 6-12, and 13-17 years]) or control (n=180, 60 for each age cohort [3-5, 6-12, and 13-17 years]). The most common injection site adverse reaction was pain (ten [4%] 251 participants in all vaccination groups of the 3-5 years cohort; 23 [9·1%] of 252 participants in all vaccination groups and one [1·2%] of 84 in the control group of the 6-12 years cohort; 20 [7·9%] of 252 participants in all vaccination groups of the 13-17 years cohort). The most common systematic adverse reaction was fever (32 [12·7%] of 251 participants in all vaccination groups and six [7·1%] of 84 participants in the control group of the 3-5 years cohort; 13 [5·2%] of 252 participants in the vaccination groups and one [1·2%] of 84 in the control group of the 6-12 years cohort; 26 [10·3%] of 252 participants in all vaccination groups and eight [9·5%] of 84 in the control group of the 13-17 years cohort). Adverse reactions were mostly mild to moderate in severity. The neutralising antibody GMT against the SARS-CoV-2 virus ranged from 105·3 to 180·2 in the 3-5 years cohort, 84·1 to 168·6 in the 6-12 years cohort, and 88·0 to 155·7 in the 13-17 years cohort on day 28 after the second vaccination; and ranged from 143·5 to 224·4 in the 3-5 years cohort, 127 to 184·8 in the 6-12 years cohort, and 150·7 to 199 in the 13-17 years cohort on day 28 after the third vaccination. INTERPRETATION: The inactivated COVID-19 vaccine BBIBP-CorV is safe and well tolerated at all tested dose levels in participants aged 3-17 years. BBIBP-CorV also elicited robust humoral responses against SARS-CoV-2 infection after two doses. Our findings support the use of a 4 µg dose and two-shot regimen BBIBP-CorV in phase 3 trials in the population younger than 18 years to further ascertain its safety and protection efficacy against COVID-19. FUNDING: National Program on Key Research Project of China, National Mega projects of China for Major Infectious Diseases, National Mega Projects of China for New Drug Creation, and Beijing Science and Technology Plan. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

10.
J Adolesc Health ; 69(5): 696-704, 2021 11.
Article in English | MEDLINE | ID: covidwho-1364148

ABSTRACT

PURPOSE: The present study examined the risk factors of psychological disorders after COVID-19 outbreak and tested the possible mediating role of social support and emotional intelligence on the relationship between COVID-19 pandemic exposure and psychological disorders. METHODS: We conducted an online survey from May 25, 2020 until June 10, 2020 among Chinese university students who had been quarantined at home due to the COVID-19 pandemic. Social support was assessed using the Social Support Rating Scale. Self-perceived emotional competency was measured using a Chinese version of the self-report Wong Law Emotional Intelligence Scale. The 10-item Kessler Psychological Distress Scale was used to assess nonspecific symptoms of psychological disorders. RESULTS: A total of 6,027 college students participated in the survey, of whom 2,732 (45.3%) reported mental health issues. Men and people in a relationship showed higher frequencies of psychological disorders. Social support and emotional intelligence were both negatively associated with psychological disorders. Stepwise linear regression revealed that the most important predictors of psychological disorders were self-emotion appraisal, family relationships, and showing panic about COVID-19 on the social media. Path analysis suggested that the association between pandemic exposure and psychological disorders was partially mediated by emotional intelligence, but not by social support. CONCLUSIONS: Emotional intelligence may mediate the relationship between COVID-19 pandemic exposure and psychological disorders. Psychological interventions fostering emotional intelligence and social support should be implemented among university students to reduce the psychological harm caused by the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Disease Outbreaks , Emotional Intelligence , Humans , Male , Risk Factors , SARS-CoV-2 , Social Support
11.
Interactive Learning Environments ; : 1-19, 2021.
Article in English | Academic Search Complete | ID: covidwho-1358400

ABSTRACT

Although virtual learning environments (VLEs) have long been forecasted to accelerate the educational revolution, their adoption by teachers and students has not always been as effective as is expected over the years. This challenges universities that extensively investigated educational technologies. Stakeholders are keen to understand the underlying factors and mechanisms that influence technology adoption. However, the extant contradictive and inconsistent research findings from individual country or region fail to address the problem. To provide a holistic view, we follow the PRISMA protocol and synthesize 145 empirical studies across 42 countries and regions from 2001 to 2020. Our main contribution lies in integrating the institutional theory and the elements of country, culture, and university with the decision to adopt VLEs. Specifically, we develop three individual themes and two institutional themes about the factor characteristics. Power distance associates with the institutional cognitive-cultural influence, and long- and short-term orientation affects VLE adoption through the institutional normative facilitation. Masculinity-femininity links to individual cognition, while uncertainty avoidance has a connection with individual digital capability in the VLE adoption processes. We suggest that cultural dimensions should be examined as explanatory variables in future research. Implications and research significance in the COVID-19 pandemic are discussed. [ABSTRACT FROM AUTHOR] Copyright of Interactive Learning Environments is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

12.
Medicine (Baltimore) ; 100(32): e26713, 2021 Aug 13.
Article in English | MEDLINE | ID: covidwho-1358516

ABSTRACT

OBJECTIVE: The aim of this study is to investigate the impact of Coronavirus disease 2019 (COVID-19) on toothache patients through posts on Sina Weibo. METHODS: Using Gooseeker, we searched and screened 24,108 posts about toothache on Weibo during the dental clinical closure period of China (February 1, 2020-February 29, 2020), and then divided them into 4 categories (causes of toothache, treatments of toothache, impacts of COVID-19 on toothache treatment, popular science articles of toothache), including 10 subcategories, to analyze the proportion of posts in each category. RESULTS: There were 12,603 postings closely related to toothache. Among them, 87.6% of posts did not indicate a specific cause of pain, and 92.8% of posts did not clearly indicate a specific method of treatment. There were 38.9% of the posts that clearly showed that their dental treatment of toothache was affected by COVID-19, including 10.5% of the posts in which patients were afraid to see the dentists because of COVID-19, and 28.4% of the posts in which patients were unable to see the dentists because the dental clinic was closed. Only 3.5% of all posts were about popular science of toothache. CONCLUSIONS: We have studied and analyzed social media data about toothache during the COVID-19 epidemic, so as to provide some insights for government organizations, the media and dentists to better guide the public to pay attention to oral health through social media. Research on social media data can help formulate public health policies.


Subject(s)
COVID-19/complications , Social Media/statistics & numerical data , Toothache/complications , COVID-19/epidemiology , COVID-19/psychology , China/epidemiology , Data Mining/methods , Data Mining/statistics & numerical data , Humans , Oral Health/standards , Oral Health/trends , Toothache/epidemiology , Toothache/psychology
13.
J Psychosom Res ; 149: 110586, 2021 10.
Article in English | MEDLINE | ID: covidwho-1331005

ABSTRACT

OBJECTIVE: This study evaluates depression, anxiety, and stress symptoms in pregnant women before and during COVID-19 pandemic and analyzes their risk factors. METHODS: This was a cross-sectional analyses included pregnant women with depression, anxiety, and stress levels evaluated both in the Novel Coronavirus-Pregnancy Cohort study (NCP) and the Healthy Baby Cohort study (HBC). NCP was conducted during COVID-19 pandemic, while HBC was performed before the pandemic. Multiple logistic regressions were employed to evaluate the associations between COVID-19 pandemic and other co-variables and maternal mental health. RESULTS: NCP and HBC studies respectively included 531 and 2352 participants. Depression rates differed significantly between the two studies (p < 0.05). The mild and moderate-to-severe depression rates in NCP study were 25.8% and 10.36%, respectively, and 19.94% and 0.55% in HBC study. The stress rate of participants was higher in HBC study (69.39%) than in NCP study (60.45%) (p < 0.05). COVID-19 pandemic was correlated with higher depression but lower stress risks (p < 0.05) in pregnant women, with OR and 95% CI as 1.68 (1.16, 2.44) and 0.42 (0.29, 0.61), respectively. Pregnant women with pre-pregnancy obesity and high educational levels might have lower risks for depression, anxiety, and stress than those with normal weight and low educational levels. CONCLUSIONS: Depression among pregnant women was impacted by the pandemic. Apart from COVID-19 pandemic impact, pre-pregnant weight status and educational level might also influence depression, anxiety and stress statuses in pregnant women.


Subject(s)
Anxiety/epidemiology , COVID-19 , Depression/epidemiology , Pregnant Women/psychology , Stress, Psychological/epidemiology , Adult , COVID-19/epidemiology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Pandemics , Pregnancy , Risk Factors
14.
BMC Med Educ ; 21(1): 397, 2021 Jul 23.
Article in English | MEDLINE | ID: covidwho-1322933

ABSTRACT

BACKGROUND: The purpose of this study is to understand the influencing factors of Chinese college students' satisfaction with online teaching and psychological pressure on learning during the novel coronavirus epidemic. METHODS: We assessed the effect of online teaching of 7084 medical students from wannan medical college in March 5 to April 2, 2020 using cluster sampling. The respondents were asked to complete a 7-item self-compiled online teaching satisfaction questionnaire. Chi-square test and multivariate logistic regression analysis are used. RESULTS: Sex is female (OR = 1.257, 95%CI: 1.132 ~ 1.396), grades are second and third grades (second grades: OR = 1.228, 95%CI: 1.080 ~ 1.397; third grades: OR = 1.197, 95%CI: 1.048 ~ 1.367), normal/unfamiliar learning platform operation (OR = 3.692, 95%CI: 3.321 ~ 4.103) were risk factors for satisfactory teaching effect. In addition, students whose school year system is four-year (OR = 0.870, 95%CI: 0.781 ~ 0.969) and grade 4 and above (OR = 0.594, 95%CI: 0.485 ~ 0.727) were more satisfied with the teaching effect of teachers. And, during the period of the COVID-19 epidemic, the risk factors for college students to have psychological stress were: female (OR = 1.258, 95%CI: 1.096 ~ 1.442), from rural areas (OR = 1.511, 95%CI: 1.312 ~ 1.740), and the academic year system is four-year system (OR = 1.191, 95%CI: 1.028 ~ 1.380), using mobile phones and other learning tools (OR = 1.388, 95%CI: 1.205 ~ 1.600), general/unfamiliar with learning platform operations (OR = 2.273), 95%CI: 1.888 ~ 2.735). While the protective factors for college students' psychological stress included: grade three and four and above (OR = 0.463, 95%CI: 0.387 ~ 0.554; OR = 0.232, 95%CI: 0.187 ~ 0.286), and they think that the teaching effect is satisfactory (OR = 0.314, 95%CI: 0.261 ~ 0.379). CONCLUSION: This survey shows that compared with male college students, female college students were more dissatisfied with the teaching effect of teachers and havd greater psychological pressure on learning. Psychological counseling should be strengthened for students in rural areas and those who were not familiar with the operating platform to relieve their psychological pressure on learning.


Subject(s)
COVID-19 , Epidemics , Students, Medical , Female , Humans , Male , SARS-CoV-2 , Schools, Medical
16.
JAMA Ophthalmol ; 139(9): 975-982, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1300334

ABSTRACT

Importance: Interest in teleophthalmology has been growing, especially during the COVID-19 pandemic. The advent of fifth-generation (5G) wireless systems has the potential to revolutionize teleophthalmology, but these systems have not previously been leveraged to conduct therapeutic telemedicine in the ophthalmology field. Objective: To assess the feasibility of 5G real-time laser photocoagulation as a telemedicine-based treatment for diabetic retinopathy (DR). Design, Setting, and Participants: This was a prospective study involving a retinal specialist from the Peking Union Medical College Hospital in Beijing, China, who performed online 5G real-time navigated retinal laser photocoagulation to treat participants with proliferative or severe nonproliferative DR who had been recruited in the Huzhou First People's Hospital in Zhejiang Province, China, located 1200 km from Beijing from October 2019 to July 2020. Interventions: These teleretinal DR and laser management procedures were conducted using a teleophthalmology platform that used the videoconference platform for teleconsultation, after which telelaser planning and intervention were conducted with a laser system and a platform for remote computer control, which were connected via 5G networks. Main Outcomes and Measures: Diabetic eye prognosis and the real-time laser therapy transmission speed were evaluated. Results: A total of 6 participants (9 eyes) were included. Six eyes were treated via panretinal photocoagulation alone, while 1 eye underwent focal/grid photocoagulation and 2 eyes underwent both panretinal photocoagulation and focal/grid photocoagulation. The mean (SD) age was 53.7 (13.6) years (range, 32-67 years). The mean (SD) duration of diabetes was 14.3 (6.4) years (range, 3-20 years). The mean (SD) logMAR at baseline was 0.32 (0.20) (20/30 Snellen equivalent). Retinal telephotocoagulation operations were performed on all eyes without any noticeable delay during treatment. The mean (SD) number of panretinal photocoagulation laser spots per eye in 1 session was 913 (243). Conclusions and Relevance: This study introduces a novel teleophthalmology paradigm to treat DR at a distance. Applying novel technologies may continue to ensure that remote patients with DR and other conditions have access to essential health care. Further studies will be needed to compare this approach with the current standard of care to determine whether visual acuity or safety outcomes differ.


Subject(s)
Diabetic Retinopathy/surgery , Light Coagulation , Telemedicine , Wireless Technology , Adult , Aged , Beijing , Diabetic Retinopathy/diagnostic imaging , Female , Humans , Light Coagulation/adverse effects , Male , Middle Aged , Prospective Studies , Treatment Outcome
17.
Bioengineered ; 12(1): 2836-2850, 2021 12.
Article in English | MEDLINE | ID: covidwho-1297360

ABSTRACT

Angiotensin I-converting enzyme 2 (ACE2), type II transmembrane serine protease 2 and 4 (TMPRSS2 and TMPRSS4) are important receptors for SARS-CoV-2 infection. In this study, the full-length tree shrewACE2 gene was cloned and sequenced, and its biological information was analyzed. The expression levels of ACE2, TMPRSS2 and TMPRSS4 in various tissues or organs of the tree shrew were detected. The results showed that the full-length ACE2 gene in tree shrews was 2,786 bp, and its CDS was 2,418 bp, encoding 805 amino acids. Phylogenetic analysis based on the CDS of ACE2 revealed that tree shrews were more similar to rabbits (85.93%) and humans (85.47%) but far from mice (82.81%) and rats (82.58%). In silico analysis according to the binding site of SARS-CoV-2 with the ACE2 receptor of different species predicted that tree shrews had potential SARS-CoV-2 infection possibility, which was similar to that of rabbits, cats and dogs but significantly higher than that of mice and rats. In addition, various tissues or organs of tree shrews expressed ACE2, TMPRSS2 and TMPRSS4. Among them, the kidney most highly expressed ACE2, followed by the lung and liver. The esophagus, lung, liver, intestine and kidney had relatively high expression levels of TMPRSS2 and TMPRSS4. In general, we reported for the first time the expression of ACE2, TMPRSS2 and TMPRSS4 in various tissues or organs in tree shrews. Our results revealed that tree shrews could be used as a potential animal model to study the mechanism underlying SARS-CoV-2 infection.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/etiology , Membrane Proteins/genetics , SARS-CoV-2 , Serine Endopeptidases/genetics , Tupaiidae/genetics , Tupaiidae/metabolism , Amino Acid Sequence , Angiotensin-Converting Enzyme 2/chemistry , Angiotensin-Converting Enzyme 2/metabolism , Animals , Bioengineering , COVID-19/enzymology , COVID-19/genetics , Computational Biology , Disease Models, Animal , Female , Humans , Male , Membrane Proteins/chemistry , Membrane Proteins/metabolism , Models, Molecular , Phylogeny , Protein Structure, Tertiary , Sequence Homology, Amino Acid , Serine Endopeptidases/chemistry , Serine Endopeptidases/metabolism , Structural Homology, Protein , Tissue Distribution , Tupaiidae/virology
18.
Front Public Health ; 9: 663965, 2021.
Article in English | MEDLINE | ID: covidwho-1295721

ABSTRACT

Objectives: To develop and validate a radiomics model for distinguishing coronavirus disease 2019 (COVID-19) pneumonia from influenza virus pneumonia. Materials and Methods: A radiomics model was developed on the basis of 56 patients with COVID-19 pneumonia and 90 patients with influenza virus pneumonia in this retrospective study. Radiomics features were extracted from CT images. The radiomics features were reduced by the Max-Relevance and Min-Redundancy algorithm and the least absolute shrinkage and selection operator method. The radiomics model was built using the multivariate backward stepwise logistic regression. A nomogram of the radiomics model was established, and the decision curve showed the clinical usefulness of the radiomics nomogram. Results: The radiomics features, consisting of nine selected features, were significantly different between COVID-19 pneumonia and influenza virus pneumonia in both training and validation data sets. The receiver operator characteristic curve of the radiomics model showed good discrimination in the training sample [area under the receiver operating characteristic curve (AUC), 0.909; 95% confidence interval (CI), 0.859-0.958] and in the validation sample (AUC, 0.911; 95% CI, 0.753-1.000). The nomogram was established and had good calibration. Decision curve analysis showed that the radiomics nomogram was clinically useful. Conclusions: The radiomics model has good performance for distinguishing COVID-19 pneumonia from influenza virus pneumonia and may aid in the diagnosis of COVID-19 pneumonia.


Subject(s)
COVID-19 , Orthomyxoviridae , Humans , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
19.
Chin J Acad Radiol ; : 1-9, 2021 Jun 28.
Article in English | MEDLINE | ID: covidwho-1286228

ABSTRACT

Background: Coronary artery calcification (CAC) is an independent risk factor of major adverse cardiovascular events; however, the impact of CAC on in-hospital death and adverse clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective: To explore the association between CAC and in-hospital mortality and adverse events in patients with COVID-19. Methods: This multicenter retrospective cohort study enrolled 2067 laboratory-confirmed COVID-19 patients with definitive clinical outcomes (death or discharge) admitted from 22 tertiary hospitals in China between January 3, 2020 and April 2, 2020. Demographic, clinical, laboratory results, chest CT findings, and CAC on admission were collected. The primary outcome was in-hospital death and the secondary outcome was composed of in-hospital death, admission to intensive care unit (ICU), and requiring mechanical ventilation. Multivariable Cox regression analysis and Kaplan-Meier plots were used to explore the association between CAC and in-hospital death and adverse clinical outcomes. Results: The mean age was 50 years (SD,16) and 1097 (53.1%) were male. A total of 177 patients showed high CAC level, and compared with patients with low CAC, these patients were older (mean age: 49 vs. 69 years, P < 0.001) and more likely to be male (52.0% vs. 65.0%, P = 0.001). Comorbidities, including cardiovascular disease (CVD) ([33.3%, 59/177] vs. [4.7%, 89/1890], P < 0.001), presented more often among patients with high CAC, compared with patients with low CAC. As for laboratory results, patients with high CAC had higher rates of increased D-dimer, LDH, as well as CK-MB (all P < 0.05). The mean CT severity score in high CAC group was also higher than low CAC group (12.6 vs. 11.1, P = 0.005). In multivariable Cox regression model, patients with high CAC were at a higher risk of in-hospital death (hazard ratio [HR], 1.731; 95% CI 1.010-2.971, P = 0.046) and adverse clinical outcomes (HR, 1.611; 95% CL 1.087-2.387, P = 0.018). Conclusion: High CAC is a risk factor associated with in-hospital death and adverse clinical outcomes in patients with confirmed COVID-19, which highlights the importance of calcium load testing for hospitalized COVID-19 patients and calls for attention to patients with high CAC. Supplementary Information: The online version contains supplementary material available at 10.1007/s42058-021-00072-4.

20.
Emerg Microbes Infect ; 10(1): 1418-1428, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1284839

ABSTRACT

Chlamydia psittaci infection in humans, also known as psittacosis, is usually believed to be an uncommon disease which mainly presents as community-acquired pneumonia (CAP). It is usually sporadic, but outbreaks of infection may occasionally occur. In outbreaks, diagnosis and investigations were usually hampered by the non-specificity of laboratory testing methods to identify C. psittaci. In this study, we use metagenomic next-generation sequencing (mNGS) in the diagnosis of a family outbreak of psittacosis under COVID-19. Three members of an extended family of 6 persons developed psittacosis with pneumonia and hepatic involvement with common symptoms of fever and weakness. Two newly purchased pet parrots, which had died successively, were probably the primary source of infection. Imagings show lung consolidations and infiltrates, which are difficult to be differentiated from CAP caused by other common pathogens. mNGS rapidly identified the infecting agent as C. psittaci within 48 h. The results of this work suggest that there are not characteristic clinical manifestations and imagings of psittacosis pneumonia which can differentiate from CAP caused by other pathogens. The use of mNGS can improve accuracy and reduce the delay in the diagnosis of psittacosis especially during the outbreak, which can shorten the course of the disease control. Family outbreak under COVID-19 may be related to the familial aggregation due to the epidemic. To our knowledge, this is the first reported family outbreak of psittacosis in China, and the first reported psittacosis outbreak identified by the method of mNGS in the world.


Subject(s)
Chlamydophila psittaci/genetics , Family , High-Throughput Nucleotide Sequencing , Metagenomics , Pneumonia/microbiology , Psittacosis/diagnostic imaging , Adult , Aged , Animals , COVID-19/epidemiology , China/epidemiology , Chlamydophila psittaci/isolation & purification , Disease Outbreaks , Female , Humans , Male , Metagenome , Middle Aged , Parrots/microbiology , Pneumonia/diagnostic imaging , Psittacosis/microbiology , Psittacosis/transmission , Retrospective Studies , Tomography, X-Ray Computed
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