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1.
Vaccines (Basel) ; 10(6)2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1884442

ABSTRACT

PURPOSE: To report the clinical characteristics of ocular adverse events that have occurred, in China, after vaccination with inactivated COVID-19 vaccines. METHODS: A retrospective cross-sectional observational study was conducted of ocular disorders that occurred within 15 days from any dose of an inactivated COVID-19 vaccine. Information on gender, age, the interval between the vaccination and ocular symptoms, laterality, duration of the ocular symptoms, primary visual acuity, and clinical diagnosis were retrospectively collected. RESULTS: Twenty-four patients were involved in the study, including 15 females and 9 males, with a mean age of 41 ± 16 years (range of 8-71 years). The patients all denied a prior history of COVID-19 infection. Ocular adverse events occurred after the first dose of vaccine in 18 patients and, after the second or third doses, in six patients. The interval between vaccination with the inactivated COVID-19 vaccine and ocular symptoms was 6 ± 5 days; six patients were bilaterally involved and 18 patients were unilaterally involved. Regarding the diagnosis, 10 patients were diagnosed with white dot syndrome (WDS), 9 patients were diagnosed with uveitis, and 5 patients were diagnosed with retinal vascular disorders. The ages of patients with WDS were younger than those with uveitis or retinal vascular disorders (32 ± 10 vs. 48 ± 18, p < 0.05). For patients diagnosed with WDS, the best-corrected visual acuity (BCVA) was 0.74 ± 0.73 LogMAR. For patients diagnosed with retinal vascular disorders or uveitis, the BCVA was 1.44 ± 1.26 LogMAR. There was no significant difference (p > 0.05). CONCLUSIONS: A relationship cannot be established between inactivated COVID-19 vaccines and ocular disorders; therefore, further investigation of the clinical spectrum of ocular adverse events after vaccination with an inactivated COVID-19 vaccine is necessary.

2.
Chemosphere ; 303(Pt 2): 135013, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1864545

ABSTRACT

A single particle aerosol mass spectrometer was deployed in a heavily polluted area of China during a coronavirus lockdown to explore the impact of reduced anthropogenic emissions on the chemical composition, size distributions, mixing state, and secondary formation of urban aerosols. Ten particle groups were identified using an adaptive resonance network algorithm. Increased atmospheric oxidation during the lockdown period (LP) resulted in a 42.2%-54% increase in the major NaK-SN particle fraction relative to the normal period (NP). In contrast, EC-aged particles decreased from 31.5% (NP) to 23.7% (LP), possibly due to lower emissions from motor vehicles and coal combustion. The peak particle size diameter increased from 440 nm during the NP to 500 nm during LP due to secondary particle formation. High proportions of mixed 62NO3- indicate extensive particle aging. Correlations between secondary organic (43C2H3O+, oxalate) and secondary inorganic species (62NO3-, 97HSO4- and 18NH4+) versus oxidants (Ox = O3 + NO2) and relative humidity (RH) indicate that increased atmospheric oxidation promoted the generation of secondary species, while the effects of RH were more complex. Differences between the NP and LP show that reductions in primary emissions had a remarkable impact on the aerosol particles. This study provides new insights into the effects of pollution emissions on atmospheric reactions and the specific aerosol types in urban regions.


Subject(s)
Air Pollutants , Particulate Matter , Aerosols/analysis , Air Pollutants/analysis , China , Environmental Monitoring/methods , Particle Size , Particulate Matter/analysis
3.
Commun Biol ; 5(1): 262, 2022 03 24.
Article in English | MEDLINE | ID: covidwho-1799550

ABSTRACT

Understanding the underlying molecular mechanisms behind ADE of SARS-CoV-2 is critical for development of safe and effective therapies. Here, we report that two neutralizing mAbs, MW01 and MW05, could enhance the infection of SARS-CoV-2 pseudovirus on FcγRIIB-expressing B cells. X-ray crystal structure determination and S trimer-binding modeling showed that MW01 and MW05 could bind to RBDs in S trimer with both "up" and "down" states. While, the neutralizing mAb MW07, which has no ADE activity only binds to RBD in S trimer with "up" state. Monovalent MW01 and MW05 completely diminished the ADE activity compared with their bivalent counterparts. Moreover, both macropinocytosis and endocytosis are confirmed involving in ADE of SARS-CoV-2 pseudoviral infection. Blocking endosome transportation and lysosome acidification could inhibit the ADE activity mediated by MW05. Together, our results identified a novel ADE mechanism of SARS-CoV-2 pseudovirus in vitro, FcγRIIB-mediated uptake of SARS-CoV-2/mAb complex with bivalent interaction.


Subject(s)
Antibody-Dependent Enhancement , COVID-19 , Antibodies, Viral , Humans , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
4.
Mikrochim Acta ; 189(3): 125, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1712245

ABSTRACT

A novel electrochemical sensor is reported for the detection of the antiviral drug favipiravir based on the core-shell nanocomposite of flower-like molybdenum disulfide (MoS2) nanospheres and molecularly imprinted polymers (MIPs). The MoS2@MIP core-shell nanocomposite was prepared via the electrodeposition of a MIP layer on the MoS2 modified electrode, using o-phenylenediamine as the monomer and favipiravir as the template. The selective binding of target favipiravir at the MoS2@MIP core-shell nanocomposite produced a redox signal in a concentration dependent manner, which was used for the quantitative analysis. The preparation process of the MoS2@MIP core-shell nanocomposite was optimized. Under the optimal conditions, the sensor exhibited a wide linear response range of 0.01 ~ 100 nM (1.57*10-6 ~ 1.57*10-2 µg mL-1) and a low detection limit of 0.002 nM (3.14*10-7 µg mL-1). Application of the sensor was demonstrated by detecting favipiravir in a minimum amount of 10 µL biological samples (urine and plasma). Satisfied results in the recovery tests indicated a high potential of favipiravir monitoring in infectious COVID-19 samples.


Subject(s)
Amides/analysis , Antiviral Agents/analysis , Disulfides/chemistry , Molecularly Imprinted Polymers/chemistry , Molybdenum/chemistry , Nanocomposites/chemistry , Nanospheres/chemistry , Pyrazines/analysis , Amides/blood , Amides/therapeutic use , Amides/urine , Antiviral Agents/blood , Antiviral Agents/therapeutic use , Antiviral Agents/urine , COVID-19/drug therapy , COVID-19/virology , Electrochemical Techniques/methods , Humans , Limit of Detection , Oxidation-Reduction , Pyrazines/blood , Pyrazines/therapeutic use , Pyrazines/urine , Reproducibility of Results , SARS-CoV-2/isolation & purification
5.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-326494

ABSTRACT

Purpose: To explore whether comments could be used as an assistant tool for heuristic decision-making, especially in cases where missing, incomplete, uncertain, or even incorrect evidence is acquired. Methods: Six COVID-19 drug candidates were selected from WHO clinical guidelines. Evidence-comment networks (ECNs) were completed of these six drug candidates based on evidence-comment pairs from all PubMed indexed COVID-19 publications with formal published comments. WHO guidelines were utilized to validate the feasibility of comment-derived evidence assertions as a fast decision supporting tool. Results: Out of 6 drug candidates, comment-derived evidence assertions of leading subgraphs of 5 drugs were consistent with WHO guidelines, and the overall comment sentiment of 6 drugs was aligned with WHO clinical guidelines. Additionally, comment topics were in accordance with the concerns of guidelines and evidence appraisal criteria. Furthermore, half of the critical comments emerged 4.5 months earlier than the date guidelines were published. Conclusions: Comment-derived evidence assertions have the potential as an evidence appraisal tool for heuristic decisions based on the accuracy, sensitivity, and efficiency of evidence-comment networks. In essence, comments reflect that academic communities do have a self-screening evaluation and self-purification (argumentation) mechanism, thus providing a tool for decision makers to filter evidence.

6.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-326493

ABSTRACT

Purpose: To explore whether comments could be used as an assistant tool for heuristic decision-making, especially in cases where missing, incomplete, uncertain, or even incorrect evidence is acquired. Methods: Six COVID-19 drug candidates were selected from WHO clinical guidelines. Evidence-comment networks (ECNs) were completed of these six drug candidates based on evidence-comment pairs from all PubMed indexed COVID-19 publications with formal published comments. WHO guidelines were utilized to validate the feasibility of comment-derived evidence assertions as a fast decision supporting tool. Results: Out of 6 drug candidates, comment-derived evidence assertions of leading subgraphs of 5 drugs were consistent with WHO guidelines, and the overall comment sentiment of 6 drugs was aligned with WHO clinical guidelines. Additionally, comment topics were in accordance with the concerns of guidelines and evidence appraisal criteria. Furthermore, half of the critical comments emerged 4.5 months earlier than the date guidelines were published. Conclusions: Comment-derived evidence assertions have the potential as an evidence appraisal tool for heuristic decisions based on the accuracy, sensitivity, and efficiency of evidence-comment networks. In essence, comments reflect that academic communities do have a self-screening evaluation and self-purification (argumentation) mechanism, thus providing a tool for decision makers to filter evidence.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323697

ABSTRACT

Background: The novel coronavirus (COVID-19), which began in Wuhan, China, in December 2019, has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension. Methods: : A total of 188 COVID-19 patients were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of anti-hypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed. Results: : The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in the Wuhan area. Common symptoms of all of the patients included fever, cough, and fatigue. Chest CT scans showed bilateral patchy shadows or ground glass opacity in the lungs of all of the patients. All (98 [100%]) of the hypertensive patients received antiviral therapy (Arbidol was used alone or in combination with Ribavirin), antibiotic therapy (85 [86.7%]), and corticosteroids (31 [31.6%]). It has been suggested that the combination of Arbidol and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) had no statistically significant differences between the mild and severe groups (p > 0.05). Conclusion: In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Arbidol and Ribavirin played an important role in the treatment of the viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than non-hypertensive patients.

8.
MAbs ; 13(1): 1953683, 2021.
Article in English | MEDLINE | ID: covidwho-1327301

ABSTRACT

The global pandemic of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in widespread social and economic disruption. Effective interventions are urgently needed for the prevention and treatment of COVID-19. Neutralizing monoclonal antibodies (mAbs) have demonstrated their prophylactic and therapeutic efficacy against SARS-CoV-2, and several have been granted authorization for emergency use. Here, we discover and characterize a fully human cross-reactive mAb, MW06, which binds to both SARS-CoV-2 and SARS-CoV spike receptor-binding domain (RBD) and disrupts their interaction with angiotensin-converting enzyme 2 (ACE2) receptors. Potential neutralization activity of MW06 was observed against both SARS-CoV-2 and SARS-CoV in different assays. The complex structure determination and epitope alignment of SARS-CoV-2 RBD/MW06 revealed that the epitope recognized by MW06 is highly conserved among SARS-related coronavirus strains, indicating the potential broad neutralization activity of MW06. In in vitro assays, no antibody-dependent enhancement (ADE) of SARS-CoV-2 infection was observed for MW06. In addition, MW06 recognizes a different epitope from MW05, which shows high neutralization activity and has been in a Phase 2 clinical trial, supporting the development of the cocktail of MW05 and MW06 to prevent against future escaping variants. MW06 alone and the cocktail show good effects in preventing escape mutations, including a series of variants of concern, B.1.1.7, P.1, B.1.351, and B.1.617.1. These findings suggest that MW06 recognizes a conserved epitope on SARS-CoV-2, which provides insights for the development of a universal antibody-based therapy against SARS-related coronavirus and emerging variant strains, and may be an effective anti-SARS-CoV-2 agent.


Subject(s)
Antibodies, Monoclonal, Humanized/immunology , Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , COVID-19/virology , SARS Virus/immunology , SARS-CoV-2/immunology , Amino Acid Sequence , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Neutralizing/chemistry , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral/chemistry , Antibodies, Viral/therapeutic use , Antibody-Dependent Enhancement , COVID-19/drug therapy , COVID-19/therapy , Conserved Sequence , Cross Reactions , Epitopes/chemistry , Epitopes/genetics , Epitopes/immunology , Humans , Models, Molecular , Neutralization Tests , Pandemics , Protein Domains , Protein Interaction Domains and Motifs , SARS Virus/chemistry , SARS Virus/genetics , SARS-CoV-2/chemistry , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology
9.
Crit Care Res Pract ; 2021: 5585291, 2021.
Article in English | MEDLINE | ID: covidwho-1255646

ABSTRACT

BACKGROUND: COVID-19 may result in multiorgan failure and death. Early detection of patients at risk may allow triage and more intense monitoring. The aim of this study was to develop a simple, objective admission score, based on laboratory tests, that identifies patients who are likely going to deteriorate. METHODS: This is a retrospective cohort study of all COVID-19 patients admitted to a tertiary academic medical center in New York City during the COVID-19 crisis in spring 2020. The primary combined endpoint included intubation, stage 3 acute kidney injury (AKI), or death. Laboratory tests available on admission in at least 70% of patients (and age) were included for univariate analysis. Tests that were statistically or clinically significant were then included in a multivariate binary logistic regression model using stepwise exclusion. 70% of all patients were used to train the model, and 30% were used as an internal validation cohort. The aim of this study was to develop and validate a model for COVID-19 severity based on biomarkers. RESULTS: Out of 2545 patients, 833 (32.7%) experienced the primary endpoint. 53 laboratory tests were analyzed, and of these, 47 tests (and age) were significantly different between patients with and without the endpoint. The final multivariate model included age, albumin, creatinine, C-reactive protein, and lactate dehydrogenase. The area under the ROC curve was 0.850 (CI [95%]: 0.813, 0.889), with a sensitivity of 0.800 and specificity of 0.761. The probability of experiencing the primary endpoint can be calculated as p=e (-2.4475+0.02492age - 0.6503albumin+0.81926creat+0.00388CRP+0.00143LDH)/1+e (-2.4475+ 0.02492age - 0.6503albumin+0.81926creat+0.00388CRP+0.00143LDH). CONCLUSIONS: Our study demonstrated that poor outcome in COVID-19 patients can be predicted with good sensitivity and specificity using a few laboratory tests. This is useful for identifying patients at risk during admission.

10.
J Clin Lab Anal ; 35(4): e23703, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1151916

ABSTRACT

COVID-19 has a worldwide distribution; however, there is no effective diagnosis marker, especially for the mild-type COVID-19. The purpose of the current study was to identify parameters for mild-type COVID-19. We retrospectively analyzed a single-center data of patients with mild COVID-19. Forty patients diagnosed with COVID-19 were enrolled. Peripheral blood indices between the admission and discharge times were collected and analyzed. The platelet distribution width (PDW) was shown to be an indicator of significant change. The receiver operating characteristic curve for PDW was 0.7; the sensitivity and specificity for PDW were 82.5% and 55.0%, respectively. Therefore, a potential diagnostic value of PDW for mild-type COVID-19 was demonstrated.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Mean Platelet Volume/methods , Adult , Aged , COVID-19/blood , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , ROC Curve , Retrospective Studies
11.
Open Med (Wars) ; 16(1): 367-374, 2021.
Article in English | MEDLINE | ID: covidwho-1140551

ABSTRACT

BACKGROUND: SARS-CoV-2 has spread worldwide and poses a great threat to human health. Among COVID-19 patients, those with hypertension have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 with hypertension. METHODS: A total of 623 COVID-19 patients enrolled in Wuhan's hospital were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive patients with COVID-19 were collected, retrospectively analyzed, and compared with a normotensive group. The use of antihypertensive drugs, general treatment, and clinical outcomes of hypertensive patients were also analyzed. RESULTS: The median ages in hypertensive patients with mild and severe COVID-19 were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive and normotensive groups. All patients had lived in Wuhan area. Common symptoms of all patients included fever, cough, and fatigue. Chest computed tomography (CT) scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. All (315 (100%)) of the hypertensive patients received antiviral therapy (Umifenovir was used alone or in combination with Ribavirin), antibiotic therapy (215 (68.3%)), and corticosteroids (118 (37.5%)). The results suggest that the combination of Umifenovir and Ribavirin as initial therapy for hypertensive patients with COVID-19 is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive and the normotensive groups. In the severe cases, the hypertensive patients had higher plasma levels of D-dimer, C-reactive protein (CRP), and Interleukin-6 (IL-6) (P < 0.05). Furthermore, the hypertensive patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were not represented in a statistically significant manner between the mild and severe groups (p > 0.05). CONCLUSION: In this study, we demonstrated that the hypertensive patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19. Umifenovir and Ribavirin played an important role in the treatment of viral pneumonia. Hypertensive patients with severe viral pneumonia had stronger inflammatory responses than nonhypertensive patients.

13.
J Clin Lab Anal ; 35(1): e23654, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-932443

ABSTRACT

BACKGROUND: Geriatric patients with coronavirus disease (COVID-19) are at high risk of developing cardiac injury. Identifying the factors that affect high-sensitivity cardiac troponin I may indicate the cause of cardiac injury in elderly patients, and this could hopefully assist in protecting heart function in this patient population. METHODS: One hundred and eighty inpatients who were admitted for COVID-19 were screened. Patients older than 60 years were included in this study, and the clinical characteristics and laboratory results of the cohort were analyzed. The correlation between cardiac injury and clinical/laboratory variables was statistically analyzed, and further logistic regression was performed to determine how these variables influence cardiac injury in geriatric patients. RESULTS: Age (p < 0.001) significantly correlated with cardiac injury, whereas sex (p = 0.372) and coexisting diseases did not. Rising procalcitonin (p = 0.001), interleukin-2 receptor (p < 0.001), interleukin 6 (p = 0.001), interleukin 10 (p < 0.001), tumor necrosis factor α (p = 0.001), high-sensitivity C-reactive protein (p = 0.001), D-dimer (p < 0.001), white blood cells (p < 0.001), neutrophils (p = 0.001), declining lymphocytes (p < 0.001), and natural killer cells (p = 0.005) were associated with cardiac injury and showed predictive ability in the multivariate logistic regression. CONCLUSION: Our results suggest that age and inflammatory factors influence cardiac injury in elderly patients. Interfering with inflammation in this patient population may potentially confer cardiac protection.


Subject(s)
COVID-19/complications , Cardiomyopathies/virology , Aged , Aged, 80 and over , COVID-19/blood , Cardiomyopathies/etiology , Creatine Kinase/blood , Humans , Inflammation Mediators/blood , Killer Cells, Natural , L-Lactate Dehydrogenase/blood , Male , Middle Aged , Myocarditis/etiology , Myocarditis/virology , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Risk Factors , Troponin T/blood
14.
Nat Commun ; 11(1): 5752, 2020 11 13.
Article in English | MEDLINE | ID: covidwho-926678

ABSTRACT

Efficacious interventions are urgently needed for the treatment of COVID-19. Here, we report a monoclonal antibody (mAb), MW05, with SARS-CoV-2 neutralizing activity by disrupting the interaction of receptor binding domain (RBD) with angiotensin-converting enzyme 2 (ACE2) receptor. Crosslinking of Fc with FcγRIIB mediates antibody-dependent enhancement (ADE) activity by MW05. This activity is eliminated by introducing the LALA mutation to the Fc region (MW05/LALA). Potent prophylactic and therapeutic effects against SARS-CoV-2 are observed in rhesus monkeys. A single dose of MW05/LALA blocks infection of SARS-CoV-2 in prophylactic treatment and clears SARS-CoV-2 in three days in a therapeutic treatment setting. These results pave the way for the development of MW05/LALA as an antiviral strategy for COVID-19.


Subject(s)
Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antiviral Agents/pharmacology , Betacoronavirus/immunology , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Spike Glycoprotein, Coronavirus/immunology , Angiotensin-Converting Enzyme 2 , Animals , Antibodies, Viral/immunology , COVID-19 , Cell Line , Chlorocebus aethiops , Coronavirus Infections/prevention & control , Female , HEK293 Cells , Humans , Macaca mulatta , Male , Pandemics/prevention & control , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/prevention & control , Receptors, IgG/genetics , Receptors, IgG/immunology , Receptors, Virus/metabolism , SARS-CoV-2 , Vero Cells , Virus Attachment
15.
Front Med (Lausanne) ; 7: 190, 2020.
Article in English | MEDLINE | ID: covidwho-327631

ABSTRACT

The new coronavirus SARS-CoV-2 pandemic of early 2020 poses an enormous challenge to global public health. Coronavirus Disease 2019 (COVID-19) caused by the virus has spread rapidly throughout the world, taking thousands of lives in just over 2 months. It is critical to refine the incidence and mortality risks of COVID-19 for the effective management of the general public and patients during the outbreak. In this report, we investigate the incidence and mortality risks of the infection by analyzing the age composition of 5,319 infected patients, 76 fatal cases, and 1,144,648 individuals of the general public in China. Our results show a relatively low incidence risk for young people but a very high mortality risk for seniors. Notably, mortality risk could be as high as 0.48 for people older than 80 years. Furthermore, our study suggests that a good medical service can effectively reduce the mortality rate of the viral infection to 1% or less.

16.
J Med Internet Res ; 22(4): e18948, 2020 04 22.
Article in English | MEDLINE | ID: covidwho-62910

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) has been an unprecedented challenge to the global health care system. Tools that can improve the focus of surveillance efforts and clinical decision support are of paramount importance. OBJECTIVE: The aim of this study was to illustrate how new medical informatics technologies may enable effective control of the pandemic through the development and successful 72-hour deployment of the Honghu Hybrid System (HHS) for COVID-19 in the city of Honghu in Hubei, China. METHODS: The HHS was designed for the collection, integration, standardization, and analysis of COVID-19-related data from multiple sources, which includes a case reporting system, diagnostic labs, electronic medical records, and social media on mobile devices. RESULTS: HHS supports four main features: syndromic surveillance on mobile devices, policy-making decision support, clinical decision support and prioritization of resources, and follow-up of discharged patients. The syndromic surveillance component in HHS covered over 95% of the population of over 900,000 people and provided near real time evidence for the control of epidemic emergencies. The clinical decision support component in HHS was also provided to improve patient care and prioritize the limited medical resources. However, the statistical methods still require further evaluations to confirm clinical effectiveness and appropriateness of disposition assigned in this study, which warrants further investigation. CONCLUSIONS: The facilitating factors and challenges are discussed to provide useful insights to other cities to build suitable solutions based on cloud technologies. The HHS for COVID-19 was shown to be feasible and effective in this real-world field study, and has the potential to be migrated.


Subject(s)
Cloud Computing , Coronavirus Infections/epidemiology , Decision Support Systems, Clinical , Pneumonia, Viral/epidemiology , Sentinel Surveillance , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus , Delivery of Health Care , Humans , Mobile Applications , Pandemics , Patient Discharge , Public Health , SARS-CoV-2
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