Epidemiological and clinical characteristics of 10 children with coronavirus disease (COVID-19) in Jinan City

Objective: To analysis the epidemiological and clinical characteristics of 10 children with coronavirus disease(COVID-19) in Jinan City.

Investigation and analysis of a cluster of COVID-19 associated with exposure to a shopping mall in Jinan City

Objective: To analyze a cluster outbreak of COVID-19 associated with exposure to a shopping mall in Jinan City, investigate the possible transmission chain, and provide reference for further prevention and control.

Statistical Analysis of Green Laboratory Practice Survey: Conservation on Non-Distilled Water from Distillation Process

The water crisis is identified as the most serious global risk for the coming decade. Distilled water is one of the on-demand elements in academic laboratories;however, water scarcity may eventually affect the education sector, necessitating the implementation of new policies. Human behavior, awareness, knowledge, and opinion is having an impact on water management;accordingly, a questionnaire was purposely designed and validated to assess these variables in a Malaysian public university regarding the use of non-distilled water produced by the distillation process. An exploratory factor analysis yielded four factors: “concept of green laboratory and water”, “usage of non-distilled water”, “knowledge about water distillation”, and “behavior related to water conservation”. Using the Mann–Whitney U test to compare laboratory and non-laboratory users’ responses, the variables “Knowledge”, “Behavior”, and “Opinion” revealed statistically significant differences, with laboratory users scoring higher in all four variables. Employing the Kruskal–Wallis H test in an occupation-based comparison among laboratory users, and with an additional variable “Practice”, showed that “Lecturer” has the highest mean rank for “Awareness”, “Behavior”, and “Opinion”, while “Laboratory Assistant” has the highest mean rank for “Knowledge”. This study provides a rationale analysis for future insights to educate faculty members about the reuse of non-distilled water sustainably.

A Scoring System for Predicting the Prognosis of Late-Onset Severe Pneumonia after Allogeneic Hematopoietic Stem Cell Transplantation.

Late-onset severe pneumonia (LOSP) is defined as severe pneumonia developing during the late phase of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Because of the high mortality in patients with LOSP, it is important to identify prognostic factors. In this study, we aimed to develop a risk score system with broad applicability that can help predict the risk of LOSP-associated mortality. We retrospectively analyzed 100 patients with LOSP after allo-HSCT between June 2009 and July 2017. The assessment variables included immune, nutritional, and metabolic parameters at the onset of LOSP. Of these 100 patients, 45 (45%) eventually died, and 55 (55%) were positive for organisms, most commonly viruses. In the multivariate analysis, higher monocyte count (≥0.20 × 109/L versus <0.20 × 109/L; P = .001), higher albumin level (≥30.5 g/L versus <30.5 g/L; P = .044), lower lactic dehydrogenase level (<250 U/L versus ≥250 U/L; P = .008) and lower blood urea nitrogen concentration (<7.2 mmol/L versus ≥7.2 mmol/L; P = .026) at the onset of LOSP were significantly associated with better 60-day survival. A risk score system based on the foregoing results showed that the probability of 60-day survival decreased with increasing risk factors, from 96.3% in the low-risk group to 49.1% in the intermediate-risk group and 12.5% in the high-risk group. Our results indicate that this scoring system using 4 variables can stratify patients with different probabilities of survival after LOSP, which suggests that patients' immune, nutritional, and metabolic status are crucial factors in determining outcome.

A cohort autopsy study defines COVID-19 systemic pathogenesis.

Severe COVID-19 disease caused by SARS-CoV-2 is frequently accompanied by dysfunction of the lungs and extrapulmonary organs. However, the organotropism of SARS-CoV-2 and the port of virus entry for systemic dissemination remain largely unknown. We profiled 26 COVID-19 autopsy cases from four cohorts in Wuhan, China, and determined the systemic distribution of SARS-CoV-2. SARS-CoV-2 was detected in the lungs and multiple extrapulmonary organs of critically ill COVID-19 patients up to 67 days after symptom onset. Based on organotropism and pathological features of the patients, COVID-19 was divided into viral intrapulmonary and systemic subtypes. In patients with systemic viral distribution, SARS-CoV-2 was detected in monocytes, macrophages, and vascular endothelia at blood-air barrier, blood-testis barrier, and filtration barrier. Critically ill patients with long disease duration showed decreased pulmonary cell proliferation, reduced viral RNA, and marked fibrosis in the lungs. Permanent SARS-CoV-2 presence and tissue injuries in the lungs and extrapulmonary organs suggest direct viral invasion as a mechanism of pathogenicity in critically ill patients. SARS-CoV-2 may hijack monocytes, macrophages, and vascular endothelia at physiological barriers as the ports of entry for systemic dissemination. Our study thus delineates systemic pathological features of SARS-CoV-2 infection, which sheds light on the development of novel COVID-19 treatment.