Clinical observation of neutralizing antibody DXP-604 for treatment critical COVID-19 patients infected with SARS-CoV-2 Delta variant.

From January to March 2022, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta (B.1.617.2) infection was prevalent in Yuzhou and Zhengzhou. DXP-604 is a broad-spectrum antiviral monoclonal antibody, which has excellent viral neutralization ability in vitro and a long half-life in vivo, with good biosafety and tolerability. Preliminary results showed that DXP-604 can accelerate recovery from Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 Delta variant in hospitalized patients with mild to moderate clinical symptoms. However, the efficacy of DXP-604 has not been fully studied in high-risk severe patients. Here, we prospectively enrolled 27 high-risk patients, two groups were divided, in addition to receiving standard of care (SOC), 14 of them additionally received the neutralizing antibody DXP-604 therapy, and another 13 intensive care unit (ICU) patients simultaneously underwent SOC as a control group matched for age, gender, and clinical type. The results revealed lower C-reactive protein, interleukin-6, lactic dehydrogenase and neutrophil counts, and higher lymphocyte and monocyte counts from Day 3 post-DXP-604 treatment compared with SOC treatment. Besides, thoracic CT images showed improvements in lesion areas and degrees, along with changes in blood inflammatory factors. Moreover, DXP-604 reduced the invasive mechanical ventilation and mortality of high-risk SARS-CoV-2 infected patients. The ongoing clinical trials of DXP-604 neutralizing antibody will clarify its utility as a new attractive countermeasure for high-risk COVID-19.

Analysis of CT signs, radiomic features and clinical characteristics for delta variant COVID-19 patients with different vaccination status.

OBJECTIVE: To explore the characteristics of peripheral blood, high resolution computed tomography (HRCT) imaging and the radiomics signature (RadScore) in patients infected with delta variant virus under different coronavirus disease (COVID-19) vaccination status. METHODS: 123 patients with delta variant virus infection collected from November 1, 2021 to March 1, 2022 were analyzed retrospectively. According to COVID-19 vaccination Status, they were divided into three groups: Unvaccinated group, partially vaccinated group and full vaccination group. The peripheral blood, chest HRCT manifestations and RadScore of each group were analyzed and compared. RESULTS: The mean lymphocyte count 1.22 ± 0.49 × 10^9/L, CT score 7.29 ± 3.48, RadScore 0.75 ± 0.63 in the unvaccinated group; The mean lymphocyte count 1.55 ± 0.70 × 10^9/L, CT score 5.27 ± 2.72, RadScore 1.03 ± 0.46 in the partially vaccinated group; The mean lymphocyte count 1.87 ± 0.70 × 10^9/L, CT score 3.59 ± 3.14, RadScore 1.23 ± 0.29 in the fully vaccinated group. There were significant differences in lymphocyte count, CT score and RadScore among the three groups (all p < 0.05); Compared with the other two groups, the lung lesions in the unvaccinated group were more involved in multiple lobes, of which 26 cases involved the whole lung. CONCLUSIONS: Through the analysis of clinical features, pulmonary imaging features and radiomics, we confirmed the positive effect of COVID-19 vaccine on pulmonary inflammatory symptoms and lymphocyte count (immune system) during delta mutant infection.

Assessment of left ventricular myocardial scar in coronary artery disease by a three-dimensional MR imaging technique.

PURPOSE: To evaluate the feasibility of free-breathing three-dimensional (3D) phase sensitive inversion recovery (PSIR) Turbo FLASH late gadolinium enhancement (LGE) magnetic resonance images (MRI) on left ventricular scar in patients with coronary artery disease (CAD) compared with clinically established breathhold two-dimensional (2D) PSIR Turbo FLASH images. MATERIALS AND METHODS: In 58 consecutive patients with confirmed CAD, LGE MRI using the two sequences have been acquired. Image quality was graded on a four-point scale according to the image appearance. Qualitative evaluation including the distribution area and the transmural extent of the scar based on the American Heart Association's (AHA's) 17-segment model was performed in both of 2D and 3D images. The scar volumes were compared quantitatively between 2D and 3D images. RESULTS: A total of 51 individuals were used for final statistical analysis. No differences were noted in image quality (P = 0.80), scar distribution area (P = 0.17), and scar transmural extent (P = 0.20) between 3D and 2D images. There was strong correlation in scar volume between the 3D and 2D results (r = 0.940; P < 0.001; Y = 0.298 + 1.251X, R(2) = 0.876). But the scar volume derived from 3D images was significantly larger than that derived from 2D images (2D versus 3D, 20.08 ± 9.41 cm(3) versus 25.41 ± 12.57 cm(3) , t = -7.60; P < 0.001). The trend toward a larger scar volume identified by 3D method was indicated through Bland-Altman analysis. CONCLUSION: Free-breathing 3D PSIR Turbo FLASH imaging is another feasible method to identify left ventricular myocardial scar in patients with CAD and detects more scar volume compared with breathhold 2D PSIR Turbo FLASH imaging.

Association of SPP1 promoter variants with hip osteoarthritis susceptibility in Chinese population.

Three genetic variants in the promoter of SPP1 (secreted phosphoprotein 1) gene have been reported to affect transcriptional activity of SPP1, thus conferring an increased risk for some diseases. To testify if these variants are associated with risk of hip osteoarthritis (OA) as well, we performed a case-control study including 389 hip OA patients and 315 healthy controls. Genotypes of SPP1 were determined by DNA sequencing, and differential expressions of SPP1 in relation with genotypes were evaluated by RT-PCR and ELISA. The results showed that rs17524488 (delG>insG) increased the risk of hip OA, with the adjusted OR 1.48 (95% CI 1.18-1.85, P<0.01) for risk allele insG, 1.90 (95% CI 1.35-2.66, P<0.01) for delG/insG and 2.04 (95% CI 1.20-3.49, P<0.01) for insG/insG respectively. However, as for rs11730582 (T>C), the adjusted ORs were 1.18 (95% CI 0.94-1.49, P=0.148) for allele C, 1.26 (95% CI 0.90-1.75, P=0.158) for TC, and 1.31 (95% CI 0.77-2.24, P=0.293) for CC, indicating no association of rs11730582 with hip OA risk. The variant rs28357094 was not observed in the tested subjects. Furthermore, the delG/insG and insG/insG genotypes of rs17524488 both correlated with higher levels of SPP1 expression in articular cartilage (P<0.01 for all comparisons) as well as in in synovial fluid (P<0.01 for all comparisons) compared with delG/delG, while rs11730582 had no effect on the SPP1 expression (P>0.05 for all comparisons). These results collectively indicate that the genetic variant rs17524488 in SPP1 promoter confers high risk for hip OA in a Chinese population, possibly through enhancing SPP1 expression.