Risk Factors Associated with Clinical Outcomes in 323 COVID-19 Patients in Wuhan, China

BackgroundWith evidence of sustained transmission in more than 190 countries, coronavirus disease 2019 (COVID-19) has been declared a global pandemic. As such, data are urgently needed about risk factors associated with clinical outcomes. MethodsA retrospective chart review of 323 hospitalized patients with COVID-19 in Wuhan was conducted. Patients were classified into three disease severity groups (non-severe, severe, and critical), based on their initial clinical presentation. Clinical outcomes were designated as favorable and unfavorable, based on disease progression and response to treatments. Logistic regression models were performed to identify factors associated with clinical outcomes, and log-rank test was conducted for the association with clinical progression. ResultsCurrent standard treatments did not show significant improvement on patient outcomes in the study. By univariate logistic regression model, 27 risk factors were significantly associated with clinical outcomes. Further, multivariate regression indicated that age over 65 years, smoking, critical disease status, diabetes, high hypersensitive troponin I (>0.04 pg/mL), leukocytosis (>10 x 109/L) and neutrophilia (>75 x 109/L) predicted unfavorable clinical outcomes. By contrast, the use of hypnotics was significantly associated with favorable outcomes. Survival analysis also confirmed that patients receiving hypnotics had significantly better survival. ConclusionsTo our knowledge, this is the first indication that hypnotics could be an effective ancillary treatment for COVID-19. We also found that novel risk factors, such as higher hypersensitive troponin I, predicted poor clinical outcomes. Overall, our study provides useful data to guide early clinical decision making to reduce mortality and improve clinical outcomes of COVID-19. (Funded by the Natural Science Foundation of Hubei Province ZRMS2019000029 and the Top Youth Talent Program in Hubei Province.)

CT imaging characteristics of incomplete and complete myocardial bridges-mural coronary artery / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the CT imaging characteristics of incomplete and complete myocardial bridges-mural coronary artery (MB-MCA).</p><p><b>METHODS</b>Fifty subjects with dual source coronary CT angiography (DSCTA) evidenced MB were included. The subjects were divided into incomplete MB-MCA and complete MB-MCA groups. The diameter of MCA in best systole phase and diastole phase, the MCA stenosis rate, the presence of atheromatous change proximal to the MB were evaluated.</p><p><b>RESULTS</b>There were 58 MB, the average length was (2.02 ± 1.02) cm, 23 were incomplete MB and 35 were complete MB. Thirty-two MB were in the middle segments of left anterior descending artery (55.2%); 17 MB were in the distal segment of the left anterior descending artery (29.3%); 1 MB was in the proximal segment of left anterior descending artery; 3 MB in diagonal branch; 4 MB in obtuse marginal branch, 1 MB in distal right coronary artery. It was statistically significant difference between the incomplete MB-MCA and the complete MB-MCA of the diameter change in diastole and systole phase [(1.93 ± 0.49) mm, (1.71 ± 0.45) mm vs. (2.21 ± 0.41) mm, (1.63 ± 0.52) mm, P = 0.008] and stenosis rate (10.38% ± 20.2% vs. 25.12% ± 21.02%, P = 0.01). Atherosclerotic finding was evidenced in 8 incomplete MB (34.78%) and 15 complete MB (42.86%) at the proximal vessel of mural coronary artery (P > 0.05).</p><p><b>CONCLUSION</b>DSCTA can vividly display the incomplete and complete myocardial MB, accurately evaluate the shape change of MB-MCA in diastole and systole phase and detect the atherosclerotic change in the proximal vessel of MB.</p>

Affection of metallothionein-3 to dUTPase's accommodating cellular toxicity of dUTP / 生物工程学报

Metallothionein-3 (MT-3), renamed as growth inhibitory factor (GIF), is a brain specific member of the metallothionein family. Human dUTPase is a recently found protein in brain that can interact with hMT-3. They have the growth inhibitory activity on neuron cell by interaction. To study the affection of hMT-3 to dUTPase's eliminating the cellular toxicity caused by dUTP, the pSVHA-dUTPase and pFLag-hMT-3 genes have been transfected into HEK293 cells. In addition, the dUTPase and hMT-3 proteins were expressed in BL21 to study the role of hMT-3 on the hydrolyzation of dUTP by dUTPase. The results demonstrate that the cells co-transfected with dUTPase and hMT-3 genes have more strong resistibility to dUTP than the cells transfected only with dUTPase gene. And that the hMT-3 protein can accelerate the hydrolyzation of dUTP by dUTPase. All these indicate that hMT-3 can cooperate with dUTPase to protect better the 293 cells from dUTP. This research offered the theoretic elements for the application of hMT-3 and dUTPase in chemic cure.