A Model for Predicting the Duration of Viral Shedding in Patients Who Had Been Hospitalized with Mild COVID-19: A Single-Center Retrospective Study.

Background: Clinical decision-making is enhanced by the development of a mathematical model for prognosis prediction. Screening criteria associated with viral shedding time and developing a prediction model facilitate clinical decision-making and are, thus, of great medical value. Methods: This study comprised 631 patients who were hospitalized with mild COVID-19 from a single center and 30 independent variables included. The data set was randomly divided into the training set (80%) and the validation set (20%). The outcome variable included viral shedding time and whether the viral shedding time >14 days, LASSO was used to screen the influencing factors. Results: There were 321 males and 310 females among the 631 cases, with an average age of 62.1 years; the median viral shedding time was 12 days, and 68.8% of patients experienced viral shedding within 14 days, with fever (50.9%) and cough (44.2%) being the most common clinical manifestations. Using LASSO with viral shedding time as the outcome variable, the model with lambda as 0.1592 (λ = 0.1592) and 13 variables (eg the time from diagnosis to admission, constipation, cough, hs-CRP, IL-8, IL-1ß, etc.) was more accurate. Factors were screened by LASSO and multivariable logistic regression with whether the viral shedding time >14 days as the outcome variable, five variables, including the time from diagnosis to admission, CD4 cell count, Ct value of ORF1ab, constipation, and IL-8, were included, and a nomogram was drawn; after model validation, the consistency index was 0.888, the AUC was 0.847, the sensitivity was 0.744, and the specificity was 0.830. Conclusion: A clinical model developed after LASSO regression was used to identify the factors that influence the viral shedding time. The predicted performance of the model was good, and it was useful for the allocation of medical resources.

Effect of "yang-warming and kidney essence-replenishing" herbal paste on cold-related asthma exacerbation.

OBJECTIVE: To observe the effect of "Yang-warming and kidney essence-replenishing" herbal paste on cold-related asthma exacerbation. METHODS: One hundred and fifty one patients with moderate to severe persistent asthma were randomly divided into a treatment group (n = 74) and a control group (n = 69). Both groups were given basic treatment according to the Global Initiative for Asthma scheme. The treatment group was also treated with herbal paste in the winter. The frequency of asthma exacerbation, cold and cold-related asthma exacerbation, scores of the asthma control test (ACT), and kidney-deficiency syndrome during the one-year follow-up in each group were recorded. RESULTS: Compared with the control group, the onset frequencies of catching cold, asthma exacerbation, cold-related asthma exacerbation, and kidney-deficiency syndrome score were significantly reduced. There was no significant difference in scores of ACT between the two groups. CONCLUSION: "Yang-warming and kidney essence-replenishing" herbal paste could reduce cold-related asthma exacerbation.

[Effects of medicinal extract for tonifying kidney to relieve asthma on glucocorticoid receptor expression in lung tissues of rats with bronchial asthma].

OBJECTIVE: To observe the effects of medicinal extract for tonifying kidney to relieve asthma on glucocorticoid receptor (GR) expression in rats with asthma, and to explore its mechanism in treating asthma. METHODS: Sixty SD rats were randomly divided into normal control group, untreated group, dexamethasone group, and medicinal extract-prevented, medicinal extract-treated, and medicinal extract-prevented and -treated groups, with ten rats in each group. Asthma was induced by intraperitoneal injection of ovalbumin (OVA) and forced inhalation of atomized OVA. Expression of GR in lung tissues was detected by immunohistochemical method. Pathological changes of the lung tissues were observed by HE straining. RESULTS: Expression of GR was lower in the untreated group than in the normal control group (P<0.05). Expressions of GR in medicinal extract groups were up-regulated as compared with those in the untreated group and dexamethasone group (P<0.05, P<0.01), and there were no significant differences as compared with the normal control group (P>0.05). CONCLUSION: Medicinal extract for tonifying kidney to relieve asthma can increase the expression of GR in lung tissues of asthmatic rats, which may be one of its mechanisms in preventing and treating asthma.