Impact of COVID-19 on acute ischemic stroke presentation and prognosis in a county-level stroke center.

OBJECTIVE: The COVID-19 pandemic has influenced regular medical procedures and health-seeking behaviors. In this study, we aimed to investigate the influence of the COVID-19 pandemic on the presentation and prognosis of acute ischemic stroke (AIS) patients in county-level stroke centers. PATIENTS AND METHODS: We retrospectively collected AIS patients during the strict lockdown period (January 24, 2020, to March 27, 2020) and the corresponding "new normal" period (2021) of the COVID-19 pandemic. Patients seen during the same timeframe in 2019 were enrolled as controls. Statistical analysis was conducted to compare the clinical characteristics of AIS patients who presented during the lockdown and new normal periods and those who presented during the pre-COVID-19 pandemic period. RESULTS: A total of 134 AIS patients presented during the lockdown period (the 2020 group), 207 patients in the pre-COVID-19 period (the 2019 group) and 201 patients in the "new normal" period (the 2021 group). Compared to the 2019 group, there was approximately 1/3 reduction in the number of patients who presented during the lockdown period, while the number of patients who received IVT or EVT was similar between the two groups. The number of patients, baseline characteristics, workflow intervals and clinical outcomes presented during the "new normal" period were similar between the 2019 and 2021 groups. Logistic regression showed that lockdown or new normal status were not risk factors associated with a poor outcome at 90 days. CONCLUSIONS: In county-level city stroke centers, the COVID-19 lockdown resulted in a reduction in the number of patients with AIS admitted to the hospital but had no effect on patients treated with IVT or EVT. Lockdown or new normal status did not influence the prognosis of AIS patients.

Circulating levels of autoantibodies against L1-cell adhesion molecule as a potential diagnostic biomarker in esophageal squamous cell carcinoma.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is a common malignant disease worldwide, especially in China. We aimed to determine the level of autoantibodies against L1CAM in patients with ESCC. METHODS: Levels of circulating autoantibodies against L1CAM antigens were determined by an enzyme-linked immunosorbent assay in cohort 1 (191 patients with ESCC and 94 normal controls) and validated in cohort 2 (47 patients with ESCC and 47 normal controls). Receiver-operating characteristics were employed to calculate diagnostic accuracy. Cumulative survival time was calculated by the Kaplan-Meier method and analyzed by the log-rank test. RESULTS: In cohorts 1 and 2, levels of autoantibodies against L1CAM were all significantly higher in sera of patients with ESCC compared to normal controls (P < 0.05). Detection of autoantibodies against L1CAM provided a sensitivity of 26.2%, a specificity of 90.4%, and an area under the curve (AUC) of 0.603 (95% CI 0.535-0.672) in diagnosing ESCC in cohort 1, and a sensitivity of 27.7%, a specificity of 91.5%, and an AUC of 0.628 (95% CI 0.516-0.741). Similar results were observed in the diagnosis of early stage ESCC (25.2% sensitivity, 90.4% specificity, and an AUC of 0.611 (95% CI 0.533-0.689) in cohort 1, and 33.3% sensitivity, 91.5% specificity, and an AUC of 0.636 (95% CI 0.439-0.832) in cohort 2). Moreover, positive rates of autoantibodies against L1CAM had no statistical correlation with clinical outcome of ESCC (P > 0.05). CONCLUSIONS: Our results suggest that circulating autoantibodies against L1CAM is a potential biomarker for the early detection of ESCC.