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1.
Preprint | medRxiv | ID: ppmedrxiv-21249676

RESUMO

ObjectiveSome retrospective studies reporting epidemiological, clinical characteristics of COVID-19 patients of early stage were published. We aim to provide an overview of epidemiological and clinical characteristics of the COVID-19 patients, and identification, treatment of early stage, especially for the patients with poor prognosis. Data SourcesPubMed, CNKI and Google Scholar. Study SelectionWe searched for published retrospective studies that described epidemiological and clinical characteristics of confirmed COVID-19 patients in China by April 14th, 2020 with search terms. Some studies were excluded according to criteria. Finally, 53 studies were included. Data ExtractionCharacteristics of the COVID-19 patients available from included articles were extracted, reorganized and recorded into electronic data forms. Data SynthesisCharacteristics of patients in the included studies were summarized and analyzed for median-interquartile ranges and univariable odds ratio. ConclusionThis study summarized, analyzed and compared epidemiological, clinical characteristics and estimated univariable risk factors among confirmed COVID-19 patients either in former epicenter, in severe condition, with ICU admission or not of early stage. Higher proportions of patients were found to have older age and more comorbidities, typical characteristics on admission and complications either in former epicenter, with severe condition or ICU admission. No evidence showed that patients who were male or had smoking history had higher susceptibility, but they were significant risk factors for severe condition. Some self-implementable traditional Chinese medicine therapies conducted for immunity improvement, control of comorbidities and reduction of some medicine intake. Limited evidence revealed that some characteristics of the disease might be changing with human-to-human transmission, and more research, especially international collaboration, is needed. Copyright form disclosureThe authors have disclosed that they do not have any potential conflicts of interest.

2.
Chemosphere ; : 129008, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-33261839

RESUMO

Due to human activity and global climate change, the Yellow River Delta, the youngest delta wetland in China, is suffering serious degradation. The study of hydrological connection provides new perspectives and technical support for the protection and restoration of delta wetlands. To quantify the interaction between the hydrological connection and the root-soil complex, the current study took dye-tracing experiments to examine the small-scale hydrological connectivity in soil where Phramites australis grew. The dye coverage was selected as the indicator of hydrological connectivity after preliminary analysis in this study. The main results were that (1) the strength of hydrological connectivity was negatively related to the microaggregates content, but had little to do with other soil physical properties; (2) there was a notable positive correlation between the indexes of thick root (D > 5 mm) and the dye coverage hydrological connectivity, while root biomass had little effect on hydrological connectivity; and (3) the influence of the microaggregate content dominated in the combined effect of the total surface area of the root (D > 5 mm) and the microaggregate content on hydrological connectivity in each soil layer.

4.
Zhongguo Zhong Yao Za Zhi ; 45(21): 5177-5183, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33350233

RESUMO

In the current study, schisandrin B(SchB)-loaded F127 modified lipid-polymer hybrid nanoparticles(SchB-F-LPNs) were developed to improve the inhibition of breast cancer lung metastasis. Modified nanoprecipitation method was used to prepare SchB-F-LPNs. The nanoparticles were spherical in shape with shell-core structure by TEM observation. SchB-F-LPNs showed a mean particle size of(234.60±6.11) nm with zeta potential of(-5.88±0.49) mV. XRD results indicated that SchB existed in the nanoparticles in an amorphous state. The apparent permeability coefficient through porcine mucus of F-LPNs was 1.43-fold of that of LPNs as shown in the in vitro mucus penetration study. The pharmacokinetics study showed that the C_(max) of SchB was(369.06±146.94) µg·L~(-1),(1 121.34±91.65) µg·L~(-1) and(2 951.91±360.53) µg·L~(-1) respectively in SchB suspensions group, SchB-LPNs group and SchB-F-LPNs group after oral administration in rats. With SchB suspensions as the reference formulation, the relative bioavailability of SchB-F-LPNs was 568.60%. SchB-F-LPNs inhibited the morphological change during transforming growth factor-ß1(TGF-ß1)-induced epithelial-mesenchymal transition. In addition, SchB-F-LPNs significantly decreased the number of metastatic pulmonary nodules in 4 T1 tumor-bearing mice, suggesting that SchB-F-LPNs may inhibit the metastasis of breast cancer. These results reveal the promising potential of SchB-F-LPNs in treatment of breast cancer lung metastasis.


Assuntos
Neoplasias Pulmonares , Nanopartículas , Animais , Ciclo-Octanos , Lignanas , Lipídeos , Neoplasias Pulmonares/tratamento farmacológico , Camundongos , Compostos Policíclicos , Polietilenos , Polímeros , Polipropilenos , Ratos , Suínos
5.
Zhongguo Zhong Yao Za Zhi ; 45(17): 4163-4182, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33164402

RESUMO

Polygonati Rhizoma(PR), listed as a top-grade medicine, was recorded first in the Mingyi Bielu written by TAO Hongjing. It is a good medicine through the ages to tonify Qi and nourish Yin, strengthen spleen and kidney. PR has a long history of processing and has a variety of processing methods and technologies. Steaming and stewing are the main processing methods. There are many different excipients used in processing PR, such as wine, honey, black beans, and multiple excipients. At present, there are three plant varieties of PR recorded in Chinese Pharmacopoeia, including Polygonatum sibiricum, P. kingianum and P. cyrtonema, collectively called medicinal PR. Medicinal PR has a wide range of chemical components, mainly including polysaccharides, steroidal saponins, flavonoids, phenylpropanoids and alkaloids etc. It also has a wide range of pharmacological effects, such as anti-oxidation, anti-osteoporosis and anti-tumor effects. In this paper, we review the historical evolution, chemical components, pharmacological effects, and the effects of processing on ingredients and pharmacological effects of PR. We also analyze the limitations of the current research on PR, and put forward the prospects on the scientific connotation of processing, quality improvement, process innovation and new product development of PR for further researches.


Assuntos
Polygonatum , Vinho , Evolução Química , Polissacarídeos , Rizoma
6.
Sci Rep ; 10(1): 19807, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33168931

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

7.
J Environ Manage ; : 111654, 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33221044

RESUMO

Conservation agriculture is considered as an agro-ecological approach to the sustainable and resource-saving crop production system. Previous studies on the adoption of agricultural innovation often consider socio-economic characteristics and overlook underlying psychological factors influencing farmers' behavioral intention. This study adopted three socio-psychological constructs, Attitude, Subjective Norm (SN), and Perceived Behavioral Control (PBC), which originated from the Theory of Planned Behavior (TPB), and proposed two new constructs, Knowledge (K) and Perceived Climatic Threats of Conventional Farming (PCTCV). Using the Extended Theory of Planned Behavior Model (ETPBM), this study analyzed factors affecting the intention of farmers to continue Conservation Agriculture (CA) for the following year (2020) in three districts located in the northern part of Bangladesh. This research found evidence from the hierarchical regression analysis that variables of ETPBM could explain 7% more variation (change in R2) in intention than variables of TPB, while the socio-economic characteristics of farmers can explain only 0.5% more than the variables of ETPBM. Structural Equation Modelling (SEM) was used to determine and examine the extended theory and indicated that farmers' knowledge (K) had the highest total impact, while attitude had the highest direct impact on intention. The results indicated that factors including Attitude, SN, PBC, Knowledge (K), and PCTCV are positively significant when attempting to understand farmers' intentions to adopt CA. This study presented evidence about the effectiveness of ETPBM when assessing the farmers' intentions towards conservation farming. Based on these findings, we concluded that the combination of extension services for upgrading the level of knowledge concerning the importance of CA could significantly affect farmers' attitudes on intention towards the application of CA.

8.
Virology ; 551: 16-25, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33010671

RESUMO

Knowledge about the special characteristics of HIV-1 envelope (env) glycoproteins in rare individuals developing >90% neutralization breadth in Chinese subtype B' slow progressors may provide insights for vaccine design against local viruses. We performed a cross-sectional analysis on 7 samples. We tested the neutralization breadth and geometric mean ID50 titers (GMTs) of these samples, and divided them into hBCN+ and hBCN- group according to whether their neutralization breadth >90%. We obtained env sequences in these samples through single genome amplification (SGA) assay. By comparing with hBCN-, subtype B chronically infected group (B-SP), and Chinese subtype B group (B-Database), we analyzed the characteristics of the env sequences of hBCN+ group. Longer V1 and V4 regions with more glycosylation sites were found in hBCN+ samples compared to hBCN- samples. Further analysis compared to B-SP and B-Database showed that hBCN+ group exhibited unique extra-long V1 region containing higher proportion of N-glycan sites and additional cysteines.

9.
Artigo em Inglês | MEDLINE | ID: mdl-32948945

RESUMO

Greenhouse gas effect is known as the main cause of worldwide warming and environmental change. The present study was planned to examine the causal relationship between carbon dioxide (CO2) emissions, CO2 emissions from solid fuel consumption (CO2S), energy use (EU), fossil fuel energy consumption (FOF), gross domestic product (GDP), and net domestic credit (NDC). This research work is based on Pakistan's annual data from 1971 to 2014. Autoregressive distributed lag (ARDL) bound testing design was used to measure both long-run and the short-run relationships among all study variables. To inspect the stationarity of the study variables, augmented Dickey-Fuller (ADF) and Phillips-Perron (PP) tests were also carried out. The outcome of the long-run estimates indicated that CO2S, EU, and GDP all have a significant relationship with CO2 emissions while both FOF and NDC did not exhibit any significant effect. The value of error correction term (ECT) was - 0.977 which signifies that the deviation of CO2 emissions from short-run to long-run equilibrium was fitted by 97.7% per year. Johansen co-integration test results display a long-run association between the study variables. Based on the study findings, the government requires to take effective measures for constructive policy-making and identification of environmental threats in Pakistan. Additionally, emission decreasing actions should be settled the fundamental agenda in energy and environmental strategies of Pakistan for the reduction in damages connected with carbon dioxide emissions.

10.
Front Physiol ; 11: 884, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32765306

RESUMO

Salinity is an important ecological factor that impacts the growth and survival of aquatic organisms. The salinity of seawater in coastal and estuarine areas is often subject to dynamic changes because of seasonal rainfall and continental runoff. Thus, the current study investigated the effects of sudden changes in salinity on the survival rate and osmotic pressure regulation mechanisms of bottom-sowing seedlings of the economically important ark shell, Scapharca subcrenata. By simulating the sudden changes that occur in seawater salinity after rainstorms, the results showed that the osmotic pressure of the hemolymph and Na+, K+, Ca2+, and Cl- concentrations first decreased and then increased. When the salinity decreased from 30 to 14‰, hemoglobin, soluble total protein, taurine, and total free amino acid gradually increased; maximum levels of hemoglobin, soluble total protein, and taurine occurred once the salinity increased to 22‰ at 96 h. After 96 h, the total free amino acid content increased until 144 h. The reactive oxygen species (ROS) content and total antioxidant capacity (T-AOC) peaked at 96 h, whereas the expression levels of Mn-superoxide dismutase (MnSOD) and catalase (CAT) increased earlier, indicating that, with continuous ROS generation, antioxidant defense mechanisms were activated to avoid oxidative damage. Expression levels of cathepsin C (CTSC), cathepsin D (CTSD), heat shock protein 20 (HSP20), and heat shock protein 70 (HSP70) were significantly higher than in the control group at 48 h (salinity level 14‰); the expression levels of HSP20, heat shock protein 90 (HSP90), MnSOD, and glutathione peroxidase (GP x ) remained high, indicating that they were still required for osmotic pressure regulation to maintain the dynamic balance between the generation and removal of ROS as the salinity level increased. These results not only add to our basic understanding of the aquatic ecology of S. subcrenata, but also provide a theoretical ground for improving the survival rate of bottom-sowing, propagation, and release of S. subcrenata seedlings.

11.
Preprint | medRxiv | ID: ppmedrxiv-20144030

RESUMO

BackgroundLymphopenia is a typical symptom in the COVID-19 patients. While millions of patients are clinical recovered, little is known about the immune status of lymphocytes in these individuals. MethodsA clinical recovered cohort (CR) of 55 COVID-19 individuals (discharged from hospital 4 to 11 weeks), and 55 age and sex matched healthy donors cohort (HD) were recruited. Detailed analysis on phenotype of the lymphocytes in peripheral blood mononuclear cells (PBMCs) was performed by flow cytometry. FindingsCompared with cohort HD, the CD8+ T cells in cohort CR had higher Teff and Tem, but lower Tc1 (IFN-{gamma}+), Tc2 (IL-4+) and Tc17 (IL-17A+) frequencies. The CD4+ T cells of CR had decreased frequency, especially on the Tcm subset. Moreover, CD4+ T cells of CR expressed lower PD-1 and had lower frequencies of Th1 (IFN-{gamma}+), Th2 (IL-4+), Th17 (IL-17A+) as well as circulating Tfh (CXCR5+PD-1+). Accordingly, isotype-switched memory B cell (IgM-CD20hi) in CR had significantly lower proportion in B cells, though level of activation marker CD71 elevated. For CD3-HLA-DRlo lymphocytes of CR, besides levels of IFN-{gamma}, Granzyme B and T-bet were lower, the correlation between T-bet and IFN-{gamma} became irrelevant. In addition, taken into account of discharged days, all the lowered function associated phenotypes showed no recovery tendency within whole observation period. InterpretationThe CR COVID-19 individuals still showed remarkable phenotypic alterations in lymphocytes after clinical recovery 4 to 11 weeks. This suggests SARS-CoV-2 infection imprints profoundly on lymphocytes and results in long-lasting potential dysfunctions. FundingKunming Science and Technology Department (2020-1-N-037)

12.
Int J Biol Sci ; 16(12): 2180-2191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32549764

RESUMO

The histone H3K9 methyltransferase SETDB2 is involved in cell cycle dysregulation in acute leukemia and has oncogenic roles in gastric cancer. In our study, we found that SETDB2 plays essential roles in breast cancer stem cell maintenance. Depleted SETDB2 significantly decreased the breast cancer stem cell population and mammosphere formation in vitro and also inhibited breast tumor initiation and growth in vivo. Restoring SETDB2 expression rescued the defect in breast cancer stem cell maintenance. A mechanistic analysis showed that SETDB2 upregulated the transcription of the ΔNp63α downstream Hedgehog pathway gene. SETDB2 also interacted with and methylated ΔNp63α, and stabilized ΔNp63α protein. Restoring ΔNp63α expression rescued the breast cancer stem cell maintenance defect which mediated by SETDB2 knockdown. In conclusion, our study reveals a novel function of SETDB2 in cancer stem cell maintenance in breast cancer.

13.
Technol Health Care ; 28(S1): 273-287, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32364160

RESUMO

BACKGROUND: Metal artifact reduction (MAR) techniques can improve metal artifacts of computed tomography (CT) images. OBJECTIVE: This work focused on conducting a quantitative analysis to compare the effectiveness of four commercial MAR techniques on three types of metal implants (hip implant, spinal implant, and dental filling) with a self-made acrylic phantom. METHODS: A cylindrical phantom was made from acrylic with a groove in the middle, and then three types of metal implants were placed in the groove. The phantom was scanned by four CT scanners and four commercialized MAR techniques were used to analyze the images. The techniques used were single-energy metal artifact reduction (SEMAR, Canon), smart metal artifact reduction software (Smart-MAR, GE), iterative metal artifact reduction (IMAR, Siemens), and metal artifact reduction for orthopedic implants (OMAR, Philips). Quantitative analysis methods included objective and subjective analysis. RESULTS: The expected value of SEMAR, Smart-MAR, IMAR, and OMAR were 36.6, 37.8, 5.0, and 2.3, respectively. SEMAR and Smart-MAR achieved optimal results. CONCLUSION: This study successfully evaluated the effects of four commercial MAR techniques on three types of metal implants in a phantom. All MAR techniques effectively reduced metal artifacts, but the effect was not significant with dental fillings due to high-density material.

14.
Artigo em Inglês | MEDLINE | ID: mdl-32365947

RESUMO

An increasing number of studies have demonstrated that blue space can promote the recovery of the human body, as does green space. However, the influence of blue space on the color space has been studied much less. Based on research on color psychology and healthy cities, the current study takes Yijie District of Dujiangyan City as the research object. Logistic regression models and the semantic differential method was used to explore residents' perceptions of color space and their restorative ratings of blue space. This study describes the characteristics of the people visiting blue space, investigates whether the benefits brought about by blue space are related to the color space, and studies whether the surrounding colors in the blue space have a positive effect in promoting residents' perceptions of pleasure. Based on residents' choices of environmental pictures containing various colors, a color tendency map was constructed. The results revealed strong correlations between residents' perceived pleasure and color space color collocation. Socio-demographic factors were found to affect the frequency of visiting blue space. Reasonable color planning is necessary for human health. Based on the study findings, relevant planning suggestions are proposed as a reference basis for waterfront space color planning.


Assuntos
Percepção de Cores , Nível de Saúde , Características de Residência , Percepção Espacial , Adulto , Cidades , Cor , Feminino , Humanos , Masculino
15.
J Pain Symptom Manage ; 60(1): e48-e53, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32276095

RESUMO

BACKGROUND: In treating highly infectious coronavirus disease-19 (COVID-19) pneumonia, intensive care unit (ICU) nurses face a high risk of developing somatic symptom disorder (SSD).The symptom clusters in one population may show overlaps and involvements, a phenomenon that should be deliberately resolved to improve the management efficiency. OBJECTIVES: The present study aims to investigate the symptoms and causes of SSD of ICU nurses treating COVID-19 pneumonia. The research results are expected to provide evidence for the establishment of a better management strategy. METHODS: This study enrolled a total of 140 ICU nurses who were selected by Jiangsu Province Hospital to work in Wuhan (the epicenter of the COVID-19 epidemic in China) on February 3, 2020. A questionnaire, Somatic symptom disorders for ICU nurses in Wuhan No. 1 Hospital, was designed based on the International Classification of Functioning, Disability and Health. Exploratory factor analysis was performed to cluster the symptoms and logistic regression analysis to find the risk factors of the symptoms. RESULTS: Five major symptoms were chest discomfort and palpitation (31.4%), dyspnea (30.7%), nausea (21.4%), headache (19.3%), and dizziness (17.9%). In exploratory factor analysis, the symptoms were classified into three clusters: Cluster A of breathing and sleep disturbances (dizziness, sleepiness, and dyspnea); Cluster B of gastrointestinal complaints and pain (nausea and headache), and Cluster C of general symptoms (xerostomia, fatigue, as well as chest discomfort and palpitation). In Cluster A, urine/feces splash, sex, and sputum splash were independent predictive factors. In Cluster B, fall of protective glasses and urine/feces splash were independent predictive factors. In Cluster C, urine/feces splash and urine/feces clearance were independent predictive factors. CONCLUSION: The ICU nurses in Wuhan showed varying and overlapping SSDs. These SSDs could be classified into three symptom clusters. Based on the characteristics of their SSDs, specific interventions could be implemented to safeguard the health of ICU nurses.


Assuntos
Infecções por Coronavirus/terapia , Enfermagem de Cuidados Críticos , Sintomas Inexplicáveis , Enfermeiras e Enfermeiros , Pneumonia Viral/terapia , Pneumonia/etiologia , Pneumonia/terapia , Adulto , China/epidemiologia , Cidades , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Cuidados Críticos , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Exposição Ocupacional , Pandemias , Pneumonia/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Fatores de Risco , Adulto Jovem
16.
Preprint | bioRxiv | ID: ppbiorxiv-990226

RESUMO

A global pandemic of Corona Virus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome CoV-2 (SARS-CoV-2) is ongoing spread. It remains unclear whether the convalescing patients have a risk of reinfection. Rhesus macaques were rechallenged with SARS-CoV-2 during an early recovery phase from initial infection characterized by weight loss, interstitial pneumonia and systemic viral dissemination mainly in respiratory and gastrointestinal tracts. The monkeys rechallenged with the identical SARS-CoV-2 strain have failed to produce detectable viral dissemination, clinical manifestations and histopathological changes. A notably enhanced neutralizing antibody response might contribute the protection of rhesus macaques from the reinfection by SARS-CoV-2. Our results indicated that primary SARS-CoV-2 infection protects from subsequent reinfection. One Sentence SummaryNeutralizing antibodies against SARS-CoV-2 might protect rhesus macaques which have undergone an initial infection from reinfection during early recovery days.

17.
Preprint | medRxiv | ID: ppmedrxiv-20045427

RESUMO

While lymphocytopenia is a common characteristic of patients infected by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the mechanisms responsible for this depletion are unclear. Through careful inspection of the spleens and lymph nodes (LNs) from six cases with postmortem examinations, we observed that SARS-CoV-2 could directly infect secondary lymphoid organs to induce cell death. Immunohistochemistry demonstrated ACE2 (angiotensin-converting enzyme 2), the potential receptor of SARS-CoV-2, expresses on tissue-resident CD169+ macrophages in spleens and LNs. Immunofluorescent staining confirmed that viral nucleocaspid protein (NP) can be found in ACE2+ cells, CD169+ macrophages, but not in CD3+ T cells or B220+ B cells in spleens and LNs. SARS-CoV-2 infection induces severe tissue damage including lymph follicle depletion, splenic nodule atrophy, histiocyte hyperplasia and lymphocyte reductions. Moreover, in situ TUNEL staining illustrated that viral infection leads to severe lymphocyte apoptosis, which might be mediated by viral antigens inducing Fas upregulation. Furthermore, SARS-CoV-2 also triggers macrophages to produce IL-6, a proinflammatory cytokine that directly promotes lymphocyte necrosis. Collectively, these results demonstrate that SARS-CoV-2 directly neutralizes human spleens and LNs through infecting tissue-resident CD169+ macrophages.

18.
Preprint | medRxiv | ID: ppmedrxiv-20044883

RESUMO

[Abstract]O_ST_ABSObjectiveC_ST_ABSCoronavirus disease 2019 (COVID-19) has become pandemic in the world. The need for IgG-IgM combined antibody test is booming, but data on diagnostic indexes evaluation was inadequate. The aim of this study was to evaluate diagnostic indexes of a rapid IgG-IgM combined antibody test for SARS-CoV-2. MethodsA total of 179 patients were enrolled. Serum were collected for IgG-IgM combined antibody test and corresponding nasal and pharyngeal swab specimens were collected for SARS-CoV-2 RT-PCR. According to SARS-CoV-2 RT-PCR results, patients under study were categorized as PCR positive group in 90 patients and PCR negative group in 89 patients. Results1. Of the 90 PCR positive samples, 77 were tested positive by SARS-CoV-2 IgG-IgM test kit, yielding a sensitivity of 85.6%. Meanwhile, of the 89 PCR negative sample, 8 samples were detected positive, resulting in a specificity of 91%. Positive predictive value, negative predictive value and accuracy of this test kit was 95.1%, 82.7%, and 88.3%, respectively. Kappa efficiency between IgG/IgM test kit and RT-PCR were 0.75. 2. Accuracy in mild/common and severe/critical subgroup were 73.9% and 97.7%, respectively. Accuracy in clinical confirmed, suspected cases and other disease subgroups were 70%, 60%, and 100%, respectively. 3. Patients were further divided into 0 - 7, 8 - 15 and >= 16 groups according to the time from illness onset to sample collection. Sensitivity, specificity and accuracy in these three groups were 18.8%, 77.8% and 40%; 100%, 50% and 87.5%; 100%, 64.3%, and 93.9, respectively. ConclusionThe sensitivity and specificity of this ease-of-use IgG/IgM combined test kit were adequate, plus short turnaround time, no specific requirements for additional equipment or skilled technicians, all of these collectively contributed to its competence for mass testing. At the current stage, it cannot take the place of SARA-CoV-2 nucleic acid RT-PCR, but can be served as a complementary option for RT-PCR. The combination of RT-PCR and IgG-IgM combined test kit could provide further insight into SARS-CoV-2 infection diagnosis.

19.
Preprint | medRxiv | ID: ppmedrxiv-20036145

RESUMO

Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease (COVID-19). In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65x109/L vs. 0.76x109/L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials. Significance StatementCOVID-19 is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination showed varying degrees of absorption of lung lesions within 7 days. These results indicate that CP can serve as a promising rescue option for severe COVID-19 while the randomized trial is warranted.

20.
Preprint | medRxiv | ID: ppmedrxiv-20031120

RESUMO

BACKGROUNDThe outbreak of a novel coronavirus (SARS-CoV-2, previously provisionally named 2019 novel coronavirus or 2019-nCoV) since December 2019 in Wuhan, China, has become an emergency of major international concern. Apart from the respiratory system, it is unclear whether SARS-CoV-2 can also directly infect other tissues such as the kidney or induce acute renal failure. METHODSWe conducted a retrospective analysis of estimated glomerular filtration rate (eGFR) along with other clinical parameters from 85 patients with laboratory-confirmed COVID-19 admitted to a hospital in Wuhan from January 17, 2020 to March 3, 2020. Kidney tissues from six patients with postmortem examinations were analyzed by Hematoxylin and Eosin (H&E) and in situ expression of viral nucleocaspid protein (NP) antigen, immune cell markers (CD8, CD68 and CD56) and the complement C5b-9 was detected by immunohistochemistry. Moreover, the viral particles in kidneys were also investigated by transmission electronic microscope (EM). RESULTS27.06% (23/85) patients exhibited acute renal failure (ARF). The eldery patients and cases with comorbidities such as hypertension and heart failure more easily developed ARF (65.22% vs 24.19%, p< 0.001; 69.57% vs 11.29%, p< 0.001, respectively). H&E staining demonstrated kidney tissues from postmortems have severe acute tubular necrosis and lymphocyte infiltration. Immunohistochemistry showed that SARS-CoV-2 NP antigen was accumulated in kidney tubules. EM observation also demonstrated that viruses-like particles are visible in the kidneys. Viral infection not only induces CD68+ macrophages infiltrated into tubulointerstitium, but also enhances complement C5b-9 deposition on tubules. CONCLUSIONSSARS-CoV-2 induces ARF in COVID-19 patients. Viruses directly infect human kidney tubules to induce acute tubular damage. The viruses not only have direct cytotoxicity, but also initiate CD68+ macrophage together with complement C5b-9 deposition to mediate tubular pathogenesis.

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