期刊,当代医学科学(英文) 2021年卷1期_国家学术搜索

Characteristics of Viral Shedding in Respiratory Samples and Specific Antibodies Production in 564 COVID-19 Patients

Jing GONGHui DONGDing-kun WANGFu-er LU...

46-50页

查看更多>>摘要：Positive nucleic acid(NA)results have been found in recovered and discharged COVID-19 patients,but the proportion is unclear.This study was designed to analyze the recurrent positive rate of NA results after consecutively negative results,and the relationship between the specific antibody production and positive NA rate.According to Strengthening the Reporting of Observational Studies in Epidemiology guidelines,data of inpatients in Sino-French New City Branch of Tongji Hospital between Jan.28 and Mar.6,2020 were collected.A total of 564 COVID-19 patients over 14 years old who received the examinations of NA and antibodies against SARS-CoV-2 were included.Days of viral shedding and specific antibodies were recorded and assessed.Among NA tests in respiratory samples(throat swabs,nasopharyngeal swabs,sputum and flushing fluid in alveoli),the patients with all-negative NA results accounted for 17.20％,those with single-positive results for 46.63％,and those with multiple-positive results for 36.17％respectively.Besides,the recurrent positive NA results after consecutively negative results appeared in 66 patients(11.70％).For multiple-positive patients,median viral shedding duration was 20 days(range:1 to 57 days).Of the 205 patients who received 2 or more antibody tests,141(68.78％)had decreased IgG and IgM concentrations.IgM decreased to normal range in 24 patients,with a median of 44 days from symptom onset.Viral shedding duration was not significantly correlated with gender,age,disease severity,changes in pulmonary imaging,and antibody concentration.It is concluded that antibody level and antibody change had no significant correlation with the positive rate of NA tests and the conversion rate after continuous negative NA tests.In order to reduce the recurrent positive proportion after discharge,3 or more consecutive negative NA test results with test interval more than 24 h every time are suggested for the discharge or release from quarantine.

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NETL
NSTL
万方数据
维普

Co-infection of SARS-COV-2 and Influenza A Virus:A Case Series and Fast Review

Xuan XIANGZi-hao WANGLin-lin YEXin-liang HE...

51-57页

查看更多>>摘要：Coronavirus disease 2019(COVID-19)occurs in the influenza season and has become a global pandemic.The present study aimed to examine severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)co-infection with influenza A virus(IAV)in an attempt to provide clues for the antiviral interventions of co-infected patients.We described two patients who were co-infected with SARS-CoV-2 and IAV treated at Wuhan Union Hospital,China.In addition,we performed a review in PubMed,Web of Science and CNKI(from January 1 up to November 1,2020)with combinations of the following key words:"COVID-19,SARS-COV-2,influenza A and co-infection".A total of 28 co-infected patients were enrolled in the analysis.Of the 28 patients,the median age was 54.5 years(IQR,34.25-67.5)and 14 cases(50.0％)were classified as severe types.The most common symptoms were fever(85.71％),cough(82.14％)and dyspnea(60.71％).Sixteen patients had lymphocytopenia on admission and 23 patients exhibited abnormal radiological changes.The median time from symptom onset to hospital admission was 4 days(IQR,3-6),and the median time of hospital stay was 14 days(IQR,8.5-16.75).In conclusion,patients with SARS-COV-2 and IAV co-infection were similar to those infected with SARS-COV-2 alone in symptoms and radiological images.SARS-COV-2 co-infection with IAV could lead to more severe clinical condition but did not experience longer hospital stay compared with patients infected with SARS-COV-2 alone.

原文链接:

NETL
NSTL
万方数据
维普

Co-infection of SARS-COV-2 and Influenza A Virus:A Case Series and Fast Review

Xuan XIANGZi-hao WANGLin-lin YEXin-liang HE...

51-57页

查看更多>>摘要：Coronavirus disease 2019(COVID-19)occurs in the influenza season and has become a global pandemic.The present study aimed to examine severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)co-infection with influenza A virus(IAV)in an attempt to provide clues for the antiviral interventions of co-infected patients.We described two patients who were co-infected with SARS-CoV-2 and IAV treated at Wuhan Union Hospital,China.In addition,we performed a review in PubMed,Web of Science and CNKI(from January 1 up to November 1,2020)with combinations of the following key words:"COVID-19,SARS-COV-2,influenza A and co-infection".A total of 28 co-infected patients were enrolled in the analysis.Of the 28 patients,the median age was 54.5 years(IQR,34.25-67.5)and 14 cases(50.0％)were classified as severe types.The most common symptoms were fever(85.71％),cough(82.14％)and dyspnea(60.71％).Sixteen patients had lymphocytopenia on admission and 23 patients exhibited abnormal radiological changes.The median time from symptom onset to hospital admission was 4 days(IQR,3-6),and the median time of hospital stay was 14 days(IQR,8.5-16.75).In conclusion,patients with SARS-COV-2 and IAV co-infection were similar to those infected with SARS-COV-2 alone in symptoms and radiological images.SARS-COV-2 co-infection with IAV could lead to more severe clinical condition but did not experience longer hospital stay compared with patients infected with SARS-COV-2 alone.

原文链接:

NETL
NSTL
万方数据
维普

Differences in Immune Responses between Children and Adults with COVID-19

Yin YUANQiu-peng WANGDan SUNZu-bo WU...

58-61页

查看更多>>摘要：Over 85 590 000 individuals have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although there have been an increasing number of reports on coronavirus disease 2019(COVID-19),it is unclear why infected children show milder symptoms than adults.A retrospective case study was performed at two designated hospitals for COVID-19.Patients(56 children and 63 adults)with confirmed SARS-CoV-2 infection and mild pneumonia were randomly enrolled in this study.The median age of the children was 7.0 years,and 51.79％of them were boys.The median age of the adults was 57 years,and 47.62％were men.The most common symptoms were fever,cough,sputum and diarrhoea.There were no significant differences in symptoms between children and adult patients.In terms of immunological indices on admission,adult patients displayed typical leukopenia and markedly higher levels of IL-2,IL-4,and IL-6 than child patients.The elevation of IL-2,IL-4 and IL-6 in adults induced more extensive lung injury.The effective and non-aggressive immune response successfully resisted SARS-CoV-2 invasion and maintained mild symptoms in child patients.The correlation of higher IL-2,IL-4,and IL-6 with the lung injury might be evidence that preventing excessive cytokine production can avoid further lung damage in these patients.

原文链接:

NETL
NSTL
万方数据
维普

Differences in Immune Responses between Children and Adults with COVID-19

Yin YUANQiu-peng WANGDan SUNZu-bo WU...

58-61页

查看更多>>摘要：Over 85 590 000 individuals have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Although there have been an increasing number of reports on coronavirus disease 2019(COVID-19),it is unclear why infected children show milder symptoms than adults.A retrospective case study was performed at two designated hospitals for COVID-19.Patients(56 children and 63 adults)with confirmed SARS-CoV-2 infection and mild pneumonia were randomly enrolled in this study.The median age of the children was 7.0 years,and 51.79％of them were boys.The median age of the adults was 57 years,and 47.62％were men.The most common symptoms were fever,cough,sputum and diarrhoea.There were no significant differences in symptoms between children and adult patients.In terms of immunological indices on admission,adult patients displayed typical leukopenia and markedly higher levels of IL-2,IL-4,and IL-6 than child patients.The elevation of IL-2,IL-4 and IL-6 in adults induced more extensive lung injury.The effective and non-aggressive immune response successfully resisted SARS-CoV-2 invasion and maintained mild symptoms in child patients.The correlation of higher IL-2,IL-4,and IL-6 with the lung injury might be evidence that preventing excessive cytokine production can avoid further lung damage in these patients.

原文链接:

NETL
NSTL
万方数据
维普

Analysis of Monitoring,Early Warning and Emergency Response System for New Major Infectious Diseases in China and Overseas

Xing-li DUXin-rui ZHAOHuan GAOWan-wan SHEN...

62-68页

查看更多>>摘要：In recent years,the impact of new major infectious diseases on people's normal life is becoming more and more frequent,which has brought great impact on people's life safety and social economy,especially the corona virus disease 2019,which has been sweeping the globe.Public health and disease prevention and control systems in different countries have different performances in response to the pandemic,but they all have exposed many shortcomings.Countries around the world urgently need to improve the monitoring,early warning and emergency response systems for new major infectious diseases.As the outpost and main part of medical rescue,the hospital urgently needs to establish a set of scientifically advanced emergency response mechanism that is suitable for the business process of the medical system and unified standards in order to improve the response efficiency and quality of emergency treatment.

原文链接:

NETL
NSTL
万方数据
维普

Analysis of Monitoring,Early Warning and Emergency Response System for New Major Infectious Diseases in China and Overseas

Xing-li DUXin-rui ZHAOHuan GAOWan-wan SHEN...

62-68页

查看更多>>摘要：In recent years,the impact of new major infectious diseases on people's normal life is becoming more and more frequent,which has brought great impact on people's life safety and social economy,especially the corona virus disease 2019,which has been sweeping the globe.Public health and disease prevention and control systems in different countries have different performances in response to the pandemic,but they all have exposed many shortcomings.Countries around the world urgently need to improve the monitoring,early warning and emergency response systems for new major infectious diseases.As the outpost and main part of medical rescue,the hospital urgently needs to establish a set of scientifically advanced emergency response mechanism that is suitable for the business process of the medical system and unified standards in order to improve the response efficiency and quality of emergency treatment.

原文链接:

NETL
NSTL
万方数据
维普

Early Warning Factors of Death in COVID-19 Patients

Min SHANGJie WEIHan-dong ZOUQing-shan ZHOU...

69-76页

查看更多>>摘要：The infectious coronavirus disease 2019(COVID-19)has spread all over the world and been persistently evolving so far.The number of deaths in the whole world has been rising rapidly.However,the early warning factors for mortality have not been well ascertained.In this retrospective,single-centre cohort study,we included some adult inpatients(≥18 years old)with laboratory-confirmed COVID-19 from Renmin Hospital of Wuhan University who had been discharged or had died by Apr.8,2020.Demographic,clinical and laboratory data at admission were extracted from electronic medical records and compared between survivors and non-survivors.We used univariable analysis,Cox proportional hazard model analysis and receiver operating characteristic(ROC)curve to explore the early warning factors associated with in-hospital death.A total of 159 patients were included in this study,of whom 86 were discharged and 73 died in hospital.Hypertension(52.1％vs.29.1％,P=0.003)and coronary heart disease(28.8％vs.12.8％,P=0.012)were more frequent among non-survived patients than among survived patients.The proportions of patients with dyspnoea(67.1％vs.25.6％,P＜0.001),chest distress(58.9％vs.26.7％,P＜0.001)and fatigue(64.4％vs.25.6％,P＜0.001)were significantly higher in the non-survived group than in the survived group.Regression analysis with the Cox proportional hazards mode revealed that increasing odds of in-hospital death were associated with higher IL-6(odds ratio 10.87,95％CI 1.41-83.59;P=0.022),lactate(3.59,1.71-7.54;P=0.001),older age(1.86,1.03-3.38;P=0.041)and lower lymphopenia(5.44,2.71-10.93;P＜0.001)at admission.The areas under the ROC curve(AUCs)of IL-6,lymphocyte,age and lactate were 0.933,0.928,0.786 and 0.753 respectively.The AUC of IL-6 was significantly higher than that of age(z=3.332,P=0.0009)and lactate(z=4.441,P＜0.0001)for outcome prediction.There was no significant difference between the AUCs of IL-6 and lymphocyte for outcome prediction(z=0.372,P=0.7101).It was concluded that the potential risk factors of higher IL-6,lactate,older age and lower lymphopenia at admission could help clinicians to identify patients with poor prognosis at an early stage.

原文链接:

NETL
NSTL
万方数据
维普

Early Warning Factors of Death in COVID-19 Patients

Min SHANGJie WEIHan-dong ZOUQing-shan ZHOU...

69-76页

查看更多>>摘要：The infectious coronavirus disease 2019(COVID-19)has spread all over the world and been persistently evolving so far.The number of deaths in the whole world has been rising rapidly.However,the early warning factors for mortality have not been well ascertained.In this retrospective,single-centre cohort study,we included some adult inpatients(≥18 years old)with laboratory-confirmed COVID-19 from Renmin Hospital of Wuhan University who had been discharged or had died by Apr.8,2020.Demographic,clinical and laboratory data at admission were extracted from electronic medical records and compared between survivors and non-survivors.We used univariable analysis,Cox proportional hazard model analysis and receiver operating characteristic(ROC)curve to explore the early warning factors associated with in-hospital death.A total of 159 patients were included in this study,of whom 86 were discharged and 73 died in hospital.Hypertension(52.1％vs.29.1％,P=0.003)and coronary heart disease(28.8％vs.12.8％,P=0.012)were more frequent among non-survived patients than among survived patients.The proportions of patients with dyspnoea(67.1％vs.25.6％,P＜0.001),chest distress(58.9％vs.26.7％,P＜0.001)and fatigue(64.4％vs.25.6％,P＜0.001)were significantly higher in the non-survived group than in the survived group.Regression analysis with the Cox proportional hazards mode revealed that increasing odds of in-hospital death were associated with higher IL-6(odds ratio 10.87,95％CI 1.41-83.59;P=0.022),lactate(3.59,1.71-7.54;P=0.001),older age(1.86,1.03-3.38;P=0.041)and lower lymphopenia(5.44,2.71-10.93;P＜0.001)at admission.The areas under the ROC curve(AUCs)of IL-6,lymphocyte,age and lactate were 0.933,0.928,0.786 and 0.753 respectively.The AUC of IL-6 was significantly higher than that of age(z=3.332,P=0.0009)and lactate(z=4.441,P＜0.0001)for outcome prediction.There was no significant difference between the AUCs of IL-6 and lymphocyte for outcome prediction(z=0.372,P=0.7101).It was concluded that the potential risk factors of higher IL-6,lactate,older age and lower lymphopenia at admission could help clinicians to identify patients with poor prognosis at an early stage.

原文链接:

NETL
NSTL
万方数据
维普

Government Intervention Measures Effectively Control COVID-19 Epidemic in Wuhan,China

Xing XINShu-fang LILing CHENGChang-yu LIU...

77-83页

查看更多>>摘要：The coronavirus disease 2019(COVID-19)outbreak has been brought under control through a nationwide effort,and now it has become a global pandemic and the situation seems grim.We summarized the measures taken in Wuhan and analyzed the effects to comprehensively describe the factors involved in controlling the COVID-19 in China.In China,several measures such as the lockdown of Wuhan,restriction of traffic and communities,increasing hospital beds,nationwide support from medical staff,epidemic prevention equipment and supplies,and establishment of makeshift shelter hospitals have been taken.The lockdown of Wuhan reduced the propagation of cases to other cities in Hubei province and throughout China,traffic and community restrictions reduced the flow of population and the spread of disease,increasing wards and beds and medical personnel reduced the incidence of severe cases and mortality,the establishment of the Fangcang shelter hospitals provided a good isolation and monitoring environment,and further reduced the spread and fatality of the disease.The fact that China was able to control the spread of COVID-19 within three months without a specific drug or vaccine suggests that these measures are more adequate and effective.

原文链接:

NETL
NSTL
万方数据
维普