Surveillance is an essential work on infectious diseases prevention and control.When the pandemic occurred,the inadequacy of traditional surveillance was exposed,but it also provided a valuable opportunity to explore ...Surveillance is an essential work on infectious diseases prevention and control.When the pandemic occurred,the inadequacy of traditional surveillance was exposed,but it also provided a valuable opportunity to explore new surveillance methods.This study aimed to estimate the transmission dynamics and epidemic curve of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)Omicron BF.7 in Beijing under the emergent situation using Baidu index and influenza-like illness(ILI)surveillance.A novel hybrid model(multiattention bidirectional gated recurrent unit(MABG)-susceptible-exposed-infected-removed(SEIR))was developed,which leveraged a deep learning algorithm(MABG)to scrutinize the past records of ILI occurrences and the Baidu index of diverse symptoms such as fever,pyrexia,cough,sore throat,anti-fever medicine,and runny nose.By considering the current Baidu index and the correlation between ILI cases and coronavirus disease 2019(COVID-19)cases,a transmission dynamics model(SEIR)was formulated to estimate the transmission dynamics and epidemic curve of SARS-Co V-2.During the COVID-19 pandemic,when conventional surveillance measures have been suspended temporarily,cases of ILI can serve as a useful indicator for estimating the epidemiological trends of COVID-19.In the specific case of Beijing,it has been ascertained that cumulative infection attack rate surpass 80.25%(95%confidence interval(95%CI):77.51%-82.99%)since December 17,2022,with the apex of the outbreak projected to transpire on December 12.The culmination of existing patients is expected to occur three days subsequent to this peak.Effective reproduction number(Rt)represents the average number of secondary infections generated from a single infected individual at a specific point in time during an epidemic,remained below 1 since December 17,2022.The traditional disease surveillance systems should be complemented with information from modern surveillance data such as online data sources with advanced technical support.Modern surveillance channels should be used primarily in emerging infectious and disease outbreaks.Syndrome surveillance on COVID-19 should be established to following on the epidemic,clinical severity,and medical resource demand.展开更多
Sanhan Huashi granules(SHG)demonstrated therapeutic effects against coronavirus disease 2019(COVID-19)in observational studies.In order to compare the effectiveness and safety of SHG and nirmatrelvir–ritonavir in tre...Sanhan Huashi granules(SHG)demonstrated therapeutic effects against coronavirus disease 2019(COVID-19)in observational studies.In order to compare the effectiveness and safety of SHG and nirmatrelvir–ritonavir in treating adults with mild-to-moderate COVID-19,we conducted a randomized,activecontrolled,open-label,multi-center trial conducted between February and July in 2023.The patients were randomized in a 1:1 ratio to the SHG group and the nirmatrelvir–ritonavir group.A total of 400participants were randomized,among which 200 participants ultimately received SHG and 198 received nirmatrelvir–ritonavir.The primary outcome was time to sustained clinical recovery through day 28.SHG significantly shortened the median time to sustained clinical recovery compared to nirmatrelvir–ritonavir(6.0(95%CI,5.0 to 6.0)vs.8.0(95%CI,6.0 to 9.0)d;P=0.001),particularly for individual symptoms including fever,sore throat,cough and fatigue.No participants in either group died and incidence of severe COVID-19 showed no difference between two groups.Participants who received nirmatrelvir–ritonavir demonstrated a higher rate of virus clearance on day 5 compared to those received SHG(46.4%(95%CI,39.1 to 53.7)vs.65.6%(95%CI,58.3 to 72.4);P<0.001).Most adverse events were mild in both groups.In summary,SHG was superior to nirmatrelvir–ritonavir in shortening the time to sustained clinical recovery in participants with mild-to-moderate COVID-19,despite a lower virus clearance rate observed after 5 d of treatment(Chinese Clinical Trial Registry Identifier:Chi CTR2300067872).展开更多
The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospectiv...The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospective analysis of hospitalized adult COVID-19 patients in Wuhan,China,who had definite clinical outcome(dead or discharged)by February 15,2020.Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes.The medical records from 702 patients were screened.Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication,40 patients were receiving ACEI/ARB as part of their regimen,and 61 patients were on antihypertensive medication other than ACEI/ARB.We observed no statistically significant differences in percentages of in-hospital mortality(28%vs.34%,P=0.46),ICU admission(20%vs.28%,P=0.37)or invasive mechanical ventilation(18%vs.26%,P=0.31)between patients with or without ACEI/ARB treatment.Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes.Our findings confirm the lack of an association between chronic receipt of reninangiotensin system antagonists and severe outcomes of COVID-19.Patients should continue previous antihypertensive therapy until further evidence is available.展开更多
What is already known about this topic?Individuals who initially contract severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)lack significant mixed immunity.Therefore,it is crucial to monitor the clinical char...What is already known about this topic?Individuals who initially contract severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)lack significant mixed immunity.Therefore,it is crucial to monitor the clinical characteristics and associated factors of these individuals in order to inform policymaking.What is added by this report?The common symptoms reported were fever,cough,and sore throat.Reinfections and receiving four vaccination doses within a 6-month period were found to be associated with a shorter duration of virus shedding,decreased hospitalization rate,and reduced risk of pneumonia.Individuals aged 60 years and older,as well as those with underlying medical conditions,had a higher risk of developing pneumonia.What are the implication for public health practices?Online surveys conducted through social media platforms have the potential to complement disease surveillance and data collection efforts.In terms of vaccination prioritization,it is recommended to prioritize older individuals and those with underlying diseases.展开更多
Background:The impact of corticosteroids on humoral responses in coronavirus disease 2019(COVID-19)sur-vivors during the acute phase and subsequent 6-month period remains unknown.This study aimed to determine how the ...Background:The impact of corticosteroids on humoral responses in coronavirus disease 2019(COVID-19)sur-vivors during the acute phase and subsequent 6-month period remains unknown.This study aimed to determine how the use of corticosteroids influences the initiation and duration of humoral responses in COVID-19 survivors 6 months after infection onset.Methods:We used kinetic antibody data from the lopinavir-ritonavir trial conducted at Jin Yin-Tan Hospital in January 2020,which involved adults hospitalized with severe COVID-19(LOTUS,ChiCTR2000029308).Anti-body samples were collected from 192 patients during hospitalization,and kinetic antibodies were monitored at all available time points after recruitment.Additionally,plasma samples were collected from 101 COVID-19 survivors for comprehensive humoral immune measurement at the half-year follow-up visit.The main focus was comparing the humoral responses between patients treated with systemic corticosteroid therapy and the non-corticosteroid group.Results:From illness onset to day 30,the median antibody titre areas under the receiver operating characteristic curve(AUCs)of nucleoprotein(N),spike protein(S),and receptor-binding domain(RBD)immunoglobulin G(IgG)were significantly lower in the corticosteroids group.The AUCs of N-,S-,and RBD-IgM as well as neutralizing antibodies(NAbs)were numerically lower in the corticosteroids group compared with the non-corticosteroid group.However,peak titres of N,S,RBD-IgM and-IgG and NAbs were not influenced by corticosteroids.During 6-month follow-up,we observed a delayed decline for most binding antibodies,except N-IgM(𝛽−0.05,95%CI[−0.10,0.00])in the corticosteroids group,though not reaching statistical significance.No significant difference was observed for NAbs.However,for the half-year seropositive rate,corticosteroids significantly accelerated the decay of IgA and IgM but made no difference to N-,S-,and RBD-IgG or NAbs.Additionally,corticosteroids group showed a trend towards delayed viral clearance compared with the non-corticosteroid group,but the results were not statistically significant(adjusted hazard ratio 0.71,95%CI 0.50-1.00;P=0.0508).Conclusion:Our findings suggested that corticosteroid therapy was associated with impaired initiation of the antibody response but this did not compromise the peak titres of binding and neutralizing antibodies.Throughout the decay phase,from the acute phase to the half-year follow-up visit,short-term and low-dose corticosteroids did not significantly affect humoral responses,except for accelerating the waning of short-lived antibodies.展开更多
基金supported by grants from the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021I2M-1-044)。
文摘Surveillance is an essential work on infectious diseases prevention and control.When the pandemic occurred,the inadequacy of traditional surveillance was exposed,but it also provided a valuable opportunity to explore new surveillance methods.This study aimed to estimate the transmission dynamics and epidemic curve of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)Omicron BF.7 in Beijing under the emergent situation using Baidu index and influenza-like illness(ILI)surveillance.A novel hybrid model(multiattention bidirectional gated recurrent unit(MABG)-susceptible-exposed-infected-removed(SEIR))was developed,which leveraged a deep learning algorithm(MABG)to scrutinize the past records of ILI occurrences and the Baidu index of diverse symptoms such as fever,pyrexia,cough,sore throat,anti-fever medicine,and runny nose.By considering the current Baidu index and the correlation between ILI cases and coronavirus disease 2019(COVID-19)cases,a transmission dynamics model(SEIR)was formulated to estimate the transmission dynamics and epidemic curve of SARS-Co V-2.During the COVID-19 pandemic,when conventional surveillance measures have been suspended temporarily,cases of ILI can serve as a useful indicator for estimating the epidemiological trends of COVID-19.In the specific case of Beijing,it has been ascertained that cumulative infection attack rate surpass 80.25%(95%confidence interval(95%CI):77.51%-82.99%)since December 17,2022,with the apex of the outbreak projected to transpire on December 12.The culmination of existing patients is expected to occur three days subsequent to this peak.Effective reproduction number(Rt)represents the average number of secondary infections generated from a single infected individual at a specific point in time during an epidemic,remained below 1 since December 17,2022.The traditional disease surveillance systems should be complemented with information from modern surveillance data such as online data sources with advanced technical support.Modern surveillance channels should be used primarily in emerging infectious and disease outbreaks.Syndrome surveillance on COVID-19 should be established to following on the epidemic,clinical severity,and medical resource demand.
基金supported by the Jiangsu Kanion Pharmaceutical Co.,Ltd.and partially supported by the Innovation TeamTalents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202208)。
文摘Sanhan Huashi granules(SHG)demonstrated therapeutic effects against coronavirus disease 2019(COVID-19)in observational studies.In order to compare the effectiveness and safety of SHG and nirmatrelvir–ritonavir in treating adults with mild-to-moderate COVID-19,we conducted a randomized,activecontrolled,open-label,multi-center trial conducted between February and July in 2023.The patients were randomized in a 1:1 ratio to the SHG group and the nirmatrelvir–ritonavir group.A total of 400participants were randomized,among which 200 participants ultimately received SHG and 198 received nirmatrelvir–ritonavir.The primary outcome was time to sustained clinical recovery through day 28.SHG significantly shortened the median time to sustained clinical recovery compared to nirmatrelvir–ritonavir(6.0(95%CI,5.0 to 6.0)vs.8.0(95%CI,6.0 to 9.0)d;P=0.001),particularly for individual symptoms including fever,sore throat,cough and fatigue.No participants in either group died and incidence of severe COVID-19 showed no difference between two groups.Participants who received nirmatrelvir–ritonavir demonstrated a higher rate of virus clearance on day 5 compared to those received SHG(46.4%(95%CI,39.1 to 53.7)vs.65.6%(95%CI,58.3 to 72.4);P<0.001).Most adverse events were mild in both groups.In summary,SHG was superior to nirmatrelvir–ritonavir in shortening the time to sustained clinical recovery in participants with mild-to-moderate COVID-19,despite a lower virus clearance rate observed after 5 d of treatment(Chinese Clinical Trial Registry Identifier:Chi CTR2300067872).
基金This work was supported by Major Projects of National Science and Technology on New Drug Creation and Development(Nos.2020ZX09201001 and 2020ZX09201012)Chinese Academy of Medical Sciences(CAMS)Emergency Project of COVID-19(No.2020HY320001).
文摘The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospective analysis of hospitalized adult COVID-19 patients in Wuhan,China,who had definite clinical outcome(dead or discharged)by February 15,2020.Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes.The medical records from 702 patients were screened.Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication,40 patients were receiving ACEI/ARB as part of their regimen,and 61 patients were on antihypertensive medication other than ACEI/ARB.We observed no statistically significant differences in percentages of in-hospital mortality(28%vs.34%,P=0.46),ICU admission(20%vs.28%,P=0.37)or invasive mechanical ventilation(18%vs.26%,P=0.31)between patients with or without ACEI/ARB treatment.Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes.Our findings confirm the lack of an association between chronic receipt of reninangiotensin system antagonists and severe outcomes of COVID-19.Patients should continue previous antihypertensive therapy until further evidence is available.
基金Supported by the CAMS Innovation Fund for Medical Sciences(2021-I2M-1-044)the Beijing Natural Science Foundation(L222028)the Special Funds for the Basic Research and Development Program in the Central Non-profit Research Institutes of China(2021-RC330-002).
文摘What is already known about this topic?Individuals who initially contract severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)lack significant mixed immunity.Therefore,it is crucial to monitor the clinical characteristics and associated factors of these individuals in order to inform policymaking.What is added by this report?The common symptoms reported were fever,cough,and sore throat.Reinfections and receiving four vaccination doses within a 6-month period were found to be associated with a shorter duration of virus shedding,decreased hospitalization rate,and reduced risk of pneumonia.Individuals aged 60 years and older,as well as those with underlying medical conditions,had a higher risk of developing pneumonia.What are the implication for public health practices?Online surveys conducted through social media platforms have the potential to complement disease surveillance and data collection efforts.In terms of vaccination prioritization,it is recommended to prioritize older individuals and those with underlying diseases.
基金supported by the National Natural Science Foundation of China(No.82200009)the National Key Research and Development Program of China(No.2021YFC0864700)+1 种基金the National Natural Science Foundation of China(No.81930063)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(CIFMS No.2021-I2M-1-048).
文摘Background:The impact of corticosteroids on humoral responses in coronavirus disease 2019(COVID-19)sur-vivors during the acute phase and subsequent 6-month period remains unknown.This study aimed to determine how the use of corticosteroids influences the initiation and duration of humoral responses in COVID-19 survivors 6 months after infection onset.Methods:We used kinetic antibody data from the lopinavir-ritonavir trial conducted at Jin Yin-Tan Hospital in January 2020,which involved adults hospitalized with severe COVID-19(LOTUS,ChiCTR2000029308).Anti-body samples were collected from 192 patients during hospitalization,and kinetic antibodies were monitored at all available time points after recruitment.Additionally,plasma samples were collected from 101 COVID-19 survivors for comprehensive humoral immune measurement at the half-year follow-up visit.The main focus was comparing the humoral responses between patients treated with systemic corticosteroid therapy and the non-corticosteroid group.Results:From illness onset to day 30,the median antibody titre areas under the receiver operating characteristic curve(AUCs)of nucleoprotein(N),spike protein(S),and receptor-binding domain(RBD)immunoglobulin G(IgG)were significantly lower in the corticosteroids group.The AUCs of N-,S-,and RBD-IgM as well as neutralizing antibodies(NAbs)were numerically lower in the corticosteroids group compared with the non-corticosteroid group.However,peak titres of N,S,RBD-IgM and-IgG and NAbs were not influenced by corticosteroids.During 6-month follow-up,we observed a delayed decline for most binding antibodies,except N-IgM(𝛽−0.05,95%CI[−0.10,0.00])in the corticosteroids group,though not reaching statistical significance.No significant difference was observed for NAbs.However,for the half-year seropositive rate,corticosteroids significantly accelerated the decay of IgA and IgM but made no difference to N-,S-,and RBD-IgG or NAbs.Additionally,corticosteroids group showed a trend towards delayed viral clearance compared with the non-corticosteroid group,but the results were not statistically significant(adjusted hazard ratio 0.71,95%CI 0.50-1.00;P=0.0508).Conclusion:Our findings suggested that corticosteroid therapy was associated with impaired initiation of the antibody response but this did not compromise the peak titres of binding and neutralizing antibodies.Throughout the decay phase,from the acute phase to the half-year follow-up visit,short-term and low-dose corticosteroids did not significantly affect humoral responses,except for accelerating the waning of short-lived antibodies.
