Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group de...Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19.According to the 1:1 ratio between the study groups(ivermectin group and standard treatment group),patients were randomly admitted to each intervention arm.Results:The mean age of the participants in the ivermectin group was(48.37±13.32)years.Eighteen of them were males(54.5%)and the participants in the control group had a mean age of(46.28±14.47)years,with nineteen of them being males(59.4%).As a primary outcome,after 5 days of randomization,there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital(P=0.168).ICU admission(P=0.764),length of stay in ICU(P=0.622),in-hospital mortality(P=0.427),adverse drug reactions,and changes in the mean difference of laboratory data had not any significant difference between the two groups(except for urea change).In addition,the radiologic findings of the two groups of patients were not significantly different.Linear regression analysis showed that for every 10 years increase of age,0.6 day of hospitalization duration was increased.There was no statistically significant association between other variables and clinical outcomes.Conclusions:Among adult hospitalized patients with moderate to severe COVID-19,there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement,and mortality of the participants.展开更多
<em>Background</em>: The aim of this study was to test Viusid and Asbrip as adjuvants to the standard treatment of patients with COVID-19 disease which could favor the recovery of the patients and reduce t...<em>Background</em>: The aim of this study was to test Viusid and Asbrip as adjuvants to the standard treatment of patients with COVID-19 disease which could favor the recovery of the patients and reduce the hospitalization days.<em> Design</em>: This is a randomized, open-label, controlled trial to determine the efficacy and safety of Viusid and Asbrip in hospitalized patients with mild to moderate symptoms of COVID-19. <em>Material and Methods</em>: A total of 60 patients with proven COVID-19 disease by PCR test were randomized in a 2:1 ratio. In the active group 40 patients received oral doses of Viusid (30 ml TID) and Asbrip (10 ml TID) plus standard treatment. The control group consisted of 20 patients receiving only standard treatment. The trial began with hospitalization, followed by home treatment for a total of 21 days. Four symptoms were followed: fever, dyspnea, cough and fatigue, assessed by score 0 - 3: 0 = well, 1 = mild, 2 = moderate, 3 = severe, with total sum, Composite Symptom Score (CSS) from 0 to 12. <em>Results</em>: The 21 days diagram of CSS shows statistically better results of Viusid-Asbrip group vs. Control group from day 4 to day 21. Time to semi-recovery in days, assessed by 50% of CSS, is better in Viusid-Asbrip group vs. Control group (6.07 ± 2.77 vs. 8.35 ± 2.94, p = 0.02). Time to recovery in days respectively is (14.05 ± 4.15 vs. 19.25 ± 2.12, p = 0.0001). And Hospitalization days are (9.05 ± 2.58 vs. 12.75 ± 4.44, p = 0.0003). <em>Conclusion</em>: This trial shows that adding of Viusid & Asbrip to the treatment of COVID-19 can contribute to faster recovery of the patients, decreasing of the hospital stay and milder course of the disease.展开更多
Objective Phillyrin(KD-1)is a traditional Chinese monomer and the main active component in Lianhua Qingwen.At present,sufficient studies have confirmed that KD-1 has significant anti-SARS-CoV-2 activity and antiinflam...Objective Phillyrin(KD-1)is a traditional Chinese monomer and the main active component in Lianhua Qingwen.At present,sufficient studies have confirmed that KD-1 has significant anti-SARS-CoV-2 activity and antiinflammatory effects in vitro and in vivo.However,evidence-based studies to evaluate its therapeutic effect on COVID-19 are lacking.Therefore,we designed a clinical trial to evaluate the efficacy and safety of KD-1 in the treatment of moderate COVID-19 infection.Methods This is a multicenter,randomized,double-blind,placebo-controlled clinical trial.A total of 120 participants will be recruited and randomized to receive KD-1 capsule or placebo treatment for 14 days,50 mg per capsule,four capsules each time,three times a day.If the SARS-CoV-2 nucleic acid test results are negative twice within 14 days,the KD-1 capsule will be stopped the following day.Symptoms,patient compliance,and adverse reactions will be recorded,and nucleic acid testing will be conducted daily.Primary and secondary outcomes,as well as safety indicators,will be used to evaluate the efficacy and safety of the KD-1 capsule in the treatment of COVID-19.Discussion Herein,we describe the first clinical trial in China to treat COVID-19 using a traditional Chinese medicine monomer.A randomized,double-blind,placebo-controlled clinical trial is the best way to evaluate the efficacy and safety of KD-1 against moderate COVID-19 infection.If a good clinical benefit is observed,this represents the first step toward the use of KD-1 capsules to treat COVID-19.This clinical trial can serve as a model for other evidence-based research of traditional herbal medicines.Trial registration This study is registered at chinadrugtrials.org.cn,with registration number:CTR20211800.展开更多
Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unpr...Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.展开更多
Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),not only affects the lungs but also damages various non-pulmonary organs,resulting in tissue injury and potentia...Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),not only affects the lungs but also damages various non-pulmonary organs,resulting in tissue injury and potential long-term sequelae in infected individuals.COVID-19 is likely to persist as a public health concern,given the frequent emergence of new mutations and viral strains.Multiple clinical lines of evidence indicate the efficacy of traditional Chinese medicine(TCM)in the prevention and treatment of COVID-19.However,the exact mechanism underlying these effects remains unclear.In this perspective review,we summarize the utility of in vitro three-dimensional(3D)cultured organoid models and organ-on-a-chip(OoC)technology for studying COVID-19 pathogenesis,viral tropism,and infectious mechanisms across different tissues.We highlight the successful application of these platforms in aiding drug development and discuss their advantages and limitations.We also review how such organotypic models can be employed to study TCMs.Finally,we discuss the opportunities for integrated microphysiological multi-tissue models to rapidly discover active components and potential targets in the context of COVID-19.The utilization of these emerging technologies could accelerate drug discovery and the modernization of TCM.展开更多
Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumon...Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.展开更多
Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moder...Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center.The primary composite outcomes were admission to intensive care unit,requirement of mechanical ventilation,and death.Results:The median age of the patients was 50 years,and 62.8%of the patients were male.Out of 43 patients,15(34.88%)were categorized as severe.A total of 26(60.47%)patients had 1 or more comorbidities[diabetes(34.88%)and hypertension(30.23%)].The median duration from the onset of symptoms to admission was 3 days,and the most common symptoms were dyspnoea(90.7%),cough(79.07%),fever(69.77%),and body ache(46.51%).Leucopenia was presented in 14(32.56%)patients,lymphopenia in 26(60.47%)patients,and monocytosis in 7(16.28%)patients.Besides,40(93.02%)patients had bilateral patchy nodular or interstitial infiltration on chest X-ray.The primary outcomes occurred in 20 patients(46.5%),among whom 8 required mechanical ventilation.The patients who had met the primary outcomes were older.They were prone to have at least 1 comorbidity(P=0.004),diabetes(P=0.01),hypertension,higher sequential organ failure assessment score,more tachycardia,lower SpO2,lower PaO2/FiO2,more thrombocytopenia,and more pancytopenia.Conclusions:This retrospective study identified several risk factors for poor outcomes in adults with COVID-19.In particular,older age,tachycardia,high SOFA score,low SpO2,low PaO2/FiO2,presence of comorbidities in form of diabetes and hypertension,thrombocytopenia,and pancytopenia at admission were associated with higher odds of ICU admission,a requirement of mechanical ventilation and in-hospital death.展开更多
Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients...Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.展开更多
Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and ...Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19.Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected.The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon(IFN)-cinduced protein 10(IP10), interleukin(IL)-10 and IL-16. We observed an increase in T helper(Th)-2 cells and a suppression in regulatory T cells(Treg) in patients during acute phase, but no significant response was found in the IFN-cproducing or tumor necrosis factor(TNF)-a-producing CD8?T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4?T cell response and inactive CD8?T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.展开更多
The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the...The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic.The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care.Additionally,the adverse effects of any surgery delays and the financial consequences complicate the picture.Therefore,patients’admission during the COVID-19 pandemic should be taken into consideration,as well as preoperative measures.The COVID-19 situation brings particular risk to patients during surgery,where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients.This review discusses the recent factors associated with surgical complications,mortality rates,outcomes,and experience in COVID-19 surgical patients.展开更多
Background: COVID-19 is currently one of the most infectious diseases worldwide. In this study, we focused on the mild and moderate cases of COVID-19 that can present with mild respiratory symptoms or non-respiratory ...Background: COVID-19 is currently one of the most infectious diseases worldwide. In this study, we focused on the mild and moderate cases of COVID-19 that can present with mild respiratory symptoms or non-respiratory symptoms. Many of that cases got miss diagnoses. We aim to help emergency physicians in reaching a proper and faster diagnosis of COVID-19 cases. Method: In this retrospective cross-sectional qualitative study, we collected 100 confirmed cases of COVID-19 that were presented in April 2020 in Al Wakra Hospital, Qatar. All that cases were mild-moderate cases without severe respiratory symptoms. We reviewed the electronic files on patient presentation, emergency department physician’s note, temperature data, and chest X-ray findings. Result: Our result showed about 49% of the total COVID-19 confirmed cases had respiratory symptoms, while the remaining 51% had no respiratory symptoms. The respiratory symptoms, such as cough and sore throat, and non-respiratory symptoms like headache, vomiting, abdominal pain, and skin rash. Regarding fever presentation, we found that 66% of cases had a fever, while 34% had no fever complaints. The most frequently observed body temperature of patients was 37+ °C, followed by 38+ °C, 36+ °C, and 39+ °C. About 41% of cases had non-significant X-ray findings, and 40% cases had significant X-ray findings. The remaining 19% of cases did not undergo any X-ray examination due to mild and stable presentation. Conclusion: The presentations and symptoms of a mild-moderate case of COVID-19 are not respiratory only, there are extra-pulmonary symptoms and presentations should be considered. The most common presentation for mild-moderate COVID-19 was found to be fever. Chest X-ray may be performed depending on the patient’s condition, red flags, and abnormal findings in clinical examination, and should not be routine in cases with the mild presentation of COVID-19 suspicion in the emergency department.展开更多
BACKGROUND Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019(COVID-19).AIM To characterize differences between hospitalized diabetic patients with vs without COVID-19,and paramet...BACKGROUND Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019(COVID-19).AIM To characterize differences between hospitalized diabetic patients with vs without COVID-19,and parameters associated with COVID-19 severity for prediction.METHODS This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center(Nahariya,Israel)and recruited between September 2020 and May 2021,65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other reasons.Clinical parameters-including age,type of antiglycemic medications,presence of retinopathy,smoking history,body mass index(BMI),glycosylated hemoglobin,maximum neutrophil:lymphocyte ratio(NLR_(max)),C-reactive protein(CRP),estimated glomerular filtration rate(eGFR),and albumin(blood and urine)-were compared between the two primary patient groups,and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious disease.Finally,we explored which parameters were associated with severe COVID-19 pneumonia.RESULTS COVID-19-negative patients were older(63.9±9.9 vs 59.8±9.2,P=0.005),and had longer duration of diabetes(P=0.031),lower eGFR(P=0.033),higher albumin(P=0.026),lower CRP(P<0.001),greater smoking prevalence(P<0.001),and more baseline albuminuria(54.9%vs 30.8%,P=0.005)at admission;70%of COVID-19 patients with albuminuria had moderate-range albuminuria(albumin:creatinine 30-300 mg/g).Most of the patients with albuminuria had chronic kidney disease stage II(CKD II).Oral antiglycemic therapies were not significantly different between the two groups.Multivariable logistic regression showed that higher BMI was significantly associated with severe COVID-19(OR 1.24,95%CI:1.01-1.53,P=0.04),as was higher NLR_(max)(OR 1.2,95%CI:1.06-1.37,P=0.005).Surprisingly,pre-hospitalization albuminuria,mostly moderate-range,was associated with reduced risk(OR 0.09,95%CI:0.01-0.62,P=0.015).Moderate-range albuminuria was not associated with bacterial infections.CONCLUSION Moderate-range albuminuria in COVID-19-positive diabetic patients with CKD II is associated with less severe COVID-19.Further studies should explore this potential biomarker for risk of COVID-19-related deterioration and early interventions.展开更多
Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COV...Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021.Fifty-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were excluded.Patients were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.Results:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was observed.The electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of patients.On echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of patients.Conclusions:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.展开更多
Background:The benefits and harms of methylprednisolone treatment in patients with moderate coronavirus disease 2019(COVID-19)remain controversial.In this study,we investigated the effect of methylprednisolone on mort...Background:The benefits and harms of methylprednisolone treatment in patients with moderate coronavirus disease 2019(COVID-19)remain controversial.In this study,we investigated the effect of methylprednisolone on mortality rate,viral clearance,and hospitalization stay in patients with moderate COVID-19.Methods:This retrospective study included 4827 patients admitted to Wuhan Huoshenshan and Wuhan Guanggu hospitals from February to March 2020 diagnosed with COVID-19 pneumonia.The participants’epidemiological and demographic data,comorbidities,laboratory test results,treatments,outcomes,and vital clinical time points were extracted from electronic medical records.The primary outcome was in-hospital death;secondary outcomes were time from admission to viral clearance and hospital stay.Univariate and multivariate logistic or linear regression analysis were used to assess the roles of methylprednisolone in different outcomes.The propensity score matching(PSM)method was used to control for confounding factors.Results:A total of 1320 patients were included in this study,of whom 100 received methylprednisolone.Overall,in-hospital mortality was 0.91%(12/1320);the 12 patients who died were all in the methylprednisolone group,though multivariate logistic regression analysis showed methylprednisolone treatment was not a risk factor for in-hospital death in moderate patients before or after adjustment for confounders by PSM.Methylprednisolone treatment was correlated with longer length from admission to viral clearance time and hospital stay before and after adjustment for confounders.Conclusions:Methylprednisolone therapy was not associated with increased in-hospital mortality but with delayed viral clearance and extended hospital stay in moderate COVID-19 patients.展开更多
To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019(the COVID-19 infection epidemic),this research constructed a mediating effect mode...To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019(the COVID-19 infection epidemic),this research constructed a mediating effect model to explore the mediating psychological mechanism of social support influencing sleep quality of front-line community workers.A total of 500 front-line community workers in Wuhan were investigated.We used the perceived social support scale(PSSS),the Connor-Davidson Resilience Scale(CD-RISC),the perceived stress scale(PSS),and the Pittsburgh sleep quality index(PSQI)to measure social support,psychological resilience,perceived stress and sleep quality.Specifically,the higher the PSQI,the worse the sleep quality.Pearson correlation structural equation model was used to analyze the relationship between these factors.The results showed that:(1)There was a significant negative correlation between social support,psychological resilience,and perceived stress of community workers and PSQI,that means,the higher the level of social support,psychological resilience,and perceived stress,the higher the sleep quality.(2)Social support positively predicted psychological resilience and perceived stress,and perceived stress negatively predicted PSQI.(3)Social support can affect sleep quality through the mediating role of psychological resilience and perceived stress,and the mediating role includes two paths:the single mediating role of perceived stress and the chain mediating role of psychological resilience-perceived stress.(4)Gender moderates the relation-ship between social support and perceived stress,and the influence of social support on perceived stress of women is higher than that of men.Gender moderates the relationship between psychological resilience and PSQI,and only women’s psychological resilience had a negatively predictive effect on PSQI,while men did not,which means that psychological resilience of female frontline community workers can positively predict sleep quality.This research reveals the relationship between social support and sleep quality and its mechanism and verifies that social support can indirectly affect physical health through psychological resilience and perceived stress.It provides reference suggestions and intervention guidance for improving the sleep quality of community workers.展开更多
目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸...目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸联合刺络拔罐治疗。比较两组退热时间,两组治疗前后咳嗽视觉模拟量表(visual analog scale,VAS)、中文版莱塞斯特咳嗽生命质量问卷(Mandarin Chinese version of the Leicester cough questionnaire,LCQ-MC)、咽干/痛缓解程度,并比较两组安全性情况,追踪观察两组患者是否出现“长新冠综合征”和COVID-19二次感染情况。结果两组退热时间比较差异有统计学意义(P<0.05)。两组治疗后咳嗽VAS评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后LCQ-MC评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后咽干/痛程度分布优于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05)。两组“长新冠综合征”发生率比较差异无统计学意义(P>0.05)。两组COVID-19二次感染率比较差异无统计学意义(P>0.05)。两组疗法安全性均可。结论在口服中成药的基础上,温针灸联合刺络拔罐治疗COVID-19轻型患者在急性期临床疗效显著,安全性高。展开更多
基金Hormozgan University of Medical Sciences,Bandar Abbas,Iran(grant No.990238)。
文摘Objective:To evaluate the effectiveness and safety of ivermectin in patients with mild and moderate COVID-19.Methods:This study was a single-center,randomized,open-label,controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19.According to the 1:1 ratio between the study groups(ivermectin group and standard treatment group),patients were randomly admitted to each intervention arm.Results:The mean age of the participants in the ivermectin group was(48.37±13.32)years.Eighteen of them were males(54.5%)and the participants in the control group had a mean age of(46.28±14.47)years,with nineteen of them being males(59.4%).As a primary outcome,after 5 days of randomization,there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital(P=0.168).ICU admission(P=0.764),length of stay in ICU(P=0.622),in-hospital mortality(P=0.427),adverse drug reactions,and changes in the mean difference of laboratory data had not any significant difference between the two groups(except for urea change).In addition,the radiologic findings of the two groups of patients were not significantly different.Linear regression analysis showed that for every 10 years increase of age,0.6 day of hospitalization duration was increased.There was no statistically significant association between other variables and clinical outcomes.Conclusions:Among adult hospitalized patients with moderate to severe COVID-19,there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement,and mortality of the participants.
文摘<em>Background</em>: The aim of this study was to test Viusid and Asbrip as adjuvants to the standard treatment of patients with COVID-19 disease which could favor the recovery of the patients and reduce the hospitalization days.<em> Design</em>: This is a randomized, open-label, controlled trial to determine the efficacy and safety of Viusid and Asbrip in hospitalized patients with mild to moderate symptoms of COVID-19. <em>Material and Methods</em>: A total of 60 patients with proven COVID-19 disease by PCR test were randomized in a 2:1 ratio. In the active group 40 patients received oral doses of Viusid (30 ml TID) and Asbrip (10 ml TID) plus standard treatment. The control group consisted of 20 patients receiving only standard treatment. The trial began with hospitalization, followed by home treatment for a total of 21 days. Four symptoms were followed: fever, dyspnea, cough and fatigue, assessed by score 0 - 3: 0 = well, 1 = mild, 2 = moderate, 3 = severe, with total sum, Composite Symptom Score (CSS) from 0 to 12. <em>Results</em>: The 21 days diagram of CSS shows statistically better results of Viusid-Asbrip group vs. Control group from day 4 to day 21. Time to semi-recovery in days, assessed by 50% of CSS, is better in Viusid-Asbrip group vs. Control group (6.07 ± 2.77 vs. 8.35 ± 2.94, p = 0.02). Time to recovery in days respectively is (14.05 ± 4.15 vs. 19.25 ± 2.12, p = 0.0001). And Hospitalization days are (9.05 ± 2.58 vs. 12.75 ± 4.44, p = 0.0003). <em>Conclusion</em>: This trial shows that adding of Viusid & Asbrip to the treatment of COVID-19 can contribute to faster recovery of the patients, decreasing of the hospital stay and milder course of the disease.
基金This work was supported in part by the National Natural Science Foundation of China(No.82174053)This research received a grant from Dalian Fusheng Pharmaceutical Co.,Ltd.(Liaoning province,China)。
文摘Objective Phillyrin(KD-1)is a traditional Chinese monomer and the main active component in Lianhua Qingwen.At present,sufficient studies have confirmed that KD-1 has significant anti-SARS-CoV-2 activity and antiinflammatory effects in vitro and in vivo.However,evidence-based studies to evaluate its therapeutic effect on COVID-19 are lacking.Therefore,we designed a clinical trial to evaluate the efficacy and safety of KD-1 in the treatment of moderate COVID-19 infection.Methods This is a multicenter,randomized,double-blind,placebo-controlled clinical trial.A total of 120 participants will be recruited and randomized to receive KD-1 capsule or placebo treatment for 14 days,50 mg per capsule,four capsules each time,three times a day.If the SARS-CoV-2 nucleic acid test results are negative twice within 14 days,the KD-1 capsule will be stopped the following day.Symptoms,patient compliance,and adverse reactions will be recorded,and nucleic acid testing will be conducted daily.Primary and secondary outcomes,as well as safety indicators,will be used to evaluate the efficacy and safety of the KD-1 capsule in the treatment of COVID-19.Discussion Herein,we describe the first clinical trial in China to treat COVID-19 using a traditional Chinese medicine monomer.A randomized,double-blind,placebo-controlled clinical trial is the best way to evaluate the efficacy and safety of KD-1 against moderate COVID-19 infection.If a good clinical benefit is observed,this represents the first step toward the use of KD-1 capsules to treat COVID-19.This clinical trial can serve as a model for other evidence-based research of traditional herbal medicines.Trial registration This study is registered at chinadrugtrials.org.cn,with registration number:CTR20211800.
基金the Natural Science Basic Research Program of Shaanxi Province,China[2023-JC-QN-0858]the Free Exploration Program of the Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University[2020YJ(ZYTS)605]the National Natural Science Foundation of China[81900620].
文摘Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.
基金supported by the Zhejiang Provincial Natural Science Foundation of China(LDT23H19012H19)the National Key R&D Program of China(2021YFC1712905)+5 种基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-D-202002)the Fundamental Research Funds for the Central Universities(226-2024-00001)Volker M.Lauschke was supported by the Swedish Research Council(2019-01837 and 2021-02801)Ruth och Richard Julins Foundation for Gastroenterology(2021-00158)the Knut and Alice Wallenberg Foundation(VC-2021-0026)Robert Bosch Foundation,Stuttgart,Germany.
文摘Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),not only affects the lungs but also damages various non-pulmonary organs,resulting in tissue injury and potential long-term sequelae in infected individuals.COVID-19 is likely to persist as a public health concern,given the frequent emergence of new mutations and viral strains.Multiple clinical lines of evidence indicate the efficacy of traditional Chinese medicine(TCM)in the prevention and treatment of COVID-19.However,the exact mechanism underlying these effects remains unclear.In this perspective review,we summarize the utility of in vitro three-dimensional(3D)cultured organoid models and organ-on-a-chip(OoC)technology for studying COVID-19 pathogenesis,viral tropism,and infectious mechanisms across different tissues.We highlight the successful application of these platforms in aiding drug development and discuss their advantages and limitations.We also review how such organotypic models can be employed to study TCMs.Finally,we discuss the opportunities for integrated microphysiological multi-tissue models to rapidly discover active components and potential targets in the context of COVID-19.The utilization of these emerging technologies could accelerate drug discovery and the modernization of TCM.
基金supported by grants from the second batch of emergency key scientific and technological project of Shanghai Municipal Committee of Science and Technology(Nos.20411950300,20411950301)the Clinical Research Project of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(No.2018CR004)to EnQiang Mao and the National Natural Science Foundation of China to Jun Huang(No.81870311)。
文摘Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.
文摘Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center.The primary composite outcomes were admission to intensive care unit,requirement of mechanical ventilation,and death.Results:The median age of the patients was 50 years,and 62.8%of the patients were male.Out of 43 patients,15(34.88%)were categorized as severe.A total of 26(60.47%)patients had 1 or more comorbidities[diabetes(34.88%)and hypertension(30.23%)].The median duration from the onset of symptoms to admission was 3 days,and the most common symptoms were dyspnoea(90.7%),cough(79.07%),fever(69.77%),and body ache(46.51%).Leucopenia was presented in 14(32.56%)patients,lymphopenia in 26(60.47%)patients,and monocytosis in 7(16.28%)patients.Besides,40(93.02%)patients had bilateral patchy nodular or interstitial infiltration on chest X-ray.The primary outcomes occurred in 20 patients(46.5%),among whom 8 required mechanical ventilation.The patients who had met the primary outcomes were older.They were prone to have at least 1 comorbidity(P=0.004),diabetes(P=0.01),hypertension,higher sequential organ failure assessment score,more tachycardia,lower SpO2,lower PaO2/FiO2,more thrombocytopenia,and more pancytopenia.Conclusions:This retrospective study identified several risk factors for poor outcomes in adults with COVID-19.In particular,older age,tachycardia,high SOFA score,low SpO2,low PaO2/FiO2,presence of comorbidities in form of diabetes and hypertension,thrombocytopenia,and pancytopenia at admission were associated with higher odds of ICU admission,a requirement of mechanical ventilation and in-hospital death.
文摘Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.
基金supported by grants specific for Coronavirus Disease 2019 from the Children’s Hospital of Fudan University (Grant No. EKXGZX006)。
文摘Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19.Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected.The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon(IFN)-cinduced protein 10(IP10), interleukin(IL)-10 and IL-16. We observed an increase in T helper(Th)-2 cells and a suppression in regulatory T cells(Treg) in patients during acute phase, but no significant response was found in the IFN-cproducing or tumor necrosis factor(TNF)-a-producing CD8?T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4?T cell response and inactive CD8?T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.
文摘The coronavirus disease 2019(COVID-19)pandemic has had a considerable impact on the work of physicians and surgeons.The connection between the patient and the surgeon cannot be replaced by telemedicine.For example,the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic.The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care.Additionally,the adverse effects of any surgery delays and the financial consequences complicate the picture.Therefore,patients’admission during the COVID-19 pandemic should be taken into consideration,as well as preoperative measures.The COVID-19 situation brings particular risk to patients during surgery,where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients.This review discusses the recent factors associated with surgical complications,mortality rates,outcomes,and experience in COVID-19 surgical patients.
文摘Background: COVID-19 is currently one of the most infectious diseases worldwide. In this study, we focused on the mild and moderate cases of COVID-19 that can present with mild respiratory symptoms or non-respiratory symptoms. Many of that cases got miss diagnoses. We aim to help emergency physicians in reaching a proper and faster diagnosis of COVID-19 cases. Method: In this retrospective cross-sectional qualitative study, we collected 100 confirmed cases of COVID-19 that were presented in April 2020 in Al Wakra Hospital, Qatar. All that cases were mild-moderate cases without severe respiratory symptoms. We reviewed the electronic files on patient presentation, emergency department physician’s note, temperature data, and chest X-ray findings. Result: Our result showed about 49% of the total COVID-19 confirmed cases had respiratory symptoms, while the remaining 51% had no respiratory symptoms. The respiratory symptoms, such as cough and sore throat, and non-respiratory symptoms like headache, vomiting, abdominal pain, and skin rash. Regarding fever presentation, we found that 66% of cases had a fever, while 34% had no fever complaints. The most frequently observed body temperature of patients was 37+ °C, followed by 38+ °C, 36+ °C, and 39+ °C. About 41% of cases had non-significant X-ray findings, and 40% cases had significant X-ray findings. The remaining 19% of cases did not undergo any X-ray examination due to mild and stable presentation. Conclusion: The presentations and symptoms of a mild-moderate case of COVID-19 are not respiratory only, there are extra-pulmonary symptoms and presentations should be considered. The most common presentation for mild-moderate COVID-19 was found to be fever. Chest X-ray may be performed depending on the patient’s condition, red flags, and abnormal findings in clinical examination, and should not be routine in cases with the mild presentation of COVID-19 suspicion in the emergency department.
文摘BACKGROUND Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019(COVID-19).AIM To characterize differences between hospitalized diabetic patients with vs without COVID-19,and parameters associated with COVID-19 severity for prediction.METHODS This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center(Nahariya,Israel)and recruited between September 2020 and May 2021,65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other reasons.Clinical parameters-including age,type of antiglycemic medications,presence of retinopathy,smoking history,body mass index(BMI),glycosylated hemoglobin,maximum neutrophil:lymphocyte ratio(NLR_(max)),C-reactive protein(CRP),estimated glomerular filtration rate(eGFR),and albumin(blood and urine)-were compared between the two primary patient groups,and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious disease.Finally,we explored which parameters were associated with severe COVID-19 pneumonia.RESULTS COVID-19-negative patients were older(63.9±9.9 vs 59.8±9.2,P=0.005),and had longer duration of diabetes(P=0.031),lower eGFR(P=0.033),higher albumin(P=0.026),lower CRP(P<0.001),greater smoking prevalence(P<0.001),and more baseline albuminuria(54.9%vs 30.8%,P=0.005)at admission;70%of COVID-19 patients with albuminuria had moderate-range albuminuria(albumin:creatinine 30-300 mg/g).Most of the patients with albuminuria had chronic kidney disease stage II(CKD II).Oral antiglycemic therapies were not significantly different between the two groups.Multivariable logistic regression showed that higher BMI was significantly associated with severe COVID-19(OR 1.24,95%CI:1.01-1.53,P=0.04),as was higher NLR_(max)(OR 1.2,95%CI:1.06-1.37,P=0.005).Surprisingly,pre-hospitalization albuminuria,mostly moderate-range,was associated with reduced risk(OR 0.09,95%CI:0.01-0.62,P=0.015).Moderate-range albuminuria was not associated with bacterial infections.CONCLUSION Moderate-range albuminuria in COVID-19-positive diabetic patients with CKD II is associated with less severe COVID-19.Further studies should explore this potential biomarker for risk of COVID-19-related deterioration and early interventions.
文摘Objective:To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography(CT)severity score.Methods:A prospective,non-randomized,observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021.Fifty-nine were male[mean age(54.1±12.2)years]and 41 were female[mean age(46.9±15.1)years].Patients with previous cardiovascular disease,previous chronic lung disease,and pre-existing primary or secondary pulmonary hypertension were excluded.Patients were examined,and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality.Results:Post-COVID-19 patients had persistent symptoms,the most common being fatigue(59%).Most of these symptoms were relieved on follow-up.A rise in systolic,diastolic blood pressure,and pulse rate was observed.The electrocardiographic evaluation revealed ST-T segment changes,sinus tachycardia,ventricular hypertrophy,and arrhythmias among a considerable number of patients.On echocardiography,left ventricular diastolic dysfunction was most common(43%).Pulmonary hypertension,as evidenced by elevated pulmonary artery systolic pressure,was seen in 15%of patients.Conclusions:The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.
基金supported by grants from the National Key R&D Program of China(2020YFC0860900)the Emergency Key Program of Guangzhou Laboratory(EKPG21-30-4).
文摘Background:The benefits and harms of methylprednisolone treatment in patients with moderate coronavirus disease 2019(COVID-19)remain controversial.In this study,we investigated the effect of methylprednisolone on mortality rate,viral clearance,and hospitalization stay in patients with moderate COVID-19.Methods:This retrospective study included 4827 patients admitted to Wuhan Huoshenshan and Wuhan Guanggu hospitals from February to March 2020 diagnosed with COVID-19 pneumonia.The participants’epidemiological and demographic data,comorbidities,laboratory test results,treatments,outcomes,and vital clinical time points were extracted from electronic medical records.The primary outcome was in-hospital death;secondary outcomes were time from admission to viral clearance and hospital stay.Univariate and multivariate logistic or linear regression analysis were used to assess the roles of methylprednisolone in different outcomes.The propensity score matching(PSM)method was used to control for confounding factors.Results:A total of 1320 patients were included in this study,of whom 100 received methylprednisolone.Overall,in-hospital mortality was 0.91%(12/1320);the 12 patients who died were all in the methylprednisolone group,though multivariate logistic regression analysis showed methylprednisolone treatment was not a risk factor for in-hospital death in moderate patients before or after adjustment for confounders by PSM.Methylprednisolone treatment was correlated with longer length from admission to viral clearance time and hospital stay before and after adjustment for confounders.Conclusions:Methylprednisolone therapy was not associated with increased in-hospital mortality but with delayed viral clearance and extended hospital stay in moderate COVID-19 patients.
基金supported and granted by the“National Social Science Fund Emergency Management System Construction Research Special Project(20VYJ040),”“Central China Think Tank Special Key Projects(2020HZZK031),”+1 种基金“Key Projects of Educational Science Planning of Hubei Province(2019CFB425)”“Ministry of Education of Humanities and Social Sciences Research Fund(19YJA880082)”to YZ.
文摘To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019(the COVID-19 infection epidemic),this research constructed a mediating effect model to explore the mediating psychological mechanism of social support influencing sleep quality of front-line community workers.A total of 500 front-line community workers in Wuhan were investigated.We used the perceived social support scale(PSSS),the Connor-Davidson Resilience Scale(CD-RISC),the perceived stress scale(PSS),and the Pittsburgh sleep quality index(PSQI)to measure social support,psychological resilience,perceived stress and sleep quality.Specifically,the higher the PSQI,the worse the sleep quality.Pearson correlation structural equation model was used to analyze the relationship between these factors.The results showed that:(1)There was a significant negative correlation between social support,psychological resilience,and perceived stress of community workers and PSQI,that means,the higher the level of social support,psychological resilience,and perceived stress,the higher the sleep quality.(2)Social support positively predicted psychological resilience and perceived stress,and perceived stress negatively predicted PSQI.(3)Social support can affect sleep quality through the mediating role of psychological resilience and perceived stress,and the mediating role includes two paths:the single mediating role of perceived stress and the chain mediating role of psychological resilience-perceived stress.(4)Gender moderates the relation-ship between social support and perceived stress,and the influence of social support on perceived stress of women is higher than that of men.Gender moderates the relationship between psychological resilience and PSQI,and only women’s psychological resilience had a negatively predictive effect on PSQI,while men did not,which means that psychological resilience of female frontline community workers can positively predict sleep quality.This research reveals the relationship between social support and sleep quality and its mechanism and verifies that social support can indirectly affect physical health through psychological resilience and perceived stress.It provides reference suggestions and intervention guidance for improving the sleep quality of community workers.
文摘目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸联合刺络拔罐治疗。比较两组退热时间,两组治疗前后咳嗽视觉模拟量表(visual analog scale,VAS)、中文版莱塞斯特咳嗽生命质量问卷(Mandarin Chinese version of the Leicester cough questionnaire,LCQ-MC)、咽干/痛缓解程度,并比较两组安全性情况,追踪观察两组患者是否出现“长新冠综合征”和COVID-19二次感染情况。结果两组退热时间比较差异有统计学意义(P<0.05)。两组治疗后咳嗽VAS评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后LCQ-MC评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后咽干/痛程度分布优于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05)。两组“长新冠综合征”发生率比较差异无统计学意义(P>0.05)。两组COVID-19二次感染率比较差异无统计学意义(P>0.05)。两组疗法安全性均可。结论在口服中成药的基础上,温针灸联合刺络拔罐治疗COVID-19轻型患者在急性期临床疗效显著,安全性高。
