<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in...<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.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
Background:To investigate the clinical value of Zengneng Jiedu Formula in treating asymptomatic and mild COVID-19 patients.Methods:Asymptomatic and mild COVID-19 patients admitted to the Changji Stadium Fangcang Hospi...Background:To investigate the clinical value of Zengneng Jiedu Formula in treating asymptomatic and mild COVID-19 patients.Methods:Asymptomatic and mild COVID-19 patients admitted to the Changji Stadium Fangcang Hospital were randomly divided into treatment and control groups in a 1:1 ratio.The treatment group received Zengneng Jiedu Formula in addition to the standard treatment protocol outlined in the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia.The control group received the standard treatment protocol alone.The hospitalization duration and time to viral clearance were compared between the two groups.The study adhered to CONSORT guidelines and was registered at the Chinese Clinical Trial Registry(ChiCTR2200060589).Results:A total of 246 patients completed the entire treatment and assessment.Data analysis after treatment showed that Zengneng Jiedu Formula significantly reduced the hospitalization duration for asymptomatic and mild COVID-19 patients(7.06 days vs.8.01 days,P<0.001)and shortened the overall time to viral clearance(8.58 days vs.10.12 days,P<0.001).The incidence of adverse events was similar between the two groups.Conclusion:Zengneng Jiedu Formula can effectively shorten the hospitalization duration and time to viral clearance for asymptomatic and mild COVID-19 patients,providing a safe and effective treatment option that warrants clinical application and further study.展开更多
This study aims to evaluate the clinical effectiveness of different drug treatment regimens for cervical high-risk human papillomavirus (HR-HPV) infection. Through literature review and randomized group experiment des...This study aims to evaluate the clinical effectiveness of different drug treatment regimens for cervical high-risk human papillomavirus (HR-HPV) infection. Through literature review and randomized group experiment design, the study compares the HPV-DNA clearance rate, TCT results, and colposcopic biopsy findings among the control group, interferon group, and combination treatment group after six months of treatment. The results indicate that recombinant human interferon-2b vaginal effervescent tablets can effectively improve HPV clearance and reduce the risk of lesion progression, although individual responses to treatment vary. Combination therapy may enhance treatment efficacy by boosting immune response. The study also explores the relationship between drug treatment, viral load, cervical lesions, and vaginal microecology, providing scientific support for clinical medication decisions and offering a detailed analysis of the role of pharmacological intervention in the prognosis of HR-HPV infections.展开更多
Objective:To evaluate the effect and safety of Chinese medicine(CM) Fuzheng Huazhuo Decoction(FHD) in treating patients with coronavirus disease 2019(COVID-19) who persistently tested positive for severe acute respira...Objective:To evaluate the effect and safety of Chinese medicine(CM) Fuzheng Huazhuo Decoction(FHD) in treating patients with coronavirus disease 2019(COVID-19) who persistently tested positive for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods:This retrospective cohort study was conducted at Shanghai New International Expo Center shelter hospital in China between April 1 and May 30,2022.Patients diagnosed as COVID-19 with persistently positive SARS-CoV-2 reverse transcription-polymerase chain reaction(RT-PCR) test results for ≥8 days after diagnosis were enrolled.Patients in the control group received conventional Western medicine(WM) treatment,while those in the FHD group received conventional WM plus FHD for at least 3 days.The primary outcome was viral clearance time.Secondary outcomes included negative conversion rate within 14 days,length of hospital stay,cycle threshold(Ct) values of the open reading frame 1ab(ORF1ab) and nucleocapsid protein(N) genes,and incidence of new-onset symptoms during hospitalization.Adverse events(AEs) that occurred during the study period were recorded.Results:A total of 1,765 eligible patients were enrolled in this study(546 in the FHD group and 1,219 in the control group).Compared with the control group,patients receiving FHD treatment showed shorter viral clearance time for nucleic acids [hazard ratio(HR):1.500,95% confidence interval(CI):1.353-1.664,P<0.001] and hospital stays(HR:1.371,95% Cl:1.238-1.519,P<0.001),and a higher negative conversion rate within 14 days(96.2% vs.82.6%,P<0.001).The incidence of new-onset symptoms was 59.5% in the FHD group,similar to 57.8% in the control group(P>0.05).The Ct values of ORF1ab and N genes increased more rapidly over time in the FHD group than those in the control group post-randomization(ORF1ab gene:β=0.436 ± 0.053,P<0.001;N gene:β=0.415±0.053,P<0.001).The incidence of AEs in the FHD group was lower than that in the control group(24.2% vs.35.4%,P<0.001).No serious AEs were observed.Conclusion:FHD was effective and safe for patients with persistently positive SARS-CoV-2 PCR tests.(Registration No.ChiCTR2200063956)展开更多
文摘<strong>Background:</strong> Novel corona virus (SARS-Coronavirus-2 SARS-CoV-2) which emerged in China has spread to multiple countries rapidly. Little information is known about delayed viral clearance in mild to moderate COVID-19 pa-tients. As it is highly contagious, health care workers including physicians are high risk of being infected in hospital care. <strong>Case Report:</strong> A 37 years old Bangladeshi physician working in a paediatric unit of a medical college hos-pital with multiple co-morbidities, hypertension, diagnosed axial spondy-loarthropathy (ankylosing spondylitis) taking disease modifying anti rheu-matic drugs— DMARDs (Salfasalazine) from 2016 till now, chronic persis-tent bronchial asthma on medication developed sore throat, increasing breathlessness and cough admitted to his own hospital on 22 April, 2020. He had a history of contact with a relapse nephrotic syndrome (glomerulone-phritis) patient admitted with severe respiratory distress later confirmed as COVID-19 following RT PCR test on 14 April, 2020. After 3 days of contact with the patient, the physician also developed the symptoms mentioned above. The RT PCR test result of the physician came positive on 18 April, 2020. The physician primarily taken only azithromycin 500 mg once daily along with other regular drugs. On 5, 12 and 18 May, 2020, his sample was taken for re-test and came positive subsequently. After that he started Iver-mectin (0.15 mg/kg) once daily for 3 days and doxycycline 100 mg BD for 7 days. He gave samples again on 27 and 29 May, 2020 which were came nega-tive after 39 days. On full recovery he was discharged from hospital on day 40. We choose the patient because presence of co-morbidities may be asso-ciated with delayed viral clearance and physicians with co-morbidities working in a hospital have high risk of being infected.
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 by the Construction Fund of Shanghai Innovative Flagship Hospital of Integrated Traditional Chinese and Western Medicine(ZY(2021-2023)-0205-05)the Special TCM Emergency Response Project for Novel Coronavirus Infection of the State Administration of Traditional Chinese Medicine(2023ZYLCYJ02-6).
文摘Background:To investigate the clinical value of Zengneng Jiedu Formula in treating asymptomatic and mild COVID-19 patients.Methods:Asymptomatic and mild COVID-19 patients admitted to the Changji Stadium Fangcang Hospital were randomly divided into treatment and control groups in a 1:1 ratio.The treatment group received Zengneng Jiedu Formula in addition to the standard treatment protocol outlined in the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia.The control group received the standard treatment protocol alone.The hospitalization duration and time to viral clearance were compared between the two groups.The study adhered to CONSORT guidelines and was registered at the Chinese Clinical Trial Registry(ChiCTR2200060589).Results:A total of 246 patients completed the entire treatment and assessment.Data analysis after treatment showed that Zengneng Jiedu Formula significantly reduced the hospitalization duration for asymptomatic and mild COVID-19 patients(7.06 days vs.8.01 days,P<0.001)and shortened the overall time to viral clearance(8.58 days vs.10.12 days,P<0.001).The incidence of adverse events was similar between the two groups.Conclusion:Zengneng Jiedu Formula can effectively shorten the hospitalization duration and time to viral clearance for asymptomatic and mild COVID-19 patients,providing a safe and effective treatment option that warrants clinical application and further study.
文摘This study aims to evaluate the clinical effectiveness of different drug treatment regimens for cervical high-risk human papillomavirus (HR-HPV) infection. Through literature review and randomized group experiment design, the study compares the HPV-DNA clearance rate, TCT results, and colposcopic biopsy findings among the control group, interferon group, and combination treatment group after six months of treatment. The results indicate that recombinant human interferon-2b vaginal effervescent tablets can effectively improve HPV clearance and reduce the risk of lesion progression, although individual responses to treatment vary. Combination therapy may enhance treatment efficacy by boosting immune response. The study also explores the relationship between drug treatment, viral load, cervical lesions, and vaginal microecology, providing scientific support for clinical medication decisions and offering a detailed analysis of the role of pharmacological intervention in the prognosis of HR-HPV infections.
基金Supported by the State Administration of Traditional Chinese MedicineTraditional Chinese Medicine for the Prevention and Treatment of Novel Coronavirus Pneumonia Emergency and Special Project (No. 2022ZYLCYJ05-4)Shanghai University of Traditional Chinese Medicine,Traditional Chinese Medicine on Prevention and Treatment of Novel Coronavirus Pneumonia Emergency and Special Project (Nos. 2022YJ-03 and 2022YJ-06)。
文摘Objective:To evaluate the effect and safety of Chinese medicine(CM) Fuzheng Huazhuo Decoction(FHD) in treating patients with coronavirus disease 2019(COVID-19) who persistently tested positive for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods:This retrospective cohort study was conducted at Shanghai New International Expo Center shelter hospital in China between April 1 and May 30,2022.Patients diagnosed as COVID-19 with persistently positive SARS-CoV-2 reverse transcription-polymerase chain reaction(RT-PCR) test results for ≥8 days after diagnosis were enrolled.Patients in the control group received conventional Western medicine(WM) treatment,while those in the FHD group received conventional WM plus FHD for at least 3 days.The primary outcome was viral clearance time.Secondary outcomes included negative conversion rate within 14 days,length of hospital stay,cycle threshold(Ct) values of the open reading frame 1ab(ORF1ab) and nucleocapsid protein(N) genes,and incidence of new-onset symptoms during hospitalization.Adverse events(AEs) that occurred during the study period were recorded.Results:A total of 1,765 eligible patients were enrolled in this study(546 in the FHD group and 1,219 in the control group).Compared with the control group,patients receiving FHD treatment showed shorter viral clearance time for nucleic acids [hazard ratio(HR):1.500,95% confidence interval(CI):1.353-1.664,P<0.001] and hospital stays(HR:1.371,95% Cl:1.238-1.519,P<0.001),and a higher negative conversion rate within 14 days(96.2% vs.82.6%,P<0.001).The incidence of new-onset symptoms was 59.5% in the FHD group,similar to 57.8% in the control group(P>0.05).The Ct values of ORF1ab and N genes increased more rapidly over time in the FHD group than those in the control group post-randomization(ORF1ab gene:β=0.436 ± 0.053,P<0.001;N gene:β=0.415±0.053,P<0.001).The incidence of AEs in the FHD group was lower than that in the control group(24.2% vs.35.4%,P<0.001).No serious AEs were observed.Conclusion:FHD was effective and safe for patients with persistently positive SARS-CoV-2 PCR tests.(Registration No.ChiCTR2200063956)
