Coronavirus Disease Research Articles

CCL2-mediated endothelial injury drives cardiac dysfunction in long COVID.

Evidence linking the endothelium to cardiac injury in long coronavirus disease (COVID) is well documented, but the underlying mechanisms remain unknown. Here we show that cytokines released by endothelial cells (ECs) contribute to long-COVID-associated cardiac dysfunction. Using thrombotic vascular tissues from patients with long COVID and induced pluripotent stem cell-derived ECs (iPSC-ECs), we modeled endotheliitis and observed similar dysfunction and cytokine upregulation, notably CCL2. Cardiac organoids comprising iPSC-ECs and iPSC-derived cardiomyocytes showed cardiac dysfunction after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, driven by CCL2. Profiling of chromatin accessibility and gene expression at a single-cell resolution linked CCL2 to 'phenotype switching' and cardiac dysfunction, validated by high-throughput proteomics. Disease modeling of cardiac organoids and exposure of human ACE2 transgenic mice to SARS-CoV-2 spike proteins revealed that CCL2-induced oxidative stress promoted post-translational modification of cardiac proteins, leading to cardiac dysfunction. These findings suggest that EC-released cytokines contribute to cardiac dysfunction in long COVID, highlighting the importance of early vascular health monitoring in patients with long COVID.

The relationship between sustainability and financial performance of South African companies

Orientation: Environmental, social and governance (ESG) performance remains crucial information required by stakeholders as they are interested in monitoring whether companies contribute to sustainability or not.Research purpose: The study’s purpose was to determine how the sample companies scored on the three pillars of ESG performance and to determine the relationship between ESG scores and the financial performance of selected South African listed companies, with special reference to the impact of coronavirus disease 2019 (COVID-19) on that relationship.Motivation for the study: Because of crises such as the COVID-19 pandemic, companies tend to focus on their ESG-impact, resulting in them investing in sustainable operations.Research approach/design and method: Linear mixed-effect regression analysis models were developed to determine the relationship between ESG scores and financial performance. The sample consisted of 104 companies listed on the Johannesburg Stock Exchange (JSE) from 2017 to 2022.Main findings: We found that companies do not equitably score on the ESG performance pillars. We also found the following significant relationships: (1) Return on equity (ROE) positively impacts governance performance, (2) ESG positively impacts Tobin’s Q and (3) governance performance positively impacts ROE. Furthermore, the results show that sustainability and financial performance before and after COVID-19 are mainly not meaningful.Practical/managerial implications: New insights are revealed in the interests of shareholders, potential investors and company management regarding how to interpret the relationship between ESG pillars and financial ratios.Contribution/value-add: We contribute to the theory as a conceptual framework was developed to interpret the results within the shareholder’s theory.

Protein Nanoparticles for Targeted SARS-CoV-2 Trapping and Neutralization.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to challenge global health despite widespread vaccination efforts, underscoring the need for innovative strategies to combat emerging infectious diseases effectively. Herein, LCB1-NPs and LCB3-NPs are engineered as a novel class of protein-only nanoparticles formed through coiled coil-driven self-assembly and tailored to interact specifically with the SARS-CoV-2 spike protein. The multivalency of LCB1-NPs and LCB3-NPs offers a strategy for efficiently targeting and neutralizing SARS-CoV-2 both in solution and when immobilized on surfaces. It is demonstrated that LCB1-NPs and LCB3-NPs bind to the SARS-CoV-2 spike protein's receptor-binding domain (RBD) with high affinity, effectively blocking the entry of SARS-CoV-2 virus-like particles into angiotensin-converting enzyme 2 (ACE2)-coated human cells. The cost-effectiveness, scalability, and straightforward production process of these protein nanoparticles make them suitable for developing novel anti-viral materials. Accordingly, it is shown how these nanostructures can be packed into columns to build up economic and highly potent trapping devices for SARS-CoV-2 adsorption.

Subcutaneous adipose tissue measured by computed tomography could be an independent predictor for early outcomes of patients with severe COVID-19.

Patients with severe Coronavirus Disease 2019 (COVID-19) can experience protein loss due to the inflammatory response and energy consumption, impairing immune function. The presence of excessive visceral and heart fat leads to chronic long-term inflammation that can adversely affect immune function and, thus, outcomes for these patients. We aimed to explore the roles of prognostic nutrition index (PNI) and quantitative fat assessment based on computed tomography (CT) scans in predicting the outcomes of patients with severe COVID-19. A total of 130 patients with severe COVID-19 who were treated between December 1, 2022, and February 28, 2023, were retrospectively enrolled. The patients were divided into survival and death groups. Data on chest CT examinations following admission were collected to measure cardiac adipose tissue (CAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) and to analyze the CT score of pulmonary lesions. Clinical information and laboratory examination data were collected. Univariate and multivariate logistic regression analyses were used to explore the risk factors associated with death, and several multivariate logistic regression models were established. Of the 130 patients included in the study (median age, 80.5 years; males, 32%), 68 patients died and 62 patients survived. PNI showed a strong association with the outcome of severe COVID-19 (p < 0.001). Among each part of the fat volume obtained based on a CT scan, SAT showed a significant association with the mortality of severe COVID-19 patients (p = 0.007). However, VAT and CAT were not significantly correlated with the death of patients. In the multivariate models, SAT had a higher predictive value than PNI; the area under the curve (AUC) of SAT was 0.844, which was higher than that of PNI (AUC = 0.833), but in the model of the combination of the two indexes, the prediction did not improve (AUC = 0.830), and SAT lost its significance (p = 0.069). Subcutaneous adipose tissue measured by computed tomography and PNI were found to be independent predictors of death in patients with severe COVID-19.

Study of CRP, ferritin, and D-dimer in COVID-19 RICU patients as per HRCT severity in assiut university hospitals

BackgroundInflammatory markers were found to be elevated in patients with coronavirus disease (COVID-19). C-reactive protein (CRP), serum ferritin, and D-dimer levels may predict morbidity and mortality in (COVID-19) patients. Radiology plays a key role in the diagnosis, management, and follow-up of this disease. This study aimed to describe the radiological features of (COVID-19) infection, measure C-reactive protein (CRP), D-dimer, and ferritin levels and to correlate them with patient’s outcome and to consider them as predictors of morbidity and mortality in (COVID-19) patients.MethodsThis prospective cross-sectional analytic study had been done on 159 patients aged ≥ 18 years old, admitted at Assiut University Hospital RICU from November 2021 to November 2022, diagnosed as COVID-19 by positive RT-PCR. All patients were categorized on bases of HRCT chest disease reporting and data system (CO-RADS) scoring system into non-severe (CO-RADS 1,2,3) and severe (CO-RADS 4,5) groups. Inflammatory markers such as CRP, ferritin, and D-dimer were measured. Age, sex, comorbidities, need to mechanical ventilation MV, and mortality rate were reported. Correlation between HRCT(CO-RADS) score, inflammatory markers, and patient’s outcome was assessed.ResultsHigher CRP and serum ferritin levels, lower lymphocytic count, and higher frequency of need for mechanical ventilation were significantly greater in the severe group (P < 0.0001). Predictors of morbidity and mortality were CRP ≥ 133 mg/dl, DM, presence of chronic chest disease (P < 0.0001). A higher mortality rate was in patients of the severe group (65%) versus (9%) in the non-severe group (P < 0.0001).ConclusionsHRCT scan and measurement of CRP and ferritin plasma levels can be considered significant predictors for future prognosis and can early identify patients at risk of death and need for MV. Male gender, presence of DM, and chronic chest diseases are risk factors for severe illness.

The severity assessment and nucleic acid turning-negative-time prediction in COVID-19 patients with COPD using a fused deep learning model

BackgroundPrevious studies have shown that patients with pre-existing chronic obstructive pulmonary diseases (COPD) were more likely to be infected with coronavirus disease (COVID-19) and lead to more severe lung lesions. However, few studies have explored the severity and prognosis of COVID-19 patients with different phenotypes of COPD.PurposeThe aim of this study is to investigate the value of the deep learning and radiomics features for the severity evaluation and the nucleic acid turning-negative time prediction in COVID-19 patients with COPD including two phenotypes of chronic bronchitis predominant patients and emphysema predominant patients.MethodsA total of 281 patients were retrospectively collected from Hohhot First Hospital between October 2022 and January 2023. They were divided to three groups: COVID-19 group of 95 patients, COVID-19 with emphysema group of 94 patients, COVID-19 with chronic bronchitis group of 92 patients. All patients underwent chest computed tomography (CT) scans and recorded clinical data. The U-net model was pretrained to segment the pulmonary involvement area on CT images and the severity of pneumonia were evaluated by the percentage of pulmonary involvement volume to lung volume. The 107 radiomics features were extracted by pyradiomics package. The Spearman method was employed to analyze the correlation of the data and visualize it through a heatmap. Then we establish a deep learning model (model 1) and a fusion model (model 2) combined deep learning with radiomics features to predict nucleic acid turning-negative time.ResultsCOVID-19 patients with emphysema was lowest in the lymphocyte count compared to COVID-19 patients and COVID-19 companied with chronic bronchitis, and they have the most extensive range of pulmonary inflammation. The lymphocyte count was significantly correlated with pulmonary involvement and the time for nucleic acid turning negative (r=-0.145, P < 0.05). Importantly, our results demonstrated that model 2 achieved an accuracy of 80.9% in predicting nucleic acid turning-negative time.ConclusionThe pre-existing emphysema phenotype of COPD severely aggravated the pulmonary involvement of COVID-19 patients. Deep learning and radiomics features may provide more information to accurately predict the nucleic acid turning-negative time, which is expected to play an important role in clinical practice.

Long COVID in Immunocompromised and Immunocompetent Patients: A Clinical, Morphologic, and Virologic Portrait.

Coronavirus disease 2019 (COVID) primarily affects the lung and can lead to chronic/post-COVID syndrome. Some insights about late pulmonary changes occurring in patients recovering from COVID have been published, but the evidence of detailed pathologic changes coming from follow-up care patients with long COVID is limited. To evaluate tissue morphologic and viral features in transbronchial biopsies of long COVID patients (immunocompetent and immunocompromised). This retrospective observational study included 18 patients (9 immunocompetent and 9 immunocompromised) who were consecutively referred to outpatient clinic for post-COVID pneumonia, undergoing transbronchial biopsy. Several histologic changes were analyzed by computer-assisted morphometric analysis. As organizing pneumonia (OP) was consistently detected, fibrosis and inflammation were also evaluated in transbronchial biopsies from 28 control patients with histologic confirmation of OP. Tissue SARS-CoV-2 and the subgenomic transcripts were investigated. Morphologic findings were correlated with clinical and radiologic data. Long COVID patients showed lower inflammation than controls (P < .001) despite a similar fibrotic extension. When considering separately the 2 long COVID groups, the same inflammatory infiltrate extension was found, whereas a higher fibrotic remodeling characterized the immunocompetent subgroup (P = .05). Molecular investigation showed that SARS-CoV-2 was present in tissue samples obtained from 3 long COVID patients. Long COVID patients showed a peculiar OP pattern, with more vascular and fibrotic changes. SARS-CoV-2 RNA, even in replicative status, can be detected in lung biopsies of both immunocompetent and immunocompromised patients. This pilot study is a forerunner of more in-depth lung tissue investigations to gain a better understanding of long COVID pathobiology.

Effectiveness and safety of azvudine versus nirmatrelvir-ritonavir in adult patients infected with COVID-19 omicron strains: a retrospective study in Beijing

The study was to evaluate the clinical outcomes of azvudine versus nirmatrelvir-ritonavir against omicron strains of coronavirus disease 2019 infections and determine their comparative effectiveness. This retrospective study included 716 patients who received nirmatrelvir-ritonavir (NR group) or azvudine (FNC group) at Peking Union Medical College Hospital between 1 November 2022 and 27 February 2023. Patients in the FNC group (n = 304) were younger, exhibited less severe symptoms, started antiviral therapy later, received corticosteroids more frequently, and used tocilizumab less frequently than patients in the NR group (n = 412). Within 28 d of therapy, 40 (9.7%) and 20 (6.6%) deaths were in the NR and FNC groups, respectively. No differences were observed between drugs and mortality rates (odds ratio [OR] 0.78, 95% CI 0.40–1.5, P = 0.45), clinical improvement (OR 0.79, 95% CI 0.79–1.3, P = 0.38), and clinical progression (OR 1.0, 95% CI 0.58–1.8, P = 0.96). More patients in the NR group experienced platelet decline than those in the FNC group (17.6% vs. 8.9%, P = 0.034). This study indicated that the effectiveness and safety of azvudine were comparable to those of nirmatrelvir-ritonavir.

The gaps and strengths towards effective infection prevention and control on a background of knowledge attitude and perception on COVID-19 among undergraduate students in Southeastern Nigeria: a multicentre online cross-sectional survey

The advent of the Coronavirus Disease (COVID-19) pandemic posed a serious health burden locally and globally as it altered people’s daily activities due to restrictive preventive measures instituted by countries and health authorities to curb its spread like wildfire. The undergraduate population remains at the epicentre for the spread and curbing of COVID-19. This study assessed the knowledge, attitude, and perception of COVID-19 among undergraduate students in Southeastern Nigeria. The gaps and strengths achieved towards effective infection prevention and control in the eastern states were assessed. This was a cross-sectional online population-based survey conducted among undergraduate students attending Universities in 5 states (Abia, Anambra, Ebonyi, Enugu, and Imo), located in Southeastern Nigeria from June 29 to July 20, 2020. A structured pre-tested questionnaire was designed for the Google survey tool (Google Forms), and the generated link was shared with students online. From a total of 1,012 respondents from Universities in Southeastern Nigeria, 560 (55%) were females and 452 (45%) were males. The overall mean age of the respondents was 21.63±0.65years. The age distribution did not vary considerably across states (t=-0.007, p=0.995&gt;0.05). The majority (93.8%) of the respondents were Igbos, Yorubas, and Hausas accounting for 2.6% and 0.4% respectively while 3.3% did not identify their ethnic group. Christians (96.0%) were dominant compared to Islam (2.7%) while traditionalists and other non-captured worshippers accounted for 0.5% and 0.8% respectively. Most of the respondents were in second and fourth years in the university. The variation across the states is statistically significant ( =112.01, p=0.000&lt;0.05). The respondents identified that their main source of information concerning COVID-19 was social media (26.9%). The level of knowledge was highest among people in Anambra state (78.0%); followed by those in Enugu state (74.3%), those in Abia state (72.2%), those in Imo state (70.8%), and lastly, by those in Ebonyi state (65.4%). The participants’ attitudes about COVID-19 safety practices were on average moderately positive (49.2%) with the best result in Imo state (60.5%), followed by Abia state (55.3%), Ebonyi state (52.4%), Enugu state (42.9%) and lastly Anambra state (35.1%). In summary, the respondents’ general perception of the realness, infectiveness, and source is positive (&gt;50.0%) in all the Southeastern states. The knowledge, attitude, and perception of COVID-19 among undergraduate students in Eastern states, of Nigeria were appreciable but a lot has to be done in terms of enhanced public health education, positive behavioural changes as well as proactive preventive measures to curb the progress of the COVID-19 pandemic.

The effect of combination treatment with casirivimab and imdevimab versus standard antiviral therapy on clinical outcomes in hospitalized COVID-19 patients

BackgroundThe Coronavirus Disease of 2019 (COVID-19) pandemic motivated research efforts to address this catastrophe from the beginning of 2020 to the present. The year 2021 is coming to an end, and several developments in pharmacotherapy for COVID-19 have occurred. In terms of antiviral therapy, monoclonal antibody combinations have become one type of COVID-19 immunotherapy. Remdesivir and favipiravir are two antiviral medications typically used to treat COVID-19. Paxlovid (nirmatrelvir plus ritonavir) and molnupiravir are other antiviral agents used in COVID-19. The purpose of this study was to compare the effects of combinations of antibodies (casirivimab and imdevimab), remdesivir, and favipiravir on COVID-19 swab results in hospitalized patients with COVID-19 at discharge.MethodsThis research is a phase IV non-randomized controlled trial (< 300 patients as sample size) with no comparison to placebo. In this study, 265 COVID-19 patients confirmed by polymerase chain reaction (PCR) and indications for antiviral medication were non-randomized into three groups at a ratio of (1:2:2): REGN3048-3051 (group A), remdesivir (group B), and favipiravir (group C). A nonrandomized single-blind controlled study design was used. The study's medication was provided by the Hospital of Mansoura University. Following ethical approval, the study was conducted for approximately 6 months.ResultsCompared to remdesivir and favipiravir, casirivimab and imdevimab cause less hepatotoxicity, less renal impairment, and more negative swab results at discharge. The three tested antivirals also had no significant adverse effects. All three antivirals are considered safe based on these findings.ConclusionCompared with remdesivir and favipiravir, casirivimab and imdevimab result in better clinical outcomes. All three antivirals are safe and have no significant toxicity.Trial registration: Clinicaltrials.gov, NCT05502081, 16/08/2022.

Improving Patient Wait Times on the First Day of Radiotherapy Treatment

Long wait times on starting day of radiotherapy (day 1) can cause dissatisfaction among both patients and healthcare providers. Reducing these wait times will decrease stress and decongest hospital facilities especially in current coronavirus disease 2019 times. A multidisciplinary core team was formed during the Stanford-India Collaborative Quality Improvement training to reduce the median wait times on day 1 of treatment from 6 to 4.5 hours (a 25% reduction). Several factors were identified on the fishbone diagram, and key causes were identified using a Pareto chart and action prioritization matrix. The Plan-Do-Study-Act Cycle strategy was undertaken for the identified interventions. The outcome measure was time from arrival at the hospital to entry into a treatment room. Data were obtained from time charts at various stations and electronic records. The secondary measures were visual analog scale (VAS) scores, 80th percentile wait times, and the day-2 delay percentage. The balancing measure was “new errors” due to interventions. The interventions included the completion of all administrative tasks not needing patients' presence on the day before day 1. Baseline data from 198 patients and postintervention data from 160 patients were compared and analyzed. The median wait time at baseline, which was 6 hours, was reduced to 4.2 hours. The VAS score showed 70.4, 67.7, and 71.9% satisfaction for the resident physician, therapists, and patients, respectively. The 80th percentile wait times reduced from 8 to 5.7 hours; and the day 2 starting rate decreased from 22.5 to 2.04%, with no new errors reported. Radiotherapy day 1 wait times can be safely decreased, leading to improved satisfaction among patients and healthcare providers, by utilizing classic quality improvement methods and tools.

Examination of Potential of Fe-Si78, Fe-C78, Fe-B39P39, Fe-SiNT (9, 0), Fe-CNT (9, 0) and Fe-BPNT (9, 0) to Deliver the Chloroquine as Drug of Coronavirus Disease

Examination of Potential of Fe-Si78, Fe-C78, Fe-B39P39, Fe-SiNT (9, 0), Fe-CNT (9, 0) and Fe-BPNT (9, 0) to Deliver the Chloroquine as Drug of Coronavirus Disease

Effect of The Pfizer-Biontech Vaccine on Ifn-Γ Serum Levels and its Genetic Variations in Response to Vaccination

Background: Pfizer vaccine, which is a nucleoside-modified mRNA vaccine against coronavirus disease 2019 (COVID-19) is one of the first mRNA products to be approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Aim of the study: The aim of this study is to study the impact of Pfizer vaccine on the levels of interferon gamma (IFN-γ) serum levels and its gene polymorphism after 3 months and 6 months of vaccination with Pfizer vaccine . Materials and methods: This case-control study involved (150) subjects who were divided into three groups (each group included 50 subjects). The first group included (50) vaccinated group 3 months after second dose of Pfizer vaccine, and the second group included (50) vaccinated group 6 month after second dose of Pfizer vaccine. The third group was the control group which included (50) healthy unvaccinated subjects. The study was done during the period from May /2022 to September / 2022). Serum levels of IFN-γ were estimated by ELISA technique. The PCR technique was used to study gene polymorphism for IFN-γ. Results: The results in figure (1) showed that the mean levels of INF-γ among the male participants (after 3 months of vaccination, after 6 months of vaccinations, and the control group) were (292.54, 231.48, and 15.71), respectively, with highly significant differences (HS) between the three groups (p&lt;0.01). The results also showed that the mean levels of INF-γ among female participants (after 3 months of vaccination, after 6 months of vaccinations, and the control group) were (317.31, 228.14, and 15.74), respectively, with highly significant differences (HS) between the three groups (p&lt;0.01). Analysis of rs2430561 SNP of (IFN-γ) gene using Sanger sequencing. Single “T” peak indicative of a T homozygous allele showed that Single “A” peak indicative of a A homozygous allele. Presence of the “T” and “A” peak indicative of T/A heterozygous allele. Conclusion: Pfizer vaccine was shown to have significant impacts on IFN-γ levels and presence of single T/A alleles is indicative of heterogeneous T/A allele on analysis of rs2430561 SNP of (IFN-γ) gene among vaccinated individuals.

Examining the Impact of Socio-economic, Demographic and Policy Factors on Reverse Migration in India During COVID-19 Pandemic

This article examines the factors that determined ‘reverse migration’ of households from urban locations in India in the aftermath of a series of lockdowns that followed the coronavirus disease-2019 (COVID-19) pandemic. Positioning reverse migration as a coping strategy to ameliorate negative consequences of loss of livelihood, food shortages and loss of shelter in urban India, this article examines the factors that led to the utilization of this strategy in the aftermath of lockdown during the pandemic outbreak. The article also tests whether returning to hinterland persisted after the period of lockdowns. The lockdowns had exacerbated living conditions for urban poor. Migration to rural areas continued despite various policies and programmes that the national and state governments instituted to counter the negative impact of lockdowns, particularly on low-income households. Examining the socio-economic, demographic and policy factors, this article provides evidence that family support and rural social institutions such as self-help groups played a crucial role in providing support system during pandemic even to those who migrated back from urban areas. Government programmes such as Rural Employment Guarantee Scheme and access to public distribution system were also important for reverse migrants. An important result is that the first wave of reverse migration was due to family and emotional reasons that arose because of lockdowns, the second wave of migration was for economic reasons as households continued to struggle in urban areas, and the migration during the third wave was a usual seasonal migration.

The Effect of Online Music Therapy Interventions on Reducing Stress Levels in Small Hotel Managers: A Mixed-Methods Pilot Study

Abstract The rapidly changing business environment and increasing uncertainties due to the coronavirus disease 2019 pandemic since 2020 have led to heightened stress levels among managers. This study employed a mixed-method design to examine the effects of online music therapy interventions on reducing stress levels in small hotel managers. Thirteen managers participated in the online music therapy program, which consisted of six weekly music therapy sessions and self-guided music interventions for practice during the week. The music therapy interventions included music-assisted relaxation, improvisation, music listening with drawing, moving with music, song discussion, songwriting, and singing. The intake questionnaire collected participants’ demographic information and musical backgrounds. The Thai Perceived Stress Scale-10 (T-PSS-10) and Visual Analog Scale of Stress (VAS-S) were used to measure perceived stress levels. A paired t-test analysis compared the average participants’ perceived stress scores between pre and post-tests. Results demonstrated a significant reduction in perceived stress scores. Both the VAS-S for music therapy interventions and self-guided music interventions showed significant decreases after participation in each music therapy session and self-guided practice. In conclusion, online music therapy interventions can effectively reduce the perceived stress levels of managers facing uncertainty in small hotel businesses.

Effects of the coronavirus 2019 pandemic on medical publishing: The sacrifice of quality for quantity?

AbstractFacing the coronavirus disease 2019 (COVID‐19) pandemic, medical publishers rose to the occasion, moving to make their full portfolio of COVID‐19–related research available to read for free and expediting peer review and production processes. With such a rapid transition from paper submission to publication, however, concerns also arose regarding whether the quality of the research publication process was being affected. This article seeks to document the transformation of medical publishers' practices in response to the COVID‐19 pandemic and briefly discuss where they may go from here. For this goal, a literature search was performed in PubMed at several points to identify papers that reported early trends in how medical publishers handled COVID‐19 research.

Baseline level of interleukin-6 is associated with the risk of acute coronary syndrome development in SARS-CoV‐2 infection

BackgroundAcute coronary syndrome (ACS) is frequently reported in patients with coronavirus disease 2019 (COVID-19). Cytokine storm induced by interleukin-6 (IL-6) has been suggested to potentially cause myocardial injury in COVID-19. We investigated the association between baseline level of IL-6 and development of ACS in COVID-19 patients.MethodsDemographic and clinical data of hospitalized COVID-19 patients from 2020 to 2022 were reviewed. Extracted data including patient characteristics, laboratory biomarkers, and systemic inflammation indexes in patients with or without ACS were reviewed and analyzed. Logistic regression models were applied to analyze predictors of ACS development and receiver-operating characteristic (ROC) curves were used to assess discriminatory power of IL-6 and other risk factors for predicting ACS development.ResultsAmong 1,753 COVID-19 patients, 37 cases experienced ACS and 159 patients without main COVID-19 complications were randomly selected as controls. ACS patients were older (p = 0.001) and suffered from more comorbidities including diabetes (43% vs. 18%, p = 0.001), hypertension (40.5% vs. 24.5%, p = 0.050), ischemic heart disease (49% vs. 9%, p = 0.001), and hyperlipidemia (19% vs. 5%, p = 0.010). Also, decreased level of consciousness (31.6% vs. 2.5%, p = 0.001), ICU admission (65% vs. 2%, p = 0.001), and mortality events (70% vs. 0.6%, p = 0.001) were more prevalent in the ACS group. Baseline levels of IL-6 (p = 0.001), D-dimer (p = 0.026), troponin (p = 0.001), blood urea nitrogen (p = 0.002), and creatinine (p = 0.008) were higher in ACS patients but erythrocyte sedimentation rate (p = 0.013), hemoglobin (p = 0.033), and red blood cells (p = 0.028) were lower compared with controls. Also, age (OR: 1.06, p = 0.019), IL-6 (OR: 1.44, p = 0.047), and cardiovascular disease (CVD) (OR: 3.66, p = 0.043) were associated with ACS development. The area under the curve (AUC) of IL-6 and combined predictors respectively was 0.661 (p = 0.002) and 0.829 (p = 0.001).ConclusionsHigh IL-6 concentration at baseline is a strong predictor for ACS development in COVID-19 patients. Also, elderly and concurrent CVD are significantly associated with ACS development.

Comparative clinical trial of Langenlianqiao oral liquid and Lianhuaqingwen capsule in the treatment of mild cases of coronavirus disease 2019 (COVID-19)

ObjectiveTo evaluate the clinical efficacy of Langenlianqiao (LGLQ) oral liquid treatment and provide a reference basis for the clincal treatment of coronavirus disease 2019 (COVID-19).DesignAn experimental clinical study was conducted on three groups with confirmed diagnoses of COVID-19.SiteThis study was conducted at Changde Hospital.ParticipantsA total of 253 patients were enrolled in this study.MethodsThe patients were divided into the LGLQ treatment group (100 cases), the Lianhuaqingwen (LHQW) treatment group (100 cases) and the placebo control group (53 cases), according to the treatment each group received. The occurrence of major clinical symptoms, the duration of symptom disappearance, the number of days in hospitalisation and the duration of infection were compared among the three groups.ResultsCompared with the placebo control group (10.0 [1.2] d, 9.4 [1.3] d), the duration of infection and hospitalisation effectively decreased in the LGLQ group (6.8 [0.6] d, 7.4 [0.8] d) and the LHQW group (6.8 [1.0] d, 7.3 [1.0] d). Furthermore, the incidence of fatigue in the LGLQ group (4.0%) was lower compared to the LHQW group (14.0%) and the placebo control group (15.1%), but this difference was not statistically significant (P = 0.580 for LGLQ vs. LHQW, P = 0.246 for LGLQ vs. placebo). In the treatment of cough, the LGLQ group showed a significantly different effect compared to both the LHQW group (P = 0.014) and the placebo group (P = 0.016). Additionally, for dry cough specifically, LHQW was effective in reducing its incidence compared to the placebo control group (P < 0.05), while LGLQ showed no statistically significant difference from either LHQW (P = 0.39) or the placebo group (P = 0.14). However, neither the LGLQ group nor the LHQW group showed a reduction in the duration of symptom disappearance in patients with pre-existing symptoms (P > 0.05).ConclusionsCompared with the placebo control group, the LGLQ group showed an improvement in the clinical symptoms of COVID-19 and a decrease in the duration of hospitalisation and infection, which confirmed that the LGLQ treatment had the same antiviral effect as the LHQW treatment. This may provide in-depth insights for antiviral therapy research.

Is detrusor underactivity the urodynamic characteristic of long-COVID in patients with benign prostate hyperplasia?

Although coronavirus disease 19 (COVID-19) was reported to involve with multiple organs, COVID-19 reports focusing on urinary system mostly evaluated the association between lower urinary tract symptoms and COVID-19 using questionnaire score. In this study, sonography video urodynamic studies was first conducted to explore the effects of COVID-19 on contractility of bladder detrusor of patients with benign prostate hyperplasia (BPH). Clinical data was respectively reviewed and compared between BPH patients with previous COVID-19 infection (COVID-19 group) and without previous COVID-19 (non-COVID-19 group). The incidence of detrusor underactivity (DU) was compared between 2 groups. Comparison of age and noninvasive parameters was conducted between BPH patients with DU and without DU in COVID-19 group. Correlation coefficient between noninvasive parameters and detrusor contractility was determined and receiver operating characteristic curve of noninvasive parameters was used to choose the most appropriate cutoff for detection of DU in COVID-19 group. Beside a significant increase in the incidence of DU in BPH patients of COVID-19 group, a lower detrusor contractility and a greater bladder wall thick was detected compared to that of patients in non-COVID-19 group. Post-voiding residual urine was found to have a linear correlation with detrusor contractility in COVID-19 group. It was suggested that COVID-19 infection would further exacerbate impairment of detrusor previously resulted from bladder outlet obstruction in BPH patients. DU may be a urodynamic characteristic of long-COVID.

Identifying Mechanism of RSV for the Treatment of COVID-19 and Idiopathic Pulmonary Fibrosis via Suppressing Inflammation Response Through IL-17 Signaling Pathway from the Perspectives of in silico Study.

Both coronavirus disease 2019 (COVID-19) and idiopathic pulmonary fibrosis (IPF) could cause severe pulmonary injury and have extremely dismal prognoses with a high risk of mortality. Resveratrol (RSV), a natural polyphenol, has promising potential in the treatment of viral infection and pulmonary fibrosis. The purpose of this research was to investigate the unclear mechanism of RSV as an anti-COVID-19 and IPF therapy. Utilizing relevant databases, the intersection of genes related to IPF, COVID-19, and possible RSV targets was discovered. Then the obtained targets were investigated using GO and KEGG analysis, TP and PPI network analysis. Furthermore, the binding affinities between core targets and RSV were calculated using molecular docking. The 1101 COVID-19 targets, 2166 IPF targets, and 341 RSV targets intersected with 21 overlapping targets. PPI network reveals the interactions among targets and TP network reveals interactions between targets and pathways. Five targets including JUN, CCL2, CXCL8, IL6, and SERPINE1 were identified as the core targets through two network analyses. GO analysis demonstrated chemotaxis, inflammatory response and angiogenesis were the significant pathophysiological processes. Combing TP network analysis and KEGG analysis, IL-17 signaling pathway was considered as the significant pathway. Except for JUN, molecular docking showed the binding energies of other four targets were lower than -5 kcal/mol indicating intimate interactions between RSV and other targets. Our research elucidate the targets, pathways and pathophysiological processes of RSV involved in effects of anti-COVID-19 and IPF, suggesting RSV could be a therapeutic candidate for reducing infection and fibrosis.