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Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19

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World Journal of Clinical Cases 2020年第20期8卷 4726-4734页

作者： Yan Li Shuang Yang Ding Peng Hong-Ming Zhu Bang-Yi Li Xiaojiao Yang Xue-Lian Sun Mei Zhang Department of Pulmonology Xuanwu Hospital of Capital Medical UniversityBeijing 100053China Department of Gastroenterology Xuanwu Hospital of Capital Medical UniversityBeijing 100053China School of Human Nutrition Faculty of Agricultural and Environmental SciencesMcGill UniversityMontreal H9X 3V9QuebecCanada Department of Emergency Medicine Xuanwu Hospital of Capital Medical UniversityBeijing 100053China

BACKGROUND The outbreak of coronavirus disease 2019(COVID-19)has rapidly evolved into a global ***-19 is clinically categorized into mild,moderate,severe,and critical *** kidney injury is an independent risk factor for poor prognosis in patients *** cystatin C(s Cys C)is considered a more sensitive biomarker for early renal insufficiency than conventional indicators of renal *** detection of risk factors that affect the prognosis of severe and critically ill patients while using active and effective treatment measures is very important and can effectively reduce the potential mortality *** To determine the predictive value of s Cys C for the prognosis of patients with *** The clinical data of 101 severe and critically ill patients with COVID-19 at a designated hospital in Wuhan,Hubei Province,China were analyzed *** to the clinical outcome,the patients were divided into a discharge group(64 cases)and a death group(37 cases).The general information,underlying diseases,and laboratory examination indexes of the two groups were *** Cox regression was used to explore the relationship between s Cys C and *** receiver operating characteristic(ROC)curve was used to demonstrate the sensitivity and specificity of s Cys C and its optimal cut-off value for predicting *** There were significant differences in age,s Cys C,creatinine,C-reactive protein,serum albumin,creatine kinase-MB,alkaline phosphatase,lactate dehydrogenase,neutrophil count,and lymphocyte count between the two groups(P<0.001).Multivariate logistic regression analysis showed that s Cys C was an independent risk factor for death in patients with COVID-19(Odds ratio=1.812,95%confidence interval[CI]:1.300-2.527,P<0.001).The area under the ROC curve was 0.755(95%CI:1.300-2.527),the cut-off value was 0.80,the specificity was 0.562,and the sensitivity was *** s Cys C is an independent risk

关键词： COVID-19 Cystatin C Acute kidney injury Renal function coronavirus infections Multiple organ dysfunction syndrome

Effect of methylprednisolone in severe and critical COVID-19:Analysis of 102 cases

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World Journal of Clinical Cases 2020年第23期8卷 5952-5961页

作者： Hong-Ming Zhu Yan Li Bang-Yi Li Shuang Yang Ding Peng Xiaojiao Yang Xue-Lian Sun Mei Zhang Department of Gastroenterology Xuanwu Hospital of Capital Medical UniversityBeijing 100053China Department of Pulmonology Xuanwu Hospital of Capital Medical UniversityBeijing 100053China School of Human Nutrition Faculty of Agricultural and Environmental SciencesMcGill UniversityMontrealQC H9X 3V9Canada Department of Emergency Medicine Xuanwu Hospital of Capital Medical UniversityBeijng 100053China

BACKGROUND The coronavirus disease 2019(COVID-19)outbreak has brought great challenges to public *** of COVID-19 is closely related to the secondary systemic inflammatory *** are used to control severe diseases caused by the cytokine storm,owing to their anti-inflammatory ***,glucocorticoids are a double-edged sword,as the use of large doses has the potential risk of secondary infection and long-term serious complications,and may prolong virus clearance ***,the risks and benefits of glucocorticoid adjuvant therapy for COVID-19 are *** To determine the effect of methylprednisolone in severe and critically ill patients with *** This single-center retrospective study included 102 adult COVID-19 patients admitted to a ward of a designated hospital in Wuhan,Hubei Province from January to March *** patients received general symptomatic treatment and organ function support,and were given different respiratory support measures according to their *** case of deterioration,considering the hyperinflammatory state of the patients,methylprednisolone was intravenously administered at 0.75-1.5 mg/kg/d,usually for less than 14 *** vital signs and oxygenation were closely monitored,in combination with imaging and routine blood tests such as C-reactive protein,biochemical indicators(liver and kidney function,myocardial enzymes,electrolytes,etc.),and coagulation *** clinical outcomes were discharge or *** A total of 102 severe and critically ill COVID-19 patients were included in this *** were divided into treatment(69,67.6%)and control groups(33,32.4%)according to methylprednisolone *** of baseline data between the two groups showed that the treatment group patients had higher aspartic acid aminotransferase,globulin,hydroxybutyrate dehydrogenase,and lactate *** was no significant difference in other baseline data between

关键词： COVID-19 Glucocorticoids Methylprednisolone Cytokine storm coronavirus infections Cytokines

Expert Consensus on the Clinical Application of Oral Small-molecule Antiviral Drugs Against COVID-19

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Infectious Diseases & Immunity 2024年第4期4卷 158-169页

作者：无 Nanshan Zhong Guiqiang Wang Society of Bacterial Infection and Resistance of Chinese Medical Association National Clinical Research Center for Respiratory Disease National Center for Respiratory Medicine First Affiliated Hospital of Guangzhou Medical University Guangzhou Institute of Respiratory HealthNational Clinical Research Center for Respiratory DiseaseNational Center for Respiratory MedicineState Key Laboratory of Respiratory DiseaseGuangzhou 510120China Department of Infectious Diseases Peking University First HospitalBeijing 100034China

Although COVID‑19 no longer constitutes a“public health emergency of international concern”,which still has being spreading around the world at a low *** molecule drugs are the main antiviral treatment for novel coronavirus recommended in *** a variety of small‑molecule antiviral drugs against COVID‑19 have been listed in China,there is no specific drug recommendation for special *** of Bacterial Infection and Resistance of Chinese Medical Association,together with the National Clinical Research Center for Respiratory Disease,and the National Center for Respiratory Medicine,organized domestic experts in various fields such as respiratory,virology,infection,critical care,emergency medicine and pharmacy to release Expert Consensus on the Clinical Application of Oral Small‑Molecule Antiviral Drugs against COVID‑*** main content of this consensus includes the introduction of seven small‑molecule antiviral drugs against COVID‑19,focusing on the drug recommendations for 14 special groups such as the elderly,patients with complicated chronic diseases,tumor patients,pregnant women,and children,and providing suggestions for clinicians to standardize drug use.

关键词： coronavirus infections Antiviral therapy Small molecule drugs Early stage Expert consensus

Vaginal delivery after 37 days of a convalescent pregnant woman with COVID-19: a case report

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中华围产医学杂志 2020年第4期 280-282页

作者： Xiong Xiali Pang Qiumei Wei Hong Ma Xiaopeng Zhang Zhihong Gao Xiang Department of Obstetrics and Gynecology Beijing You''an Hospital Capital Medical University Beijing 100069 China

We present a case report of a healthy neonate born by vaginal delivery to a woman who had recovered from COVID-19 after 37 days of discharge. The pregnant woman had fever, cough, and chills at 33+1 gestational weeks and was diagnosed with COVID-19 by coronavirus nucleic acid test one day later. She recovered and was discharged after a series of treatment, and the 2019 novel coronavirus nucleic acid test and pulmonary CT were negative at the 2nd and 4th weeks after being discharged. The patient was admitted in early labor at 38+4 gestational weeks and delivered a healthy newborn vaginally at that day. Both the mother and the baby were in good condition. All the maternal or neonatal specimens taken immediately after birth in the delivery room for 2019 novel coronavirus nucleic acid tests were negative, including the maternal pharynx, rectal and cervical secretions, amniotic fluid, an neonatal pharynx and rectal swabs. The qualitative examination of 2019 novel coronavirus antibodies in the maternal venous blood test showed that both IgG and IgM were positive. While the same test for neonatal cord blood and femoral vein blood showed negative results. No inflammatory reaction was found in the placenta and immunohistochemistry detection of novel coronavirus N protein was negative. The mother and newborn were observed postnatally and treated in the same ward, neither of them had fever, cough or fatigue, and were discharged three days after delivery. The qualitative examination of 2019 novel coronavirus antibodies (IgM and IgG) in the femoral vein blood of the nenonate 27 days old showed negative results.

关键词： coronavirus infections Pregnancy complications, infectious Parturition

Asymptomatic novel coronavirus infection in pregnant woman in the third trimester: a case report

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中华围产医学杂志 2020年第3期 229-231页

作者： Yao Li Wang Jing Zhao Jingjing Cui Jing Hu Zhihang Department of Intensive Care Unit the Second People''s Hospital of Hefei Hefei 230011 China

We report a case of asymptomatic COVID-19 infection in a pregnant woman in the third trimester with good maternal and infant outcomes. The patient was admitted to the Second People''s Hospital of Hefei on February 11, 2020, because of a "positive novel coronavirus nucleic acid test result for one day" at 38 weeks of gestation. No abnormality was observed during her previous regular prenatal examinations. A throat swab sample was obtained from the patient four days before admission due to the diagnosis of COVID-19 infection in her husband and sister on the 14th and 7th day before her admission, and the new coronavirus nucleic acid test showed positive. The patient reported no discomfort before admission. Chest CT on the 3rd after admission showed a small amount of bilateral pleural effusion. Irregular contractions occurred three days after admission and labor was considered to be imminent. An emergency cesarean section was performed and the patient delivered a live baby girl. No tests were performed on amniotic fluid, cord blood or placenta for new coronavirus nuclei acid. The patient was isolated from the infant without breastfeeding after surgery. All medical staff involved in the cesarean section were isolated after surgery. Neonatal peripheral blood and nasopharyngeal swabs were collected for the new coronavirus nucleic acid tests on the day of birth and one day of age respectively, and nasopharyngeal swabs and anal suabs were taken at nine days after birth. All test results were negative. The patient recovered well after surgery with stable vital signs. Chest CT on the 8th after operation showed a small amount of bilateral pleural effusion, while the new coronavirus nucleic acid test results of the pharyngeal swabs were positive on the 11th and 12th day after operation. The throat swabs of all medical staff involved in the operation were negative 14 days after the operation. The mother and baby were discharged 14 days after the Cesarean section.

关键词： Pregnancy complications, infectious coronavirus infections COVID-19 coronavirus Nucleic acids

Clinical characteristics of COVID-19 hospitalized patients associated with mortality:A cohort study in Spain

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Infectious Medicine 2022年第2期1卷 81-87页

作者： Manuel Lozano Adina Iftimi Alvaro Briz-Redon Juanjo Peiró Lara Manyes María Otero Mayte Ballester MDolores de las Marinas Juan Carlos Catalá Joséde Andrés Carolina Romero Preventive Medicine and Public Health Food SciencesToxicology and Forensic Medicine DepartmentUniversitat de ValènciaValenciaSpain Epidemiology and Environmental Health Joint Research Unit FISABIO−Universitat Jaume I−Universitat de ValènciaValenciaSpain Department of Statistics and Operations Research University of ValenciaValenciaSpain Statistics Office City Council of ValenciaValenciaSpain Department of Anesthesia Critical Care and Pain UnitUniversity General HospitalValenciaSpain Division of Allergy and Immunology University General HospitalValenciaSpain Anesthesia Unit-Surgical Specialties Department Valencia University Medical SchoolValenciaSpain Division of Research Methodology European UniversityValenciaSpain

Background:The heterogeneity of patients with COVID-19 may explain the wide variation of mortality rate due to the population characteristics,presence of comorbidities and clinical ***:In this study,we analyzed 5342 patients’recordings and selected a cohort of 177 hospitalized patients with a poor prognosis at an early *** assessed during 6 months their symptomatology,coexisting health conditions,clinical measures and health assistance related to *** Cox proportional hazards models were built to identify the associated factors with mortality ***:We observed that cough and kidney failure triplicate the mortality risk and both bilirubin levels and oncologic condition are shown as the most associated with the demise,increasing in four and ten times the risk,*** clinical characteristics such as fever,diabetes mellitus,breathing frequency,neutrophil-lymphocyte ratio,oxygen saturation,and troponin levels,were also related to mortality risk of in-hospital ***:The present study shows that some symptomatology,comorbidities and clinical measures could be the target of prevention tools to improve survival rates.

关键词： COVID-19 SARS-CoV-2 Respiratory insufficiency Mortality Proportional hazard model Pandemics coronavirus infections Epidemiology

Translation:Expert Consensus on the Application of Artificial Liver Blood Purification System in the Treatment of Severe and Critical COVID-19

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Infectious Microbes & Diseases 2020年第2期2卷 64-66页

作者：无 Lanjuan Li National Clinical Research Center for Infectious Diseases State Key Laboratory for Diagnosis and Treatment of Infectious Diseases State Key Laboratory for Diagnosis and Treatment of Infectious Diseases The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

The prevention and treatment of COVID-19 nationwide has entered a tackling *** treatment of severe and critically ill patients is the key to reducing the fatality of the *** artificial liver blood purification system can remove inflammatory factors,alleviate the damage of the inflammatory response to the body,and has important value for the treatment of severe *** by Academician Lanjuan Li,based on the experience of treating patients across the country,integrating the opinions of experts from all over the country,the center summarized and formulated the consensus including the basic principles,treatment indications,relative contraindications,mode selection,monitoring indicators,and efficacy evaluation of artificial liver,which provides reference for treatment of severe COVID-19 patients.

关键词： coronavirus infections liver artificial COVID-19 expert consensus

Expert consensus on elderly patients with hip fracture under epidemic of novel coronavirus pneumonia

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中华创伤杂志 2020年第2期36卷 104-110页

作者： Liu Guohui Liu Ximing Tong Xiaoling Wang Dongliang Chen Yanxi Cao Liehu Liu Guodong Liu Jing Hu Yan Huang Biaotong Shi Zhongmin Zhang Dianying Hou Zhiyong Liu Hongjian Tong Peijian Song Shaojun Yang Lei Wang Yong Zhang Lei Luo Tao Wang Meitang Zhang Peng Zhang Yong Lin Haodong Yu Baoqing Mi Bobin Zhang Yingze Su Jiacan Department of Orthopedics Union Hospital of Tongji Medical College Huazhong University of Science and Technology Wuhan 430000 China Central Theater General Hospital of PLA Outpatient Department Hankou Hospital Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai 200092 Zhongshan Hospital Affiliated to Fudan University Shanghai 200032 Department of Traumatic Orthopedics Changhai Hospital Affiliated to Naval Medical University Shanghai 200433 Department of Orthopedics Luodian Hospital Baoshan District Shanghai 201908 Medical Center of Trauma and War Injuries Daping Hospital Army Military Medical University Chongqing 400042 Institute of Translational Medicine Shanghai University Shanghai 200444 Sixth People''s Hospital Affiliated to Shanghai Jiaotong University Shanghai 200233 Peking University People''s Hospital Beijing 100035 Trauma Emergency Center Third Affiliated Hospital of Hebei Medical University Shijiazhuang 075061 First Affiliated Hospital of Zhengzhou University Wenzhou 450018 Zhejiang Provincial Hospital of Traditional Chinese Medicine Hangzhou 310003 Department of Emergency Second Affiliated Hospital of Wenzhou Medical University Wenzhou 325027 Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Wenzhou 325001 Putuo District Central Hospital Affiliated to Shanghai University of Chinese Medicine Shanghai 200062 Shanghai Public Health Clinical Center Shanghai 200083 Changhai Hospital Naval Medical University Shandong Provincial Hospital Jinan 250021 Tangdu Hospital Air Force Medical University Xi''an 710038 First Affiliated Hospital of Shanghai Jiaotong University Shanghai 200080 Pudong Hospital Fudan University Shanghai 201399

With the spread of novel coronavirus pneumonia (NCP) in December 2019, the management and rehabilitation of elderly patients with hip fractures and protection of medical staff face new challenges, and need to be adjusted appropriately under this very circumstances. Hip fractures in the elderly account for more than half of osteoporotic fractures. Expert group formulate this consensus so as to make better decision against this epidemic and protect patients'' families and medical staff. This consensus elaborates not only epidemic condition of NCP, but also general principles of medical admission, treatment and protection for both medical staff and patients, in order to provide some reference and promote the standardization of clinical diagnosis and treatment of elderly patients with hip fractures under the condition of NCP.

关键词： Aged Hip fractures coronavirus infections Pneumonia Expert consensus

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Effect of drug therapies on self-reported chemosensory outcomes after COVID-19

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 88-96页

作者： Marco A.Fornazieri Bruno M.Cunha Samuel P.Nicácio Lucas K.Anzolin JoséL.B.da Silva Aristides Fernandes Neto Deusdedit Brandão Neto Richard L.Voegels Fábio D.R.Pinna Department of Surgery Londrina State UniversityLondrinaBrazil Department of Medicine Pontifical Catholic University of ParanáLondrinaBrazil Department of Otorhinolaryngology University of São PauloSao PauloBrazil Department of Otorhinolaryngology:Head and Neck Surgery Perelman School of MedicineSmell and Taste CenterUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection on self-reported alterations in taste and/or smell ***:Seven hundred and fourteen persons with self-reported postcoronavirus disease 2019(post-COVID-19)chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the *** dependent measure—self-reported total recovery of chemosensory symptoms—was subjected to stepwise logistic *** predictors included demographic and clinical variables,in addition to specific medications used to mitigate disease symptoms(i.e.,systemic corticosteroids,oseltamivir,vitamin C,ibuprofen,hydroxychloroquine,azithromycin,ivermectin,nitazoxanide,anticoagulants,and zinc).Results:The median time between COVID-19 symptom onset and the interviews was 81 days(interquartile range:60-104).Of the 714 subjects,249(34.9%)reported total recovery of their chemosensory function;437(61.2%)had at least one treatment since the beginning of the *** and those with more comorbidities had undergone more *** recovery rates of the treated and nontreated groups did not differ ***,respondents who had used nitazoxanide tended to have a higher rate of self-reported taste or smell *** who took oral zinc were less likely to ***:No medication employed during the first months after SARS-CoV-2 infection had a clear positive effect on returning self-reported smell or taste function to normal,although nitrazoxide trended in a positive *** zinc had a negative effect on the reported recovery of these senses.

关键词： chemosensory disorder coronavirus infections COVID-19 drug therapy SARS-CoV-2 smell loss taste loss

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