1.Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China.
Dong WEI ; Yusang XIE ; Xuefei LIU ; Rong CHEN ; Min ZHOU ; Xinxin ZHANG ; Jieming QU
Frontiers of Medicine 2023;17(6):1030-1046
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.
Humans
;
COVID-19
;
SARS-CoV-2
;
Pneumonia, Viral/prevention & control*
;
Global Health
;
China/epidemiology*
2.Analysis of the clinical features and the risk factors of severe human metapneu movirus-associated community acquired pneumonia in children.
Ke HUANG ; Hai Yan LI ; Ming Hui CHEN ; Ting Ting ZHU ; Xue Ya ZHANG ; Fang Fang LYU ; Li LIN ; Miao Shang SU ; Lin DONG
Chinese Journal of Pediatrics 2023;61(4):322-327
Objective: To investigate the clinical characteristics and the risk factors of severe human metapneumovirus (hMPV)-associated community acquired pneumonia (CAP) in children. Methods: A retrospective case summary was conducted. From December 2020 to March 2022, 721 children who were diagnosed with CAP and tested positive for hMPV nucleic acid by PCR-capillary electrophoresis fragment analysis of nasopharyngeal secretions at the Yuying Children's Hospital, the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects. The clinical characteristics, epidemiological characteristics and mixed pathogens of the two groups were analyzed. According to CAP diagnostic criteria, the children were divided into the severe group and the mild group. Chi-square test or Mann-Whitney rank and contrast analysis was used for comparison between groups, while multivariate Logistic regression was applied to analyze the risk factors of the severe hMPV-associated CAP. Results: A total of 721 children who were diagnosed with hMPV-associated CAP were included in this study, with 397 males and 324 females. There were 154 cases in the severe group. The age of onset was 1.0 (0.9, 3.0) years, <3 years old 104 cases (67.5%), and the length of hospital stay was 7 (6, 9) days. In the severe group, 67 children (43.5%) were complicated with underlying diseases. In the severe group, 154 cases (100.0%) had cough, 148 cases (96.1%) had shortness of breath and pulmonary moist rales, and 132 cases (85.7%) had fever, 23 cases (14.9%) were complicated with respiratory failure. C-reactive protein (CRP) was elevated in 86 children (55.8%), including CRP≥50 mg/L in 33 children (21.4%). Co-infection was detected in 77 cases (50.0%) and 102 strains of pathogen were detected, 25 strains of rhinovirus, 17 strains of Mycoplasma pneumoniae, 15 strains of Streptococcus pneumoniae, 12 strains of Haemophilus influenzae and 10 strains of respiratory syncytial virus were detected. Six cases (3.9%) received heated and humidified high flow nasal cannula oxygen therapy, 15 cases (9.7%) were admitted to intensive care unit, and 2 cases (1.3%) received mechanical ventilation. In the severe group, 108 children were cured, 42 children were improved, 4 chlidren were discharged automatically without recovery and no death occurred. There were 567 cases in the mild group. The age of onset was 2.7 (1.0, 4.0) years, and the length of hospital stay was 4 (4, 6) days.Compared with the mild group, the proportion of children who age of disease onset <6 months, CRP≥50 mg/L, the proportions of preterm birth, congenital heart disease, malnutrition, congenital airway malformation, neuromuscular disease, mixed respiratory syncytial viruses infection were higher (20 cases (13.0%) vs. 31 cases (5.5%), 32 cases (20.8%) vs. 64 cases (11.3%), 23 cases (14.9%) vs. 44 cases (7.8%), 11 cases (7.1%) vs. 18 cases (3.2%), 9 cases (5.8%) vs. 6 cases (1.1%), 11 cases (7.1%) vs. 12 cases (2.1%), 8 cases (5.2%) vs. 4 cases (0.7%), 10 cases (6.5%) vs. 13 cases (2.3%), χ2=0.42, 9.45, 7.40, 4.94, 11.40, 8.35, 3.52, 6.92, all P<0.05). Multivariate Logistic regression analysis showed that age<6 months (OR=2.51, 95%CI 1.29-4.89), CRP≥50 mg/L (OR=2.20, 95%CI 1.36-3.57), prematurity (OR=2.19, 95%CI 1.26-3.81), malnutrition (OR=6.05, 95%CI 1.89-19.39) were the independent risk factors for severe hMPV-associated CAP. Conclusions: Severe hMPV-associated CAP is most likely to occur in infants under 3 years old and has a higher proportion of underlying diseases and co-infection. The main clinical manifestations are cough, shortness of breath and pulmonary moist rales, fever. The overall prognosis is good. Age<6 months, CRP≥50 mg/L, preterm birth, malnutrition are the independent risk factors for severe hMPV-associated CAP.
Infant
;
Male
;
Female
;
Humans
;
Child
;
Infant, Newborn
;
Child, Preschool
;
Retrospective Studies
;
Cough
;
Coinfection
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Premature Birth
;
Respiratory Sounds
;
Metapneumovirus
;
Pneumonia, Viral/epidemiology*
;
Respiratory Syncytial Virus, Human
;
Community-Acquired Infections/epidemiology*
;
Risk Factors
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Dyspnea
;
Malnutrition
3.Gastrointestinal involvement of COVID-19 and potential faecal transmission of SARS-CoV-2.
Min SONG ; Zong-Lin LI ; Ye-Jiang ZHOU ; Gang TIAN ; Ting YE ; Zhang-Rui ZENG ; Jian DENG ; Hong WAN ; Qing LI ; Jin-Bo LIU
Journal of Zhejiang University. Science. B 2020;21(9):749-751
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was found initially in Wuhan, China in early December 2019. The pandemic has spread to 216 countries and regions, infecting more than 23310 000 people and causing over 800 000 deaths globally by Aug. 24, 2020, according to World Health Organization (https://www.who.int/emergencies/diseases/ novel-coronavirus-2019). Fever, cough, and dyspnea are the three common symptoms of the condition, whereas the conventional transmission route for SARS-CoV-2 is through droplets entering the respiratory tract. To date, infection control measures for COVID-19 have been focusing on the involvement of the respiratory system. However, ignoring potential faecal transmission and the gastrointestinal involvement of SARS-CoV-2 may result in mistakes in attempts to control the pandemic.
Betacoronavirus/isolation & purification*
;
COVID-19
;
China/epidemiology*
;
Coronavirus Infections/virology*
;
Environmental Microbiology
;
Feces/virology*
;
Gastrointestinal Diseases/virology*
;
Humans
;
Models, Biological
;
Pandemics
;
Pneumonia, Viral/virology*
;
RNA, Viral/genetics*
;
SARS-CoV-2
;
Virus Shedding
8.A comparative study of international and Chinese public health emergency management from the perspective of knowledge domains mapping.
Juan LI ; Yuhang ZHU ; Jianing FENG ; Weijing MENG ; Kseniia BEGMA ; Gaopei ZHU ; Xiaoxuan WANG ; Di WU ; Fuyan SHI ; Suzhen WANG
Environmental Health and Preventive Medicine 2020;25(1):57-57
BACKGROUND:
At the end of 2019, the outbreak of coronavirus disease 2019 (COVID-19) severely damaged and endangered people's lives. The public health emergency management system in China has played an essential role in handling the response to the outbreak, which has been appreciated by the World Health Organization and some countries. Hence, it is necessary to conduct an overall analysis of the development of the health emergency management system in China. This can provide a reference for scholars to aid in understanding the current situation and to reveal new research topics.
METHODS:
We collected 2247 international articles from the Web of Science database and 959 Chinese articles from the China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domain analysis methods were used in this study for temporal distribution analysis, cooperation network analysis, and co-word network analysis.
RESULTS:
The first international article in this field was published in 1991, while the first Chinese article was published in 2005. The research institutions producing these studies mainly existed in universities and health organizations. Developed countries and European countries published the most articles overall, while eastern China published the most articles within China. There were 52 burst words for international articles published from 1999-2018 and 18 burst words for Chinese articles published from 2003-2018. International top-ranked articles according to the number of citations appeared in 2005, 2007, 2009, 2014, 2015, and 2016, while the corresponding Chinese articles appeared in 2003, 2004, 2009, and 2011.
CONCLUSIONS
There are differences in the regional and economic distribution of international and Chinese cooperation networks. International research is often related to timely issues mainly by focusing on emergency preparedness and monitoring of public health events, while China has focused on public health emergencies and their disposition. International research began on terrorism and bioterrorism, followed by disaster planning and emergency preparedness, epidemics, and infectious diseases. China considered severe acute respiratory syndrome as the starting research background and the legal system construction as the research starting point, which was followed by the mechanism, structure, system, and training abroad for public health emergency management.
Betacoronavirus
;
China
;
epidemiology
;
Communicable Disease Control
;
organization & administration
;
Coronavirus Infections
;
epidemiology
;
prevention & control
;
Disease Outbreaks
;
prevention & control
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Humans
;
Internationality
;
Pandemics
;
prevention & control
;
Pneumonia, Viral
;
epidemiology
;
prevention & control
9.An especial transition phase of hospitals: the adaptation of hospital operations to the development of COVID-19 and policy adjustments.
Xiucheng LIU ; Wei ZHUANG ; Xiaoyu QUAN ; Yeqing ZHOU ; Hao QIN ; Chenghang ZOU ; Hao ZHANG
Environmental Health and Preventive Medicine 2020;25(1):55-55
The ongoing pandemic coronavirus disease 19 (COVID-19) remains a significant issue for global health, economics, and society. In order to balance epidemic control and economic recovery, many countries have successively announced the gradual relaxation of some lockdown restrictions. Hospitals and medical staff constitute the backbone in this war against COVID-19. In response to this serious situation, many hospitals went into emergency and impaired healthcare access to patients with conditions other than COVID-19. Therefore, gradually promoting hospital operations and functions back to the new normal is important, especially when this outbreak has been effectively controlled. In this study, we introduce existing and potential problems that could seriously affect people's health. Additionally, we propose that an especial transition phase between the emergency and regular modes of hospitals can be well adapted to the current situation.
Coronavirus Infections
;
epidemiology
;
Health Policy
;
trends
;
Hospitals
;
standards
;
trends
;
Humans
;
Pandemics
;
Pneumonia, Viral
;
epidemiology
10.Remote cardiac rehabilitation is a good alternative of outpatient cardiac rehabilitation in the COVID-19 era.
Atsuko NAKAYAMA ; Naoko TAKAYAMA ; Momoko KOBAYASHI ; Kanako HYODO ; Naomi MAESHIMA ; Fujiwara TAKAYUKI ; Hiroyuki MORITA ; Issei KOMURO
Environmental Health and Preventive Medicine 2020;25(1):48-48
BACKGROUND:
In the wake of the coronavirus disease 2019 (COVID-19) pandemic, people need to practice social distancing in order to protect themselves from SARS-CoV-2 infection. In such stressful situations, remote cardiac rehabilitation (CR) might be a viable alternative to the outpatient CR program.
METHODS:
We prospectively investigated patients hospitalized for heart failure (HF) with a left ventricular ejection fraction of < 50%. As for patients who participated in the remote CR program, telephone support was provided by cardiologists and nurses who specialized in HF every 2 weeks after discharge. The emergency readmission rate within 30 days of discharge was compared among the outpatient CR, remote CR, and non-CR groups, and the EQ-5D score was compared between the outpatient CR and remote CR groups.
RESULTS:
The participation rate of HF patients in our remote CR program elevated during the COVID-19 pandemic. As observed in the outpatient CR group (n = 69), the emergency readmission rate within 30 days of discharge was lower in the remote CR group (n = 30) than in the non-CR group (n = 137) (P = 0.02). The EQ-5D score was higher in the remote CR group than in the outpatient CR group (P = 0.03) 30 days after discharge.
CONCLUSIONS
Remote CR is as effective as outpatient CR for improving the short-term prognosis of patients hospitalized for heart failure post-discharge. This suggests that the remote CR program can be provided as a good alternative to the outpatient CR program.
Aged
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Betacoronavirus
;
Cardiac Rehabilitation
;
methods
;
Coronavirus Infections
;
epidemiology
;
Heart Failure
;
rehabilitation
;
Humans
;
Japan
;
Middle Aged
;
Monitoring, Ambulatory
;
Pandemics
;
Pneumonia, Viral
;
epidemiology
;
Prospective Studies
;
Self Care
;
Telemedicine
;
methods
;
Telephone

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