Year 2020
Authors LIANG Ying , ZENG Simin , LIU Ting , WU Shimin - More
Journal 武汉大学学报(医学版) (Medical Journal of Wuhan University)
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OBJECTIVE: To investigate the value of serum-specific antibody of 2019 novel coronavirus(2019-nCoV) in the diagnosis of Coronavirus Disease 2019(COVID-19).METHODS: The plasma samples of236 confirmed and 79 suspected patients with COVID-19 were detected by immunochromatography assays for 2019-nCoV total antibodies and IgM/IgG antibodies.The nucleic acids were detected by real-time fluorescent quantitative PCR.RESULTS: In the confirmed group of 236 cases, the positive rates of the two detection reagents were 86.02%(203/236) and 84.32%(199/236); Among the 79 suspected cases, the positive rates of the two agents were 78.48%(62/79) and 70.89%(56/79).The sensitivity, specificity, positive value(PPV), negative predictive value(NPV) and compliance rates of the two reagents were 86.02% and 84.32%, 96.61% and 96.61%, 99.02% and 99.00%,63.33% and 60.64%, 88.14% and 86.78%, respectively.There was no significant difference in the detection efficacy between the two reagents by statistical analysis(P>0.05).The positive rates of IgM and IgG were 73.31%(173/236) and 85.59%(202/236) in the COVID-19 confirmed group,and 12.66%(10/79) and 65.82%(52/79) in COVID-19 suspected group, respectively.There was a statistically significant difference in IgM positive rates between the two groups(P<0.01).CONCLUSION: Serum-specific antibody could be used as a valued index to evaluate 2019-nCoV infection, and IgM is efficient for the diagnosing and excluding the COVID-19 patients with negative nucleic acid tests.

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Year 2020
Journal 中华检验医学杂志 (Chinese Journal of Laboratory Medicine)
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Objective To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district. Methods A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9, 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR. Results Among the 8 274 subjects, 2 745 (33.2%) were 2019-nCoV infected; 5 277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (40 vs 56, t =27.569, P <0.001; 52 vs 56, t =6.774, P <0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ 2 =24.105, P =0.003). Four types of respiratory tract samples and five types of non-respiratory tract samples were found to be positive for 2019-nCoV nucleic acid test. Conclusion The 2019-nCoV nucleic acid positive rate in male is higher than in female. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.

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Year 2020
Journal 武汉大学学报(医学版) (Medical Journal Wuhan University)
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OBJECTIVE: To compare the chemiluminescence and colloidal gold method in the detection of 2019 novel Coronavirus (2019⁃nCoV, or SARS ⁃CoV ⁃2) specific antibody and to evaluate the impor⁃ tance in the diagnosis and treatment of COVID ⁃ 19. METHODS: A total of 191 cases of diagnosed and suspected COVID ⁃19 patients admitted in Febrary 2020 in Wuhan Leishenshan Hospital were includ⁃ ed. The patients were divided into 2019⁃nCoV continuous positive group, 2019⁃nCoV positive to neg⁃ ative group, and 2019 ⁃ nCoV suspect group according to the results of pharyngeal swab 2019 ⁃ nCoV nucleic acid detection. In addition, 27 patients without COVID ⁃ 19 were set as control group to test the specificity. The serum samples were collected, and colloidal gold and chemiluminescence method were used to detect total antibodies (IgM+IgG) and IgM. SPSS 24. 0 was used to compare the difference in antibody detection rates between the two methods. RESULTS: The specificity of total antibodies (IgM+IgG) and IgM detection was 100%. Two methods of total antibody detection had no signifi⁃ cant difference in continuous positive group (P=1. 00). In positive to negative group and suspect group, the positive detection rate of chemiluminescence method was significantly higher than colloidal gold method (95. 2% vs 76. 2% and 94. 9% vs 70. 5%, respectively, both P<0. 05). The chemiluminescence method showed no significant difference between the three groups in IgM detection (P> 0. 05). CONCLUSION: The detection of 2019⁃ nCoV specific antibody can be an important supplemental method to pharyngeal swab 2019 ⁃ nCoV nucleic acid detection during the diagnosis and treatment of COVID ⁃ 19. The chemiluminescence method is better than colloidal gold method in the detection of total antibody. The IgM detection using chemiluminescence method is suitable for all stages of the dis⁃ ease.

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Year 2020
Authors 李若青 - More
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Objective: To explore the relationship between different serum albumin concentrations and lymphocyte levels in patients with pneumonia (COVID-19) infected by 2019-novel coronavirus (2019-NCoV). Method: Retrospective research method to collect general information on 205 patients with COVID-19 who were admitted to hospital in the Happy Street area of Hanchuan People's Hospital, Xiaoseng, Hubei Province, from 24 January to 12 February 2020, serum albumin (ALB), lymphocyte count (LYM), lymphocyte percentage (LYM%) and other test parameters level, analysis of clinical patients with COVID-19 Data characteristics; the difference between LYM, LYM% levels and LYM and LYM% decrease were analyzed by ALB concentration 35 g/L as the tangent point of the low ALB group and normal ALB group. Result: 17.5% of COVID-19 patients combined with hypoalbuminemia, the LYM, LYM% levels were significantly lower than normal ALB group (P<0.001), the incidence of LYM, LYM% decrease was significantly higher than normal ALB group (P<0.05), LYM and LYM levels in the low ALB group, respectively B concentration is of Significantly positively correlated (P<0.05). Conclusion: Reduction of lymphocyte levels in COVID-19 patients may be associated with hypoalbuminemia, should actively intervene with COVID-19 in patients with hypoalbuminemia, maintaining serum albumin in the normal range.

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Year 2020
Journal 中国人兽共患病学报 (Chinese Journal of Zoonoses)
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To investigate the status of viral infection in the feces of confirmed COVID-19, cases fecal samples or anal swabs from 36 patients were collected, SARS-CoV-2 was detected by real-time fluorescence RT-PCR, and the infection rates of the cases were compared by statistical analysis software SPSS 19 0 Among the 36 samples, 20 (55 56%) were positive for SARS-CoV-2 The positive rate of critical cases (2/3) and severe cases (6/9) were both 66 67%, the positive rate of common pneumonia was 62 50% (10/16), and the positive rate of mild pneumonia was 25 00% (2/8) The 36 confirmed COVID-19 cases included 22 males and 14 females, with a detection rate of 54 55% and 57 14%, respectively The age distribution range of the cases was between 17 and 86 years old, with an average age of 48 75 years Among the 36 samples, 2 positive specimens were detected in 5 anal swab specimens and 18 positive specimens in 31 fecal specimens There were no statistically significant differences in the positive detection rates among clinical typing, gender, age and specimen type, respectively From these results, we deduced that fecal samples of confirmed COVID-19 cases contained SARS-CoV-2, which can cause infection through potential fecal-oral transmission and be significant for clinical treatment and epidemiological study

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Year 2020
Journal 中华创伤杂志(Chinese Journal of Trauma)
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A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.

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Year 2020
Journal 中华肿瘤杂志 (Chinese Journal of Oncology)
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OBJECTIVE: To investigate the principles of differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of novel coronavirus (2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities (GGO) after courses of chemotherapy. METHODS: Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT scan images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were searched from databases including PUBMED, EMBASE and CNKI. RESULTS: Among the 139 cancer patients who underwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients (5.8%), five of whom were characterized with GGOs in lungs. 2019-nCoV nuclear acid testing was performed in three patients and the results were negative. One case was a 66-year-old man who was diagnosed with non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocytes. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection, fever or other respiratory symptoms. Considering the negative result of nuclear acid testing, this patient was presumptively diagnosed with viral pneumonia and an experiential anti-infection treatment had been prescribed for him. CONCLUSIONS: The 2019 novel coronavirus disease (COVID-19) complicates the clinical scenario of pulmonary infiltrates in cancer patients. The epidemic history, clinical manifestation, CT scan image and lab test should be taken into combined consideration. The 2019-nCoV nuclear acid testing might be applied in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered.

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Year 2020
Authors Hui Xiong , Yuwu Jiang , Junfen Fu - More
Journal Chinese Journal of Applied Clinical Pediatrics
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my country's new coronavirus pneumonia (Corona Virus Disease, COVID-19) is still ongoing. Existing epidemiology shows that the population is generally susceptible to 2019 novel coronavirus (2019 novel coronavirus, 2019-nCoV), and patients with underlying diseases or over 60 years of age are at high risk for severe COVID-19 cases. For rare diseases, especially for children with neuromuscular diseases that are susceptible to respiratory infections and are easily exacerbated, and even life-threatening, more attention is needed to strengthen protection and home rehabilitation. Therefore, the Endocrine Genetic Metabolism Group of the Pediatrics Branch of the Chinese Medical Association, the Neurology Group of the Pediatrics Branch of the Chinese Medical Association, the Rehabilitation Group of the Pediatrics Branch of the Chinese Medical Association, and the editorial board of the Chinese Journal of Practical Pediatrics Muscular disease-spinal muscular atrophy (SMA) as an example, according to the relevant disease diagnosis and treatment plan issued by the National Health Commission and the consensus of SMA multidisciplinary management experts, combined with the clinical characteristics of COVID-19 in children, the SMA was developed The representative recommendations for the prevention and control of COVID-19 in children with neuromuscular diseases and expert advice on rehabilitation training and medication guidance during the epidemic are to guide the diagnosis and treatment of children with neuromuscular diseases with COVID-19, as well as home management and rehabilitation.

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Year 2020
Journal 药物不良反应杂志 (Adverse Drug Reactions Journal)
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OBJECTIVE: To systematically evaluate the efficacy and safety of arbidol in the treatment of novel coronavirus pneumonia (COVID-19). METHODS: Randomized controlled trials (RCTs), cohort studies, and case-control studies on the efficacy and safety of arbidol for COVID-19, influenza, andother respiratory virus infections were collected by searching related database at home and abroad and network platform for preprint of Health Science Papers (medRxiv) (up to April 25, 2020). Quality of the enrolled studies was evaluated by bias risk assessment tool of Cochrane collaboration network and Newcastle-Ottawa Scale (NOS). Meta-analysis and descriptive analysis of relevant outcome indicators were performed using RevMan 5.3 software. RESULTS: A total of 15 studies were enrolled in the study, including 7 cohort studies with high-quality and 8 RCTs, 6 of which were with low bias risk and the other 2 of which were with medium bias risk. Among these studies, 8 were on arbidol treatment for COVID-19, including 5 retrospective cohort studies, 2 prospective cohort studies, and 1 RCT, and involving 809 patients (479 patients in the arbidol group and 330 in the control group); 7 were RCTs on arbidol treatment for influenza or other respiratory virus infections, involving 1 471 patients (745 patients in the arbidol group and 726 in the control group).In these studies, patients were treated with arbidol (0.15-1.2 g daily for 5-21 d) in the arbidol group while with the other antiviral agents or without any antiviral drug in the control group. Meta analysis on the efficacy and safety of arbidol in treatment for COVID-19 showed that the novel coronavirus (2019-nCoV) nucleic acid negative conversion rate in the arbidol group was significantly higher than that in the control group [71.7% (109/152) vs. 58.8% (94/160), relative risk (RR)=1.30, 95% confidence interval (CI): 1.01-1.67, P=0.04]; the difference of time taken for 2019-nCoV nucleic acid negative conversion between the 2 groups was not statistically significant (standardized mean difference=-0.17, 95%CI: -0.72-0.38, P=0.55); the difference of disease improvement rate shown by chest CT on day 7 after treatment between the 2 groups was not statistically significant [46.2% (30/65) vs. 50.7% (36/71), RR=0.88, 95%CI: 0.39-1.98, P=0.76]; and the difference of incidence of adverse reactions between the 2 groups was not statistically significant [16.9% (39/231) vs. 19.2% (47/245), risk difference (RD)=-0.03, 95%CI: -0.10-0.04, P=0.44]. Meta analysis on the safety of arbidol in treatment for influenza and other respiratory virus infections showed that the incidence of adverse reactions in the arbidol group was significantly lower than that in the control group [5.9% (44/745) vs. 11.3% (82/726), RR=0.52, 95%CI: 0.37-0.74, P<0.01]. CONCLUSION: Arbidol could effectively increase the 2019-nCoV nucleic acid negative conversion rate and it might be safe to treat COVID-19 using arbidol.

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Year 2020
Journal 中华创伤杂志 (Chinese Journal of Trauma)
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Corona virus disease 2019 (COVID-19) patients with trauma are at high risk of venous thromboembolism (VTE), which must be taken seriously in the therapeutic processes Hypercoagulable state is induced by 2019 novel coronavirus (2019-nCoV) in many ways, such as increasing the level of inflammatory factors and fibrinogen, and inducing endothelial cell injury The venous wall injuries from trauma and operation directly or indirectly trigger off the exogenous coagulation pathway and the microcirculation can be damaged at the same time, which may initiate the exogenous pathway of VTE Immobilization of limbs and forced bed rest during the treatment of traumatic patients will slow venous blood flow Chronic non-communicable diseases such as diabetes in the elderly were independent risk factors for VTE Furthermore, the persistent fever, severe lung disease, respiratory failure, sepsis and invasive technology application add the risk of VTE and the difficulty of treatment In order to help effective prevention VTE of for COVID-19 patients with trauma, the authors put forward relevant technical suggestions for prevention and nursing of VTE to provide basis for nursing work during pandemic of COVID-19

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