As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, ...As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, diabetes and diseases that may contribute to the severity and risk factor of diabetes in individuals and this impact on COVID-19 and the mortality rate. These diseases include respiratory diseases, cardiovascular diseases, and obesity. Equally significant is the statistical analysis on ethnicity, age, and sex on COVID-19 infection as well as mortality rate. Their possible contributions to increasing the severity and risk factor of diabetes as a risk to mortality to individuals who have COVID-19. Objectives: The ultimate objectives of this investigation are as follow: 1) Is there a risk factor of diabetes on COVID-19 infection and increasing mortality rate? 2) To what extent do other disease conditions that include, obesity, heart failure, and respiratory diseases influence the severity and risk factor of diabetes on increasing COVID-19 infection and mortality rate? 3) To what extent does age, race, and gender increase the mortality of COVID-19 and increase the severity and risk factor of diabetes on COVID-19 mortality rate? 4) How and why COVID-19 virus increases the risk of diabetes in children? 5) Diabetes and COVID-19: Who is most at Risk? Lastly, understanding the misconception of COVID-19 and diabetes.展开更多
BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and c...BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and coronavirus infections.Despite the large amount of data concerning the use of ribavirin alone or in combination for measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and coronavirus disease 2019(COVID-19)outbreaks,the conclusions of these studies have been contradictory.Underlying reasons for these discrepancies include possible study design inaccuracies and failures and misinterpretations of data,and these potential confounds should be addressed.AIM To determine the confounding factors of ribavirin treatment studies and propose a therapeutic scheme for COVID-19.METHODS PubMed database was searched over a period of five decades utilizing the terms“ribavirin”alone or combined with other compounds in measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and COVID-19 infections.The literature search was performed and described according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Articles were considered eligible when they reported on ribavirin dose regimens and/or specified outcomes concerning its efficacy and/or possible adverseeffects.In vitro and animal studies were also retrieved.A chapter on ribavirin’s pharmacology was included as well.RESULTS In addition to the difficulties and pressures of an emerging pandemic,there is the burden of designing and conducting well-organized,double-blind,randomized controlled trials.Many studies have succumbed to specific pitfalls,one of which was identified in naturally ribavirin-resistant Vero cell lines in in vitro studies.Other pitfalls include study design inconsistent with the well-established clinical course of disease;inappropriate pharmacology of applied treatments;and the misinterpretation of study results with misconceived generalizations.A comprehensive treatment for COVID-19 is proposed,documented by thorough,longterm investigation of ribavirin regimens in coronavirus infections.CONCLUSION A comprehensive treatment strictly tailored to distinct disease stages was proposed based upon studies on ribavirin and coronavirus infections.展开更多
Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electr...Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19,SARS and MERS pneumonia respectively.Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists.Vote-counting method was employed to include cases of each group.Data of patients’manifestations in early chest CT including lesion patterns,distribution of lesions and specific imaging signs for the three groups were extracted and recorded.Data were compared and analyzed using SPSS 22.0.Results A total of 24 studies were included,composing of 10 studies of COVID-19,5 studies of MERS and 9 studies of SARS.The included CT exams were 147,40,and 122 respectively.For the early CT features of the 3 pneumonias,the basic lesion pattern with respect to"mixed ground glass opacity(GGO)and consolidation,GGO mainly,or consolidation mainly"was similar among the 3 groups(χ^2=7.966,P>0.05).There were no significant differences on the lesion distribution(χ^2=13.053,P>0.05)and predominate involvement of the subpleural area of bilateral lower lobes(χ^2=4.809,P>0.05)among the 3 groups.The lesions appeared more focal in COVID-19 pneumonia at early phase(χ^2=23.509,P<0.05).The proportions of crazy-paving pattern(χ^2=23.037,P<0.001),organizing pneumonia pattern(P<0.05)and pleural effusions(P<0.001)in COVID-19 pneumonia were significantly lower than the other two.Although rarely shown in the early CT findings of all three viral pneumonias,the fibrotic changes were more frequent in SARS than COVID-19 and MERS(χ^2=6.275,P<0.05).For other imaging signs,only the MERS pneumonia demonstrated tree-in-buds,cavitation,and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia(χ^2=22.412,P<0.05).No pneumothorax,pneumomediastinum and lymphadenopathy was present for each group.Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns,including GGO and consolidation,bilateral distribution,and predominant involvement of the subpleural area and the lower lobes.Early signs of COVID-19 pneumonia showed less severity of inflammation.Early fibrotic changes appeared in SARS only.MERS had more severe inflammatory changes including cavitation and pleural effusion.The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.展开更多
At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effect...At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effective antiviral treatment for this infectious disease is absent.At the beginning of the epidemic,relevant cellular and animal experiments of antiviral treatment for SARS-CoV-2 were conducted based on the prior studies of SARS-CoV and Middle East respiratory syndrome coronavirus.Some antivirals were preliminarily validated to be potentially effective in the clinical settings.But as the epidemic continued and more studies were carried out,the efficacy of these antiviral drugs became controversial.This paper reviews the pharmacology and application of interferon,lopinavir/ritonavir,ribavirin,chloroquine,arbidol,favipiravir,remdesivir,and thymosinα1 in coronavirus disease 2019.The actual effect of these drugs remains controversial.Meanwhile,the efficacy and safety of these drugs for patients with coronavirus disease 2019 still need to be explored.展开更多
Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for...Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for a user-friendly system for rapid drug screening.In this study,we constructed a MERS-CoV replicon containing the Renilla luciferase(Rluc)reporter gene and a stable luciferase replicon-carrying cell line.Using this cell line,we showed that MERS-CoV replication was inhibited by combined application of lopinavir and ritonavir,indicating that this cell line can be used to screen inhibitors of MERS-CoV replication.Importantly,the MERS-replicon cell line can be used for high-throughput screening of antiviral drugs without the need for live virus handling,providing an effective and safe tool for the discovery of antiviral drugs against MERS-CoV.展开更多
文摘As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, diabetes and diseases that may contribute to the severity and risk factor of diabetes in individuals and this impact on COVID-19 and the mortality rate. These diseases include respiratory diseases, cardiovascular diseases, and obesity. Equally significant is the statistical analysis on ethnicity, age, and sex on COVID-19 infection as well as mortality rate. Their possible contributions to increasing the severity and risk factor of diabetes as a risk to mortality to individuals who have COVID-19. Objectives: The ultimate objectives of this investigation are as follow: 1) Is there a risk factor of diabetes on COVID-19 infection and increasing mortality rate? 2) To what extent do other disease conditions that include, obesity, heart failure, and respiratory diseases influence the severity and risk factor of diabetes on increasing COVID-19 infection and mortality rate? 3) To what extent does age, race, and gender increase the mortality of COVID-19 and increase the severity and risk factor of diabetes on COVID-19 mortality rate? 4) How and why COVID-19 virus increases the risk of diabetes in children? 5) Diabetes and COVID-19: Who is most at Risk? Lastly, understanding the misconception of COVID-19 and diabetes.
文摘BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action,which supports its longevity and quality as a clinical resource.It has been widely administered for measles and coronavirus infections.Despite the large amount of data concerning the use of ribavirin alone or in combination for measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and coronavirus disease 2019(COVID-19)outbreaks,the conclusions of these studies have been contradictory.Underlying reasons for these discrepancies include possible study design inaccuracies and failures and misinterpretations of data,and these potential confounds should be addressed.AIM To determine the confounding factors of ribavirin treatment studies and propose a therapeutic scheme for COVID-19.METHODS PubMed database was searched over a period of five decades utilizing the terms“ribavirin”alone or combined with other compounds in measles,severe acute respiratory syndrome,Middle East respiratory syndrome,and COVID-19 infections.The literature search was performed and described according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Articles were considered eligible when they reported on ribavirin dose regimens and/or specified outcomes concerning its efficacy and/or possible adverseeffects.In vitro and animal studies were also retrieved.A chapter on ribavirin’s pharmacology was included as well.RESULTS In addition to the difficulties and pressures of an emerging pandemic,there is the burden of designing and conducting well-organized,double-blind,randomized controlled trials.Many studies have succumbed to specific pitfalls,one of which was identified in naturally ribavirin-resistant Vero cell lines in in vitro studies.Other pitfalls include study design inconsistent with the well-established clinical course of disease;inappropriate pharmacology of applied treatments;and the misinterpretation of study results with misconceived generalizations.A comprehensive treatment for COVID-19 is proposed,documented by thorough,longterm investigation of ribavirin regimens in coronavirus infections.CONCLUSION A comprehensive treatment strictly tailored to distinct disease stages was proposed based upon studies on ribavirin and coronavirus infections.
文摘Objective To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2(COVID-19),SARS-CoV(SARS)and MERS-CoV(MERS)using a systemic review.Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19,SARS and MERS pneumonia respectively.Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists.Vote-counting method was employed to include cases of each group.Data of patients’manifestations in early chest CT including lesion patterns,distribution of lesions and specific imaging signs for the three groups were extracted and recorded.Data were compared and analyzed using SPSS 22.0.Results A total of 24 studies were included,composing of 10 studies of COVID-19,5 studies of MERS and 9 studies of SARS.The included CT exams were 147,40,and 122 respectively.For the early CT features of the 3 pneumonias,the basic lesion pattern with respect to"mixed ground glass opacity(GGO)and consolidation,GGO mainly,or consolidation mainly"was similar among the 3 groups(χ^2=7.966,P>0.05).There were no significant differences on the lesion distribution(χ^2=13.053,P>0.05)and predominate involvement of the subpleural area of bilateral lower lobes(χ^2=4.809,P>0.05)among the 3 groups.The lesions appeared more focal in COVID-19 pneumonia at early phase(χ^2=23.509,P<0.05).The proportions of crazy-paving pattern(χ^2=23.037,P<0.001),organizing pneumonia pattern(P<0.05)and pleural effusions(P<0.001)in COVID-19 pneumonia were significantly lower than the other two.Although rarely shown in the early CT findings of all three viral pneumonias,the fibrotic changes were more frequent in SARS than COVID-19 and MERS(χ^2=6.275,P<0.05).For other imaging signs,only the MERS pneumonia demonstrated tree-in-buds,cavitation,and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia(χ^2=22.412,P<0.05).No pneumothorax,pneumomediastinum and lymphadenopathy was present for each group.Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns,including GGO and consolidation,bilateral distribution,and predominant involvement of the subpleural area and the lower lobes.Early signs of COVID-19 pneumonia showed less severity of inflammation.Early fibrotic changes appeared in SARS only.MERS had more severe inflammatory changes including cavitation and pleural effusion.The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.
基金Supported by the 345 Talent Project of Shengjing Hospital of China Medical University。
文摘At present,over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide and there have been more than 3.8 million deaths due to the virus.However,specific effective antiviral treatment for this infectious disease is absent.At the beginning of the epidemic,relevant cellular and animal experiments of antiviral treatment for SARS-CoV-2 were conducted based on the prior studies of SARS-CoV and Middle East respiratory syndrome coronavirus.Some antivirals were preliminarily validated to be potentially effective in the clinical settings.But as the epidemic continued and more studies were carried out,the efficacy of these antiviral drugs became controversial.This paper reviews the pharmacology and application of interferon,lopinavir/ritonavir,ribavirin,chloroquine,arbidol,favipiravir,remdesivir,and thymosinα1 in coronavirus disease 2019.The actual effect of these drugs remains controversial.Meanwhile,the efficacy and safety of these drugs for patients with coronavirus disease 2019 still need to be explored.
基金This study was supported by the strategic priority research program of the Chinese academy of sciences(XDB29010101).
文摘Middle East respiratory syndrome coronavirus(MERS-CoV)is the causative agent of a severe respiratory disease with a high mortality of~35%.The lack of approved treatments for MERS-CoV infection underscores the need for a user-friendly system for rapid drug screening.In this study,we constructed a MERS-CoV replicon containing the Renilla luciferase(Rluc)reporter gene and a stable luciferase replicon-carrying cell line.Using this cell line,we showed that MERS-CoV replication was inhibited by combined application of lopinavir and ritonavir,indicating that this cell line can be used to screen inhibitors of MERS-CoV replication.Importantly,the MERS-replicon cell line can be used for high-throughput screening of antiviral drugs without the need for live virus handling,providing an effective and safe tool for the discovery of antiviral drugs against MERS-CoV.
