Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,...Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,2]. The disease, 2019-novel coronavirus(2019-nCoV) infection, already existed outside China and the importation of disease is the cause of emerging 2019-nCoV infections in new settings.展开更多
Wuhan novel coronavirus or 2019-novel coronavirus(2019-nCoV)infection is a rapidly emerging respiratory viral disease[1].2019-nCoV infection is characterized as febrile illness with possible severe lung complication[1...Wuhan novel coronavirus or 2019-novel coronavirus(2019-nCoV)infection is a rapidly emerging respiratory viral disease[1].2019-nCoV infection is characterized as febrile illness with possible severe lung complication[1].The disease was firstly reported in China in December 2019 and then spread to many countries(such as Thailand,Japan and Singapore)[2,3].As a new disease,there is a limited knowledge of treatment for the infection.Lu recently proposed that some drug might be useful in treatment of 2019-nCoV infection[3].展开更多
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is a highly contagious virus that can transmit through respiratory droplets,aerosols,or contacts.Frequent touching of contaminated surfaces in public areas is...Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is a highly contagious virus that can transmit through respiratory droplets,aerosols,or contacts.Frequent touching of contaminated surfaces in public areas is therefore a potential route of SARS-CoV-2 transmission.The inanimate surfaces have often been described as a source of nosocomial infections.However,summaries on the transmissibility of coronaviruses from contaminated surfaces to induce the coronavirus disease 2019 are rare at present.This review aims to summarize data on the persistence of different coronaviruses on inanimate surfaces.The literature was systematically searched on Medline without language restrictions.All reports with experimental evidence on the duration persistence of coronaviruses on any type of surface were included.Most viruses from the respiratory tract,such as coronaviruses,influenza,SARS-CoV,or rhinovirus,can persist on surfaces for a few days.Persistence time on inanimate surfaces varied from minutes to up to one month,depending on the environmental conditions.SARSCoV-2 can be sustained in air in closed unventilated buses for at least 30 min without losing infectivity.The most common coronaviruses may well survive or persist on surfaces for up to one month.Viruses in respiratory or fecal specimens can maintain infectivity for quite a long time at room temperature.Absorbent materials like cotton are safer than unabsorbent materials for protection from virus infection.The risk of transmission via touching contaminated paper is low.Preventive strategies such as washing hands and wearing masks are critical to the control of coronavirus disease 2019.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinica...BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 patients.In addition,Fusarium spp.is a rare cause of opportunistic life-threatening fungal infections.Disseminated Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting mortality.To our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(F.solani)and Aspergillus niger(A.niger)during systemic steroid treatment for COVID-19.CASE SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and dyspnea.We established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal failure.He was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous hemodiafiltration.His condition improved,and we finished the vasopressor on the fifth hospital day.We administered dexamethasone for ten days,and finished the course of treatment.On the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the lung.we changed antibiotics to meropenem plus vancomycin.In addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of voriconazole.However,the pneumonia worsened,and the patient died on the seventeenth day of illness.Later,F.solani and A.niger were identified from sputum collected on the twelfth day.It was believed that he developed a cell-mediated immune deficiency during COVID-19 treatment,which led to the complication of pneumonia caused by the above-mentioned fungi,contributing to his death.CONCLUSION Because early initiation of intense antifungal therapy offers the best chance for survival in pulmonary fusariosis,computed tomography scans and appropriate microbiologic investigations should be obtained for severely immunocompromised patients.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of deve...BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age,decreased immune function,intense inflammatory response,and comorbidities.Shanghai has experienced a wave of infection with Omicron,a new variant of SARS-CoV-2,since March 2022.There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers,public health officials,researchers,and the general public.AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group(82 patients)and a nonsevere group(246 patients)according to the diagnosis and treatment protocol of COVID-19(version 7).The clinical data and laboratory results of both groups were collected and compared.A chi-square test,t test,Mann-Whitney U test,hierarchical log-rank test,univariate and multivariate logistic regression,and hierarchical analyses were used to determine significant differences.RESULTS The severe group was older(84 vs 74 years,P<0.001),included more males(57.3%vs 43.9%,P=0.037),had a lower vaccination rate(P<0.001),and had a higher proportion of comorbidities,including chronic respiratory disease(P=0.001),cerebral infarction(P<0.001),chronic kidney disease(P=0.002),and neurodegenerative disease(P<0.001),than the nonsevere group.In addition,severe disease patients had a higher inflammatory index(P<0.001),greater need for symptomatic treatment(P<0.001),longer hospital stay(P=0.011),extended viral shedding time(P=0.014),and higher mortality than nonsevere disease patients(P<0.001).No difference was observed in the application of Paxlovid in the severe and nonsevere groups(P=0.817).Oxygen saturation,cerebral infarction,and D-dimer were predictive factors for developing severe disease in patients with COVID-19,with D-dimer having an excellent role(area under the curve:90.1%,95%CI:86.1-94.0%).In addition,D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.CONCLUSION The clinical course of severe COVID-19 is complex,with a higher need for symptomatic treatment.D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.展开更多
目的分析新型冠状(新冠)病毒感染后分泌性中耳炎(otitis media with effusion,OME)发病情况及临床特点。方法回顾性选取2018年12月至2019年1月、2021年12月至2022年1月、2022年12月至2023年1月中国人民解放军总医院第九医学中心耳鼻喉...目的分析新型冠状(新冠)病毒感染后分泌性中耳炎(otitis media with effusion,OME)发病情况及临床特点。方法回顾性选取2018年12月至2019年1月、2021年12月至2022年1月、2022年12月至2023年1月中国人民解放军总医院第九医学中心耳鼻喉科门诊就诊患者21454例,其中OME患者201例。根据北京地区疫情流行及政府管控政策(公共场所佩戴口罩、减少聚集、居家隔离、疫苗接种等)时间,将201例OME患者分为疫情前组68例(2018年12月至2019年1月)、防控期组30例(2021年12月至2022年1月)、爆发期组103例(2022年12月至2023年1月)。收集201例OME患者资料,分析新冠病毒感染相关OME人口学特征及发病特点。结果防控期组OME就诊率(0.40%)较疫情前组(0.82%)显著下降,爆发期组(1.82%)较疫情前组、防控期组升高了51.5%与243.3%,差异均有统计学意义(P<0.01)。爆发期组92.2%的OME是新冠病毒感染之后出现的,较疫情前组、防控期组上呼吸道感染导致OME在中耳炎患者中的比例升高,差异均有统计学意义(P<0.01)。爆发期组上呼吸道感染导致OME患者年龄高于疫情前组和防控期组,差异有统计学意义(P<0.01,P=0.002)。74.6%的患者在新冠病毒感染之后的1~3周发病,7.5%的患者(5/67)在感染1月后才出现耳部症状。50.7%的患者仅有耳部症状且电子鼻咽喉镜检查仅31.3%合并鼻、鼻咽部轻微炎症。结论新冠病毒感染可明显提高OME发病率,老年人患病率更高。新冠相关OME往往在感染后2周甚至更晚出现。新冠病毒有可能通过直接感染中耳引发炎症,具体机制有待进一步研究。展开更多
文摘Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,2]. The disease, 2019-novel coronavirus(2019-nCoV) infection, already existed outside China and the importation of disease is the cause of emerging 2019-nCoV infections in new settings.
文摘Wuhan novel coronavirus or 2019-novel coronavirus(2019-nCoV)infection is a rapidly emerging respiratory viral disease[1].2019-nCoV infection is characterized as febrile illness with possible severe lung complication[1].The disease was firstly reported in China in December 2019 and then spread to many countries(such as Thailand,Japan and Singapore)[2,3].As a new disease,there is a limited knowledge of treatment for the infection.Lu recently proposed that some drug might be useful in treatment of 2019-nCoV infection[3].
文摘Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is a highly contagious virus that can transmit through respiratory droplets,aerosols,or contacts.Frequent touching of contaminated surfaces in public areas is therefore a potential route of SARS-CoV-2 transmission.The inanimate surfaces have often been described as a source of nosocomial infections.However,summaries on the transmissibility of coronaviruses from contaminated surfaces to induce the coronavirus disease 2019 are rare at present.This review aims to summarize data on the persistence of different coronaviruses on inanimate surfaces.The literature was systematically searched on Medline without language restrictions.All reports with experimental evidence on the duration persistence of coronaviruses on any type of surface were included.Most viruses from the respiratory tract,such as coronaviruses,influenza,SARS-CoV,or rhinovirus,can persist on surfaces for a few days.Persistence time on inanimate surfaces varied from minutes to up to one month,depending on the environmental conditions.SARSCoV-2 can be sustained in air in closed unventilated buses for at least 30 min without losing infectivity.The most common coronaviruses may well survive or persist on surfaces for up to one month.Viruses in respiratory or fecal specimens can maintain infectivity for quite a long time at room temperature.Absorbent materials like cotton are safer than unabsorbent materials for protection from virus infection.The risk of transmission via touching contaminated paper is low.Preventive strategies such as washing hands and wearing masks are critical to the control of coronavirus disease 2019.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 patients.In addition,Fusarium spp.is a rare cause of opportunistic life-threatening fungal infections.Disseminated Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting mortality.To our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(F.solani)and Aspergillus niger(A.niger)during systemic steroid treatment for COVID-19.CASE SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and dyspnea.We established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal failure.He was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous hemodiafiltration.His condition improved,and we finished the vasopressor on the fifth hospital day.We administered dexamethasone for ten days,and finished the course of treatment.On the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the lung.we changed antibiotics to meropenem plus vancomycin.In addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of voriconazole.However,the pneumonia worsened,and the patient died on the seventeenth day of illness.Later,F.solani and A.niger were identified from sputum collected on the twelfth day.It was believed that he developed a cell-mediated immune deficiency during COVID-19 treatment,which led to the complication of pneumonia caused by the above-mentioned fungi,contributing to his death.CONCLUSION Because early initiation of intense antifungal therapy offers the best chance for survival in pulmonary fusariosis,computed tomography scans and appropriate microbiologic investigations should be obtained for severely immunocompromised patients.
基金This study was reviewed and approved by the Ethics Committee of the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(Ethics Approval No.:SH9H-2022-T139-1).
文摘BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age,decreased immune function,intense inflammatory response,and comorbidities.Shanghai has experienced a wave of infection with Omicron,a new variant of SARS-CoV-2,since March 2022.There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers,public health officials,researchers,and the general public.AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group(82 patients)and a nonsevere group(246 patients)according to the diagnosis and treatment protocol of COVID-19(version 7).The clinical data and laboratory results of both groups were collected and compared.A chi-square test,t test,Mann-Whitney U test,hierarchical log-rank test,univariate and multivariate logistic regression,and hierarchical analyses were used to determine significant differences.RESULTS The severe group was older(84 vs 74 years,P<0.001),included more males(57.3%vs 43.9%,P=0.037),had a lower vaccination rate(P<0.001),and had a higher proportion of comorbidities,including chronic respiratory disease(P=0.001),cerebral infarction(P<0.001),chronic kidney disease(P=0.002),and neurodegenerative disease(P<0.001),than the nonsevere group.In addition,severe disease patients had a higher inflammatory index(P<0.001),greater need for symptomatic treatment(P<0.001),longer hospital stay(P=0.011),extended viral shedding time(P=0.014),and higher mortality than nonsevere disease patients(P<0.001).No difference was observed in the application of Paxlovid in the severe and nonsevere groups(P=0.817).Oxygen saturation,cerebral infarction,and D-dimer were predictive factors for developing severe disease in patients with COVID-19,with D-dimer having an excellent role(area under the curve:90.1%,95%CI:86.1-94.0%).In addition,D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.CONCLUSION The clinical course of severe COVID-19 is complex,with a higher need for symptomatic treatment.D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.
文摘目的分析新型冠状(新冠)病毒感染后分泌性中耳炎(otitis media with effusion,OME)发病情况及临床特点。方法回顾性选取2018年12月至2019年1月、2021年12月至2022年1月、2022年12月至2023年1月中国人民解放军总医院第九医学中心耳鼻喉科门诊就诊患者21454例,其中OME患者201例。根据北京地区疫情流行及政府管控政策(公共场所佩戴口罩、减少聚集、居家隔离、疫苗接种等)时间,将201例OME患者分为疫情前组68例(2018年12月至2019年1月)、防控期组30例(2021年12月至2022年1月)、爆发期组103例(2022年12月至2023年1月)。收集201例OME患者资料,分析新冠病毒感染相关OME人口学特征及发病特点。结果防控期组OME就诊率(0.40%)较疫情前组(0.82%)显著下降,爆发期组(1.82%)较疫情前组、防控期组升高了51.5%与243.3%,差异均有统计学意义(P<0.01)。爆发期组92.2%的OME是新冠病毒感染之后出现的,较疫情前组、防控期组上呼吸道感染导致OME在中耳炎患者中的比例升高,差异均有统计学意义(P<0.01)。爆发期组上呼吸道感染导致OME患者年龄高于疫情前组和防控期组,差异有统计学意义(P<0.01,P=0.002)。74.6%的患者在新冠病毒感染之后的1~3周发病,7.5%的患者(5/67)在感染1月后才出现耳部症状。50.7%的患者仅有耳部症状且电子鼻咽喉镜检查仅31.3%合并鼻、鼻咽部轻微炎症。结论新冠病毒感染可明显提高OME发病率,老年人患病率更高。新冠相关OME往往在感染后2周甚至更晚出现。新冠病毒有可能通过直接感染中耳引发炎症,具体机制有待进一步研究。
