Centralization and perceived control of COVID-19 during the pandemic:A cross-sectional study

Objective:To uncover the impact of centralization of COVID-19 and perceived control of COVID-19 on society during the pandemic.Methods:We recruited a total of 1041 people in this cross-sectional study.The data were collected using a questionnaire booklet covering demographics,a COVID-19-related information form,the Centrality of Event Scale,and the Perception of Control of COVID-19 Scale.We utilized independent samples t-test,chi-square test,and one-way analysis of variance to analyze the data.Results:1041 questionnaires were collected and no questionnaire were excluded from our study.Slightly more than half of the participants(51.2%)stated that social isolation impaired public mental health,while 30.1%reported adverse impacts of the pandemic on their sleep quality.Participants with changes to their sleep patterns were found to centralize COVID-19 more.Moreover,measures against COVID-19 and constant announcements of the daily number of cases in the media brought both positive and negative effects on people and further contributed to the participants’centralization of COVID-19.Individuals with low centralization scores were concluded to perceive COVID-19 as a minor disease.Healthcare professionals without a relative diagnosed with COVID-19 and those satisfied with treatment opportunities had a higher perceived control of COVID-19,while those who were not interested in statistical data on COVID-19 and who had difficulty complying with the rules had a lower perceived control of COVID-19.Besides,poorer perceived control of COVID-19 was found to adversely affect sleep quality.Furthermore,healthcare professionals scored higher on the inevitability subscale of the Perception of Control of COVID-19 Scale.Finally,among the participants,most COVID-19 survivors thought COVID-19 to be an avoidable disease.Conclusion:In addition to its physical impacts,COVID-19 adversely impacts on mental health,and these effects are closely linked to a society’s centralization of COVID-19 and perceived control of COVID-19.

Management experience of care workers during epidemic prevention and control of COVID-19

Since the rapid spread of COVID‑19,our hospital has actively implemented the idea of“preventing the coronavirus from entering.”We paid close attention to details,rapidly carried out personnel and material management at all levels,and strived to do a good job in the prevention and control of the epidemic,so as to achieve zero infection.Patients’carers are an important part of quality care.Lacking of protection knowledge of infectious diseases would increase the risk of nosocomial infection.Therefore,our nursing department set up a team of epidemic prevention and control management.The team made the revision on contingency plans and care management regulations during the outbreak of COVID‑19,strengthened epidemic prevention and control knowledge training,carried out the supervision inspection work,and paid attention to humanized management measures to provide an important guarantee for victory over the COVID‑19.

Diagnosis and Treatment and Infection Protection Strategy of Osteoporotic Vertebral Compression Fractures Minimally Invasive Percutaneous Kyphoplasty Surgery during the Prevention and Control of COVID-19

Background: As the global novel coronavirus pneumonia (NCP) remains severe, elderly people are at high risk for NCP and osteoporotic vertebral compression fractures, with high complications and mortality. How to treat patients and protect medical staff from infection, and at the same time strictly prevent the occurrence of clustered transmission events in the hospital, the establishment of perfect pre-hospital emergency measures and infection prevention and control strategy is the first element to ensure success. Objective: To establish the diagnosis and treatment and infection protection strategy for Osteoporotic vertebral compression fractures (OVCF) patients undergoing minimally invasive percutaneous kyphoplasty (PKP) surgery during the prevention and control of COVID-19, so as to ensure the stable, orderly and safe medical treatment. Methods: A total of 583 OVCF patients were admitted to the First Affiliated Hospital of Hebei North University during the epidemic prevention and control period from January 2020 to July 2022. After urgent and outpatient strict standardized screening, 382 patients met the inclusion criteria, including 112 males and 270 females, aged (70.50 ± 5.49) years. The preoperative visual analogue scale (VAS) score was 6.92 ± 1.86. Preoperative Oswestry disability index (ODI) was 74.67 ± 4.84. The satisfaction rate was (45.89 ± 3.67) %. According to the clinical diagnostic criteria and classification, 367 patients were diagnosed as ordinary OVCF, including 156 cases of mild compression and 226 cases of moderate compression. The clinical classification of 15 patients with OVCF diagnosed as COVID-19 was type I, including 10 cases of mild COVID-19 and 5 cases of common COVID-19. All patients were treated with PKP. Results: All patients were followed up at 1 day, 1 month and 3 months after operation, VAS (2.01 ± 0.56, 0.45 ± 0.11, 0 ± 0), ODI (45.41 ± 4.15, 10.22 ± 2.73, 4.03 ± 1.57) and satisfaction (90.12%, 95.57%, 99.23%) were significantly improved compared with those before operation (p < 0.05), and the original medical diseases were not aggravated. In this group, 15 cases of OVCF diagnosed with COVID-19 were given priority to treat COVID-19 under strict three-level protection in the designated isolation ward. PKP was carried out after the condition was stable, and the areas, items and personnel in contact with patients during the perioperative period must be strictly and thoroughly disinfected. The patient had a good prognosis, no complications, no cross-infection in the hospital, and no infection rate among medical staff. Conclusions: The implementation of the diagnosis and treatment and infection protection strategy for OVCF patients undergoing minimally invasive PKP surgery during the prevention and control of COVID-19 has a guiding role in preventing the spread of infection, improving the cure rate, promoting rapid recovery, reducing complications and reducing mortality.

Analysis of the application of five tone therapy in the prevention and control of COVID-19

The new coronavirus variant Omicron spread in China this time has the characteristics of strong transmission,short infection incubation period and mild symptoms.In order to effectively prevent and control the epidemic,medical staff,public security,volunteers and other staff are facing great challenges.At the same time,due to the unknown of the disease and many conditions such as home isolation,the entire society has a lot of social anxiety and sadness.Music therapy is an important supplement for the treatment of mental and behavioral disorders.This commentary takes the prevention idea of"preventing disease"as the basic principle to analyze the application of five-tone therapy to the mitigation and control of Coronavirus disease 2019.It is a method worth popularizing and applying.

Modeling and optimal control of COVID-19 with comorbidity and three-dose vaccination in Indonesia

This paper presents and examines a COVID-19 model that takes comorbidities and up to three vaccine doses into account.We analyze the stability of the equilibria,examine herd immunity,and conduct a sensitivity analysis validated by data on COVID-19 in Indonesia.The disease-free equilibrium is locally and globally asymptotically stable whenever the basic reproduction number is less than one,while an endemic equilibrium exists and is globally asymptotically stable when the number is greater than one.Subsequently,the model incorporates two effective measures,namely public education and enhanced medical care,to determine the most advantageous approach for mitigating the transmission of the disease.The optimal control model is then determined using Pontryagin’s maximum principle.The integrated control strategy is the best method for reliably safeguarding the general population against COVID-19 infection.Cost evaluations and numerical simulations corroborate this conclusion.

Practice of Infection Prevention and Control Strategies in Risk Departments during the COVID-19 Epidemic

Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.

Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19:A randomized placebo-controlled trial

Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).Conclusion: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.

Combined prevention and treatment measures are essential to control nosocomial infections during the COVID-19 pandemic

Severe acute respiratory syndrome coronavirus-2 is a highly contagious positive-sense,single-stranded RNA virus that has rapidly spread worldwide.As of December 17,2023,772838745 confirmed cases including 6988679 deaths have been reported globally.This virus primarily spreads through droplets,airborne transmission,and direct contact.Hospitals harbor a substantial number of confirmed coronavirus disease 2019(COVID-19)patients and asymptomatic carriers,accompanied by high population density and a larger susceptible population.These factors serve as potential triggers for nosocomial infections,posing a threat during the COVID-19 pandemic.Nosocomial infections occur to varying degrees across different countries worldwide,emphasizing the urgent need for a practical approach to prevent and control the intra-hospital spread of COVID-19.This study primarily concentrated on a novel strategy combining preventive measures with treatment for combating COVID-19 nosocomial infections.It suggests preventive methods,such as vaccination,disinfection,and training of heathcare personnel to curb viral infections.Additionally,it explored therapeutic strategies targeting cellular inflammatory factors and certain new medications for COVID-19 patients.These methods hold promise in rapidly and effectively preventing and controlling nosocomial infections during the COVID-19 pandemic and provide a reliable reference for adopting preventive measures in the future pandemic.

基于CiteSpace及VOSviewer的COVID-19相关心律失常的文献计量学分析

目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。

麻杏石甘汤干预COVID-19肺炎的网络药理学研究及分子对接分析

目的:运用网络药理学与分子对接研究方法探讨麻杏石甘汤干预COVID-19肺炎的作用机制。方法:经TCMSP、HTDocking数据库检索麻杏石甘汤所有药物的成分并进行ADME筛选得到活性成分,在Uniport数据库检索其发挥治疗作用可能的基因靶点;借助GeneCards、PharmGKB等数据库检索COVID-19肺炎相关基因靶点,利用Cytoscape软件构建药物-活性成分-靶基因-疾病网络;借助String系统构建PPI网络,并进行拓扑学特征分析,筛选核心基因;利用R语言的clusterProfiler包对核心基因进行GO、KEGG富集分析;利用AutoDock Vina软件对疾病靶蛋白及药物活性成分进行分子对接验证。结果:共筛选出麻杏石甘汤与COVID-19肺炎交集基因靶点67个。PPI网络分析显示,其发挥治疗作用的核心基因靶点有MAPK1、MAPK3、STAT1、JUN等8个。GO富集分析显示,相关生物过程1863个,分子功能95个,细胞成分36个;KEGG富集分析显示,相关作用通路167条。分子对接结果显示,麻杏石甘汤活性成分槲皮素、山奈酚、熊果酸等与核心基因靶点JUN、MAK1、IL2等有较好的结合活性。结论:麻杏石甘汤可能以槲皮素、山奈酚等为物质基础,多成分、多靶点、多通路、相互协同发挥抑制病毒活性,降低炎症反应,保护肺部组织,从而对COVID-19肺炎起到积极的干预作用。

COVID-19诊疗信息、中医证型分布及组方用药规律的文献研究

目的利用数据挖掘技术深入探究新型冠状病毒感染(COVID-19,简称新冠感染)患者的诊断、中医证型分布以及药物使用规律,以期为中医药治疗新冠感染提供有效的参考依据。方法通过搜索,可以获取来自国家卫生健康委员会和全国各地的《新型冠状病毒肺炎诊疗方案》内涉及的中医证型和中医药防治方案,以及中国生物医学文献服务系统、知网、维普、万方数据库收录的治疗新冠感染相关文献共249份。对文献通过筛选、整理和去重并建立中药复方数据库、诊疗信息数据库、证型数据库,运用频数分析、频率分析进行探究。结果新冠感染患者常见的症状频数较高的为咳嗽、咽干咽痛、发热、纳差、乏力;大多数患者呈淡红舌、红舌,脉象为滑脉、滑数脉;中医证型频数较高的有湿毒郁肺证、湿热蕴肺证、肺脾气虚证、寒湿郁肺证、气阴两伤证、兼夹瘀血证。此外,共纳入491首治疗新冠感染中药复方,涉及中药227味,得到高频中药共64个,药物类别以清热药、补益药、解表药、化痰止咳平喘药、化湿药为主;药性以温、平、寒为主,药味以甘、辛、苦为主,归经中归肺、脾、胃经中药居多;聚类分析结果根据中药性能将治疗新冠感染的高频药物聚为8类较好。结论中医药治疗新型冠状病毒感染用药具有以下特点:补益药用药次数较多体现攻邪不忘扶正;解表、清热、攻下、化湿、利湿、渗湿药物俱全体现多种逐邪之法;药类以清热药、补益药、化湿药、化痰止咳平喘药、解表药为主,彰显新冠感染基本治法为清热化湿、止咳平喘、补养气阴。可为指导临床用药及研发新药提供一定的参考与借鉴。

低频脉冲磁场诱导TRPC1改善COVID-19患者康复期下肢的肌肉无力症状

背景:肌肉无力是新型冠状病毒(COVID-19)感染后的常见症状,影响康复期人体日常活动能力。在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激下可通过诱导和激活经典瞬时感受器电位通1(classical transient receptor potential channel 1,TRPC1),提升人体骨骼肌的最大自主收缩力与力量耐力,对肌肉组织产生一系列生理支持效应,该手段是否会改善新型冠状病毒肺炎患者康复期的肌无力症状尚无研究。目的:选用低频脉冲磁场对新型冠状病毒肺炎患者下肢肌群进行磁刺激,以观察该刺激对新型冠状病毒肺炎患者康复期下肢肌群肌无力改善的影响。方法:招募胶体金法抗原检测试剂(COVID-19)为阳性并伴有肌肉无力症状的新型冠状病毒(奥密克戎毒株)感染患者14例,将所有受试者随机分成2组,分别为接受磁场刺激的试验组和接受假治疗的对照组。试验总时长3周,试验组每隔48 h对腿部进行低频脉冲磁刺激,对照组与试验组干预流程一致但给予假刺激,两组患者均不被告知磁刺激仪器是否运行,两组患者共进行9次操作,随后观察两组患者下肢局部肌群最大自主收缩力、腿部爆发力与力量耐力的变化情况。结果与结论:①在采集的8个局部肌群中,试验组患者7个局部肌群在经过3周的低频脉冲磁场刺激,最大自主收缩力值均增长。对照组除3个肌群最大自主收缩力自行增长改善以外,其他肌群肌力无提升。②试验组的左腿前群与双腿后群提升率显著高于对照组。③两组的纵跳摸高高度与膝关节峰值角速度相比试验前测均提升,试验组摸高高度提升率高于对照组。④在疲劳状态下,试验组膝关节峰值角速度下降率显著下降,对照组膝关节峰值角速度下降率无显著性变化;试验组摸高高度下降率显著下降,而对照组摸高高度下降率无显著性变化。⑤上述数据证实,在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激方案下,新型冠状病毒肺炎患者在康复期经过3周的低频脉冲磁场刺激相比人体自愈过程可使更多的下肢局部肌群肌力获得提升,对基于腿部爆发力的全身协调发力能力及功能状态明显改善。因此,低频脉冲磁场刺激可作为一种改善新冠感染患者下肢肌肉无力症状的有效、非运动的康复手段。

COVID-19疫情前后28个国家生育率变化及影响因素研究:线性模型和中断时间序列分析

目的分析COVID-19疫情暴发前后不同国家经季节和日历调整后的生育率(seasonally and calendar adjusted fertility rate,SAFR)趋势的变化及其影响因素。方法使用国际人类生育力数据库(Human Fertility Database,HFD)中28个国家自2012年1月至2022年12月的月度SAFR数据,以2020年12月(2020年3月疫情暴发起点加9个月妊娠过程)为节点划分为疫情前(2012.1-2020.11)和疫情后(2020.12-2022.12)进行比较,使用中断时间序列方法分析各国疫情前后的SAFR趋势(短期波动和长期趋势)是否发生变化,使用秩和检验分析疫情前SAFR、人均GDP、公共卫生和社会措施(public health and social measures,PHSM)和失业率是否与SAFR趋势变化有关。结果疫情后28个国家中19个国家的SAFR出现短期下降,随后反弹。对于长期趋势,2个国家由下降趋势转为上升趋势,8个国家由上升趋势转为下降趋势,6个国家的SAFR保持不变。SAFR变化率下降主要集中在部分中欧国家以及地中海西岸的国家,而SAFR变化率增加的国家主要分布在北欧以及西欧地区。SAFR无短期波动的国家疫情前的SAFR低于有短期波动的国家(P=0.041),SAFR变化率下降国家的疫情前SAFR(P=0.005)与人均GDP(P=0.027)均低于SAFR变化率上升国家。未发现SAFR短期波动或长期趋势与PHSM严重程度指数或失业率存在关联。结论COVID-19疫情对28个国家的SAFR造成了不同的短期和长期影响,特别是经济水平和疫情前SAFR相对较低的国家可能更易遭到进一步打击。COVID-19疫情对各国人口的更长期影响值得进一步关注。

显微镜下多血管炎相关间质性肺病合并COVID-19患者疫苗保护作用初探

目的分析显微镜下多血管炎(MPA)相关间质性肺病(ILD)患者合并新型冠状病毒肺炎(COVID-19)的临床特征,初步探究新型冠状病毒(SARS-CoV-2)疫苗的保护作用。方法纳入确诊的MPA-ILD患者,同时符合《新型冠状病毒感染诊疗方案(第十版)》制定的COVID-19诊断标准,且均有明确SARS-CoV-2抗原或核酸检测阳性证据。收集并分析患者临床资料,ILD影像学分型,SARS-CoV-2疫苗接种情况、临床分型及预后。结果共纳入37例MPA-ILD患者,女14例,男23例。32例在并发COVID-19时MPA病情处于缓解期,31例同时维持免疫抑制剂或生物制剂治疗。ILD的影像学类型以寻常型间质性肺炎(15例)和非特异性间质性肺炎(14例)为主,剩余8例分型不确定。COVID-19分型中,27例为轻症,5例因COVID-19死亡。11例未接种疫苗,26例接种SARS-CoV-2灭活疫苗,其中11例完成3剂次加强免疫。接种疫苗患者COVID-19轻症比例高于未接种疫苗组(P=0.038)。多因素分析显示接种疫苗为MPA-ILD患者合并COVID-19住院(OR=0.045,95%CI:0.004~0.472,P=0.010)及非轻症感染(OR=0.049,95%CI:0.005~0.517,P=0.012)的独立保护因素。同时MPA处于缓解期为COVID-19非轻症感染的保护因素(OR=0.021,95%CI:0.001~0.459,P=0.014)。结论接种SARS-CoV-2疫苗及MPA病情处于缓解期有可能减轻MPA患者合并COVID-19的严重程度。

全球COVID-19疫情主要预测模型比较分析

目的新冠感染病死率预测对于深入理解新冠病毒严重性、合理配置医疗资源及开展针对性防疫策略有重大意义。方法本研究依据新冠病毒变异优势株,将疫情发展划分四个时期,选取美国、印度、巴西、墨西哥、秘鲁、中国六个国家以及全球平均水平的病死率为研究对象。运用灰色模型、指数平滑模型、ARIMA模型、支持向量机、Prophet和LSTM模型六个模型进行拟合预测,探讨各模型的优缺点和适用性,选取效果最优的模型对全球和重点国家的病死率进行预测。结果模型比较显示多种模型各有优缺点,经预测,多数国家的累计确诊人数和累计死亡人数增长速度减缓,发展趋势逐渐平稳。结论传统时间序列模型适于发展趋势平稳、有限样本的预测;而机器学习模型更适用于波动型变化数据,可进行大样本预测,进一步外推,运用到其他卫生领域的研究。

系统性红斑狼疮合并COVID-19住院患者的临床特征分析

目的探讨系统性红斑狼疮(SLE)合并新型冠状病毒(SARS-CoV-2)感染住院患者的临床特点。方法选取2022年12月—2023年2月于南昌大学第一附属医院风湿免疫科就诊且确诊为COVID-19的SLE患者为研究对象,根据是否住院治疗将其分为未住院组和住院组,比较两组患者的人口学数据、临床症状和实验室检查结果。评估淋巴细胞/单核细胞(LMR)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、系统性免疫炎症指数(SⅡ)、SⅡ/白蛋白、红细胞沉降率/淋巴细胞(ELR)和C反应蛋白/淋巴细胞(CLR)等指标对SLE合并COVID-19患者住院的影响。结果两组患者在年龄、糖皮质激素剂量、SLEDAI评分、红细胞沉降率、C反应蛋白、血小板、淋巴细胞、白蛋白、NLR、PLR、LMR、CLR、ELR、SⅡ和SⅡ/ALB等方面存在统计学差异(P<0.05)。多因素Logistic回归分析显示,CLR(OR=1.16)、糖皮质激素剂量(OR=1.11)及SLEDAI评分(OR=1.23)为SLE合并COVID-19住院患者的临床特点。ROC曲线分析显示,CLR曲线下面积(AUC)为0.751,其灵敏度为50.0%,特异度为94.0%;糖皮质激素剂量的AUC为0.778,其灵敏度为76.9%,特异度为75.9%;SLEDAI的AUC为0.754,其灵敏度为50.0%,特异度为91.6%。结论对于SLE合并COVID-19住院患者而言,较高的CLR、糖皮质激素剂量及SLEDAI评分为其临床特点。

Mental health status among COVID-19 patients survivors of critical illness in Saudi Arabia:A 6-month follow-up questionnaire study

BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.

Hepatic angiotensin-converting enzyme 2 expression in metabolic dysfunction-associated steatotic liver disease and in patients with fatal COVID-19

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and fibrosis.Liver injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated cholangiopathy.Mechanisms of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell invasion.AIM To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe COVID-19.METHODS ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel classifiers.RESULTS ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct cholangiocytes.Strikingly,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in cirrhosis.ACE2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD spectrum.Hepatic ACE2 levels are also increased in COVID-19 patients,especially those showing evidence of LI,but are not correlated with the presence of SARS-CoV-2 virus in the liver.However,there is a clear association between the hepatic lipid droplet content and the presence of the virus,suggesting a possible functional link.CONCLUSION Hepatic ACE2 levels were elevated in nonfibrotic MASH and COVID-19 patients with LI,while lipid accumulation may promote intra-hepatic SARS-CoV-2 replication,accelerating MASLD progression and COVID-19-mediated liver damage.

Clinical application of COVID-19 vaccine in liver transplant recipients

Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related complications.Therefore,COVID-19 vaccination has been recommended to be administered as early as possible in LTRs.Data sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in PubMed.Results:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of vaccination.Although the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained unresponsive.Furthermore,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver injury.Conclusions:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.

Immunobiology of COVID-19: Mechanistic and therapeutic insights from animal models

The distribution of the immune system throughout the body complicates in vitro assessments of coronavirus disease 2019(COVID-19)immunobiology,often resulting in a lack of reproducibility when extrapolated to the whole organism.Consequently,developing animal models is imperative for a comprehensive understanding of the pathology and immunology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.This review summarizes current progress related to COVID-19 animal models,including non-human primates(NHPs),mice,and hamsters,with a focus on their roles in exploring the mechanisms of immunopathology,immune protection,and long-term effects of SARS-CoV-2 infection,as well as their application in immunoprevention and immunotherapy of SARS-CoV-2 infection.Differences among these animal models and their specific applications are also highlighted,as no single model can fully encapsulate all aspects of COVID-19.To effectively address the challenges posed by COVID-19,it is essential to select appropriate animal models that can accurately replicate both fatal and non-fatal infections with varying courses and severities.Optimizing animal model libraries and associated research tools is key to resolving the global COVID-19 pandemic,serving as a robust resource for future emerging infectious diseases.