Discussion on Etiology and Pathogenesis of Corona Virus Disease 2019 from“Cold-dampness and Insidious Dryness”

Based on the characteristics of the epidemic situation and the authors’understanding of the related ancient books and documents,this paper explores the etiology and pathogenesis of Corona Virus Disease 2019(COVID-19)from 5 aspects:abnormal climate in"warm winter",unique geographical location,pathogenesis evolution of cold and dampness mixed with insidious dryness,transmission and change of"triple energizer"of toxic pathogens,and game between healthy Qi and toxic pathogens.Combined with the special treatment of traditional Chinese medicine(TCM),the purpose is to make a modest contribution to curbing the epidemic situation with TCM.

The latest research progress of the Corona Virus Disease 2019 mutant strain"Omicron"

Coronavirus disease 2019(COVID-19)that broke out at the end of December 2019 has been raging for 3 years,bringing unpredictable harm to the physical and mental health of all mankind and global economic development.The new type of coronavirus pneumonia is a new type of respiratory infectious disease with a high incidence and fatality rate caused by SARS-CoV-2.Up to now,hundreds of millions of people have been infected with new coronary pneumonia worldwide,and millions of people have died.Due to the specificity of the new coronavirus itself and its high mutation rate,a series of different new coronavirus variants have appeared,which has caused the new crown pneumonia epidemic to repeat.Recently,the World Health Organization(WHO)announced a new variant"omicron"(omicron,B.1.1.529),and declared that the mutant strain may be highly infectious,antibody tolerant and highly resistant to vaccines.This article briefly reviews the latest research progress of the"omicron"variants.

Corona virus disease 2019-associated liver injury in cold regions

The corona virus disease 2019(COVID-19)pandemic has created a global health and economic crisis.Our studies uncovered that in addition to respiratory symptoms,liver damage is also common in COVID-19 patients;however,the cause of liver damage has not been fully elucidated.In this article,we summarize the clinical manifestations and pathological features of COVID-19 reported in published relevant studies and delineate the etiology and pathogenesis of COVID-19-related liver injury.We speculate that cold stimulation may be associated with COVID-19-related liver injury,which should be considered in clinical decision-making and treatment of COVID-19 in cold regions.

Bibliometric analysis of nursing studies on Corona Virus Disease 2019 in China

Objective:To analysis the current status and research focus of Corona Virus Disease 2019(COVID-19)nursing research in China.Methods:China National Knowledge Infrastructure(CNKI),WanFang,Chinese Scientific Journals Database(VIP)and Chinese Biomedical Literature Service System(SinoMed)databases were searched for the literatures on COVID-19 nursing published from January 1,2020,to May 15,2020.The Bibliographic Items Co-occurrence Matrix Builder was used to perform bibliometric analysis on journals,authors,keywords,etc.of the articles,and SPSS 23.0 was utilized to cluster analysis of high-frequency keywords.Results:A total of 458 related articles and 429 first authors were extracted.There articles were published most in the journal of Chinese General Practice Nursing(12.25%).33 high-frequency keywords were extracted such as“COVID-19”,“nurse”,etc.,accounting for 50.19%of the total frequency.Co-word cluster analysis obtained four research hotspots:the psychological status and psychological care of medical staff fighting COVID-19;the nursing strategy of critically ill patients with COVID-19 and the psychological experience of nurses against COVID-19;operating room emergency management and infection prevention during epidemic;the triage management of novel coronavirus infection in fever clinic.Conclusion:The psychological status,the nursing strategy on critically ill patients,the psychological experience of nurses,operating room emergency management and infection prevention,the triage management of novel coronavirus infection in fever clinic had become hot topics when facing the COVID-19 epidemic.

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Interpretation of the Traditional Chinese Medicine portion of the diagnosis and treatment protocol for corona virus disease 2019(Trial Version 7)

The TCM protocol in the Diagnosis and Treatment Protocol for corona virus disease 2019(COVID-19)(Trial Version 7) has been updated from previous versions. The protocol was formulated under the direct leadership of the National Administration of Traditional Chinese Medicine, based on the experience of a panel of experts, supported by evidence from fever clinics and from the outcomes of emergency(EM) observation rooms and inpatients throughout China(especially in Wuhan, Hubei Province) in combination with the latest scientific research results and data. The present interpretation of the TCM protocol is based on an overall understanding of the revised content, and aims to guide and standardize its clinical application to provide a reference for clinicians.

Treatment of pulmonary fibrosis in one convalescent patient with corona virus disease 2019 by oral traditional Chinese medicine decoction:A case report

After one-month of oral treatment with traditional Chinese medicine decoction,without using other drugs,the lung inflammatory exudate,pulmonary fibrosis and quality of life of a 61-year-old female patient with corona virus disease 2019(COVID-19)were significantly improved.No recurrence or deterioration of the patient’s condition was found within seven weeks of treatment and follow-up,and no adverse events occurred,indicating that oral Chinese medicine decoction was able to improve the pulmonary inflammation and fibrosis in a patient recovering from COVID-19,but further research is still needed.

Expert Consensus on Prevention and Treatment of COVID-19 Infection in Patients with Lung Cancer

Corona virus disease 2019(COVID-19)infection has become a major public health issue affecting human health.The main goal of epidemic prevention and control at the current stage in China is to“protect people’s health and prevent severe cases”.Patients with lung cancer who receive antitumor therapy have low immunity,and the risk of severe illness and death once infected is much higher than healthy people,so they are vulnerable to COVID-19 infection.At present,less attention has been paid to the prevention and treatment of COVID-19 infection in patients with lung cancer in domestic guidelines and consensus.Based on the published data in China and abroad,we proposed recommendations and formed expert consensus on the vaccination of COVID-19,the use of neutralizing antibodies and small molecule antiviral drugs for patients with lung cancer,for physician’s reference.

Acquired immune thrombotic thrombocytopenic purpura(TTP)associated with inactivated COVID-19 vaccine CoronaVac

Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after administration of mRNA-or adenoviral vector-based COVID-19 vaccines,including Ad26.COV2-S,BNT162b2,mRNA-1273,and ChAdOx1 nCov-19.However,whether inactivated vaccines,such as CoronaVac,could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown.In this study,two cases were reported.Both cases developed TTP after the second CoronaVac vaccination shot,but not the first.They demonstrated symptoms of fever,neurological abnormalities,renal dysfunction,thrombocytopenia,and hemolysis.Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression.The incidence of TTP in Nanjing area was analyzed.The number of patients with TTP was 12 in 2019,6 in 2020,16 in 2021,and 19 in 2022.To the authors’knowledge,this report is the first report of TTP associated with inactivated COVID-19 vaccine(CoronaVac).The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones.Timely plasma exchange is a vital treatment for CoronaVac-related TTP,similar to activated vaccine-related TTP.

Clinical andTransmission Characteristics of COVID-19-A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department

The outbreak of corona virus disease 2019(COVID-19)imposes a major challenge in managing patients undergoing surgical operation.In this study,we analyzed clinical and transmission features of 25 cases of COVID-19 from a single thoracic department,including 13 patients and 12 health care staff.There were 13 males and 12 females.The median age of the patients was 61(range:51 to 69)years.The median age of the health care staff was 35(range:22 to 51)years.By the end of follow-up date(Mar.3,2020),there were 16 non-severe cases(64%)and 9 severe cases(36%),5 cases were dead(20%).Nineteen(76%)of the infected cases were confirmed by SARS-CoV-2 nucleic acid test,the rest were clinically diagnosed as suspected COVID-19 cases,and 19(76%)of the infected cases had positive exposure history.We found that COPD was significantly associated with severity and death(P-0.040,and P=0.038,respectively),and chest operation was significantly associated with death for COVID-19 patients(P-0.039).A potential“super spreader"may be the source of the transmission before the implementation of quarantine and comprehensive protcction.It was concluded that COVID-19 is associated with poor prognosis for patients undergoing thoracic operation,especially for those with COPD.Implementation of comprehensive protective measures is important to control nosocomial infection.

Impact of Azithromycin on Forsythiaside Pharmacokinetics in Rats:A Population Modeling Method

Objective:Lianhuaqingwen and Shuanghuanglian are drug treatment options for Corona Virus Disease 2019(COVID-19).In China,use of traditional Chinese medicine with Shuanghuanglian or Lianhuaqingwen(for them,forsythiaside is the active antiviral and antibacterial component)in combination with azithromycin is common for the treatment of pediatric pneumonia.It is important to understand the reason why the combination of these compounds is better than a single drug treatment.This study aimed to explore the pharmacokinetic interaction between forsythiaside and azithromycin.Methods:Twelve male Sprague-Dawley rats were randomly divided into an experimental group(Forsythia suspensa extract and azithromycin)and a control group(a single dose of Forsythia suspensa extract in 5%glucose solution).Plasma samples were collected at scheduled time points,and the high-performance liquid chromatography combined with ultraviolet method was used to determine the plasma forsythiaside concentration.Non-compartmental analysis and population pharmacokinetic methods were used to investigate the forsythiaside pharmacokinetic difference between the experimental and control group.Results:Compared with a single administration,the area under the curve and half-life of forsythiaside increased,and forsythiaside clearance decreased significantly after co-administration with azithromycin.The in vivo behavior of forsythiaside could be described by the one compartment model.The forsythiaside clearance decreased when combined with azithromycin.Visual evaluation and bootstrap results suggested that the final model was precise and stable.Conclusion:Co-administration of azithromycin can significantly decrease the forsythiaside clearance and increase drug exposure.A lower dose of azithromycin can obtain sufficient forsythiaside concentration to provide antiviral and antibacterial activity.

SARS-CoV-2 effects in the genitourinary system and prospects of sex hormone therapy

Object:Corona virus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which leads to acute respiratory infection symptoms.SARS-CoV-2 infection is not always limited to the respiratory tract,and renal infection and dysfunction have been shown to be specific risk factors for death.In addition,COVID-19 has a higher incidence,severity and mortality in men than women.This disparity is due to biological rather than comorbid or behavioral sex differences.Because the male reproductive system is unique,the function of sex hormones in COVID-19 infection may explain the differences between males and females.Understanding these factors will provide appropriate prevention measures and adequate triage strategies and guide the drug discovery process.Methods:An electronic search was completed in PubMed,ARXIV,MEDRXIV and BIORXIV.The most relevant articles were systematically reviewed.In addition,single cell RNA sequencing analysis of tissue samples from human cell landscape was conducted.Results:The influence of SARS-CoV-2 on the urogenital system,the possibility of urinary tract transmission and the functions of sex hormones were discussed in this review.Conclusion:Corona viruses can invade the genitourinary system,causing urological symptoms.Identifying the potential genitourinary organ impairments and protecting them from damage are necessary.Since sex hormones have potential as specific drugs,the gonadal hormones substitution therapy should be considered in both sexes in the COVID-19 pandemic.

Is There a Link between Circadian Clock Protein PERIOD 3 (PER3) (rs57875989) Variant and the Severity of COVID-19 Infection?

Objective:Corona Virus Disease-2019(COVID-19)has been among the major infectious events of the century.In today’s literature where COVID-19 and host factor effects are frequently examined,we aimed to examine another factor:Circadian Clock Protein PERIOD 3(PER3).There is a significant correlation between PER3 gene polymorphism and circadian rhythm disturbances and immune system dysregulation.Methods:In our study,we recruited 200 patients diagnosed with COVID-19 in our hospital between April-June 2020,and 100 volunteers without known comorbidities to create a healthy control group.After comparing the initial gene polymorphisms of the patients with healthy controls,three separate clinical subgroups were formed.Gene polymorphism distribution and statistical significance were examined in the formed patient groups.Results:No significant difference was found between the patient group and the healthy controls(P>0.05,for all).When patients were divided into two separate clinical subgroups as exitus/alive according to their last condition during their 28-day follow-up,the 4R/5R genotype was significantly more common in patients with a mortal course(P=0.007).The PER34R75R genotype was found at a significantly higher rate in the group of patients with the need for intensive care(P=0.034).Conclusion:The 4R/5R genotype may be associated with the need for intensive care and mortality in COVID-19 patients.These important results will be a guide for future studies.

Recommended prophylactic and management strategies for severe acute respiratory syndrome coronavirus 2 infection in transplant recipients

Since December 2019.increasing attention has been paid to the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)epidemic in Wuhan,China.SARS-CoV-2 primarily invades the respiratory tract and lungs,leading to pneumonia and other systemic disorders.The effect of SARS-CoV-2 in transplant recipients has raised significant concerns,especially because there is a large population of transplant recipients in China.Based on the current epidemic situation,this study reviewed publications on this virus and coronavirus disease 2019(COVID-19),analyzed common features of respiratory viral pneumonias,and presented the currently reported clinical characteristics of COVID-19 in transplant recipients to improve strategies regarding the diagnosis and treatment of COVID-19 in this special population.

Framework for COVID-19 Segmentation and Classification Based on Deep Learning of Computed Tomography Lung Images

Corona Virus Disease 2019(COVID-19) has affected millions of people worldwide and caused more than6.3 million deaths(World Health Organization, June 2022). Increased attempts have been made to develop deep learning methods to diagnose COVID-19 based on computed tomography(CT) lung images. It is a challenge to reproduce and obtain the CT lung data, because it is not publicly available. This paper introduces a new generalized framework to segment and classify CT images and determine whether a patient is tested positive or negative for COVID-19 based on lung CT images. In this work, many different strategies are explored for the classification task.ResNet50 and VGG16 models are applied to classify CT lung images into COVID-19 positive or negative. Also,VGG16 and ReNet50 combined with U-Net, which is one of the most used architectures in deep learning for image segmentation, are employed to segment CT lung images before the classifying process to increase system performance. Moreover, the image size dependent normalization technique(ISDNT) and Wiener filter are utilized as the preprocessing techniques to enhance images and noise suppression. Additionally, transfer learning and data augmentation techniques are performed to solve the problem of COVID-19 CT lung images deficiency, therefore the over-fitting of deep models can be avoided. The proposed frameworks, which comprised of end-to-end, VGG16,ResNet50, and U-Net with VGG16 or ResNet50, are applied on the dataset that is sourced from COVID-19 lung CT images in Kaggle. The classification results show that using the preprocessed CT lung images as the input for U-Net hybrid with ResNet50 achieves the best performance. The proposed classification model achieves the 98.98%accuracy(ACC), 98.87% area under the ROC curve(AUC), 98.89% sensitivity(Se), 97.99 % precision(Pr), 97.88%F-score, and 1.8974-seconds computational time.

Bullectomy used to treat a patient with pulmonary vesicles related to COVID-19:A case report

BACKGROUND The corona virus disease 2019(COVID-19)has been a pandemic for more than one year and estimated to affect the whole world in the near future.CASE SUMMARY Here we reported that one COVID-19 patient with vesicles was treated by bullectomy.The patient’s perioperative laboratory tests were analyzed.The pathological findings of bullectomy were described and compared with those of common bulla cases.CONCLUSION This patient with vesicles underwent bullectomy and had a poor prognosis.He showed diffuse alveolar damage and extensive necrosis in bullectomy specimen.We hope our report will be of interest for clinicians who will treat COVID-19 patients in the future.

Discussion on prevention and control of COVID-19 by non-drug methods in traditional Chinese medicine

COVID-19 has been discovered since December 2019 and has become a global pandemic recently,killing hundreds of thousands of people in 216 countries and regions around the world.COVID-19 has caused more than 4000 deaths in China,seriously affecting national health and national economy.Since the outbreak of COVID-19,National Health Commission of the People's Republic of China has used the method of sino-western medicine to prevent and control COVID-19,effectively curbed the spread of the epidemic.But the TCM methods in the scheme are all oral prescriptions,less involving non-drug methods.Therefore,I searched the COVID-19 control methods published in various parts of the country,this paper plans to discuss how to improve immunity from the perspective of non-drug methods such as moxibustion,diet therapy,self massage,physical exercise skills and traditional music,hoping can helps the susceptible populations,infected,discharged and medical staff in COVID-19 epidemic.

The potential mechanism of prevention and treatment of COVID-19 by shufeng jiedu capsule was studied based on network pharmacology

Objective: To investigate the mechanism of Shufeng Jiedu Capsule(SJC) for treatment of COVID-19 based on network pharmacology. Methods: Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) was used to obtain the active components and targets information of Polygoni Cuspidati Rhizoma Et Radix, Forsythiae Fructus, Istidis Radix, Radix Bupleuri, Herba Patriniae, Verbenae Herb, Phragmitis Rhizoma and licorice in SJC. The Genecards databases were used to obtain COVID-19 targets. The meridian tropisms of each herb in SJC were collected from ETCM Database.the proteins interations network were build by STRING database. The GO and KEGG pathways were analyzed by the computer R language. Results: SFC contains 8herbs, 176 compounds and the corresponding targets 237. 48 COVID-19 targets are treated by SJC. Such as IL-10, IL-6, PTGS1, PTGS2, GSK3B, STAT-1, IL-17 signaling pathway, HIF-1 signaling pathway, Toll-like receptor signaling pathway, T cell receptor signaling pathway and VEGF signaling pathway may be potential targets and signaling pathways for the prevention and treatment of COVID-19. Conclusion: The COVID-19 cantreatmented the potential targets and signaling pathways by the SJC, and play the role of antipyretic, anti-inflammatory, balance immunity, antiviral and so on. It will provide strong support for the later stage experiment and clinical application of SJC.

Role of Radiological Investigations of COVID-19 Patients with Pneumonia, Karachi Pakistan

The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasound. This was a retrospective study conducted on 105 COVID-19 patients with symptoms of fever, cough, dyspnea, loss of sense of smell and taste, body ache. Diagnostic tests PCR were positive for COVID-19 included from Medicare Cardiac and General Hospital and Jinnah Medical College Hospital Korangi (JMCH) from April to November 2020. Written informed consent was taken from all participants. This study was approved by ethical review committee, Jinnah Medical & Dental College. Real time-PCR (RT-PCR) was done for the confirmation. Radiological imaging including Chest X-ray, HRCT chest, and ultrasound was done to study the severity of symptoms. Sixty-five patients had mild to moderate symptoms with oxygen saturation between 96% - 98% and 30 patients with severe pneumonia had between saturation 50% - 55%. Patients with mild symptoms were followed up by chest X-ray showing mostly normal chest X-rays but single or patches of ground glass opacities (HRCT). HRCT of 10 patients with low oxygen saturation 50% were already done showing bilateral peripheral patchy consolidation predominantly involving mid and lower lobes. 3 patients presented with patchy lung opacities and ultrasound showing similar findings with pleural effusion and ascites. Radiological imaging, specially CT-Scan was highly significant for diagnosing COVID-19 and severity of infection even in patients with negative PCR. Chest X-ray and ultrasound were also found to be a very useful tool.

Contribution of the Advanced Research Laboratories at the Noguchi Memorial Institute for Medical Research (NMIMR) to SARS-CoV-2 Testing in Ghana

In March 2020, the first cases of SARS-CoV-2 were reported in Accra, Ghana. These initial cases were diagnosed at the Advanced Research Laboratories (ARL) of the Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana. The ARL which hitherto was used for routine clinical research in viral, bacteria and immunological studies has since been the facility of choice for testing for all suspected cases of COVID-19 submitted from across Ghana and beyond. The success of testing at the ARL hinged on the availability of several laboratory spaces furnished with state-of-the-art diagnostic equipment and working aids. During the “peak season” where overwhelming numbers of clinical specimens were received, the ARL processed and got results for close to four thousand samples daily. After general disinfection and re-bagging into smaller numbers, at the entrance of the ARL, the samples are taken to a central receiving laboratory, where they are received and entered in a database with accompanying case investigation forms. All samples that are successfully sorted and matched are sent to general laboratories for nucleic acid extraction and then referred to the Instrumentation laboratory for real time reverse-transcription polymerase chain reaction (RT-PCR). When the RT-PCRs were completed, results were analysed and transmitted via email and/or local network to the data reporting office. The data managers then reported results to the investigators and the Ghana Health Service (GHS). Additionally, the ARL provided a next-generation Genome Sequencing platform in partnership with the West African Centre for Cell Biology of Infectious Pathogens at the University of Ghana, which was essential in reporting the genome data of the circulating variants of SARS-CoV-2 in Ghana. Conclusively, it is worth noting, that the NMIMR fulfilled its mandate of supporting the country with specialized diagnostics through the judicious use of the ARL for SARS-CoV-2 testing, from sample receipt to data reporting. The ARL facility and the research faculty have trained and continue to train budding laboratories on biosafety, biosecurity, best practices and testing protocols. It is obvious that the success story of SARS-CoV-2 testing in Ghana, cannot be complete without the mention of the ARL at NMIMR.