Prediction System for Diagnosis and Detection of Coronavirus Disease-2019(COVID-19):A Fuzzy-Soft Expert System

In early December 2019,a new virus named“2019 novel coronavirus(2019-nCoV)”appeared in Wuhan,China.The disease quickly spread worldwide,resulting in the COVID-19 pandemic.In the currentwork,we will propose a novel fuzzy softmodal(i.e.,fuzzy-soft expert system)for early detection of COVID-19.Themain construction of the fuzzy-soft expert systemconsists of five portions.The exploratory study includes sixty patients(i.e.,fortymales and twenty females)with symptoms similar to COVID-19 in(Nanjing Chest Hospital,Department of Respiratory,China).The proposed fuzzy-soft expert systemdepended on five symptoms of COVID-19(i.e.,shortness of breath,sore throat,cough,fever,and age).We will use the algorithm proposed by Kong et al.to detect these patients who may suffer from COVID-19.In this way,the present system is beneficial to help the physician decide if there is any patient who has COVID-19 or not.Finally,we present the comparison between the present system and the fuzzy expert system.

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。

TCM theoretical analysis and modern pharmacological mechanism of Huashi Baidu decoction in treating severe novel coronavirus pneumonia

The main symptom elements of the severe novel coronavirus pneumonia epidemic virus closed lung syndrome are cold, damp, poisonous, heat, dryness, blood stasis, and deficiency, which mainly involve the lung and spleen, and are closely related to the heart, liver, kidney, and large intestine. Chinese medicine has accumulated rich academic theories and clinical experience in the prevention and treatment of infectious diseases. The treatment of lung syndrome recommends the use of Huashibaidu formula in the treatment of novel coronavirus pneumonia with integrated traditional Chinese and western medicine. The prescription for removing dampness and detoxification is composed of Maxingshigan formula in "Treatise on Febrile Diseases", "Tingli Dazao Xiefei formula" in "An Outline of Jinkui", Xuanbai Chengqi formula in "Diagnosis of Warm Diseases", "Medical Source Moisture" The combination of four prescriptions of Huopu Xialing formula in "On" is made according to the specific requirements. Through the composition of the prescription of Huashibaidu formula and the pharmacological research involving drugs, the mechanism of the novel coronavirus pneumonia severe epidemic closed lung syndrome may be combined with the blocking of cytokine inflammation storm, immune regulation, antispasmodic and asthma, and improvement Related to hemodynamics.

CT Imaging Evolution of Novel Coronavirus Pneumonia during Hospitalization

Object: To evaluate CT Features on serial thin-section computed tomographic (CT) scans in patients with conventional Novel Coronavirus Pneumonia (COVID-19) for the period during which they remained hospitalized. Methods: In this Retrospective study, we collected clinical information including Laboratory investigations and more importantly we focused on collecting imaging data of these 15 selected patients (8 men and 7 women, 22 - 70 years old, average age (45 ± 15)) with COVID-19 disease. The mean time between the initial and repeat thin-section CT scans was 3.3 ± 2.1 days, 7.9 ± 2.1 days, 14.2 ± 1.3 days after onset of symptoms in these 15 patients. Three experienced Radiologists reviewed the CT images independently and also in collaboration with each other for complicated or unique cases, for the Imaging characteristics like number and site of lesions, distribution of lesions whether it is lobular, lobar, unilateral or bilateral, and comparing the severity of disease in relation to the CT findings. The CT features were compared using the χ2 test and Fisher’s exact probability. Results: All of 15 patients had a history of visit to the endemic center i.e. Wuhan city or came in direct contact with an infected individual. Fever (93.3%) was the most common symptom. Majority of patients had a normal white blood cell count, and normal lymphocyte count although there were patients with leucopenia and lymphocytopenia. CT images showed predominate Ground-Glass opacities in the initial and repeat CT scans with a percentage of 90.6%, 53.9%, 44.2% respectively during the three spaced CT examinations;most patients had bilateral lung involvement (60%, 93.3%, 93.3%), the lesions predominantly involved the posterior (87.5%, 71.9%, 76.6%) and peripheral (90.6%, 84.3%, 85.7%) part of the lungs. There were more consolidation and mixed patterns in repeat CT scan Versus initial CT scan, the difference was statistically significant (P-values were < 0.001). The total lung severity score in the three aforementioned timely spaced CT scans were 36 (3.3 ± 2.1 days) 63 (7.9 ± 2.1 days), and 57 (14.2 ± 1.3 days) respectively. The median percentage of pneumonia lesions of the whole lung volume in three times CT scan was 1.69% (4.59), 3.47% (5.46), 2.33% (4.75) respectively. Besides, “Tree-in-bud” sign, lung cavitation, and lymphadenopathy were absent. Conclusion: The Thin-slice Section CT Imaging features show uniquely different characteristics, each time the scans are taken. The most common findings in our study were bilateral multiple peripheral and mostly posterior ground-glass opacities (GGO), however the CT scan images that were taken in a timely manner to follow up demonstrated some remarkable changes, which undoubtedly play an important role in the diagnosis and management of the patient with COVID-19 disease.

Radiation and Differential Diagnosis of Computed Tomography (CT) Data for Coronavirus Infection “COVID-19” with Clinical Examples

This article is presenting data from a retrospective analysis of medical records and computed tomography (CT) scans of patients’ chests with coronavirus infection “COVID-19” who applied to the diagnostic center of URFA in Osh during the first wave of the pandemic in the Kyrgyz Republic, with a description of individual clinical cases and their differential diagnosis. Chest computed tomography is one of the main methods in visual diagnosis of pneumonia in COVID-19 in hospitalized patients, which allows determining signs, symptoms for effective treatment.

Mechanism prediction analysis of an epidemic prevention sachet in preventing new coronavirus pneumonia

Objective:To explore the prevention mechanism of an anti-epidemic sachet on the new coronavirus pneumonia(COVID-19)based on the network pharmacology and molecular docking method.Methods:The chemical constituents and action targets of wormwood leaves,white peony,borneol,Rhizoma atracylodis,and Herba pogostemonis in the epidemic-preventive sachet were retrieved in TCMSP database.Query the genes of targets through the Uniprot database,and then use Cytoscape 3.7.2 software to build a medicinal drugs-active ingredients-targets(genes)network for visualization.Then we used DAVID to perform gene ontology(GO)function enrichment analysis and genome encyclopedia(KEGG)pathway analysis to predict the mechanisms of action.Draw histograms and bubble charts for visualization with Excel software and Omicshare database.The crystal structure of ACE2 was searched in the RCSB PDB database,and the compounds and proteins were molecularly docked with the help of PyMOL,AutoDockTool,and Vina software.Results:Sixty-seven effective chemical components in the anti-epidemic sachet were screened and a drugs-chemical components-targets network was constructed to obtain 948 targets,and 18 core targets and 28 core target pathways were predicted.6 compounds in Folium artemisiae argyi,13 compounds in Radix angelicae dahuricae,3 compounds in Rhizoma atracylodis,4 compounds in Fructus tsaoko,8 compounds in Herba pogostemonis,and 3 compounds in Rhizoma acori talarinowii have less binding energy with 1R42 than the ligand.Conclusion:It is predicted that the anti-epidemic sachet has prevention effects on new coronavirus pneumonia.

Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children:a retrospective multi-center cohort study during COVID-19 outbreak

Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.

COVID-19 or non-COVID viral pneumonia:How to differentiate based on the radiologic findings?

Influenza viruses were responsible for most adult viral pneumonia.Presently,coronavirus disease 2019(COVID-19)has evolved into serious global pandemic.COVID-19 outbreak is expected to persist in months to come that will be synchronous with the influenza season.The management,prognosis,and protection for these two viral pneumonias differ considerably and differentiating between them has a high impact on the patient outcome.Reverse transcriptase polymerase chain reaction is highly specific but has suboptimal sensitivity.Chest computed tomography(CT)has a high sensitivity for detection of pulmonary disease manifestations and can play a key-role in diagnosing COVID-19.We reviewed 47 studies and delineated CT findings of COVID-19 and influenza pneumonia.The differences observed in the chest CT scan can be helpful in differentiation.For instance,ground glass opacities(GGOs),as the most frequent imaging finding in both diseases,can differ in the pattern of distribution.Peripheral and posterior distribution,multilobular distribution,pure or clear margin GGOs were more commonly reported in COVID-19,whereas central or peri-bronchovascular GGOs and pure consolidations were more seen in influenza A(H1N1).In review of other imaging findings,further differences were noticed.Subpleural curvilinear lines,sugar melted sign,intra-lesional vascular enlargement,reverse halo sign,and fibrotic bands were more reported in COVID-19 than H1N1,while air space nodule,tree-in-bud,bronchiectasia,pleural effusion,and cavitation were more seen in H1N1.This delineation,when combined with clinical manifestations and laboratory results may help to differentiate these two viral infections.

Comparative Study of Traditional Chinese Medicine and Western Medicine in the Treatment of Coronavirus

Taking the process of treating coronavirus disease 2019(COVID-19)with Western medicine and traditional Chinese medicine(TCM)as the research object,this article compares the characteristics of Western medicine and TCM from the perspectives of aetiology,pathogenesis,diagnosis,and treatment.Western medicine and TCM each has its own theoretical system.Each has its own exposition in explaining the etiology and pathogenesis of the disease,and each has its own characteristics and advantages in diagnosis and treatment.Integrating TCM and Western medicine can improve the effect of treatment by forming a coordinated traditional Chinese and Western medicine treatment method.

Secondary Bacterial Organizing Pneumonia in a Patient Recovered from COVID-19 Disease: A Case Report

COVID-19 disease is a global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) that mainly presents with pneumonia, but has variable multi-systemic manifestations. Concomitant bacterial infections associated with the acute stage of COVID-19 disease have been rarely reported in the literature. However, to our knowledge, post viral organizing pneumonia (OP) secondary to bacterial infection after recovery from SARS-CoV2 infection has not been noted before. We report a 27-year-old male patient with Type 1 Diabetes Mellitus who presented with fever post recovery from COVID-19 disease for seven weeks and was found to have OP secondary to Klebsiella pneumoniae. Furthermore, the bronchoalveolar lavage was positive for SARS-CoV2 by RT-PCR despite multiple negative nasopharyngeal RT-PCR. The patient was successfully treated with antibiotics only. Therefore, we conclude that early recognition of OP secondary to bacterial infection in patients with COVID-19 disease and prompt antibiotic treatment could avoid the use of a prolonged course of steroids.

预测COVID-19感染风险的医疗决策机器学习方法研究

开发一种机器学习模型,用于预测个体是否处于受COVID-19(COrona VIrus Disease 2019)影响的危险之中,并辅助医疗决策,包括就医或选择居家隔离。基于GradientBoost、XGBoost、随机森林3种集成学习算法以及决策树、逻辑回归、支持向量机、KNN算法4种非集成学习算法,构建COVID-19风险预测模型并验证模型效能,识别COVID-19风险因素。集成学习与非集成学习模型ROC曲线下面积大致都在0.94左右。同时识别出年龄、是否是住院患者、是否携带病毒、是否怀孕、是否患有肺炎、是否插氧等重要风险因素。结果表明,在大样本量下集成学习不一定会优于非集成学习方法。

COVID-19疫情对台湾地区旅游业的影响

旅游业对政治、经济、社会、文化以及国际关系都会产生一定的影响。随着跨地域流动渐趋频繁,旅游业成为了地方化与全球化连结的重要指标。2020年伊始,新冠肺炎(COVID-19)疫情全球肆虐,台湾地区的旅游业也饱受考验。疫情影响下旅游产业发生巨变,旅游业复苏需更具弹性、重视可持续性性及包容性。在全球追求可持续性风潮、倡议气候变迁治理政策与COVID-19疫情影响之下,台湾地区旅游产业的发展可实施以下策略:1)创新旅游产业,升级核心业务:因疫情不确定性,调整并升级服务或产品;2)加速科技应用与导入:应用多元科技,解决无法面对面服务的痛点;3)转型旅游产业,吸引国际及在地游客:重新定位品牌在地化,调整商品销售与营销模式;4)转变个人化旅客消费模式,带动旅宿产业转型:数字游民(Digital Nomad)带动居家度假Staycation(stay+vacation)与工作度假Workation(work+vacation),实行生活、工作、旅游界线模糊模式,结合深度文化或自然体验;5)由环境可持续性转变为可持续旅游模式:可持续性的理念是实施环境可持续性的基石,在疫情影响下,将旅游景点与生态休养生息相结合,为动植物与环境增加新生机,提供旅客深度旅游体验规划。

新冠病症统一命名的建议

新冠疫情暴发三年多来,国内外出现多种有关新冠病症的名称,如国内有新型冠状病毒肺炎、新型冠状病毒感染等,国外有世卫组织命名的2019冠状病毒病以及倡用的新冠后症状,此外还有长新冠、新冠后综合征、新冠后遗症等较为常见的名称。目前已出现一定的混乱,需要正视。通过辨析,提出取舍意见,认为目前应与世卫组织一致,统一使用2019冠状病毒病、新冠后症状。根据术语学有关要求,同时提出规范名词的建议,为进一步审定新冠病症名称提供参考。

肺炎衣原体与新型冠状病毒共感染及其对机体炎症因子分泌水平的影响

目的明确肺炎衣原体(Cpn)与新型冠状病毒(SARS-CoV-2)共感染的特征及其对SARS-CoV-2诱导机体炎症反应的影响。方法选取2022年12月20日—2023年2月20日郴州市某医院就诊的新型冠状病毒感染(COVID-19)患者,按COVID-19严重程度将重型和危重型作为重症组,轻型和中型作为轻症组,再依据患者年龄(≥18岁为成年,<18岁为未成年)分为成年重症组、成年轻症组、未成年重症组、未成年轻症组。采用倾向性评分对重症组、轻症组患者的年龄、性别、基础疾病进行1∶1匹配。收集患者支气管肺泡灌洗液(BALF)、咽拭子及血清标本,应用酶联免疫吸附测定法(ELISA)检测Cpn IgG/IgM抗体,流式细胞术检测BALF中白细胞介素(IL)-8等12项常见细胞因子水平,并比较各组之间的差异。结果共纳入102例患者,其中重型和危重型(重症)患者61例,轻型和中型(轻症)患者41例;年龄≥18岁的患者71例,年龄<18岁未成年患者31例。成年重症组患者39例,成年轻型组患者32例,经倾向性评分成功匹配30对;未成年重症组患者22例,未成年轻型组患者9例,经倾向性评分成功匹配8对。COVID-19患者中Cpn IgG、IgM阳性率分别为36.27%(37例)、8.82%(9例),其中1例Cpn IgG和IgM同为阳性。成人重症组合并Cpn IgG阳性患者血清标本中干扰素(IFN)-α水平高于IgG阴性患者(P=0.037),两组患者BALF、血清标本中其他细胞因子水平比较差异均无统计学意义(均P>0.05);成人轻症组合并Cpn IgG阳性患者血清标本中IL-8和IL-17水平均高于Cpn IgG阴性患者(均P<0.05)。未成年轻症组合并Cpn IgM阳性患者BALF及血清标本中IL-8水平均高于Cpn IgM阴性患者(均P<0.05)。Logistic回归分析结果显示,Cpn IgG阳性和IgM阳性都不是导致COVID-19发展成重症的危险因素。结论合并Cpn感染不是导致COVID-19患者发展成重症的危险因素,Cpn感染对SARS-CoV-2导致的炎症因子分泌影响有限。

CT征象及动态变化对COVID-19疑似病例鉴别诊断的价值

目的:探讨CT征象及动态变化对COVID-19疑似病例鉴别诊断的价值。方法:回顾性分析2020年1月20日至2020年2月25日收治的54例COVID-19疑似病例的资料。最终COVID-19确诊病例25例,患者年龄3~94岁,≤50岁16例(64%)。排除病例(非COVID-19)29例。54例均行CT平扫,首次检查后间隔3~6 d复查。结果:COVID-19病灶多分布于双肺胸膜下,主要征象为磨玻璃密度改变并小叶内间隔增厚,伴血管影增粗;进展期13例呈胸膜下融合改变,好转消散期15例密度增高,边缘平直及出现纤维条索。非COVID-19病灶多沿支气管血管束分布,树芽征及腺泡结节7例,均见于细菌性肺炎及支原体肺炎患者;进展期9例沿支气管血管束扩散,好转消散期27例表现为整体密度浅淡。两组以上征象检出率差异均有统计学意义(P<0.05)。结论:精准CT征象分析可以用于COVID-19和非COVID-19的鉴别,有助于缩小疑诊范围,减轻临床排查压力。

生命伦理视阈下新型冠状病毒肺炎(COVID-19)疫情的反思

病毒丰富的遗传多样性使其具有进化上的优势,并已成为人类面临的最具威胁力的对手之一。人类直立行走至今,其文明不断发展与壮大,特别是科学与技术的发展日新月异,但对病毒所引发的疫情危害仍然措手不及。频频发生的疫情,一次次地考验着人类的灵魂与智慧,也一次次呼唤我们对生命伦理的全新认知。本文在生命伦理视阈下,对当前我国正在经历的大规模新冠肺炎(COVID-19)疫情进行反思,期待人们对自然与生命、科学研究与应用,特别是对人类自身与自然的关系,有更深刻和清醒的认识。

清肺排毒汤联合西医治疗新型冠状病毒肺炎临床疗效的Meta分析

目的:系统评价清肺排毒汤治疗新型冠状病毒肺炎(COVID-19)的临床疗效与安全性。方法:检索中国知网、万方、维普、Pubmed、Embase、Cochrane Library等数据库,检索时间截至2022年4月20日,筛选有关清肺排毒汤联合西医治疗COVID-19的临床疗效研究。采用Cochrane偏倚风险评价工具对纳入的研究进行风险评估及质量评价,提取相关数据,采用State17.0软件进行Meta分析,Begg’s检验分析发表偏倚。结果:最终纳入6篇临床疗效研究共602例患者,其中实验组采用清肺排毒汤联合西医治疗295例,对照组单纯西医治疗307例。Meta分析结果显示,实验组在提高临床有效率[RR=1.17,95%CI(1.09,1.26),P<0.0001]、CT好转情况[RR=1.20,95%CI(1.10,1.30),P<0.0001],降低不良反应[RR=0.73,95%CI(0.60,0.90),P=0.002],缩短核酸转阴时间[WMD=-6.56,95%CI(-10.37,-2.75),P=0.0007]、住院天数[WMD=-4.75,95%CI(-6.26,-3.25),P<0.00001]等方面的作用优于对照组。结论:清肺排毒汤联合西医常规疗法可有效改善COVID-19临床症状,具有一定的疗效和安全性,但仍需大量高质量研究证实疗效。

COVID-19不同临床分型患者病例资料回顾性分析

目的分析不同临床分型的新型冠状病毒性肺炎(COVID-19)确诊病例的特征。方法收集江汉大学附属湖北省第三人民医院2020年1月24日至2月8日确诊COVID-19患者54例,分为普通组,重症组及死亡组。比较3组患者流行病学、临床症状、检验结果、影像资料及用药情况。结果COVID-19确诊患者的核酸检测阳性率为45.5%;普通组、重症组、死亡组患者中位年龄分别为49岁、60岁、70岁,差异有统计学意义(P<0.05);合并基础疾病比率分别为13.0%,80.0%,66.7%,差异有统计学意义(P<0.01);潜在并发症比率分别为4.4%,40.0%,100.0%,差异有统计学意义(P<0.01);死亡组患者住院时间为6.5 d,低于普通组(11 d,P=0.026)和重症组(21 d,P=0.045);临床症状主要为发热47例(87.0%)、咳嗽41例(75.9%)、乏力29例(53.7%)、肌肉酸痛25例(46.3%);患者入院当天中位淋巴细胞计数为0.7×109·L-1(IQR0.6~1.2),C反应蛋白为46.4 mg·L-1(IQR12.7~84.3),血清淀粉样蛋白为373.5 ng·mL^-1(IQR57.1~961.7)及红细胞沉降率为42.7 mm·h-1(IQR17.3~74.5);死亡组中位肌钙蛋白为0.6μg·L-1(IQR0.5~0.6),乳酸脱氢酶为842.0 U·L-1(IQR556.5~1127.5);影像学检查提示68.5%患者肺部出现斑片状影;抗病毒药物、抗菌药物、提高免疫力药物及皮质类固醇药物使用率分别为100.0%,100.0%,51.9%,85.2%。结论核酸检测结果存在一定的假阴性,患者临床症状、实验室指标中淋巴细胞计数、C反应蛋白、血清淀粉样蛋白、红细胞沉降率及影像资料具有一定参考意义。重症患者多为老年患者且合并基础性疾病。COVID-19患者使用抗菌药物、皮质类固醇药物比率较高。

COVID-19胸部CT结构化报告临床应用价值评价

目的:探究新型冠状病毒肺炎(COVID-19)胸部CT结构化报告临床诊断应用价值。方法:回顾性分析310例疑似COVID-19患者胸部CT及临床资料。根据纳入标准最终共纳入253例患者,阳性组203名,阴性组50名。对胸部CT进行诊断分型,并记录CT征象。以模式1(CT诊断分型)、模式2(CT诊断分型+CT征象)、模式3(CT诊断分型+基本信息+流行病学史+临床及实验室检查)三种模式进行二元逻辑回归分析,采用ROC曲线及曲线下面积(AUC)评价三种模型诊断准确性。结果:逻辑回归分析显示三种模式诊断敏感度分别为95.6%、96.0%和95.2%,特异度分别为34.0%、48.9%和32.7%,符合率分别为83.4%、87.0%、82.2%,AUC为0.768、0.895和0.812。结论:COVID-19胸部CT结构化报告能较为准确地诊断COVID-19肺炎,敏感度较高,但缺乏特异度,结合CT征象可进一步提高诊断准确性,特别是提高诊断特异度。

中药天然产物抗新型冠状病毒肺炎(COVID-19)研究进展

新型冠状病毒肺炎(COVID-19)患者往往表现出"寒、热、虚、实、表、里、阴、阳"中的多个表象,因此中药处方将根据机体的不同表象及其诊断结果进行调药遣方,体现出"中药-药对-经方-处方"的用药形式。各地推荐的新型冠状病毒肺炎(COVID-19)中药处方以解表、祛湿、祛痰、清热、理气为主,辅以和解、泻下、温里、补益等经典方剂,在疾病的不同阶段进行辨证施治。分析各地推荐处方和相关文献,新方法与新技术大量应用于中药科学的现代化研究,充分描述了中药"多成分-多靶点-多途径-多网络"的作用特点,同时也极大地丰富了传统中医药的科学内涵,推动了中医药事业的发展。但是,中药"多成分-多药味-多通路-多网络"的复杂性本质依然存在,本文分析了部分中药抗COVID-19的相关文献,试图结合其实际应用,整合出中药天然产物抗COVID-19的作用规律,对后续实验研究、临床应用和新药开发提供有益借鉴。另外,中医药是个宝库,从中筛选并发掘出少量结构独特且具有抗COVID-19活性的天然产物,结合化学合成技术和成药性评价方法,将为抗病毒药物的开发,尤其是抗COVID-19的新药开发提供有益参考。