A Comparative Study of Myocardial Damage Caused by Novel Coronavirus Infection and Influenza A Virus Infection in Children during the COVID-19 Epidemic Period

Objective: To explore the comparative study of myocardial damage in children infected with COVID-19 and influenza A virus during the COVID-19 pandemic. Method: Retrospective analysis of myocardial injury caused by COVID-19 infection and influenza A virus infection in children during the COVID-19 from October 2022 to May 2023, including 106 cases of COVID-19 infection, that is, the COVID-19 group;And 164 cases of influenza A virus infection, namely, H1N1 group;Two groups were tested for various indicators of myocardial enzyme spectrum, and the situation of myocardial injury was compared between the two groups. Result: In the enrolled cases, there was no statistically significant difference in the prevalence rate of men and women in the COVID-19 group (P > 0.05);There was no statistically significant difference in the average age between men and women (P > 0.05);The comparison of the incidence rates between males and females in the H1N1 group showed a statistically significant difference (P 0.05);There was no statistically significant difference in the average age between the two groups of girls (P > 0.05). A comparison between two groups of various indicators of myocardial enzyme spectra showed that the results of AST, -HBDH and LDH were statistically significant (P 0.05). Conclusion: Both COVID-19 infection and influenza A virus infection in children have different degrees of myocardial damage, but COVID-19 infection causes more myocardial damage than influenza A virus infection, and influenza A virus is more prone to myocardial infarction, which deserves our attention.

COVID-19/Tuberculosis Co-Infection at the Epidemic Treatment Center (ETC) of Saint-Louis (Senegal): About 9 Cases

Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert? MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.

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.

Epidemiological and Clinical Profile of Children Exposed to SARS-CoV-2 at the COVID-19 Treatment Center at the ISIRO Hospital and WATSA in the Democratic Republic of the Congo

Introduction: COVID-19, an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typically presents with mild clinical manifestations in pediatric populations. As in many other regions of the Democratic Republic of the Congo (DRC), the COVID-19 pandemic affected children in Haut-Uélé, a province bordering South Sudan and Uganda. This study aimed to describe the epidemiological profile of COVID-19 in pediatric population in this area. Materials and Methods: This descriptive cross-sectional study was conducted over a 6-month period from August 1, 2021 to February 7, 2022. It included all patients aged 0 to 19 years with confirmed COVID-19 using RT-PCR and managed at the COVID-19 Treatment Centers (CTCO) in ISIRO and WATSA. Data were collected from patient records supplemented by the dataset from the service of Health Information System (SNIS) and the Epidemiological Surveillance Commission of the Provincial Health Division (DPS). Epidemiological and clinical profiles were analyzed. All statistical analyses were performed using SPSS software, Version 18. Results: During the 4th wave of the pandemic, 5 out of 13 health zones in Haut-Uélé province were affected, with a total of 569 recorded cases;45 of them were children aged 0 to 19 years (7.9%). Asymptomatic cases accounted for 33.3% (15 cases). The mean age was 9.88 ± 5.49 years, with the most affected age group being 10 - 14 years (44.45%). There was a predominance of males (73.3%), with a male-to-female sex ratio of 2.75. Half of the patients (53.3%) were from Watsa Health Zone. A seasonal peak was observed between December and January. Comorbidities were present in 10% of infected patients, and nearly half of participants were contacts of infected individuals. The primary reasons for admission were fever (66.66%), followed by rhinorrhea (57.77%) and cough (31.11%). All patients responded favorably to treatment. Conclusion: The proportion of pediatric COVID-19 cases at the CTCO centers in Haut-Uélé was low, with adolescent males being the most affected group. More than half of the cases were asymptomatic. The most common reasons for consultation were fever, rhinorrhea, and cough.

Historical review and reflections on the participation of acupuncture and moxibustion in the treatment of epidemics in the People’s Republic of China (from 1950 until now)

Since the establishment of the People’s Republic of China, both the Communist Party and the government have placed great emphasis on the advancement of traditional Chinese medicine. Acupuncture and moxibustion have been actively involved in combating major epidemics such as malaria, schistosomiasis, and COVID-19. This article conducts a historical review of these three significant cases to elucidate how the acupuncture community has effectively utilized its unique advantages and characteristics through theoretical discussions, clinical practices, experimental research, as well as receiving administrative leadership and political support from the Communist Party of China and government. We provide an objective evaluation of their effectiveness while summarizing historical experiences to serve as a reference for future utilization of acupuncture and moxibustion therapy in epidemic relief efforts. Additionally, propose four suggestions: strengthening Party leadership and enhancing political support;timely summarization of experiences to establish programs and systems;deepening scientific research by integrating experimental findings with clinical practice;focusing on public awareness campaigns and education to solidify grassroots foundations.

Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at Dakar, Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

Risk Factors for Severity and Mortality of Patients Hospitalized for COVID-19 during the 3rd Wave of the Epidemic-Sao Tome and Principe

Rationale: In the literature, some risk factors for severity and mortality from COVID-19 have been indicated. However, these factors can change, depending on the characteristics of the population and health services. In this sense, longitudinal studies can be useful for understanding local realities and subsidizing health actions based on these realities. Objective: To analyze the risk factors for severity and death in hospitalized patients with COVID-19. Methods: A retrospective cohort of patients with COVID-19 hospitalized from August 1 to October 16, 2021 (3rd wave of the pandemic), notified by the Department of Epidemiological Surveillance of Sao Tome and Principe. We employed measures of strength of associations for the analysis of exposure risk factors. Results: We analyzed 110 hospitalized patients (31.8% severe-critical and 68.2% non-severe). The risk factors for severe forms of COVID-19 were: being aged ≥60 years (RR = 3.3), being male (RR = 2), having comorbidities (RR = 2) and the risk increases to 10-fold for multicomorbidities, with emphasis on obesity, neoplasia, skin-muscle-surgical infection, dementia and to some degree CVD. 62.9% of patients with severe forms of the disease were not vaccinated. Risk factors for death among hospitalized and severe/critical cases, respectively, were having comorbidities (RR = 8 and 2.4) multicomorbidities (RR = 10 and 2.8 for those with 2 comorbidities and RR = 33.3 and 4 for those with 3 or 4 comorbidities), especially diabetes, dementia, neoplasia, cutaneous-muscular infection, and obesity. Although CVD was not associated with risk factors for death, these were the most frequently found among the severely hospitalized and deaths. In addition, important risk factors associated with death were not using corticoids (RR = 3.3, 230-fold risk) and not using anticoagulants-heparin (RR = 1.3, 30% risk) more compared to the severe cases that did use them. Most of the patients who died (63.2%) were not vaccinated. Moreover, having only 1 dose of the vaccine was a risk factor 1.9 times more for death among all hospitalized patients, but in the severe cases, there was no association between the variable vaccination and death. Among those hospitalized with 2 doses, it was a 0.5-fold protective factor among those hospitalized. The Delta variant of Sarscov-2 was the one found among severe cases and deaths investigated by genetic sequencing, with more exuberant clinical features compared to the other 2 previous vaccinations. Conclusion: Being elderly, male and presenting comorbidities, mainly multicomorbidities were the main characteristics associated with severity of COVID-19. On the other hand, comorbidities, and even worse, multicomorbidities, hospitalization for respiratory failure, lowered level of consciousness, no use of corticoid and no use of anticoagulation in critically ill patients, and not having at least 2 doses of vaccine for covid-19, were characteristics associated with death by COVID-19. These results will help inform healthcare providers so that the best interventions can be implemented to improve outcomes for patients with COVID-19. Public health interventions must be carefully tailored and implemented in these susceptible groups to reduce the risk of mortality in patients with COVID-19 and then the risk of major complications. Intensive and regular follow-up is needed to detect early occurrences of clinical conditions.

Study on Influence of the COVID-19 Epidemic on Tourism Consumption Structure in Shandong Province

At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on tourism consumption structure has become a research focus in the post-epidemic era.In this study,based on Shandong Tourism Statistics Handbook from 2018 to 2020,taking Shandong Province as an example,the changes of total tourism revenue and tourism consumption structure in Shandong Province before and after the COVID-19 epidemic were compared to predict the development of tourism in Shandong Province in the post-epidemic era and find out existing problems,and optimization paths were put forward for the development of tourism in Shandong Province in the post-epidemic era.

Lessons for Epidemic Emergency Policy: A Scoping Review of Ebola and COVID-19 Pandemics in Africa

Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new experience. It is imperative to draw lessons to prepare for future disease outbreaks. This was a scoping review, a method that allows the assessment of emerging evidence. The objectives of the review were to 1) describe the manifestation of the epidemics;2) elaborate on the social and economic effects;3) characterize the responses;and 4) draw lessons. The findings show that Ebola risk is permanent and even increasing. The next COVID-19 epidemic is around the corner. For Africa, the situation has been made worse by poverty and fragility of institutions. Africa’s incapacity to manufacture its own vaccines, medicines, diagnostics and protective wear has been detrimental in the management of epidemics. The need for personal and home hygiene has been emphatically brought to attention. The trust in the government and other agencies is the cornerstone in the management of emergencies. The use of armed soldiers should be discouraged, for they scare people from seeking help. It is much better to use trusted local leaders instead of strangers during pandemic emergencies. Understanding the local politics without getting involved in them is essential. It is critical to understand community and individual perception of the risk of the disease in question. Often neglected is the psycho-social aspect, which should be planned early. The science of response measures ought to be explained simply and transparently, as part of risk communication. Emergency funds should be raised, and made easy and quick to disburse. Mechanisms of sharing health technologies and knowledge need to be devised under the UN. People centeredness ought to guide the conduct of trans-border movements and all transactions during pandemics.

Comparison of Two Molecular Diagnostic Tests for COVID-19: Abbott RealTime SARS-CoV-2 and Allplex™2019-nCoV, in the Epidemic Context in Senegal

Background: The persistence of the rapid spread of the COVID-19 pandemic is linked to the appearance of several variants of SARS-CoV2 with an impact on biological diagnosis, treatment and vaccination. The United States Food and Drug Administration (FDA) has granted several SARS-CoV-2 detection tests Emergency Use Authorization (EUA) for diagnosis and better epidemiological surveillance. Thus, multiple RT-PCR tests have been developed and brought to market in order to meet the urgent need for the diagnosis of COVID-19. However, comparative data between these tests in clinical laboratories are scarcely available to assess their performance. Objective: To compare two molecular methods for detecting SARS-CoV-2: the RT-PCR, Allplex™2019-nCoV tests on CFX96 Bio-Rad and the Abbott m2000sp/rt RealTime SARS-CoV-2. Materials and Methods: Nasopharyngeal and oropharyngeal swabs were taken from patients to diagnose SARS-CoV-2 infection. For each sample, we searched for the virus with two different RT-PCR tests: 1) first on Abbott m2000 SARS-CoV-2 targeting the N and RdRp genes, 2) then on Allplex™2019-nCoV Assay looking for the E, N and RdRp genes. Results: Percentages of the agreement were calculated. A total of 100 samples that tested negative and 90 positives on Abbott m2000 SARS-CoV-2 were retested on Allplex™2019-nCoV. Overall agreement was 74.74% on all samples. The specific agreement was 84% and 64.4% respectively for negative and positive samples with the RealTime SARS-CoV-2 test. A positive correlation (r2 = 0.63;p Conclusion: Our results showed good overall agreement between RT-PCR, Allplex™2019-nCoV and Abbott RealTime SARS-CoV-2 tests in the diagnosis of COVID-19. As the concordance is low for small viremias, the RT-PCR Allplex™2019-nCoV Assay would be better indicated during the acute and symptomatic phase of the disease.

Pregnant Women with Diabetes under the Novel COVID-19 Pneumonia Epidemic Home Protection and Diet and Exercise Management

Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patients during pregnancy may have a variety of complications, which can have a serious adverse impact on their own and fetal health. This article elaborates on home protection and diet and exercise guidance for pregnant women with diabetes in order to provide guidance for pregnant women with diabetes in a special period, and further prevent and control the pneumonia epidemic caused by novel COVID-19 infection in pregnant women.

新型冠状病毒感染(COVID-19)流行期间妊娠期肝生化指标异常情况分析

目的分析比较新型冠状病毒感染(COVID-19)流行期和非COVID-19流行期孕妇的肝生化指标异常情况。方法回顾性分析2017年10月—2022年3月北京大学第一医院产科出院的肝生化指标ALT、AST、GGT、TBil、总胆汁酸中至少一项异常的孕妇共539例次。按照COVID-19流行期和非流行期两组分析患者的病因、凝血指标、转氨酶、胆汁酸、肾功能。计量资料两组间比较采用独立样本t检验,计数资料两组间比较采用χ^(2)检验。结果非COVID-19流行期产科出院患者中262例次肝生化指标异常,占同期产科出院患者的1.46%,COVID-19流行期为277例次,占比1.73%,差异有统计学意义(χ^(2)=3.947,P=0.047)。两个时期肝生化指标异常患者病因分析提示,四种妊娠期特有肝病(妊娠剧吐、子痫前期和子痫、妊娠期肝内胆汁淤积症、妊娠期急性脂肪肝)的比例,差异均无统计学意义(P值均>0.05)。COVID-19流行期的妊娠肝生化指标异常的患者中肌酐及估算的肾小球滤过率均正常的比例与非COVID-19流行期相比无统计学意义(86.78%vs 87.90%,χ^(2)=0.141,P=0.708)。COVID-19流行期和非流行期ALT达到正常值上限5倍以上的比例分别为7.94%和9.54%(χ^(2)=0.433,P=0.511);重度胆汁淤积(总胆汁酸>40μmol/L)的比例分别为7.75%和9.27%(χ^(2)=0.392,P=0.531),差异均无统计学意义。COVID-19流行期产科出血的比例较非流行期明显下降,分别为14.61%和24.19%(χ^(2)=489.334,P<0.001)。结论COVID-19流行期妊娠期肝生化指标异常的患者中,妊娠期特有肝病的比例较非流行期无差别。COVID-19流行期这些患者中肌酐及估算的肾小球滤过率均正常的比例无变化。

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。

脐带血造血干细胞移植患者合并COVID-19的临床特征分析

目的:探讨脐带血造血干细胞移植患者合并新型冠状病毒感染的临床特点及治疗策略,从而提升此类患者的临床诊疗水平。方法:回顾性分析16例脐带血移植患者的一般情况、临床诊断、新型冠状病毒感染特征、细胞植活时间、治疗方案以及预后。结果:15例患者以发热伴咳嗽为首发症状,均为轻型,1例为中型。14例患者造血干细胞顺利植活并出仓,1例继发植入失败但桥接同胞异基因造血干细胞移植,1例死亡。结论:新型冠状病毒感染增加了脐带血干细胞移植的难度,但仍需要更多临床数据进一步佐证。

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。

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。

基于SEAIQR模型与Dropout-LSTM模型的西安市COVID-19疫情趋势预测

目的基于传染病动力学SEAIQR(susceptible-exposed-asymptomatic-infected-quarantined-removed)模型和Dropout-LSTM(Dropout long short term memory network)模型预测西安市新型冠状病毒肺炎(COVID-19)疫情的发展趋势,为评估“动态清零”策略防控效果提供科学依据。方法考虑到西安市本轮疫情存在大量的无症状感染者、依时变化的参数以及采取的管控举措等特点,构建具有阶段性防控措施的时变SEAIQR模型。考虑到COVID-19疫情数据的时序性特征及它们之间的非线性关系,构建深度学习Dropout-LSTM模型。选用2021年12月9日-2022年1月31日西安市新增确诊病例数据进行拟合,用2022年2月1日-2022年2月7日数据评估预测效果,计算有效再生数(R_(t))并评价不同参数对疫情发展的影响。结果SEAIQR模型预测的新增确诊病例拐点预计在2021年12月26日出现,约为176例,疫情将于2022年1月24日实现“动态清零”,模型R^(2)=0.849。Dropout-LSTM模型能够体现数据的时序性与非线性特征,预测出的新增确诊病例数与实际情况高度吻合,R^(2)=0.937。Dropout-LSTM模型的MAE和RMSE均较SEAIQR模型低,说明预测结果更为理想。疫情暴发初期,R 0为5.63,自实施全面管控后,R_(t)呈逐渐下降趋势,直到2021年12月27日降至1.0以下。随着有效接触率不断缩小、管控措施的提早实施及免疫阈值的提高,新增确诊病例在到达拐点时的人数将会持续降低。结论建立的Dropout-LSTM模型实现了较准确的疫情预测,可为COVID-19疫情“动态清零”防控决策提供借鉴。

集成磁共振成像技术评估COVID-19康复患者神经损伤

【目的】应用集成磁共振成像技术(SyMRI)评估COVID-19康复患者脑灰质微结构的改变。【方法】29例COVID-19康复患者分为重症患者组(SG=11例)和普通患者组(OG=18例),选取年龄、性别、体质指数(BMI)和教育年限相匹配的健康志愿者作为健康对照组(HC=23例)。所有受试者均行SyMRI扫描,生成T1、T2定量图谱,利用自动解剖标记(AAL)模板将T1和T2图谱分割成90个感兴趣区(ROIs)。通过对ROI内的所有体素进行平均得到每个ROI的T1、T2弛豫值。分析比较三组间90个脑区的T1、T2值。【结果】HC相比,SG在双侧眶内额上回、双侧海马旁回、双侧豆状壳核、双侧颞中回、双侧颞下回、左侧眶部额上回、左侧眶部额下回、左侧直回、左侧前扣带与旁扣带脑回、右侧内侧和旁扣带脑回、左侧后扣带回、左侧缘上回的T2值显著升高(P<0.05);与OG相比,SG在左侧直回、左侧海马旁回、双侧颞中回、双侧颞下回的T2值显著升高(P<0.05)。与HC相比SG在双侧眶内额上回、左侧直回、左侧前扣带和旁扣带脑回、右侧后扣带回、左侧海马旁回、左侧舌回、左侧豆状壳核、左侧丘脑的T1值显著升高(P<0.05);与OG相比,SG在右侧后扣带回、右侧距状裂周围皮层、左侧豆状壳核的T1值显著升高(P<0.05)。【结论】COVID-19患者即使在康复后脑灰质微结构仍可能存在持续性或迟发性损伤,且损伤程度与病情严重程度相关;SyMRI可作为一项敏感的工具评估中枢神经系统(CNS)微结构损伤情况,有助于早期临床诊断。

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。