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.

Diabetes and susceptibility to COVID-19:Risk factors and preventive and therapeutic strategies

Coronavirus disease 2019(COVID-19)is a highly infectious disease caused by a novel human coronavirus called severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Diabetes is a well-known risk factor for infectious diseases with high prevalence and increased severity.Here,we elucidated the possible factors for the increased vulnerability of diabetic patients to SARS-CoV-2 infection and the more severe COVID-19 illness.The worsened prognosis of patients with both COVID-19 and diabetes may be attributable to host receptor angiotensinconverting enzyme 2-assisted viral uptake.Moreover,insulin resistance is often associated with impaired mucosal and skin barrier integrity,resulting in microbiota dysbiosis,which increases susceptibility to viral infections.It may also be associated with higher levels of pro-inflammatory cytokines resulting from an impaired immune system in diabetics,inducing a cytokine storm and excessive inflammation.This review describes diabetes mellitus and its complications,explains the risk factors,such as disease characteristics and patient lifestyle,which may contribute to the high susceptibility of diabetic patients to COVID-19,and discusses preventive and therapeutic strategies for COVID-19-positive diabetic patients.

Network Pharmacology Approach to Investigate the Preventive Mechanism of Hunan Expert Group Recommended Chinese Medicine Prevention No.2 Prescription Against COVID-19

Objective To explore the possible preventive mechanism of Hunan expert group recommended Chinese medicine prescription of No.2(Pre-No.2)against coronavirus disease 2019(COVID-19)by network pharmacology method.Methods The target proteins of effective components and active compounds in Pre-No.2 were screened by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).A component-target-disease interaction network of Pre-No.2 was constructed by Cytoscape 3.7.2,gene ontology(GO)analysis,and Kyoto encyclopedia of genes and genomes(KEGG)analysis of target protein pathway by DAVID.Results A total of 163 compounds and 278 target protein targets in Pre-No.2 were collected from the TCMSP database.Kaempferol,wogonin,7-methoxy-2-methyl isoflavone,formononetin,isorhamnetin,and licochalcone A were the most frequent targets in the regulatory network.GO enrichment analysis showed that Pre-No.2 regulated response to virus,viral processes,humoral immune responses,defense responses to virus and viral entry into host cells.KEGG enrichment analysis showed that the formula regulated the NF-κB signaling pathway,B cell receptor signaling pathway,viral carcinogenesis,T cell signaling pathway and FcγR-mediated phagocytosis signaling pathway.Conclusions Pre-No.2 may play a preventive role against COVID-19 through regulation of the Toll-like signaling,T cell signaling,B cell signaling and other signaling pathways.It may regulate the immune system to protect against anti-influenza virus.

“Three medicines and three formulas”in COVID-19:from bench to bedside

Chinese guideline has proven effective in the fight against coronavirus disease 2019(COVID-19)during the global spread of the epidemic.Traditional Chinese medicine(TCM)is widely recognized for its effectiveness in alleviating symptoms,inhibiting disease progress,reducing mortality,and improving the cure rate of patients with COVID-19.During the pandemic,“three medicines and three formulas”(TMTFs)stood out from hundreds of others in registered clinical studies,which became highly recommended as TCM for COVID-19 treatment.The TMTFs not only effectively relieve the clinical symptoms of fever,cough,fatigue,and phlegm,but also substantially shorten the time of nucleic acid negative conversion,improve lung computed tomography imaging features and inflammation,ameliorate clinical biochemical indicators,and reduce sequelae.Their potential pharmacological mechanisms are mainly related to the crosstalk between viral toxicity,endothelial damage,cytokine storm,immune response,and microthrombus.In brief,the clinical effects and the potential mechanisms of TMTFs on COVID-19 were systematically analyzed and summarized covering the entirety of disease development,including virus invasion and replication,immune response and cytokine storm,and acute respiratory distress syndrome and multiple organ dysfunction syndrome.This review provides a theoretical basis and reference for the in-depth understanding of the positive role of TMTFs in COVID-19 treatment.

Study on novel coronavirus pneumonia (COVID-19) mechanism by Huashi Baidu Formula based on network pharmacology

Objective:To explore novel coronavirus pneumonia(COVID-19)by the method of network pharmacology.Methods:The compounds contained in the Huashi Baidu Formula were searched by TCMSP database,the active components and their action targets were screened,and the proteins were standardized by Uniprot database,and the drug-active ingredient-target network was constructed by Cytoscape3.7.2 software.The targets related to COVID-19 were screened by GeneCards database.STRING database and DAVID database were used to construct and analyze PPI network,GO analysis and KEGG enrichment analysis(P<0.05).Results:The"drug-active ingredient-target"network of Huashi Baidu Formula consists of 176 components and 149targets,including AR,ESR1,PTGS2,PPARG,NOS2 and so on.251 targets related to COVID-19.GO functional enrichment analysis showed that there were 179 biological processes,mainly related to inflammation,regulation of apoptosis and immune response,and 82 KEGG related signaling pathways were obtained,including HIF-1,TNF,small cell lung cancer,non-small cell lung cancer,tuberculosis,PI3K-Akt,NF-κB,MAPK and so on.Conclusion:Huashi Baidu Formula may regulate the immune and inflammatory response of the body by acting on AR,ESR1,PTGS2,PPARG,NOS2 and other targets,which is the result of multi-component,multi-target and multi-channel interaction.

Synbiotic for Prevention of SARS-Cov2 Infection in High Risk Hospital Staffs: A Randomized Controlled Trial

Introduction: COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 increasingly involves people worldwide. Probiotics can improve immune system functions via different mechanisms. We proposed that Synbiotic Lactocare? may also reduce SARS-Cov2 infection in high-risk medical staff working in COVID-19 hospital wards. Method: In a randomized, controlled trial, 60 hospital staff without any history of clinical or laboratory evidence of SARS-Cov2 infection were received either once-daily oral synbiotic capsule (Lactocare?) that contains 1 billion CFU/Cap of L. (Lactobacillus) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium infantis, L. bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo with the same appearance for 30 days. They were followed for two months. Result: During the two-month period of this study, SARS-COV-2 RT-PCR test results were positive in three participants (9.67%) in placebo group compared to zero positive tests in synbiotic group. The differences were not statistically significant (p = 0.238). During the study, two persons (7 %) of placebo group had respiratory complaints such as cough, rhinorrhea and/or dyspnea, compared with one in synbiotic group (p = 0.492). Conclusion: This study showed that overall frequency of SARS-COV2 infection in participants receiving synbiotic and those receiving placebo did not differ significantly. However, 3 hospital staff in placebo group compared to no one in synbiotic group had SARS-COV2 infection. Further studies with greater power and alternative probiotic strains and mixture are warranted to determine whether Synbiotic can prevent COVID-19 in at-risk hospital staff.

Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary

On 6 February 2020,our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infection,and this guideline provided our experience and make well reference for fighting against this pandemic worldwide.However,the coronavirus disease 2019(COVID-19)is a new disease,our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience;hence,the strategies of diagnosis and treatment are also continually updated.In this letter,we answered one comment on our guideline and provided the newest diagnostic criteria of"suspected case"and"confirmed case"according to the latest Diagnosis and Treatment Guidelines for COVID-19(seventh version)that issued by the National Health Committee of the People’s Republic of China.

COVID-19: An overview and a clinical update

The outbreak of coronavirus disease-2019(COVID-19,previously known as 2019 nCoV)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in Wuhan City,China,has spread rapidly around the world.Most patients from the first cluster had an epidemiological connection to the Wuhan's Huanan Seafood Wholesale Market.Available evidence has shown that SARSCoV-2 can be easily transmitted from person to person through close contact and respiratory droplets,posing a substantial challenge to public health.At present,the research on SARS-CoV-2 is still in the primary stages.However,dexamethasone and remdesivir are appeared to be promising medical therapies.Still,there is no definite specific treatment,and the mainstay of treatment is still focused on supportive therapies.Currently,over 150 vaccines are under investigation.It is necessary to understand the nature of the virus and its clinical characteristics in order to find effectively manage the disease.The knowledge about this virus is rapidly evolving,and clinicians must update themselves regularly.The present review comprehensively summarizes the epidemiology,pathogenesis,clinical characteristics,and management of COVID-19 based on the current evidence.

Recent insights for the emerging COVID-19:Drug discovery,therapeutic options and vaccine development

SARS-CoV-2 has been marked as a highly pathogenic coronavirus of COVID-19 disease into the human population,causing over 5.5 million confirmed cases worldwide.As COVID-19 has posed a global threat with significant human casualties and severe economic losses,there is a pressing demand to further understand the current situation and develop rational strategies to contain the drastic spread of the virus.Although there are no specific antiviral therapies that have proven effective in randomized clinical trials,currently,the rapid detection technology along with several promising therapeutics for COVID-19 have mitigated its drastic transmission.Besides,global institutions and corporations have commenced to parse out effective vaccines for the prevention of COVID-19.Herein,the present review will give exhaustive details of extensive researches concerning the drug discovery and therapeutic options for COVID-19 as well as some insightful discussions of the status of COVID-19.

Natural compounds may contribute in preventing SARS-CoV-2 infection:a narrative review

Coronavirus pandemic infection is the most important health issue worldwide.Coronavirus disease 2019 is a contagious disease characterized by severe acute respiratory syndrome coronavirus 2.To date,excluding the possibility of vaccination,against SARS-CoV-2 infection it is possible to act only with supportive care and non-virus-specific treatments in order to improve the patient’s symptoms.Pharmaceutical industry is investigating effects of medicinal plants,phytochemical extracts and aromatic herbs to find out natural substances which may act as antiviral drugs.Several studies have revealed how these substances may interfere with the viral life cycle,viral entry,replication,assembly or discharge,as well as virus-specific host targets or stimulating the host immune system,reducing oxidative stress and inflammatory response.A natural compound can be used as a prophylaxis by people professionally exposed to the risk of contagion and/or positive patients not in intensive care.The aim of this paper is to perform a narrative review of current literature in order to summarize the most studied natural compounds and their modes of action.

COVID-19疫情与院内感染防控措施探讨

新型冠状病毒(COVID-19)感染的肺炎疫情来势凶猛,病毒传染性强,与病毒相关的院内感染风险巨大,防止院内感染对疫情防控有重要意义。依据国家相关规范指南,结合参考文献和多年防控经验,我院在疫情期间,采取了一些新冠病毒院内感染防控管理措施,取得了较好的效果,现对相应工作进行介绍、总结,为同行和今后工作提供参考。

Analysis of the Role of General Practitioners Services in Rural Areas during the COVID-19 Epidemic

Since the outbreak of the COVID-19,various regions of China have been rapidly deployed under the leadership of the Central Committee of the Party to actively prevent and control the COVID-19.The rural areas of my country have weak links to the prevention and management of public health emergencies.Problems include lack of medical and health resources and farmers’low awareness of epidemic prevention.Situations that correspond to the prevention and management of the COVID-19 are more serious.As the patient’s first contact and“gatekeeper”in the fight against the epidemic,the general practitioner is responsible for the“first visit-subsequent ongoing intervention”.This article is about the prevention and control of the COVID-19 epidemics and epidemic prevention in terms of dissemination of knowledge,informed crowd control,joint prevention and control,and standardized management of people.This is a summary of the efforts of general practitioners.Quarantine at home,interactive referrals to medical consortiums,special care for contracted families.The function during the management period aims to analyze the role played by general practitioners during the epidemic and to provide new ideas for the prevention and management of the epidemic.Provide more targeted general practitioner-style services in rural areas to promote the implementation and improvement of health and poverty alleviation.The health level of the rural population provides a theoretical standard.

COVID-19 and the digestive system:A comprehensive review

The coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is spreading at an alarming rate,and it has created an unprecedented health emergency threatening tens of millions of people worldwide.Previous studies have indicated that SARS-CoV-2 ribonucleic acid could be detected in the feces of patients even after smearnegative respiratory samples.However,demonstration of confirmed fecal-oral transmission has been difficult.Clinical studies have shown an incidence rate of gastrointestinal(GI)symptoms ranging from 2%to 79.1%in patients with COVID-19.They may precede or accompany respiratory symptoms.The most common GI symptoms included nausea,diarrhea,and abdominal pain.In addition,some patients also had liver injury,pancreatic damage,and even acute mesenteric ischemia/thrombosis.Although the incidence rates reported in different centers were quite different,the digestive system was the clinical component of the COVID-19 section.Studies have shown that angiotensinconverting enzyme 2,the receptor of SARS-CoV-2,was not only expressed in the lungs,but also in the upper esophagus,small intestine,liver,and colon.The possible mechanism of GI symptoms in COVID-19 patients may include direct viral invasion into target cells,dysregulation of angiotensin-converting enzyme 2,immune-mediated tissue injury,and gut dysbiosis caused by microbiota.Additionally,numerous experiences,guidelines,recommendations,and position statements were published or released by different organizations and societies worldwide to optimize the management practice of outpatients,inpatients,and endoscopy in the era of COVID-19.In this review,based on our previous work and relevant literature,we mainly discuss potential fecal-oral transmission,GI manifestations,abdominal imaging findings,relevant pathophysiological mechanisms,and infection control and prevention measures in the time of COVID-19.

China’s Experience in Controlling COVID-19

Background: In less than a year, COVID-19 has swept the world and continued, too, seriously threatening the safety of all mankind, and caused great social panic and global economic and financial crisis. At the beginning, the epidemic was first diagnosed in China and the epidemic was severe. Under the strong command of the highest level of the Chinese government, the whole Chinese people united as one, and achieved initial results in the struggle against COVID-19 with scientific prevention and control. Objective: Summarizing China’s experience and lessons in combating the epidemic is undoubtedly very beneficial to the people of the world in jointly combating the impact of the COVID-19 epidemic. Measures: The article shows the imminent Chinese experience in controlling the spread of SARS-CoV-2. It details the lines of action and the measures taken to control this epidemic in the country where the population is quite large. The most important experience is: strong organizational leadership, enhanced cooperation with the WHO, the establishment of a national anti-epidemic headquarters, responsible for the command and control of human, financial and material resources throughout the country, and local officials at all levels in the front line of the epidemic, Heart to heart with the people, breathing together and sharing a common destiny. Prevention is the first, prevention and treatment are combined. All measures were taken to control the source of infection, cut off the spread and protect susceptible people. Conclusion: As long as the people of the world unite, make scientific decisions and learn from the successful experience of countries around the world, especially the China’s experience, combine the national conditions of each country, and use the wisdom of all man-kind to deal with the common enemy SARS-CoV-2 and COVID-19, we can definitely win this people’s war against the disease.

Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital

The coronavirus disease 2019 was first reported in Wuhan in December 2019 and then spread rapidly throughout the world.On March 11,2020,the World Health Organization declared coronavirus disease 2019 a pandemic.In response to the pandemic,the management division of West China Hospital oversaw the implementation of hospital-wide emergency measures.In accordance with these measures,the hospital's thoracic surgery ward implemented a new management system by reformulating staff training plans,patient admission procedures,and other systems for managing the ward and protecting perioperative patients.Overall,the ward was successful in restoring normal working order,protecting all staff from occupational exposures,and ensuring the safety of inpatients and their families.

Can Ursodeoxycholic Acid Prevent SARS-CoV-2 Infection or Reduce the COVID-19 Severity? Current Knowledge and Unresolved Issues

A recent study revealed that the inhibition of the farnesoid X receptor using ursodeoxycholic acid(UDCA)significantly reduces angiotensin-converting enzyme 2(ACE2)expression.Therefore,considerable attention has been paid to the use of UDCA to prevent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and reduce the severity of the disease.This review compre-hensively summarizes the role of ACE2 in SARS-CoV-2 infection and the potential role and mechanisms of UDCA in the prevention of SARS-CoV-2 infection or reinfection.It also discusses unresolved issues and the potential use of UDCA in the treatment of patients with coronavirus disease.

New insights for infection mechanism and potential targets of COVID-19:Three Chinese patent medicines and three Chinese medicine formulas as promising therapeutic approaches

The coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with high pathogenicity and infectiousness has become a sudden and lethal pandemic worldwide.Currently,there is no accepted specific drug for COVID-19 treatment.Therefore,it is extremely urgent to clarify the pathogenic mechanism and develop effective therapies for patients with COVID-19.According to several reliable reports from China,traditional Chinese medicine(TCM),especially for three Chinese patent medicines and three Chinese medicine formulas,has been demonstrated to effectively alleviate the symptoms of COVID-19 either used alone or in combination with Western medicines.In this review,we systematically summarized and analyzed the pathogenesis of COVID-19,the detailed clinical practice,active ingredients investigation,network pharmacology prediction and underlying mechanism verification of three Chinese patent medicines and three Chinese medicine formulas in the COVID-19 combat.Additionally,we summarized some promising and high-frequency drugs of these prescriptions and discussed their regulatory mechanism,which provides guidance for the development of new drugs against COVID-19.Collectively,by addressing critical challenges,for example,unclear targets and complicated active ingredients of these medicines and formulas,we believe that TCM will represent promising and efficient strategies for curing COVID-19 and related pandemics.

新冠肺炎预防2号方联合胸腺法新对晚期非小细胞肺癌化疗后免疫功能的影响

目的探讨新冠肺炎预防2号方联合胸腺法新对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗后免疫功能及生活质量的影响。方法选取2020年1月1日—2020年3月15日该院收治的晚期NSCLC患者为研究对象,根据随机数字表随机分为观察组和对照组,每组各50例。两组患者均采用多西他赛联合顺铂进行化疗,对照组另给予胸腺法新皮下注射,观察组在对照组基础上另加新冠肺炎预防2号方口服治疗。1个化疗周期为21 d,连续治疗3个周期。比较两组治疗前后T细胞亚群、体液免疫指标、淋巴细胞水平及生活质量改变情况。结果治疗后,观察组CD_(4)^(+)水平和CD_(4)^(+)/CD_(8)^(+)比值高于对照组,差异有统计学意义(P<0.05);治疗后,两组IgG、IgA、IgM水平以及淋巴细胞百分率、淋巴细胞绝对值无明显差异(P>0.05);观察组生活质量改善情况明显优于对照组,差异有统计学意义(P<0.05)。结论新冠肺炎预防2号方联合胸腺法新治疗晚期NSCLC患者,能增强化疗后机体细胞免疫功能,提高化疗后生活质量。

China's practice to prevent and control COVID-19 in the context of large population movement

Background:The emerging infectious disease,coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),poses a serious threat in China and worldwide.Challenged by this serious situation,China has taken many measures to contain its transmission.This study aims to systematically review and record these special and effective practices,in hope of benefiting for fighting against the ongoing worldwide pandemic.Methods:The measures taken by the governments was tracked and sorted on a daily basis from the websites of governmental authorities(e.g.National Health Commission of the People's Republic of China).And the measures were reviewed and summarized by categorizations,figures and tables,showing an ever-changing process of combating with an emerging infectious disease.The population shift levels,daily local new diagnosed cases,daily mortality and daily local new cured cases were used for measuring the effect of the measures.Results:The practices could be categorized into active case surveillance,rapid case diagnosis and management,strict follow-up and quarantine of persons with close contacts,and issuance of guidance to help the public understand and adhere to control measures,plus prompt and effective high-level policy decision,complete activation of the public health system,and full involvement of the society.Along with the measures,the population shift levels,daily local new diagnosed cases,and mortality were decreased,and the daily local new cured cases were increased in China.Conclusions:China's practices are effective in controlling transmission of SARS-CoV-2.Considering newly occurred situations(e.g.imported cases,work resumption),the control measures may be adjusted.

Viruses and autism: A Bi-mutual cause and effect

Autism spectrum disorder(ASD)is a group of heterogeneous,multi-factorial,neurodevelopmental disorders resulting from genetic and environmental factors interplay.Infection is a significant trigger of autism,especially during the critical developmental period.There is a strong interplay between the viral infection as a trigger and a result of ASD.We aim to highlight the mutual relationship between autism and viruses.We performed a thorough literature review and included 158 research in this review.Most of the literature agreed on the possible effects of the viral infection during the critical period of development on the risk of developing autism,especially for specific viral infections such as Rubella,Cytomegalovirus,Herpes Simplex virus,Varicella Zoster Virus,Influenza virus,Zika virus,and severe acute respiratory syndrome coronavirus 2.Viral infection directly infects the brain,triggers immune activation,induces epigenetic changes,and raises the risks of having a child with autism.At the same time,there is some evidence of increased risk of infection,including viral infections in children with autism,due to lots of factors.There is an increased risk of developing autism with a specific viral infection during the early developmental period and an increased risk of viral infections in children with autism.In addition,children with autism are at increased risk of infection,including viruses.Every effort should be made to prevent maternal and early-life infections and reduce the risk of autism.Immune modulation of children with autism should be considered to reduce the risk of infection.