Mouth shield to minimize airborne transmission risk of COVID-19 and other infectious diseases in the dental office

Transmission of coronavirus disease(COVID-19)and other infectious diseases is a significant risk during dental procedures because most dental interventions involve aerosols or droplets that could contaminate the surrounding environment.Current protection guidelines to address the high risk of droplets,aerosols,and airborne particle transmission of COVID-19 in the dental office recommend minimizing aerosol-generating procedures.In this paper,an innovative mouth shield is presented that should minimize water backsplash from the air-water syringe during dental treatment.The mouth shield can be added to the personal protective equipment to provide the dental team with extra protection.It can be made of different materials,is straightforward,inexpensive,and safe to fabricate,and is easy to use.

Risk of COVID-19 Spread and Mitigation Strategies in Public Transportation Sector

The world is trying to recover from once in the COVID-19 pandemic, which has a higher mortality rate than the common flu. However, the threat of different variants is still affecting us in a different capacity. Several preventive measures have been adopted across the nation and the globe to avoid the spread of this virus, such as lockdown, restricted travel, social distancing guidelines, obligatory face mask use, etc. These activities directly influenced the management of social life, economy, and livelihoods. The effect of COVID-19 on the public transit industry and strategies the transit agencies adapted to continue providing the service during the pandemic has been synthesized in this paper. As a result of the pandemic, public transit ridership decreased by about 70 percent for most agencies compared to pre-pandemic levels. This article also highlights the prevention of COVID-19 spread in the public transit industry using engineering solutions and advanced material science and nanotechnology solutions.

Survival and risk analysis of patients with COVID-19 in Iran

Objective:To evaluate the risk factors of death caused by COVID-19 in Iran.Methods:This study was a retrospective cohort study from February 20,2020,to August 22,2022,in the hospitals in Isfahan,Iran.The data were collected through a researcher-made checklist.To determine the risk factors of the death,logistic regression and Cox regression models were used.For each variable,the odds ratio and 95%confidence interval were also reported.Results:1885 Patients were included.The age of deceased persons was significantly higher than that of the surviving persons.The risk of death for the age group above 60 years was about 14 times higher than that of people aged 19-35 years[95%CI:14.41(2.02-102.99),P<0.01].Hypertension[95%CI:1.92(1.47-2.5),P<0.01],diabetes[95%CI:1.62(1.23-2.13),P<0.001],and chronic obstructive pulmonary disease[95%CI:1.92(1.47-2.50),P<0.01]were also risk factors of mortality.Conclusions:This study reveals that the mortality rate due to COVID-19 is associated with old age,longer hospitalization in the ICU,increased length of stay,and comorbidities of high blood pressure,diabetes,and chronic pulmonary 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.

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.

Cardiovascular risk factors affecting COVID-19 outcomes at a tertiary referral hospital in northwest Iran: A prospective cohort study

Objective:To investigate cardiovascular risk factors affecting COVID-19 outcomes in a tertiary referral hospital.Methods:This prospective cohort study analyzed 269 participants with COVID-19.The primary outcomes were ICU admission,prolonged hospital stay duration,and in-hospital death.The secondary outcomes included death,chronic symptoms,and NYHA functional class during follow-up periods.Results:A total of 412 patients with COVID-19 symptoms were enrolled in the study,and out of which 269 patients had complete medical records and positive SARS-CoV-2 PCR test results,fulfilling the study criteria were analyzed.The patients were divided into two groups,with cardiovascular comorbidities(group A,n=122),such as established cardiovascular disease,diabetes mellitus,and hypertension,and without cardiovascular comorbidities(group B,n=147).Binary logistic regression analysis showed that patients with underlying hypertension,diabetes,and established cardiovascular disease had a 1.55(95%CI:1.28-2.26),1.62(95%CI:1.34-2.13),and 1.63(95%CI:1.07-5.34)-fold risk of mortality,respectively in the adjusted model.Conclusions:Hospitalized COVID-19 patients with predisposing cardiovascular risk factors are more susceptible to develop worse outcomes.More attention should be paid to the management and follow-up of these patients.

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

Anti-corisin immunotherapy:therapeutic perspective for reducing the risk of developing COVID-19 coagulopathy?

Corisin,a 19 amino acid proapoptotic peptide derived from the lung microbiota(i.e.,by Staphylococci),is implicated in the pathogenesis of acute lung injury and exacerbation of pulmonary fibrosis.Recent evidence also suggests that this molecule may have a role in lung thrombosis,as its concentration correlates with a prothrombotic state.It has also been demonstrated that corisin inhibition by using monoclonal antibodies is effective inhibiting pulmonary fibrosis and venous thrombosis in patients with coronavirus disease 2019(COVID-19).Further studies should hence be planned to verify whether anti-corisin immunotherapy could become a reliable therapeutic perspective against the risk of developing COVID-19 coagulopathy.

Does Herd Immunity Reduce the Risk of Contracting COVID-19?

Herd immunity is often considered a measure to protect a whole community or population from disease if the vaccination threshold is met. Using the demographic and COVID-19 infection data from the state of Pennsylvania, United States, the study aimed to determine if herd immunity by vaccination is an effective way to reduce the spread of the COVID-19 virus. The Pennsylvania counties were split into two groups based on qualification of herd immunity: counties that met the COVID-19 herd immunization rate of 70% and counties that did not. The ANOVA test was used to analyze the difference between the groups with and without herd immunity by the COVID-19 vaccine. The results demonstrated that there was no significant statistical difference between counties that did achieve and those that did not achieve the herd immunity threshold for the COVID-19 vaccine. On the other hand, it was observed that there had been a significant decrease in positive cases between 2020 and 2023. This decline can be attributed to the overall protection by the vaccination and adaptability to the disease, not specifically due to herd immunity alone. Ultimately, these outcomes suggest that herd immunity cannot reduce the risk of contracting COVID-19. Increased efforts to get vaccinated should be implemented to protect the general community and a wider scope of age.

COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women: A Knowledge, Attitude, and Perceived Risks Survey in Lusaka, Zambia

Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.

Occupational health risks among healthcare workers during the COVID-19 pandemic in Saudi Arabia: preparing for the future pandemics

Background:This study aimed to assess the occupational risks encountered by Healthcare Workers(HCWs)in Saudi Arabia during the COVID-19 pandemic.Methods:A cross-sectional survey was carried out from May to October 2021.Using a multi-stage stratified random sampling technique,an online questionnaire was sent to the recruited HCWs,across Saudi Arabia.Results:Of the 768 HCWs recruited,702 participated in the survey.A significant majority(over 80%)reported working beyond 8 hours daily.COVID-19 infection,confirmed via PCR,was identified in 25%of the participants.Notably,infection was significantly correlated with direct or close contact(p=0.0007).Psychological distress was reported by 81%,with anxiety being the most prevalent(33%),followed by stress(19%),depression(17%),and insomnia(12%).Around 20%experienced headaches post-PPE use,while 14%reported adverse skin reactions,predominantly allergy and dermatitis.A concerning one-third of respondents reported exposure to violence.Conclusion:High infection rate,physical and psychological risks among HCWs especially those in direct contact with patients,reflect the need for enhancing the entirety of outbreak preparedness and response,specifically training.Active surveillance system,is crucial to adequately monitor and support HCWs during pandemic scenarios.

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

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

麻杏石甘汤干预COVID-19肺炎的网络药理学研究及分子对接分析

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

COVID-19诊疗信息、中医证型分布及组方用药规律的文献研究

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

低频脉冲磁场诱导TRPC1改善COVID-19患者康复期下肢的肌肉无力症状

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

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

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

显微镜下多血管炎相关间质性肺病合并COVID-19患者疫苗保护作用初探

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

全球COVID-19疫情主要预测模型比较分析

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

系统性红斑狼疮合并COVID-19住院患者的临床特征分析

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

Clinical application of COVID-19 vaccine in liver transplant recipients

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