Coronavirus disease 2019(COVID-19)consists of a systemic disease that can present many complications.The infection presents broad clinical symptoms and a high rate of transmissibility.In addition to severe acute respi...Coronavirus disease 2019(COVID-19)consists of a systemic disease that can present many complications.The infection presents broad clinical symptoms and a high rate of transmissibility.In addition to severe acute respiratory syndrome,the patients manifest complications beyond the respiratory system.The frequency of liver damage in COVID-19 patients ranges from 14.8% to 53% of patients.One should pay attention to drug-induced liver injury(DILI)in patients with COVID-19,especially considering the off-label use of drugs in prophylactic and therapeutic regimens applied on large scales.This review aims to present relevant information on the medication used so far in COVID-19 patients and its possible hepatotoxicity.We reviewed liver damage in patients with COVID-19 on PubMed and Virtual Health Library to investigate DILI cases.Four studies were selected,involving the medicines remdesivir,tocilizumab and a pharmacovigilance analysis study.The hepatotoxicity profile of drugs presented in the literature considers use in accordance to usual posology standards for treatment.However,drugs currently used in the management of COVID-19 follow different dosages and posology than those tested by the pharmaceutical industry.The deficiency of uniformity and standardization in the assessment of hepatotoxicity cases hinders the publication of information and the possibility of comparing information among healthcare professionals.It is suggested that severe liver injury in COVID-19 patients should be reported in pharmacovigilance institutions,and physicians should pay attention to any considerable abnormal liver test elevation as it can demonstrate unknown drug hepatotoxicity.Liver disorders in COVID-19 patients and the use of several concomitant off-label medications—with a potential risk of further damaging the liver-should at least be a warning sign for rapid identification and early intervention,thus preventing liver damage from contributing to severe impairment in patients.展开更多
COVID-19 is a pandemic that has affected nearly every country in the world.At present,sustainable development in the area of public health is considered vital to securing a promising and prosperous future for humans.H...COVID-19 is a pandemic that has affected nearly every country in the world.At present,sustainable development in the area of public health is considered vital to securing a promising and prosperous future for humans.However,widespread diseases,such as COVID-19,create numerous challenges to this goal,and some of those challenges are not yet defined.In this study,a Shallow Single-Layer Perceptron Neural Network(SSLPNN)and Gaussian Process Regression(GPR)model were used for the classification and prediction of confirmed COVID-19 cases in five geographically distributed regions of Asia with diverse settings and environmental conditions:namely,China,South Korea,Japan,Saudi Arabia,and Pakistan.Significant environmental and non-environmental features were taken as the input dataset,and confirmed COVID-19 cases were taken as the output dataset.A correlation analysis was done to identify patterns in the cases related to fluctuations in the associated variables.The results of this study established that the population and air quality index of a region had a statistically significant influence on the cases.However,age and the human development index had a negative influence on the cases.The proposed SSLPNN-based classification model performed well when predicting the classes of confirmed cases.During training,the binary classification model was highly accurate,with a Root Mean Square Error(RMSE)of 0.91.Likewise,the results of the regression analysis using the GPR technique with Matern 5/2 were highly accurate(RMSE=0.95239)when predicting the number of confirmed COVID-19 cases in an area.However,dynamic management has occupied a core place in studies on the sustainable development of public health but dynamic management depends on proactive strategies based on statistically verified approaches,like Artificial Intelligence(AI).In this study,an SSLPNN model has been trained to fit public health associated data into an appropriate class,allowing GPR to predict the number of confirmed COVID-19 cases in an area based on the given values of selected parameters. Therefore, this tool can help authorities in different ecological settingseffectively manage COVID-19.展开更多
BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfec...BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.METHODS This study was a systematic review of current evidence conducted in August 2020.The authors studied the probable reinfection risk of novel coronavirus(CoVID-19).We performed a systematic search using the keywords in online databases.The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)checklist to ensure the reliability and validity of this study and results.RESULTS We reviewed 31 studies.Eight studies described reCoVered patients with reinfection.Only one study reported reinfected patients who died.In 26 studies,there was no information about the status of the patients.Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.CONCLUSION Based on our review,we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease.Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.展开更多
BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019(COVID-19).Reports of such cases are rare,and the mechanism and outcome of low-grade fever during COVID-19 convalescenc...BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019(COVID-19).Reports of such cases are rare,and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear.We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical,radiographic,and laboratory characteristics,thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.CASE SUMMARY We describe 3 patients with COVID-19,two females aged 62 and 66 years and a male 55 years,who had low-grade fever during COVID-19 convalescence.All 3 patients had no other discomfort or comorbidities during low-grade process.Lesions on computed tomography in all 3 patients had resolved during this period.Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests.Body temperature in all 3 patients returned to normal after several days without treatment,and fever recurrence was not observed.CONCLUSION Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.展开更多
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 res...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.展开更多
The aim of this manuscript is to discuss the practice of antenatal corticosteroids administration for fetal maturation in severe acute respiratory syndrome coronavirus 2 positive pregnant women.Recent high-quality evi...The aim of this manuscript is to discuss the practice of antenatal corticosteroids administration for fetal maturation in severe acute respiratory syndrome coronavirus 2 positive pregnant women.Recent high-quality evidence supports the use of dexamethasone in the treatment of hospitalized patients with coronavirus disease 2019(COVID-19).Randomized disease outcome data have identified an association between disease stage and treatment outcome.In contrast to patients with more severe forms who benefit from dexamethasone,patients with mild disease do not appear to improve and may even be harmed by this treatment.Therefore,indiscriminate usage of fluorinated corticosteroids for fetal maturation,regardless of disease trajectory,is unadvisable.Obstetrical care needs to be adjusted during the COVID-19 pandemic with careful attention paid to candidate selection and risk stratification.展开更多
文摘Coronavirus disease 2019(COVID-19)consists of a systemic disease that can present many complications.The infection presents broad clinical symptoms and a high rate of transmissibility.In addition to severe acute respiratory syndrome,the patients manifest complications beyond the respiratory system.The frequency of liver damage in COVID-19 patients ranges from 14.8% to 53% of patients.One should pay attention to drug-induced liver injury(DILI)in patients with COVID-19,especially considering the off-label use of drugs in prophylactic and therapeutic regimens applied on large scales.This review aims to present relevant information on the medication used so far in COVID-19 patients and its possible hepatotoxicity.We reviewed liver damage in patients with COVID-19 on PubMed and Virtual Health Library to investigate DILI cases.Four studies were selected,involving the medicines remdesivir,tocilizumab and a pharmacovigilance analysis study.The hepatotoxicity profile of drugs presented in the literature considers use in accordance to usual posology standards for treatment.However,drugs currently used in the management of COVID-19 follow different dosages and posology than those tested by the pharmaceutical industry.The deficiency of uniformity and standardization in the assessment of hepatotoxicity cases hinders the publication of information and the possibility of comparing information among healthcare professionals.It is suggested that severe liver injury in COVID-19 patients should be reported in pharmacovigilance institutions,and physicians should pay attention to any considerable abnormal liver test elevation as it can demonstrate unknown drug hepatotoxicity.Liver disorders in COVID-19 patients and the use of several concomitant off-label medications—with a potential risk of further damaging the liver-should at least be a warning sign for rapid identification and early intervention,thus preventing liver damage from contributing to severe impairment in patients.
文摘COVID-19 is a pandemic that has affected nearly every country in the world.At present,sustainable development in the area of public health is considered vital to securing a promising and prosperous future for humans.However,widespread diseases,such as COVID-19,create numerous challenges to this goal,and some of those challenges are not yet defined.In this study,a Shallow Single-Layer Perceptron Neural Network(SSLPNN)and Gaussian Process Regression(GPR)model were used for the classification and prediction of confirmed COVID-19 cases in five geographically distributed regions of Asia with diverse settings and environmental conditions:namely,China,South Korea,Japan,Saudi Arabia,and Pakistan.Significant environmental and non-environmental features were taken as the input dataset,and confirmed COVID-19 cases were taken as the output dataset.A correlation analysis was done to identify patterns in the cases related to fluctuations in the associated variables.The results of this study established that the population and air quality index of a region had a statistically significant influence on the cases.However,age and the human development index had a negative influence on the cases.The proposed SSLPNN-based classification model performed well when predicting the classes of confirmed cases.During training,the binary classification model was highly accurate,with a Root Mean Square Error(RMSE)of 0.91.Likewise,the results of the regression analysis using the GPR technique with Matern 5/2 were highly accurate(RMSE=0.95239)when predicting the number of confirmed COVID-19 cases in an area.However,dynamic management has occupied a core place in studies on the sustainable development of public health but dynamic management depends on proactive strategies based on statistically verified approaches,like Artificial Intelligence(AI).In this study,an SSLPNN model has been trained to fit public health associated data into an appropriate class,allowing GPR to predict the number of confirmed COVID-19 cases in an area based on the given values of selected parameters. Therefore, this tool can help authorities in different ecological settingseffectively manage COVID-19.
文摘BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019(CoVID-19)patients.AIM To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.METHODS This study was a systematic review of current evidence conducted in August 2020.The authors studied the probable reinfection risk of novel coronavirus(CoVID-19).We performed a systematic search using the keywords in online databases.The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)checklist to ensure the reliability and validity of this study and results.RESULTS We reviewed 31 studies.Eight studies described reCoVered patients with reinfection.Only one study reported reinfected patients who died.In 26 studies,there was no information about the status of the patients.Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.CONCLUSION Based on our review,we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease.Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.
基金Supported by Emergency Special Project on Prevention and Treatment of COVID-19 with Traditional Chinese Medicine,No.2020YBBGWL007.
文摘BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019(COVID-19).Reports of such cases are rare,and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear.We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical,radiographic,and laboratory characteristics,thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.CASE SUMMARY We describe 3 patients with COVID-19,two females aged 62 and 66 years and a male 55 years,who had low-grade fever during COVID-19 convalescence.All 3 patients had no other discomfort or comorbidities during low-grade process.Lesions on computed tomography in all 3 patients had resolved during this period.Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests.Body temperature in all 3 patients returned to normal after several days without treatment,and fever recurrence was not observed.CONCLUSION Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.
文摘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.
文摘The aim of this manuscript is to discuss the practice of antenatal corticosteroids administration for fetal maturation in severe acute respiratory syndrome coronavirus 2 positive pregnant women.Recent high-quality evidence supports the use of dexamethasone in the treatment of hospitalized patients with coronavirus disease 2019(COVID-19).Randomized disease outcome data have identified an association between disease stage and treatment outcome.In contrast to patients with more severe forms who benefit from dexamethasone,patients with mild disease do not appear to improve and may even be harmed by this treatment.Therefore,indiscriminate usage of fluorinated corticosteroids for fetal maturation,regardless of disease trajectory,is unadvisable.Obstetrical care needs to be adjusted during the COVID-19 pandemic with careful attention paid to candidate selection and risk stratification.
