Background: Coronavirus disease 2019(COVID-19)is pandemic.It is critical to identify COVID-19 patients who are most likely to develop a severe disease.This study was designed to determine the clinical and epidemiologi...Background: Coronavirus disease 2019(COVID-19)is pandemic.It is critical to identify COVID-19 patients who are most likely to develop a severe disease.This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression.Methods:: Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing,China from December 27,2019 to March 12,2020 were enrolled in this study and followed-up to March 16,2020.Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by theχ2 test or the Fisher exact test(categorical variables)and independent group t test or Mann–Whitney U test(continuous variables).The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19.Results: The mean incubation was 8.67(95%confidence interval,6.78–10.56)days.Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38(9.86–12.90)days.Compared to pneumonia-free patients,pneumonia patients were 16.5 years older and had higher frequencies of having hypertension,fever,and cough and higher circulating levels of neutrophil proportion,interleukin-6,low count(<190/µl)of CD8+T cells,and neutrophil/lymphocyte ratio.Thirteen patients deteriorated during hospitalization.Cox regression analysis indicated that older age and higher serum levels of interleukin-6,C-reactive protein,procalcitonin,and lactate at admission significantly predicted the progression of COVID-19.During hospitalization,circulating counts of T lymphocytes,CD4+T cells,and CD8+T cells were lower,whereas neutrophil proportion,neutrophil/lymphocyte ratio,and the circulating levels of interleukin-6,C-reactive protein,and procalcitonin were higher,in pneumonia patients than in pneumonia-free patients.CD8+lymphocyte count in pneumonia patients did not recover when discharged.Conclusions: Older age and higher levels of C-reactive protein,procalcitionin,interleukin-6,and lactate might predict COVID-19 progression.T lymphocyte,especially CD8+cell-mediated immunity is critical in recovery of COVID-19.This study may help in predicting disease progression and designing immunotherapy for COVID-19.展开更多
As natural ecosystems provide the material basis and fundamental support for regional sustainable devel-opment,the sustainability of natural ecosystems is an important prerequisite and a viable approach for the achiev...As natural ecosystems provide the material basis and fundamental support for regional sustainable devel-opment,the sustainability of natural ecosystems is an important prerequisite and a viable approach for the achievement of regional sustainable development.It is also the final criteria to assess whether sustainable development paradigm is successful.Along with the increasing impacts of human activities on natural ecosystems,the evaluation of regional ecological sustainability has become one of the key issues for research on macro ecology and sustainable development.Based on different unit of indicators,this study firstly groups the evaluation frameworks of regional ecological sus-tainability into three major types:comprehensive index evaluation with dimensionless unit,monetary valuation,and biophysical quantity measurement.We then discuss and compare these types in terms of basic principles,scope of ap-plications,advantages and shortcomings.Finally,drawn on the discussion about characteristics of ecological sustain-ability,we outline the current trend and future directions of regional ecological sustainability evaluation,for instance,transition from sustainable development evaluation to sustainability science,integration of goal-oriented and problem-solving approaches,combination of spatial pattern analysis and ecological sustainability evaluation,and en-hancement of ecological sustainability evaluation at landscape scale.展开更多
基金This study was partly supported by National Natural Science Foundation of China(82041022 to:G Cao)Science and Technology Commission Shanghai Municipality(20JC1410200,20431900404 to:G Cao)Ministry of Science and Technology of the People’s Republic of China(2018ZX10101003-001-003 to:G Cao).
文摘Background: Coronavirus disease 2019(COVID-19)is pandemic.It is critical to identify COVID-19 patients who are most likely to develop a severe disease.This study was designed to determine the clinical and epidemiological features of COVID-19 patients associated with the development of pneumonia and factors associated with disease progression.Methods:: Seventy consecutive patients with etiologically confirmed COVID-19 admitted to PLA General Hospital in Beijing,China from December 27,2019 to March 12,2020 were enrolled in this study and followed-up to March 16,2020.Differences in clinical and laboratory findings between COVID-19 patients with pneumonia and those without were determined by theχ2 test or the Fisher exact test(categorical variables)and independent group t test or Mann–Whitney U test(continuous variables).The Cox proportional hazard model and Generalized Estimating Equations were applied to evaluate factors that predicted the progression of COVID-19.Results: The mean incubation was 8.67(95%confidence interval,6.78–10.56)days.Mean duration from the first test severe acute respiratory syndrome coronavirus 2-positive to conversion was 11.38(9.86–12.90)days.Compared to pneumonia-free patients,pneumonia patients were 16.5 years older and had higher frequencies of having hypertension,fever,and cough and higher circulating levels of neutrophil proportion,interleukin-6,low count(<190/µl)of CD8+T cells,and neutrophil/lymphocyte ratio.Thirteen patients deteriorated during hospitalization.Cox regression analysis indicated that older age and higher serum levels of interleukin-6,C-reactive protein,procalcitonin,and lactate at admission significantly predicted the progression of COVID-19.During hospitalization,circulating counts of T lymphocytes,CD4+T cells,and CD8+T cells were lower,whereas neutrophil proportion,neutrophil/lymphocyte ratio,and the circulating levels of interleukin-6,C-reactive protein,and procalcitonin were higher,in pneumonia patients than in pneumonia-free patients.CD8+lymphocyte count in pneumonia patients did not recover when discharged.Conclusions: Older age and higher levels of C-reactive protein,procalcitionin,interleukin-6,and lactate might predict COVID-19 progression.T lymphocyte,especially CD8+cell-mediated immunity is critical in recovery of COVID-19.This study may help in predicting disease progression and designing immunotherapy for COVID-19.
基金Under the auspices of National Natural Science Foundation of China (No.40635028,40801066)State Key Laboratory of Earth Surface Processes and Resource Ecology of China (No.2008-KF-04)
文摘As natural ecosystems provide the material basis and fundamental support for regional sustainable devel-opment,the sustainability of natural ecosystems is an important prerequisite and a viable approach for the achievement of regional sustainable development.It is also the final criteria to assess whether sustainable development paradigm is successful.Along with the increasing impacts of human activities on natural ecosystems,the evaluation of regional ecological sustainability has become one of the key issues for research on macro ecology and sustainable development.Based on different unit of indicators,this study firstly groups the evaluation frameworks of regional ecological sus-tainability into three major types:comprehensive index evaluation with dimensionless unit,monetary valuation,and biophysical quantity measurement.We then discuss and compare these types in terms of basic principles,scope of ap-plications,advantages and shortcomings.Finally,drawn on the discussion about characteristics of ecological sustain-ability,we outline the current trend and future directions of regional ecological sustainability evaluation,for instance,transition from sustainable development evaluation to sustainability science,integration of goal-oriented and problem-solving approaches,combination of spatial pattern analysis and ecological sustainability evaluation,and en-hancement of ecological sustainability evaluation at landscape scale.
