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Acute kidney injury (AKI) frequently complicates corona virus disease 2019 (COVID-19) and is associated with significant mortality. Kidney disease in COVID-19 is usually due to acute tubular injury, but a variety of glomerular processes, especially collapsing glomerulopathy, have been increasingly described. Until recently, proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) had not been reported in the setting of COVID-19. We present a case of dialysis-dependent AKI developing soon after symptomatic COVID-19 which, on kidney biopsy, was found to be due to PGNMID with IgG3 kappa deposits. As is typical of PGNMID, a search for evidence of extra-renal monoclonal immunoglobulin or clonal lymphocyte population was negative. However, the patient had a favorable response to anti-plasma cell therapy and was ultimately able to stop hemodialysis. Though monoclonal gammopathy of renal significance (MGRS) is usually not associated with infection, other cases of post-viral MGRS, including PGNMID, have been previously reported. PGNMID has recently been linked specifically to COVID-19, with this representing one of only four cases reported thus far. Though causality between the preceding viral infection and the subsequent glomerulonephritis cannot be proven in these reports, nephrologists should be aware that not all kidney disease occurring in the aftermath of COVID-19 is due to tubular injury or collapsing glomerulopathy. As such, kidney biopsy should be routinely considered in the setting of COVID-19-associated glomerular disease as findings may change management. In the case of COVID-19-associated PGNMID data to guide treatment are limited, but our report suggests that anti-plasma cell therapy may be effective.

OBJECTIVE: Corona Virus Disease-2019 (COVID-19) has been among the major infectious events of the century. In today's literature where COVID-19 and host factor effects are frequently examined, we aimed to examine another factor: Circadian Clock Protein PERIOD 3 (PER3). There is a significant correlation between PER3 gene polymorphism and circadian rhythm disturbances and immune system dysregulation. METHODS: In our study, we recruited 200 patients diagnosed with COVID-19 in our hospital between April-June 2020, and 100 volunteers without known comorbidities to create a healthy control group. After comparing the initial gene polymorphisms of the patients with healthy controls, three separate clinical subgroups were formed. Gene polymorphism distribution and statistical significance were examined in the formed patient groups. RESULTS: No significant difference was found between the patient group and the healthy controls (P>0.05, for all). When patients were divided into two separate clinical subgroups as exitus/alive according to their last condition during their 28-day follow-up, the 4R/5R genotype was significantly more common in patients with a mortal course (P=0.007). The PER3 4R/5R genotype was found at a significantly higher rate in the group of patients with the need for intensive care (P=0.034). CONCLUSION: The 4R/5R genotype may be associated with the need for intensive care and mortality in COVID-19 patients. These important results will be a guide for future studies.

This rapid review aims to compile evidence on the lung function of people with history of COVID-19

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.

With the rapid development of industrialization and urbanization in China, energy and vehicle consumption have continued to increase in recent years and air pollution has become serious. In early 2020, Corona Virus Disease 2019 broke out in Wuhan, China. From January 29, 2020, several sources of the air pollution almost all stopped working, including gasoline burning vehicles, dust producing building sites, coal-fired factories, etc. Five indicators of the atmospheric environmental quality were observed from December 19, 2019 to April 30, 2020 in nine cities and 1-h average concentrations, 24-h average concentrations and Air Quality Index were assessed. The 1-h average concentrations of the nitrogen dioxide, the ozone and the sulfur dioxide showed obvious difference though the closure did not change the sequence of the five pollutants’ concentrations in the air at diverse sampling moments. The changing of the 24-h average concentrations of the five pollutants indicated the amount of pollutants in the air were greatly affected by human activities. The nitrogen dioxide, the sulfur dioxide and the particulate matters decreased obviously in the closure. The air in the metropolis and the south-east cities were relatively clean and the pollutants’ concentrations decreased slightly during the closure period. The northern and the heavy industrial cities showed significant drop on air pollution indicators and the air quality of the two city groups could be greatly improved if some effective measures could be taken of environmental management and regional development.

The outbreak of Coronavirus Disease 2019 (COVID-19) has become a severe global acute respiratory pandemic around the world in just a few months with an increasing number of infections and deaths. COVID-19 is a highly contagious and fatal disease. Almost everyone in the population is susceptible, and the incubation period is 1–14 days, mostly 3–7 days. The clinical symptoms of the COVID-19 are fever, dry cough and fatigue. Some patients are accompanied by symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. Severe patients could even develop acute respiratory distress syndrome, septic shocks, metabolic acidosis and multifunctional organ failure, etc. Due to the relatively closed environment of dental clinics and the unique nature of dental procedures, both dental personnel and patients are easy to get infection through currently known respiratory droplet transmission, aerosol transmission, close contact transmission and other ways, inducing mutual cross-infection. Dental practitioners are facing unprecedented challenges due to the high risk of exposure to droplets and aerosols from saliva and other body fluids during dental procedures. Based on our experience and relevant research, this article introduces the basic knowledge about COVID-19 and the corresponding protective measures for dental practitioners, includes the risk of infection during dental procedures, the precautions related to the patients, infection control measures during dental treatment in clinics, protection measures at different levels for dental practitioners, and emergency dental treatment for confirmed COVID-19. It is the responsibility of every dental practitioner to fully understand the characteristics of the new coronavirus and strictly implement the most appropriate protective measures to reduce and control the risk of cross infection in dental procedures.

Corona virus disease 2019 (COVID‐19) was caused by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). The phenomenon of positive real time reverse transcription polymerase chain reaction (RT‐PCR) result of SARS‐CoV‐2 in recovered patients had occurred and the research about these patients was rare. In our study, we did a retrospective review of medical records from COVID‐19 patients admitted to one ward of Tongji Hospital of Hua Zhong University of Science and Technology from 10 February to 13 April 2020. From 10 February to 13 April 2020, there were 108 patients of COVID‐19 admitted in the one ward of Tongji Hospital. Among them, eight cases were readmission patients because the RT‐PCR result of SARS‐CoV‐2 was positive again after discharge. On the second admission, they had no symptoms and their chest computed tomography was almost normal. Data from laboratory tests of the readmission patients showed that all eight patients had normal white blood cell count, lymphocyte count. The inflammatory factors like procalcitonin and interleukin 6 were normal. After treatment, two patients met the standard and were discharged. The other six patients were still in the hospital because their RT‐PCR of SARS‐CoV‐2 did not get three consecutive negative results and the course of two patients had persisted more than 90 days. We still needed to be alert that these patients could infect other people as a source of infection, and we also needed to be alert that these patients become chronic virus carriers. It also aroused our concern about the discharge standard of COVID‐19., Highlights From 10 February to 13 April 2020, there were 108 patients of COVID‐19 admitted in the one ward of Tongji Hospital.Among them, eight cases were readmission patients because the RT‐PCR result of Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐COV‐2) was positive again after discharge.The course of two patients had persisted more than 90 days.We still needed to be alert that these patients become chronic virus carriers.It also aroused our concern about the discharge standard of COVID‐19.

Vaccine-induced thrombotic thrombocytopenia is a life-threatening prothrombotic syndrome that has been associated with two adenoviral vector-based coronavirus disease 2019 (COVID-19) vaccines. Although it remains a rare disorder with relatively low incidence, awareness of this condition is crucial given the ongoing vaccination programs of millions around the world. In this case series, we report four cases of vaccine-induced thrombotic thrombocytopenia, diagnosed at Queen Alexandra Hospital, Portsmouth, United Kingdom. We also review the mechanism of this syndrome, its clinical presentation, diagnosis, and course of treatment with emphasis on the role of therapeutic plasma exchange.

Objectives: To evaluate the effect of in-hospital pulmonary rehabilitation (PR) on short-term pulmonary functional recovery in patients with COVID-19.Methods: Patients with COVID-19 (n = 123) were divided into two groups (PR group or Control group) according to recipient of pulmonary rehabilitation. Six-min walk distance (6MW), heart rate (HR), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), diffusing capacity of the lung for carbon monoxide (DLCO), and CT scanning were measured at the time of discharge, 1, 4, 12, and 24 weeks.Results: At week one, both PR group and Control group showed no significant changes in pulmonary function. At 4 and 12 weeks, 6MW, HR, FVC, FEV1, and DLCO improved significantly in both groups. However, the improvement in the PR group was greater than the Control group. Pulmonary function in the PR group returned to normal at 4 weeks [FVC (% predicted, PR vs. Control): 86.27 ± 9.14 vs. 78.87 ± 7.55; FEV1 (% predicted, PR vs. Control) 88.76 ± 6.22 vs. 78.96 ± 6.91; DLCO (% predicted, PR vs. Control): 87.27 ± 6.20 vs. 77.78 ± 5.85] compared to 12 weeks in the control group [FVC (% predicted, PR vs. Control): 90.61 ± 6.05 vs. 89.96 ± 4.05; FEV1 (% predicted, PR vs. Control) 94.06 ± 0.43 vs. 93.85 ± 5.61; DLCO (% predicted, PR vs. Control): 91.99 ± 8.73 vs. 88.57 ± 5.37]. Residual lesions on CT disappeared at week 4 in 49 patients in PR group and in 28 patients in control group (p = 0.0004).Conclusion: Pulmonary rehabilitation could accelerate the recovery of pulmonary function in patients with COVID-19.

Background Inadvertent delays in access to appropriate therapeutic interventions in high-risk group coronavirus disease 2019 (COVID-19) patients contribute to mortality in patients with severe/critical disease presentation. Objectives The aim of this study was to determine the effect of timely admission to the hospital on mortality of patients with severe/critical COVID-19. Another secondary aspect of this study was to observe the efficacy of time-dependent use of corticosteroids on mortality of critical/severe COVID-19 patients. Methods Clinical data of 659 patients with severe/critical COVID-19, admitted to four major tertiary care hospitals from the Islamabad-Rawalpindi region of Pakistan was retrospectively collected from a period February–August 2020. Multivariate logistic regression analysis was carried out to determine the predictors of mortality in severe/critical COVID-19 patients. Results Out of a total of 659 patients, 469 (71.2%) patients died. Age > 60 years, presence of hypertension, heart disease and kidney disease along with late admission (>5 days) were significant predictors of mortality in patients with severe/critical COVID-19. Conclusions The study highlights the importance of well-timed provision of appropriate medical interventions control COVID-19-associated mortality.

Like its predecessors, coronavirus disease 2019 (COVID-19) can lead to long-term health-related consequences in a significant segment of the afflicted population. Although the medical community has developed multiple vaccines by now, COVID-19 has affected over 100 million individuals worldwide and will infect millions more before vaccines can be effectively distributed on a global scale. Additionally, it seems probable that another outbreak caused by a coronavirus may occur in the future, given that this is the third outbreak caused by a coronavirus in recent history. In light of this, the medical community must develop reliable methods of curtailing long-term sequelae of coronaviruses, and the use of corticosteroids in affected patients may be vital for this purpose. In this report, we present a case of progressive dyspnea caused by COVID-19 pneumonia; the patient was treated with a short course of oral corticosteroids, and subsequently showed marked improvement of the dyspnea with corresponding improvements on chest CT.

Background To permit timely mitigation of adverse effects on overall clinical outcome, it is essential to understand how the pandemic influences distress and health‐related quality of life (HRQOL) in cancer patients during the coronavirus disease 2019 (COVID‐19) pandemic. Methods In this cross‐sectional study, adult cancer patients, without COVID‐19 symptoms, completed a 13‐item questionnaire about the pandemic's impacts on distress and everyday‐life; associations with age, sex, or impaired HRQOL were then assessed by binary logistic regressions. In a subsample of patients with HRQOL assessment available from both before and during the pandemic, we evaluated the pandemic's impact on longitudinal changes in HRQOL reported within 6 months before versus during the COVID‐19 lockdown using McNemar's test, and thresholds for clinical importance. Results We consecutively enrolled 240 patients with solid (50%) or hematological (50%) cancers. Median age was 67 years, 46% were females. The majority ranked heeding their health (80%) and keeping their appointment schedule in hospital (78%) as important. Being younger than 60, or aged 60–70 was independently associated with limitations in everyday life (OR = 3.57, p, In this cross‐sectional study of 240 cancer patients, the majority reported heeding their own health and wished to maintain their appointment schedule. We observed significantly more restrictions in younger and female patients. Comparing quality of life in the timespan before versus during the COVID‐19 pandemic revealed that quality of life was not substantially affected by the COVID‐19 crisis but indicated that cancer patients generally cope unexpectedly well with the pandemic, being already used to restrictions in their everyday life.

It is recommended to use visual laryngoscope for tracheal intubation in a Corona Virus Disease 2019 patient to keep the operator farther from the patient. How the position of the operator affects the distance in this setting is not ascertained. This manikin study compares the distances between the operator and the model and the intubation conditions when the operator is in sitting position and standing position, respectively. Thirty one anesthesiologists with minimum 3-years’ work experiences participated in the study. The participant's posture was photographed when he performed tracheal intubation using UE visual laryngoscope in standing and sitting position, respectively. The shortest distance between the model's upper central incisor and operator's face screen (UF), the horizontal distance between the model's upper central incisor and the operator's face screen, the angle between the UF line and the vertical line of the model's upper central incisor were measured. The success rate of intubation, the duration of intubation procedure, the first-attempt success rate, the Cormack–Lehane grade, and operator comfort score were also recorded. When the operator performed the procedure in sitting position, the horizontal distance between the model's upper central incisor and the operator's face screen distance was significantly longer (9.5 [0.0–17.2] vs 24.3 [10.3–33.0], P ≤ .001) and the angle between the UF line and the vertical line of the model's upper central incisor angle was significantly larger (45.2 [16.3–75.5] vs 17.7 [0.0–38.9], P ≤ .001). There was no significant difference in UF distance when the operator changed the position. Cormack–Lehane grade was significantly improved when it was assessed using visual laryngoscope. Cormack–Lehane grade was not significantly different when the operator assessed it in sitting and standing position, respectively. No significant differences were found in the success rate, duration for intubation, first-attempt success rate, and operator comfort score. The operator is kept farther from the patient when he performs intubation procedure in sitting position. Meanwhile, it does not make the procedure more difficult or uncomfortable for the operator, though all the participants prefer to standing position.

Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has been associated with a significantly increased risk of venous and arterial thromboembolism, particularly in severely sick patients. Recently, cerebral venous sinus thrombosis (CVST) cases have been reported in the context of coronavirus disease-2019 (COVID-19). These cases either had an active COVID infection with a positive reverse transcription‐polymerase chain reaction (RT‐PCR) or were symptomatic (fever, respiratory symptoms, myalgia) during the presentation. We present here a 41-year-old male with CVST who had negative RT-PCR and positive immunoglobulin G (IgG) COVID-19 antibodies. He was neither diagnosed nor had a flu-like illness before admission. This case highlights that CVST can be a late sequela of previously undiagnosed asymptomatic COVID-19 infection.

We investigated hospital admission rates for the entire spectrum of acute cerebrovascular diseases and of recanalization treatments for ischaemic stroke (IS) in the Austrian federal state of Styria during and also after the first coronavirus disease 2019 (COVID-19) wave. We retrospectively identified all patients with transient ischaemic attack (TIA), IS and non-traumatic intracranial haemorrhage (ICH; including intracerebral, subdural and subarachnoid bleeding types) admitted to one of the 11 public hospitals in Styria (covering > 95% of inhospital cerebrovascular events in this region). Information was extracted from the electronic medical documentation network connecting all public Styrian hospitals. We analysed two periods of interest: (1) three peak months of the first COVID-19 wave (March–May 2020), and (2) three recovery months thereafter (June–August 2020), compared to respective periods 4 years prior (2016–2019) using Poisson regression. In the three peak months of the first COVID-19 wave, there was an overall decline in hospital admissions for acute cerebrovascular diseases (RR = 0.83, 95% CI 0.78–0.89, p p p = 0.02), but not for IS (RR = 0.93, 95% CI 0.85–1, p = 0.08). Thrombolysis and thrombectomy numbers were not different compared to respective months 4 years prior. In the recovery period after the first COVID-19 wave, TIA (RR = 0.82, 95% CI 0.71–0.96, p = 0.011) and ICH (RR = 0.86, 95% CI 0.74–0.99, p = 0.045) hospitalizations remained lower, while the frequency of IS and recanalization treatments was unchanged. In this state-wide analysis covering all types of acute cerebrovascular diseases, hospital admissions for TIA and ICH were reduced during and also after the first wave of the COVID-19 pandemic, but hospitalizations and recanalization treatments for IS were not affected in these two periods.

Background: Since its first report in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly emerged as a pandemic affecting nearly all countries worldwide. So far, there is no specific anti-coronavirus therapy approved for the treatment of COVID-19. In China, some traditional Chinese medicines (TCM) have been successfully applied to the treatment of SARS-CoV-2 and have achieved good clinical results, including the Reyanning mixture, but there is no systematic review about it. This study will systematically evaluate its efficacy and safety in the treatment of COVID-19. Methods: The following electronic bibliographic databases will be searched to identify relevant studies: PubMed, MEDLINE, EMBASE, CNKI, CBM, and Wanfang databases. We will use the Cochrane Handbook for Systematic Reviews of Interventions to assess the risk of bias. The protocol will be conducted according to the approach and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Manager 5.3 software and STATA 16.0 software were used to perform the meta-analysis. Results: The systematic review and meta-analysis aims to review and pool current clinical outcomes of Reyanning mixture for the treatment of COVID-19. Conclusion: The conclusion of this review will provide evidence to judge whether Reyanning mixture combined with Conventional Western Medicine is an effective and safe intervention for COVID-19. INPLASY registration number: INPLASY2020120044.

Huashi Baidu prescription (HSBDF), recommended in the Guideline for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Pneumonia (On Trials, the Seventh Edition), was clinically used to treat severe corona virus disease 2019 (COVID-19) with cough, blood-stained sputum, inhibited defecation, red tongue etc. symptoms. This study was aimed to elucidate and profile the knowledge on its chemical constituents and the potential anti-inflammatory effect in vitro. In the study, the chemical constituents in extract of HSBDF were characterized by UPLC-Q-TOF/MS in both negative and positive modes, and the pro-inflammatory cytokines were measured by enzyme-linked immunosorbent assays (ELISA) to determine the effects of HSBDF in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The results showed that a total of 217 chemical constituents were tentativedly characterized in HSBDF. Moreover, HSBDF could alleviate the expression levels of IL-6 and TNF-α in the cell models, indicating that the antiviral effects of HSBDF might be associated with regulation of the inflammatory cytokines production in RAW264.7 cells. We hope that the results could be served as the basic data for further study of HSBDF on anti-COVID-19 effect.

ObjectivesWe performed an environmental sampling study to investigate the environmental contamination of SARS-CoV-2 by COVID-19 patients with prolonged PCR positive status of clinical samples.MethodsWe sampled the air from rooms for nine COVID-19 patients with illness or positive PCR > 30 days, before and after nasopharyngeal/oropharyngeal swabbing and before and after nebulization treatment. We also sampled patients’ surroundings and healthcare workers’ personal protection equipment (PPE) in a non-ICU ward. SARS-CoV-2 was detected by PCR.ResultsEighty-eight samples were collected from high-touch surfaces and floors in patient rooms and toilets, with only the bedsheets of two patients and one toilet positive for SARS-CoV-2. All air samples (n = 34) were negative for SARS-CoV-2. Fifty-five samples collected from PPE were all negative.ConclusionContamination of near-patient surroundings was uncommon for COVID-19 patients with prolonged PCR positive status if environmental cleaning/disinfection were performed rigorously. Airborne transmission of SARS-CoV-2 was unlikely in these non-ICU settings.

Importance: Corona virus disease 2019 (COVID-19) has long latent period, strong infectivity, and non-specific symptoms and signs in the upper respiratory tract. Some initial neurological symptoms appear, including dizziness, headache, seizures, slurred speech, disturbance of consciousness, and limb paralysis among a few COVID-19 patients, which share similar manifestations with central nervous system (CNS) infection. Improving the diagnostic efficiency of suspected CNS infection patients on the basis of preventing and controlling COVID-19 plays a key role in preventing nosocomial and cross infections. This study intends to formulate a hospital emergency management system of fastlane treatment of CNS infection for epidemic prevention and control, aiming at providing references and guidelines for the government and medical institutions to improve the efficiency of treating CNS infection patients in the clinical practice during COVID-19. Observations: This study formulated a framework of a fastlane treatment of CNS infection based on the cooperation of resources and experience, aiming at the key and difficult problems faced by the hospital emergency management system during the COVID-19 outbreak in Changsha, China. The main problem of formulating the hospital emergency management system is efficiently identifying whether CNS infection was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The framework improves the efficiency of diagnosing and treating CNS infections by standardizing the diagnosis and treatment process of patients in emergency observation and strengthening the management of inpatient wards, aiming at assisting medical staff during clinical practice. Conclusions and Relevance: The hospital emergency management system of a fastlane treatment of CNS infection for epidemic prevention and control of the COVID-19 outbreak is a professional and multisystem project, which needs the cooperation of various resources and the experience of clinical leadership.

Since the declaration of coronavirus disease 2019 (COVID-19) disease as a pandemic by the World Health Organization (WHO), it has been a challenge to the whole medical community. Researchers and clinicians have been trying to explain and explore its mechanism and pathophysiology to get a better understanding of this disease, as it has exhausted the healthcare resources and has impacted human life in general. Many tests have been developed including polymerase chain reaction (PCR) of the virus and rapid diagnostic testing in patients based on IgM/IgG serology. But owing to variable sensitivity and specificity of these tests, it has created a challenging situation to proceed with the further management plan. We are reporting a case series where we experienced the dilemma of diagnosing COVID-9 disease in our patients and further plan of care.

Background: A worldwide concern has been raised that novel infectious diseases may outbreak rapidly with a limited response time due to globalization. Severe Acute Respiratory Syndrome, influenza A, Avian Influenza Virus, and Corona Virus Disease 2019 are acute respiratory diseases that have been affected by the movements of people, and globalization accelerates these movements. These infectious diseases not only have an overwhelming health impact but also impact the worldwide economy. Methods: We will conduct a systematic review and meta-analysis in Chinese National Knowledge Infrastructure, WANFANG Database, and the VIP Database for Chinese Technical Periodicals, Web of Science, PubMed, EMBASE, the Cochrane Library, EBSCO host, ProQuest, ProQuest Dissertations & Theses A&I, SAGE Journals, ScienceDirect, JSTOR, and Scopus. We will evaluate the risk of bias of included RCTs according to the criteria and technique proposed in the Cochrane Handbook V.5.1.0 and use ROBINS-I to assess risk of bias in nonrandomized studies. We will use GRADE to evaluate the quality of evidence. Results: Results of this review will be submitted to a peer-reviewed journal. Conclusion: To the best of our knowledge, this study will firstly evaluate both health and economic impact of infectious diseases in china and may provide strategy development ideas for future resistance.

Rationale: To assess the longitudinal changes and relationships of clinical measures and extent of CT lung abnormalities in COVID-19. Methods: 81 patients with COVID-19 were prospectively enrolled and followed until discharge. CT scores were quantified on a basis of a CT scoring system where each lung was divided into 3 zones: upper (above the carina), middle, and lower (below the inferior pulmonary vein) zones; each zone was evaluated for percentage of lung involvement on a scale of 0-4 (0, 0%; 1, 0-24%; 2, 25% - 49%; 3, 50% -74%; 4, >74%).Temporal trends of CT scores and the laboratory parameters characteristic of COVID-19 were analyzed. Correlations between the two were determined at three milestones (initial presentation, worst CT manifestation, and recovery finding before discharge). Their correlations with duration to worst CT manifestation and discharge from symptom onset were evaluated. Results: CT scores peaked during illness days 6-11 (median: 5), and stayed steady. C-reactive protein and lactate dehydrogenase increased, peaked on illness days 6-8 and 8-11 (mean: 23.5 mg/L, 259.9 U/L), and gradually declined. Continual decrease and increase were observed in hemoglobin and lymphocyte count, respectively. Albumin reduced and remained at low levels with a nadir on illness days 12-15 (36.6 g/L). Both initial (r = 0.58, 0.64, p < 0.05) and worst CT scores (r = 0.47, 0.65, p < 0.05) were correlated with C-reactive protein and lactate dehydrogenase; and CT scores before discharge, only with albumin (r = -0.41, p < 0.05). Duration to worst CT manifestation was associated with initial and worst CT scores (r = 0.33, 0.29, p < 0.05). No parameters were related to timespan to discharge. Conclusion: Our results illustrated the temporal changes of characteristic clinical measures and extent of CT lung abnormalities in COVID-19. CT scores correlated with some important laboratory parameters, and might serve as prognostic factors.

Object Corona virus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which leads to acute respiratory infection symptoms. SARS-CoV-2 infection is not always limited to the respiratory tract, and renal infection and dysfunction have been shown to be specific risk factors for death. In addition, COVID-19 has a higher incidence, severity and mortality in men than women. This disparity is due to biological rather than comorbid or behavioral sex differences. Because the male reproductive system is unique, the function of sex hormones in COVID-19 infection may explain the differences between males and females. Understanding these factors will provide appropriate prevention measures and adequate triage strategies and guide the drug discovery process. Methods An electronic search was completed in PubMed, ARXIV, MEDRXIV and BIORXIV. The most relevant articles were systematically reviewed. In addition, single cell RNA sequencing analysis of tissue samples from human cell landscape was conducted. Results The influence of SARS-CoV-2 on the urogenital system, the possibility of urinary tract transmission and the functions of sex hormones were discussed in this review. Conclusion Corona viruses can invade the genitourinary system, causing urological symptoms. Identifying the potential genitourinary organ impairments and protecting them from damage are necessary. Since sex hormones have potential as specific drugs, the gonadal hormones substitution therapy should be considered in both sexes in the COVID-19 pandemic.

The Corona Virus Disease 2019 (COVID-19) is an acute respiratory infectious disease. At present, COVID-19 has no specific therapeutic drugs, and the main clinical treatment is symptomatic treatment and control of complications. On March 5, 2020, the National Health Commission of the People’s Republic of China issued the Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection (Trial Version 7), which integrated traditional Chinese medicine (TCM) into the treatment of COVID-19. The purpose of this study is to summarize recent studies on the clinic application, pharmacological action, chemical substances and mechanism of Qingwen Baidu Decoction (QBD) on the treatment of various diseases. The results suggested that QBD has multiple pharmacological effects such as anti-inflammation, antiviral, antibacterial, immunomodulatory, antipyretic and so on. It has been used in the treatment of sepsis, epidemic hemorrhagic fever, epidemic cerebrospinal meningitis, infantile pneumonia, sepsis-related encephalopathy, epidemic encephalitis B and other diseases. In addition, this study attempts to explore the possible mechanism of QBD in the prevention and treatment of COVID-19. Through the analysis of the chemical substances, pharmacological action and mechanism of QBD, this paper will provide a reference theoretical basis for the prevention and treatment of COVID-19 by QBD.

The study analysed healthcare workers' (HCWs) knowledge, practices, and attitudes regarding coronavirus disease 2019 (COVID-19). A cross-sectional survey was conducted from February 4th to February 8th, 2020, involving a total of 1357 HCWs across 10 hospitals in Henan, China. Of those surveyed, 89% of HCWs had sufficient knowledge of COVID-19, more than 85% feared self-infection with the virus, and 89.7% followed correct practices regarding COVID-19. In addition to knowledge level, some risk factors including work experience and job category influenced HCWs' attitudes and practice concerning COVID-19. Measures must be taken to protect HCWs from risks linked to job category, work experience, working hours, educational attainment, and frontline HCWs.

Since December 2019, increasing attention has been paid to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in Wuhan, China. SARS-CoV-2 primarily invades the respiratory tract and lungs, leading to pneumonia and other systemic disorders. The effect of SARS-CoV-2 in transplant recipients has raised significant concerns, especially because there is a large population of transplant recipients in China. Based on the current epidemic situation, this study reviewed publications on this virus and coronavirus disease 2019 (COVID-19), analyzed common features of respiratory viral pneumonias, and presented the currently reported clinical characteristics of COVID-19 in transplant recipients to improve strategies regarding the diagnosis and treatment of COVID-19 in this special population.

Background The ongoing new coronavirus pneumonia (Corona Virus Disease 2019,COVID-19) outbreak is spreading in China, but it has not yet reached its peak. Five million people emigrated from Wuhan before lockdown, potentially representing a source of virus infection. Determining case distribution and its correlation with population emigration from Wuhan in the early stage of the epidemic is of great importance for early warning and for the prevention of future outbreaks. Methods The official case report on the COVID-19 epidemic was collected as of January 30, 2020. Time and location information on COVID-19 cases was extracted and analyzed using ArcGIS and WinBUGS software. Data on population migration from Wuhan City and Hubei province were extracted from Baidu Qianxi, and their correlation with the number of cases was analyzed. Results The COVID-19 confirmed and death cases in Hubei province accounted for 59.91% (5806/9692) and 95.77% (204/213) of the total cases in China respectively. Hot spot provinces included Sichuan and Yunnan, which are adjacent to Hubei. The time risk of Hubei province on the following day was 1.960 times that on the previous day. The number of cases in some cities was relatively low, but the time risk appeared to be continuously rising. The correlation coefficient between the provincial number of cases and emigration from Wuhan was up to 0.943. The lockdown of 17 cities in Hubei province and the implementation of nationwide control measures efficiently prevented an exponential growth in the number of cases. Conclusions The population that emigrated from Wuhan was the main infection source in other cities and provinces. Some cities with a low number of cases showed a rapid increase in case load. Owing to the upcoming Spring Festival return wave, understanding the risk trends in different regions is crucial to ensure preparedness at both the individual and organization levels and to prevent new outbreaks. Key words: COVID-19; 2019-nCoV; Temporal; Spatial; Distribution; Outbreak

Introduction: With the current coronavirus disease 2019 (COVID-19) pandemic, concerns have been raised about the risk to children with inflammatory bowel diseases (IBD). We aimed to collate global experience and provide provisional guidance for managing paediatric IBD (PIBD) in the era of COVID-19. Methods: An electronic reporting system of children with IBD infected with SARS-CoV-2 has been circulated among 102 PIBD centres affiliated with the Porto and Interest-group of ESPGHAN. A survey has been completed by major PIBD centres in China and South-Korea to explore management during the pandemic. A third survey collected current practice of PIBD treatment. Finally, guidance points for practice have been formulated and voted upon by 37 PIBD authors and Porto group members. Results: Eight PIBD children had COVID-19 globally, all with mild infection without needing hospitalization despite treatment with immunomodulators and/or biologics. No cases have been reported in China and South Korea but biologic treatment has been delayed in 79 children, of whom 17 (22%) had exacerbation of their IBD. Among the Porto group members, face-to-face appointments were often replaced by remote consultations but almost all did not change current IBD treatment. Ten guidance points for clinicians caring for PIBD patients in epidemic areas have been endorsed with consensus rate of 92% to 100%. Conclusions: Preliminary data for PIBD patients during COVID-19 outbreak are reassuring. Standard IBD treatments including biologics should continue at present through the pandemic, especially in children who generally have more severe IBD course on one hand, and milder SARS-CoV-2 infection on the other. Supplemental digital content: An infographic accompanying this article can be found at.

Introduction: Since 2019, corona virus disease 2019 (COVID-19) has become a new round of “epidemic,” which has brought about a major crisis to the world from national development, to people's life safety and mental health. Faced with the constant variation of viruses, from COVID-19 to Delta to Omicron. How to curb its further deterioration and enhance human defense against viruses is the focus of scientific researchers. From previous studies, we found that in addition to basic medical treatment, swimming with a certain amount of load and intensity can promote the ventilator of the human body, thereby playing an auxiliary and preventive role in the treatment of COVID-19 and its variant strains. Methods: This study searched China knowledge network, Web of science, Google scholar, PubMed database to search for the relevant research on swimming prevention and treatment for COVID-19, and the deadline for searching was December 2021. Two researchers independently screened and extracted the literature, and evaluated the bias risk of the included studies. The methodological quality of the included literature was evaluated by the Chochrane bias risk assessment tool. Result: This study will provide new evidence for the prevention and recovery of COVID-19 and its variant strains by swimming. Conclusion: To provide a method to help the prevention and restoration of COVID-19 and its variant strains by swimming. INPLASY registration number: INPLASY2021120075.

Background: In December 2019, the first case of Corona Virus Disease 2019 (COVID-19) associated with severe acute respiratory syndrome coronavirus-2 viral infection was described in Wuhan. Similar to SARS in 2003, COVID-19 also had a lasting impact. Approximately 76% of patients discharged after hospitalization for COVID-19 had neurological manifestations which could persist for 6 months, and some long-term consequences such as the gradual loss of lung function due to pulmonary interstitial fibrosis could have comprehensive effects on daily quality of life for people who were initially believed to have recovered from COVID-19. Methods and analysis: Our comprehensive search strategy developed in consultation with a research librarian. We will search these following electronic databases: PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, Google Scholar, Embase, ProQuest, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure, WANFANG DATA, WHO covid-19 website, and Centers for Disease Control and the Prevention COVID-19 websites of the United States and China. The bias of publication will be confirmed via the P value of Egger test. The quality of studies will be evaluated by the Newcastle-Ottawa Scale. Ethics and dissemination: There are no ethical considerations associated with this study protocol for this systematic review which mainly focuses on the examination of secondary data. On completion of this analysis, we will prepare a manuscript for publication in a peer-reviewed medical journal. PROSPERO registration number: CRD42021258711.

Corona virus disease 2019 (COVID-19) is a global emergency able to overwhelm the healthcare capacities worldwide and to affect the older generation especially. When addressing the pathophysiological mechanisms and clinical manifestations of COVID-19, it becomes evident that the disease targets pathways and domains affected by the main aging- and frailty-related pathophysiological changes. A closer analysis of the existing data supports a possible role of biological age rather than chronological age in the prognosis of COVID-19. There is a need for systematic, consequent action of identifying frail (not only older, not only multimorbid, not only symptomatic) persons at risk of poor outcomes.

Aim: The present study explores the effects of high population density (PD), climatic and environmental factors on transmission of coronavirus disease 2019 (COVID-19) in selected metropolitan cities of India. Materials and Methods: A data extraction sheet has been prepared to summarize the data of confirmed severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) cases and number of deaths in ten metropolitan cities, which was taken from Government of India website. The data on environmental factors of each selected metropolitan city were compiled from the official website and climatic conditions from Meteorological Department Government of India. Results: In India, maximum positive COVID-19 cases (>32%) has been found in tropical wet and dry climate zone. While the incidence of COVID-19 cases has been found less in the arid zone of India. Poor correlation has been found between level of Vitamin D, total COVID-19 cases, and mortalities in the studied metropolitan cities. No significant correlation was found between the health care index and COVID-19 cases and mortality. Conclusions: Correspondence and principal component analysis statistics showed high PD, poverty, climatic and environmental factors influenced the SARS-CoV-2 transmission in metropolitan cities of India.

Thrombotic complications have been reported widely in patients with severe coronavirus disease 2019 (COVID-19) infection. There has been an increasing trend of arterial thrombosis leading to significant morbidity and mortality. We report a case of a patient with COVID-19 related pneumonia who presented with acute limb ischemia.

Background: Since the COVID-19 outbreak in 2020, more than 20 million people worldwide have been diagnosed with COVID-19, and all health care workers are looking for ways to improve the cure rate of the disease. As an important method of rehabilitation therapy, exercise therapy has been proved to improve the level of human function, promote the recovery of diseases, and improve the human immune ability. The main objective of this study was to provide reliable methods and credible evidence for exercise therapy to improve the prognosis of COVID-19 patients. Methods and analysis: The scheme was systematically reviewed in accordance with the preferred reporting items. We searched the following experimental databases: Cochrane Library, PubMed, EMBASE, Web of Science, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure Database (CNKI), China Science and Wanfang Database. All trials using exercise therapy for rehabilitation of COVID-19 patients in the above database should be considered for inclusion. Relevant randomised controlled trials(RCTS), controlled before and after, interrupted time series and prospective analytic cohort studies regardless of publication date, language and geographic location, will be included. To summarize the therapeutic effect of exercise therapy on COVID-19 patients, high-quality literature was selected for data extraction and analysis. Two reviewers will independently screen titles, abstracts and full-text articles against inclusion criteria; perform data extraction and assess risk of bias in included studies. We will assess the certainty of the overall evidence using the Grading of Recommendations Assessment, Development and Evaluation approach and report findings accordingly. Results: In this study, we hope to summarize effective exercise therapy that can improve the prognosis of COVID-19 patients and find strong evidence for it. Conclusions: The conclusions of this study will provide reliable evidence to determine whether exercise and exercise therapy can improve the prognosis of COVID-19 patients and guide future studies. PROSPERO registration number: CRD42020209025.

Background: In times of the corona virus disease 2019 (COVID-19) pandemic, due to the urgent need to respond quickly to the challenges posed by the introduction of a new etiological agent and the peculiarity of the disease, which poses risks to people's lives and health, the use of digital technologies for monitoring and surveillance have been used as a means of fighting coronavirus. Thus, this study will identify the use of digital technologies to monitor, identify contacts and track transmission chains of COVID-19 worldwide. Methods: The systematic review of this protocol will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Protocols. We will include studies that present digital technologies used in the monitoring of infected people, contact identification and the transmission chain of COVID-19 developed worldwide. For the selection of articles, the following databases will be consulted: PubMed, EMBASE, LILACS, Web of Science, Science Direct, Scopus, Livivo and CINAHL. In addition, we will conduct extensive research on selected sources of gray literature, including bibliographic databases, web-based search engines, practice-oriented magazines and government websites. Data extraction will take place in 2 stages (1- title and abstract screening and 2- full-text screening) and will be carried out independently by 2 reviewers, using the Mendeley software and the Rayyan QCRI application. The studies will be characterized as to the type and design of the study in relation to the ease in demonstrating the technologies used and the type of information produced. If it is necessary to synthesize quantitative data, the heterogeneity assessment will be performed using I2 statistics, and the meta-analysis will be processed using Review Manager 5.3. Results: The development of this research will allow the knowledge of how these technologies were applied according to each territory and their effectiveness in reducing cases of COVID-19. Conclusion: The results of this review can reveal the importance of modern technologies for reducing cases of COVID-19 and that these measures can be adopted by governments, organizations and for everyone Record of systematic review: CRD42020211744.

Highlights • COVID-19 pandemic significantly affects mental health of Chinese people. • Younger people had a higher rate of anxiety and depressive disorder than older people. • Healthcare workers were at high risk for lacking of sleep., We aimed to assess the Chinese mental health burden during the COVID-19 pandemic. Data were collected from 7,236 participants assessed with anxiety disorders, depressive symptoms, and poor sleep . The overall prevalence of anxiety disorders, depressive symptoms, sleep quality were 35.1%, 20.1%, 18.2%, respectively. Younger people reported a higher prevalence of anxiety disorders and depressive symptoms than older people (P < 0.001). Compared with other occupation, healthcare workers have the highest rate of poor sleep quality (P < 0.001). We identified a major mental health burden of the public during the COVID-19 pandemic outbreak in China. Younger people and healthcare workers were at high risk for mental illness.

Background: Cancer patients are in a state of systemic immunosuppression and are considered a highly vulnerable population in the Corona Virus Disease 2019 (COVID-19) epidemic. However, the relationship between cancer and the severity and mortality of patients with COVID-19 remains unclear. This study aims to evaluate whether cancer patients with COVID-19 may be at an increased risk of severe illness and mortality. Methods: We will perform comprehensive searches in PubMed, EMBASE.com, Web of Science, and the Cochrane Central Register of Controlled Trials to identify studies providing prevalence of cancer between patients with severe and non-severe illness or between non-survivors and survivors. We will use the Newcastle-Ottawa quality assessment scale to assess the quality of included studies. We will conduct pairwise meta-analyses to compute the odds ratio and 95% confidence interval using the Mantel Haenszel method with the random-effects model. The statistical heterogeneity will be assessed using the I2 statistic. Subgroup analyses, sensitivity analyses, and meta-regression analyses will be performed to explore the sources of heterogeneity. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: Our meta-analysis will systematically evaluate the association between cancer and the severity and mortality of patients with COVID-19. This study will provide evidence to help determine whether cancer patients should be provided with special precautions and advised to use stronger personal protection. INPLASY registration number: INPLASY202090093.

Background: The outbreak of Corona Virus Disease 2019 (COVID-19) might affect the psychological health of population, especially medical workers. We aimed to investigate the impact of the COVID-19 pandemic on emotional and cognitive responses and behavioral coping among Chinese residents. Methods: An online investigation was run from 5 February to 25 February 2020, which recruited a total of 616 Chinese residents. Self-designed questionnaires were used to collect demographic information, epidemic knowledge and prevention of COVID-19 and characteristics of medical workers. The emotional and cognitive responses were assessed via the Symptom Check List-30 (SCL-30) and Yale&ndash, Brown Obsessive Compulsive Scale (Y-BOCS). Behavioral coping was assessed via Simplified Coping Style Questionnaire (SCSQ). Results: In total, 131 (21.3%) medical workers and 485 (78.7%) members of the general public completed the structured online survey. The structural equation models showed that emotional response interacted with cognitive response, and both emotional response and cognitive response affected the behavioral coping. Multivariate regression showed that positive coping enhanced emotional and cognitive responses, while negative coping reduced emotional and cognitive responses. The emotional response (depression, anxiety and photic anxiety) scores of the participants were higher than the norm (all p &lt, 0.001), in particular, the panic scores of members of the general public were higher than those of medical workers (p &lt, 0.05), as well as the cognitive response (paranoia and compulsion). Both positive and negative coping scores of the participants were lower than the norm (p &lt, 0.001), and the general public had higher negative coping than medical workers (p &lt, 0.05). Conclusion: During the preliminary stage of COVID-19, our study confirmed the significance of emotional and cognitive responses, which were associated with behavioral coping and significantly influenced the medical workers and the general public&rsquo, s cognition and level of public health emergency preparedness. These results emphasize the importance of psychological health at times of widespread crisis.

Graphical abstract, Highlights • A total of 129 compounds of QFPD were dissected by UPLC-MS and molecular networking of MS data. • COVID-19 disease network was constructed to generate the QFPD therapeutic network based on chemical constituents and target prediction. • Toll-like signaling pathway was found to be important pathway regulated by QFPD. • Transcriptomic analysis revealed MXSG Decoction regulated multiple complement, coagulation cascades and thrombin system to interfere infection., The Coronavirus Disease 2019 (COVID-19) pandemic has become a huge threaten to global health, which raise urgent demand of developing efficient therapeutic strategy. The aim of the present study is to dissect the chemical composition and the pharmacological mechanism of Qingfei Paidu Decoction (QFPD), a clinically used Chinese medicine for treating COVID-19 patients in China. Through comprehensive analysis by liquid chromatography coupled with high resolution mass spectrometry (MS), a total of 129 compounds of QFPD were putatively identified. We also constructed molecular networking of mass spectrometry data to classify these compounds into 14 main clusters, in which exhibited specific patterns of flavonoids (45 %), glycosides (15 %), carboxylic acids (10 %), and saponins (5 %). The target network model of QFPD, established by predicting and collecting the targets of identified compounds, indicated a pivotal role of Ma Xing Shi Gan Decoction (MXSG) in the therapeutic efficacy of QFPD. Supportively, through transcriptomic analysis of gene expression after MXSG administration in rat model of LPS-induced pneumonia, the thrombin and Toll-like receptor (TLR) signaling pathway were suggested to be essential pathways for MXSG mediated anti-inflammatory effects. Besides, changes in content of major compounds in MXSG during decoction were found by the chemical analysis. We also validate that one major compound in MXSG, i.e. glycyrrhizic acid, inhibited TLR agonists induced IL-6 production in macrophage. In conclusion, the integration of in silico and experimental results indicated that the therapeutic effects of QFPD against COVID-19 may be attributed to the anti-inflammatory effects of MXSG, which supports the rationality of the compatibility of TCM.

Highlights • Mental health, resilience & social support of 1521 health care workers during the outbreak of COVID-19 were investigated. • The fresh staff tended to suffer from psychological abnormality on interpersonal sensitivity and photic anxiety. • Resilience and social support were necessary to health care workers who are first taking part in public health emergence., The spread of Corona Virus Disease 2019 (COVID-19) has become a global major public health event, threatening people's physical and mental health and even life safety. This study is to investigate the psychological abnormality in health care workers battling the COVID-19 epidemic and to explore the associations among social support, resilience and mental health. A total of 1521 health care workers, of whom 147 had public health emergency experience while 1374 showed no experience, completed the Symptom Check-List-90 (SCL-90), Chinese version of Connor-Davidson resilience scale (CD-RISC) and Social Support Rating Scale (SSRS). χ2 test, t test and multiple regression analyses were used in statistical analysis. The results showed that people without public health emergency treatment experience showed worse performance in mental health, resilience and social support, and tended to suffer from psychological abnormality on interpersonal sensitivity and photic anxiety. This finding suggested that high levels of training and professional experience, resilience and social support were necessary to health care workers who are first taking part in public health emergence.