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A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

《医学前沿（英文）》 doi: 10.1007/s11684-023-1011-0

摘要： We aimed to investigate the safety and efficacy of nirmatrelvir/ritonavir (Paxlovid) therapy for hemodialysis-dependent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thirteen hemodialysis patients infected with the Omicron variant of SARS-CoV-2 from April 3 to May 30, 2022, were recruited. Laboratory parameters and chest CT (computed tomography) imaging were analyzed. The treatment group included six patients who received 150 mg/100 mg of Paxlovid orally once daily for 5 days, whereas the control group included seven patients who received basic treatment. No serious adverse reactions or safety events were recorded. Four control patients progressed to moderate disease, and none in the treatment group showed progression of chest CT findings (P < 0.05). Paxlovid therapy tended toward early viral clearance and low viral load on Day 8. Moreover, 83.3% of the patients in the treatment group and 57.1% of the patients in the control group turned negative within 22 days. In the Paxlovid treatment group, we found significantly increased levels of lymphocytes (P=0.03) and eosinophils (P=0.02) and decreased levels of D-dimer on Day 8 compared with those on Day 1. Paxlovid therapy showed a potential therapeutic effect with good tolerance in hemodialysis patients. The optimal dose and effectiveness evaluation must be further investigated in a largeer cohort.

关键词： Paxlovid     hemodialysis     SARS-CoV-2     viral load     chest CT scan    

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Clinical characteristics of 19 neonates born to mothers with COVID-19

Wei Liu, Jing Wang, Wenbin Li, Zhaoxian Zhou, Siying Liu, Zhihui Rong

《医学前沿（英文）》 2020年 第14卷 第2期   页码 193-198 doi: 10.1007/s11684-020-0772-y

摘要： The aim of this study was to investigate the clinical characteristics of neonates born to SARS-CoV-2 infected mothers and increase the current knowledge on the perinatal consequences of COVID-19. Nineteen neonates were admitted to Tongji Hospital from January 31 to February 29, 2020. Their mothers were clinically diagnosed or laboratory-confirmed with COVID-19. We prospectively collected and analyzed data of mothers and infants. There are 19 neonates included in the research. Among them, 10 mothers were confirmed COVID-19 by positive SARS-CoV-2 RT-PCR in throat swab, and 9 mothers were clinically diagnosed with COVID-19. Delivery occurred in an isolation room and neonates were immediately separated from the mothers and isolated for at least 14 days. No fetal distress was found. Gestational age of the neonates was 38.6±1.5 weeks, and average birth weight was 3293±425 g. SARS-CoV-2 RT-PCR in throat swab, urine, and feces of all neonates were negative. SARS-CoV-2 RT-PCR in breast milk and amniotic fluid was negative too. None of the neonates developed clinical, radiologic, hematologic, or biochemical evidence of COVID-19. No vertical transmission of SARS-CoV-2 and no perinatal complications in the third trimester were found in our study. The delivery should occur in isolation and neonates should be separated from the infected mothers and care givers.

关键词： coronavirus disease 2019     severe acute respiratory syndrome-associated coronavirus     maternal-infant infection     newborn    

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Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns

null

《医学前沿（英文）》 2016年 第10卷 第2期   页码 111-119 doi: 10.1007/s11684-016-0446-y

摘要：

The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 brought back memories of the occurrence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002. More than 1500 MERS-CoV cases were recorded in 42 months with a case fatality rate (CFR) of 40%. Meanwhile, 8000 cases of SARS-CoV were confirmed in six months with a CFR of 10%. The clinical presentation of MERS-CoV ranges from mild and non-specific presentation to progressive and severe pneumonia. No predictive signs or symptoms exist to differentiate MERS-CoV from community-acquired pneumonia in hospitalized patients. An apparent heterogeneity was observed in transmission. Most MERS-CoV cases were secondary to large outbreaks in healthcare settings. These cases were secondary to community-acquired cases, which may also cause family outbreaks. Travel-associated MERS infection remains low. However, the virus exhibited a clear tendency to cause large outbreaks outside the Arabian Peninsula as exemplified by the outbreak in the Republic of Korea. In this review, we summarize the current knowledge about MERS-CoV and highlight travel-related issues.

关键词： coronavirus     MERS     Middle East respiratory syndrome    

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Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai, Hanlan Jiang, Simin Zhang, Shengying Xia, Wenhui Du, Yaoling Ma, Tao Yu, Wenbin Li

《医学前沿（英文）》 2020年 第14卷 第6期   页码 776-785 doi: 10.1007/s11684-020-0820-7

摘要： Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was (29, 29.9%). One patient with confirmed COVID 19 died. Our results strongly indicated that the detection of asymptomatic COVID 19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.

关键词： coronavirus disease 2019     pediatrics     emergency     retrospective investigation     severe acute respiratory syndrome coronavirus 2    

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Middle East respiratory syndrome coronavirus: a comprehensive review

null

《医学前沿（英文）》 2016年 第10卷 第2期   页码 120-136 doi: 10.1007/s11684-016-0430-6

摘要：

The Middle East respiratory syndrome coronavirus was first identified in 2012 and has since then remained uncontrolled. Cases have been mostly reported in the Middle East, however travel-associated cases and outbreaks have also occurred. Nosocomial and zoonotic transmission of the virus appear to be the most important routes. The infection is severe and highly fatal thus necessitating rapid and efficacious interventions. Here, we performed a comprehensive review of published literature and summarized the epidemiology of the virus. In addition, we summarized the virological aspects of the infection and reviewed the animal models used as well as vaccination and antiviral tested against it.

关键词： MERS     coronavirus     review    

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Middle East respiratory syndrome coronavirus in pediatrics: a report of seven cases from Saudi Arabia

Sarah H. Alfaraj, Jaffar A. Al-Tawfiq, Talal A. Altuwaijri, Ziad A. Memish

《医学前沿（英文）》 2019年 第13卷 第1期   页码 126-130 doi: 10.1007/s11684-017-0603-y

摘要： Infection with Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 as an important respiratory disease with high fatality rates of 40%–60%. Despite the increased number of cases over subsequent years, the number of pediatric cases remained low. A review of studies conducted from June 2012 to April 19, 2016 reported 31 pediatric MERS-CoV cases. In this paper, we present the clinical and laboratory features of seven patients with pediatric MERS. Five patients had no underlying medical illnesses, and three patients were asymptomatic. Of the seven cases, four (57%) patients sought medical advice within 1–7 days from the onset of symptoms. The three other patients (43%) were asymptomatic and were in contact with patients with confirmed diagnosis of MERS-CoV. The most common presenting symptoms were fever (57%), cough (14%), shortness of breath (14%), vomiting (28%), and diarrhea (28%). Two (28.6%) patients had platelet counts of<150 × 10 /L, and one patient had an underlying end-stage renal disease. The remaining patients presented with normal blood count, liver function, and urea and creatinine levels. The documented MERS-CoV Ct values were 32–38 for four of the seven cases. Two patients (28.6%) had abnormal chest radiographic findings of bilateral infiltration. One patient (14.3%) required ventilator support, and two patients (28.6%) required oxygen supplementation. All the seven patients were discharged without complications.

关键词： Middle East respiratory syndrome coronavirus     MERS-CoV     pregnancy     pediatrics    

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Early and marked up-regulation of TNF-α in acute respiratory distress syndrome after cardiopulmonary

null

《医学前沿（英文）》 2012年 第6卷 第3期   页码 296-301 doi: 10.1007/s11684-012-0219-1

摘要：

Despite the technique of cardiopulmonary bypass (CPB) improved the development of modern cardiac surgery, many factors during CPB have been reported to induce acute respiratory distress syndrome (ARDS). The present study was to investigate which pro-inflammatory factors involved in the early phase of ARDS. Ten patients underwent valve replacement surgery with or without ARDS were enrolled for analysis of pulmonary function and inflammatory factors release including white blood cell (WBC), neutrophils, CD11b, CD18, interleukin (IL)-8 and tumor necrosis factor-α (TNF-α). The results demonstrated that the ratio of arterial oxygen tension/fraction of inspire oxygen (PaO2/FiO2) was greatly reduced in ARDS patients, but only the release of TNF-α was significantly increased, which was reversely correlated to the values of PaO2/FiO2. Also, the count of neutrophils adhesive to pulmonary endothelial cells was significantly increased in ARDS patients. Therefore, we concluded that TNF-α was quickly up-regulated and involved in the pathogenesis of CPB-induced ARDS via guiding primed neutrophils to pulmonary interstitium.

关键词： tumor necrosis factor-α     cardiopulmonary bypass     inflammation     acute respiratory distress syndrome    

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间充质干细胞——新冠病毒肺炎相关急性呼吸窘迫综合征潜在的治疗选择

赵璇, 张毅

《工程（英文）》 2020年 第6卷 第10期   页码 1073-1075 doi: 10.1016/j.eng.2020.05.015

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中药治疗新冠病毒肺炎的科学基础 Perspective

梁丽娴, 潘胡丹, 黄虞枫, 范星星, 王婉莹, 何芳, 蔡俊, 周华, 刘良

《工程（英文）》 2020年 第6卷 第10期   页码 1099-1107 doi: 10.1016/j.eng.2020.08.009

摘要：

新近暴发的新冠病毒肺炎（COVID-19）已成为危害全球健康的紧急事件。现有证据表明，新冠病毒（SARS-CoV-2）与其他冠状病毒（如SARS-CoV和MERS-CoV）的基因序列具有相似性。因此， 针对现存冠状病毒的引发疾病的机制研究和在治疗SARS时所取得的经验和教训，可咨今天对抗新冠病毒引发疾病的参考。COVID-19患者的临床病理特征提示患者在病情进展过程中通常会经历五个发展阶段：大量病毒感染、免疫系统抑制、细胞因子风暴、多器官损伤及后期的肺纤维化样改变， 严重者常导致死亡。早期阻断疾病进展是取得治疗成功的关键。但是，目前尚无针对COVID-19的 特效药物或疫苗，世界卫生组织（WHO）正敦促尽快建立新型预防和治疗策略。传统中医药（TCM） 对于疫病的防治的实践已经积累了几千年的有用经验，它通过整体调节机体功能发挥疗效。在此次疫情中，中医药作为替代治疗或与西药联合使用，在疫情防控中发挥了重要的作用。本文总结了此次抗疫过程中中国国家和省级机构推荐使用的中药复方和中成药的潜在用途和治疗机制，以期发现其治疗COVID-19的潜在科学内涵。同时，整合应用多种组学及转化医学技术开展基础与临床研究有望进一步证实中药复方的治疗机制。

关键词： COVID-19     SARS-CoV-2     中药     抗病毒     细胞因子风暴     肺纤维化    

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Clinical study using mesenchymal stem cells for the treatment of patients with severe COVID-19

Lingling Tang, Yingan Jiang, Mengfei Zhu, Lijun Chen, Xiaoyang Zhou, Chenliang Zhou, Peng Ye, Xiaobei Chen, Baohong Wang, Zhenyu Xu, Qiang Zhang, Xiaowei Xu, Hainv Gao, Xiaojun Wu, Dong Li, Wanli Jiang, Jingjing Qu, Charlie Xiang, Lanjuan Li

《医学前沿（英文）》 2020年 第14卷 第5期   页码 664-673 doi: 10.1007/s11684-020-0810-9

摘要： The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was identified in December 2019. The symptoms include fever, cough, dyspnea, early symptom of sputum, and acute respiratory distress syndrome (ARDS). Mesenchymal stem cell (MSC) therapy is the immediate treatment used for patients with severe cases of COVID-19. Herein, we describe two confirmed cases of COVID-19 in Wuhan to explore the role of MSC in the treatment of COVID-19. MSC transplantation increases the immune indicators (including CD4 and lymphocytes) and decreases the inflammation indicators (interleukin-6 and C-reactive protein). High-flow nasal cannula can be used as an initial support strategy for patients with ARDS. With MSC transplantation, the fraction of inspired O (FiO ) of the two patients gradually decreased while the oxygen saturation (SaO ) and partial pressure of oxygen (PO ) improved. Additionally, the patients’ chest computed tomography showed that bilateral lung exudate lesions were adsorbed after MSC infusion. Results indicated that MSC transplantation provides clinical data on the treatment of COVID-19 and may serve as an alternative method for treating COVID-19, particularly in patients with ARDS.

关键词： coronavirus disease 2019 (COVID-19)     mesenchymal stem cell     acute respiratory distress syndrome     stem cell therapeutics    

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一款用于快速检测包括SARS-CoV-2 在内的19 种常见呼吸道病毒的高通量、多指标等温扩增平台 Article

邢婉丽,刘莹莹,王会丽,李尚霖,林勇平,陈蕾,赵艳,晁爽,黄小兰,葛少林,邓涛,赵添,李宝莲,王瀚博,王磊,宋云鹏,金荣华,何建行,赵秀英,刘鹏,李为民,程京

《工程（英文）》 2020年 第6卷 第10期   页码 1130-1140 doi: 10.1016/j.eng.2020.07.015

摘要：

快速、准确地诊断以及及时对感染严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）的患者进行隔离被认为是抗击新冠病毒肺炎（COVID-19）大流行的最有效的措施。本文介绍了一款高通量、多指标的等温扩增检测平台（RTisochipTM-W），该平台使用离心式微流控芯片，在90 min内即可完成一次运行，从16个样本中检测出包括SARS-CoV-2在内的19种常见呼吸道病毒。通过RTisochipTM-W系统检测的所有病毒的检出限均等于或小于50拷贝· μL−1，与常规逆转录聚合酶链反应（RT-PCR）灵敏度相当。该系统具有重复性好、鲁棒性强和特异性高的优点。最后，使用RTisochipTM-W系统对201例临床前样本、14例COVID-19阳性临床样本、25例临床确诊样本以及614例来自呼吸道感染或疑似感染的患者的临床样本进行了测试。测试结果与临床诊断结果吻合良好，也反映出呼吸道传染病的流行特征。在对SARS-CoV-2的诊断上，RTisochipTM-W系统与参考试剂盒的一致性达到98.15%。基于大量的测试结果，我们相信RTisochipTM-W系统是一款抗击COVID-19大流行的强有力工具。

关键词： COVID-19     SARS-CoV-2     微流控     核酸检测     等温扩增    

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Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

Chun Tang, Baolin Wang, Bing Xie, Hongming Liu, Ping Chen

《医学前沿（英文）》 2011年 第5卷 第3期   页码 302-305 doi: 10.1007/s11684-011-0145-7

摘要： A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method. Ten patients received only drainage via retroperitoneal laparoscopy, four patients received drainage via both retroperitoneal and preperitoneal laparoscopy, and one patient received drainage via conversion to laparotomy. Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment. Two patients had encapsulated effusions or pancreatic pseudocysts after surgery, but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage. SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method, resulting in minor injury.

关键词： severe acute pancreatitis (SAP)     laparoscope     retroperitoneal drainage     treatment    

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Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

《医学前沿（英文）》 doi: 10.1007/s11684-023-1041-7

摘要： The coronavirus disease 2019 (COVID-19) epidemic has triggered a huge impact on healthcare, socioeconomics, and other aspects of the world over the past three years. An increasing number of studies have identified a complex relationship between COVID-19 and stroke, although active measures are being implemented to prevent disease transmission. Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality, posing a serious challenge to acute stroke diagnosis, treatment, and care. This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke, including arterial stroke (ischemic stroke and hemorrhagic stroke) and venous stroke (cerebral venous thrombosis). Additionally, the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented. Evidence on vaccinations, potential therapeutic approaches, and effective strategies for stroke management has been highlighted.

关键词： SARS-CoV-2     ischemic stroke     stroke     hemorrhagic stroke     cerebral venous thrombosis     vaccination    

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Clinical factors associated with composition of lung microbiota and important taxa predicting clinicalprognosis in patients with severe community-acquired pneumonia

《医学前沿（英文）》 2022年 第16卷 第3期   页码 389-402 doi: 10.1007/s11684-021-0856-3

摘要： Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2=0.033; P=0.018), followed by acute kidney injury (AKI; R2=0.032; P=0.011) and plasma MIP-1β level (R2=0.027; P=0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients’ lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

关键词： severe community-acquired pneumonia     lung microbiota     clinical improvements     7-category ordinal scale     Prevotellaceae    

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Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational

《医学前沿（英文）》 2022年 第16卷 第4期   页码 651-658 doi: 10.1007/s11684-021-0859-0

摘要： To present the clinical characteristics and the misdiagnosis rate of acute coronary syndrome manifested primarily as throat discomfort, we conducted a multicentric and retrospective study in the cardiology and otorhinolaryngology departments. Records of patients with primary complaint of throat discomfort, absence of chest pain at onset, and an ultimate diagnosis of acute coronary syndrome, as well as patients with pharyngitis (as controls) were collected from May 2015 to April 2016. The patients’ main manifestations were compared. Logistic regression results showed that chest tightness, dyspnea, perspiring, and exertional throat symptoms were significantly associated with acute coronary syndrome, with odds ratios of 8.3 (95% CI 2.2−31.5), 10.9 (95% CI 1.8−66.9), 25.4 (95% CI 3.6−179.9), and 81.2 (95% CI 13.0−506.7). A total of 25 (56.82%) out of 44 acute coronary syndrome patients, who were first admitted to the otorhinolaryngology department, were misdiagnosed, with a 12% (3/25) mortality rate. Throat discomfort can be the principal manifestation of acute coronary syndrome. Such patients exhibit high misdiagnosis and mortality rates. Exertional throat symptoms, chest tightness, perspiring, and dyspnea were important indicators of acute coronary syndrome in patients whose main complaint was throat discomfort. The awareness of this condition will result in prompt diagnosis and reduce morbidity and mortality.

关键词： acute coronary syndrome (ACS)     throat discomfort (TD)     throat pain     cardiology departments     non-cardiologic physicians    

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标题 作者 时间 类型 操作

A pilot study on Paxlovid therapy for hemodialysis patients with severe acute respiratory syndrome coronavirus

期刊论文

Clinical characteristics of 19 neonates born to mothers with COVID-19

Wei Liu, Jing Wang, Wenbin Li, Zhaoxian Zhou, Siying Liu, Zhihui Rong

期刊论文

Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns

null

期刊论文

Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai, Hanlan Jiang, Simin Zhang, Shengying Xia, Wenhui Du, Yaoling Ma, Tao Yu, Wenbin Li

期刊论文

Middle East respiratory syndrome coronavirus: a comprehensive review

null

期刊论文

Middle East respiratory syndrome coronavirus in pediatrics: a report of seven cases from Saudi Arabia

Sarah H. Alfaraj, Jaffar A. Al-Tawfiq, Talal A. Altuwaijri, Ziad A. Memish

期刊论文

Early and marked up-regulation of TNF-α in acute respiratory distress syndrome after cardiopulmonary

null

期刊论文

间充质干细胞——新冠病毒肺炎相关急性呼吸窘迫综合征潜在的治疗选择

赵璇, 张毅

期刊论文

中药治疗新冠病毒肺炎的科学基础

梁丽娴, 潘胡丹, 黄虞枫, 范星星, 王婉莹, 何芳, 蔡俊, 周华, 刘良

期刊论文

Clinical study using mesenchymal stem cells for the treatment of patients with severe COVID-19

Lingling Tang, Yingan Jiang, Mengfei Zhu, Lijun Chen, Xiaoyang Zhou, Chenliang Zhou, Peng Ye, Xiaobei Chen, Baohong Wang, Zhenyu Xu, Qiang Zhang, Xiaowei Xu, Hainv Gao, Xiaojun Wu, Dong Li, Wanli Jiang, Jingjing Qu, Charlie Xiang, Lanjuan Li

期刊论文

一款用于快速检测包括SARS-CoV-2 在内的19 种常见呼吸道病毒的高通量、多指标等温扩增平台

邢婉丽,刘莹莹,王会丽,李尚霖,林勇平,陈蕾,赵艳,晁爽,黄小兰,葛少林,邓涛,赵添,李宝莲,王瀚博,王磊,宋云鹏,金荣华,何建行,赵秀英,刘鹏,李为民,程京

期刊论文

Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

Chun Tang, Baolin Wang, Bing Xie, Hongming Liu, Ping Chen

期刊论文

Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

期刊论文

Clinical factors associated with composition of lung microbiota and important taxa predicting clinicalprognosis in patients with severe community-acquired pneumonia

期刊论文

Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational

期刊论文