Summary In China, where air pollution has become a major threat to public health, public awareness of the detrimental effects of air pollution on respiratory health is increasing—particularly in ...relation to haze days. Air pollutant emission levels in China remain substantially higher than are those in developed countries. Moreover, industry, traffic, and household biomass combustion have become major sources of air pollutant emissions, with substantial spatial and temporal variations. In this Review, we focus on the major constituents of air pollutants and their impacts on chronic respiratory diseases. We highlight targets for interventions and recommendations for pollution reduction through industrial upgrading, vehicle and fuel renovation, improvements in public transportation, lowering of personal exposure, mitigation of the direct effects of air pollution through healthy city development, intervention at population-based level (systematic health education, intensive and individualised intervention, pre-emptive measures, and rehabilitation), and improvement in air quality. The implementation of a national environmental protection policy has become urgent.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
We truly appreciate the comments from C.E. Leiva Sisnieguez and colleagues, who have performed a further analysis on the potential association between cardiovascular comorbidities and the clinical ...outcomes of coronavirus disease 2019 (COVID-19), particularly the mortality). We also applaud the suggestion to thoroughly adjust for potential confounding factors when interpreting the association between specific categories of cardiovascular comorbidities (
e.g.
hypertension) and the clinical outcomes of COVID-19. To this end, we have attempted to incorporate the cardiovascular diseases (including coronary heart disease) into the multivariate regression model 1. Findings of the model indicated a prominent collinearity between hypertension and coronary heart disease, and we have therefore elected to retain hypertension in the regression model for further analyses.
Comorbid hypertension correlates with poorer outcomes in patients with COVID-19
https://bit.ly/2zoT9f0
Since the outbreak in Wuhan city in December 2019, there has been a surge of newly diagnosed cases with coronavirus disease 2019 (Covid-19) globally 1–4. The total number has reached to 101 927 ...laboratory-confirmed cases as of March 8
th
, 2020 5. An increasing number of countries have issued the alert of the highest level.
Early protection, early identification, early diagnosis, and early isolation are crucial to combat with Covid-19 outbreaks
In comparison to severe acute respiratory syndrome coronavirus (SARS-CoV), SARS-CoV-2 appears to be more contagious 1, and coronavirus disease 2019 (COVID-19) patients demonstrate varied clinical ...manifestations distinct from those seen in patients with SARS-CoV and Middle East respiratory syndrome coronavirus infections 2. Collective results from the clinical and epidemiological observations suggest a distinct viral–host interaction in COVID-19 patients. Profiling of the antibody response during SARS-CoV-2 infection may help improve our understanding of the viral–host interaction and the immunopathological mechanisms of the disease.
Humoral immune response to SARS-CoV-2 showed an early response of IgA, instead of IgM, in COVID-19 patients. As highlighted by this study, enhanced IgA responses observed in severe COVID-19 might confer damaging effects in severe COVID-19.
https://bit.ly/3fA7c1I
Coronavirus disease 2019 (Covid-19) has resulted in a global outbreak. Few existing targeted medications are available. Lianhuaqingwen (LH) capsule, a repurposed marketed Chinese herb product, has ...been proven effective for influenza.
To determine the safety and efficacy of LH capsule in patients with Covid-19.
We did a prospective multicenter open-label randomized controlled trial on LH capsule in confirmed cases with Covid-19. Patients were randomized to receive usual treatment alone or in combination with LH capsules (4 capsules, thrice daily) for 14 days. The primary endpoint was the rate of symptom (fever, fatigue, coughing) recovery.
We included 284 patients (142 each in treatment and control group) in the full-analysis set. The recovery rate was significantly higher in treatment group as compared with control group (91.5% vs. 82.4%, p = 0.022). The median time to symptom recovery was markedly shorter in treatment group (median: 7 vs. 10 days, p < 0.001). Time to recovery of fever (2 vs. 3 days), fatigue (3 vs. 6 days) and coughing (7 vs. 10 days) was also significantly shorter in treatment group (all p < 0.001). The rate of improvement in chest computed tomographic manifestations (83.8% vs. 64.1%, p < 0.001) and clinical cure (78.9% vs. 66.2%, p = 0.017) was also higher in treatment group. However, both groups did not differ in the rate of conversion to severe cases or viral assay findings (both p > 0.05). No serious adverse events were reported.
In light of the safety and effectiveness profiles, LH capsules could be considered to ameliorate clinical symptoms of Covid-19.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To the Editor:
Multiple reassortant strains of novel, highly pathogenic avian influenza A(H5) viruses in clade 2.3.4.4 have recently emerged and spread in Asia, Europe, and North America, giving rise ...to multiple subtypes (H5N2, H5N5, H5N6, and H5N8).
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3
We report on a 59-year-old man in Guangzhou, China, with influenza A(H5N6) infection and associated illness. He had a 30-year history of smoking and had stopped smoking in January 2014. He had undergone surgery and chemotherapy for colon cancer, the last chemotherapy dose having been administered in April 2014. During the weeks before illness onset, he regularly purchased and handled live . . .
During the outbreak of coronavirus disease 2019 (COVID-19), consistent and considerable differences in disease severity and mortality rate of patients treated in Hubei province compared to those in ...other parts of China have been observed. We sought to compare the clinical characteristics and outcomes of patients being treated inside and outside Hubei province, and explore the factors underlying these differences.
Collaborating with the National Health Commission, we established a retrospective cohort to study hospitalised COVID-19 cases in China. Clinical characteristics, the rate of severe events and deaths, and the time to critical illness (invasive ventilation or intensive care unit admission or death) were compared between patients within and outside Hubei. The impact of Wuhan-related exposure (a presumed key factor that drove the severe situation in Hubei, as Wuhan is the epicentre as well the administrative centre of Hubei province) and the duration between symptom onset and admission on prognosis were also determined.
At the data cut-off (31 January 2020), 1590 cases from 575 hospitals in 31 provincial administrative regions were collected (core cohort). The overall rate of severe cases and mortality was 16.0% and 3.2%, respectively. Patients in Hubei (predominantly with Wuhan-related exposure, 597 (92.3%) out of 647) were older (mean age 49.7
44.9 years), had more cases with comorbidity (32.9%
19.7%), higher symptomatic burden, abnormal radiologic manifestations and, especially, a longer waiting time between symptom onset and admission (5.7
4.5 days) compared with patients outside Hubei. Patients in Hubei (severe event rate 23.0%
11.1%, death rate 7.3%
0.3%, HR (95% CI) for critical illness 1.59 (1.05-2.41)) have a poorer prognosis compared with patients outside Hubei after adjusting for age and comorbidity. However, among patients outside Hubei, the duration from symptom onset to hospitalisation (mean 4.4
4.7 days) and prognosis (HR (95%) 0.84 (0.40-1.80)) were similar between patients with or without Wuhan-related exposure. In the overall population, the waiting time, but neither treated in Hubei nor Wuhan-related exposure, remained an independent prognostic factor (HR (95%) 1.05 (1.01-1.08)).
There were more severe cases and poorer outcomes for COVID-19 patients treated in Hubei, which might be attributed to the prolonged duration of symptom onset to hospitalisation in the epicentre. Future studies to determine the reason for delaying hospitalisation are warranted.
Coronavirus disease 2019 (COVID-19), caused by infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is transmitted through respiratory droplets and close contact 1–4. To ...diagnose COVID-19, oropharyngeal swab (OP swab) sampling is widely used for viral nucleic acid detection 3. However, healthcare workers who perform OP swab are at high risk of infection due to aerosol from patients during the process of sampling. And the quality of manual OP swabs is inconsistent among different collectors, which may lead to misdiagnosis 5. Use of a remote-controlled OP swab robot has the potential to avoid close contact between healthcare workers with patients, and thus reduce the risk of SARS-CoV-2 infection during sampling. Here, we invented a robotic sampling (RS) system and evaluated the safety and efficacy of this system on OP swab sampling during the period of pandemic.
Clinical application of the safety and effectiveness of an intelligent oropharyngeal-swab robot, and its implication for the COVID-19 pandemic
https://bit.ly/2BUsV55
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