COVID19

COVID19
  • 文章类型: Case Reports
    已知SARS-COVID-19表现出各种各样的症状,其中大部分是呼吸。肌痛是COVID-19的常见症状,但也报道了严重的病毒诱导的炎性肌肉损伤导致横纹肌溶解和多发性肌炎的病例。这里,我们介绍并讨论一例56岁女性患者,该患者初次出现COVID-19感染并伴有炎性多发性肌炎,导致横纹肌溶解.该患者首先接受横纹肌溶解症治疗,并使用静脉生理盐水进行积极的液体复苏,而症状没有改善。然后,她开始使用大剂量静脉注射甲基强的松龙治疗假定的免疫介导的多发性肌炎。双侧下肢的MRI和左大腿的活检证实了炎性肌炎。类固醇开始后,肝功能检查和肌酐激酶水平呈下降趋势,症状改善。患者使用泼尼松锥度出院,并在六个月后的随访中完全康复。COVID后严重的肌肉骨骼受累,包括多发性肌炎或横纹肌溶解症,是罕见的,到目前为止,只有少数其他案例发表。病毒性肌炎,有肌肉病理学证据支持,在排除更常见的肌炎原因后,应仔细考虑近期感染COVID-19的患者。一些提出的机制包括肌肉的直接感染或引发自身免疫的环境事件。治疗通常涉及逐渐变细的皮质类固醇。
    SARS-COVID-19 is known to manifest with a wide variety of symptoms, most of which are respiratory. Myalgias are a common symptom of COVID-19, but cases of severe virus-induced inflammatory muscle injury leading to rhabdomyolysis and polymyositis have also been reported. Here, we present and discuss a case of a 56-year-old woman who presented with an initial presentation of COVID-19 infection with inflammatory polymyositis leading to rhabdomyolysis. The patient was first treated for rhabdomyolysis with aggressive fluid resuscitation with intravenous normal saline without improvement in symptoms. She was then started on high-dose intravenous methylprednisolone for presumed immune-mediated polymyositis. An MRI of the bilateral lower extremities and a biopsy of the left thigh confirmed inflammatory myositis. After the initiation of steroids, liver function tests and creatinine kinase levels trended down, and symptoms improved. The patient was discharged with a prednisone taper and completely recovered at a follow-up six months later. Post-COVID severe musculoskeletal involvement, including polymyositis or rhabdomyolysis, is rare, with only a few other cases published so far. Viral myositis, supported by myopathological evidence, should be considered carefully in patients with a recent COVID-19 infection after ruling out more common causes of myositis. Some proposed mechanisms include direct infection of the muscle or an environmental event triggering autoimmunity. Treatment generally involves corticosteroids that are gradually tapered.
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  • 文章类型: Case Reports
    特发性系统性毛细血管渗漏综合征(ISCLS)的特征是复发性系统性毛细血管渗漏和低血容量性休克。
    我们报告了一名59岁的高加索人,在COVID-19感染后患有ISCLS并持续低血容量和心源性休克。静脉动脉体外膜氧合和微轴泵为机械循环提供支持。需要大量液体复苏。随后的并发症延长了重症监护治疗。需要机械循环支持22天。心脏功能最终完全恢复,病人在没有神经系统损害的情况下存活了下来。
    这起由COVID-19引发的严重ISCLS病例强调,即使是最严重的低血容量和心源性休克在ISCLS中也可能是可逆的。
    UNASSIGNED: Idiopathic systemic capillary leak syndrome (ISCLS) is characterized by recurrent systemic capillary leakage and hypovolemic shock.
    UNASSIGNED: We report a 59-year-old Caucasian man with ISCLS and persistent hypovolemic and cardiogenic shock after COVID-19 infection. Mechanical circulatory support was provided with veno-arterial extracorporeal membrane oxygenation and a microaxial pump. Massive fluid resuscitation was needed. Subsequent complications prolonged the intensive care treatment. Mechanical circulatory support was needed for 22 days. Cardiac function eventually fully recovered, and the patient survived without neurologic compromise.
    UNASSIGNED: This case of severe ISCLS triggered by COVID-19 highlights that even the most severe hypovolemic and cardiogenic shock may be reversible in ISCLS.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    已经开发并在人群中实施了几种有效的严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)疫苗。然而,目前的生产能力不足以满足全球需求。因此,进一步开发能够弥合分布差距的新型疫苗平台至关重要。AVX/COVID-12是一种基于载体的疫苗,它利用新城疫病毒(NDV)将SARS-CoV-2刺突蛋白提供给免疫系统。
    本研究旨在通过检查感染SARS-CoV-2或关注变种(VOC)的个体的抗体结合和T细胞活化来分析候选疫苗的抗原性,以及接受2019年冠状病毒病(COVID-19)疫苗接种的健康志愿者。
    我们的发现表明,该疫苗有效结合抗体并激活接受2或3剂BNT162b2或AZ/ChAdOx-1-S疫苗的个体的T细胞。此外,用AVX/COVID-12刺激患者和疫苗接受者的T细胞,导致其在CD4+和CD8+T细胞中增殖和分泌干扰素-γ(IFN-γ).
    AVX/COVID-12载体疫苗候选物显示出刺激强烈细胞反应的能力,并被感染患者的SARS-CoV-2病毒中存在的刺突蛋白引发的抗体识别,以及BNT162b2mRNA和AZ/ChAdOx-1-S疫苗。这些结果支持将AVX/COVID-12疫苗纳入疫苗接种计划,旨在解决SARS-CoV-2及其挥发性有机化合物引起的COVID-19。
    UNASSIGNED: Several effective vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed and implemented in the population. However, the current production capacity falls short of meeting global demand. Therefore, it is crucial to further develop novel vaccine platforms that can bridge the distribution gap. AVX/COVID-12 is a vector-based vaccine that utilizes the Newcastle Disease virus (NDV) to present the SARS-CoV-2 spike protein to the immune system.
    UNASSIGNED: This study aims to analyze the antigenicity of the vaccine candidate by examining antibody binding and T-cell activation in individuals infected with SARS-CoV-2 or variants of concern (VOCs), as well as in healthy volunteers who received coronavirus disease 2019 (COVID-19) vaccinations.
    UNASSIGNED: Our findings indicate that the vaccine effectively binds antibodies and activates T-cells in individuals who received 2 or 3 doses of BNT162b2 or AZ/ChAdOx-1-S vaccines. Furthermore, the stimulation of T-cells from patients and vaccine recipients with AVX/COVID-12 resulted in their proliferation and secretion of interferon-gamma (IFN-γ) in both CD4+ and CD8+ T-cells.
    UNASSIGNED: The AVX/COVID-12 vectored vaccine candidate demonstrates the ability to stimulate robust cellular responses and is recognized by antibodies primed by the spike protein present in SARS-CoV-2 viruses that infected patients, as well as in the mRNA BNT162b2 and AZ/ChAdOx-1-S vaccines. These results support the inclusion of the AVX/COVID-12 vaccine as a booster in vaccination programs aimed at addressing COVID-19 caused by SARS-CoV-2 and its VOCs.
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  • 文章类型: Journal Article
    连续的封锁对大学生的心理健康有重大影响。博士生的心理健康经历了最严重的恶化。在大学生群体中,自杀意念的发生率显着增加。
    UNASSIGNED: Successive lockdowns have a significant impact on the mental health of university students.PhD students have experienced the most significant deterioration in their mental health.The rate of suicidal ideation has increased significantly across the university student population.
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  • 文章类型: Journal Article
    背景:有必要协调和标准化临床研究病例报告表(CRF)中使用的数据变量,以促进在多个临床研究中收集的患者数据的合并和共享。对于专注于传染病的临床研究尤其如此。公共卫生可能高度依赖于这些研究的结果。因此,有一种更高的紧迫性来产生有意义的,可靠的见解,理想情况下基于高样本数量和质量数据。核心数据元素的实施和互操作性标准的合并可以促进统一的临床数据集的创建。
    目的:本研究的目的是比较,协调,并标准化变量,这些变量集中在6项国际传染病临床研究中用作CRF一部分的诊断测试中,最终,然后为正在进行的和未来的研究提供全研究通用数据元素(CDE),以促进跨试验收集数据的互操作性和可比性.
    方法:为了确定CDE,我们回顾并比较了包含在所有6项传染病研究中和所有研究中用于数据收集的CRF的元数据。我们检查了医学系统化命名法-临床术语中国际语义标准代码的可用性,国家癌症研究所词库,和逻辑观察标识符名称和代码系统,用于明确表示构成CDE的诊断测试信息。然后,我们提出了2个数据模型,这些模型结合了已识别的CDE的语义和句法标准。
    结果:在分析范围内考虑的216个变量中,我们确定了11个CDE来描述诊断测试(特别是,血清学和测序)用于传染病:病毒谱系/进化枝;测试日期,type,表演者,和制造商;目标基因;定量和定性结果;和样本标识符,type,和收集日期。
    结论:确定用于感染性疾病的CDE是促进整个临床研究中数据子集的交换和可能合并的第一步(并且,大型研究项目),以进行可能的共享分析,以增加发现的力量。为了互操作性,临床研究数据的协调和标准化路径可以以两种方式铺就。首先,映射到标准术语确保每个数据元素的(变量)定义是明确的,并且它有一个,跨研究的独特解释。第二,这些数据的交换是通过以标准交换格式“包装”来辅助的,如快速医疗保健互操作性资源或临床数据交换标准联盟的临床数据采集标准协调模型。
    It is necessary to harmonize and standardize data variables used in case report forms (CRFs) of clinical studies to facilitate the merging and sharing of the collected patient data across several clinical studies. This is particularly true for clinical studies that focus on infectious diseases. Public health may be highly dependent on the findings of such studies. Hence, there is an elevated urgency to generate meaningful, reliable insights, ideally based on a high sample number and quality data. The implementation of core data elements and the incorporation of interoperability standards can facilitate the creation of harmonized clinical data sets.
    This study\'s objective was to compare, harmonize, and standardize variables focused on diagnostic tests used as part of CRFs in 6 international clinical studies of infectious diseases in order to, ultimately, then make available the panstudy common data elements (CDEs) for ongoing and future studies to foster interoperability and comparability of collected data across trials.
    We reviewed and compared the metadata that comprised the CRFs used for data collection in and across all 6 infectious disease studies under consideration in order to identify CDEs. We examined the availability of international semantic standard codes within the Systemized Nomenclature of Medicine - Clinical Terms, the National Cancer Institute Thesaurus, and the Logical Observation Identifiers Names and Codes system for the unambiguous representation of diagnostic testing information that makes up the CDEs. We then proposed 2 data models that incorporate semantic and syntactic standards for the identified CDEs.
    Of 216 variables that were considered in the scope of the analysis, we identified 11 CDEs to describe diagnostic tests (in particular, serology and sequencing) for infectious diseases: viral lineage/clade; test date, type, performer, and manufacturer; target gene; quantitative and qualitative results; and specimen identifier, type, and collection date.
    The identification of CDEs for infectious diseases is the first step in facilitating the exchange and possible merging of a subset of data across clinical studies (and with that, large research projects) for possible shared analysis to increase the power of findings. The path to harmonization and standardization of clinical study data in the interest of interoperability can be paved in 2 ways. First, a map to standard terminologies ensures that each data element\'s (variable\'s) definition is unambiguous and that it has a single, unique interpretation across studies. Second, the exchange of these data is assisted by \"wrapping\" them in a standard exchange format, such as Fast Health care Interoperability Resources or the Clinical Data Interchange Standards Consortium\'s Clinical Data Acquisition Standards Harmonization Model.
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  • 文章类型: Journal Article
    尽管如此,高度传染性的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019年冠状病毒病(COVID19)尚无治愈方法。COVID19大流行造成了突发卫生事件,在包括沙特阿拉伯在内的全球范围内造成了巨大的医疗和财务后果。沙特阿拉伯是中东最大的阿拉伯国家。沙特阿拉伯的城市环境使其容易受到SARS-CoV-2(SCV-2)的影响。每年都有数百万朝圣者前往该国的宗教地区进行乌姆拉朝圣和朝圣,这导致了潜在的COVID19流行风险。由于缺乏新药,COVID19给医疗保健专业人员在临床环境中选择合适的药物或治疗带来了各种挑战。目前的药物开发和发现是一个昂贵的,复杂,漫长的过程,这涉及临床试验的高失败率。虽然美国食品和药物管理局(FDA)批准的抗病毒药物的再利用提供了许多好处,包括完整的药代动力学和安全性,大大缩短药物开发周期,降低成本。一系列美国FDA批准的抗病毒药物,包括利巴韦林,洛匹那韦/利托那韦组合,奥司他韦,darunavir,remdesivir,尼玛特雷韦/利托那韦组合,和molnupiravir在COVID19治疗的临床试验中显示出令人鼓舞的结果。在这篇文章中,已经提供了一些与COVID19相关的讨论,包括新出现的令人关注的变体,COVID19发病机制,沙特阿拉伯的COVID19大流行情景,针对SCV-2的药物再利用策略,以及美国FDA批准的可能被认为在沙特阿拉伯对抗SCV-2的抗病毒药物的再利用。此外,总结了COVID19管理背景下的药物再利用及其局限性和未来前景。
    Still, there is no cure for the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-caused coronavirus disease 2019 (COVID19). The COVID19 pandemic caused health emergencies which resulted in enormous medical and financial consequences worldwide including Saudi Arabia. Saudi Arabia is the largest Arab country of the Middle East. The urban setting of Saudi Arabia makes it vulnerable towards SARS-CoV-2 (SCV-2). Religious areas of this country are visited by millions of pilgrims every year for the Umrah and Hajj pilgrimage, which contributes to the potential COVID19 epidemic risk. COVID19 throws various challenges to healthcare professionals to choose the right drugs or therapy in clinical settings because of the lack of availability of newer drugs. Current drug development and discovery is an expensive, complex, and long process, which involves a high failure rate in clinical trials. While repurposing of United States Food and Drug Administration (US FDA)-approved antiviral drugs offers numerous benefits including complete pharmacokinetic and safety profiles, which significantly shorten drug development cycles and reduce costs. A range of repurposed US FDA-approved antiviral drugs including ribavirin, lopinavir/ritonavir combination, oseltamivir, darunavir, remdesivir, nirmatrelvir/ritonavir combination, and molnupiravir showed encouraging results in clinical trials in COVID19 treatment. In this article, several COVID19-related discussions have been provided including emerging variants of concern of, COVID19 pathogenesis, COVID19 pandemic scenario in Saudi Arabia, drug repurposing strategies against SCV-2, as well as repurposing of US FDA-approved antiviral drugs that might be considered to combat SCV-2 in Saudi Arabia. Moreover, drug repurposing in the context of COVID19 management along with its limitations and future perspectives have been summarized.
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  • 文章类型: Journal Article
    目的:评估与冠状病毒相关的破坏健康和社会护理治疗的程度,以及在苏格兰有使用药物的生活或生活经验的人之间的社会互动,并探索中断变化的潜在原因。
    方法:横断面混合方法访谈,纳入社交网络\“egonet访谈\”方法,询问参与者是否与一系列物质使用有互动,健康,社会关怀或第三部门组织,或非正式的社会互动。
    方法:苏格兰的五个酒精和毒品合作领域。
    方法:57名(42%为女性)参与者参与了这项研究,平均年龄42岁。
    方法:五点李克特量表报告与一系列服务和人员的互动是否变得更好,更好,没有不同(或没有变化),更糟,或者自COVID19和封锁以来更糟。评级嵌套在参与者内(个人提供多个评级),并且一些评级也嵌套在治疗服务内(服务获得多个评级)。嵌套结构使用交叉分类序数逻辑多水平模型进行解释。
    结果:虽然总体平均值表明相互作用仅有轻微的负变化(平均评分为2.93),根据相互作用的类型有很大的差异,和个人之间。报告的变化对精神卫生服务更常见的是负面的(调整后的OR=0.9395%CI0.17,0.90),药房呈阳性(3.0395%CI1.36,5.93)。模型发现参与者之间的差异约为10%,和微不足道的服务之间的变化,大约1%的评级。评级没有因个人年龄或性别而异,但地区之间存在差异。
    结论:由于COVID19封锁而导致的物质使用治疗服务适应导致了积极和消极的服务用户体验。社会网络方法为描述复杂的全系统交互模式提供了一种有效的方法,并测量个体的变化,服务,和区域水平。
    To assess the extent of Coronavirus-related disruption to health and social care treatment and social interactions among people with lived or living experience of substance use in Scotland, and explore potential reasons for variations in disruption.
    Cross sectional mixed methods interview, incorporating a social network \'egonet interview\' approach asking about whether participants had interactions with a range of substance use, health, social care or third sector organisations, or informal social interactions.
    Five Alcohol and Drug Partnership Areas in Scotland.
    57 (42% women) participants were involved in the study, on average 42 years old.
    Five-point Likert scale reporting whether interactions with a range of services and people had gotten much better, better, no different (or no change), worse, or much worse since COVID19 and lockdown. Ratings were nested within participants (Individuals provided multiple ratings) and some ratings were also nested within treatment service (services received multiple ratings). The nested structure was accounted for using cross classified ordinal logistic multilevel models.
    While the overall average suggested only a slight negative change in interactions (mean rating 2.93), there were substantial variations according to type of interaction, and between individuals. Reported change was more often negative for mental health services (Adjusted OR = 0.93 95% CI 0.17,0.90), and positive for pharmacies (3.03 95% CI 1.36, 5.93). The models found between-participant variation of around 10%, and negligible between-service variation of around 1% in ratings. Ratings didn\'t vary by individual age or gender but there was variation between areas.
    Substance use treatment service adaptations due to COVID19 lockdown led to both positive and negative service user experiences. Social network methods provide an effective way to describe complex system-wide interaction patterns, and to measure variations at the individual, service, and area level.
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  • 文章类型: Journal Article
    由SARS-CoV-2引起的COVID-19影响神经元细胞,导致记忆丧失等症状,嗅觉缺失和脑部炎症。姜黄素(Me08eMe23)和姜黄素(CUR)源自姜黄提取物(EXT)。许多治疗作用与这些化合物有关,包括抗病毒作用。鉴于COVID-19的严重影响,特别是在中枢神经系统内,我们的研究旨在阐明类姜黄素对SARS-CoV-2感染的治疗潜力,特别是在神经元细胞中。这里,我们调查了CUR的影响,EXT,Me08和Me23在人神经母细胞瘤SH-SY5Y中的表达。我们观察到Me23显著降低了质膜相关跨膜蛋白酶丝氨酸2(TMPRSS2)和TMPRSS11D的表达,因此减轻了SARS-CoV-2诱导的ROS水平升高。此外,Me23在SARS-CoV-2感染后通过增加NRF2基因表达和恢复NQO1活性而表现出抗氧化特性。Me08和Me23均有效降低了过表达ACE2(SH-ACE2)的SH-SY5Y细胞中SARS-CoV-2的复制。此外,所有这些化合物都显示出降低促炎细胞因子如IL-6,TNF-α,和IL-17,而Me08特异性降低INF-γ水平。我们的研究结果表明,类姜黄素Me23可以作为减轻COVID-19影响的潜在药物,特别是在中枢神经系统受累的情况下。
    COVID-19, caused by SARS-CoV-2, affects neuronal cells, causing several symptoms such as memory loss, anosmia and brain inflammation. Curcuminoids (Me08 e Me23) and curcumin (CUR) are derived from Curcuma Longa extract (EXT). Many therapeutic actions have been linked to these compounds, including antiviral action. Given the severe implications of COVID-19, especially within the central nervous system, our study aims to shed light on the therapeutic potential of curcuminoids against SARS-CoV-2 infection, particularly in neuronal cells. Here, we investigated the effects of CUR, EXT, Me08 and Me23 in human neuroblastoma SH-SY5Y. We observed that Me23 significantly decreased the expression of plasma membrane-associated transmembrane protease serine 2 (TMPRSS2) and TMPRSS11D, consequently mitigating the elevated ROS levels induced by SARS-CoV-2. Furthermore, Me23 exhibited antioxidative properties by increasing NRF2 gene expression and restoring NQO1 activity following SARS-CoV-2 infection. Both Me08 and Me23 effectively reduced SARS-CoV-2 replication in SH-SY5Y cells overexpressing ACE2 (SH-ACE2). Additionally, all of these compounds demonstrated the ability to decrease proinflammatory cytokines such as IL-6, TNF-α, and IL-17, while Me08 specifically reduced INF-γ levels. Our findings suggest that curcuminoid Me23 could serve as a potential agent for mitigating the impact of COVID-19, particularly within the context of central nervous system involvement.
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