Influencing factors for COVID-19 Re-positive patients by EClinicalMedicine (of The Lancet)

 

Influencing factors for COVID-19 re-positive patients by EClinicalMedicine

EClinicalMedicine is an open-access medical journal under The Lancet. It is committed to publishing original research results. It aims to help front-line medical professionals cope with the complex and rapid changes in the medical and health industry faced by the global society. The Lancet micro-signal is specially launched EClinicalMedicine edits a collection of selected papers to share with readers.

Selected Papers by EClinicalMedicine


1. Burden of Inflammatory Bowel Disease in China from 1990 to 2017: Based on the Summary of the 2017 Global Burden of Disease Report

Inflammatory bowel disease (IBD) is a chronic disease that is difficult to cure and causes a heavy burden of disease in Western countries. The prevalence of IBD is also increasing in Asia; however, few studies have reported the prevalence and incidence of inflammatory bowel disease in China.

 In this study, Ren Jingjing's research team from the First Affiliated Hospital of Zhejiang University used the Global Burden of Disease 2017 (GBD) to summarize the trend of the burden of inflammatory bowel disease in China from 1990 to 2017. 

The authors found that between 1990 and 2017, although the age-standardized prevalence, morbidity and healthy life loss years of inflammatory bowel disease increased, the age-standardized disability-adjusted life years, mortality and the life loss has been reduced. 

The authors concluded that although China is still a low-endemic area of ​​inflammatory bowel disease, strategies should be considered to reduce the burden of the disease in the future.


2. Evaluation of the efficacy of IFN-κ+TFF2 combined with standard treatment for patients with moderate COVID-19: an open randomized controlled trial

There is an urgent need for an effective COVID-19 treatment plan. Among a variety of compounds, IFN-κ has been shown to inhibit SARS-CoV-2 replication, and TFF2 (a small molecule secreted polypeptide) can promote the repair of damaged mucosa and reduce inflammation. 

The Lu Hongzhou team from the Public Health Clinical Center of Shanghai (affiliated to Fudan University) designed an open randomized controlled clinical trial to evaluate the synergy of these two proteins.

Influencing factors for COVID-19 Re-positive patients by EClinicalMedicine (of The Lancet)


 The trial combined standard treatment with aerosol inhalation of IFN-κ+TFF2 to evaluate its efficacy and safety in 80 patients with moderate COVID-19. 

The results show that the IFN-κ+TFF2 combined standard treatment plan is safe, and it is better than the standard treatment alone in shortening the RNA conversion time of SARS-CoV-2 and improving the results of computed tomography (CT), which can promote the clinical treatment of patients Recovery and early discharge.


3. Study on the influencing factors of 12 cases of Fuyang in 117 COVID-19 cured patients in China

Few studies have reported on the clinical features and risk factors of SARS-CoV-2 re-positive patients. In a single-center study titled "12 Fuyang patients among 117 COVID-19 cured patients in China", Huang Xiaoying's team from the First Affiliated Hospital of Wenzhou Medical University analyzed 117 discharged patients through a retrospective cohort study and explored.

The differences in demographic characteristics, clinical characteristics, laboratory test results, chest CT characteristics, and treatment process of patients who were retested as positive and persistently negative. 

The results showed that a longer hospital stay and lymphopenia may be potential risk factors for COVD-19 patients to be tested positive for SARS-CoV-2 again after discharge.


4. Follow-up study on lung function and related physiological characteristics of COVID-19 survivors 3 months after recovery

The long-term lung function and related physiological characteristics of COVID-19 survivors are the focus of research. The Xu Aiguo research team of the First Affiliated Hospital of Zhengzhou University recruited 55 COVID-19 survivors and performed high-resolution computed tomography (CT) scans of their chests.

 At the same time, the lung function and the SARS-CoV-2 IgG antibody level in the serum were evaluated 3 months after discharge. 

Three months after discharge, a higher proportion of radiological and physiological abnormalities were observed among COVID-19 survivors. In addition, the high level of D-dimer when the patient was admitted to the hospital can effectively predict the impaired carbon monoxide (CO) diffusion capacity 3 months after discharge. 

The results show that it is necessary to follow up COVID-19 patients to monitor and manage long-term sequelae.


5. Brain microstructure changes in patients with COVID-19: a 3-month follow-up study based on MRI

Yin Bo's team from Huashan Hospital of Fudan University led the investigation of the brain microstructure changes in patients after SARS-CoV-2 infection. In this prospective study, 60 COVID-19 patients who recovered 3 months after SARS-CoV-2 infection and 39 age- and gender-matched normal volunteers were subjected to diffusion tensor imaging and high-resolution 3D respectively -T1WI sequence. 

During follow-up, 55% of COVID-19 patients developed neurological symptoms such as mood changes, fatigue and headaches. In addition, compared with the control group, COVID-19 patients have statistically significantly higher bilateral gray matter volumes in multiple brain regions including the olfactory cortex and hippocampus.

 In general, the results of the study show that during the recovery phase of COVID-19, the integrity of the microstructure and functional brain may be damaged, which indicates the long-term outcome of SARS-CoV-2 infection.


6. Multisystem inflammatory syndrome in children (MIS-C): a systematic review

Mubbasheer Ahmed of Texas Children's Hospital and colleagues conducted a systematic review of the typical manifestations and outcomes of children diagnosed with multiple system inflammatory syndrome, which is temporarily considered to be a disease related to COVID -19 related new dangerous childhood diseases. 

A total of 39 observational studies were included in the review, and a total of 662 patients were included. 

The author reports the most common signs and symptoms, quantifies the results of laboratory tests, and describes the imaging characteristics of children with MIS-C. 71.0% of children (n=470) were admitted to the intensive care unit (ICU), and 11 deaths (1.7%) were reported. 

Fever, abdominal pain or diarrhea and vomiting are the most common clinical manifestations. 

Serum inflammation markers, coagulation markers and cardiac markers were significantly abnormal. 22.2% (n=147) and 4.4% (n=29) of patients required mechanical ventilation and extracorporeal membrane oxygenation (ECMO), respectively. 

In addition, abnormal echocardiography was observed in 314 (54.0%) of 581 patients. 


Conclusion

The authors concluded that with timely diagnosis and treatment, most children can survive. However, the long-term outcome of this syndrome is currently unclear.

 

All content is subject to the original.



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