A case of the application of Paxlovid for a patient infected by the SARS-CoV-2 Omicron variant

Coronavirus disease 2019 (COVID-19) is a new acute respiratory infectious disease with high infectivity. To date, > 500 million cases of COVID-19 have been confirmed worldwide (World Health Organization). The Omicron variant has affected nearly every country worldwide due to its high infectivity and immune evasion, which has caused widespread anxiety. However, most of the existing treatments do not effectively reduce the risk of progression to more severe disease, or the existing treatments are too costly or not suitable for extensive use.Paxlovid is a novel oral antiviral drug that has proven effective against symptomatic COVID-19 infection by reducing the risk of progression to severe disease, hospitalization, and mortality

Analysis of the imaging and clinical features of subsolid pulmonary nodules in stage IA non-small cell lung cancer

The subsolid pulmonary nodules (SSPNs) in the imaging diagnosis of stage IA non-small cell lung cancer (NSCLC) is very important since they are closely related to early lung cancer. The CT imaging and pathology data of 230 patients with solitary pulmonary nodules (SPNs) who underwent thoracoscopic treatment at Guizhou Provincial People’s Hospital between July 2021 and June 2022 were collected. Based on postoperative pathology, the patients were divided into a benign group and a stage IA NSCLC group. The imaging and clinical features of SPNs in stage IA NSCLC were analysed. A total of 230 patients with SPNs were enrolled. There were 146 cases of SSPNs (including 34 cases of pure ground-glass opacities (pGGOs) and 112 cases of mixed GGOs (mGGOs)), and the incidence rate was significantly higher in the stage IA NSCLC group than in the benign group [96.7% (146/151) vs. 74.7% (59/79), P<0.05]. The overall malignancy rate of subsolid nodules was 71.2% (146/205); the malignancy rate of mGGO lesions was higher (75.2%) than that of pGGO lesions (60.7%) and solid nodules (20%). Malignant subsolid nodules mostly occurred in middle-aged women, mostly in the upper lobe of the lungs, with unclear edges and lobular signs, and accompanied by spur signs and pleural indentation signs (P<0.05). SSPNs are an important sign of lung cancer, and mGGO lesions have the highest malignant tendency. CT imaging findings such as unclear lesion edges, lobular signs, and pleural indentation signs are important for determining benign and malignant SSPNs. CT imaging manifestations are helpful for correctly assessing the nature of early SSPNs so that patients can receive timely and effective treatment

The value of diagnostic model on COVID-19 by Comparing the Features between SARS-COV-2 and other viral infections: DOI: 10.14800/ics.1197

With the expansion of 2019 novel coronavirus disease(COVID-19), large of suspected cases were reported. This essay compares the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and other viral infections among the suspected COVID-19 patients, and attempts to explore an ideal diagnostic model of COVID-19. 60 viral pneumonia patients from 86 suspected patients were enrolled and grouped into two: the COVID-19 group (19 cases) and other viral infections group (41 cases). Compare and analyze the blood test results, biochemical indicators and chest CT scan changes of patients. 60 patients were mainly young and middle-aged men, of which 60%were infected with influenza virus, and 31.6%were infected with SARS-COV-2 according to pathogenic distribution. And we found statistic differences among blood cell counts and blood biochemistry between the two groups. The COVID-19 patients' chest CT showed that the lung lesions were mainly bilateral nodule or appeared to be patchy and ground glass shadowed. While most of the lung lesions caused by other virus were mainly unilateral patchy shadow (P?0.05). We found a new multi-marker PTG, which composed of platelet-to-neutrophil ratio(PNR), total bilirubin(TBIL) and ground-grass density, The area sunder curves(AUC)of PTG was 0.908, the sensitivity was 73.17%and the specificity was 94.44%. The ratio of blood RT to its sub-group and chest CT were considered as important reference in differential diagnosis. The PTG, with extremely high specificity and sensitivity in early differential diagnosis of COVID-19 and other viral pneumonia, had a significant clinical value

A study on the significance of anti-endothelial cell antibodies in chronic obstructive pulmonary disease and the effect of methylprednisolone intervention: DOI: 10.14800/ics.1210

Objective: The purpose was to confirm the significance of Anti-endothelial cell antibodies(AECA) in chronic obstructive pulmonary disease (COPD) and validate the effect of methylprednisolone intervention. Methods: We recruited 40 patients with stable COPD, 40 patients with an acute exacerbation of COPD, and 20 healthy volunteers from March 2019 to August 2021. The healthy volunteers constituted the healthy control group. All patients with stable COPD were divided into the mild-moderate COPD group and the severe-very severe COPD group, for whom AECA and vascular endothelial growth factor (VEGF) in peripheral blood were detected by ELISA. The patients with acute exacerbation of COPD were divided into routine treatment group and methylprednisolone group by random number method. The routine group received routine treatment, and the methylprednisolone group was treated with methylprednisolone on the basis of routine treatment, and the course of treatment was 1 week, respectively. The AECA and VEGF in the peripheral blood of the two groups of patients before and after treatment were detected by ELISA. Results: Compared to control group, the AECA concentration was significantly elevated as the condition of COPD got serious between mild-moderate COPD group and the severe-very severe COPD group(P<0.05). And VEGF concentration was significantly lower as the condition of COPD got serious(P<0.05). AECA concentration was significantly lower after methylprednisolone treatment than before in patients with COPD exacerbation, and significantly lower than patients receiving the routine treatment (P<0.05). Besides, VEGF concentration was significantly elevated in patients with COPD exacerbation after methylprednisolone treatment than before, and considerably higher than patients receiving the routine treatment (P<0.05).   Conclusion: AECAs may be involved in the occurrence and development of COPD and related to its severity. Methylprednisolone can help reduce AECA expression while promoting VEGF expression

Plasma level of M-CSF was independently related to 30-day survival in patients with suspected sepsis, and correlated to pathogen load: A prospective cohort study.: DOI: 10.14800/ics.1186

The purpose of our study was to screen the plasma cytokines to find possible indicators of disease progression and prognosis of patients with infection. With a prospective cohort study, selected patients were divided into sepsis group and non-sepsis group. Demographic and clinical information were collected. Blood samples were tested for the levels of plasma cytokines and metagenomic next-generation sequencing (mNGS). 30-day follow-up information was recorded, and data was analyzed by SPSS22.0 (SPSS Inc, Chicago, IL). A total of 95 patients were selected. After propensity score matching of age and gender, 36 patients with sepsis and 36 with non-sepsis were enrolled. 30-day follow-up data exhibited that 41 patients died and 31 survived. Patients with sepsis and 30-day death had higher plasma levels of cytokines, including macrophage-stimulating factor (M-CSF), monocyte chemoattractant protein-3 (MCP-3), etc., than patients with non-sepsis and 30-day survival, respectively. M-CSF > 8.21pg/ml was an independent risk factor for 30-day death, and the reads of pathogens in mNGS reports was positively correlated with the plasma concentrations of various cytokines, including M-CSF

Neutrophil/lymphocyte ratio: A promising prognostic marker in patients with chronic kidney disease: DOI: 10.14800/ics.683

Chronic kidney disease (CKD), especially end-stage renal disease (ESRD), is associated with high morbidity and mortality due to cardiovascular disease (CVD) and infection, two common complications of ESRD that may be related, in part, to chronic inflammation and protein-energy wasting (PEW). Recently, in a Japanese prospective cohort study, we reported that there was significantly higher risk for CVD-related events in CKD patients with an increased neutrophil/lymphocyte ratio (NLR) at the start of their dialysis therapy. Because higher neutrophil count reflects inflammation and lower lymphocyte count may reflect malnutrition, NLR is hypothesized to be a more sensitive index than other existing inflammatory markers for detecting those at high risk for CVD-related events. This research highlight describes the potentials of NLR as a prognostic marker in patients with CKD. Although further studies are required to better understand its value as prognostic tool in clinical practice, current data suggest that NLR may be a useful and inexpensive marker for identifying CKD patients at high risk for CVD-related complications

Potential Contribution of Microbiome In Neurodegenerative Diseases: Alzheimer's Disease: DOI: 10.14800/ics.1595

Alzheimer’s Disease (AD) is described as a gradual decrease in cognition and memory frequently causing dementia in most cases. Human microbiome (HM) contribute to the regulation of multiple neuro-chemical and neuro-metabolic pathways. The pathological features of AD include amyloid beta peptide (A?) deposition, neuronal tangle formation and granulovacuolar degeneration. A? protein is a normal part of the innate immune system, the body's first-line defense against infection. However recent report shows that A? expression protects against fungal and bacterial infections in mouse, nematode, and cell culture models of AD. Recent reports suggest that these proteins are also expressed on bacterial and fungal cell surfaces and might contribute to immune response. In addition to commensal microbes, there are other pathogens like Chlamydophila pneumoniae, Toxoplasma gondii, Viroids, Hepatitis, Cytomegalovirus have been suspected to be involved in AD. Microbes are proposed to play an important role in the pathophysiology of neurodegenerative disease. Microbes are shown to produce relevant neurotransmitter, modulate immune response and translocate through blood or lymphatic system to brain from the site of infection. Here we elaborated on the emerging ideas showing the contribution of the gut microbiome to human neurological diseases with special emphasis on AD. The evidences described here may be helpful in designing further studies for taxonomic and functional profiling of microbiota in patients with AD which may open doors for advanced therapeutic inventions

Distinct RT-PCR diagnosis profiles of father and son patients of COVID-19 using nasopharyngeal and alveolar lavage fluid samples: DOI: 10.14800/ics.1164

The detection of viral nucleic acid by real time RT-PCR is the main confirmative diagnostic method for COVID-19 in clinical practice in China and worldwide. However, its sensitivity is unclear. Here we report two cases in a family in Guizhou, southwestern China. The father had a history of long stay in Wuhan, the center of the first recorded COVID-19 outbreak. Surprisingly, although the son was diagnosed positive using the nasopharyngeal swab specimen and the rRT-PCR method, the father was diagnosed negative continuously for multiple times. Only after the alveolar lavage fluid sample was used, the father’s rRT-PCR diagnosis turned positive. Their CT diagnosis and clinical symptoms did not completely align with their rRT-PCR diagnostic results. The underlying mechanisms and their implications to clinical practice are discussed

Vascular enlargement and bronchiolectasis: Two important CT manifestations in Coronavirus Disease 2019 (COVID-19) and clinicopathologic analysis: DOI: 10.14800/ics.1168

Coronavirus disease 2019 (COVID-19) is a novel infectious disease that spreads rapidly around the world and endangers global public health. Because of the lack of specificity of previously identified CT images, such as peripheral and subpleural ground glass opacities, early diagnosis is still a big challenge for radiologists. How to improve the accuracy of diagnosis and make diagnosis as early as possible is a problem concerned by the medical field. This article reports two important CT manifestations in COVID-19 patients, and investigates the pathogenesis and clinical significance of them. Single or multiple CT scans in COVID-19 patients confirmed at our hospital were retrospectively analyzed. The presence of vascular enlargement sign and bronchiolectasis sign on CT images were evaluated with the help of sophisticated post-processing techniques. A total of 14 patients (6 men and 8 women; mean ± standard deviation age: 41.51 ± 20.98 years) with 34 CT series were included. Vascular enlargement sign at a distribution of interior or the edge of pulmonary lesions was observed in all CT series (34/34, 100%). Bronchiolectasis sign was observed in 30 CT series (88%), with 4 series (4/7, 57.1%) in early stage, 16 series (16/16, 100%) in progressive stage, 5 series (5/5, 100%) in severe stage and 9 series (9/9, 100%) in absorption stage. The occurrence of bronchiolectasis sign in COVID-19 patients was significantly different between early stage and non-early stage (P=0.005). This study suggests that the vascular enlargement sign and bronchiolectasis sign are two important CT features in COVID-19 patients and may be of great significance in early diagnosis and guiding treatment decisions

COVID-19 pneumonia with night sweat as the first symptom: DOI: 10.14800/ics.463

A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. The major presentations of patients are fever, fatigue, and dry cough. No cases have been reported with night sweats as the first symptom. This article present a case which diagnosed with COVID-19 pneumonia with night sweats as the first symptom.  Chest CT showed patches of ground-glass opacity, qRT-PCR of SARS-CoV-2 were positive. After treatment, the patient did not present with night sweats again. A recheck of the chest CT showed that the ground-glass opacity was completely absorbed and the SARS-CoV-2 nucleic acid test was negative. This case suggests that night sweats might be the first and major symptom of COVID-19 pneumonia