新型冠状病毒肺炎患者急诊科转运路径

2019年12月以来,武汉市暴发新型冠状病毒肺炎(COVID-19),并迅速蔓延至全国各地。为了有效防控疾病的蔓延,大部分省市均启动限制交通、出入等措施,这给患者的急诊转运流程带来了巨大的挑战。为了有效促使患者顺利入院接受救治,四川大学华西医院急诊科采用了一种创新医疗隔离运输系统以转运新型冠状病毒肺炎患者,并应用于首例患者的急诊转运,最终使该患者顺利入院,且转运途中病情稳定,按计划进行治疗,未发生二次感染病例。     

三级综合医院手术室应对新型冠状病毒肺炎疫情期间的管理策略

新型冠状病毒肺炎作为急性呼吸道传染病已被纳入乙类传染病,按甲类传染病管理。我院作为重庆市定点救治医院,启动突发公共事件一级响应。手术室是临床枢纽科室,人员复杂,是感染发生的高风险科室。我院手术室根据国家相关规定制定管理对策,全面做好人力、物资、环境管理,确保手术室的正常运行,保障患者及医务人员安全。     

1例疑似新型冠状病毒肺炎患者的手术管理策略

回顾1例疑似新型冠状病毒肺炎(COVID-19)患者的急诊手术管理,医护团队根据COVID-19的感染特点,参照核应急演习及手术室特殊感染手术的防控要求,提出严密的隔离措施和管理计划策略,从患者的病情评估、术前准备、手术间及器材设备准备、手术人员管控、麻醉防护特点、术中护理关键点及术后环境、器械、用物处置的特殊性进行积极探索,以期为保障手术顺利进行及制定疑似/确诊COVID-19患者手术管理流程和感染防控规范提供依据。     

Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan,China: part of the city-wide massive testing campaign

ObjectivesThe outbreak of the 2019 coronavirus disease (COVID-19) pandemic in Wuhan, China, has subsided after being hard hit by the disease and subsequent city lockdown. Information on the number of people involved in Wuhan is still inadequate. This study aimed to describe the screening results of 61 437 community members in Wuchang District, Wuhan.MethodsIn mid-May 2020, Wuhan launched a population-scale city-wide SARS-CoV-2 testing campaign, which aimed to perform nucleic acid and viral antibody testing for citizens in Wuhan. Here we show the screening results of cluster sampling of 61 437 residents in Wuchang District, Wuhan, China.ResultsA total of 1470 (2.39%, 95% CI 2.27–2.52) individuals were detected positive for at least one antiviral antibody. Among the positive individuals, 324 (0.53%, 95% CI 0.47–0.59) and 1200 (1.95%, 95% CI 1.85–2.07) were positive for immunoglobulin IgM and IgG, respectively, and 54 (0.08%, 95% CI 0.07–0.12) were positive for both antibodies. The positive rate of female carriers of antibodies was higher than those of male counterparts (male-to-female ratio of 0.75), especially in elderly citizens (ratio of 0.18 in 90+ age subgroup), indicating a sexual discrepancy in seroprevalence. In addition, viral nucleic acid detection using real-time PCR had showed 8 (0.013%, 95% CI 0.006–0.026) asymptomatic virus carriers.DiscussionThe seroprevalence of SARS-CoV-2 in Wuhan was low. Most Wuhan residents are still susceptible to this virus. Precautions, such as wearing mask, frequent hand hygiene and proper social distance, are necessary before an effective vaccine or antiviral treatments are available.     

Is COVID-19 another case of the obesity paradox? Results from an international ecological study on behalf of the REPROGRAM Consortium Obesity study group

IntroductionObesity has emerged as one of the major risk factors of severe morbidity and cause-specific mortality among severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected individuals. Patients with obesity also have overlapping cardiovascular diseases and diabetes, which make them increasingly vulnerable. This novel ecological study examines the impact of obesity and/or body mass index (BMI) on rates of population-adjusted cases and deaths due to coronavirus disease 2019 (COVID-19).Material and methodsPublicly available datasets were used to obtain relevant data on COVID-19, obesity and ecological variables. Group-wise comparisons and multivariate logistic regression analyses were performed. The receiver operating characteristic curve (ROC) was plotted to compute the area under the curve.ResultsWe found that male BMI is an independent predictor of cause-specific (COVID-19) mortality, and not of the caseload per million population. Countries with obesity rates of 20–30% had a significantly higher (approximately double) number of deaths per million population to both those in < 20% and > 30% slabs. We postulate that there may be a U-shaped paradoxical relationship between obesity and COVID-19 with the cause-specific mortality burden more pronounced in the countries with 20–30% obesity rates. These findings are novel along with the methodological approach of doing ecological analyses on country-wide data from publicly available sources.ConclusionsWe anticipate, in light of our findings, that appropriate targeted public health approaches or campaigns could be developed to minimize the risk and cause-specific morbidity burden due to COVID-19 in countries with nationwide obesity rates of 20–30%.     

Immune-epidemiological parameters of the novel coronavirus – a perspective

ABSTRACT

Introduction

At the end of 2019, Wuhan, a city in China with a population of about 11 million, witnessed the outbreak of unusual pneumonia. As of 29 March 2020, the disease has spread to more 199 countries and territories worldwide. The 2019 novel coronavirus, 2019-nCoV, is known as the probable causative agent of the illness.     

Epidemiological trends of COVID-19 epidemic in Italy over March 2020: From 1000 to 100 000 cases

The coronavirus disease 2019 epidemic started in Italy by the end of January 2020 and, after 1 month, it affected 1049 persons. Based on the Italian Ministry of Health data, we reconstructed the daily course of virus-positive cases and deaths over March 2020 for the whole of Italy, 19 regions and 2 provinces. From 29 February to 31 March, there was a 100.9-fold increase in the cumulative number of cases and a 428.6-fold increase in the number of deaths in Italy. When plotted on a semilogarithmic scale, the curves tended to diverge from linearity with 23%, 16%, and 7% average daily increases during the three decades of March. Similarly, the number of deaths decreased from an average daily growth of 19% over the second decade to 10% over the third decade. The correlation coefficients relating the days to cases or deaths over each one of the three decades approached unity. As inferred from the equations of the regression lines relative to the three decades, the doubling times of cases were 3.4, 5.1, and 9.6 days, respectively. The doubling times of deaths over the second and third decades were 4.9 and 7.0 days, respectively. There was a broad geographic variability, with a striking gradient from the North, where 40.8% of cases and 57.9% of deaths occurred in Lombardy, to the South. On the whole, over March there was a trend to epidemic growth decline but the time for the end of the epidemic will depend on a variety of factors and, at present, it is unpredictable.     

基于Web of Science数据库对新冠疫苗副作用相关文献的计量学分析

目的 通过文献计量学方法分析新冠疫苗副作用相关研究文献,了解国内外新冠疫苗相关的前沿问题。方法 计算机检索2020年1月-2021年8月Web of Science核心合集数据库（WOSCC）中发表的新冠疫苗副作用的相关文献,分析文献的发表国家、作者、期刊、机构、关键词、文献引用情况及被引频次等情况。结果 共纳入文献489篇,Harvard Med Sch为最大的发文机构,NEW ENGL J MED为文献被引用次数最多的期刊,美国是新冠疫苗副作用相关文献的主要产出国家,李敬新和朱凤才为发文量最多的作者;该领域主要的研究热点为新冠病毒感染、预先暴露、副作用、严重新冠病毒感染、人类健康体系、进展前景、疫苗观望态度、其他人类冠状病毒感染等。结论 目前新冠疫苗副作用的相关研究总体呈增长趋势,随着新冠疫苗接种人群越来越多,其有效性及安全性将会愈发受到重视,医务工作者应投入更多的研究,深化国际间合作,为未来的研究奠定基础。