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During coronavirus disease 2019 pandemic, the exponential increase in clinical waste (CW) generation has caused immense burden to CW treatment facilities. Co-incineration of CW in municipal solid waste incinerator (MSWI) is an emergency treatment method. A material flow model was developed to estimate the change in feedstock characteristics and resulting acid gas emission under different CW co-incineration ratios. The ash contents and lower heating values of the feedstocks, as well as HCl concentrations in flue gas showed an upward trend. Subsequently, 72 incineration residue samples were collected from a MSWI performing co-incineration (CW ratio <10 wt%) in Wuhan city, China, followed by 20 incineration residues samples from waste that were not co-incineration. The results showed that the contents of major elements and non-volatile heavy metals in the air pollution control residues increased during co-incineration but were within the reported ranges, whereas those in the bottom ashes revealed no significant changes. The impact of CW co-incineration at a ratio <10 wt% on the distribution of elements in the incineration residues was not significant. However, increase in alkali metals and HCl in flue gas may cause potential boiler corrosion. These results provide valuable insights into pollution control in MSWI during pandemic. [Display omitted] • Clinical waste co-incineration in municipal solid waste incinerator was evaluated. • HCl in flue gas increased from 825 to 3359 mg/Nm3 with the CW ratio from 0% to 20%. • Alkali and heavy metals in air pollution control residues increased with CW ratios. • The CW co-incineration ratios ought to be below 10 wt%. [ABSTRACT FROM AUTHOR]

• EB-LPME-LC-MS/MS was developed to determine trace level illicit drugs in wastewater. • EB-LPME displayed higher recovery and larger mass transfer flux than HF-LPME. • Thickness of the membrane support was the main mass transfer rate–determining factor. • EB-LPME showed great potential for high through-put and on-site sample preparation. To concentrate trace level of analytes in complex wastewater, sample preparation is necessary prior to instrumental analysis. In this work, an enrichment bag-based liquid-phase microextraction (EB-LPME) system was therefore proposed for the first time to isolate and enrich the illicit drugs (amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), ketamine, codeine and fentanyl) from wastewater. Under the optimum EB-LPME conditions, the recoveries of the model illicit drugs were 40–93% with enrichment factors up to 93. The optimized EB-LPME was compared to hollow fiber-LPME (HF-LPME) in terms of the thickness of the supported liquid membrane (SLM), the effective SLM area, extraction recovery and mass transfer flux. Compared with HF-LPME, EB-LPME possesses larger effective SLM area, and provided higher extraction recovery. In addition, EB-LPME provided larger mass transfer flux than HF-LPME, which was mainly due to the differences in SLM thickness. Therefore, SLM thickness was identified as the main mass transfer flux-determining factor experimentally. The matrix effect of EB-LPME was evaluated using liquid chromatography-tandem mass spectrometry (LC-MS/MS), and excellent sample clean-up was confirmed. Subsequently, EB-LPME-LC-MS/MS was validated with satisfactory results, and the detection of limit of the proposed method was in the range of 0.3–8.7 ng/L. Finally, with standard addition method, EB-LPME-LC-MS/MS was successfully applied for the determination of the model drugs in a local hospital wastewater from Wuhan, China. This study clearly showed that EB-LPME displayed great potential as an efficient sample preparation method for isolation and enrichment of the drugs/pollutants from complex environmental samples for wastewater-based epidemiology in the near future. [ABSTRACT FROM AUTHOR]

Background: In December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. Moreover, it has become a global pandemic. This is of great value in describing the clinical symptoms of COVID-19 patients in detail and looking for markers which are significant to predict the prognosis of COVID-19 patients.Methods: In this multicenter, retrospective study, 476 patients with COVID-19 were enrolled from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.Results: The main symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most common comorbidities were hypertension and diabetes mellitus. Patients with lower CD4+T cell level were older and more often male compared to those with higher CD4+T cell level. Reduced CD8+T cell level was an indicator of the severity of COVID-19. Both decreased CD4+T [HR:13.659; 95%CI: 3.235-57.671] and CD8+T [HR: 10.883; 95%CI: 3.277-36.145] cell levels were associated with in-hospital death in COVID-19 patients, but only the decrease of CD4+T cell level was an independent predictor of in-hospital death in COVID-19 patients.Conclusions: Reductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases of COVID-19. It was the CD8+T cell level, not the CD4+T cell level, that reflected the severity of the patient's disease. Only reduced CD4+T cell level was independently associated with increased in-hospital death in COVID-19 patients.Trial Registration: Prognostic Factors of Patients With COVID-19, NCT04292964 . Registered 03 March 2020. Retrospectively registered. [ABSTRACT FROM AUTHOR]