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Background Secondary bloodstream infection (SBI) is considered one of the most perilous complications of coronavirus disease 2019 (COVID-19). Although the etiology of SBI has been reported, the clinical course and outcomes of this illness have not been well described. Methods In this retrospective study, all patients with confirmed SBI were included from a cohort of 1,651 patients hospitalized with COVID-19 in the Wuhan Union Hospital between January 25 and April 23, 2020. Demographics, clinical features, laboratory findings, treatments and outcomes were extracted from electronic medical records. The data were compared between survivors and non-survivors based on whether patients died within 30 days following SBI onset. Results A total of 31 patients corresponding to 1.9% (31/1,651) who exhibited SBI were included in the present study. The median time from admission to the onset of SBI was 22.0 days (2.0–64.0). The most common symptoms were shortness of breath (74%), fever (65%) and decreased blood pressure (52%) at the onset of SBI. The levels of white blood cell count, C-reactive protein, and procalcitonin were mostly elevated. Carbapenem-resistant Klebsiella pneumoniae (15 [48%]) and Acinetobacter baumannii (7 [23%]) were the main pathogens. In empirical treatment, carbapenems were still the first choice. The 30-day mortality following SBI onset and the hospital mortality of the 31 patients were 67.7% (21/31) and 77.4% (24/31), respectively. Almost every patient with SBI had complication due to sepsis (28 [90%]). The median time periods to sepsis and septic shock were 1 days (1.0 ~ 5.0) and 3.0 days (1.0 ~ 12.0), respectively. The proportion of carbapenem-resistant gram-negative bacteria (CRGNB) detected in blood cultures of non-survivors was higher (18 [86%] vs. 4 [40%]) compared to that of the survivors. These patients were more likely to develop sepsis (21 [100%] vs. 7 [70%]), and acute cardiac injury (19 [90%] vs. 5 [50%]). Conclusions The mortality of SBI patients with COVID-19 is considerable. Increased risk of mortality was noted for the following three subgroups: Patients infected with CRGNB, patients with complications of sepsis and patients with acute cardiac injury.

Lung cancer is the most commonly diagnosed cancer with a high mortality rate. Cisplatin is one of the most important chemotherapeutic agents for the treatment of lung cancer patients, especially in advanced stages. Recent studies showed that cisplatin may interact with mitochondria which may partly account for its cytotoxicity. In the study, we explored the effect of resistin on cisplatin-induced cytotoxicity in A549 cells and assessed whether mitochondria-dependent apoptosis was involved. Our results found that 25 ng/ml resistin could significantly increase cisplatin-induced apoptosis and G2/M phase arrest, enhance reactive oxygen species generation, exacerbate the collapse of mitochondrial membrane potential, promote the distribution of cytochrome C in the cytoplasm from mitochondria, and activate caspase 3. Therefore, the results suggested that resistin might increase cisplatin-induced cytotoxicity via a mitochondria-mediated pathway in A549 cells. However, the precise mechanism has yet to be explored in the future.

Background: Coronavirus disease-2019 (COVID-19) spreads rapidly throughout the world. So far, no therapeutics have yet been proven to be effective. Ribavirin was recommended for the treatment of COVID-19 because of its in vitro activity. However, evidence supporting its clinical use with good efficacy is still lacking.Methods: A total of 208 confirmed severe or critical COVID-19 patients who were hospitalized in Wuhan Union West Campus between 1 February 2020 and 10 March 2020 were enrolled in the retrospective study. Patients were divided into two groups based on the use of ribavirin. The primary endpoint was the time to clinical improvement. The secondary endpoints included mortality, survival time, time to throat swab SARS-CoV-2 nucleic acid negative conversion, and hospital duration.Results: 68 patients were treated with ribavirin while 140 not. There were no significant between-group differences in demographic characteristics, baseline laboratory test results, treatment, and distribution of ordinal scale scores at enrollment, except coexisting diseases especially cancer (ribavirin group vs no ribavirin group, P = 0.014). Treatment with ribavirin was not associated with a difference in the time to clinical improvement (P = 0.483, HR = 0.884, 95% CI = 0.627-1.247). There were also no significant differences between-group in the number of patients with SARS-CoV-2 nucleic acid negative conversion, mortality, survival time, and hospital duration. Conclusion: In hospitalized adult patients with severe or critical COVID-19, no significant benefit was observed with ribavirin treatment.

During coronavirus disease 2019 (COVID-19) pandemic, medical resources in every country is in shortage. Efficacious indicators of discriminating severe illness and predicting outcome is in urgent need. We collected data and clinical records from 79 COVID-19 patients admitted between January 12, 2020 and February 21, 2020 at Wuhan Union hospital, China. Spearman’s correlation analysis, receiver operating characteristic (ROC) curve, logistic regression model, and Kaplan-Meier survival curves were employed in the analysis. Of 79 patients enrolled, 2 died in hospital, 8 were transferred to other hospitals, and 69 were discharged. Patients with elevated ferritin levels (> 200 ng/mL) had a higher incidence of severity illness when compared with those with normal ferritin levels (≤ 200 ng/mL) (50.0% vs 2.9%). In addition, severity illness manifested significantly higher level of ferritin as compared with non-severe ones (median 921.3 vs 130.7 ng/mL, p