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Beginning in 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly resulted in a worldwide pandemic. Many patients with coronavirus disease-19 (COVID-19) require invasive ventilation due to severe respiratory failure. However, many medical hospitals experienced shortages of personal protective equipment, increasing the risk of healthcare workers contracting an infection. However, we report a case of acute respiratory distress syndrome during the early stage of COVID-19 treated at a university hospital outside of Wuhan, China. We described the optimization of healthcare worker personal protection and a procedure for airway management in the context of insufficient personal protective equipment. This report may provide a reference for resource-limited settings in low- and middle-income countries, even countries where healthcare systems have been overwhelmed by the pandemic., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Sheng Zhang, Yingxin Lin, Yanyan Li, Weixing Zhang, Qing Feng, Hua Luo.)

Background: Rational use of antibiotics received great attention in China, therefore the multifaceted antimicrobial stewardship (MAMS) is urgently required in hospital management. We conducted this study to assess the impact of a MAMS programme on antimicrobial use in a tertiary teaching hospital in Shanghai., Methods: This retrospective observational study was conducted at a tertiary teaching hospital in Shanghai. The MAMS programme involved multifaceted interventions consisting of a quality premium with financial incentives, antibiotic restriction, audit and feedback, and education. Data were extracted from the electronic medical records of inpatients to analyse monthly and annual antibiotic consumption and the percentage of antibiotic prescriptions during 2017-2020. Segmented regression analysis of the interrupted time series was used to contrast antimicrobial use during 2019-2020, with non-MAMS data from the 2017-2018 period as the historical control., Results: With MAMS implementation, antibiotic consumption decreased from 63.3 (59.3, 67.2) defined daily doses (DDDs) per 100 patient-days (PD) to 43.3 (39.0, 49.8) DDDs/100 PD (P<0.001), and the percentage of antibiotic prescriptions decreased from 44.8% (44.1%, 45.4%) to 43.3% (42.2%, 44.3%) (P<0.001). Segmented regression models suggested a reduction in antibiotic consumption (coefficient = -12.537, P<0.001) and indicated a downward trend in the percentage of antibiotic prescriptions (coefficient =-0.165, P=0.049). Neither antibiotic consumption nor the percentage of antibiotic prescriptions was influenced by the coronavirus disease 2019 (COVID-19) pandemic., Conclusions: This study suggests that MAMS plays an important role in reducing antibiotic use and is not affected by special circumstances such as the COVID-19 pandemic. This novel intervention, consisting of a quality premium and multidisciplinary cooperation, should be prioritized by policy and decision makers, where rational management of antimicrobial use is urgently needed.

When the coronavirus disease (COVID-19) virus swept the world in December 2019, it brought widespread side-effects. While there is no specific treatment for COVID-19, individuals and collectives often respond rapidly to develop a routine, making the prevention and control of COVID-19 normalized and institutionalized and creating vaccines successfully in a short time. However, this situation also exposed a spectrum of problems triggered by lockdown, isolation, and vaccinations. Herein, we analyze the prevention management of COVID-19 from epidemic psychology in order to provide a new sight for overcoming the psychological problems of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease-2019 (COVID-19) has spread worldwide. The study aimed to understand the clinical characteristics of young COVID-19 patients.Material and methods: Ninety patients with severe COVID-19 infection in western Chongqing were collected from 21 January to 14 March 2020. They were divided into 4 groups based on age: youth (< 39 years), middle-aged (39-48 years), middle-elderly aged (49-60 years), and elderly (> 60 years). The clinical symptoms, laboratory findings, imaging findings, and treatment effects were compared among the groups.Results: There were 22, 27, 19, and 22 cases in the youth, middle-aged, middle-elderly, and elderly groups, respectively. There were no significant differences with respect to gender or smoking status among the four groups. The clinical indicators of severe disease in the youth group were significantly different from the other three groups, and included the lymphocyte count (p < 0.001), C-reactive protein level (p = 0.03), interleukin-6 level (p = 0.01), chest computed tomography (CT) findings (p < 0.001), number of mild cases (p = 0.02), education level (p < 0.001), and CD4 + T lymphocyte level (p = 0.02) at the time of admission, and the pneumonia severity index (PSI) at the time of discharge (p < 0.001). The complications (p < 0.001) among the youth group were also significantly different from the other groups.Conclusions: Young patients have milder clinical manifestations, which may be related to higher education level, higher awareness and higher acceptance of the prevention and control of the COVID-19 epidemic, as well as their good immune function. [ABSTRACT FROM AUTHOR]

As the SARS-CoV-2 virus swept the world in late 2019, it has brought widespread fear, some suspicion, and degrees of stigma. In the shadow of the COVID-19 pandemics, a series of collective irrationalities such as panic buying, protest marches against vaccines, and pandemic stigma occurred. This phenomenon is inseparable from the spread of rumors about the epidemic. The advent of social media has radically changed the way we consume information and form opinions and made a flood of digital misinformation becoming ubiquitous. The diffusion of false rumors affects the public's perception of reality and disrupts the prevention of the epidemic. This paper analyzes the COVID-19 collective irrationalities from epidemic psychology to provide a new reference view for overcoming psychological problems related to COVID-19. [ABSTRACT FROM AUTHOR]

Background: A novel coronavirus was identified in December, 2019 in Wuhan, China, and traditional Chinese medicine (TCM) played an active role in combating the novel coronavirus pneumonia (NCP) caused by this fast-spreading virus COVID-19. Thus, we aimed to explore TCM characteristics of clinical efficacy to NCP, as well as to optimize Qingfei Paidu decoction (QFPDD) and the recommended formulas to NCP by National Health Commission (NHC). Methods: Chinese medical sciences theory and clinical application of TCM were analyzed. A total of 54 NCP patients were observed in a hospital from Wuhan, whose clinical characteristics and utilization of Chinese Medicines (CMs) were described. Paired t test was used to measure the change of patients' hemogram during hospitalization period, indicating the effect of CMs. Multiple linear regression analysis was applied to explore the factors affecting the length of hospital stay. Network pharmacology analysis was applied to figure out the performance of NHC-recommended formulas of five disease stages at levels of compounds, targets and pathways. Result: The average length of hospital stay was 8.96 days. Patients over 45 stayed 9.79 days in hospital in average, longer than 7.64 days of patients under 45. Comparing the hemograms between admission and discharge of hospital, the number of leukocytes, neutrophil, lymphocyte and platelet increased, while the numbers of erythrocytes, hemoglobin concentration and hematocrit decreased. According to the standard coefficients of regression, the factor affecting the length of stay for the most was CMs in category of invigorating spleen and removing dampness (ISRD), followed by administrating CMs, male, and cough. Thirty-two CMs were screened after deleting duplication from QFPDD and NHC-recommended formulas. Compound quercetin, luteolin, kaempferol, acacetin etc., were all involved in the treatment of various disease stages on the compound level both in generality and individuality. Conclusion: TCM has a systemic theoretical understanding on the pathological evolution and a positive clinical efficacy on NCP. The CMs of ISRD improved patients' recovery, suggesting the importance of regulating intestinal function and keeping microenvironmental balance in TCM treatment of NCP. The active compounds from QFPDD and NHC-recommended formulas contribute to recovery of varied disease progresses during TCM treating NCP. [ABSTRACT FROM AUTHOR]

Reduning injection (RDNI) is a patented Traditional Chinese medicine that contains three Chinese herbal medicines, respectively are the dry aboveground part of Artemisia annua L. , the flower of Lonicera japonica Thunb. , and the fruit Gardenia jasminoides J.Ellis. RDNI has been recommended for treating Coronavirus Disease 2019 (COVID-19) in the "New Coronavirus Pneumonia Diagnosis and Treatment Plan". To elucidate and verify the underlying mechanisms of RDNI for the treatment of COVID-19. This study firstly performed anti-SARS-CoV-2 experiments in Vero E6 cells. Then, network pharmacology combined with molecular docking was adopted to explore the potential mechanisms of RDNI in the treatment for COVID-19. After that, western blot and a cytokine chip were used to validate the predictive results. We concluded that half toxic concentration of drug CC50 (dilution ratio) = 1:1280, CC50 = 2.031 mg crude drugs/mL (0.047 mg solid content/mL) and half effective concentration of drug (EC50) (diluted multiples) = 1:25140.3, EC50 = 103.420 μg crude drugs/mL (2.405 μg solid content/mL). We found that RDNI can mainly regulate targets like carbonic anhydrases (CAs), matrix metallopeptidases (MMPs) and pathways like PI3K/AKT, MAPK, Forkhead box O s and T cell receptor signaling pathways to reduce lung damage. We verified that RDNI could effectively inhibit the overexpression of MAPKs, PKC and p65 nuclear factor-κB. The injection could also affect cytokine levels, reduce inflammation and display antipyretic activity. RDNI can regulate ACE2, Mpro and PLP in COVID-19. The underlying mechanisms of RDNI in the treatment for COVID-19 may be related to the modulation of the cytokine levels and inflammation and its antipyretic activity by regulating the expression of MAPKs, PKC and p65 nuclear factor NF-κB. [Display omitted] [ABSTRACT FROM AUTHOR]