Rationale: The coronavirus disease (COVID-19) pandemic is now a global health concern. Objectives: We compared the clinical characteristics, laboratory examinations, computed tomography images, and treatments of patients with COVID-19 from three different cities in China. Methods: A total of 476 patients were recruited from January 1, 2020, to February 15, 2020, at three hospitals in Wuhan, Shanghai, and Anhui. The patients were divided into four groups according to age and into three groups (moderate, severe, and critical) according to the fifth edition of the Guidelines on the Diagnosis and Treatment of COVID-19 issued by the National Health Commission of China. Measurements and Main Results: The incidence of comorbidities was higher in the severe (46.3%) and critical (67.1%) groups than in the moderate group (37.8%). More patients were taking angiotensinconverting enzyme inhibitors/angiotensin II receptor blockers in the moderate group than in the severe and critical groups. More patients had multiple lung lobe involvement and pleural effusion in the critical group than in the moderate group. More patients received antiviral agents within the first 4 days in the moderate group than in the severe group, and more patients received antibiotics and corticosteroids in the critical and severe groups. Patients .75 years old had a significantly lower survival rate than younger patients. Conclusions: Multiple organ dysfunction and impaired immune function were the typical characteristics of patients with severe or critical illness. There was a significant difference in the use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers among patients with different severities of disease. Involvement of multiple lung lobes and pleural effusion were associated with the severity of COVID-19. Advanced age (>75 yr) was a risk factor for mortality.
The outbreak of novel coronavirus SARS-CoV-2 has caused a worldwide threat to public
health. COVID-19 patients with SARS-CoV-2 infection can develop clinical symptoms that
are often confused with the infections of other respiratory pathogens. Sensitive and
specific detection of SARS-CoV-2 with the ability to discriminate from other viruses is
urgently needed for COVID-19 diagnosis. Herein, we streamlined a highly efficient
CRISPR-Cas12a-based nucleic acid detection platform, termed
Ca
s12a-
li
nked
b
eam
u
nlocking
r
eactio
n
(CALIBURN). We show that CALIBURN could detect
SARS-CoV-2 and other coronaviruses and influenza viruses with little cross-reactivity.
Importantly, CALIBURN allowed accurate diagnosis of clinical samples with extremely low
viral loads, which is a major obstacle for the clinical applications of existing CRISPR
diagnostic platforms. When tested on the specimens from SARS-CoV-2-positive and negative
donors, CALIBURN exhibited 73.0% positive and 19.0% presumptive positive rates and 100%
specificity. Moreover, unlike existing CRISPR detection methods that were mainly
restricted to respiratory specimens, CALIBURN displayed consistent performance across
both respiratory and nonrespiratory specimens, suggesting its broad specimen
compatibility. Finally, using a mouse model of SARS-CoV-2 infection, we demonstrated
that CALIBURN allowed detection of coexisting pathogens without cross-reactivity from a
single tissue specimen. Our results suggest that CALIBURN can serve as a versatile
platform for the diagnosis of COVID-19 and other respiratory infectious diseases.
Closure of bronchopleural fistula remains a difficult challenge for clinicians. Although several therapeutic approaches have been proposed, the clinical results are commonly unsatisfactory. Previous reports have indicated that autologous mesenchymal stem cells (MSCs) are useful for aiding treatment of bronchopleural fistula. We report here the use of umbilical cord MSCs to effect the successful closure of a bronchopleural fistula (5 mm) in a 33-year-old woman 6 months after a lobectomy. A review of the relevant literature is included. The use of MSCs may be a promising therapeutic method for the closure of bronchopleural fistula. Randomized controlled trials with larger samples are required.
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