The human coronavirus HCoV-19 infection can cause acute respiratory distress syndrome 47 (ARDS), hypercoagulability, hypertension, extrapulmonary multiorgan dysfunction. Effective 48 antiviral and anti-coagulation agents with safe clinical profiles are urgently needed to improve the 49 overall prognosis. We screened an FDA approved drug library and found that an anticoagulant agent 50 dipyridamole (DIP) suppressed HCoV-19 replication at an EC50 of 100 nM in vitro. It also elicited 51 potent type I interferon responses and ameliorated lung pathology in a viral pneumonia model. In 52 analysis of twelve HCoV-19 infected patients with prophylactic anti-coagulation therapy, we found 53 that DIP supplementation was associated with significantly increased platelet and lymphocyte counts 54 and decreased D-dimer levels in comparison to control patients. Two weeks after initiation of DIP 55 treatment, 3 of the 6 severe cases (60%) and all 4 of the mild cases (100%) were discharged from the 56 hospital. One critically ill patient with extremely high levels of D-dimer and lymphopenia at the time 57 of receiving DIP passed away. All other patients were in clinical remission. In summary, HCoV-19 58 infected patients could potentially benefit from DIP adjunctive therapy by reducing viral replication, 59 suppressing hypercoagulability and enhancing immune recovery. Larger scale clinical trials of DIP 60 are needed to validate these therapeutic effects.61 62

Study Objectives: We conducted a meta-analysis to assess the effects of different regular exercise (lasting at least 2 months on a regular basis) on self-reported and physiological sleep quality in adults. Varied exercise interventions contained traditional physical exercise (e.g., walking, cycling) and mind–body exercise characterized by gentle exercise with coordination of the body (e.g., yoga).Methods: Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematical searches were conducted in three electronic databases (PubMed, Embase, and Web of Science) for relevant research that involved adult participants without pathological diseases receiving exercise intervention. The search strategy was based on the population, intervention, comparison, and outcome study design (PICOS) framework. The self-reported outcomes included varied rating scales of Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS). Subgroup meta-analyses of PSQI scores were conducted based on type of exercise, duration of intervention, and participants' age and gender. The physiological outcomes were measured by Actigraph. All meta-analyses were performed in a fixed or random statistic model using Revman software.Results: Twenty-two randomized controlled trials were included in the analysis. The overall analysis on subjective outcomes suggests that exercise interventions significantly improved sleep quality in adults compared with control interventions with lower PSQI (MD −2.19; 95% CI −2.96 to −1.41), ISI (MD −1.52; 95% CI −2.63 to −0.41), and ESS (MD −2.55; 95% CI −3.32 to −1.78) scores. Subgroup analyses of PSQI scores showed both physical and mind–body exercise interventions resulted in improvements of subjective sleep to the same extent. Interestingly, short-term interventions (≤3 months) had a significantly greater reduction in sleep disturbance vs. long-term interventions (>3 months). Regarding physiological sleep, few significant effects were found in various sleep parameters except the increased sleep efficiency in the exercise group vs. control group.Conclusions: Results of this systematic review suggest that regular physical as well as mind–body exercise primarily improved subjective sleep quality rather than physiological sleep quality in adults. Specifically, self-reported sleep quality, insomnia severity, and daytime sleepiness could be improved or ameliorated with treatment of exercise, respectively, evaluated by PSQI, ISI, and ESS sleep rating scales.

Excellent disease control can be achieved by reirradiation with IMRT for recurrent T1 to T2 NPC. However, the main challenge remains severe late complications.