Progression to severe disease is a difficult problem in treating coronavirus disease 2019 . The purpose of this study is to explore changes in markers of severe disease in COVID-19 patients. Sixty-nine severe COVID-19 patients were included. Patients with severe disease showed significant lymphocytopenia. Elevated level of lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, and D-dimer was found in most severe cases. Baseline interleukin-6 (IL-6) was found to be associated with COVID-19 severity. Indeed, the significant increase of baseline IL-6 was positively correlated with the maximal body temperature during hospitalization and with the increased baseline of CRP, LDH, ferritin, and D-dimer. High baseline IL-6 was also associated with more progressed chest computed tomography (CT) findings. Significant decrease in IL-6 and improved CT assessment was found in patients during recovery, while IL-6 was further increased in exacerbated patients. Collectively, our results suggest that the dynamic change in IL-6 can be used as a marker for disease monitoring in patients with severe COVID-19.

Background The outbreak of coronavirus disease 2019 in Wuhan City, China has spreads rapidly since December, 2019. Most patients show mild symptoms, but some of them develop into severe disease. There is currently no specific medication. The purpose of this study is to explore changes of markers in peripheral All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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Development of proper skin wound dressing is a vital step for wound repair, especially for those patients with serious skin injuries. Herein, zinc-doped bioactive glass (ZBG)/succinyl chitosan (SCS)/oxidized alginate (OAL) composite hydrogels (Gel-ZBG) have been developed as wound dressings to accelerate wound closure. Schiff-based linkages have been introduced into the composite hydrogels, which provide a humid microenvironment for the proliferation of cells on wound sites. The amino groups from SCS and Zn 2+ released from ZBG exhibited excellent antibacterial properties to composite hydrogels, confirmed by the antibacterial tests in vitro. Si 4+ and Ca 2+ ions are essential factors that stimulate fibroblasts to secrete beneficial factors for angiogenesis and wound closure. The epidermal growth factor (EGF) was further embedded into the hydrogels to improve cell proliferation and tissue remodeling in the wound bed. Finally, the formation of granulation tissue, deposition of collagen and myofibril, the release of anti-inflammatory factors, and angiogenesis have been investigated to determine the healing mechanism of the composite hydrogels as the wound dressings.