Objective@#Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province.@*Methods@#A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data.@*Results@#The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05).@*Conclusions@#The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.
{"title":"Early antiviral therapy of abidor combined with lopinavir/ritonavir and re-combinant interferonα-2b in patients with novel coronavirus pneumonia in Zhejiang: A multicenter and prospective study/ 中华临床感染病杂志","authors":"Runan Wei, Nanhong Zheng, Xiangao Jiang, Chun-hong Ma, Xiaowei Xu, Shourong Liu, Yongping Chen, Kaijin Xu, Hainv Gao, Jiansheng Zhu, Q. Shu, J. Sheng, Xiaoqiang Zhang, Minghui Li, Yan Zhang, M. Ma, Xuan Zhang, Shibo Li, Qiujing Wang, L. Ying, Yongjun Zhang, Yun-zhen Shi, Lingyan Fan, Wanjun Yu, Huaying Wang, Dandan Sun, Xiaodong Wang, Jichan Shi, Ying-hu Chen, Xinsheng Xie, Yunqing Chen, Weihong Wang, Zhaowei Tong, Lingling Tang, Meng Zhu, Lingjian Zhang, Lanjuan Li","doi":"10.3760/CMA.J.CN115673-20200224-00069","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115673-20200224-00069","url":null,"abstract":"Objective@#Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province.@*Methods@#A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data.@*Results@#The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05).@*Conclusions@#The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.","PeriodicalId":52394,"journal":{"name":"Chinese Journal of Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45723365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-28DOI: 10.3760/CMA.J.CN115673-20200225-00072
N. Qin, Cheng Ding, Yongtao Li, Hong Zhao, Jun Liu, Xuan Zhang, Yanfei Chen, Yong-zheng Guo, Liang Yu, H. Ju, Jingjing Tao, Ping Yi, Guan-jing Lang, Jun-wei Su, D. Shi, Wen-rui Wu, Xiaoxin Wu, Ling Yu, J. Sheng, Kaijin Xu
Objective@#To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19.@*Methods@#A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg-1·d-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups.@*Results@#The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P 0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group.@*Conclusions@#Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.
{"title":"Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia","authors":"N. Qin, Cheng Ding, Yongtao Li, Hong Zhao, Jun Liu, Xuan Zhang, Yanfei Chen, Yong-zheng Guo, Liang Yu, H. Ju, Jingjing Tao, Ping Yi, Guan-jing Lang, Jun-wei Su, D. Shi, Wen-rui Wu, Xiaoxin Wu, Ling Yu, J. Sheng, Kaijin Xu","doi":"10.3760/CMA.J.CN115673-20200225-00072","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115673-20200225-00072","url":null,"abstract":"Objective@#To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19.@*Methods@#A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg-1·d-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups.@*Results@#The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P 0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group.@*Conclusions@#Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.","PeriodicalId":52394,"journal":{"name":"Chinese Journal of Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44409180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-24DOI: 10.3760/CMA.J.CN115673-20200212-00030
Qiuhua Wan, A. Shi, Ting He, Li-xin Tang
Objective To analyze the clinical data of 153 patients with novel coronavirus pneumonia (COVID-19) in chongqing ,and provide reference and thinking for the diagnosis and treatment. Methods Analyze the clinical data, laboratory examination and chest imaging characteristics of 153 COVID-19 patients in Chongqing Public Health Medical Center from January 26 to February 5, 2020. According to the relevant diagnostic criteria ,patients were divided into non-severe group(n=132) and severe group(n=21),and analyze the correlation between serum index changes and disease severity. Results Combined with diabetes and chronic respiratory diseases, the severity of the disease was statistically significant (χ2=11.04和6.94, P<0.05). No symptoms were found in patients with mild illness (χ2=4.09, P<0.05) .The proportion of fever and muscle soreness in the severe group was higher than that in the non-severe group (χ2=4.40 and 22.67,P<0.05).Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (χ2=8.46 and 4.80,P<0.05).C-reactive protein and d-dimer were higher in the severe group than in the non-severe group (t=43.44 and 37.13, P<0.05), and the number of CD3+T lymphocyte cells, CD4+T lymphocyte cells and CD8+T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05).Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to involved (χ2=6.95和20.39, P<0.05) . Conclusion Severity of COVID-19 was associated with underlying disease, symptoms, site of involvement, C-reactive protein, d-dimer, CD3+T lymphocyte count, CD4+T lymphocyte count, and CD8+T lymphocyte count. Key words: 2019 novel Coronavirus; Clinical features; Severe disease
{"title":"Analysis of clinical features of 153 patients with novel coronavirus pneumonia in Chongqing/ 中华临床感染病杂志","authors":"Qiuhua Wan, A. Shi, Ting He, Li-xin Tang","doi":"10.3760/CMA.J.CN115673-20200212-00030","DOIUrl":"https://doi.org/10.3760/CMA.J.CN115673-20200212-00030","url":null,"abstract":"Objective \u0000To analyze the clinical data of 153 patients with novel coronavirus pneumonia (COVID-19) in chongqing ,and provide reference and thinking for the diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000Analyze the clinical data, laboratory examination and chest imaging characteristics of 153 COVID-19 patients in Chongqing Public Health Medical Center from January 26 to February 5, 2020. According to the relevant diagnostic criteria ,patients were divided into non-severe group(n=132) and severe group(n=21),and analyze the correlation between serum index changes and disease severity. \u0000 \u0000 \u0000Results \u0000Combined with diabetes and chronic respiratory diseases, the severity of the disease was statistically significant (χ2=11.04和6.94, P<0.05). No symptoms were found in patients with mild illness (χ2=4.09, P<0.05) .The proportion of fever and muscle soreness in the severe group was higher than that in the non-severe group (χ2=4.40 and 22.67,P<0.05).Among the concomitant symptoms, the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group (χ2=8.46 and 4.80,P<0.05).C-reactive protein and d-dimer were higher in the severe group than in the non-severe group (t=43.44 and 37.13, P<0.05), and the number of CD3+T lymphocyte cells, CD4+T lymphocyte cells and CD8+T lymphocyte cells in the severe group was lower than that in the non-severe group (Z=27.25, 20.60 and 17.36, P<0.05).Compared with the non-severe group, both lungs and the right lung lower lobe were more susceptible to involved (χ2=6.95和20.39, P<0.05) . \u0000 \u0000 \u0000Conclusion \u0000Severity of COVID-19 was associated with underlying disease, symptoms, site of involvement, C-reactive protein, d-dimer, CD3+T lymphocyte count, CD4+T lymphocyte count, and CD8+T lymphocyte count. \u0000 \u0000 \u0000Key words: \u00002019 novel Coronavirus; Clinical features; Severe disease","PeriodicalId":52394,"journal":{"name":"Chinese Journal of Clinical Infectious Diseases","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41371396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-28DOI: 10.3760/CMA.J.ISSN.1674-2397.2016.03.006
Yi Zheng, Xiao-fang Xie, Hong Du, Haifang Zhang, Xueming Zhu, Min Wang, Hua Yang, Aiqing Li, Y. Jiang, Hui-qin Zhou
Objective To analyze hemolysin and virulence-related genes in incomplete hemolytic Staphylococcus aureus. Methods Fifty strains of incomplete hemolytic Staphylococcus aureus were isolated from patients admitted in the Second Affiliated Hospital of Soochow University during 2013 and 2014, and the isolates with complete hemolytic phenotype were also collected at the same period as the control strains. All the strains were inoculated and subcultured on four kinds of sheep blood agar plates supplied by different manufacturers to compare their hemolytic phenotype. The relative mRNA expressions of hemolysin genes (hla, hlb, hlc, hld) in standard strain, complete and incomplete hemolytic phenotype strains were detected by real-time quantitative polymerase chain reaction (RT-qPCR), and valued by 2-△△Ct method. t test was used to compare mRNA expressions of hemolysin genes. Western blot was performed to analyze the expression of α-hemolysin. Antibiotic susceptibility test of incomplete hemolytic strains was performed using broth microdilution method. Resistant gene mecA and virulence genes pvl, tst were detected by PCR. Results The steady and hereditary incomplete hemolysis was observed in 50 strains of incomplete hemolytic Staphylococcus aureus on the sheep blood agar plates from different suppliers. Taking mRNA expression of hla, hlb, hlc, hld in standard strain as 1, the relative mRNA expressions of hemolysin genes in incomplete hemolytic strains were 0.02, 7.51, 0.06 and 0.12 respectively, there were statistical differences between standard strain and incomplete hemolytic strains (t=8.46, -56.40, 8.12 and 7.61, all P<0.05). And the expression of α-hemolysin was decreased in incomplete hemolytic strains. All the strains were identified as methicillin resistant Staphylococcus aureus (MRSA). Three strains exhibited different minimum inhibitory concentrations of teicoplanin and linezolid after subcultured, but the differences had no impact on the final results of antibiotic susceptibility test. mecA, pvl and tst genes were positive in incomplete hemolytic strains. Conclusion Staphylococcus aureus with incomplete hemolytic phenotype is methicillin resistant with higher expression of β-hemolysin and lower expressions of α-hemolysin, γ-hemolysin and δ-hemolysin. It carries plv and tst virulence genes and is of high virulence. Key words: Staphylococcus aureus; Incomplete hemolysis; Hemolysin; Drug resistance; Virulence
{"title":"Analysis of the hemolysin and virulence-related genes of incomplete hemolysis Staphylococcus aureus","authors":"Yi Zheng, Xiao-fang Xie, Hong Du, Haifang Zhang, Xueming Zhu, Min Wang, Hua Yang, Aiqing Li, Y. Jiang, Hui-qin Zhou","doi":"10.3760/CMA.J.ISSN.1674-2397.2016.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-2397.2016.03.006","url":null,"abstract":"Objective \u0000To analyze hemolysin and virulence-related genes in incomplete hemolytic Staphylococcus aureus. \u0000 \u0000 \u0000Methods \u0000Fifty strains of incomplete hemolytic Staphylococcus aureus were isolated from patients admitted in the Second Affiliated Hospital of Soochow University during 2013 and 2014, and the isolates with complete hemolytic phenotype were also collected at the same period as the control strains. All the strains were inoculated and subcultured on four kinds of sheep blood agar plates supplied by different manufacturers to compare their hemolytic phenotype. The relative mRNA expressions of hemolysin genes (hla, hlb, hlc, hld) in standard strain, complete and incomplete hemolytic phenotype strains were detected by real-time quantitative polymerase chain reaction (RT-qPCR), and valued by 2-△△Ct method. t test was used to compare mRNA expressions of hemolysin genes. Western blot was performed to analyze the expression of α-hemolysin. Antibiotic susceptibility test of incomplete hemolytic strains was performed using broth microdilution method. Resistant gene mecA and virulence genes pvl, tst were detected by PCR. \u0000 \u0000 \u0000Results \u0000The steady and hereditary incomplete hemolysis was observed in 50 strains of incomplete hemolytic Staphylococcus aureus on the sheep blood agar plates from different suppliers. Taking mRNA expression of hla, hlb, hlc, hld in standard strain as 1, the relative mRNA expressions of hemolysin genes in incomplete hemolytic strains were 0.02, 7.51, 0.06 and 0.12 respectively, there were statistical differences between standard strain and incomplete hemolytic strains (t=8.46, -56.40, 8.12 and 7.61, all P<0.05). And the expression of α-hemolysin was decreased in incomplete hemolytic strains. All the strains were identified as methicillin resistant Staphylococcus aureus (MRSA). Three strains exhibited different minimum inhibitory concentrations of teicoplanin and linezolid after subcultured, but the differences had no impact on the final results of antibiotic susceptibility test. mecA, pvl and tst genes were positive in incomplete hemolytic strains. \u0000 \u0000 \u0000Conclusion \u0000Staphylococcus aureus with incomplete hemolytic phenotype is methicillin resistant with higher expression of β-hemolysin and lower expressions of α-hemolysin, γ-hemolysin and δ-hemolysin. It carries plv and tst virulence genes and is of high virulence. \u0000 \u0000 \u0000Key words: \u0000Staphylococcus aureus; Incomplete hemolysis; Hemolysin; Drug resistance; Virulence","PeriodicalId":52394,"journal":{"name":"Chinese Journal of Clinical Infectious Diseases","volume":"9 1","pages":"236-242"},"PeriodicalIF":0.0,"publicationDate":"2016-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70017674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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