Pub Date : 2020-04-17DOI: 10.1097/IM9.0000000000000021
Lanjuan Li
The prevention and treatment of COVID-19 nationwide has entered a tackling phase. Effective treatment of severe and critically ill patients is the key to reducing the fatality of the disease. The artificial liver blood purification system can remove inflammatory factors, alleviate the damage of the inflammatory response to the body, and has important value for the treatment of severe COVID-19. Led by Academician Lanjuan Li, based on the experience of treating patients across the country, integrating the opinions of experts from all over the country, the center summarized and formulated the consensus including the basic principles, treatment indications, relative contraindications, mode selection, monitoring indicators, and efficacy evaluation of artificial liver, which provides reference for treatment of severe COVID-19 patients.
{"title":"Translation: Expert Consensus on the Application of Artificial Liver Blood Purification System in the Treatment of Severe and Critical COVID-19: National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases.","authors":"Lanjuan Li","doi":"10.1097/IM9.0000000000000021","DOIUrl":"10.1097/IM9.0000000000000021","url":null,"abstract":"<p><p>The prevention and treatment of COVID-19 nationwide has entered a tackling phase. Effective treatment of severe and critically ill patients is the key to reducing the fatality of the disease. The artificial liver blood purification system can remove inflammatory factors, alleviate the damage of the inflammatory response to the body, and has important value for the treatment of severe COVID-19. Led by Academician Lanjuan Li, based on the experience of treating patients across the country, integrating the opinions of experts from all over the country, the center summarized and formulated the consensus including the basic principles, treatment indications, relative contraindications, mode selection, monitoring indicators, and efficacy evaluation of artificial liver, which provides reference for treatment of severe COVID-19 patients.</p>","PeriodicalId":73374,"journal":{"name":"Infectious microbes & diseases","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46141884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-17DOI: 10.1097/IM9.0000000000000022
Yueyue He
The National Health Commission of the People's Republic of China has released the document: Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia to standardize the diagnosis and treatment of COVID-19.
中华人民共和国国家卫生健康委员会发布《新型冠状病毒肺炎诊疗方案》，规范新型冠状病毒肺炎诊疗
{"title":"Translation: Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7): National Health Commission, National Administration of Traditional Chinese Medicine.","authors":"Yueyue He","doi":"10.1097/IM9.0000000000000022","DOIUrl":"10.1097/IM9.0000000000000022","url":null,"abstract":"<p><p>The National Health Commission of the People's Republic of China has released the document: Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia to standardize the diagnosis and treatment of COVID-19.</p>","PeriodicalId":73374,"journal":{"name":"Infectious microbes & diseases","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41926580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><p>The current epidemic situation of coronavirus disease 2019 (COVID-19) still remains severe. As the National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital of the Zhejiang University School of Medicine is the primary medical care center for COVID-19 in Zhejiang Province. Based on the present expert consensus carried out by the National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance" strategy includes antivirus, anti-shock, anti-hypoxemia, and anti-secondary infection, and maintaining of water, electrolyte and acid/base balance and microecological balance. Simultaneously, an integrated multidisciplinary personalized treatment is recommended to improve therapeutic effects. The importance of early viral detection, dynamic monitoring of inflammatory indexes, and chest radiographs has been emphasized in clinical decision-making. Sputum was observed with the highest positive rate by RT-PCR. Viral nucleic acids could be detected in 10% of the patients' blood samples at the acute phase and 50% of patients had positive RT-PCR results in their feces. We also isolated live viral strains from feces, indicating potential infectiousness of feces. Dynamic cytokine detection was necessary to timely identify cytokine storms and for the application of the artificial liver blood purification system. The "Four-Anti and Two-Balance" strategy effectively increased cure rates and reduced mortality. Early antiviral treatment alleviated disease severity and prevented illness progression. We found that lopinavir/ritonavir combined with abidol showed antiviral effects against COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system was able to rapidly remove inflammatory mediators and block the cytokine storm. Moreover, it also contributed to the balance of fluids, electrolytes, and acids/bases and thus improved treatment efficacy during critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid administration was supported. Patients with an oxygenation index below 200 mm Hg were transferred to the intensive care unit. Conservative oxygen therapy was preferred and noninvasive ventilation (NIV) was not recommended. Patients with mechanical ventilation were strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis was prescribed rationally and was not recommended, except for patients with a long course of disease, repeated fever, and elevated procalcitonin, similarly secondary fungal infections were of concern. Some patients with COVID-19 showed intestinal microbial dysbiosis with decreased genus such as <i>Lactobacillus</i> and <i>Bifidobacterium</i>. Nutritional and gastrointestinal funct
当前，新型冠状病毒病2019 (COVID-19)疫情形势依然严峻。浙江大学医学院第一附属医院是国家传染病临床研究中心，是浙江省新冠肺炎基层医疗服务中心。我们团队在国家卫健委、国家中医药管理局专家共识的基础上，总结并建立了以“四抗两平衡”为核心的有效治疗策略，用于临床实践。“四抗两平衡”策略包括抗病毒、抗休克、抗低氧血症、抗继发感染，以及维持水电解质酸碱平衡和微生态平衡。同时建议多学科综合个性化治疗，提高治疗效果。早期病毒检测、动态监测炎症指标和胸片在临床决策中的重要性已得到强调。痰液RT-PCR阳性率最高。10%的患者急性期血液样本中检测到病毒核酸，50%的患者粪便中RT-PCR结果阳性。我们还从粪便中分离出活的病毒株，表明粪便具有潜在的传染性。动态细胞因子检测对于及时识别细胞因子风暴和人工肝血液净化系统的应用是必要的。“四抗两平衡”战略有效提高治愈率，降低死亡率。早期抗病毒治疗减轻了疾病的严重程度，防止了疾病的发展。我们发现洛匹那韦/利托那韦联合阿比多尔对COVID-19具有抗病毒作用。休克和低氧血症通常由细胞因子风暴引起。人工肝血液净化系统能够快速清除炎症介质，阻断细胞因子风暴。此外，它还有助于平衡液体、电解质和酸/碱，从而提高危重疾病期间的治疗效果。对于病情严重的病例，支持早期和短时间的适度糖皮质激素治疗。氧合指数低于200 mm Hg的患者转至重症监护病房。首选保守氧疗，不推荐无创通气(NIV)。对机械通气患者进行严格的监督，并采取群集呼吸机相关肺炎预防策略。除病程长、反复发热、降钙素原升高的患者外，不建议合理使用抗菌药物预防，同样值得关注的是继发性真菌感染。部分患者出现肠道菌群失调，乳酸杆菌、双歧杆菌等菌群减少。营养和胃肠功能应;因此，对所有患者进行评估。建议营养支持和应用益生元或益生菌，以调节肠道菌群平衡，降低因细菌易位引起继发感染的风险。焦虑和恐惧在COVID-19患者中很常见。为此，建立了心理危机动态评估预警体系。我们还结合中医治疗，促进康复。优化重症患者护理流程，促进患者康复。由于严重急性呼吸综合征冠状病毒2型感染后的病毒清除模式尚不清楚，因此需要对出院患者进行2周的隔离，并定期随访。这些浙江的经验和建议在我中心得到了落实，取得了良好的效果。然而，由于新冠肺炎是一种新发疾病，需要进一步完善预防、诊断和治疗策略。
{"title":"Translation: Management of Coronavirus Disease 2019 (COVID-19): Experience in Zhejiang Province, China.","authors":"Kaijin Xu, Hongliu Cai, Yihong Shen, Qin Ni, Yu Chen, Shaohua Hu, Jianping Li, Huafen Wang, Liang Yu, He Huang, Yunqing Qiu, Guoqing Wei, Qiang Fang, Jianying Zhou, Jifang Sheng, Tingbo Liang, Lanjuan Li","doi":"10.1097/IM9.0000000000000023","DOIUrl":"10.1097/IM9.0000000000000023","url":null,"abstract":"<p><p>The current epidemic situation of coronavirus disease 2019 (COVID-19) still remains severe. As the National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital of the Zhejiang University School of Medicine is the primary medical care center for COVID-19 in Zhejiang Province. Based on the present expert consensus carried out by the National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on \"Four-Anti and Two-Balance\" for clinical practice. The \"Four-Anti and Two-Balance\" strategy includes antivirus, anti-shock, anti-hypoxemia, and anti-secondary infection, and maintaining of water, electrolyte and acid/base balance and microecological balance. Simultaneously, an integrated multidisciplinary personalized treatment is recommended to improve therapeutic effects. The importance of early viral detection, dynamic monitoring of inflammatory indexes, and chest radiographs has been emphasized in clinical decision-making. Sputum was observed with the highest positive rate by RT-PCR. Viral nucleic acids could be detected in 10% of the patients' blood samples at the acute phase and 50% of patients had positive RT-PCR results in their feces. We also isolated live viral strains from feces, indicating potential infectiousness of feces. Dynamic cytokine detection was necessary to timely identify cytokine storms and for the application of the artificial liver blood purification system. The \"Four-Anti and Two-Balance\" strategy effectively increased cure rates and reduced mortality. Early antiviral treatment alleviated disease severity and prevented illness progression. We found that lopinavir/ritonavir combined with abidol showed antiviral effects against COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system was able to rapidly remove inflammatory mediators and block the cytokine storm. Moreover, it also contributed to the balance of fluids, electrolytes, and acids/bases and thus improved treatment efficacy during critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid administration was supported. Patients with an oxygenation index below 200 mm Hg were transferred to the intensive care unit. Conservative oxygen therapy was preferred and noninvasive ventilation (NIV) was not recommended. Patients with mechanical ventilation were strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis was prescribed rationally and was not recommended, except for patients with a long course of disease, repeated fever, and elevated procalcitonin, similarly secondary fungal infections were of concern. Some patients with COVID-19 showed intestinal microbial dysbiosis with decreased genus such as <i>Lactobacillus</i> and <i>Bifidobacterium</i>. Nutritional and gastrointestinal funct","PeriodicalId":73374,"journal":{"name":"Infectious microbes & diseases","volume":"1 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41421902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25eCollection Date: 2021-03-01DOI: 10.1097/IM9.0000000000000056
[This retracts the article DOI: 10.1097/IM9.0000000000000050.].
[本文撤消了文章 DOI：10.1097/IM9.0000000000000050]。
{"title":"Use of Antimicrobial Peptides Against SARS-CoV-2: Today is the Future: Retraction.","authors":"","doi":"10.1097/IM9.0000000000000056","DOIUrl":"10.1097/IM9.0000000000000056","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1097/IM9.0000000000000050.].</p>","PeriodicalId":73374,"journal":{"name":"Infectious microbes & diseases","volume":"3 1","pages":"49"},"PeriodicalIF":2.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44234763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-01DOI: 10.1097/MD.0000000000003130
So Young Kim, Min-Su Kim, Songyong Sim, Bumjung Park, Hyo Geun Choi
The objective of this study was to evaluate the association between falls and obesity using Asian body mass index (BMI) classifications. Using the data from the Korean community health survey in 2011, a total of 229,226 participants ranging from 19 to 106 years old were included in this study. The BMI groups were classified as underweight (<18.5), healthy (18.5 ≤ BMI < 23), overweight (23 ≤ BMI <25), and obese (≥25) using Asian BMI classifications. The associations between BMI groups and falls (≥1 time or ≥2 times per year) were analyzed using multiple logistic regression analyses with complex sampling. A subgroup analysis was conducted according to age (19-40, 41-60, and ≥61 years) and the location of the fall (indoor and outdoor). Physical activity, household income, education level, alcohol consumption, smoking, stress level, and medical comorbidities were adjusted as confounders. In total, 16.8% and 6.1% of the participants experienced falls ≥1 time and ≥2 times per year, respectively. Compared to the healthy weight group, the other BMI groups showed a significant U-shaped relationship with falls ≥1 time (AOR underweight = 1.12, 95% CI [confidence interval] = 1.05-1.19; AOR obese = 1.06, 95% CI = 1.02-1.10, P < 0.001) and ≥2 times (AOR underweight = 1.14, 95% CI = 1.04-1.26; AOR obese = 1.04, 95% CI = 0.99-1.10, P < 0.001). Obese status was significantly associated with falls (≥1 fall per year) in all age groups, whereas being underweight was significantly associated with falls in the 19 to 40 year age group only. In conclusion, both underweight and obese statuses were significantly associated with falls in this adult Korean population. However, the relationship between BMI group and falls varied according to age and the location of the falls.
{"title":"Association Between Obesity and Falls Among Korean Adults: A Population-Based Cross-Sectional Study.","authors":"So Young Kim, Min-Su Kim, Songyong Sim, Bumjung Park, Hyo Geun Choi","doi":"10.1097/MD.0000000000003130","DOIUrl":"10.1097/MD.0000000000003130","url":null,"abstract":"<p><p>The objective of this study was to evaluate the association between falls and obesity using Asian body mass index (BMI) classifications. Using the data from the Korean community health survey in 2011, a total of 229,226 participants ranging from 19 to 106 years old were included in this study. The BMI groups were classified as underweight (<18.5), healthy (18.5 ≤ BMI < 23), overweight (23 ≤ BMI <25), and obese (≥25) using Asian BMI classifications. The associations between BMI groups and falls (≥1 time or ≥2 times per year) were analyzed using multiple logistic regression analyses with complex sampling. A subgroup analysis was conducted according to age (19-40, 41-60, and ≥61 years) and the location of the fall (indoor and outdoor). Physical activity, household income, education level, alcohol consumption, smoking, stress level, and medical comorbidities were adjusted as confounders. In total, 16.8% and 6.1% of the participants experienced falls ≥1 time and ≥2 times per year, respectively. Compared to the healthy weight group, the other BMI groups showed a significant U-shaped relationship with falls ≥1 time (AOR underweight = 1.12, 95% CI [confidence interval] = 1.05-1.19; AOR obese = 1.06, 95% CI = 1.02-1.10, P < 0.001) and ≥2 times (AOR underweight = 1.14, 95% CI = 1.04-1.26; AOR obese = 1.04, 95% CI = 0.99-1.10, P < 0.001). Obese status was significantly associated with falls (≥1 fall per year) in all age groups, whereas being underweight was significantly associated with falls in the 19 to 40 year age group only. In conclusion, both underweight and obese statuses were significantly associated with falls in this adult Korean population. However, the relationship between BMI group and falls varied according to age and the location of the falls. </p>","PeriodicalId":73374,"journal":{"name":"Infectious microbes & diseases","volume":"4 1","pages":"e3130"},"PeriodicalIF":1.6,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61669319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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