ObjectiveTo systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.4.1 software. ResultsA total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. ConclusionCurrent evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or non-critical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
This article discusses the concret implementation of day surgery in Ophthalmology Center, Beijing Tongren Hospital, Capital Medical University during the coronavirus disease 2019 epidemic and under the regular prevention and control, so as to provide a basis for ensuring the safety and effectiveness of clinical work in the special period. According to the requirements of health administration departments and the hospital for the prevention and control of epidemic, combining with the characteristics of concret work, the Ophthalmology Center carried out and accurately implemented a series of prevention and control management measures, and obtained good results in the clinical work on the basis of comprehensive security protection. From February to October, 2020, there were a total of 16 507 cases who underwent the day surgery in the Ophthalmology Center, with no surgical infection or suspected case of coronavirus disease 2019. The safety and quality management of epidemic prevention and control has played an active and effective role in the active development of day surgery in this center. The safe and optimized diagnosis and treatment process has reassured the patients and their families, and the strict implementation of protective measures by medical staff has ensured the safety of surgery and the work being proceed with smooth progress and high efficacy.
ObjectiveTo investigate the psychological status and its influencing factors of hospital staff during the outbreak of coronavirus disease 2019 (COVID-19), and provide a reference for psychological intervention strategies for hospital staff in public health emergencies.MethodsIn this cross-sectional study, we investigated the staff of Mianzhu People’s Hospital through an anonymous questionnaire survey sent through WeChat group from February 13th to 18th, 2020, to analyze the psychological situation and influencing factors of the on-the-job staff. SPSS 22.0 software was used for statistical analysis.ResultsAmong the 1 115 staff members who met the inclusion criteria, 951 completed the questionnaire, with a response rate of 85.3%. There were 945 valid questionnaires, with an effective response rate of 84.8%. A total of 224 staff members (23.7%) had mental health problems. Multivariate logistic regression analysis showed that the total scores of social support [odds ratio (OR)=0.869, 95% confidence interval (CI) (0.805, 0.938), P<0.001] and the total scores of stress coping strategies [OR=0.685, 95%CI (0.607, 0.772), P<0.001] were protective factors of psychological status, while having kids [OR=1.607, 95%CI (1.084, 2.382), P=0.018] and the position being logistic worker [OR=2.229, 95%CI (1.326, 3.746), P=0.002] were risk factors of psychological status.ConclusionsDuring the outbreak of COVID-19, mental health problems emerged among the staff of designated medical treatment hospital. When a public health emergency occurs, hospitals and relevant departments should take psychological intervention measures as soon as possible to ensure the work of epidemic prevention and control.
With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.
In December 2019, an outbreak of pneumonia associated with the coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The lung imaging finding is like that of the lung cancer immune checkpoint inhibitors (ICI) associated pneumonia. Therefore, we speculated that they may have similar pathogenesis and treatment strategies, which is reviewed in this article in order to provide some reference to timely and effectively reduce the fatality rate of COVID-19.
Objective To understand the impact of an infection risk control measures implemented in the non-clinical areas of a hospital on the visitors during the coronavirus disease 2019 (COVID-19) epidemic period, in an attempt to provide scientific evidence for the improvement and optimization of subsequent prevention and control measures. Methods The convenience sampling method was used to investigate and analyze all the personnel who came to the hospital for treatment or work on February 22, 2020. Collect the influence of the personnel coming to the hospital on the sense of security, medical behavior (work) and the acceptance of the measures arising from the implementation of infection control measures such as sub-regional management of people and vehicles, body temperature screening during admission, and sub-channel management of hospital visitors in the non-clinical areas of the hospital. ResultsA total of 1 098 patients/family members were included. 70.13% (770/1 098) of the patients/family members thought that visiting the hospital during the COVID-19 epidemic would make them feel uneasy; 90.26% (991/1 098) of the patients/family members could accept the body temperature screening during admission, 96.99% (1 065 / 1 098) of the patients/family members could accept the sub-regional management of people and vehicles, and 100.00% (1 098/1 098) of the patients/family members could accept the sub-channel management of hospital visitors in the non-clinical areas of the hospital; 71.22% (782/1 098) of the patients/family members thought that the peripheral prevention and control measures had increased the sense of security in medical treatment, and they would continue to choose this hospital for the next time if necessary. A total of 2 543 employees were included. 37.55% (955/2543) of the employees felt uneasy because they were afraid of being infected in the hospital; 93.12% (2 368/2 543) of the employees could accept the establishment of a dedicated channel for staff admission, 99.25% (2 524/2 543) of the employees could accept the temperature screening at the entrance of the dedicated channel, and 97.48% (2 479/2 543) of the employees could accept the subregional management measures. 82.54% (2 099/2 543) of the employees thought that the peripheral prevention and control measures would not affect their work. Conclusions Implementing a series of prevention and control measures in the non-clinical areas during the emergency response state can improve the sense of security of the patients, family members of the patients and employees who come to the hospital to some extent. In the future, measures such as strengthening publicity and education, improving facilities, perfecting the planning and design, providing the complete information, and strengthening supervision, can be taken to further optimize the risk control of infection in non-clinical areas and improve the acceptance of personnel coming to the hospital.
Due to the coronavirus disease 2019 pandemic, the traditional outpatient and medical center pulmonary rehabilitation models for chronic obstructive pulmonary disease have been limited, while pulmonary rehabilitation technology has always been the focus of clinical and scientific research in rehabilitation. This article reviews the application status of remote pulmonary rehabilitation for chronic obstructive pulmonary disease under the coronavirus disease 2019 epidemic in recent years. From the selection and method of remote pulmonary rehabilitation equipment before the epidemic, to the development of rehabilitation forms and equipment innovation after the epidemic, the current status and problems of remote pulmonary rehabilitation are clarified. Establishing a remote pulmonary rehabilitation model in line with China’s national conditions is the direction and goal of future development.
Objective To investigate the values of cytokines in evaluating the severity and prognosis of patients with coronavirus disease 2019 (COVID-19). Methods A total of 205 COVID-19 patients in Wuhan Leishenshan Hospital were retrospectively analyzed. According to the severity of the disease, patients were divided into common group (n=117), severe group (n=69) and critical group (n=19). The patients’ basic condition and cytokine related parameters were collected, the differences between the three groups were compared and their values in assessing the severity and prognosis of COVID-19 patients were analyzed. Results There were statistically significant differences in the age, severe acute respiratory syndrome coronavirus 2 nucleic acid test results, interleukin (IL)-6, IL-10, IL-2 receptor, IL-8, and tumor necrosis factor-α among the three groups of patients (P<0.05). Correlation analysis showed that the age, severe acute respiratory syndrome coronavirus 2 nucleic acid test continued to be positive for 20 days, IL-6 level, IL-10 level, IL-2 receptors level, IL-8 level and tumor necrosis factor-α level were related to the classification of COVID-19. The correlation coefficient rs was 0.354, 0.187, 0.366, 0.327, 0.329, 0.273 and 0.157, respectively (P<0.05). The levels of IL-6, IL-10, IL-2 receptor, IL-8, and tumor necrosis factor-α in dead patients with COVID-19 were higher than those in surviving patients (P<0.05). Multivariate analysis showed that age [odds ratio (OR)=1.034, 95% confidence interval (CI) (1.006, 1.063), P=0.016], IL-6 level [OR=1.030, 95%CI (1.006, 1.055), P=0.015], IL-10 level [OR=1.088, 95%CI (1.003, 1.179), P=0.042] and IL-2 receptor level [OR=1.003, 95%CI (1.001, 1.005), P=0.001] were independent risk factors for common COVID-19 to become severe or critical. Conclusion The levels of cytokines in COVID-19 patients are closely related to the severity and prognosis of the disease.
Objective To analyze the clinical characteristics of adverse drug reaction (ADR) caused by 3 kinds of coronavirus disease 2019 drugs, and provide a reference for clinical safe medication. MethodsA total of 33 patients with coronavirus disease 2019 admitted to Xiangtan Central Hospital from January 20 to March 5, 2020 were selected as the research objects. The clinical data of patients with ADR during the antiviral process were analyzed retrospectively. The patients’ gender, age, type of medication, combination medication, organs or systems involved, and clinical manifestations were summarized and analyzed. Results A total of 33 patients were enrolled. A total of 21 cases of ADR were reported. The incidence of ADR is higher in patients older than 60 years (80.0%). The most common clinical manifestations are digestive tract symptoms (66.7%). The incidence of ADR is highest in the combination of lopinavir/ritonavir+arbidol+ribavirin (100.0%), followed by the combination of lopinavir/ritonavir+arbidol (85.7%). Abidol and ribavirin each caused 1 case of severe ADR. Conclusion For patients with coronavirus disease 2019, the combination of two or more antiviral drugs should be avoided, and pharmaceutical monitoring should be strengthened for elderly, severe/critical and allergic patients.
During the coronavirus disease 2019 epidemic, West China Hospital, Sichuan University explored a new management model to ensure timely diagnosis and treatment and regular follow-up for breast cancer patients. On the basis of previous internet Breast Cancer Information Management System, patient management WeChat groups were integrated to develop an online and offline interconnect management platform. Regular follow-up of patients was mainly conducted by telephone, with WeChat management group as auxiliary. Coronavirus infections were screened during telephone follow-up. In the meanwhile, patients who needed to be further treated would be identified and recommended to the outpatient follow-up. The new management model can improve the efficiency of follow-up management, on the premise of reducing the risk of coronavirus disease 2019 transmission for both health care providers and patients.