Annals of Translational Medicine

Although COVID-19 pediatric patients just account for 1% of the overall cases, they are nonnegligible invisible infection sources. We quantitatively analyzed the clinical and epidemiological features of 82 confirmed cases aged 0-16 admitted to Wuhan Childrens Hospital, which are expected to shed some lights onto the pediatric diagnosis and therapy.

AimsComparison of the efficacy of six Anti- vascular endothelial growth drugs in the treatment of diabetic macular edema MethodsThis network meta-analysis has been registered on the PROSPERO platform (CRD42022295684).A comprehensive search of eight databases without language restrictions.PubMed, EMBASE, Web of Science, Cochrane Library, CBM, CNKI, VIP, and Wanfang were used to search for randomized controlled trials on anti- vascular endothelial growth factor of diabetic macular edema, no language restrictions and publication time restrictions. According to the inclusion and exclusion criteria, literatures were screened, data were extracted and literature quality was evaluated, and the mean changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were obtained. Using the Gemtc 1.0-1 package in R 4.1.2 to call the JAGS and the Markov Chain-Monte Card (MC-MC) method for Bayesian network meta-analysis. Risk of bias was assessed using RevMan 5.3. Stata 14.0 draws funnel plots to assess publication bias. RESULTSSixteen studies including 3651 eyes were included, all with treatment follow-up over 6 months. The overall heterogeneity in the network analysis was low(I{superscript 2}=0), and there was no inconsistency. For the efficacy of reducing CMT, ranking according to the cumulative probability: Faricimab (0.9) > Brolucizumab (0.87) > Aflibercept (0.58) > Conbercept (0.37) > Ranibizumab (0.29)>Bevacizumab (0), but there was no statistically significant difference between Conbercept and Faclibercept, Aflibercept, and Buloxizumab. For the efficacy of improving BCVA, ranking according to the cumulative probability: Conbercept (0.87) > Faricimab (0.79) > Aflibercept (0.61) > Brolucizumab (0.51) > Ranibizumab (0.2)>Bevacizumab (0.02), but there was no statistically significant difference between Conbercept and Faclibercept, Aflibercept, and Brolucizumab.

BackgroundCOVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference. MethodsWe analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020, included laboratory examination results, imaging findings, treatment effect, prognosis, etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients. ResultsO_LIHypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients. The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression. C_LIO_LICharacteristic images of lung CT had a clear change in COVID-19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease. C_LIO_LIBasic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2. C_LIO_LIAccording to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients. C_LI ConclusionsO_LIAccurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2. Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients. C_LI

IntroductionReports on neonatal coronavirus disease (COVID) have been focused on vertical transmission. There was little information on prevalence of neonates with COVID till up to 18 months of age. It is well known that breastfeeding is beneficial for the growth and development of infants. We hypothesized that breastfeeding will be beneficial for a better prevalence of neonatal COVID. The objective of this study is to explore the prognosis of fever neonates with confirmed community infection of SARS-CoV-2 Omicron, and to clarify whether human milk breastfeeding is beneficial for reducing the rate of severe SARS-CoV-2 Omicron infection in neonates. Methods and analysisThis is a prospective single centre cohort study. Study period is from December, 2022 to December 2024. Inclusion criteria are: (1) Age [≤] 28 days or corrected age [≤] 44 weeks. (2) Fever. (3) Both tests (throat swab) of nucleic acid and antigen of SARS-CoV-2 Omicron were positive. (4) Parents signed the consents. Exclusion criteria is confirmed brain malformations. Patients will be classified into breastfeeding, mixed feeding, and formula feeding groups. The estimate sample size will be 200. The throat swab of infants will be collected for SARS-CoV-2 omicron nucleic acid ad antigen examination. Neonatal COIVD patients will be treated in the Out-Patient Department or admitted to Neonatal Intensive Care Unit according to the severity of infection. All patients will be followed at 3/6/12/18M of age. The endpoint to study was at 18 months of age. Data will be collected by Case Record Form and Electronic Data Capture from the History of In-hospital System. The primary outcome was the rate of severe SARS-CoV-2 infection. SPSS 20.0 software will used for statistical analysis. Ethics and disseminationIt is approved by local Institute of Ethics Review Board (#[2022]-E-240-Y). RegistrationIt is registered in the Chinese Clinical Trail Registry (http://www.chictr.org.cn) (ChiCTR2200067148) Strengths and limitations of this studyO_LIThis is a prospective single centre cohort study for fever neonates with confirmed community infection of SARS-CoV-2 Omicron. C_LIO_LIPatients are categorized into breastfeeding group, mixed feeding group, and formula group. C_LIO_LIThe primary outcome is rate of severe SARS-CoV-2 infection. C_LIO_LIThe secondary outcomes include in-hospital outcomes and follow-up outcomes at 3M/6M/12//18M. C_LIO_LILimitation are the observational nature and the single centre data. C_LI

PurposeThe 2019 novel coronavirus(COVID-19) mainly transmitted by person-to-person through inhalation of respiratory droplets. We report the laboratory results of conjunctival PCR-tests and some clinical features of these patients in shenyang China. DesignThis is a cross-sectional non-randomized study SubjectsThe study include 14 confirmly diagnosed cases, 16 suspected cases and some medical observed patients. MethodsAll patients with diagnosed and suspected COVID-19 were admitted to a designated hospital in Shenyang, China. We collected conjunctival samples of these patients to do the laboratory tests by real time RT-PCR. Medical observed patients were enrolled if they had clinical symptoms. Then we analysed the PCR results and clinical data from eletronic medical records in order to find some relationships. Main Outcome MeasuresClinical condition and PCR results. of conjunctival swabs compared with other specimens ResultsOne of the identified case coverted from suspected case without typical clinical symptoms. Twenty-two medical observed cases were removed because none of them converted to identified cases. One of the suspected converted to identified case recently. The included cases in our study are imported cases with less underlying diseases and the severity of their infection was relatively moderate. All the conjunctival results of PCR-test were negative. Two cases had typical clinical symptoms but were finally confirmed by repeated pharynxswabtests. ConclusionConjunctiva may be a transmission way of COVID-19. And ocular conjunctival swabs in combination with PCR test could be a non-invasive, convenient and feasible diagnostic method for identifying the infection of COVID-19. Emphasis on the false-negative results is vital.

ObjectiveSystematically evaluate the risk prediction model for neonatal necrotizing enterocolitis (NEC) in China, providing reference for clinical work and future research. MethodsWe searched Chinese and English databases were systematically searched to focus on NEC risk prediction modeling studies.The search time ranged from database establishment to 25 August 2023.Two researchers independently screened the literature and extracted information.Then risk of bias and applicability were assessed by using the Prediction Model Risk of Bias Assessment Tool. ResultsA total of 10 papers involving 12 NEC risk prediction models were included, which is focusing on the populations of preterm infants mostly, building the methods of models diversity, predicting factors discrepancy widely. conclusionThe existing NEC risk prediction models in China have good predictive performance, while they often lack external validation, resulting in an overall high risk of bias. In the future, clinicians and nurses should learn from the evaluation criterions based on the PROBAST, then to test and verify them. Or machine learning algorithms usage is to construct models with operationalization and better predictive efficacy. [REGISTRATION: PROSPERO ID: CRD42024503844]

BackgroundAs the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection with COVID-19 is currently rare in children. ObjectiveTo discuss the latest findings and research focus on the basis of characteristics of children confirmed with COVID-19, and provide an insight into the future treatment and research direction. MethodsWe searched the terms "COVID-19 OR coronavirus OR SARS-CoV-2" AND "Pediatric OR children" on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC. ResultsWe included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. ConclusionThe numbers of children with COVID-19 pneumonia infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic, which allow children to be a risk factor for transmission. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection than other age groups in pediatric age, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children. The risk factors which may suggest severe or critical progress for children are: Fast respiratory rate and/or; lethargy and drowsiness mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children in contrast to adults suggests that the underlying coinfection/secondary infection may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.

The COVID-19 is currently spreading around the world, which has posed significant threats to global health and economy. Convalescent plasma is confirmed effective against the novel corona virus in preliminary studies. In this paper, we first described the therapeutic schedule, antibody detection method, indications, contraindications of the convalescent plasmas, and reported the operability of the treatment by case study.

BackgroundThe outbreak of novel coronavirus pneumonia in China began in December 2019. Studies on novel coronavirus disease (COVID-19) were less based on pediatric patients. This study aimed to reveal the clinical characteristics of COVID-19 in children. MethodThis study retrospectively analyzed the clinical symptoms, laboratory results, chest CT, and treatment of children with laboratory-confirmed COVID-19(ie, with samples that were positive for 2019 novel coronavirus[2019-nCoV]) who were admitted to Shenzhen Center of National Infectious Disease Clinical Medical Research from January 16 to February 8, 2020. ResultNine patients had no obvious clinical symptom. 11 patients developed fever. Other symptoms, including cough(in eleven of seventeen patients), rhinorrhea(in two), diarrhea(in two), vomiting(in two), were also observed. A small minority of patients had lymphocytopenia. Alanine transaminase or transaminase increased in three cases. According to chest CT scan, 11 patients showed unilateral pneumonia, 8 patients had no pulmonary infiltration. No serious complications such as acute respiratory syndrome and acute lung injury occurred in all patients. ConclusionThe clinical characteristics of 2019-nCoV infection in children were different from adult. The overall condition of children were mild and have a good prognosis. MainpointCOVID-19 is a kind of new infectious disease.The clinical characteristics of 2019-nCoV infection in children may different from adult. Myocardium likely less affected by 2019-nCoV in children.

BackgroundSevere patients with 2019 novel coronavirus (2019-nCoV) pneumonia progressed rapidly to acute respiratory failure. We aimed to evaluate the definite efficacy and safety of corticosteroid in the treatment of severe COVID-19 pneumonia. MethodsForty-six hospitalized patients with severe COVID-19 pneumonia hospitalized at Wuhan Union Hospital from January 20 to February 25, 2020, were retrospectively reviewed. The patients were divided into two groups based on whether they received corticosteroid treatment. The clinical symptoms and chest computed tomography(CT) results were compared. ResultsA total of 26 patients received intravenous administration of methylprednisolone with a dosage of 1-2mg/kg/d for 5-7 days, while the remaining patients not. There was no significant difference in age, sex, comorbidities, clinical or laboratory parameters between the two groups on admission. The average number of days for body temperature back to the normal range was significantly shorter in patients with administration of methylprednisolone when compared to those without administration of methylprednisolone (2.06{+/-}0.28 vs. 5.29{+/-}0.70, P=0.010). The patients with administration of methylprednisolone had a faster improvement of SpO2, while patients without administration of methylprednisolone had a significantly longer interval of using supplemental oxygen therapy (8.2days[IQR 7.0-10.3] vs. 13.5days(IQR 10.3-16); P<0.001). In terms of chest CT, the absorption degree of the focus was significantly better in patients with administration of methylprednisolone. ConclusionOur data indicate that in patients with severe COVID-19 pneumonia, early, low-dose and short-term application of corticosteroid was associated with a faster improvement of clinical symptoms and absorption of lung focus.

OBJECTIVEClinical characteristics of novel coronavirus disease (COVID-19) have been described in numerous studies but yielded varying results. We aimed to conduct a systematic review on scientific literatures and to synthesize critical data on clinical traits of COVID-19 from its initial outbreak to pandemic. METHODSSystematic searches were conducted to identify retrospective observational study that contained clinical characteristics on COVID-19 through multiple databases. Two reviewers independently evaluated eligible publications. Data on clinical characteristics of COVID-19 were extracted and analyzed. RESULTSSeventy-two retrospective studies demonstrating the clinical characteristics of COVID-19 were included. A total of 3470 COVID-19 patients were synthesized to the final analysis in an unbiased manner. The most common symptom was fever (2878 [83.0%]), and 63.4% of the patients presented fever as onset symptom. There were 2528 [88.2%] of 2866 cases had abnormal lung findings on chest CT scan. Laboratory findings showed that 1498 [62.8%] of 2387 cases had lymphopenia, and 1354 [64.8%] of 2091 cases had an increased level of C-reactive protein (CRP). A total of 185 [11.5%] patients were admitted to intensive care unit (ICU) while the overall case fatality rate (CFR) was 3.7%. Compared to patients admitted outside of Hubei, China, those from Hubei had a significant higher ICU admission rate (21.9% vs. 2.5%, p<0.001). Also, CFR attributed to COVID-19 was significantly higher in Hubei than that of non-Hubei admissions (10.4% vs. 0.6%, p<0.001). INTERPRETATIONThis large patient-based systematic review presents a more precise profiling of the COVID-19 from its outbreak to current pandemic. Dynamic evolvements of COVID-19 are needed to be characterized in future studies.

PurposeCoronavirus disease (COVID-19) pandemic is now a global health concern. However, there is no detailed analysis of the factors related to patients improvement. Patients and methodsWe compared the clinical characteristics, laboratory findings, CT images, and treatment of COVID-19 patients from two different cities in China. One hundred and sixty-nine patients were recruited from January 27 to March 17, 2020 at five hospitals in Hubei and Guangxi. They were divided into four groups according to age and into two groups according to presence of comorbidities. Multivariate statistical analyses were performed for the prognosis of the disease. ResultsFifty-two patients (30.8%) had comorbidities, and the percentage of critical COVID-19was higher in the comorbidities group (11.6%vs.0.9%, p<0.05). Older patients had higher proportion of severe or critical disease. The results showed that lymphocyte count was significantly associated with the number of days from positive COVID-19 nucleic acid test to negative test; number of days from onset of symptoms to confirmation of diagnosis was significantly associated with the time it took for symptoms to improve; and number of days from onset of symptoms to confirmation of diagnosis and disease severity were significantly associated with chest computed tomography improvement. ConclusionsAge, comorbidities, lymphocyte count, and SpO2 may predict the risk of severity of COVID-19. Early isolation, early diagnosis, and early initiation of management can slow down the progression and spread of COVID-19. Key PointsAge and comorbidities can predict the risk of severity of COVID-19, Lymphocyte count and SpO2 may predict the risk of severity of COVID-19. Early isolation, Early diagnosis can slow down the progression of COVID-19

BackgroundThe worldwide surge in coronavirus cases has led to the COVID-19 testing demand surge. Rapid, accurate, and cost-effective COVID-19 screening tests working at a population level are in imperative demand globally. MethodsBased on the eye symptoms of COVID-19, we developed and tested a COVID-19 rapid prescreening model using the eye-region images captured in China and Spain with cellphone cameras. The convolutional neural networks (CNNs)-based model was trained on these eye images to complete binary classification task of identifying the COVID-19 cases. The performance was measured using area under receiver-operating-characteristic curve (AUC), sensitivity, specificity, accuracy, and F1. The application programming interface was open access. FindingsThe multicenter study included 2436 pictures corresponding to 657 subjects (155 COVID-19 infection, 23{middle dot}6%) in development dataset (train and validation) and 2138 pictures corresponding to 478 subjects (64 COVID-19 infections, 13{middle dot}4%) in test dataset. The image-level performance of COVID-19 prescreening model in the China-Spain multicenter study achieved an AUC of 0{middle dot}913 (95% CI, 0{middle dot}898-0{middle dot}927), with a sensitivity of 0{middle dot}695 (95% CI, 0{middle dot}643-0{middle dot}748), a specificity of 0{middle dot}904 (95% CI, 0{middle dot}891-0{middle dot}919), an accuracy of 0{middle dot}875(0{middle dot}861-0{middle dot}889), and a F1 of 0{middle dot}611(0{middle dot}568-0{middle dot}655). InterpretationThe CNN-based model for COVID-19 rapid prescreening has reliable specificity and sensitivity. This system provides a low-cost, fully self-performed, non-invasive, real-time feedback solution for continuous surveillance and large-scale rapid prescreening for COVID-19. FundingThis project is supported by Aimomics (Shanghai) Intelligent

ObjectivesA kind of pneumonia caused by unknown causes that occurred in Wuhan, Hubei, China in December 2019, was reported as a result of novel coronavirus infection on January 7, 2020, and then WHO named it COVID-19. To compare the difference of epidemiology and clinical characteristics between asymptomatic COVID-19 infections and moderate type of confirmed cases. MethodsRetrospective, single-center cohort study of COVID-19 involving 52 infections of both 26 asymptomatic and 26 moderate type of confirmed cases in the recovery stage at Guizhou Provincial Staff Hospital in Guiyang, China, from January 29, to March 31, 2020; final date of follow-up was April 22. This study was registered in Chinese Clinical Trial Registry Center. Documented the asymptomatic COVID-19 infections and moderate type of confirmed cases. Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Epidemiological and clinical characteristics of asymptomatic COVID-19 infections and moderate type of confirmed cases were compared. ResultsThe median treatment cycle of asymptomatic COVID-19 infections was 16 days (interquartile range, 11-20 days) and longer than 13 days (interquartile range, 10-15 days) of moderate type of confirmed cases (p=0.049). The median incubation period of asymptomatic COVID-19 infections was 10 days (interquartile range, 0-21 days), while the control group was 7 days (interquartile range, 1-15 days) (p=0.27). On the initial chest computerized tomography (CT) check, 18 (69.2%, 18/26) asymptomatic COVID-19 infections were no imaging changes, which was of no significance compared with 12 (46.2%, 12/26) patients with moderate type of confirmed patients (p=0.092). ConclusionsIn this single-center study, we found that asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed cases. Key PointsIn this single-center case series involving 52 infections with asymptomatic and moderate type of COVID-19 cases, asymptomatic COVID-19 infections have longer treatment cycle than those moderate type of confirmed patients.

OBJECTIVESAlthough several systematic reviews attempted to compare supraglottic airway (SGA) and endotracheal intubation for or adults with out-of-hospital cardiac arrest (OHCA), the optimal airway management strategy remains debated. We conducted a systematic review and meta-analysis comparing supraglottic airway (SGA) devices and endotracheal intubation (ETI) as initial interventions in OHCA to clarify their relative clinical efficacy. DATA SOURCESWe retrieved relevant clinical trials from PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure(CNKI), as well as unpublished sources, from inception to October 10, 2025. STUDY SELECTIONWe included randomized controlled trials (RCTs) and non-randomized studies involving adult patients with OHCA who were assigned to supraglottic airway (SGA) versus endotracheal intubation for initial prehospital airway management. RESULTSOur systematic review and meta-analysis enrolled 9 randomized controlled trials and 23 non-randomized studies, involving 196,573 patients. Patients who received SGA were associated with higher incidence of return of spontaneous circulation (ROSC), (RCT RR = 1.17, 95% CI: [1.03,1.34], P = 0.016, I{superscript 2} = 48.5%), higher incidence of first-attempt success rates (RCT: RR = 1.31, 95% CI, [1.14-1.51], P = 0.0029. Non-RCTs: RR = 1.46, 95% CI: [1.26,1.70], P < 0.0001, I{superscript 2} = 83.1%), higher incidence of return of time to airway securement (RCT: MD = -2.30 min, 95% CI: [-3.54, -1.05], P = 0.0003, I{superscript 2} = 98.4%. Non-RCTs: MD = -2.86 min, 95% CI: [-3.62, -2.11], P < 0.0001, I{superscript 2} = 95.8%.). There is no difference in favorable neurological outcome (RCT: RR = 1.06, 95% CI: [0.84, 1.35], P = 0.6202, I{superscript 2} = 45.4%. Non-RCTs: RR = 0.94, 95% CI: [ 0.76, 1.18], P = 0.6198, I{superscript 2} = 74.2%.) and no difference in occurrence of regurgitation/aspiration (RR 1.03; 95% CI: [0.93, 1.14]; P=0.5426, I{superscript 2} = 0.0%). Additionally, trial sequential analysis was performed to validate these findings. CONCLUSIONFor adult patients experiencing out-of-hospital cardiac arrest (OHCA), initial airway management by using supraglottic airway (SGA) improves rate of return of spontaneous circulation (ROSC), enables faster airway placement, and achieves higher first-pass success rate when compared with endotracheal intubation. There is a high degree of certainty regarding the major outcomes.

Background and ObjectiveSince the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in Wuhan, Hubei Province, China, it has spread throughout the world and become a global public health emergency. It is important to distinguish COVID-19 from other viral pneumonias to properly screen and diagnose patients, reduce nosocomial infections, and complement the inadequacy of nucleic acid testing. In this study, we retrospectively analysed the clinical data of COVID-19 versus non-COVID-19 patients treated at our hospital between January 17 and February 27, 2020 to summarize our clinical experience in the differential diagnosis of COVID-19. MethodsIn this retrospective cohort study, 23 confirmed COVID-19 patients were consecutively enrolled from January 17 to February 27, 2020, and 29 confirmed non-COVID-19 patients were enrolled in the West China Hospital of Sichuan University. We collected baseline data, epidemiological data, clinical characteristics, imaging findings, viral nucleic acid test results, and survival data. SPSS v22.0 was used for the statistical analysis. Outcomes were followed-up until March 25. ResultsA total of 52 patients were included in this study, including 23 COVID-19 patients and 29 non-COVID-19 patients. No significant between-group differences were observed for age, sex, primary signs or symptoms, cellular immunity, or platelet count. Significant between-group differences were observed in clinical characteristics such as dry cough, contact with individuals from Wuhan, some underlying diseases, nucleated cell count, chest imaging findings, viral nucleic acid test results, 28-day mortality, and 28-day survival. ConclusionEpidemiological data, clinical symptoms, nucleic acid test results for COVID-19 and chest CT manifestation may help distinguish COVID-19 from non-COVID-19 cases, prevent imported cases and nosocomial infections.

BACKGROUNDCorona Virus Disease 2019 (COVID-19) is spreading worldwide. Effective screening for patients is important to limit the epidemic. However, some defects make the currently applied diagnosis methods are still not very ideal for early warning of patients. We aimed to develop a diagnostic model that allows for the quick screening of highly suspected patients using easy-to-get variables. METHODSA total of 1,311 patients receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleicacid detection were included, whom with a positive result were classified into COVID-19 group. Multivariate logistic regression analyses were performed to construct the diagnostic model. Receiver operating characteristic (ROC) curve analysis were used for model validation. RESULTSAfter analysis, signs of pneumonia on CT, history of close contact, fever, neutrophil-to-lymphocyte ratio (NLR), Tmax and sex were included in the diagnostic model. Age and meaningful respiratory symptoms were enrolled into COVID-19 early warning score (COVID-19 EWS). The areas under the ROC curve (AUROC) indicated that both of the diagnostic model (training dataset 0.956 [95%CI 0.935-0.977, P < 0.001]; validation dataset 0.960 [95%CI 0.919-1.0, P < 0.001]) and COVID-19 EWS (training dataset 0.956 [95%CI 0.934-0.978, P < 0.001]; validate dataset 0.966 [95%CI 0.929-1, P < 0.001]) had good discrimination capacity. In addition, we also obtained the cut-off values of disease severity predictors, such as CT score, CD8+ T cell count, CD4+ T cell count, and so on. CONCLUSIONSThe new developed COVID-19 EWS was a considerable tool for early and relatively accurately warning of SARS-CoV-2 infected patients.

ObjectiveWe performed a meta-analysis in order to determine safety of granulocyte-macrophage colony-stimulating factor (GM-CSF) antibodies on COVID-19. MethodsWe searched from the Cochrane Library, PubMed, Embase, biorxiv and medrxiv databases beginning in the COVID-19 outbreak on December 1, 2019 until August 29, 2021. The primary outcomes included death, the incidence of invasive mechanical ventilation (IMV), ventilation requirement, and secondary infection. Results6 eligible literature involving 1501 COVID-19 patients were recruited, and they were divided into experimental group (n = 736) and control group (n = 765). Using a random-effect model, we found that the GM-CSF antibodies treatment was associated with a 3.8-26.9% decline of the risk of mortality[odds ratio (OR) = 0.06, 95% confidence interval (CI): -0.11, -0.01, p =0.02], a 5.3-28.7% reduction of incidence of IMV [OR = 0.51, 95% CI: 0.28, 0.95, p =0.03], and a 23.3-50.0% enhancement of ventilation improvement [OR = 11.70, 95% CI: 1.99, 68.68, p=0.006]. There were no statistically significant differences in the association between two groups in second infection. ConclusionSevere COVID-19 patients may benefit from GM-CSF antibodies.

Background & AimsThe efficacy and safety of lenvatinib (LEN) as a second/third-line treatment for unresectable hepatocellular carcinoma (HCC) after sorafenib (SOR) therapy remains unknown. We evaluated the outcomes of second/third-line treatment of LEN, investigated the sensitivity of SOR-resistant HCC cell line (PLC/PRF5-R2) to LEN, and their signal transduction pathway by protein array analysis. MethodsWe retrospectively enrolled 57 unresectable HCC patients. Radiologic responses in 53 patients were evaluated by modified Response Evaluation Criteria in Solid Tumors. Active signal transduction pathways in cells were identified by protein array analysis, including 1205 proteins. ResultsPatients comprised 34 tyrosine kinase inhibitor (TKI)-naive (first-line), nine SOR-intolerant (second-line), and ten resistant to regorafenib (third-line). Objective response rates (ORRs) were 61.8% (21/34) in TKI-naive, 33.3% (3/9) in second-line, and 20.0% (2/10) in third-line groups. The overall survival (OS) and the progression free survival (PFS) in the first-line was significantly longer than those in third-line group (p<0.05). Patients with better liver functional reserve (Child score, ALBI grade) exhibited higher ORR and longer OS. LEN was well-tolerated as second/third-line treatment. The IC50 value of LEN against PLC/PRF5-R2 cells (30 M) was significantly higher than that against PLC/PRF5 cells (6.4 M). LEN inhibited significantly more signal transduction pathways related to FRS2, a crucial FGFR downstream molecule, in PLC/PRF5 than PLC/PRF5-R2 cells. ConclusionsLEN was active and safe as a second/third-line treatment for unresectable HCC. LEN seems to be more effective for HCC patients with better hepatic reserve function or before TKI-resistance is acquired because of partial cross-resistance to SOR.

Pancreatic cancer is one of the most common malignant tumors of the digestive tract. It is known as the "king of cancer" in the field of cancer, and is one of the worst prognosis malignant tumors. Pyroptosis is a kind of programmed cell death, which can promote the inflammatory response of cells. Studies have shown that the effect of pyroptosis-related genes in cancer is significant. However, the role of pyroptosis in pancreatic cancer is not clear. The aim of this study is to establish a prognostic model based on pyroptosis. The gene expression and clinical data of pancreatic cancer patients were obtained from TCGA and verified in GEO. The differential expression of 33 pyroptosis-related genes in pancreatic cancer and normal tissues was analyzed, of which 6 genes were up-regulated and 12 genes were down regulated. Then, it was analyzed that pyroptosis-related genes were mainly enriched in the defense against bacteria and pyroptosis pathways. A concise and reliable model is established by lasso-cox regression analysis. Km curve shows that there are differences between high-risk group and low-risk group. And the nomogram has reliable prediction ability. In conclusion, pyroptosis an important role in pancreatic cancer, which can be used for the prediction of pancreatic cancer and provide a new perspective for the treatment of pancreatic cancer. AUTHOR APPROVALSThe authors have seen and approved the manuscript, and that it hasnt been accepted or published elsewhere. COMPETING INTERESTSThe authors declare no competing interests.