Author：Zhang Ting

Abstract： Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) shared similar pathogenetic, clinical and pathological features. Fever and cough were the most common symptoms of both diseases, while myalgia and diarrhea were less common in patients with COVID-19. Acute respiratory distress syndrome (ARDS) was the most severe pulmonary complication that caused high mortality rate. Histologically, diffuse alveolar damage (DAD) was the most characteristic finding in non-survivors with either SARS or COVID-19. Cases of patients died less than 10~14 days of disease duration demonstrated acute-phase DAD, while cases beyond 10~14 days of disease duration exhibited organizing-phase DAD in SARS. Meanwhile, organization and fibrosis were usually accompanied by exudation. Coronavirus was mostly detected in pneumocytes, while less in macrophages and bronchiolar epithelial cells. Hemorrhagic necrosis and lymphocytes depletion were found in lymph nodes and spleen in both SARS and COVID-19, indicating a pathological basis of lymphocytopenia. Thrombosis was commonly observed in small vessels and microvascular in lungs accompanying DAD. Microthrombosis was also found in extrapulmonary organs in COVID-19, that was less reported in SARS. Damages in multiple extrapulmonary organs were observed, but coronavirus was not detected in some of those organs, might indicating an alternative mechanism beyond viral infection, such as hypoxemia, ischemia and cytokine storm induced immunological injury. Diffuse alveolar damage due to viral infection and immunological injury, as well as multi-organ dysfunction and extensive microthrombus formation, brought huge challenge to the management of patients with severe SARS or COVID-19.

Journal：Chinese Journal of Tuberculosis and Respiratory Diseases

Publishing Time：2020,43(00):E040-E040

DOI：10.3760/cma.j.cn112147-20200311-00312

Author：Wu Weigang

Abstract： Analysis of a case of an elderly patient visiting relatives from Wuhan to Shenzhen on January 19,2020 who was been diagnosed of COVID-19 and isolated after two visits on January 21 and January 29. According to the 'diagnostic and treatment options of the novel coronavirus pneumonia (trial version)' issued by National Health Commission of the People’s Republic of China on January 15, the patient can only be isolated at home because he did not met the diagnostic standard of 'suspected case' on January 21. But on January 21, the patient met the criteria and must be isolated in hospital according to the new 'diagnostic and treatment options of the novel coronavirus pneumonia (the 4th version)' issued on January 27 which .Therefore,it is suggested that during the outbreak of new infectious diseases, the diagnostic and treatment options should be revised quickly and reasonably for reducing the missed diagnosis and control the spread of infectious diseases.

Journal：Chinese Journal of Experimental and Clinical Virology

Publishing Time：2020,34(00):E007-E007

DOI：10.3760/cma.j.issn.1003-9279.2020.0007

Author：Shen Yuehao

Abstract： Objective To explore the relationships between medical coping modes of patients with COVID-2019 and general information and social supports. Methods From January to February 2020, a total of 128 patients in a designated hospital in Wuhan with novel coronavirus pneumonia were investigated using the General Information Questionnaire and the Chinese version of the Medical Coping Modes Questionnaire(MCMQ) by convenient sampling. Pearson univariate analysis and multiple linear regression were used to analyze the relationship between the basic situation of patients with novel coronavirus pneumonia and coping modes. Results The scores of the face dimension and yield dimension of patients with COVID-2019 were lower than the norm model, while the avoidance dimension was higher than the norm model, and the differences were statistically significant ( P <0.05). Support utilization and complexity were influencing factors of the face dimension ( P <0.05). Support utilization and age were influencing factors of the yielding dimension ( P <0.01). Subjective support, the complexity dimension of disease uncertainty and the number of confirmed patients in the family were influencing factors of the avoidance dimension ( P <0.01). Conclusions Patients with COVID-2019 have poor medical coping modes, and they are prone to face the disease with a negative attitude. Patients are unwilling to face the disease and the tendency to yield to the disease is greater. And the older the patients, the less likely they are to succumb to the disease. The more patients diagnosed in the family, the less likely they are to avoid the disease. Patients with higher social supports and utilization have a more reasonable medical coping mode. This reminds medical staff to pay more attention to the psychological problems of patients in coping with COVID-2019 and improve their coping modes and methods.

Journal：Chinese Journal of Modern Nursing

Publishing Time：2020,26(00):E015-E015

DOI：10.3760/cma.j.cn115682-20200221-00933

Author：He Shuming

Abstract： We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35 +2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively.

Journal：Chinese Journal of Perinatal Medicine

Publishing Time：2020,23(04):217-220

DOI：10.3760/cma.j.cn113903-20200228-00171

Author：Ma Siyuan

Abstract： Objective To study the clinical application effect of modified nasopharyngeal swab sampling for 2019 novel coronavirus nucleic acid detection. Methods This study covered the period from January 14 to March 1, 2020. From February 24 on, the supine position method and the protective face screen were used to collect nasopharyngeal swabs, before which, the nasopharyngeal swabs were collected by sitting position method. All the patients were diagnosed with suspected/confirmed 2019 novel coronavirus infection, who were admitted from February 19 on, before which, the nasopharyngeal swabs were collected outside the hospital. (1) Thirty-four operators meeting the inclusion criteria of the study were recruited in this retrospective cohort study. They were grouped according to the collection method of nasopharyngeal swabs. Sixteen operators of Wuhan Taikang Tongji Hospital who used the supine position method and the protective face screen were included in supine position method+protective face screen group (15 males and 1 female, aged 34-49 years); 18 operators (12 from the First Affiliated Hospital of Army Medical University (the Third Military Medical University), 1 from Wuhan Jiangxia Mobile Cabin Hospital, 5 from the East District of People's Hospital of Wuhan University) who used the traditional sitting position method were included in sitting position method group (2 males and 16 females, aged 25-49 years). In supine position method+protective face screen group, when collecting sample, the patient lay flat and wore a special protective face screen for nasopharyngeal swab sampling, with neck slightly extending and face turning to the opposite side of the operator about 10°. The self-designed questionnaire was used to investigate the cooperation, the incidence of nausea, coughing, sneezing, and struggling of patients evaluated by the operators, the operation time of single sampling, the fear of operation and the perceived exposure risk of operators of the two groups. (2) Sixty-five patients (22 males and 43 females, aged 25-91 years) admitted to Wuhan Taikang Tongji Hospital who successively received the sitting position method and supine position method+protective face screen for nasopharyngeal swabs sampling and with complete nucleic acid detection results were included. The positive rates of nucleic acid detection by the two sampling methods of nasopharyngeal swabs of the patients were statistically analyzed. (3) Forty-one patients who could express their feelings accurately were selected from the above 65 patients (12 males and 29 females, aged 27-83 years). The comfort of patients in the process of sampling by the two methods was investigated. (4) Thirty-four patients (10 males and 24 females, aged 25-83 years) with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method were selected from the above 65 patients. The positive rate of nucleic acid detection of nasopharyngeal swab of patients by supine position method+protective face screen, i.e. negative to positive rate was statistically analyzed. Data were statistically analyzed with Wilcoxon's sign rank test, t test, and chi-square test. Results (1) The cooperation score of patients evaluated by the operators in supine position method+protective face screen group was significantly higher than that in sitting position method group ( Z =-4.928, P <0.01), the incidence of nausea, choking cough, sneezing, and struggling of patients evaluated by the operators, and the fear of operation score and the perceived exposure risk score of operators were significantly lower than those of sitting position method group ( Z =-5.071, -5.046, -4.095, -4.397, -4.174, -5.049, P <0.01), and the operation time of single sampling was significantly longer than that of sitting position method group ( t =23.17, P <0.01). (2) The positive rate of nucleic acid detection of nasopharyngeal swabs by supine position method+protective face screen was 60.00% (39/65), which was obviously higher than 41.54% (27/65) by sitting position method ( χ 2 =4.432, P <0.05). (3) The comfort score of the 41 patients during nasopharyngeal swabs sampling by supine position method+protective face screen was significantly higher than that by sitting position method ( Z =-5.319, P <0.01). (4) Of the 34 patients with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method, the rate of negative to positive of nucleic acid detection was 26.47% (9/34) after sampling by supine position method+protective face screen. Conclusions Compared with the traditional sitting position method, detection of 2019 novel coronavirus nucleic acids of nasopharyngeal swabs collected by supine method combined with protective face screen is worth promoting, because of its better comfort of patients, low exposure risk for operators, in addition to reducing in the false negative result to some extent, which may help reduce false recurrence of discharged patients.

Journal：Chinese Journal of Burns

Publishing Time：2020,36(00):E009-E009

DOI：10.3760/cma.j.cn501120-20200312-00153

Author：ZHANG MEI

Abstract：COVID-19 is needed for medical staff to take preventive measures. They need to wear multiple protective equipment for a long time, frequent exposure to disinfectant materials, and psychological pressure. This paper focuses on the treatment and protective measures of the three most common skin diseases, including pressure injury, allergic dermatitis and tinea pedis, in order to provide reference for the self skin care of the first-line medical staff.

Journal：Journal of Modern Medicine & Health

Publishing Time：2020,36(19):37-38

DOI：

Author：Andrew A. Lover

Abstract：

Journal：medRxiv

Publishing Time：preprint

DOI：10.1101/2020.03.22.20040949.

Author：Kwang Su Kim

Abstract：

Journal：medRxiv

Publishing Time：preprint

DOI：10.1101/2020.03.23.20040493

Author：Zohaib Khurshid

Abstract：

Journal：International Journal of Environmental Research and Public Health

Publishing Time：2020, 17, 2225

DOI：10.3390/ijerph17072225

Author： Liu Ming

Abstract： Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×10 9 /L vs (10.49±4.46) ×10 9 /L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group ( t =2.908, 5.009, 4.391 and 2.942, respectively, all P <0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases.

Journal：Chinese Journal of Infectious Diseases

Publishing Time：2020,49:E024-E024

DOI：10.3760/cma.j.cn311365-20200304-00208

Author： Shen Wenzhuang

Abstract： The treatments of early stage breast cancer patients in the central epidemic area have been seriously delayed by 2019 coronavirus disease(COVID-19), which influences the treatment mode and prognoses of these patients. During the semi-late period of the epidemic of COVID-19, it is urgent for the breast oncology specialists to carry out relative feasible treatment adjustments.Therefore, we hereby discuss the reasonable delayed-treatment strategy for early stage breast cancer patients by combining the suggestions from multi-disciplinary treatment group of breast oncology in our hospital with the theory evidence from foreign and domestic literatures.

Journal：Chinese Journal of Metastatic Cancer

Publishing Time：2020,03:E002-E002

DOI：10.3760/cma.j.issn.2096-5400.2020.0002

Author： Cheng Zhaoping

Abstract： Objective To explorethe evolution of continuous dynamic chest high resolution CT (HRCT) image in patients with mild COVID-19. Methods The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 ordinary patients and 1 light patient) were enrolled in the group, including 14 males and 11 females, with (42±12) years and hospital stay of (19±5) days. The basic image and dynamic image of HRCT were analyzed and compared by the radiologists. Results The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lack specificity. There was no significant abnormality in chest CT of one light patient. HRCT findings of the common type patients were as follows: (1) the distribution of the lesions: most of the multiple lesions in both lungs (19 cases), the average number of involved lobes (3±1), most of which were located in the extra pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); With the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5 (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days. Conclusions Continuous dynamic chest HRCT can monitor the basic evolution process of patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.

Journal：Chinese Journal of Radiology

Publishing Time：2020,54:E021-E021

DOI：10.3760/cma.j.issn.1005-1201.2020.0021

Author： Long Xiaoru

Abstract：Human coronavirus was first isolated in 1960s and is an important pathogen of respiratory tract infection in children. 7 discovered novel coronavirus can cause human diseases. Among them, severe acute respiratory syndrome coronavirus, Middle East respiratory syndrome associated coronavirus and 2019 new coronavirus are highly infectious and pathogenic, which seriously threaten human health and global economy. This review focuses on the characteristics of the above three highly pathogenic human coronaviruses in children, in order to provide reference for the future epidemic monitoring and control.

Journal：Chinese Journal of Pediatrics

Publishing Time：2020,58(05):E014-E014

DOI：10.3760/cma.j.cn112140-20200302-00167