摘要： Introduction: People on renal replacement therapy (RRT) have a high risk of COVID-19 infection and subsequent death. COVID-19 vaccination is strongly recommended for those on RRT. Data are limited on the immune response of the ChAdOx1 nCoV-19/AZD1222 (Covishield (R)) vaccine in patients on RRT. Methods: A prospective cohort of adult (age > 18 years), on RRT in the form of hemodialysis were included and received two intramuscular doses of Covishield (R). A blood specimen of 5.0 mL was collected at two time points, within a few days before administering the first dose of the vaccine and at 4-16 weeks after the second dose. According to their prior COVID-19 infection status, the participants were grouped as (i) prior symptomatic COVID-19 infection, (ii) prior asymptomatic COVID-19 infection, and (iii) no prior COVID-19 infection. Results: A large proportion (81%) of participants had anti-spike antibodies (ASAb) before vaccination, and a reasonable proportion (30%) also had neutralizing antibodies (NAb). The titer of ASAb was relatively low (207 U/mL) before vaccination. The ASAb titer (9405 [1635-25,000] U/mL) and percentage of NAb (96.4% [59.6-98.1%]) were markedly increased following the administration of two doses of the vaccine. The participants' prior COVID-19 exposure status did not influence the rise in ASAb titer and NAb percentage. Further, administering two doses of the Covishield vaccine helps them achieve a high ASAb titer. Conclusion: Two doses of ChAdOx1 nCoV-19/AZD1222 (Covishield (R)) vaccine, given 12 weeks apart, achieve a high titer of ASAb and a high percentage of NAb in people on hemodialysis.

摘要： Background This study aimed to evaluate AZD2816, a variant-updated COVID-19 vaccine expressing the full-length SARS-CoV-2 beta (B.1.351) variant spike protein that is otherwise similar to AZD1222 (ChAdOx1 nCoV-19), and AZD1222 as third-dose boosters. Methods This phase 2/3, partly double-blinded, randomised, active-controlled study was done at 19 sites in the UK and four in Poland. Adult participants who had received a two-dose AZD1222 or mRNA vaccine primary series were randomly assigned by means of an Interactive Response Technology-Randomisation and Trial Supply Management system (1:1 within each primary-series cohort, stratified by age, sex, and comorbidities) to receive AZD1222 or AZD2816 (intramuscular injection;5 x 1010 viral particles). Participants, investigators, and all sponsor staff members involved in study conduct were masked to randomisation. AZD1222 and AZD2816 doses were prepared by unmasked study staff members. The primary objectives were to evaluate safety and humoral immunogenicity (non-inferiority of day-29 pseudovirus neutralising antibody geometric mean titre [GMT] against ancestral SARS-CoV-2: AZD1222 booster vs AZD1222 primary series [historical controls];margin 0 center dot 67;SARS-CoV-2-seronegative participants). This study is registered with ***, NCT04973449, and is *** Between June 27 and Sept 30, 2021, 1394 participants of the 1741 screened were randomly assigned to AZD1222 or AZD2816 following an AZD1222 (n=373, n=377) or mRNA vaccine (n=322, n=322) primary series. In SARS-CoV-2-seronegative participants receiving AZD1222 or AZD2816, 78% and 80% (AZD1222 primary series) and 90% and 93%, respectively (mRNA vaccine primary series) reported solicited adverse events to the end of day 8;2%, 2%, 1%, and 1% had serious adverse events and 12%, 12%, 10%, and 11% had adverse events of special interest, respectively, to the end of day 180. The primary immunogenicity non-inferiority endpoint was met: day-29 neutralis

关键词： 2019-nCoV   COVID-19   Management   Hepatocellular carcinoma   cirrhosis  

摘要： Introduction and Objectives: The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of *** and Methods: We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Overall survival were compared between the groups. Predictors of mortality were analysed with Cox ***: From the initial cohort, 575 patients were included (n = 263 Exposed_COVID, n = 312 Unexposed_COVID). Overall and disease free survival at 12 months were 59.9 +/- 3.2% vs 74.3 +/- 2.5% (p<0.001) and 40.2 +/- 3.5% vs 63.5 +/- 3.1% (p<0.001) according to the period of exposure (Exposed_COVID vs Unexposed_COVID, respectively). Adjusted Cox regression revealed that the period of exposure (Exposed_COVID HR: 1.79, 95%CI (1.36, 2.35) p<0.001) and BCLC stage B, C and D (BCLC B HR: 1.82, 95%CI (1.07, 3.08) p = 0.027 -BCLC C HR: 1.96, 95%CI (1.14, 3.38) p = 0.015 -BCLC D HR: 3.21, 95%CI (1.76, 5.85) p<0.001) were predictors of ***: Disruption of routine healthcare services because of the pandemic translated to reduced 1 year overall and disease-free survival among patients affected by HCC, in the metropolitan area of Paris, France.(c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Fundacion Clinica Medica Sur, A.C.

关键词： COVID-19   ChAdOx1 nCoV-19 Vaccine   Inflammatory mediators   Cytotoxic mediators  

摘要： Immunological and cytotoxic mediators are induced in natural infection and are essential for the effectiveness of vaccination. Vaccination is useful to prevent the spread of SARS-CoV-2 and limit the morbidity/mortality of COVID-19. ChAdOx1 nCoV-19 is one of the most widespread vaccines in the world. We compared the detection of anti-S1 SARS-CoV2 IgG and the profile of inflammatory and cytotoxic responses of patients who developed different clinical outcomes of COVID-19 with individuals previously exposed or not to the virus received the first and booster doses of ChAdOx1 nCoV-19. Plasma from 35 patients with COVID-19 and 11 vaccinated were evaluated by multiplex assay. Here, no vaccinated subjects had serious adverse effects. Those vaccinated with a booster dose had higher anti-S1 IgG than mild/moderate and recovered patients. Critically ill and deceased patients had IgG levels like those immunized. By univariate analysis, IL-2, IL-17, and perforin do not differentiate between patients and vaccinated individuals. Granzyme A increased at dose 1, while patients had their levels reduced. High levels of granulysin, sFas, and IL-6 were detected in the deaths, but after vaccination, all were declined. The multivariate analysis supports the role of IL-6 and granulysin as associated and non-confounding variables related to the worst clinical outcome of COVID-19, but not sFas. Our data confirm the ability of the ChAdOx1 vaccine to produce specific antibody levels up to booster time. Furthermore, our data suggest that the vaccine can regulate both the hyper-production and the kinetics of the production of inflammatory and cytotoxic mediators involved in the cytokine storm, such as granulysin and IL-6.

关键词： COVID-19  

摘要： Chinese health agencies informed the World Health Organization (WHO) in December 2019 about an outbreak of pneumonia of unknown etiology, attributed to a new virus called 2019-nCov, later named SARS-CoV-2 (the etiological agent of COVID-19). These microorganisms, belonging to the family Coronaviridae and subfamily Coronavirinae, are formed by positive single-stranded RNA containing nucleocapsid and spike proteins or spicules. They have high contamination rates, spread capacity, and lethality rates and are directly related to severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and occasionally a global pandemic. In this context, as a way to contribute to the development of new treatments capable of containing COVID-19 through the repositioning of drugs, the present work uses a computational study by molecular docking and in silica pharmacokinetic tests (ADMET) to track the drugs of the line of anti-inflammatory drugs, that could function as inhibitors of proteins essential for the viral cycle of this pathogen. In the end, with the selection of 71 drugs, 284 dockings were performed, of which the chemical compound Oxaprozin was described as the primary ligand suitable for pharmacological repositioning against Covid-19 since it demonstrates good molecular affinity, below -8.0 ***-1, with two vital proteins (Spike and MPro). In addition to meeting the main ADMET properties, it has a high degree of solubility, low toxicity and is not characterized as a carcinogenic agent. © 2023, The Authors. All rights reserved.

关键词： 新冠肺炎   中医药   经验   治未病   治疗  

摘要： 自新冠肺炎发生蔓延以来，胡世平教授一直积极投身于中医药防治新冠肺炎工作。对于新冠肺炎的中医病因病机认识，其阐释为主要以风寒湿热虚为主。针对新冠肺炎的防治，胡世平教授提出未病先防、既病防变、瘥后康养的三步走诊疗策略。并且依据深圳市气候变化特点、人群禀赋体质差异，对新冠肺炎的预防期、治疗期以及康养期，分别制定出疫毒清散、清瘟散和瘟热清散系列方以及新冠康养系列方，覆盖新冠肺炎的预防、治疗、康养全周期全过程。事实证明，胡世平教授运用中医药全周期防治新冠肺炎的诊疗策略，不仅在新冠肺炎初期有限的时间和区域内有效控制了疫情的蔓延，同时在治疗期很大程度上减轻了患者的症状，更在康养阶段极大提升了患者的健康水平。

摘要： Background. Adverse events after vaccination against COVID-19 include rare events, such as Guillain-Barre syndrome. Study Aims. Documentation of clinical and temporary characteristics of the Guillain-Barre syndrome after using anti-COVID-19 ChAdOx1 nCoV-19 vaccine. Case Presentation. An adult, 29-year-old male, without relevant medical history, who developed neuromuscular symptoms nine days after administration of the first dose of anti-COVID-19 ChAdOx1 nCoV-19 vaccine. Results. Symptoms appeared nine days after vaccination, with lower limbs paresthesia. Three days later, paresthesia of upper limbs occurred. The following day, distal weakness of limbs, with standing and gripping difficulties, occurred. The clinical evaluation demonstrated dysarthria, incomplete palpebral closure, bilateral facial, and tongue paresis. The electromyography was compatible with a motor demyelinating polyneuropathy, confirming the diagnosis of the Guillain-Barre syndrome. Management with five sessions of plasma exchange was prescribed, with favorable clinical results. Conclusions. Clinical and laboratory tests confirmed the Guillain-Barre syndrome and the time elapsed from the date of the vaccine administration to the appearance of initial symptoms, added to the absence of other causes, and allowed to establish that the disease was caused by the vaccination.

关键词： 微量营养素   维生素   矿物质   免疫   呼吸道感染   新型冠状病毒感染  

摘要： 微量营养素是影响免疫系统的重要因素,通过维持皮肤和黏膜完整性、调节细胞因子的活性、介导T细胞和B细胞的增殖分化等途径维持免疫系统的正常运行。人体在成长的不同阶段免疫系统具有不同状态,期间微量营养素的缺乏会损害免疫系统从而增加呼吸道疾病的易感性,因此保持最佳营养状态的免疫系统有助于预防呼吸道感染。新型冠状病毒感染是备受瞩目的呼吸道感染性疾病之一,补充多种微量营养素在新型冠状病毒感染的预防、缓解症状和促进康复方面均有积极作用。未来还需要进行更多相关研究,系统评价微量营养素对免疫和呼吸道感染的影响,并进一步明确补充的时机和剂量。

关键词： 新型冠状病毒   满意度   疫苗   接种   社区  

摘要： 目的了解上海市浦东新区社区人群对接种新型冠状病毒(以下简称新冠)疫苗门诊服务的满意度及其影响因素,为进一步提升预防接种门诊服务质量提供参考依据。方法2021年4-6月采用问卷调查方式,选择上海市浦东新区南、北片区各一家社区卫生服务中心,对免费接种新冠疫苗的人群开展接种门诊服务满意度问卷调查,分析满意度及其影响因素。结果上海市浦东新区社区人群对新冠疫苗接种服务的总体满意度为(89.52±12.11)分,满意度较高。人群对接种费用、服务态度、技术操作的满意度较高,分别为(4.71±0.59)、(4.53±0.67)、(4.52±0.67)分。年龄较大(B=0.05,P=0.000)、女性(B=0.49,P=0.030)、文化程度较高(B=0.20,P=0.028)、家庭关系更融洽(B=0.36,P=0.006)、了解新冠疫苗接种的不良反应和禁忌证(B=0.83,P=0.000)、对接种新冠疫苗不犹豫(B=1.44,P=0.000)的人群对疫苗接种服务总体满意度较高。而经常锻炼身体(B=-0.28,P=0.012)、从预约接种到接种第一针的等待时间较久(B=-0.43,P=0.000)的人群对疫苗接种服务的总体满意度较低。结论上海市浦东新区居民对新冠疫苗接种服务的总体满意度较高。年龄较大、女性、文化程度较高、家庭关系更融洽、了解新冠疫苗接种的不良反应和禁忌证、对接种新冠疫苗不犹豫的人群对疫苗接种服务的总体满意度较高。

关键词： 新冠病毒感染   风湿免疫病   疫苗   问卷调查  

摘要： 目的 了解我国风湿免疫病患者新型冠状病毒(新冠)感染现状。方法 通过在线问卷的形式,收集风湿免疫病患者的原发病特征、新冠疫苗接种情况以及新冠感染的相关信息。结果 共5 468位受试者完整地填写了问卷,女性占84.5%,系统性红斑狼疮(33.7%)是最多的疾病类型,其中3 554人(65.0%)接种了至少1剂新冠疫苗,4 370人(77.9%)已感染新冠,231人(5.3%)因新冠住院治疗。多因素回归分析显示,使用利妥昔单抗治疗原发病是新冠感染的独立危险因素(P<0.05)。存在原发病相关的肺(OR 2.098,95%CI:1.546~2.847)、心脏(OR 1.625,95%CI:1.102~2.397)和胃肠道(OR 1.432,95CI:1.021~2.009)受累是新冠感染后需要住院治疗的独立危险因素,接种新冠疫苗加强剂是其保护性因素(OR 0.681,95%CI:0.468~0.991,P<0.05)。结论 本研究提供了部分中国风湿病患者新冠感染相关的数据,接种疫苗、原发病脏器受累和治疗均可影响新冠感染风险或预后。