In the communication level, scientific research level far better than 17 years ago at the moment, this ‘Wuhan campaign’ we will win! It’s the Lunar New Year, under the lights, the battleground against the new coronavirus is not a little slack… In the face of this outbreak, the academic community also joined the battlefield at the fastest pace in history.
Photo: The Lancet/This New Coronary Virus Pneumonia Column
In the first batch of articles published, Cao Bin of Beijing Sino-Japanese Friendship Hospital and Wang Jianwei of Beijing Concord Medical College, as a joint newsletter, published an article entitled “Clinical Characteristics of Patients with New Coronary Virus Infection in Wuhan City 2019”, reporting on the epidemiological and clinical characteristics of this new influenza virus outbreak. Laboratory examination data and final clinical outcomes.
Picture: The Lancet
In the tube peeping leopard, 41 patients clinical performance open!
This article includes 41 patients diagnosed with the new coronavirus pneumonia as of January 2, 2020, 13 of whom have underlying diseases (8 diabetes, 6 for hypertension, 6 for cardiovascular disease), and most of the patients initially diagnosed are middle-aged and elderly (median age 49.0 years, IQR 41.0 – 58.0), of which more than half (27 people, 66%) have a history of contact with the South China seafood market.
If the above information is familiar to us. The next analysis is more difficult, as the paper also reports a symptom ratio of 41 patients.
How common is the most common symptom of this new coronavirus pneumonia patients is fever? Only 1 in 41 patients did not show fever, while cough (31 cases) and fatigue (18 cases) were two other common symptoms. Sputum production (11 cases), headache (3 cases), hemorrhage (2 cases), diarrhea (1 case) in patients are also seen, therefore, very symptoms also deserve the attention of clinicians.
In addition, the median time from first seizure to hospitalization was 7.0 days (4.0-8.0), and more than half of the patients (22 cases) progressed to breathing difficulty during the median time of 8.0 days (IQR 5.0-13.0-1.0). At a median time of 9.0 days (8.0-14.0) progression to acute respiratory distress syndrome (ARDS). Thirteen patients were admitted to the Intensive Care Unit (ICU) for a median time of 10.5 days (8.0-17.0), and six deaths have been reported.
Source: The Lancet/Illness Development Timeline
Patient differences: Different imaging and laboratory performance in patients with light and severe illness
Patients may experience a decrease in white blood cells (less than 4 x 109/L, 10 cases) and a decrease in lymphocytes (less than 1.0 x 109/L, 26 cases). The high level of D-dipolymer and coagulation progenitor in patients with ICU at the time of admission (12.2s median time of coagulation asegens and 2.4 mg/L of median D-dipolymer), which may help clinicians predict the progress of the patient’s condition. The researchers also noted that both patients with light (not entering the ICU) and severely ill (eventually entering the ICU) may have elevated serum aspertoidine transaminase.
Lung CT abnormality is the most typical imaging manifestation of this new coronavirus pneumonia. Of the 41 patients, 40 were suffering from double-sided lung lobes, the typical manifestation of pulmonary CT in severe patients was double-sided multi-small leaves and sub-segment substantive lesions, and the representative CT of patients with mild patients showed two-sided segmented glass-like change.
A for ICU patients, B for non-ICU patients / Picture source Lancet
The researchers said that because of the limited clinical resources available, the number of cases reported in this case is small and no more age-group edgy is covered, and in subsequent articles they will be interpreted in conjunction with more cases.
Fighting the new coronavirus pneumonia, these drugs may be effective
Given that SARS coronaviruses induce a large number of cytokines, this new coronavirus patient also showed an increase in cytokines and higher levels of cytokines in severe patients, the researchers note. However, in practice, there is no real clinical benefit to the application of glucocorticoids. Antiviral therapy is effective against coronary viral infection pneumonia based on past experience with SARS and MERS.
On January 23, Wang Guangfa, director of the Department of Respiratory and Critical Care Medicine at Peking University First Hospital, who had been diagnosed with the new coronavirus, told the media that the AIDS treatment drug Lopinavir/Litonavir tablets were effective for him and that it took only a day to improve his body temperature.
The pilot version of the Pneumonia Treatment Programme for New Coronary Virus Infections issued by the National Health And Health Council (now updated to the third edition) also indicates that Lopinavir/Litonavir tablets can be used for the treatment of new coronaviruses.
The pneumonia diagnosis and treatment plan for the new coronavirus infection (trial third edition) points out that type I interferon including IFN-alpha atomized inhalation can be used as an anti-new coronavirus treatment measure to improve the virus removal effect of the mucous membranes of the patient’s respiratory tract.
(RDV, GS-5734) is a new nucleoside analogue antiviral drug, from the current research data, RDV may be the most potential anti-new coronavirus drug. However, no studies have been made on the safety and efficacy of RDV in humans.
Studies have shown that SARS-CoV’s nuclear shell protein binds closely to Cyclophilin A in human cells, helping with infection and replication. In 2011, Swiss and U.S. scientists reported that cyclosporine (CsA) inhibited the coronavirus, the same year that German and British scientists confirmed that the host’s Cyclophilins was a possible drug for the coronavirus.
Other potentially effective drugs:
Other nucleoside analogues, such as ribavirin and fabiraze, have broad-spectrum antiviral effects in vitro and theoretically have certain anti-coronavirus activity. However, because of the external celiac nucleic acidase of coronaviruses has RNA proofing, drugs such as ribavirin are greatly weakened in preventing viral nucleic acid replication. Nucleoside retrovirus inhibitors for AIDS treatment, such as tinofovvir and lamiftine, all have the effect of inhibiting RNA synthesis and whether they can play an anti-coronavirus treatment effect, it is worth observing.
Written at the end of the text:
The Lancet columns and successive articles and editorials remind us that, even if not on the front lines, clinicians and academic squires stand with Wuhan.
Some people on the network said: “This outbreak caught up with the Spring Festival, must be more severe than SARS”, see the publication of these research results, see more people go to join the campaign, I just want to say: “in the level of communication, scientific research level far better than 17 years ago, ‘Wuhan campaign’ we will win!” “