Scientific reports
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The COVID-19 pandemic caused by the SARS-CoV-2 requires a fast development of antiviral drugs. SARS-CoV-2 viral main protease (Mpro, also called 3C-like protease, 3CLpro) is a potential target for drug design. Crystal and co-crystal structures of the SARS-CoV-2 Mpro have been solved, enabling the rational design of inhibitory compounds. ⋯ The selected compounds from both screens were tested in vitro by a protease activity inhibition assay. Two compounds showed activity at the 50 µM concentration range. Our analysis and findings can facilitate and focus the development of highly potent inhibitors against SARS-CoV-2 infection.
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Case Reports Meta Analysis
Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis.
Present study aimed to estimate the incidence of recurrent SARS-CoV-2 RNA positivity after recovery from COVID-19 and to determine the factors associated with recurrent positivity. We searched the PubMed, MedRxiv, BioRxiv, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry for studies published to June 12, 2020. Studies were reviewed to determine the risk of bias. ⋯ The pooled estimate of the interval from disease onset to recurrence was 35.4 days (95% CI 32.65-38.24 days), and from the last negative to the recurrent positive result was 9.8 days (95% CI 7.31-12.22 days). Patients with younger age and a longer initial illness were more likely to experience recurrent SARS-CoV-2 positivity, while patients with diabetes, severe disease, and a low lymphocyte count were less likely to experience. Present study concluded that the incidence of recurrent SARS-CoV-2 positivity was 14.8% suggesting further studies must be conducted to elucidate the possibility of infectious individuals with prolonged or recurrent RNA positivity.
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To describe the incidence, therapy and outcome of traumatic tracheobronchial injuries (TTBI) in trauma patients with multiple injuries derived from the DGU TraumaRegister. We analyzed the data on all patients listed on the TraumaRegister DGU (TR-DGU) in Germany between 2002 and 2015 aged 16 years or older and with an Injury Severity Score (ISS) of ≥ 9. We analyzed the data on 136,389 trauma patients, 561 of whom had suffered tracheobronchial injuries (0.4%). ⋯ TTBI injuries revealed a higher rate of progression to surgical management, with 35% undergoing surgery within the first 24 h. This excessive mortality rate demonstrates a high overall injury burden in patients with TTBI and high mortality of associated injuries. A surgical intervention's impact on mortality cannot be assessed in this study, as it would need to be investigated in a case-matched study.
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To determine the incidence of acute cardiac injury (ACI), the factors associated with ACI and the in-hospital mortality in patients with COVID-19, especially in severe patients. All consecutive in-patients with laboratory-confirmed COVID-19 from Tongji Hospital in Wuhan during February 1 and March 29, 2020 were included. The demographic, clinical characteristics, laboratory, radiological and treatment data were collected. ⋯ Moreover, the mortality was significantly higher in patients with elevation of both hs-cTnI and NT proBNP than in those with elevation of either of them. ACI develops in a substantial proportion of patients with COVID-19, and is associated with the disease severity and in-hospital mortality. A combination of hs-cTnI and NT-proBNP is valuable in predicting the mortality.
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Rapid diagnosis of myocardial infarction (MI) using electrocardiography (ECG) is the cornerstone of effective treatment and prevention of mortality; however, conventional interpretation methods has low reliability for detecting MI and is difficulty to apply to limb 6-lead ECG based life type or wearable devices. We developed and validated a deep learning-based artificial intelligence algorithm (DLA) for detecting MI using 6-lead ECG. A total of 412,461 ECGs were used to develop a variational autoencoder (VAE) that reconstructed precordial 6-lead ECG using limb 6-lead ECG. ⋯ During internal and external validation, the area under the receiver operating characteristic curves of the DLA with VAE using a 6-lead ECG were 0.880 and 0.854, respectively, and the performances were preserved by the territory of the coronary lesion. Our DLA successfully detected MI using a 12-lead ECG or a 6-lead ECG. The results indicate that MI could be detected not only with a conventional 12 lead ECG but also with a life type 6-lead ECG device that employs our DLA.