Coronavirus disease 2019 (COVID-19), the pathogen of which is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly infectious disease that broke out in Wuhan, China, in December 2019 and has spread to more than 200 countries.¹ COVID-19 has been proven to be transmitted mainly through droplets and contact.² The eye is also considered an important route of infection.

Background: The triglyceride-glucose index (TyG index) is one of the surrogate markers of insulin resistance, and high-sensitivity C-reactive protein (hsCRP) reflects systemic inflammation. Existing studies suggest that insulin resistance or systemic inflammation may be indicative of cardiometabolic disease, but few of the existing studies have combined the TyG index and inflammation levels before assessing cardiometabolic multimorbidity. Our study data came from the China Health and Retirement Longitudinal Study (CHARLS). Participants in this data were followed for 9 years, and we used these data to conduct a long-term analysis to assess the combined effects of the TyG index and hsCRP on cardiometabolic multimorbidity in Chinese adults over 45 years of age.Purpose: To study the combined effect of TyG index and hsCRP on cardiometabolic multimorbidity in middle-aged as well as elderly Chinese.Method: The study data came from the China Health and Retirement Longitudinal Study (CHARLS), which included a total of 4,483 middle-aged and elderly participants who did not have cardiovascular metabolic diseases at baseline, which was from CHARLS 2011, and the last survey was in 2020. A total of five cardiometabolic diseases were considered in this study: diabetes, hypertension, hyperlipidemia, heart disease and stroke. A person was defined as having cardiometabolic multimorbidity when he/she had two or more cardiometabolic diseases at the same time. TyG index (median as cut-off) and hsCRP (1mg/L as cut-off) were each divided into two groups and combined into four groups (Group L-L: TyG index<median & hsCRP=median & hsCRP<1mg/L; Group L-H: TyG index=1mg/L; Group H-H: TyG index>=median & hsCRP>=1mg/L). Multiple regression equations were fitted to analyse the combined influence of TyG index and hsCRP on cardiometabolic multimorbidity.Results: TyG index increases the risk of CMM events independently of hsCRP, as does the reverse. When the TyG index is elevated and hsCRP is also elevated, this condition significantly increases the danger of cardiometabolic multimorbidity in middle-aged and elderly Chinese.Conclusion: High levels of TyG index and hsCRP can enhance the danger of cardiometabolic multimorbidity in Chinese middle-aged and elderly people, and the joint use of hsCRP and TyG index assessment may be a better way to achieve primary prevention of cardiometabolic multimorbidity in Chinese middle-aged and elderly people.

Objective: Studies have suggested that coronavirus disease 2019 (COVID-19) appears to be more serious in patients with gastrointestinal symptoms. This meta-analysis was conducted to explore the relationship between gastrointestinal symptoms and the severity of COVID-19. Methods: We searched PubMed, Web of Science, Science Direct, Embase, and Google Scholar on 16 October 2020, to identify observational studies that provided data on gastrointestinal symptoms and severity of COVID-19. Gastrointestinal symptoms include diarrhea, abdominal pain, nausea, and vomiting. The severe rate and the odds ratio (OR) were pooled. Heterogeneity was assessed using the I ² statistic. Results: A total of 21 studies with 5285 patients were included in this meta-analysis. The severe rate of COVID-19 patients with diarrhea was 41.1% [95% confidence interval (CI): 31.0–51.5%], and the OR of association between diarrhea and severe COVID-19 was 1.41 (95% CI: 1.05–1.89); sensitivity analysis showed that the results for the OR and 95% CI were unstable. For abdominal pain, the severe rate and OR of association with severe COVID-19 were 59.3% (95% CI: 41.3–76.4%) and 2.76 (95% CI: 1.59–4.81), respectively; for nausea, 41.4% (95% CI: 23.2–60.7%) and 0.92 (95% CI: 0.59–1.43), respectively; for vomiting, 51.3% (95% CI: 36.8–65.8%) and 1.68 (95% CI: 0.97–2.92), respectively. Conclusion: The severe rate was more than 40% in COVID-19 patients with gastrointestinal symptoms. Abdominal pain was associated with a near 2.8-fold increased risk of severe COVID-19; the relationship between diarrhea and the severity of COVID-19 was regionally different; nausea and vomiting were limited in association with an increased risk of severe COVID-19.

Purpose: To analyze the relationship between titin (TTN) mutation gene and tumor mutational burden (TMB) and the with prognosis of lung squamous cell carcinomas (LUSC), and to explore the feasibility of TTN as a potential prognostic marker of for LUSC. Methods: We analyzed the somatic mutation landscape of LUSC samples using datasets obtained from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) databases. Sequence data were divided into wild and mutant groups, and differences in TMB values between the groups compared using a Mann–Whitney U-test. The Kaplan Meier method was used to analyze the correlation between TTN mutation and LUSC prognosis, whereas CIBERSORT algorithm was used to calculate the degree of relative enrichment degree of among tumor-infiltrating lymphocytes in LUSC. Results: Analysis of both datasets revealed high mutations in the TTN gene, with mutants exhibiting a significantly higher TMB value relative to the wild-type (P < 0.001). Prognosis of the TTN mutant group in LUSC was significantly better than that of wild-type (P = 0.009). Kaplan Meier curves showed that TTN mutation may be an independent prognostic factor in LUSC patients (HR: 0.64, 95% CI 0.48– 0.85, P = 0.001), while GSEA analysis revealed that TTN mutation plays a potential role in the development of LUSC. Finally, analysis of LUSC immune microenvironment revealed that TTN mutation was significantly associated with enrichment of macrophages M1 (p < 0.05). Conclusion: TTN mutation is associated with TMB, and is positively correlated with prognosis of LUSC. Therefore, this mutation may serve as a potential prognostic indicator of LUSC.