A new type of pneumonia caused by a novel coronavirus SARS-CoV-2 outbreaks recently in China and spreads into many other countries. This disease, named as COVID-19, is similar to patients infected by SARS-CoV and MERS-CoV, and nearly 20% of patients developed severe condition. Cardiac injury is a prevalent complication of severe patients, exacerbating the disease severity in coronavirus disease 2019 (COVID-19) patients. Angiotensin-converting enzyme 2 (ACE2), the key host cellular receptor of SARS-CoV-2, has been identified in multiple organs, but its cellular distribution in human heart is not illuminated clearly. This study performed the first state-of-art single cell atlas of adult human heart, and revealed that pericytes with high expression of ACE2 might act as the target cardiac cell of SARS-CoV-2. The pericytes injury due to virus infection may result in capillary endothelial cells dysfunction, inducing microvascular dysfunction. And patients with basic heart failure disease showed increased ACE2 expression at both mRNA and protein levels, meaning that if infected by the virus these patients may have higher risk of heart attack and critically ill condition. The finding of this study explains the high rate of severe cases among COVID-19 patients with basic cardiovascular disease; and these results also perhaps provide important reference to clinical treatment of cardiac injury among severe patients infected by SARS-CoV-2.
Human landing catch (HLC) is the most efficient method for Aedes monitoring, but it is not ethical due to its high risk of human exposure to pathogens. We designed trials to assess the performance of an alternative human-baited double net trap (HDN) for field Aedes albopictus monitoring compared with the standard HLC. Outdoor HDN and HLC catches were conducted simultaneously at 15 field sites on two sunny days in mid-July and August. The tests were performed 3 h apart: an early morning period (7:30–8:30 h), a pre-sunset period (16:30–17:30 h) and a post-sunset period (18:30–19:30 h). A total of 90 comparisons were made between the two methods. Field comparisons were designed to minimize half-hour bias and human-bait attraction bias. Two mosquito species were collected by HDN and HLC, with the predominated species being Ae. albopictus (HDN: n = 1325, 97.35% of total; HLC: n = 531, 92.51% of total). A small proportion were adults of the Culex pipiens complex (HDN: n = 36, 2.65% of total; HLC: n = 43, 7.49% of total). Although the mean Ae. albopictus catch per hour of HLC was significantly higher than HDN (14.72 vs 5.90 per h, t(178) = 3.151, P = 0.003), there were significant positive spatial and temporal correlations between HLC and HDN for Ae. albopictus sampling among different sites and hours (r(90) = 0.785, P < 0.001; r(90) = 0.785, P < 0.001). Both methods proved that Ae. albopictus was most active during the hours before sunset and least active after sunset. No significant variation was observed in Ae. albopictus catch size of HDN between groups of more attractive and less attractive humans (3.38 vs 2.51 per 30 min, t(88) = 1.283, P = 0.201). With moderate sampling efficiency, significantly positive spatial correlation with HLC, and less human-bait attraction bias, HDN appears to be a safer alternative to HLC for Ae. albopictus monitoring in Shanghai. With mosquito activity peaking in the pre-sunset hours, Ae. albopictus catches of HDN should be performed in the hours before dark. The trap design could be improved to make it more portable and easier for field operation.
17 November 2020 in Journal of the American Heart Association
Background: Alterations in serum creatinine levels delay the identification of severe cardiac surgery‐associated acute kidney injury. To provide timely diagnosis, novel predictive tools should be investigated. Methods and Results: This prospective observational study consists of a screening cohort (n=204) and a validation cohort (n=198) from 2 centers from our hospital. Thirty‐two inflammatory cytokines were measured via a multiplex cytokine assay. Least absolute shrinkage and selection operator regression was conducted to select the cytokine signatures of severe cardiac surgery‐associated acute kidney injury. Afterwards, the significant candidates including interferon‐γ, interleukin‐16, and MIP‐1α (macrophage inflammatory protein‐1 alpha) were integrated into the logistic regression model to construct a predictive model. The predictive accuracy of the model was evaluated in these 2 cohorts. The cytokine‐based model yielded decent performance in both the screening (C‐statistic: 0.87, Brier 0.10) and validation cohorts (C‐statistic: 0.86, Brier 0.11). Decision curve analysis revealed that the cytokine‐based model had a superior net benefit over both the clinical factor‐based model and the established plasma biomarker‐based model for predicting severe acute kidney injury. In addition, elevated concentrations of each cytokine were associated with longer mechanical ventilation times, intensive care unit stays, and hospital stays. They strongly predicted the risk of composite events (defined as treatment with renal replacement therapy and/or in‐hospital death) (OR of the fourth versus the first quartile [95% CI]: interferon‐γ, 27.78 [3.61–213.84], interleukin‐16, 38.07 [4.98–291.07], and MIP‐1α, 9.13 [2.84–29.33]). Conclusions: Our study developed and validated a promising blood cytokine‐based model for predicting severe acute kidney injury after cardiac surgery and identified prognostic biomarkers for assisting in outcome risk stratification.
Novel avian influenza viruses (AIVs) of H7N9, H10N8, and H5N6 are currently circulating in China’s poultry flocks, occasionally infecting human and other mammals. Human infected AIV H5N6 in China during 2014–2015 is believed to be a triple reassortant originated from H6N6 and two clades of H5 viruses. The current report suggests that its reassortment history is more complicated. Genomes of human infected isolates of AIV H5N6 were searched from the NCBI Influenza Virus Sequence Database and the Global Initiative on Sharing Avian Influenza Data. Sequences shared high identities with each segment of their genomes were obtained through the Basic Local Alignment Search Tool. Alignments were done by mafft-7.037-win32 program; 8 large-scale and then 8 gradually converged phylogenetic trees were constructed by using MEGA5.1/5.2/6.0 Software. The events that each segment of the genomes of human infected AIV H5N6 isolates circulated in China had evolved into its current status might have happened before 2013, and so were they then reassorted into the epidemic AIV H5N6. A/Guangzhou/39715/2014(H5N6) and A/Sichuan/26221/2014(H5N6) had their six internal segments (PB2, PB1, PA, NP, NEP, and M) in common, and were reassorted from AIVs H5N1 in the same period and same region as that of HA, while A/Yunnan/0127/2015(H5N6) derived its six internal segments from AIV H9N2 that has been prevalent in Eastern China since 2008. AIV H5N6 isolates established from both human and poultry in China during 2014–2015 were heterogeneous; both AIVs H5N1 and H9N2 were involved in the reassortment of AIV H5N6 in China.