With the dramatic increase of confirmed cases of coronavirus disease (COVID-19) and the increasing death toll in China, timely and effective management of severely and critically ill patients appears to be particularly important. Previous studies on COVID-19 mainly described the general features of patients (1). However, little attention has been paid to clinical characteristics and outcomes of intensive care patients, data on whom are scarce but are of paramount importance to reduce mortality. Some of the results of these studies have been previously reported in the form of an abstract (2). Methods This study enrolled 344 severely and critically ill patients (intensive care patients) who were diagnosed with COVID-19 according to World Health Organization interim guidance by positive result of an RT-PCR assay of nasal and/or throat-swab specimens, and were hospitalized in eight intensive care wards (totaling approximately 330 beds) in Tongji hospital from January 25, 2020, through February 25, 2020. The intensive care wards staff intensivists and specialist nurses in intensive care and were equipped with continuous vital signs monitoring and respiratory support, including noninvasive and invasive ventilators, high-flow nasal cannula (HFNC) oxygen therapy, and extracorporeal membrane oxygenation. We collected demographic, clinical, laboratory, and radiologic findings, and treatment and outcome data from electronic medical records. The illness severity of COVID-19 was defined according to the Chinese management guideline for COVID-19 (version 6.0) (3). Cytokines were measured by a chemiluminescent immunometric assay (Immulite 1000; Diagnostic Products). Acute respiratory distress syndrome (ARDS) was diagnosed according to the Berlin definition, and septic shock was defined according to the 2016 Third International Consensus definition (4, 5). Disseminated intravascular coagulation was

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the third most common coronavirus that causes large-scale infections worldwide. The correlations between pathogen susceptibility and blood type distribution have attracted attention decades ago. The current retrospective study aimed to examine the correlation between blood type distribution and SARS-CoV-2 infection, progression, and prognosis in patients with coronavirus disease 2019 . With 265 patients from multiple medical centers and two established cohorts, we found that the blood type A population was more sensitive to SARS-CoV-2. Moreover, the blood type distribution was not relevant to acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and mortality in COVID-19 patients. These findings are indicative of coping with the great threat since it probed the relationship between blood types and ARDS, AKI, and mortality, in addition to susceptibility in COVID-19 patients.

To investigate the feasibility of lung ultrasound in evaluating coronavirus disease 2019 and distinguish the sonographic features between COVID-19 and community-acquired pneumonia (CAP), a total of 12 COVID-19 patients and 20 CAP patients were selected and underwent lung ultrasound. The modified Buda scoring system for interstitial lung disease was used to evaluate the severity and treatment effect of COVID-19 on ultrasonography. The differences between modified lung ultrasound (MLUS) score and high-resolution computed tomography (HRCT) Warrick score were analyzed to evaluate their correlation. COVID-19 showed the following sonographic features: thickening (12/12), blurred (9/12), discontinuous (6/12) pleural line; rocket sign (4/12), partially diffused B-line (12/12), completely diffused B-line (10/12), waterfall sign (4/12); C-line sign (5/12); pleural effusion (1/12) and pulmonary balloon (Am line, 1/12). The last two features were rarely seen. Differences of ultrasonic features, including lesion range, lung signs and pneumonia-related complications, between COVID-19 and CAP were statistically significant (p ˂ 0.05 or 0.001). MLUS scores (p = 0.006) and HRCT Warrick scores (p = 0.015) increased as the severity of COVID-19 increased. The differences between moderate (29.00 [25.75À37.50]) and severe (43.00 [38.75À47.25]) (p = 0.022) or between moderate and critical (47.50 [44.25À50.00]) (p = 0.002) type COVID-19 were statistically significant, compared with those between severe and critical types. Correlation between MLUS scores and HRCT Warrick scores was positive (r = 0.54, p = 0.048). MLUS scores (Z = 2.61, p = 0.009) and HRCT Warrick scores (Z = 2.63, p = 0.009) of five severe or critical COVID-19 patients significantly decreased as their conditions improved after treatment. The differences of sonographic features between COVID-19 and CAP patients were notable. The MLUS scoring system could be used to evaluate the severity and treatment effect of COVID-19.

Background: China is facing a critical challenge of rapid and widespread human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) increase. Rural-to-urban migration plays a crucial role in shifting the HIV/sexual transmitted infection (STI) epidemic. The purpose of this study was to assess the prevalence of sexual behaviors and the correlates among the early adolescents of migrant workers in China.

Background and aims: Currently, there are no definitive therapies for coronavirus disease 2019 (COVID-19). Gut microbial dysbiosis has been proved to be associated with COVID-19 severity and probiotics is an adjunctive therapy for COIVD-19. However, the potential benefit of probiotics in COVID-19 has not been studied. We aimed to assess the relationship of probiotics use with clinical outcomes in patients with COVID-19. Methods: We conducted a propensity-score matched retrospective cohort study of adult patients with COVID-19. Eligible patients received either probiotics plus standard care (probiotics group) or standard care alone (non-probiotics group). The primary outcome was the clinical improvement rate, which was compared among propensity-score matched groups and in the unmatched cohort. Secondary outcomes included the duration of viral shedding, fever, and hospital stay. Results: Among the propensity-score matched groups, probiotics use was related to clinical improvement rates (log-rank p = 0.028). This relationship was driven primarily by a shorter (days) time to clinical improvement [difference, −3 (−4 to −1), p = 0.022], reduction in duration of fever [−1.0 (−2.0 to 0.0), p = 0.025], viral shedding [−3 (−6 to −1), p < 0.001], and hospital stay [−3 (−5 to −1), p = 0.009]. Using the Cox model with time-varying exposure, use of probiotics remained independently related to better clinical improvement rate in the unmatched cohort. Conclusion: Our study suggested that probiotics use was related to improved clinical outcomes in patients with COVID-19. Further studies are required to validate the effect of probiotics in combating the COVID-19 pandemic.

BackgroundGiven the higher prevalence of risky sexual behaviors and substance use, adolescents and youths are at risk for HIV. Despite its importance, however, to the best of our knowledge, there are only a few researches on risky behaviors in Chinese adolescents/youths. The present study aimed to describe the prevalence of sexual and substance use behaviors among a Chinese sample of senior high school students. And more specifically, the associations of socio-demographic factors and substance use with risky sexual behaviors were examined in the sample.MethodsA cross-sectional study was conducted in 10 senior high schools. A total of 2668 senior high school students aged 15.17 to 23.42 years participated in the survey. A self-administrated questionnaire was used to collect information on sexual and substance use behaviors.ResultsThe percentages of students who ever had sexual intercourse in lifetime or during last three months were 7.0% and 5.1%, respectively. Among the participants with sexual intercourse during last three months, 42.1% ever had unprotected sexual intercourse and 49.4% had intercourse with two or more partners. Multivariate logistic regression analyses showed that cigarette smoke and illicit drug use were related to unprotected sexual intercourse (defined as “sexual intercourse without condom use”) and younger age of first sexual intercourse was related to multiple-partner sexual intercourse.ConclusionsHIV/sexual transmitted infection (STI) health education and prevention are necessary among the Chinese adolescents, particularly among those adolescents with experience of sexual intercourse and/or substance use, which has a long-term beneficial to the control of HIV/STI in China.

No abstract

Objective: To assess the association between soyfood intake and risk of glycosuria. Design and methods: A cross-sectional study was conducted among participants of the Shanghai Women's Health Study, a population-based cohort study of women aged 40-70 y. Information on usual intake of soyfoods was obtained at baseline survey through an in-person interview using a validated food-frequency questionnaire. Included in this study were 39,385 cohort members screened for diabetes at the baseline survey and free of previously diagnosed diabetes, cardiovascular diseases, kidney diseases, and cancer. There were 323 women who tested positive for urine glucose. Odds ratios (ORs) and 95% confidence intervals (CIs) were employed to measure the association between soyfood intake and glycosuria using unconditional logistic regression. Setting: Urban communities of Shanghai, China. Results: Overall, soyfood intake was not related to the risk of glycosuria. Among postmenopausal women, however, intake of tofu and other soy products was inversely associated with risk of glycosuria after adjustment for potential confounders. The ORs across quintiles of intake were 1.0, 0.75 (95% CI ¼ 0.47-1.20), 0.79 (95% CI ¼ 0.51-1.25), 0.53 (95% CI ¼ 0.32-0.88), and 0.51 (95% CI ¼ 0.26-0.98; P for trend ¼ 0.05). Further analyses showed that the inverse association was primarily confined to postmenopausal women with a body mass index (BMI) of o25 kg/m 2 . The adjusted OR comparing the extreme quintiles was 0.36 (95% CI ¼ 0.13-0.97; P for trend ¼ 0.004). Conclusions: Soyfoods may play a role in the development of glycosuria, an important indicator of diabetes, among postmenopausal women with a low BMI.