Importance: Heart injury can be easily induced by viral infection such as adenovirus and enterovirus. However, whether coronavirus disease 2019 (COVID-19) causes heart injury and hereby impacts mortality has not yet been fully evaluated. Objective: To explore whether heart injury occurs in COVID-19 on admission and hereby aggravates mortality later. Design, Setting, and Participants A single-center retrospective cohort study including 188 COVID-19 patients admitted from December 25, 2019 to January 27, 2020 in Wuhan Jinyintan Hospital, China; follow up was completed on February 11, 2020. Exposures: High levels of heart injury indicators on admission (hs-TNI; CK; CK-MB; LDH; α-HBDH). Main Outcomes and Measures: Mortality in hospital and days from admission to mortality (survival days). Results: Of 188 patients with COVID-19, the mean age was 51.9 years (standard deviation: 14.26; range: 21~83 years) and 119 (63.3%) were male. Increased hs-TnI levels on admission tended to occur in older patients and patients with comorbidity (especially hypertension). High hs-TnI on admission (≥ 6.126 pg/mL), even within the clinical normal range (0~28 pg/mL), already can be associated with higher mortality. High hs-TnI was associated with increased inflammatory levels (neutrophils, IL-6, CRP, and PCT) and decreased immune levels (lymphocytes, monocytes, and CD4+ and CD8+ T cells). CK was not associated with mortality. Increased CK-MB levels tended to occur in male patients and patients with current smoking. High CK-MB on admission was associated with higher mortality. High CK-MB was associated with increased inflammatory levels and decreased lymphocytes. Increased LDH and α-HBDH levels tended to occur in older patients and patients with hypertension. Both high LDH and α-HBDH on admission were associated with higher mortality. Both high LDH and α-HBDH were associated with increased inflammatory levels and decreased immune levels. hs-TNI level on admission was negatively correlated with survival days (r= -0.42, 95% CI= -0.64~-0.12, P=0.005). LDH level on admission was negatively correlated with survival days (r= -0.35, 95% CI= -0.59~-0.05, P=0.022). Conclusions and Relevance: Heart injury signs arise in COVID-19, especially in older patients, patients with hypertension and male patients with current smoking. COVID-19 virus might attack heart via inducing inflammatory storm. High levels of heart injury indicators on admission are associated with higher mortality and shorter survival days. COVID-19 patients with signs of heart injury on admission must be early identified and carefully managed by cardiologists, because COVID-19 is never just confined to respiratory injury.

The prevalence of pterygium in a Tibetan population at high altitude is significantly high, particularly in certain at-risk groups. The primary causative factors are related to ocular sun exposure, which are easily preventable. Public health schemes to address this serious health issue are urgently needed.

Much research work has been done for hospitalized COVID-19 patients, mainly in clinical characteristics. 4 However, few studies have reported the post-discharge follow-up status, especially the mental health status of COVID-19 survivors. Therefore, in this descriptive case series, we enrolled a large number of COVID-19 survivors in Wuhan, China. We aimed to report the post-discharge mental health status of these survivors and explore relevant influencing factors.This study was conducted in Wuhan Jinyintan Hospital. All patients were confirmedly diagnosed with COVID-19. 1 The flowchart is shown in Figure S1. Eventually, 370 COVID-19 survivors were included in this study. Verbal consent of follow-up was obtained in all the 370 survivors. Survivors' readmission status and the reasons were inquired. Postdischarge respiratory symptoms were inquired. Whether the survivors worried about COVID-19 recurrence was inquired. Whether the survivors worried about COVID-19 infection to others (family members) was inquired. Home quarantine lifestyles status was inquired. Anxiety was measured using The Generalized Anxiety Disorder Screener (GAD-7). Total score 0-4 refers to no anxiety; total score 5-21 refers to anxiety. 5 Depression was measured using Patient Health Questionnaire-9 (PHQ-9). Total score 0-4 refers to no depression; total score 5-27 refers to depression. 6 Statistical analysis was performed using SPSS (Version 24.0). Continuous variables were presented by mean ± standard deviation (SD) or median with inter quartiles (IQR). Categorical variables were presented by number with percentage. Student's t-test and Chi-square test were used as appropriate. P < .05 was statistically significant.Clinical data and post-discharge status were summarized in Table 1. The median time from discharge to follow-up wereThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

This study shows a high prevalence rate of dry eye syndrome in elderly Tibetans, representing an important health problem.

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Rationale Eosinophilic inflammation is related to the progression and outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Till now, few studies have focused on low EOS in AECOPD. Objective To reveal the clinical characteristics, therapeutic responses and prognosis of patients hospitalized of AECOPD with low EOS. Methods The electronic database of Zhongshan Hospital, Fudan University was used. Cohort 1 included 608 patients with hospitalized AECOPD. Study population 2 consisted of 166 patients with AECOPD admission at least twice. Impact of low EOS on NIMV treatment, length of hospital stays and 12-month AECOPD-related readmission were analyzed with multivariable logistic regression model. Thirty-five hospitalized AECOPD patients were prospectively recruited as cohort 3 to explore the association between EOS and other immune cells using Spearman correlation coefficient for ranked data. Results EOS level was suppressed on admission in AECOPD patients, and significantly improved after hospitalized treatment ( P < 0.05). For inflammatory markers, leucocytes, neutrophils and lactate dehydrogenase levels were higher, while lymphocytes, monocytes and interleukin-6 levels were lower in the low-EOS group than those in the non-low EOS group ( P < 0.05). Low EOS (EOS < 50 cells/μL) was an independent risk factor of NIMV use (OR = 1.86, 95% CI = 1.26 ~ 2.73). The EOS percentage was positively correlated with the T cell percentage ( r = 0.46, P < 0.05) and negatively correlated with the natural killer cell percentage ( r = −0.39, P < 0.05). The patients with low EOS had lower level of CD4 + T cell ( P < 0.05) than that of patients with non-low EOS. Conclusion Low EOS might be a stable phenotype in patients with hospitalized AECOPD and could be used to inform NIMV management, hyperinflammatory state and impaired immunity situation.

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