This retrospective study was designed to explore whether neutrophil to lymphocyte ratio (NLR) is a prognostic factor in patients with coronavirus disease 2019 (COVID-19). A cohort of patients with COVID-19 admitted to the Tongren Hospital of Wuhan University from 11 January 2020 to 3 March 2020 was retrospectively analyzed. Patients with hematologic malignancy were excluded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. NLR values were measured at the time of admission. The primary outcome was all-cause in-hospital mortality. A multivariate logistic analysis was performed. A total of 1004 patients with COVID-19 were included in this study. The mortality rate was 4.0% (40 cases). The median age of nonsurvivors (68 years) was significantly older than survivors (62 years). Male sex was more predominant in nonsurvival group (27; 67.5%) than in the survival group (466; 48.3%). NLR value of nonsurvival group (median: 49.06; interquartile range [IQR]: 25.71-69.70) was higher than that of survival group (median: 4.11; IQR: 2.44-8.12; P < .001). In multivariate logistic regression analysis, after adjusting for confounding factors, NLR more than 11.75 was significantly correlated with all-cause in-hospital mortality (odds ratio = 44.351; 95% Xisheng Yan and Fen Li contributed equally to this work.

Very limited information is available concerning the epidemiology of T. gondii infection in pregnant women in eastern China. Therefore, a case-control study was conducted to estimate the seroprevalence of toxoplasmosis in this population group and to identify risk factors and possible routes of contamination. Serum samples were collected from 965 pregnant women and 965 age-matched nonpregnant control subjects in Qingdao and Weihai between October 2011 and July 2013. These were screened with enzyme linked immunoassays for the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies. 147 (15.2%) pregnant women and 167 (17.3%) control subjects were positive for anti-T. gondii IgG antibodies, while 28 (2.9%) pregnant women and 37 (3.8%) controls were positive for anti-T. gondii IgM antibodies (P = 0.256). There was no significant difference between pregnant women and nonpregnant controls with regard to the seroprevalence of either anti-T. gondii IgG or IgM antibodies. Multivariate analysis showed that T. gondii infection was associated with location, cats in home, contact with cats and dogs, and exposure to soil. The results indicated that the seroprevalence of T. gondii infection in pregnant women is high compared to most other regions of China and other East Asian countries with similar climatic conditions.

Long-term exposure to fine particulate matter (PM 2.5 ) is associated with kidney dysfunction. However, few studies have investigated acute effects of PM 2.5 elemental constituents on renal function. We evaluated associations between personal PM 2.5 and its elemental constituents and kidney function, assessed by an estimated glomerular filtration rate (eGFR) in Biomarkers of Air Pollutants Exposure in the Chinese aged 60−69 study. Seventy one older individuals were visited monthly between September 2018 and January 2019. Each participant wore a PM 2.5 monitor for 72 h, responded to a questionnaire, and underwent a physical examination with blood sampling. Linear mixed-effect models were used to estimate associations between personal PM 2.5 elemental constituents and eGFR. We found that significant changes in eGFR from −1.69% [95% confidence interval (CI): −3.34%, −0.01%] to −3.27% (95% CI: −5.04%, −1.47%) were associated with interquartile range (IQR) increases in individual PM 2.5 exposures at various lag periods (7−12, 13−24, 0−24, 25−48, and 49−72 h). An IQR increase in 72 h moving averages of copper, manganese, and titanium in personal PM 2.5 corresponded to −2.34% (95% CI: −3.67%, −0.99%) to −4.56% (95% CI: −7.04%, −2.00%) changes in eGFR. Personal PM 2.5 and some of its elemental constituents are inversely associated with eGFR in older individuals.

Liu et al. Rapid advice guidelines for management of children with COVID-19

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Background: Insulin resistance (IR) affects the development of type 2 diabetes mellitus (T2DM), which is also influenced by accumulated fine particle air pollution [particulate matter (PM) with aerodynamic diameter of ( )] exposure. Previous experimental and epidemiological studies have proposed several potential mechanisms by which contributes to IR/T2DM, including inflammation imbalance, oxidative stress, and endothelial dysfunction. Recent evidence suggests that the imbalance of the gut microbiota affects the metabolic process and may precede IR. However, the underlying mechanisms of , gut microbiota, and metabolic diseases are unclear. Objectives: We investigated the associations between personal exposure to and fasting blood glucose and insulin levels, the IR index, and other related biomarkers. We also explored the potential underlying mechanisms (systemic inflammation and sphingolipid metabolism) between and insulin resistance and the mediating effects between and sphingolipid metabolism. Methods: We recruited 76 healthy seniors to participate in a repeated-measures panel study and conducted clinical examinations every month from September 2018 to January 2019. Linear mixed-effects (LME) models were used to analyze the associations between and health data (e.g., functional factors, the IR index, inflammation and other IR-related biomarkers, metabolites, and gut microbiota). We also performed mediation analyses to evaluate the effects of mediators (gut microbiota) on the associations between exposures ( ) and featured metabolism outcomes. Results: Our prospective panel study illustrated that exposure to was associated with an increased risk of higher IR index and functional biomarkers, and our study provided mechanistic evidence suggesting that exposure may contribute to systemic inflammation and altered sphingolipid metabolism. Discussion: Our findings demonstrated that was associated with the genera of the gut microbiota, which partially mediated the association between and sphingolipid metabolism. These findings may extend our current understanding of the pathways of and IR. https://doi.org/10.1289/EHP9688

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