The objective of this study is to expound the CT features of COVID-19 patients whose throat swab samples were negative for two consecutive nucleic acid tests after treatment. We retrospectively reviewed 46 COVID-19 patients with two consecutive negative RT-PCR tests after treatment. The cases were divided into moderate group and severe/critical group according to disease severity. Clinical and CT scanning data were collected. CT signs of pulmonary lesions and the score of lung involvement were expounded. Thirty-nine moderate cases and seven severe/critical cases were included. Residual pulmonary lesions were visible in CT images. Moderate patients showed peripheral lesions while severe/critical cases exhibited both central and peripheral lesions with all lobes involvement. Mixed ground glass opacity (GGO) and pulmonary consolidation were noted. A larger proportion of severe patients showed reticular pulmonary interstitium thickening. Air bronchogram, pleural effusion, vascular enlargement, bronchial wall thickening, bronchiectasis, pleural thickening and pleural adhesion were more frequently observed in severe/critical group. The severe/critical group showed higher CT score. Pulmonary lesions persisted even after twice consecutive negative nucleic acid tests. We strongly recommended regular follow-up of CT scans after nucleic acid tests conversion. Evaluation of complete remission should base on chest CT. Coronavirus Disease-2019 (COVID-19) is an acute infectious disease mainly involving the respiratory system 1. The highly contagious disease is caused by a novel coronavirus currently termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1. So far to April 9, 2020, 1,479,748 cases of COVID-19 patients and 87,444 deaths are reported. It is a huge strike to human health and draws much attention from countries all over the world. At present, etiological examinations, including reverse transcription-polymerase chain reaction (RT-PCR) and gene sequencing of sputum, throat swab and lower respiratory tract secretion, are the gold standard for diagnosis of COVID-19 2. Nucleic acid tests are widely recognized as the primary criteria of discharge after treatment. However, it remains unclear whether damage to the lung have been completely restored when the nucleic acid tests are negative after treatment. Explanation of this issue is essential for determining the timing of treatment termination and isolation release. Chest computed tomography (CT) provides us a powerful noninvasive mean for the diagnosis and monitoring for COVID-19. Ground glass opacity (GGO) and consolidative opacity involving bilateral and peripheral lung were CT hallmarks of COVID-19 pneumonia 3-8. It has been reported that CT manifestations vary with the course of disease 8. However, post-treatment patterns of CT images after nucleic acid tests conversion have not yet been described, which are paramount for not only understanding the pathophysiology but also developing management strategies. In the present study, we assessed chest CT images...

Purpose: The objective of this study is to expound the CT features of COVID-19 patients whose nucleic acid tests converted to negative after treatment.Materials and Methods: We retrospectively reviewed 46 COVID-19 patients with two consecutive negative RT-PCR tests after treatment. The cases were divided into moderate group and severe/critical group according to disease severity. Clinical and CT scanning data were collected. CT signs of pulmonary lesions and the score of long involvement were expounded.Results: 39 moderate cases and 7 severe/critical cases were included. All moderate patients showed peripheral lesions while severe/critical cases exhibited both central and peripheral lesions with all lobes involvement. Ground glass opacity (GGO) and mixed GGO were observed. Aberrant pulmonary interstitium manifested as reticular and thin linear pattern. Thickened blood vessels and pleural thickening were found. Pulmonary fibrosis, annular thickening of the bronchial wall, bronchiectasis, air bronchogram and small amount of bilateral pleural effusion were observed in severe/critical patients. The severe/critical group showed higher CT score of involvement.Conclusions: Pulmonary lesions persisted even after twice consecutive nucleic acid tests converted to negative. We strongly recommended regular follow-up of CT scans after nucleic acid tests conversion. Evaluation of complete remission should base on chest CT.

Pulmonary fibrosis is a devastating disease, and the pathogenesis of this disease is not completely clear. Here, the medical records of 85 Covid-19 cases were collected, among which fibrosis and progression of fibrosis were analyzed in detail. Next, data independent acquisition (DIA) quantification proteomics and untargeted metabolomics were used to screen disease-related signaling pathways through clustering and enrichment analysis of the differential expression of proteins and metabolites. The main imaging features were lesions located in the bilateral lower lobes and involvement in five lobes. The closed association pathways were FcγR-mediated phagocytosis, PPAR signaling, TRP-inflammatory pathways, and the urea cycle. Our results provide evidence for the detection of serum biomarkers and targeted therapy in patients with Covid-19.

GLP-1 agonists have become increasingly interesting as a new Parkinson’s disease (PD) clinical treatment strategy. Additional preclinical studies are important to validate this approach and define the disease stage when they are most effective. We hence characterized the efficacy of PT320, a sustained release formulation of the long acting GLP-1 agonist, exenatide, in a progressive PD (MitoPark) mouse model. A clinically translatable biweekly PT320 dose was administered starting at 5 weeks of age and longitudinally evaluated to 24 weeks, and multiple behavioral/cellular parameters were measured. PT320 significantly improved spontaneous locomotor activity and rearing in MitoPark PD mice. “Motivated” behavior also improved, evaluated by accelerating rotarod performance. Behavioral improvement was correlated with enhanced cellular and molecular indices of dopamine (DA) midbrain function. Fast scan cyclic voltammetry demonstrated protection of striatal and nucleus accumbens DA release and reuptake in PT320 treated MitoPark mice. Positron emission tomography showed protection of striatal DA fibers and tyrosine hydroxylase protein expression was augmented by PT320 administration. Early PT320 treatment may hence provide an important neuroprotective therapeutic strategy in PD.

Pulmonary fibrosis is a devastating disease, and the pathogenesis of this disease is not completely clear. Here, the medical records of 85 Covid-19 cases were collected, among which fibrosis and progression of fibrosis were analyzed in detail. Next, data independent acquisition (DIA) quantification proteomics and untargeted metabolomics were used to screen disease-related signaling pathways through clustering and enrichment analysis of the differential expression of proteins and metabolites. The main imaging features were lesions located in the bilateral lower lobes and involvement in five lobes. The closed association pathways were FcγR-mediated phagocytosis, PPAR signaling, TRP-inflammatory pathways, and the urea cycle. Our results provide evidence for the detection of serum biomarkers and targeted therapy in patients with Covid-19.

Background: Early recognition of patients who are prone to develop severe or critical COVID-19 pneumonia may improve its management and modify its outcome by better treatment regimens.Objective: To investigate Computed Tomography (CT)-based early markers of COVID-19 progression. Material and methods: Thirty-two COVID-19 patients were retrospectively enrolled, including 23 moderate cases who remained moderate until being cured and discharged from hospital, and 9 progressive cases who started with moderate pneumonia and later progressed to severe or critical pneumonia. Clinical and CT data in the early course of disease were reviewed and compared. The association between early features and progression of COVID-19 were analyzed. Results: The multivariate logistic regression analysis revealed that the progression of COVID-19 were significantly associated with older age and higher CT score of the right lower lobe in the early CT images. After adjustment for relevant covariates, the relationship between CT score of the right lower lobe and COVID-19 progression persisted (odds ratio 19.28, 95% confidence interval 1.07 - 348.34).Conclusions: Higher CT Score of the right lower lobe in early images and older age appeared to be promising biomarkers for early prediction of COVID-19 prognosis. Extensive involvement of the right lower lobe at the early stage may suggest a high risk of progression.