Frontiers in Medicine最新文献

{"title":"The association between the body roundness index and the risk of chronic kidney disease in US adults.","authors":"Jiaying Zhang, Xiaofeng Yu","doi":"10.3389/fmed.2024.1495935","DOIUrl":"10.3389/fmed.2024.1495935","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to systematically assess whether the level of body roundness index (BRI) is associated with the risk of developing chronic kidney disease (CKD) in US adults.</p><p><strong>Methods: </strong>The studied data was extracted from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. A total of 29,062 participants aged ≥20 years with complete information about BRI and CKD were included in this study. Logistic regression analysis, multivariate linear regression analysis, restricted cubic spline (RCS) plots curve, stratified analysis and receiver operating characteristic (ROC) curve were performed to investigate the association between BRI and CKD.</p><p><strong>Results: </strong>A total of 29,062 patients were included, involving 4,623 individuals with CKD and 24,439 individuals without CKD. A higher BRI level was substantially related to an increased prevalence of CKD in US adults. After adjusting for confounding variables, the BRI in the fourth quartile was correlated to a higher CKD prevalence (OR: 1.36; 95% CI: 1.10-1.70) compared to the lowest quartile. After adjusting for confounding variables, the BRI in the fourth quartile was correlated to a higher CKD prevalence (OR: 1.36; 95% CI: 1.10-1.70) compared to the lowest quartile. However, in the subgroup analysis stratified by race and body mass index (BMI), no significant associations between BRI and CKD were observed among Mexican participants (OR: 1.10; 95% CI: 0.98-1.23) and those with underweight or normal weight (OR: 0.95; 95% CI: 0.81-1.05). Moreover, a non-linear relationship was found between BRI and the prevalence of CKD. In ROC analysis, BRI demonstrated higher discriminating for CKD (area under the curve: 0.6247; 95% CI: 0.6161-0.6333; optimal cutoff value: 5.161) compared with other indices.</p><p><strong>Conclusion: </strong>In summary, BRI was independently associated with a higher prevalence of CKD in overweight and obese US adults, excluding Mexican. This may be an important therapeutic target and predictor of CKD. Physicians should advise patients with high BRI scores, especially overweight and obese patients, to embrace healthy lifestyle changes, such as maintaining a balanced diet and engaging in regular physical activity. These changes can help them control their body weight and reduce abdominal fat, ultimately lowering the risk of CKD.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1495935"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of ChatGPT in nursing: a bibliometric and visualized analysis.","authors":"Peng Wang, Qian Zhang, Wenyu Zhang, Jing Sun","doi":"10.3389/fmed.2024.1521712","DOIUrl":"10.3389/fmed.2024.1521712","url":null,"abstract":"<p><strong>Objective: </strong>With the development of ChatGPT, the number of studies within the nursing field has increased. The sophisticated language capabilities of ChatGPT, coupled with its exceptional precision, offer significant support within the nursing field, which includes clinical nursing, nursing education, and the clinical decision-making process. Preliminary findings suggest positive outcomes, underscoring its potential as a valuable resource for enhancing clinical care. However, a comprehensive analysis of this domain is lacking, and the application of bibliometric methods remains rare. This study aims to describe and predict the developmental trajectory of the discipline, identify research hotspots and trends, and provide a comprehensive framework for the integration of ChatGPT in nursing.</p><p><strong>Methods: </strong>Following the development of a search strategy in collaboration with librarians, the implementation of this strategy occurred in the Web of Science Core Collection (WoSCC) on June 30, 2024. For bibliometric and visual analyses-including evaluations of sources, institutions, countries, author collaboration networks, and keywords-Bibliometrix (version 4.4.2) and CiteSpace (version 6.2.R2 Basic) were employed.</p><p><strong>Results: </strong>A total of 81 articles published by 67 authors were retrieved from the Web of Science Core Collection database, covering the period of June 30, 2024. The number of published studies has exhibited an increasing trend. The \"European Journal of Cardiovascular Nursing\" emerged as the most productive journals, while the USA, the UK, and China were identified as the leading countries in terms of publication output. The top 10 keywords identified in this study include artificial intelligence, nursing education, large language models, ChatGPT, natural language processing, generative artificial intelligence, care, nursing practice, clinical decision-making, and deep learning.</p><p><strong>Conclusion: </strong>ChatGPT is an emerging tool in the nursing field, currently in the foundational research phase. While there is significant international collaboration, cooperation among author groups remains somewhat limited. Studies focusing on ChatGPT in nursing primarily concentrate on two key themes: (1) the deep learning of ChatGPT in nursing and (2) the feasibility of its application. It is essential for nurses across various specialties to collaborate in exploring the diverse applications of ChatGPT within their domains, thereby fostering the ongoing development and enhancement of this technology.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1521712"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the shared genes between systemic sclerosis and lung cancer.","authors":"Pengfei Pan, Xin Liu, Yun Wang, Huixuan Wang, Cheng Xu, Junhui Lu","doi":"10.3389/fmed.2024.1431642","DOIUrl":"10.3389/fmed.2024.1431642","url":null,"abstract":"<p><p>The risk of lung cancer is significantly increased in patients with systemic sclerosis (SSc), yet the specific genes underlying this association remain unexplored. Our study aims to identify genes shared by SSc and lung cancer. We identified differentially expressed genes (DEGs) from SSc and lung adenocarcinoma (LUAD) datasets (SSc: GSE95065, LUAD: GSE136043) in the GEO database. We found shared genes by intersecting top genes in protein-protein interaction networks by the STRING database. The area under the ROC curve (AUC) was calculated for each shared gene in validation datasets (SSc: GSE231692; LUAD: GSE43458), identifying PRKG2 as the core shared gene. We used the UALCAN platform to assess PRKG2 expression in LUAD patients at various stages and lymph node metastasis states, and compared disease-free survival (DFS) between low and high PRKG2 expression LUAD groups. PRKG2 was overexpressed in A549 cells to study its impact on lung cancer cell proliferation and invasion <i>in vitro</i>. We identified seven shared genes (SCN7A, AGTR1, WIF1, PRKG2, LTF, AQP4, COL10A1), with the AUC for PRKG2 exceeding 0.93 in both diseases (SSc AUC = 0.973; LUAD AUC = 0.939). The PRKG2 expression levels of LUAD patients with different clinical stages and lymph node metastasis states were consistently lower than those observed in normal individuals. The DFS of LUAD patients in the high PRKG2 expression group was higher than that in the low expression group (<i>p</i> = 0.028). <i>In vitro</i> experiments confirmed elevated PRKG2 expression inhibits the proliferation and invasion of lung cancer cells. PRKG2 is one of the genes shared by SSc and lung cancer, affecting the proliferation and invasion of lung cancer cells.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1431642"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of post-COVID mortality risk in cases classified as severe acute respiratory syndrome in Brazil: a longitudinal study for medium and long term.","authors":"Nádia Cristina Pinheiro Rodrigues, Mônica Kramer de Noronha Andrade","doi":"10.3389/fmed.2024.1495428","DOIUrl":"10.3389/fmed.2024.1495428","url":null,"abstract":"<p><strong>Background: </strong>There are few studies in the literature evaluating post-COVID mortality in Brazil, along medium and long term, especially in those who presented severe clinical disease.</p><p><strong>Objective: </strong>This study aims to investigate the factors associated with post-COVID mortality of severe acute respiratory syndrome (SARS) cases from 2020 to 2023 in Brazil, along medium and long term.</p><p><strong>Methods: </strong>Retrospective cohort study using notification data of SARS classified as COVID-19 from the Brazilian National Information System, \"Sistema de Vigilância Epidemiológica (SIVEP),\" during the period 2020 to 2023. Data included demographics, comorbidities, vaccination status, number of COVID-19 vaccine doses, city of residence, and survival outcomes. Classic Cox, Cox mixed effects, and Cox fragility models were used to assess medium and long-term risks of dying post-COVID.</p><p><strong>Results: </strong>In the medium and long-term periods studied, 5,157 deaths were recorded out of 15,147 reported SARS/COVID-19 cases. Of these deaths, 91.5% (<i>N</i> = 4,720) occurred within the first year, while 8,5% (N = 437) after the first year. People without formal education, the older adult, had higher percentages of deaths in both periods. In the medium-term post-COVID period, the risk of death was reduced by 8% for those who had been vaccinated while in the long-term post-COVID period, the risk of death almost doubled for those who had been vaccinated. While in the medium term, there was a reduction in mortality risk for those who took two or three doses, in the long term the risk of death was greater for those who took one or two doses.</p><p><strong>Conclusion: </strong>The protective effect of COVID-19 immunization was observed up to one year after the first symptoms. After one year, the effect was reversed, showing an increased risk of death for those vaccinated. These results highlight the need for further research to elucidate the factors that contribute to these findings.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1495428"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between waist-to-height ratio and osteoporosis in the National Health and Nutrition Examination Survey: a cross-sectional study.","authors":"Hailong Li, Jianfeng Qiu, Zhe Gao, Chun Li, Jianjun Chu","doi":"10.3389/fmed.2024.1486611","DOIUrl":"10.3389/fmed.2024.1486611","url":null,"abstract":"<p><strong>Background: </strong>The link between waist-to-height ratio (WHtR) and osteoporosis (OP) remains a contentious issue in the field of medical research. Currently, the available evidence on this association is deemed insufficient. This topic has garnered significant attention and is a focal point of ongoing investigations.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted, involving 5,746 participants from the National Health and Nutrition Examination Survey. Data on various demographic and clinical parameters, including age, gender, race, poverty income ratio, educational level, smoking status, drinking status, cardiovascular disease, hypertension, diabetes mellitus, hemoglobin A1c, alanine transaminase, aspartate transaminase, serum total bilirubin, serum creatinine, uric acid, blood urea nitrogen, serum sodium, serum phosphorus, total calcium, serum potassium, and serum iron, were collected from all participants. The main analytical methods utilized in this study were multivariable logistic regression, restricted cubic splines, and threshold effect analysis to investigate the association between WHtR and OP.</p><p><strong>Results: </strong>A total of 5,746 elderly participants were enrolled, with a median age of 69.3 years. Compared with individuals with lower WHtR Q1 (≤0.36 to ≤0.56), the adjusted OR values for WHtR and OP in Q2 (<0.56 to ≤0.61), Q3 (<0.61 to ≤0.66), and Q4 (<0.66 to ≤ 0.94) were 0.63 (95% CI: 0.47-0.85, <i>p</i> = 0.003), 0.53 (95% CI: 0.37-0.76, <i>p</i> < 0.001), and 0.49 (95% CI: 0.35-0.68, <i>p</i> < 0.001), respectively. The association between WHtR and OP exhibited an L-shaped curve (nonlinear, <i>p</i> = 0.008) with an inflection point of roughly 0.57. The OR for the presence of OP was 0.50 (95% CI: 0.31-0.82, <i>p</i> = 0.007) in participants with WHtR <0.57. There was no association between WHtR and OP in participants with WHtR ≥0.57.</p><p><strong>Conclusion: </strong>The association between WHtR and OP showed an L-shaped curve, with an inflection point at around 0.57.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1486611"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: X-linked retinoschisis: mechanisms and therapies.","authors":"Alina V Dumitrescu, Mary Elizabeth Hartnett, Arlene V Drack","doi":"10.3389/fmed.2024.1523215","DOIUrl":"10.3389/fmed.2024.1523215","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1523215"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11690298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melanoma toolkit for early detection for primary care clinicians: a 1-year follow-up on outcomes.","authors":"Kyra Diehl, Elizabeth Stoos, Alyssa Becker, Victoria E Orfaly, Jacob Nelson, Jordan Gillespie, Justin Ng, Tayler Tobey, Emile Latour, Joanna Ludzik, Elizabeth G Berry, Alan C Geller, Heidi Jacobe, Justin Leitenberger, Danielle McClanahan, Jessica Tran, Smriti Prasad, Stephanie Mengden-Koon, Kelly C Nelson, Ryan Petering, Alex Verdieck, Stephanie Savory, Emily H Smith, Susan Tofte, Martin A Weinstock, Kevin White, Oliver Wisco, Clara Curiel-Lewandrowski, Susan M Swetter, Alexander M Witkowski, Laura Ferris, Samantha Black, Rebecca Xu, Shuai Xu, Sancy Leachman","doi":"10.3389/fmed.2024.1500216","DOIUrl":"10.3389/fmed.2024.1500216","url":null,"abstract":"<p><strong>Introduction: </strong>Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope.</p><p><strong>Methods: </strong>We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.) that suits their learning style and time availability. Here we present the toolkit, the development and validation of the curriculum, and report on 1-year outcomes of a nested survey study. Because the goal of the program is to maximize participation by allowing PCPs to tailor their experience to their own needs and interests, the majority of participants did not complete every element of the program.</p><p><strong>Results: </strong>A total of 8,683 PCPs have accessed at least one element of the toolkit from 2019-2024. Participants completed a pre-survey, online training module, and post-survey that included self-reported screening behaviors, changes in confidence, and malignant and benign lesion categorization based on clinical images. A total of 139 pre-surveys and 92 post-surveys were completed, including 55 matched participants that completed both the pre- and post-training surveys. There were significant improvements in PCP confidence (<i>P</i> < 0.001) and malignant (<i>P</i> < 0.001) and benign image (<i>P</i> = 0.029) identification respectively.</p><p><strong>Discussion: </strong>PCPs may serve as a valuable aid in skin cancer screening efforts, but additional studies are needed to evaluate the impact of these curricula in clinical practice.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1500216"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semiquantitative 2-[¹⁸F]FDG PET/CT-based parameters role in lymphoma.","authors":"Domenico Albano, Marco Ravanelli, Rexhep Durmo, Annibale Versari, Angelina Filice, Alessio Rizzo, Manuela Racca, Daniele Antonio Pizzuto, Francesco Bertagna, Salvatore Annunziata","doi":"10.3389/fmed.2024.1515040","DOIUrl":"10.3389/fmed.2024.1515040","url":null,"abstract":"<p><p>2-deoxy-2-[¹⁸F]-fluoro-D-glucose (2-[¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT) plays a crucial role in the management of lymphoma in different settings, such as staging disease, assessing response to therapy, predicting prognosis, and planning RT. Beside visual analysis, several semiquantitative parameters were introduced to study lymphoma with promising results. These parameters can represent different disease characteristics, like body composition (such as sarcopenic index), dissemination of disease (Dmax), tumor burden (including metabolic tumor volume) and texture features. All these parameters showed promising results, especially in terms of prognosis (progression free survival and overall survival), but lack of standardization and shared methodology remains a big issue. Advances in PET-based biomarkers are on the horizon, yet their integration into clinical decision-making is currently hindered by methodological limitations that require resolution through confirmatory prospective validation in specific patient groups. This review highlights studies demonstrating the prognostic and predictive value of these semiquantitative parameters in lymphoma, while also discussing their potential applicability in clinical practice.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1515040"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between type 1 diabetes mellitus and the risk of immunoglobulin A nephropathy: a Mendelian randomization study.","authors":"Chun-Hua Zhang, Yang Shen, Su-Mei Zhao","doi":"10.3389/fmed.2024.1429369","DOIUrl":"10.3389/fmed.2024.1429369","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential causal relationship between type 1 diabetes mellitus (T1DM) and IgA nephropathy (IgAN) to deepen understanding of the association between these two conditions and to provide a scientific basis for future preventive and therapeutic strategies.</p><p><strong>Methods: </strong>This study employed Mendelian randomization (MR) analysis, using single nucleotide polymorphisms (SNPs) derived from genome-wide association studies (GWAS) as genetic instrumental variables (IVs), to assess the association between T1DM and IgAN. The analytical approaches included univariable and multivariable MR, along with sensitivity analyses such as Mendelian randomization-Egger (MR-Egger) and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO), to evaluate the impact of heterogeneity and pleiotropy.</p><p><strong>Results: </strong>Univariable MR analysis using the IVW method revealed an odds ratio (OR) of 1.009 [95% confidence interval (CI): 1.032-1.206] for the association between T1DM and IgAN. Adjusted results from multivariable MR analysis indicated a significant relationship between T1DM and increased risk of IgAN; for example, after adjusting for triglycerides (TG), the OR was 1.534 (CI: 1.213-1.543). After adjustment for HOMA-IR, the OR was 1.303 (CI: 1.149-1.198). Sensitivity analyses, including MR-Egger regression intercept testing (<i>p</i> = 0.476), suggested no pleiotropy, and MR-PRESSO did not detect any influence from outlier SNPs.</p><p><strong>Conclusion: </strong>The findings suggest that T1DM is a factor in increasing the risk of IgAN, enhancing our understanding of the potential relationship between T1DM and IgAN and providing possible biological pathways for future disease prevention and intervention.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1429369"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11690302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of patients with non-severe infections of different SARS-CoV-2 omicron subvariants in China.","authors":"Wenfang Yuan, Yongmei Liu, Haoting Zhan, Feng Wei, Qian Zhang, Huixia Gao, Huimin Yan, Tao Huang, Yongzhe Li, Erhei Dai","doi":"10.3389/fmed.2024.1511227","DOIUrl":"10.3389/fmed.2024.1511227","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the clinical characteristics of patients infected with different Omicron subvariants presenting non-severe disease, evaluate the safety and efficacy of Azvudine for treatment of COVID-19, in order to broaden understanding of Omicron subvariant infections.</p><p><strong>Method: </strong>A total of 244 individuals with Omicron subvariant (BA.2.76, <i>n</i> = 158; BA.5.1, <i>n</i> = 86) were included in the study. Demographic, clinical, and laboratory data of the study participants were collected and analyzed.</p><p><strong>Result: </strong>Patients infected with BA.5.1 exhibited a higher incidence of clinical symptoms like fatigue (25.58% vs. 2.53%, <i>p</i> < 0.001), headache/dizziness (12.79% vs. 4.43%, <i>p</i> = 0.017), nausea/vomiting (10.47% vs. 1.27%, <i>p</i> = 0.002), viral loads and inflammatory factors, and shorter virus shedding time than those with BA.2.76. There are 28.1% patients reporting mild adverse events following Azvudine administration. After treatment, the levels of anti-SARS-CoV-2 IgG/IgM, white blood cell, and lymphocyte obviously increased, while C-reactive protein, procalcitonin, and D-dimer reduced. Azvudine speeded up the time for virus clearance compared to control treatment (10 vs. 11 days, <i>p</i> = 0.032). Low lymphocyte counts (odd ratio (OR) = 0.607, <i>p</i> = 0.001) and anti-SARS-CoV-2 IgG titer (OR = 0.990, <i>p</i> = 0.028) were the independent risk factors for long nucleic acid negativization duration after infection. Patients with pneumonia were often accompanied by dyspnea, fatigue and high level of D-dimer. Dyspnea (OR = 10.176, <i>p</i> = 0.019) could be used to identify the occurrence of pneumonia in patients infected with Omicron.</p><p><strong>Conclusion: </strong>The study demonstrated the difference in clinical and laboratory parameters between patients infected with Omicron BA.2.76 and BA.5.1, as well as the safety and efficacy of Azvudine therapy. Our study linked patient manifestations to Omicron subvariant, treatment, and clinical outcomes, which is conducive to healthcare providers/policymakers to revise and implement appropriate countermeasures, facilitating appropriately advise for individuals with Omicron subvariant infections.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1511227"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}