Clinical characteristics and outcomes of patients with severe covid-19 with diabetes.
Identifieur interne : 000275 ( Main/Exploration ); précédent : 000274; suivant : 000276Clinical characteristics and outcomes of patients with severe covid-19 with diabetes.
Auteurs : Yongli Yan [République populaire de Chine] ; Yan Yang [République populaire de Chine] ; Fen Wang [République populaire de Chine] ; Huihui Ren [République populaire de Chine] ; Shujun Zhang [République populaire de Chine] ; Xiaoli Shi [République populaire de Chine] ; Xuefeng Yu [République populaire de Chine] ; Kun Dong [Oman]Source :
- BMJ open diabetes research & care [ 2052-4897 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Chine (MeSH), Diabète (virologie), Estimation de Kaplan-Meier (MeSH), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (mortalité), Inflammation (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (mortalité), Sujet âgé (MeSH), Ventilation artificielle (MeSH), Études rétrospectives (MeSH).
- MESH :
- mortalité : Infections à coronavirus, Pneumopathie virale.
- virologie : Diabète.
- Adulte, Adulte d'âge moyen, Betacoronavirus, Chine, Estimation de Kaplan-Meier, Facteurs de risque, Femelle, Humains, Infections à coronavirus, Inflammation, Mâle, Pandémies, Pneumopathie virale, Sujet âgé, Ventilation artificielle, Études rétrospectives.
- Wicri :
- geographic : République populaire de Chine.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), China (MeSH), Coronavirus Infections (complications), Coronavirus Infections (mortality), Diabetes Mellitus (virology), Female (MeSH), Humans (MeSH), Inflammation (MeSH), Kaplan-Meier Estimate (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (mortality), Respiration, Artificial (MeSH), Retrospective Studies (MeSH), Risk Factors (MeSH).
- MESH :
- geographic : China.
- complications : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- virology : Diabetes Mellitus.
- Adult, Aged, Betacoronavirus, Female, Humans, Inflammation, Kaplan-Meier Estimate, Male, Middle Aged, Pandemics, Respiration, Artificial, Retrospective Studies, Risk Factors.
Abstract
OBJECTIVE
This study explores the clinical characteristics of patients with diabetes with severe covid-19, and the association of diabetes with survival duration in patients with severe covid-19.
RESEARCH DESIGN AND METHODS
In this single-center, retrospective, observational study, the clinical and laboratory characteristics of 193 patients with severe covid-19 were collected. 48 patients with severe covid-19 had diabetes, and 145 patients (ie, the controls) did not have diabetes. A severe case was defined as including at least one of the following criteria: (1) Respiratory rate >30/min. (2) Oxygen saturation ≤93%. (3) PaO
RESULTS
Of 193 patients with severe covid-19, 48 (24.9%) had diabetes. Compared with patients with severe covid-19 without diabetes, patients with diabetes were older, susceptible to receiving mechanical ventilation and admission to ICU, and had higher mortality. In addition, patients with severe covid-19 with diabetes had higher levels of leukocyte count, neutrophil count, high-sensitivity C reaction protein, procalcitonin, ferritin, interleukin (IL) 2 receptor, IL-6, IL-8, tumor necrosis factor α, D-dimer, fibrinogen, lactic dehydrogenase and N-terminal pro-brain natriuretic peptide. Among patients with severe covid-19 with diabetes, more non-survivors were men (30 (76.9%)
CONCLUSION
The mortality rate in patients with severe covid-19 with diabetes is considerable. Diabetes may lead to an increase in the risk of death.
DOI: 10.1136/bmjdrc-2020-001343
PubMed: 32345579
PubMed Central: PMC7222577
Affiliations:
Links toward previous steps (curation, corpus...)
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Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei</wicri:regionArea><wicri:noRegion>Hubei</wicri:noRegion></affiliation></author><author><name sortKey="Ren, Huihui" sort="Ren, Huihui" uniqKey="Ren H" first="Huihui" last="Ren">Huihui Ren</name><affiliation wicri:level="1"><nlm:affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei</wicri:regionArea><wicri:noRegion>Hubei</wicri:noRegion></affiliation></author><author><name 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Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei</wicri:regionArea><wicri:noRegion>Hubei</wicri:noRegion></affiliation></author><author><name sortKey="Yu, Xuefeng" sort="Yu, Xuefeng" uniqKey="Yu X" first="Xuefeng" last="Yu">Xuefeng Yu</name><affiliation wicri:level="1"><nlm:affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei</wicri:regionArea><wicri:noRegion>Hubei</wicri:noRegion></affiliation></author><author><name sortKey="Dong, Kun" sort="Dong, Kun" uniqKey="Dong K" first="Kun" last="Dong">Kun Dong</name><affiliation wicri:level="1"><nlm:affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China kundong2019@hotmail.com.</nlm:affiliation><country wicri:rule="url">Oman</country><wicri:regionArea>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei</wicri:regionArea><wicri:noRegion>Hubei</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMJ open diabetes research & care</title><idno type="eISSN">2052-4897</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>China (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (mortality)</term><term>Diabetes Mellitus (virology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Inflammation (MeSH)</term><term>Kaplan-Meier Estimate (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (mortality)</term><term>Respiration, Artificial (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Risk Factors (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Chine (MeSH)</term><term>Diabète (virologie)</term><term>Estimation de Kaplan-Meier (MeSH)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (mortalité)</term><term>Inflammation (MeSH)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (mortalité)</term><term>Sujet âgé (MeSH)</term><term>Ventilation artificielle (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>China</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Diabète</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Diabetes Mellitus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Betacoronavirus</term><term>Female</term><term>Humans</term><term>Inflammation</term><term>Kaplan-Meier Estimate</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Respiration, Artificial</term><term>Retrospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Betacoronavirus</term><term>Chine</term><term>Estimation de Kaplan-Meier</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Infections à coronavirus</term><term>Inflammation</term><term>Mâle</term><term>Pandémies</term><term>Pneumopathie virale</term><term>Sujet âgé</term><term>Ventilation artificielle</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>République populaire de Chine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>This study explores the clinical characteristics of patients with diabetes with severe covid-19, and the association of diabetes with survival duration in patients with severe covid-19.</p></div><div type="abstract" xml:lang="en"><p><b>RESEARCH DESIGN AND METHODS</b></p><p>In this single-center, retrospective, observational study, the clinical and laboratory characteristics of 193 patients with severe covid-19 were collected. 48 patients with severe covid-19 had diabetes, and 145 patients (ie, the controls) did not have diabetes. A severe case was defined as including at least one of the following criteria: (1) Respiratory rate >30/min. (2) Oxygen saturation ≤93%. (3) PaO</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of 193 patients with severe covid-19, 48 (24.9%) had diabetes. Compared with patients with severe covid-19 without diabetes, patients with diabetes were older, susceptible to receiving mechanical ventilation and admission to ICU, and had higher mortality. In addition, patients with severe covid-19 with diabetes had higher levels of leukocyte count, neutrophil count, high-sensitivity C reaction protein, procalcitonin, ferritin, interleukin (IL) 2 receptor, IL-6, IL-8, tumor necrosis factor α, D-dimer, fibrinogen, lactic dehydrogenase and N-terminal pro-brain natriuretic peptide. Among patients with severe covid-19 with diabetes, more non-survivors were men (30 (76.9%) </p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The mortality rate in patients with severe covid-19 with diabetes is considerable. Diabetes may lead to an increase in the risk of death.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32345579</PMID><DateCompleted><Year>2020</Year><Month>04</Month><Day>30</Day></DateCompleted><DateRevised><Year>2020</Year><Month>05</Month><Day>16</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2052-4897</ISSN><JournalIssue CitedMedium="Internet"><Volume>8</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>04</Month></PubDate></JournalIssue><Title>BMJ open diabetes research & care</Title><ISOAbbreviation>BMJ Open Diabetes Res Care</ISOAbbreviation></Journal><ArticleTitle>Clinical characteristics and outcomes of patients with severe covid-19 with diabetes.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">e001343</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjdrc-2020-001343</ELocationID><Abstract><AbstractText Label="OBJECTIVE">This study explores the clinical characteristics of patients with diabetes with severe covid-19, and the association of diabetes with survival duration in patients with severe covid-19.</AbstractText><AbstractText Label="RESEARCH DESIGN AND METHODS">In this single-center, retrospective, observational study, the clinical and laboratory characteristics of 193 patients with severe covid-19 were collected. 48 patients with severe covid-19 had diabetes, and 145 patients (ie, the controls) did not have diabetes. A severe case was defined as including at least one of the following criteria: (1) Respiratory rate >30/min. (2) Oxygen saturation ≤93%. (3) PaO<sub>2</sub>/FiO<sub>2</sub>≤300 mm Hg. (4) Patients, either with shock or respiratory failure, requiring mechanical ventilation, or combined with other organ failure, requiring admission to intensive care unit (ICU).</AbstractText><AbstractText Label="RESULTS">Of 193 patients with severe covid-19, 48 (24.9%) had diabetes. Compared with patients with severe covid-19 without diabetes, patients with diabetes were older, susceptible to receiving mechanical ventilation and admission to ICU, and had higher mortality. In addition, patients with severe covid-19 with diabetes had higher levels of leukocyte count, neutrophil count, high-sensitivity C reaction protein, procalcitonin, ferritin, interleukin (IL) 2 receptor, IL-6, IL-8, tumor necrosis factor α, D-dimer, fibrinogen, lactic dehydrogenase and N-terminal pro-brain natriuretic peptide. Among patients with severe covid-19 with diabetes, more non-survivors were men (30 (76.9%) <i>vs</i> 9 (23.1%)). Non-survivors had severe inflammatory response, and cardiac, hepatic, renal and coagulation impairment. Finally, the Kaplan-Meier survival curve showed a trend towards poorer survival in patients with severe covid-19 with diabetes than patients without diabetes. The HR was 1.53 (95% CI 1.02 to 2.30; p=0.041) after adjustment for age, sex, hypertension, cardiovascular disease and cerebrovascular disease by Cox regression. The median survival durations from hospital admission in patients with severe covid-19 with and without diabetes were 10 days and 18 days, respectively.</AbstractText><AbstractText Label="CONCLUSION">The mortality rate in patients with severe covid-19 with diabetes is considerable. Diabetes may lead to an increase in the risk of death.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Yan</LastName><ForeName>Yongli</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Yan</ForeName><Initials>Y</Initials><Identifier Source="ORCID">0000-0001-8146-8040</Identifier><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Fen</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ren</LastName><ForeName>Huihui</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Shujun</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shi</LastName><ForeName>Xiaoli</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yu</LastName><ForeName>Xuefeng</ForeName><Initials>X</Initials><Identifier Source="ORCID">0000-0003-3961-9321</Identifier><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dong</LastName><ForeName>Kun</ForeName><Initials>K</Initials><Identifier Source="ORCID">0000-0003-3204-078X</Identifier><AffiliationInfo><Affiliation>Endocrinology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China kundong2019@hotmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Open Diabetes Res Care</MedlineTA><NlmUniqueID>101641391</NlmUniqueID><ISSNLinking>2052-4897</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>BMJ Open Diabetes Res Care. 2020 Apr;8(1):</RefSource><PMID Version="1">32345580</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003920" MajorTopicYN="N">Diabetes Mellitus</DescriptorName><QualifierName UI="Q000821" MajorTopicYN="Y">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007249" MajorTopicYN="N">Inflammation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">adult diabetes</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>04</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>04</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32345579</ArticleId><ArticleId IdType="pii">8/1/e001343</ArticleId><ArticleId 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Chine</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Yan, Yongli" sort="Yan, Yongli" uniqKey="Yan Y" first="Yongli" last="Yan">Yongli Yan</name></noRegion><name sortKey="Ren, Huihui" sort="Ren, Huihui" uniqKey="Ren H" first="Huihui" last="Ren">Huihui Ren</name><name sortKey="Shi, Xiaoli" sort="Shi, Xiaoli" uniqKey="Shi X" first="Xiaoli" last="Shi">Xiaoli Shi</name><name sortKey="Wang, Fen" sort="Wang, Fen" uniqKey="Wang F" first="Fen" last="Wang">Fen Wang</name><name sortKey="Yang, Yan" sort="Yang, Yan" uniqKey="Yang Y" first="Yan" last="Yang">Yan Yang</name><name sortKey="Yu, Xuefeng" sort="Yu, Xuefeng" uniqKey="Yu X" first="Xuefeng" last="Yu">Xuefeng Yu</name><name sortKey="Zhang, Shujun" sort="Zhang, Shujun" uniqKey="Zhang S" first="Shujun" last="Zhang">Shujun Zhang</name></country><country name="Oman"><noRegion><name sortKey="Dong, Kun" sort="Dong, Kun" uniqKey="Dong K" first="Kun" last="Dong">Kun 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