Cigarette smoke attenuates p300-mediated Nrf2 acetylation in macrophages: Is stabilizing Nrf2 enough to halt COPD progression?

Charles Wong 1, Jacky Man Chun Chan2, Loletta Kit Ying So1

1Department of Medicine, Pamela Youde Nethersole Eastern Hospital, HKSAR, Hong Kong, 2Infectious Diseases Centre, Princess Margaret Hospital, HKSAR, Hong Kong

Background and Aims: The North Lantau Hospital Hong Kong Infection Control Centre (HKICC) was established in February 2021 as a designated hospital to combat the coronavirus disease 2019 (COVID‐19) in Hong Kong, during which an increase in emergent mutant strains of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) raised concerns pertinent to increased transmissibility and disease severity. We aim to describe the treatment outcomes of SARS‐CoV‐2 infection in HKICC, and to evaluate the impact of mutant strains in imported cases.

Methods: Consecutive patients with COVID‐19 admitted to HKICC from February to April 2021 were identified with their clinical features and treatment outcomes evaluated. Clinical features of mutant strains and wild‐type strains were compared.

Results: Of 513 COVID‐19 patients treated in HKICC (mean age 38 years, 45.2% male), 238 (46.4 %) were imported. The incidence of hypoxemia was 3.1% (16/513). All patients were discharged successfully with a median length of stay of 10 days (IQR 6‐13). All mutant strains were imported with an incidence of 47.9% (114/238), N501Y mutation was most frequently found (111/114, 97.4%). Among imported cases, strains with N501Y mutation alone were associated with more cough (16.5% vs 6.5%, p=0.022), but had similar incidence of hypoxemia and length of stay, compared with wild‐type strains.

Conclusion: HKICC successfully contributed to combating COVID‐19 pandemic in Hong Kong. Imported cases with N501Y mutation alone presented with more cough, but had similar incidence of hypoxemia and length of stay, compared with wild‐type strains. Further studies to evaluate the impact of other mutant strains are warranted.