A Cross-Sectional Study on the Cross-Talk of the COVID-19-Related Degree of Loneliness and the Etiological Factors Among the Elderly in Central China.

BACKGROUND: The outbreak of COVID-19 has undoubtedly influenced the normal lifestyle of people worldwide, including the Chinese population. This study attempted to do supplementary research to the current situation of loneliness as well as the related risk factors among the elderly in the province in central Chinese during the COVID-19. METHODS: We conducted a cross-sectional study in one of the central Chinese provinces (Henan Province) from December 2020 to March 2021 using a multistage sampling method, and 568 elderly people without cognitive impairment were interviewed. The UCLA Loneliness Scale, Pittsburgh Sleep Quality Index (PSQI), Physical Activity Rating Scale (PARS-3), and Quality of Life Questionnaire SF-36 were adopted to collect information. We used univariate and multivariate logistic regressions to analyze the factors resulting in severe loneliness among the elderly with seldom or regular participation in physical exercises. RESULTS: During the epidemic in central China, the elderly suffering from loneliness syndrome accounted for 34.2%, of which 15.5% were severely lonely. Risk factors for severe loneliness were quality of life (OR: 7.129), sleep quality (OR: 3.778), seldom exercise (OR: 4.170), poor economic status (OR: 1.769), and negative attitude toward the prospects for the epidemic control (OR: 4.033). By grouping the participants in terms of physical activity, we found that the quality of life (OR:5.778) was a significant risk factor than sleep quality (OR:2.939) in the seldom exercise group, while the only risk factor in the regular exercise group was the quality of life (OR: 5.021). CONCLUSION: There was an increase in the degree of loneliness among the elderly during the epidemic, and physical activity played an active role in relieving the severe loneliness of the elderly. Therefore, for the sake of the elderly, regular participation in physical exercises should be encouraged during the duration of the epidemic.

The Transmission, Infection Prevention, and Control during the COVID-19 Pandemic in China: A Retrospective Study.

The first wave of COVID-19 in China began in December 2019. The outbreak was quickly and effectively controlled through strict infection prevention and control with multipronged measures. By the end of March 2020, the outbreak had basically ended. Therefore, there are relatively complete and effective infection prevention and control (IPC) processes in China to curb virus transmission. Furthermore, there were two large-scale updates for the daily reports by the National Health Commission of the People's Republic of China in the early stage of the pandemic. We retrospectively studied the transmission characteristics and IPC of COVID-19 in China. Additionally, we analyzed and modeled the data in the two revisions. We found that most cases were limited to Hubei Province, especially in Wuhan, and the mortality rate was lower in non-Wuhan areas. We studied the two revisions and utilized the proposed transmission model to revise the daily confirmed cases at the beginning of the pandemic in Wuhan. Moreover, we estimated the cases and deaths for the same stage and analyzed the effect of IPC in China. The results show that strong and effective IPC with strict implementation was able to effectively and quickly control the pandemic.

Sex Differences in Association Between Anti-Hypertensive Medications and Risk of COVID-19 in Middle-Aged and Older Adults.

BACKGROUND: There is ongoing debate about the associations between drug therapies targeting the renin-angiotensin-aldosterone system (RAAS) and adverse outcomes in coronavirus disease 2019 (COVID-19). OBJECTIVE: This study aims to examine the associations between using medications for the cardiovascular system and the risks associated with COVID-19 in middle-aged and older adults. METHODS: A total of 77,221 participants (aged 50-86 years) from UK Biobank were tested for SARS-CoV-2 RNA. The medications included angiotensin-converting enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), ß-blockers, calcium channel blockers (CCB), statins, and aspirin. COVID-19 outcomes comprised a positive test result and severity of COVID-19 (defined as mild, hospitalization or death). We evaluated the risk among total participants and for sub-groups based on sex. Propensity score matching was performed 1:1 and logistic regression models were used. RESULTS: Among the middle- and older aged participants, no significant associations between any class of medications and the likelihood of COVID-19 infection were observed. ACEI were associated with a higher mortality risk from COVID-19 (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01-1.32) and CCB were associated with a lower hospitalization risk for COVID-19 (OR 0.87, 95% CI 0.79-0.96) among the male patients with COVID-19, while a lower mortality risk from COVID-19 (OR 0.67, 95% CI 0.47-0.96) was observed with ARB among the female patients with COVID-19. CONCLUSIONS: The study suggested sex differences in the risk of death from COVID-19 with the use of ACEI and ARB among middle-aged and older adults. Sex differences in the risk of hospitalization for COVID-19 with the use of CCB was observed as well. It is of clinical importance that clinicians adopt different CVD treatment approaches for female and male patients with COVID-19.

Metabolic Healthy Obesity, Vitamin D Status, and Risk of COVID-19.

Aging and obesity-related conditions seem to worsen the effect of Coronavirus Disease 2019 (COVID-19). This study assessed the possible roles of metabolic/obesity phenotypes and vitamin D status in increasing the greater severity of COVID-19. We studied 353,299 UK Biobank participants from England with a mean age of 67.7 years. Metabolic/obesity phenotypes were defined as a combination of metabolic components (hypertension, high cholesterol, and diabetes) and obesity. Multivariate logistic regression analysis was performed to test whether the addition of metabolic disorders and vitamin D insufficiency increased obesity associations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19. Metabolically unhealthy obesity (MUHO) represented 12.3% of the total analytic samples, and 21.5%, 18.5%, and 19.8% of the included subpopulations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19, respectively. Vitamin D insufficiency phenotypes represented 53.5% of the total analytic samples, and 59.5%, 61.7%, and 61.5% of the included subpopulations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19, respectively. In multivariate logistic regression, MUHO and vitamin D insufficiency and their combination were significantly associated with COVID-19 illness severity (odds ratio [OR] for COVID-19 hospitalization = 2.33, 95% confidence interval [CI], 2.02-2.70; OR for confirmed COVID-19 = 2.06, 95% CI, 1.58-2.70; OR for severe COVID-19 = 2.06, 95% CI, 1.47-2.87). Elderly men were prone to have a higher risk of COVID-19 than women. Our findings showed that MUHO and vitamin D insufficiency are associated with a significantly increased risk of COVID-19 severity, especially for adults 65 years and older. Susceptible individuals should be aware of their conditions and avoid contact with new coronavirus.