Effect of perceived customer ostracism on couriers' turnover intention

The express delivery industry has played a key role in people's lives during the COVID-19 pandemic. However, due to concerns about the virus, people frequently ostracize services from couriers, which can damage the couriers' motivation and make them consider seeking other work. In this study we explored how customer ostracism influenced turnover intention among couriers. Using a questionnaire survey of 529 couriers administered at two time points, we found that customer ostracism was positively and significantly correlated with couriers' turnover intention and that this relationship was mediated by work stress and moderated by perceived organizational support. These results enrich our knowledge of the antecedents and mechanisms related to employees' turnover intention during the pandemic, as well as having important practical implications for the management of couriers' work stress and the prevention of their turnover intention. [ FROM AUTHOR] Copyright of Social Behavior & Personality: an international journal is the property of Society for Personality Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Predictors of Basic Activity in Daily Living and Length of Hospitalization in Patients with COVID-19.

BACKGROUND: Patients recovered from COVID-19 often suffer from the sequelae of the disease, which can hinder the patients' activity in daily living. Early recognition of the patients at risk of prolonged hospitalization and impaired physical functioning is crucial for early intervention. We aim to identify the predictors of prolonged hospitalization and impaired activity in daily living in this study. METHODS: COVID-19 patients hospitalized in a medical center were divided into two groups according to the Barthel index three months after discharge and the median length of hospital stay, respectively. Chi-square test and Mann-Whitney U test were performed to check the differences between the two groups in patient characteristics as well as hematology tests at the emergency department, the intensive care unit mobility scale (ICUMS), and the medical research council sum score (MRCSS). Logistic regression and the receiver operating characteristic curve analysis were further performed for the factors with significant differences between the two groups. RESULTS: Both ICUMS and MRCSS showed significant differences between the groups. The ICUMS had an odds ratio of 0.61 and the MRCSS of 0.93 in predicting a Barthel index score less than 100 three months after discharge. The MRCSS had an odds ratio of 0.82 in predicting a prolonged length of hospital stay. CONCLUSION: Both ICUMS and MRCSS upon admission are predictive of a Barthel index score of less than 100 three months after discharge. On the other hand, only MRCSS has predictive value of a prolonged hospitalization.

Cardio- and Neurotoxicity of Selected Anti-COVID-19 Drugs.

Since December 2019, the novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected ~435 million people and caused ~6 million related deaths as of March 2022. To combat COVID-19, there have been many attempts to repurpose FDA-approved drugs or revive old drugs. However, many of the current treatment options have been known to cause adverse drug reactions. We employed a population-based drug screening platform using 13 human leukocyte antigen (HLA) homozygous human induced pluripotent cell (iPSC) lines to assess the cardiotoxicity and neurotoxicity of the first line of anti-COVID-19 drugs. We also infected iPSC-derived cells to understand the viral infection of cardiomyocytes and neurons. We found that iPSC-derived cardiomyocytes express the ACE2 receptor which correlated with a higher infection of the SARS-CoV-2 virus (r = 0.86). However, we were unable to detect ACE2 expression in neurons which correlated with a low infection rate. We then assessed the toxicity of anti-COVID-19 drugs and identified two cardiotoxic compounds (remdesivir and arbidol) and four neurotoxic compounds (arbidol, remdesivir, hydroxychloroquine, and chloroquine). These data show that this platform can quickly and easily be employed to further our understanding of cell-specific infection and identify drug toxicity of potential treatment options helping clinicians better decide on treatment options.

The Prevalence of Mycoplasma Pneumoniae Among Children in Beijing Before and During the COVID-19 Pandemic.

Objective: Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community acquired pneumonia. With the outbreak of coronavirus disease 2019 (COVID-19), the prevalence of some infectious respiratory diseases has varied. Epidemiological features of M. pneumoniae in children from Beijing (China) before and during the COVID-19 pandemic were investigated. Methods: Between June 2016 and May 2021, a total of 569,887 children with respiratory infections from Children's Hospital Affiliated to Capital Institute of Pediatrics (Beijing, China) were included in this study. M. pneumoniae specific-IgM antibody in serum specimens of these patients was tested by a rapid immunochromatographic assay kit. The relevant clinical data of M. pneumoniae-positive cases were also collected, and analyzed by RStudio software. Results: The results showed that 13.08% of collected samples were positive for M. pneumoniae specific-IgM antibody. The highest annual positive rate was 17.59% in 2019, followed by 12.48% in 2018, 12.31% in 2017, and 11.73% in 2016, while the rate dropped to 8.9% in 2020 and 4.95% in 2021, with significant difference. Among the six years, the positive rates in summer and winter seasons were significantly higher than those in spring and autumn seasons (p < 0.001). The positive rate was the highest in school-age children (22.20%), and lowest in the infant group (8.76%, p < 0.001). The positive rate in boys (11.69%) was lower than that in girls (14.80%, p < 0.001). There were no significant differences in different seasons, age groups, or genders before and during the COVID-19 pandemic (p > 0.05). Conclusions: Our study demonstrated that an M. pneumoniae outbreak started from the summer of 2019 in Beijing. After the COVID-19 pandemic outbreak in the end of 2019, the M. pneumoniae positive rates dropped dramatically. This may be due to the restrictive measures of the COVID-19 pandemic, which effectively controlled the transmission of M. pneumoniae. The relationships between M. pneumoniae positive rates and season, age, and gender were not statistically significant before and during the COVID-19 pandemic.

Demographic, Virological Characteristics and Prognosis of Asymptomatic COVID-19 Patients in South China.

BACKGROUND: Asymptomatic transmission is a major concern for SARS-CoV-2 community spread; however, little information is available on demographic, virological characteristics and prognosis of asymptomatic cases. METHODS: All COVID-19 patients hospitalized in Guangdong Province from September 1, 2020 to February 28, 2021, were included and were divided into asymptomatic and symptomaticgroup. The source country of all patients, clinical laboratory test results, the genotype of virus and the time of SARS-CoV-2 RNA turning negative or hospitalization were confirmed. RESULTS: Total 233 patients from 57 different countries or regions were included, with 83 (35.6%) asymptomatic and 150 (64.4%) symptomatic patients. Asymptomatic cases were younger (P = 0.019), lower rate in comorbidities (P = 0.021) such as hypertension (P = 0.083) and chronic liver disease (P = 0.045), lower PCT (P = 0.021), DDI (P < 0.001) and ALT (P = 0.029), but higher WBC count (P = 0.002) and lymphocyte (P = 0.011) than symptomatic patients. As for SARS-CoV-2 subtypes, patients infected with B.1.1 (53.8%), B.1.351 (81.8%) and B.1.524 (60%) are mainly asymptomatic, while infected with B, B.1, B.1.1.63, B.1.1.7, B.1.36, B.1.36.1, B.1.36.16, B.1.5 and B.6 were inclined to be symptomatic. Patients infected with variant B.1.351 and B.1.524 spent longer time in SARS-CoV-2 RNA turn negative (26 days, P = 0.085; 41 days, P = 0.007) and hospitalization (28 days, P = 0.085; 43 days, P = 0.004). CONCLUSIONS: The asymptomatic cases are prone to develop in patients with younger age, less comorbidities andinfected with B.1.1 and B.1.524 variants. More attention should be paid for lineage B.1.524 because it can significantly prolong the SARS-CoV-2 RNA negative conversion time and hospitalization in infected cases.

Exploring chemical changes of the haze pollution during a recent round of COVID-19 lockdown in a megacity in Northeast China.

COVID-19 rebounded in China in January 2021, with Heilongjiang as one of the worst-affected provinces. This resulted in a new round of lockdown in Harbin, the capital city of Heilongjiang, from 20 January to 22 February of 2021. A field campaign was conducted to explore the responses of haze pollution in Harbin to the lockdown. Levoglucosan was used to reflect biomass burning emissions, while the molar ratio of sulfur (the sum of sulfur dioxide and sulfate) to nitrogen (the sum of nitrogen dioxide and nitrate), i.e., RS/N, was used as an indicator for the relative importance of coal combustion and vehicle emissions. Based on a synthesis of the levoglucosan and RS/N results, reference period was selected with minimal influences of non-lockdown-related emission variations. As indicated by the almost unchanged sulfur dioxide concentrations, coal combustion emissions were relatively stable throughout the lockdown and reference periods, presumably because the associated activities, e.g., heating supply, power generation, etc., were usually uninterruptible. On the other hand, as suggested by the increase of RS/N, vehicle emissions were considerably reduced during lockdown, likely due to the stay-at-home orders. Compared to results from the reference samples, the lockdown period exhibited higher levels of ozone and various indicators for secondary aerosol formation, pointing to an enhancement of secondary pollution. In addition, photochemistry-related reactions in aqueous phase appeared to be present during the lockdown period, which have not been reported in the frigid atmosphere over Northeast China.

Anti-Inflammatory Azaphilones from the Edible Alga-Derived Fungus Penicillium sclerotiorum.

To discover the new medical entity from edible marine algae, our continuously natural product investigation focused on endophytes from marine macroalgae Grateloupia sp. Two new azaphilones, 8a-epi-hypocrellone A (1), 8a-epi-eupenicilazaphilone C (2), together with five known azaphilones, hypocrellone A (3), eupenicilazaphilone C (4), ((1E,3E)-3,5-dimethylhepta-1,3-dien-1-yl)-2,4-dihydroxy-3-methylbenzaldehyde (5), sclerotiorin (6), and isochromophilone IV (7) were isolated from the alga-derived fungus Penicillium sclerotiorum. The structures of isolated azaphilones (1-7) were elucidated by spectrometric identification, especially HRESIMS, CD, and NMR data analyses. Concerning bioactivity, cytotoxic, anti-inflammatory, and anti-fibrosis activities of those isolates were evaluated. As a result, compound 1 showed selective toxicity toward neuroblastoma cell line SH-SY5Y among seven cancer and one fibroblast cell lines. 20 µM of compounds 1, 3, and 7 inhibited the TNF-α-induced NFκB phosphorylation but did not change the NFκB activity. Compounds 2 and 6 respectively promoted and inhibited SMAD-mediated transcriptional activities stimulated by TGF-ß.

Influence of sense of power on epidemic control policy compliance

Incidences of noncompliance with COVID-19 prevention and control policies have occurred worldwide, increasing the risk to public safety and making epidemic control more difficult. We applied the approach–inhibition theory of power perception to investigate the underlying mechanisms and boundary conditions of the relationship between individuals' power perception and their prevention and control policy compliance. This study collected data from 303 participants in 45 counties (districts) spanning one province in China. Results show that individuals' sense of power was negatively related to their prevention and control policy compliance, with risk perception mediating and group policy control moderating this relationship. The findings provide a reference for assessing the effectiveness and relevance of government epidemic prevention and control. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR] Copyright of Social Behavior & Personality: an international journal is the property of Society for Personality Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rapid and quantitative detection of SARS-CoV-2 IgG antibody in serum using optofluidic point-of-care testing fluorescence biosensor.

The COVID-19 pandemic brings unprecedented crisis for public health and economics in the world. Detecting specific antibodies to SARS-CoV-2 is a powerful supplement for the diagnosis of COVID-19 and is important for epidemiological studies and vaccine validations. Herein, a rapid and quantitative detection method of anti-SARS-CoV-2 IgG antibody was built based on the optofluidic point-of-care testing fluorescence biosensor. Without complicated steps needed, the portable system is suitable for on-site sensitive determination of anti-SARS-CoV-2 IgG antibody in serum. Under the optimal conditions, the whole detection procedure is about 25 min with a detection limit of 12.5 ng/mL that can well meet the diagnostic requirements. The method was not obviously affected by IgM and serum matrix and demonstrated to have good stability and reliability in real sample analysis. Compared to ELISA test results, the proposed method exhibits several advantages including wider measurement range and easier operation. The method provides a universal platform for rapid and quantitative analysis of other related biomarkers, which is of significance for the prevention and control of COVID-19 pandemic.

Assessment of ICESat-2 ice surface elevations over the Chinese Antarctic Research Expedition (CHINARE) route, East Antarctica, based on coordinated multi-sensor observations

We present the results of an assessment of ice surface elevation measurements from NASA's Ice, Cloud, and land Elevation Satellite-2 (ICESat-2) along the CHINARE (CHINese Antarctic Research Expedition) route near the Amery Ice Shelf in East Antarctica. The validation campaign was designed and implemented in cooperation with the 36th CHINARE Antarctic expedition from December 2019 to February 2020. The assessment of the ICESat-2 geolocated photon product (ATL03) and land ice elevation product (ATL06) was performed based on coordinated multi-sensor observations using two roof-mounted kinematic global navigation satellite system (GNSS) receivers, two line arrays of corner cube retroreflectors (CCRs), two sets of retroreflective target sheets (RTSs), and two unmanned aerial vehicles (UAVs) with cameras. This systematic validation of the ICESat-2 data covered a variety of Antarctic ice surface conditions along the 520 km traverse from the coastal Zhongshan Station to the inland Taishan Station. This comprehensive investigation is complementary to the 750 km traverse validation of flat inland Antarctica containing a 300 km latitude traverse of 88∘ S by the mission team (Brunt et al., 2021). Overall, the validation results show that the elevation of the ATL06 ice surface points is accurate to 1.5 cm with a precision of 9.1 cm along the 520 km CHINARE route. The elevation of the ATL03 photons has an offset of 2.1 cm from a GNSS-surveyed CCR and is accurate to 2.5 cm with a precision of 2.7 cm as estimated by using RTSs. The validation results demonstrate that the estimated ICESat-2 elevations are accurate to 1.5–2.5 cm in this East Antarctic region, which shows the potential of the data products for eliminating mission biases by overcoming the uncertainties in the estimation of mass balance in East Antarctica. It should be emphasized that the results based on the CCR and RTS techniques can be improved by further aggregation of observation opportunities for a more robust assessment. The developed validation methodology and sensor system can be applied for continuous assessment of ICESat-2 data, especially for calibration against potential degradation of the elevation measurements during the later operation period.

Benchmarking of eight recurrent neural network variants for breath phase and adventitious sound detection on a self-developed open-access lung sound database-HF_Lung_V1.

A reliable, remote, and continuous real-time respiratory sound monitor with automated respiratory sound analysis ability is urgently required in many clinical scenarios-such as in monitoring disease progression of coronavirus disease 2019-to replace conventional auscultation with a handheld stethoscope. However, a robust computerized respiratory sound analysis algorithm for breath phase detection and adventitious sound detection at the recording level has not yet been validated in practical applications. In this study, we developed a lung sound database (HF_Lung_V1) comprising 9,765 audio files of lung sounds (duration of 15 s each), 34,095 inhalation labels, 18,349 exhalation labels, 13,883 continuous adventitious sound (CAS) labels (comprising 8,457 wheeze labels, 686 stridor labels, and 4,740 rhonchus labels), and 15,606 discontinuous adventitious sound labels (all crackles). We conducted benchmark tests using long short-term memory (LSTM), gated recurrent unit (GRU), bidirectional LSTM (BiLSTM), bidirectional GRU (BiGRU), convolutional neural network (CNN)-LSTM, CNN-GRU, CNN-BiLSTM, and CNN-BiGRU models for breath phase detection and adventitious sound detection. We also conducted a performance comparison between the LSTM-based and GRU-based models, between unidirectional and bidirectional models, and between models with and without a CNN. The results revealed that these models exhibited adequate performance in lung sound analysis. The GRU-based models outperformed, in terms of F1 scores and areas under the receiver operating characteristic curves, the LSTM-based models in most of the defined tasks. Furthermore, all bidirectional models outperformed their unidirectional counterparts. Finally, the addition of a CNN improved the accuracy of lung sound analysis, especially in the CAS detection tasks.

Blockchain based Privacy-Preserved Federated Learning for Medical Images: A Case Study of COVID-19 CT Scans (preprint)

Medical health care centers are envisioned as a promising paradigm to handle the massive volume of data of COVID-19 patients using artificial intelligence (AI). Traditionally, AI techniques often require centralized data collection and training the model in a single organization, which is most common weakness due to the privacy and security of raw data communication. To solve this challenging task, we propose a blockchain-based federated learning framework that provides collaborative data training solutions by coordinating multiple hospitals to train and share encrypted federated models without leakage of data privacy. The blockchain ledger technology provides the decentralization of federated learning model without any central server. The proposed homomorphic encryption scheme encrypts and decrypts the gradients of model to preserve the privacy. More precisely, the proposed framework: i) train the local model by a novel capsule network to segmentation and classify COVID-19 images, ii) then use the homomorphic encryption scheme to secure the local model that encrypts and decrypts the gradients, and finally the model is shared over a decentralized platform through proposed blockchain-based federated learning algorithm. The integration of blockchain and federated learning leads to a new paradigm for medical image data sharing in the decentralized network. The conducted experimental resultsdemonstrate the performance of the proposed scheme.

Cross the river by feeling the stones: How did nonlocal grassroots nonprofits overcome administrative barriers to provide quick responses to COVID-19?

This field report explores how nonlocal grassroots organizations provided effective and quick responses during the initial stage of the COVID-19 outbreak in Wuhan and surrounding regions. Despite the lack of resources and local connections, they were able to overcome administrative failures and provide quick responses to the crisis. Built on a researcher-practitioner collaborative action research project, three strategies facilitating grassroots organizations' quick and effective responses are analyzed and discussed: putting pandemic relief as the strategic priority of their organizations, leveraging social media platforms to scale up existing organizational networks and foster cross-sector collaboration, and effective online trust-building. As COVID-19 unprecedently pushes nonprofits to transform how they deliver services and engage stakeholders, these findings have important policy and theoretical implications for an expanded view of how nonprofits may engage in disaster responses and how public and private funders may shift their funding strategies to cultivate such capacities of grassroots nonprofits.

Co-infection of influenza A virus and SARS-CoV-2: A retrospective cohort study.

The coronavirus 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread across the world and is responsible for over 1,686,267 deaths worldwide. Co-infection with influenza A virus (IFV-A) during the upcoming flu season may complicate diagnosis and treatment of COVID-19. Little is known about epidemiology and outcomes of co-infection. Data for 213 COVID-19 patients treated at Tongji Hospital in Wuhan from January 28, 2020 to March 24, 2020 were retrospectively analyzed. Ninety-seven of the patients (45.5%) tested positive for anti- IFV-A immunoglobulin M antibodies. The clinical characteristics were described and analyzed for patients with SARS-CoV-2 infection only and patients with SARS-CoV-2/IFV-A co-infection. Patients with co-infection showed similar patterns of symptoms and clinical outcomes to patients with SARS-CoV-2 infection only. However, an increased expression of serum cytokines (interleukin-2R [IL-2R], IL-6, IL-8, and tumor necrosis factor-α) and cardiac troponin I, and higher incidence of lymphadenopathy were observed in patients with SARS-CoV-2 infection only. Male patients and patients aged less than 60 years in the SARS-CoV-2 infection group also had significantly higher computed tomography scores than patients in co-infection group, indicating that co-infection with IFV-A had no effect on the disease outcome but alleviated inflammation in certain populations of COVID-19 patients. The study will provide a reference for diagnosing and treating IFV-A and SARS-CoV-2 co-infection cases in the upcoming flu season.

When Zombies Invade Taiwan - Current Status and Future Challenges of Facebook Fake Accounts and Disinformation

社群平台假訊息、假帳號已是全球關注之議題。近期有研究發現，來自社群媒體的假訊息、假帳號的肆虐可能對台灣的民主社會帶來負面的衝擊。鑑於臺灣具有獨特的地緣政治性，特定勢力可能藉由問題帳號針對特定事件來散播假訊息，並試圖影響臺灣的政治環境。為探索假訊息在社群媒體的活動狀況，本研究以臺灣2020年總統選舉及新冠肺炎疫情為對象，觀測各種問題帳號在高聲量臉書貼文中的分布、留言情形。此外，本研究也透過焦點團體訪談，探討我國當前假訊息之現況、困境，並提出相關政策建議。最後，本研究認為網路主管機關的成立、對網站平台的課責、法令與策略的調整、強化政府假訊息闢謠之效能，以及持續關注未來假訊息的變化，是遏止危害性言論的必要之舉。 The spreading of disinformation by fake accounts on social media has become an issue of global concern. Recent studies have found that the roaming of fake messages and fake accounts from social media may have a negative impact on Taiwan's democratic society. Given Taiwan's unique geopolitical nature, certain forces may try to influence Taiwan's political environment by spreading fake messages through zombie accounts targeting specific events. This study examines the distribution of questionable accounts and messages in high-volume Facebook posts in the context of Taiwan's 2020 presidential election and the COVID-19 epidemic. In addition, focus group interviews were conducted to explore the current situation of disinformation and provide relative policy suggestions. Finally, this study argues that the establishment of a specific internet authority, the accountability of the social media platform, the adjustment of acts and strategies, the strengthening of the government's effectiveness in refuting fake messages, and the focusing on future changes in disinformation are necessary to counter the rampant spread of disinformation on social media.

The landscape of human brain immune response in patients with severe COVID-19 (preprint)

In coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the relationship between brain tropism, neuroinflammation and host immune response has not been well characterized. We analyzed 68,557 single-nucleus transcriptomes from three brain regions (dorsolateral prefrontal cortex, medulla oblongata and choroid plexus) and identified an increased proportion of stromal cells and monocytes in the choroid plexus of COVID-19 patients. Differential gene expression, pseudo-temporal trajectory and gene regulatory network analyses revealed microglial transcriptome perturbations, mediating a range of biological processes, including cellular activation, mobility and phagocytosis. Quantification of viral spike S1 protein and SARS-CoV-2 transcripts did not support the notion of brain tropism. Overall, our findings suggest extensive neuroinflammation in patients with acute COVID-19.

Immunological and cardio-vascular pathologies associated with SARS-CoV-2 infection in golden syrian hamster (preprint)

Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infection in golden Syrian hamster (GSH) causes lungs pathology and resembles to human corona virus disease (Covid-19). Extra-pulmonary pathologies and immunological parameters of SARS-CoV-2 infection remained undefined in GSH. Using in silico modelling, we identified the similarities between human and hamster angiotensin-converting enzyme-2 (ACE-2), neuropilin-1 (NRP-1) that bind to receptor-binding domain (RBD) and S1 fragment of spike protein of SARS-CoV-2. SARS-CoV-2 infection led to lung pathologies, and cardiovascular complications (CVC) marked by interstitial coronary fibrosis and acute inflammatory response. Serum lipidomic and metabolomic profile of SARS-CoV-2-infected GSH revealed changes in serum triglycerides (TG) and low-density lipoprotein (LDL), and alterations in metabolites that correlated with Covid19. Together, we propose GSH as an animal model to study SARS-CoV-2 infection and its therapy associated with pulmonary and extra-pulmonary pathologies.

Hypoxia reduces cell attachment of SARS-CoV-2 spike protein by modulating the expression of ACE2 and heparan sulfate (preprint)

A main clinical parameter of Covid-19 pathophysiology is hypoxia. Here we show that hypoxia decreases the attachment of the receptor binding domain (RBD) and the S1 subunit (S1) of the spike protein to epithelial cells. In Vero E6 cells, hypoxia reduces the protein levels of ACE2, which might in part explain the observed reduction of the infection rate. However, hypoxia also inhibits the binding of the spike to human lung epithelial cells lacking ACE2 expression, indicating that hypoxia modulates the expression of additional binding partners of SARS-CoV-2. We show that hypoxia also decreases the total cell surface levels of heparan sulfate, a known attachment receptor of SARS-CoV-2, by reducing the expression of syndecan-1 and syndecan3, the main proteoglycans containing heparan sulfate. Our study indicates that hypoxia acts to prevent SARS-CoV-2 infection, suggesting that the hypoxia signaling pathway might offer therapeutic opportunities for the treatment of Covid-19.

Influenza A virus exposure may cause increased symptom severity and deaths in coronavirus disease 2019.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak occurred during the flu season around the world. This study aimed to analyze the impact of influenza A virus (IAV) exposure on COVID-19. METHODS: Seventy COVID-19 patients admitted to the hospital during January and February 2020 in Wuhan, China were included in this retrospective study. Serum tests including respiratory pathogen immunoglobulin M (IgM) and inflammation biomarkers were performed upon admission. Patients were divided into common, severe, and critical types according to disease severity. Symptoms, inflammation indices, disease severity, and fatality rate were compared between anti-IAV IgM-positive and anti-IAV IgM-negative groups. The effects of the empirical use of oseltamivir were also analyzed in both groups. For comparison between groups, t tests and the Mann-Whitney U test were used according to data distribution. The Chi-squared test was used to compare disease severity and fatality between groups. RESULTS: Thirty-two (45.71%) of the 70 patients had positive anti-IAV IgM. Compared with the IAV-negative group, the positive group showed significantly higher proportions of female patients (59.38% vs. 34.21%, χ = 4.43, P = 0.035) and patients with fatigue (59.38% vs. 34.21%, χ = 4.43, P = 0.035). The levels of soluble interleukin 2 receptor (median 791.00 vs. 1075.50 IU/mL, Z = -2.70, P = 0.007) and tumor necrosis factor α (median 10.75 vs. 11.50 pg/mL, Z = -2.18, P = 0.029) were significantly lower in the IAV-positive group. Furthermore, this group tended to have a higher proportion of critical patients (31.25% vs. 15.79%, P = 0.066) and a higher fatality rate (21.88% vs. 7.89%, P = 0.169). Notably, in the IAV-positive group, patients who received oseltamivir had a significantly lower fatality rate (0 vs. 36.84%, P = 0.025) compared with those not receiving oseltamivir. CONCLUSIONS: The study suggests that during the flu season, close attention should be paid to the probability of IAV exposure in COVID-19 patients. Prospective studies with larger sample sizes are needed to clarify whether IAV increases the fatality rate of COVID-19 and to elucidate any benefits of empirical usage of oseltamivir.