Role of Psychosomatic Symptoms in COVID-19 Vaccine Hesitancy.

Vaccination against COVID-19 is one of the highly effective preventative strategies to reduce morbidity and mortality associated with COVID-19 infection. The rapid approval of COVID-19 vaccination due to the raging pandemic, media coverage, anti-vaccination groups, and concerns about adverse effects associated with vaccination has given rise to COVID-19 vaccine hesitancy. Current evidence suggests that psychosomatic and nocebo-related adverse effects account for a significant proportion of common adverse effects following COVID-19 vaccination. The most common adverse effects are headache, fatigue, and myalgia, which are highly prone to nocebo effects. In our review article, we discuss the role of psychosomatic and nocebo effects in COVID-19 vaccination-related hesitancy, predictors of such effects, and strategies to reduce vaccine hesitancy. General education regarding psychosomatic and nocebo effects and specialized education for at-risk populations may reduce psychosomatic and nocebo-related adverse effects following COVID-19 vaccination, ultimately reducing hesitancy.

Palliative care for cancer patients during the COVID-19 pandemic: A narrative synthesis from 36 studies of 16 countries.

BACKGROUND: During the COVID-19 epidemic, palliative care has become even more indispensable for cancer patients. AIM: To identify the changes in palliative care for cancer patients and improvements in palliative care quality during the COVID-19 pandemic. DESIGN: A systematic review and narrative synthesis was conducted in PubMed, Embase and Web of Science. An evaluation tool using mixed methods was used to assess the quality of the study. The main relevant themes identified were used to group qualitative and quantitative findings. RESULTS: A total of 36 studies were identified, primarily from different countries, with a total of 14,427 patients, 238 caregivers and 354 health care providers. Cancer palliative care has been experiencing several difficulties following the COVID-19 pandemic, including increased mortality and infection rates as well as delays in patient treatment that have resulted in poorer prognoses. Treatment providers are seeking solutions such as electronic management of patients and integration of resources to care for the mental health of patients and staff. Telemedicine plays an important role in many ways but cannot completely replace traditional treatment. Clinicians strive to meet patients' palliative care needs during special times and improve their quality of life. CONCLUSIONS: Palliative care faces unique challenges during the COVID-19 epidemic. With adequate support to alleviate care-related challenges, patients in the home versus hospital setting will be able to receive better palliative care. In addition, this review highlights the importance of multiparty collaboration to achieve personal and societal benefits of palliative care. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Clinical outcomes of the severe acute respiratory syndrome coronavirus 2 Omicron and Delta variant: systematic review and meta-analysis of 33 studies covering 6 037 144 coronavirus disease 2019-positive patients.

BACKGROUND: Although the SARS-CoV-2 Omicron variant is considered to induce less severe disease, there have been no consistent results on the extent of the decrease in severity. OBJECTIVES: To compare the clinical outcomes of COVID-19-positive patients with Omicron and Delta variant infection. DATA SOURCES: Searches were implemented up to 8 November 2022 in PubMed, Web of Science, BioRvix, and MedRvix. STUDY ELIGIBILITY CRITERIA: Eligible studies were cohort studies reporting the clinical outcomes of COVID-19-positive patients with Omicron and Delta variant infection, including hospitalization, intensive care unit (ICU) admission, receiving invasive mechanical ventilation (IMV), and death. PARTICIPANTS: COVID-19-positive patients with Omicron and Delta variant infection. ASSESSMENT OF RISK OF BIAS: Risk of bias was assessed employing the Newcastle-Ottawa Scale. METHODS OF DATA SYNTHESIS: Random-effect models were employed to pool the ORs and 95% CIs to compare the risk of clinical outcome. I2 was employed to evaluate the heterogeneity between studies. RESULTS: A total of 33 studies with 6 037 144 COVID-19-positive patients were included in this meta-analysis. In the general population of COVID-19-positive patients, compared with Delta, Omicron variant infection resulted in a decreased risk of hospitalization (10.24% vs. 4.14%, OR = 2.91, 95% CI = 2.35-3.60), ICU admission (3.67% vs. 0.48%, OR = 3.64, 95% CI = 2.63-5.04), receiving IMV (3.93% vs. 0.34%, OR = 3.11, 95% CI = 1.76-5.50), and death (2.40% vs. 0.46%, OR = 2.97, 95% CI = 2.17-4.08). In the hospitalized patients with COVID-19, compared with Delta, Omicron variant infection resulted in a decreased risk of ICU admission (20.70% vs. 12.90%, OR = 1.63, 95% CI = 1.32-2.02), receiving IMV (10.90% vs. 5.80%, OR = 1.65, 95% CI = 1.28-2.14), and death (10.72% vs. 7.10%, OR = 1.44, 95% CI = 1.22-1.71). CONCLUSIONS: Compared with Delta, the severity of Omicron variant infection decreased.

Transition to Inpatient Telepsychiatry Services and Impact on Quality of Care.

Demands for telepsychiatry have increased due to the challenges of COVID-19. The global pandemic caused a significant increase in anxiety and depression and a worsening of eating disorder symptoms, while the implementation of social distancing both exacerbated these mental health issues and disrupted the in-person delivery of mental health services. Rapid adaptation of telepsychiatry in the acute inpatient setting has been reported with favorable outcomes in patient experiences. This article reports our experience with a transition to telepsychiatry services on an acute eating disorder unit and the impact on quality of care. Forty-two inpatients on an eating disorders unit completed 410 surveys evaluating their experience with telepsychiatry. Simultaneously, surveys were distributed to physicians to identify technical and connectivity issues. Our experience showed that patients on an eating disorder unit, who had an average length of stay of 22 days, were very satisfied with telepsychiatry, with few technical or safety issues.

Experience of the COVID-19 pandemic in Wuhan leads to a lasting increase in social distancing.

On 11th Jan 2020, the first COVID-19 related death was confirmed in Wuhan, Hubei. The Chinese government responded to the outbreak with a lockdown that impacted most residents of Hubei province and lasted for almost three months. At the time, the lockdown was the strictest both within China and worldwide. Using an interactive web-based experiment conducted half a year after the lockdown with participants from 11 Chinese provinces, we investigate the behavioral effects of this 'shock' event experienced by the population of Hubei. We find that both one's place of residence and the strictness of lockdown measures in their province are robust predictors of individual social distancing behavior. Further, we observe that informational messages are effective at increasing compliance with social distancing throughout China, whereas fines for noncompliance work better within Hubei province relative to the rest of the country. We also report that residents of Hubei increase their propensity to social distance when exposed to social environments characterized by the presence of a superspreader, while the effect is not present outside of the province. Our results appear to be specific to the context of COVID-19 and are not explained by general differences in risk attitudes and social preferences.

Influencing factors of proteinuria in patients with hypertension in Qinghai-Tibet Plateau

Objective: To investigate the risk factors of proteinuria in patients with hypertension in Qinghai-Tibet Plateau.

Multi-dimensional psychosocial factors influencing the willingness to receive a COVID-19 vaccine booster: A survey among the public in Mainland China.

This study aimed to investigate multi-dimensional psychological and social factors that influence the willingness to receive a COVID-19 vaccine booster in China. A nationwide cross-sectional online survey was conducted between March and April 2022. A total of 6375 complete responses were received. The majority were of age 18 to 40 years old (80.0%) and college-educated (49.2%). In total, 79% responded extremely willing to receive a COVID-19 vaccine booster. By demographics, younger age, females, higher education, and participants with the lowest income reported higher willingness. Having a very good health status (odds ratio [OR] 3.56, 95% confidence interval [CI] 2.92-4.34) and a higher score of vaccine confidence (OR 3.50, 95% CI 2.98-4.11) were associated with an increased willingness to receive a booster shot. Experiencing no side effects with primary COVID-19 vaccination (OR 2.46, 95% CI 1.89-3.20) and higher perceived susceptibility of COVID-19 infection (OR 2.38, 95% CI 1.92-2.95) were also associated with an increased willingness to receive a booster shot. A variety of psychosocial factors, namely having no chronic diseases, lower perceived concern over the safety of a booster shot, higher perceived severity of COVID-19 infection, and a higher level of institutional trust, were also significantly associated with greater willingness to get a booster shot. In conclusion, the present study adds evidence to the significant role of psychosocial factors in predicting COVID-19 vaccine booster acceptance and provides insights to design interventions to increase booster uptake in certain targeted demographic groups.

The effect of COVID-19 restrictions on atmospheric new particle formation in Beijing

During the COVID-19 lockdown, the dramatic reduction of anthropogenic emissions provided a unique opportunity to investigate the effects of reduced anthropogenic activity and primary emissions on atmospheric chemical processes and the consequent formation of secondary pollutants. Here, we utilize comprehensive observations to examine the response of atmospheric new particle formation (NPF) to the changes in the atmospheric chemical cocktail. We find that the main clustering process was unaffected by the drastically reduced traffic emissions, and the formation rate of 1.5 nm particles remained unaltered. However, particle survival probability was enhanced due to an increased particle growth rate (GR) during the lockdown period, explaining the enhanced NPF activity in earlier studies. For GR at 1.5–3 nm, sulfuric acid (SA) was the main contributor at high temperatures, whilst there were unaccounted contributing vapors at low temperatures. For GR at 3–7 and 7–15 nm, oxygenated organic molecules (OOMs) played a major role. Surprisingly, OOM composition and volatility were insensitive to the large change of atmospheric NOx concentration;instead the associated high particle growth rates and high OOM concentration during the lockdown period were mostly caused by the enhanced atmospheric oxidative capacity. Overall, our findings suggest a limited role of traffic emissions in NPF.

The Impact of Family Factors on Children’s Mental Health during Home Quarantine: An Empirical Study in Northwest China

(1) Aims: This paper aims to analyze the factors affecting children’s mental health during home quarantine from the perspective of family composition in a specific Chinese context where historically, families are small in size. (2) Methods: Here, 10,210 online questionnaires from 3 junior high schools in Xi’an and Hanzhong from 23 to 27 February 2020, were collected to explore the impact of family factors on children’s mental health in Northwest China during home quarantine based on the ecosystem theory, by using OLS, logit regression models, and the Shapley value decomposition method. (3) Results: The mental health of northwestern Chinese children changed significantly after home quarantine. We also found that during home quarantine, some factors, such as a high-income family, lack of siblings, living with parents, mothers with middle- or high-level occupations, frequent parent–child communication, and better parent–child relationships, were positively related to children’s mental health. (4) Conclusions: Different from previous studies, this paper found that the psychological condition of children in Northwest China tended to be improved during the epidemic. In addition, family factors, especially the parent–child interaction, played an important role in the mental health of children during the epidemic.

Comparative miRNA transcriptomics of macaques and mice reveals MYOC is an inhibitor for Cryptococcus neoformans invasion into the brain.

Cryptococcal meningoencephalitis (CM) is emerging as an infection in HIV/AIDS patients shifted from primarily ART-naive to ART-experienced individuals, as well as patients with COVID-19 and immunocompetent hosts. This fungal infection is mainly caused by the opportunistic human pathogen Cryptococcus neoformans. Brain or central nervous system (CNS) dissemination is the deadliest process for this disease; however, mechanisms underlying this process have yet to be elucidated. Moreover, illustrations of clinically relevant responses in cryptococcosis are currently limited due to the low availability of clinical samples. In this study, to explore the clinically relevant responses during C. neoformans infection, macaque and mouse infection models were employed and miRNA-mRNA transcriptomes were performed and combined, which revealed cytoskeleton, a major feature of HIV/AIDS patients, was a centric pathway regulated in both infection models. Notably, assays of clinical immune cells confirmed an enhanced macrophage "Trojan Horse" in patients with HIV/AIDS, which could be shut down by cytoskeleton inhibitors. Furthermore, myocilin, encoded by MYOC, was found to be a novel enhancer for the macrophage "Trojan Horse," and an enhanced fungal burden was achieved in the brains of MYOC-transgenic mice. Taken together, the findings from this study reveal fundamental roles of the cytoskeleton and MYOC in fungal CNS dissemination, which not only helps to understand the high prevalence of CM in HIV/AIDS but also facilitates the development of novel therapeutics for meningoencephalitis caused by C. neoformans and other pathogenic microorganisms.

Air pollution: a more serious health problem than COVID-19 in 2020

As a global pandemic, Coronavirus disease 2019 (COVID-19) poses a serious threat to people's health. However, by comparing the deaths caused by COVID-19 and deaths from air pollution in 183 countries, our results show that air pollution was even more of a serious health problem than COVID-19 in 2020. The relative roles of air pollution and COVID-19-attributable deaths across countries were affected by PM2.5 exposure, population age structure, societal development and government policies. The countries with less strict policies during the early stages of COVID-19, to ensure stable economic development, paid more to control COVID-19 deaths in the subsequent stages, and hence showed large GDP reduction percentages in 2020. Our results indicate that the COVID-19 is a serious killer but also that the mortality caused by air pollution is high, which underline the concurrent need to control the dispersion of COVID-19 and improvement of air quality.

Early signs of geographic spread of COVID-19: lessons learnt from outbreaks in Wuhan 2020 and Nanjing 2021.

BACKGROUND: Knowing the spatiotemporal pattern of the early geographic spread of coronavirus disease 2019 (COVID-19) would inform the preparedness for a possible recurrence of COVID-19. METHODS: We ascertained the number of confirmed cases during the early spread of COVID-19 during the Wuhan outbreak in 2020 and the Nanjing outbreak in 2021. RESULTS: We observed a speeding-up pattern of geographic spread, in particular to cities of no particular orientation then outflowing to commercial cities during the first month of both the Wuhan and Nanjing outbreaks. CONCLUSION: Re-emergence of COVID-19 indicates it is becoming endemic, with new outbreaks and a risk of increased transmission remaining a challenge to local public health institutions. Social distancing and lockdowns should continue in response to any potential widespread and focal outbreaks.

The effect of COVID-19 restrictions on particulate matter on different modes of transport in China.

Since the COVID-19 pandemic, ventilation on transport has been improved to control the aerosol transmission. We utilized portable monitors to measure real-time concentrations of PM10, PM2.5, PM1.0 and black carbon (BC) on six modes of transport and estimate personal exposures under the epidemic prevention. The mean concentrations of PM10, PM2.5, PM1.0 and BC measured on transport were 18.8 ± 19.4, 16.6 ± 16.5, 12.2 ± 10.8 and 4.1 ± 6.9 µg/m3, respectively. It reduced PM levels on subway to apply the full fresh air mode rather than partial recirculation mode. Airplane had the lowest concentrations and the highest decay rates, implying the most efficient ventilation and filtration. PM were higher on intra-city transport than inter-city, and significantly increased on arrival at stations. BC and BC/PM ratios were higher on road transport than rail transport, indicating the contribution of exhaust emissions. The ventilation mode to exchange air with the outside and the positive association between concentrations and decay rates on high-speed train suggested filtration efficiency should be improved simultaneously with enhancing ventilation. Wearing facemasks on transport further protects passengers against PM exposure, which reduced personal exposure concentrations on four modes of transport lower than 10 µg/m3, the World Health Organization guideline.

Lymphocyte subsets as a predictor of severity and prognosis in COVID-19 patients.

BACKGROUND: Coronavirus disease 2019 (COVID-19) had become a worldwide health threat. Early prediction of the severity of COVID-19 patients was important for reducing death rate and controlling this disease. METHODS AND MATERIALS: A total of 301 patients confirmed with COVID-19 in Wuhan from 8 February to 10 April 2020 were included. Clinical data were collected and analyzed. Diagnostic and prognostic utility of blood cell counts and lymphocyte subsets in COVID-19 patients were investigated. The receiver operator characteristic curve (ROC) was used in discriminating the mild and severe/critical cases. RESULTS: There were difference in blood cell counts and lymphocyte subsets among mild, severe and critical patients, which were also influenced by comorbidities and duration of disease. The area under the ROC of lymphocyte, CD3+ T cells, CD4+ T cells, and CD8+ T cells were 0.718, 0.721, 0.718, and 0.670, which were higher than that of other hematological parameters. The optimal threshold was 1205, 691, 402, and 177 per µl, respectively. Patients with higher counts of lymphocyte, CD3+ T cells, CD4+ T cells, or CD8+ T cells were correlated with shorter length of stay in hospital (p < 0.05). Multivariable Cox regression analysis showed disease severity, CD3+ T cells counts and time when the nucleic acid turned negative were independent risk factors for in-hospital death of COVID-19 patients (p < 0.05). CONCLUSION: Blood cell counts and lymphocyte subsets correlated with severity of COVID-19.

An Analysis on the Crisis of “Chips shortage” in Automobile Industry ——Based on the Double Influence of COVID-19 and Trade Friction

The COVID-19 pandemic and various infection control measures have made a great impact on the regular operation of global integrated circuit companies,which caused the“Chips shortage” Phenomenon in the automotive industry. Based on data collected from official channels, industry associations, SIA and enterprises, this paper performed an empirical analysis on the structure of global integrated circuit market, and studied supply and demand in the market. The results of the analyses showed that:1) the pandemic control measures and the re-allocation of market resources are the short-term factors unbalancing the supply and demand for automotive chips. 2) the global shortage of Chips of the automotive industry may continue and the risk of breaking the industrial chain is increasing. Because it is a long industry chain which relies on efficient cross-border collaboration, but it is lack of international prevention and control cooperation mechanism altogether. The current situation presents both challenges and opportunities to China. This paper proposes that China should take efforts in strengthening international cooperation;and improve the core competitiveness of China’s chip industry by the top-level designing and encouraging domestic enterprises to invest in research and development,and to improve their technical performance.

Could COVID-19 pandemic be stopped with joint efforts of travel restrictions and public health countermeasures? A modelling study.

OBJECTIVE: We aim to explore and compare the effect of global travel restrictions and public health countermeasures in response to COVID-19 outbreak. DESIGN: A data-driven spatio-temporal modelling to simulate the spread of COVID-19 worldwide for 150 days since 1 January 2020 under different scenarios. SETTING: Worldwide. INTERVENTIONS: Travel restrictions and public health countermeasures. MAIN OUTCOME: The cumulative number of COVID-19 cases. RESULTS: The cumulative number of COVID-19 cases could reach more than 420 million around the world without any countermeasures taken. Under timely and intensive global interventions, 99.97% of infections could be avoided comparing with non-interventions. The scenario of carrying out domestic travel restriction and public health countermeasures in China only could contribute to a significant decrease of the cumulative number of infected cases worldwide. Without global travel restriction in the study setting, 98.62% of COVID-19 cases could be avoided by public health countermeasures in China only compared with non-interventions at all. CONCLUSIONS: Public health countermeasures were generally more effective than travel restrictions in many countries, suggesting multinational collaborations in the public health communities in response to this novel global health challenge.

Influence of COVID-19 lockdown overlapping Chinese Spring Festival on household PM2.5 in rural Chinese homes.

During the 2019 novel coronavirus (COVID-19) pandemic, many countries took strong lockdown policy to reduce disease spreading, resulting in mitigating the ambient air pollution due to less traffic and industrial emissions. However, limited studies focused on the household air pollution especially in rural area, the potential risk induced by indoor air pollution exposure was unknown during this period. This field study continuously measured real-time PM2.5 levels in kitchen, living room, and outdoor in the normal days (Period-1) and the days of COVID-19 lockdown overlapping the Chinese Spring Festival (Period-2) in rural homes in China. The average daily PM2.5 concentrations increased by 17.4 and 5.1 µg/m3 in kitchen and living room during Period-2, respectively, which may be due to more fuel consumption for cooking and heating caused by larger family sizes than those during the normal days. The ambient PM2.5 concentration in rural areas in Period-2 decreased by 6.7 µg/m3 compared to the Period-1, less than the drop in urban areas (26.8 µg/m3). An increase of mass fraction of very fine particles in ambient air was observed during lockdown overlapping annual festival days, which could be explained by the residential solid fuel burning. Due to higher indoor air pollution level and longer time spent in indoor environments, daily personal exposure to PM2.5 was 134 ± 40 µg/m3 in Period-2, which was significantly higher than that during in Period-1 (126 ± 27 µg/m3, p < 0.05). The increase of personal PM2.5 exposure during Period-2 could potentially have negative impact on human health, indicating further investigations should be performed to estimate the health impact of global COVID-19 lockdown on community, especially in rural homes using solid fuels as the routine fuels.

The relationship between SARS-COV-2 RNA positive duration and the risk of recurrent positive.

BACKGROUND: The management of discharge COVID-19 patients with recurrent positive SARS-CoV-2 RNA is challenging. However, there are fewer scientific dissertations about the risk of recurrent positive. The aim of this study was to explore the relationship between SARS-COV-2 RNA positive duration (SPD) and the risk of recurrent positive. METHODS: This case-control multi-center study enrolled participants from 8 Chinese hospital including 411 participants (recurrent positive 241). Using unadjusted and multivariate-adjusted logistic regression analyses, generalized additive model with a smooth curve fitting, we evaluated the associations between SPD and risk of recurrent positive. Besides, subgroup analyses were performed to explore the potential interactions. RESULTS: Among recurrent positive patients, there were 121 females (50.2%), median age was 50 years old [interquartile range (IQR): 38-63]. In non-adjusted model and adjusted model, SPD was associated with an increased risk of recurrent positive (fully-adjusted model: OR = 1.05, 95% CI: 1.02-1.08, P = 0.001); the curve fitting was not significant (P = 0.286). Comparing with SPD < 14 days, the risk of recurrent positive in SPD > 28 days was risen substantially (OR = 3.09, 95% CI: 1.44-6.63, P = 0.004). Interaction and stratified analyses showed greater effect estimates of SPD and risk of recurrent positive in the hypertension, low monocyte count and percentage patients (P for interaction = 0.008, 0.002, 0.036, respectively). CONCLUSION: SPD was associated with a higher risk of recurrent positive and especially SPD > 28 day had a two-fold increase in the relative risk of re-positive as compared with SPD < 14 day. What's more, the risk may be higher among those with hypertension and lower monocyte count or percentage.

Clinical Effects of the COVID-19 Pandemic Among the Uninfected Pregnant Women - 6 PLADs, China, 2019-2020.

SUMMARY: What is already known about this topic? The coronavirus disease 2019 (COVID-19) pandemic potentially affected prenatal care quality and maternal and fetal outcomes globally.What is added by this report? During COVID-19 pandemic period, the rates of caesarean sections (CS) and preterm birth for uninfected pregnant women increased slightly in areas that were relatively severely impacted by the pandemic in China. The overall number of prenatal examinations did not dramatically decrease, while the eligible examinations significantly decreased in Hubei Province.What are the implications for public health practice? Routine prenatal examinations had been well maintained during the pandemic period in China. In the future, in-time prenatal examinations should be provided to improve the quality of screening and management of high-risk pregnancy under pandemic-affected circumstances. Psychological counseling and transfer treatment channels should be strengthened for pregnant women during lockdown period.