Clinical characteristics of pediatric cases infected with the SARS-CoV-2 Omicron variant in a tertiary children's medical center in Shanghai, China.

BACKGROUND: The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has increased. Here, we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai. METHODS: A total of 676 pediatric coronavirus disease 2019 (COVID-19) cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30, 2022 were enrolled in this single-center, prospective, observational real-world study. Patient demographics and clinical characteristics, especially COVID-19 vaccine status, were assessed. RESULTS: Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant, with no significant difference between sexes. A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia, neutropenia, and thrombocytopenia (P = 0.003, P = 0.021, and P = 0.017, respectively) but not with physical symptoms or radiographic chest abnormalities. Univariable linear regression models indicated that comorbidities (P = 0.001) were associated with a longer time until viral clearance, and increasing age (P < 0.001) and two doses of COVID-19 vaccine (P = 0.001) were associated with a shorter time to viral clearance. Multivariable analysis revealed an independent effect of comorbidities (P < 0.001) and age (P = 0.003). The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases (P < 0.001). CONCLUSION: This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children.

A 1:1 ratio case-control study on coronavirus disease 2019

Objective: To compare the characteristics of COVID-19 patients and healthy people, including living habits, living environment etc. so as to provide evidence for policy making in disease control.

Effects of information sources on public preventive behaviors in health emergencies: Evidence from a digital epidemiologic study during the COVID-19 pandemic

Introduction It has been approved that information sources would affect public behaviors. However, due to the outbreak of COVID-19, this influence was enhanced and showed a distinctive pattern among different populations, which has been less noticed before. We aimed to investigate the potential roles of different information sources in COVID-19 preventive behaviors of different publics. Methods A cross-sectional online survey with 11,190 participants from 33 province-level regions in China was conducted during the COVID-19 pandemic. Sociodemographic characteristics, COVID-19 preventive behaviors, and information sources for COVID-19-related information were assessed. A mixed linear model was used to analyze risk factors of COVID-19 preventive behaviors. The effects of different information sources on COVID-19 prevention behaviors of different publics were analyzed. Results Generally, the Chinese public had good COVID-19 preventive behaviors, and the top three COVID-19 preventive behaviors with the higher action rate were avoiding eat bushmeat (76.1%), a healthy diet (74.8%), and avoiding contact with people with symptoms of respiratory diseases (73.0%). About information sources, 12320 telephone (National Public Health Hotline) (−0.62, 95% CI: −0.94 to −0.31) and acquaintances consulting (−1.00, 95% CI: −1.31 to −0.69) were negatively associated with COVID-19 preventive behaviors, while internet resources, family doctors, hospitals, and community health centers were positively associated with COVID-19 preventive behaviors (1.00 vs. 0.47 vs. 0.46 vs. 0.33, P < 0.05). For older adults, accessing to COVID-19-related information through family doctors and community health centers were positively associated with COVID-19 preventive behaviors. For the non-educated, family doctors and community health centers had positive effects on their COVID-19 preventive behaviors. Family doctors and internet resources were positively associated with COVID-19 preventive behaviors among those earning 5,000 yuans and above. The effects of family doctors, hospitals, and internet resources were higher for COVID-19 preventive behaviors of urban publics than for rural publics. Finally, the effect of internet resources on COVID-19 preventive behaviors of females was lower than males. Conclusions Obtaining COVID-19-related information through internet resources had the most significant effect on COVID-19 preventive behaviors, but was not significant among publics with old age, low education, low income, and living in rural area.

Relationship between Acute Respiratory Tract Infection and the Serum 25(OH) D3 Level in Chronic Kidney Disease Patients and Its Prevention and Treatment.

Observational studies and randomized controlled studies propose that vitamin D plays a significant role in preventing acute respiratory tract infection (RTI); however, results are inconsistent and the optimal serum 25-hydroxyvitamin D (25-OH-D3) concentration remains unknown. This study explores the risk factors associated with acute RTI in patients with chronic kidney disease (CKD) and analyzes its correlation with serum 25-OH-D3 levels, to provide appropriate preventive treatment measures for CKD patients complicated with acute RTI. Seventy cases of CKD patients treated in the department of nephrology of Jiangxi Provincial People's Hospital are recruited as the research objects and divided into a control group (CKD without RTI) and an observation group (CKD with RTI), with 35 cases in each group. The laboratory indexes and serum 25-OH-D3 levels are compared between the two groups. The area under the receiver operating characteristic curve (ROC) of 25-OH-D3 in the diagnosis of CKD patients complicated with RTI is 0.892, and the standard error is 0.038. The glomerular filtration rates (GFR) are 48.32 ± 9.87 mL/min and 50.18 ± 20.71 mL/min in the control group and the experimental group, respectively, with no statistical significance between the two groups (P > 0.05). The serum 25-OH-D3 content in the control group (35.08 ± 6.2 nmol/L) is dramatically higher than that in the observation group (20.71 ± 5.87 nmol/L) (P < 0.05). The proportion of patients with diabetes mellitus (DM) in the control group and observation group is 25.71% and 68.57%, respectively, with a considerable difference (P < 0.05). In the control group and the experimental group, the proportion of patients with oral vitamin D receptor agonists is 54.29% and 11.43%, respectively, and the difference is significant (P < 0.05). Results show that the serum 25-OH-D3 level is highly correlated with the occurrence of RTI in CKD patients. In addition, it is related to patients' age, DM, and vitamin D receptor agonists.

Electronic health literacy among older adults in the context of the COVID-19 pandemic: A mixed-methods study.

AIM: This study aimed to investigate eHealth literacy about coronavirus disease 2019 (COVID-19) among older adults during the pandemic. BACKGROUND: The COVID-19 pandemic promoted the development of online health care. Higher demand for accessing information from the Internet was seen. METHODS: This was a sequential explanatory mixed-method study, involving a survey of older adults to explore the status and influencing factors of eHealth literacy regarding COVID-19. Semi-structured interviews were used to understand experiences and challenges regarding information retrieval, judgment and utilization. RESULTS: A total of 337 older adults participated in the online questionnaire survey. Overall, older adults had slightly higher scores on eHealth literacy during the COVID-19 pandemic. Participants' location in the past month and current health issues were associated with eHealth literacy. Qualitative data were collected from nine older adults and included that some older adults retrieved health-related information during the pandemic. However, those who used non-smartphones described difficulties in information retrieval. A glut of misinformation has resulted in an 'infodemic', which has not only increased the difficulty of judging information but also posed challenges in information utilization for older adults. CONCLUSION: Improving older adults' eHealth literacy is essential in promoting an improved response to major public health events and in providing better health care for this group in the future. It is essential that government health agencies and health care providers provide evidence-based health information via social media platforms. Further efforts are needed to combine aspects of traditional and online health care services and provide reliable and updated online information and resources for older adults. IMPLICATIONS FOR NURSING MANAGEMENT: Providing evidence to eHealth literacy improvement and health management of older adults in the context of public health events.

Effect of qigong exercise and acupressure rehabilitation program on pulmonary function and respiratory symptoms in patients hospitalized with severe COVID-19: a randomized controlled trial.

BACKGROUND: There are several effective complementary and integrative therapies for patients with severe COVID-19. The trial aims to evaluate the efficacy and advantages of the qigong exercise and acupressure rehabilitation program (QARP) for treating patients with severe COVID-19. METHODS: A total of 128 patients with COVID-19 aged 20 to 80 years were recruited and randomly allocated in a 1:1 ratio to receive QARP plus standard therapies or standard therapies alone. QARP consisted of acupressure therapy and qigong exercise (Liu Zi Jue). The primary outcome was measured with the modified Medical Research Council (mMRC) dyspnea scale, and the secondary outcomes included the modified Borg dyspnea scale (MBS), fatigue Scale-14 (FS-14), patient health questionnaire-9 scale (PHQ-9), duration of respiratory symptoms, and vital signs. RESULTS: In total, 128 patients completed the clinical trial. The QARP group and standard therapies group showed significant improvements in vital signs (except blood pressure) and clinical scales compared with baseline (p<0.05). The QARP group also showed more significant improvement in the mMRC dyspnea scale (-1.8 [-2.1, -1.6], p=0.018) and modified Borg dyspnea scale (-3.7 [95% confidence intervals (CI) -4.3, -3.1], p=0.045). The duration of cough was 14.3 days (95% CI 12.6, 16.1, p=0.046), and the length of hospital stay was 18.5 days (95% CI 17.0, 20.0, p=0.042) in the QARP group, both of which were significantly reduced compared with the standard therapies group (p<0.05). CONCLUSION: QARP plus standard therapies improved lung function and symptoms such as dyspnea and cough in patients with severe COVID-19 and shortened the length of hospital stay. Therefore, QARP may be considered an effective treatment option for patients with severe COVID-19. TRIAL REGISTRATION: Clinical Research Information Service Identifier: ChiCTR2000029994.

Dynamic estimation of epidemiological parameters of COVID-19 outbreak and effects of interventions on its spread.

BACKGROUND: A key challenge in estimating epidemiological parameters for a pandemic such as the initial COVID-19 outbreak in Wuhan is the discrepancy between the officially reported number of infections and the true number of infections. A common approach to tackling the challenge is to use the number of infections exported from the originating city to infer the true number. This approach can only provide a static estimate of the epidemiological parameters before city lockdown because there are almost no exported cases thereafter. METHODS: We propose a Bayesian estimation method that dynamically estimates the epidemiological parameters by recovering true numbers of infections from day-to-day official numbers. To illustrate the use of this method, we provide a comprehensive retrospection on how the COVID-19 had progressed in Wuhan from January 19 to March 5, 2020. Particularly, we estimate that the outbreak sizes by January 23 and March 5 were 11,239 [95% CI 4,794-22,372] and 124,506 [95% CI 69,526-265,113], respectively. RESULTS: The effective reproduction number attained its maximum on January 24 (3.42 [95% CI 3.34-3.50]) and became less than 1 from February 7 (0.76 [95% CI 0.65-0.92]). We also estimate the effects of two major government interventions on the spread of COVID-19 in Wuhan. CONCLUSIONS: This case study by our proposed method affirms the believed importance and effectiveness of imposing tight non-essential travel restrictions and affirm the importance and effectiveness of government interventions (e.g., transportation suspension and large scale hospitalization) for effective mitigation of COVID-19 community spread.

The risk factors for severe patients with COVID-19 in China: A systematic review and meta-analysis

COVID-19 is spreading exponentially. In order to optimize medical resources allocation and reduce mortality, biomarkers are needed to differentiate between COVID-19 patients with or without severe diseases early as possible. We searched Ovid MEDLINE(R), Ovid EMBASE, CNKI, Wanfang, VIP databases, the Cochrane Library, and medRxiv for primary articles in English or Chinese up to March 30, 2020 to systematically evaluate the risk factors for severe patients in China. Mean difference or standardize mean difference and odds ratio with 95% confidence intervals were performed by random-effect or fixed models in cases of significant heterogeneity between studies. We used I 2 to evaluate the magnitude of heterogeneity. A total of 54 articles involving about 7000 patients were eligible for this meta-analysis. In total, 52 of 67 parameters between severe and non-severe cases were significantly different. Elderly male patients with comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease (COPD) cardiovascular disease, cerebrovascular disease, chronic kidney disease, or cancer were more common in severe COVID-19 patients. Regarding the clinical manifestations on admission, fever, cough, expectoration, dyspnea, chest distress, fatigue, headache, chills, anorexia, or abdominal pain were more prevalent in severe COVID-19 patients. The results of the clinical examination showed that high C-reactive protein (CRP), high lactate dehydrogenase (LDH), high D-dimer, and decreased T lymphocytes cells subsets, decreased lymphocyte may help clinicians predict the progression of severe illness in patients with COVID-19. Our findings will be conducive for clinician to stratify the COVID-19 patients to reduce mortality under the relative shortage of medical resources. [ABSTRACT FROM AUTHOR] Copyright of European Journal of Inflammation (Sage Publications, Ltd.) is the property of Sage Publications, Ltd. 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.)

COVID-19 Outbreak and Management Approach for Families with Children on Long-Term Kidney Replacement Therapy.

BACKGROUND AND OBJECTIVES: During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively. RESULTS: Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported. CONCLUSIONS: The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.

Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Patients Living with Human Immunodeficiency Virus: Case Reports and Review of the Literature (preprint)

Background: Novel coronavirus pneumonia (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread over the globe. The knowledge about SARS-CoV-2 infection in immunocompromised patients was limited. Case presentation: We presented here two human immunodeficiency virus (HIV)-infected cases with laboratory confirmed COVID-19 and clinically confirmed COVID-19, respectively. The patients both presented with fever at illness onset and patchy shadows in radiological images of lungs. Laboratory findings revealed leukopenia, lymphopenia and positive anti-HIV antibody. The younger case had a moderate course and was discharged after a 28-day hospitalization. However, the elder case with multiple comorbidities developed dyspnea and died on the fourth day after admission. Conclusions: Combining our data with two case reports, we summarize that disease course varies in HIV-infected patients with COVID-19. More attention should be paid to the management of these patients. Whether there is any difference about clinical characteristics and prognosis of COVID-19 between HIV-infected and non-HIV infected patients, remains to be further investigated.

Questionnaire assessment helps the self-management of patients with inflammatory bowel disease during the outbreak of Coronavirus Disease 2019 (preprint)

Background and Aims: The outbreak of Coronavirus Disease 2019 (COVID-19) may affect the disease status of patients with inflammatory bowel disease (IBD). This study aimed to assess the disease status of IBD patients in Hubei province by questionnaire online and guide to the self-management of IBD patients during this epidemic. Methods: A questionnaire was designed containing the Harvey-Bradshaw Index (HBI), the Partial Mayo Score (PMS), the short inflammatory bowel disease questionnaire (SIBDQ) and distributed to Hubei IBD patients online within one month of traffic control after the outbreak of COVID-19. This questionnaire also included some questions about patients' self-report disease conditions and their epidemiological history of COVID-19. Results: A total of 102 eligible questionnaires were included in the analysis. No patient reported infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in our study. Our result showed that 69.64% of patients with ulcerative colitis (UC) and 80.44% of patients with Crohn's disease (CD) were in remission. There was not a statistically significant difference in the proportion of the active disease stage between the two types of disease (p=0.103). The majority of patients (85.29%) had a good health-related quality of life (HRQoL) (SIBDQ[≥]50). The reduction in physical exercise is a risk factor for worsening in conditions (OR=17.593, 95%CI 2.035 to 152.097, p=0.009). Conclusions: The outbreak of COVID-19 might not have a significant impact on most Hubei IBD patients within one month after the traffic control. The patient's disease condition could be assessed by our questionnaires. Doctors utilized the information and advised for IBD patients about self-management during the period of COVID-19.