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OBJECTIVE: To evaluate whether the nature and severity of non-A-E severe acute hepatitis in children noted by the World Health Organization from late 2021 through early 2022 was indeed increased in 2021-2022 compared with prior years. STUDY DESIGN: We performed a single-center, retrospective study to track the etiology and outcomes of children with non-A-E severe acute hepatitis in 2021-2022 compared with the prior 3-year periods (2018-2019, 2019-2020, and 2020-2021). We queried electronic medical records of children ≤16 years of age with alanine or aspartate aminotransferase levels of >500 IU. Data were analyzed for the periods of October 1, 2021, to May 1, 2022, and compared with the same time periods in 2018-2021. RESULTS: Of 107 children meeting entry criteria, 82 cases occurred from October to May of 2018-2022. The average annual case number was 16.3 in 2018-2021 compared with a 2-fold increase (to 33) in 2021-2022 (P = .0054). Analyses of etiologies showed that this increase was associated with a higher number of children who tested positive for viruses (n = 16) when compared with the average of 3.7 for 2018-2021 (P = .018). Adenovirus (26.1%) and severe acute respiratory syndrome coronavirus-2 (10.3%) were the most frequently detected viruses in 2021-2022. Despite evidence of acute liver failure in 37.8% of children in the entire cohort and in 47% of those with viral infection, the overall survival rate was high at 91.4% and 88.9%, respectively. CONCLUSIONS: The number of children with severe acute hepatitis in our center increased from 2021 to May 2022, with a greater frequency of cases associated with adenovirus, yet transplant-free survival remains high.
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Objective: To investigate the risk factors of severe and critical patients with coronavirus disease 2019(COVID-19)in Hubei, China. Methods All patients with COVID-19 registered in the National Legal Infectious Disease Reporting System of Hubei Provincial Center for Disease Control and Prevention, as of March 18, 2020, were recruited. According to the symptoms, the patients were divided into two groups: mild/moderate patients and severe/critical patients. Their general characteristics were described, and the risk factors of severe and critical patients with COVID-19 were explored by using a Logistic regression model. Results A total of 48 814 cases were included, of which 38 730 were mild/moderate patients and 10 084 were severe/critical patients. The median age was 54(41, 65)years. Multivariate analysis showed that the elderly, male, home workers, people in Wuhan City, migrants, longer interval between onset and diagnosis, low temperature, higher concentrations of PM2.5/PM10/SO2/O3 increased the risk of severe/critical diagnosis in patients with COVID-19. Conclusion The elderly, male, home workers, people in Wuhan City, migrants, longer interval between onset and diagnosis, low temperature, and air pollution exposure are risk factors for severe/critical COVID-19 patients. More attention should be paid to people with these characteristics.
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ObjectivesTo determine the association of general practitioner (GP) contact with depressive symptoms during the COVID-19 pandemic and lockdown in China.DesignIn April 2020, a follow-up survey was conducted on the basis of a baseline survey conducted between October 2018 and May 2019.SettingThe survey was embedded in the Stanford Wellness Living Laboratory-China (WELL China) study, an ongoing prospective community-based cohort study during 2018–2019.ParticipantsThe survey was conducted by telephone interview among 4144 adult urban residents participating in the WELL China study at baseline. We collected information on sociodemographic characteristics, depressive symptoms and GP contact during the lockdown period (February to March 2020).Primary and secondary outcome measuresDepressive symptoms were measured using the WHO-Five Well-being Index, comprising five questionnaire items that briefly indicate psychological well-being. Logistic regression models were applied to assess the association between GP contact and depressive symptoms.ResultsIn total, 3356 participants responded to the survey;203 were excluded owing to missing data on depressive symptoms, leaving 3153 participants in the present study. During lockdown, 449 participants had GP contact. GP contact was significantly negatively associated with prevalent depressive symptoms (OR, 0.67;95% CI 0.51 to 0.89;p<0.01) and incident depressive symptoms (OR 0.68;95% CI 0.51 to 0.93;p<0.05). Stratified analysis showed a significant negative association between depressive symptoms and GP contact in individuals who were 45–64 years old (p<0.01), had a middle or high education (p<0.01) and had self-reported non-communicable diseases (p<0.05).ConclusionsContact with GPs during the COVID-19 pandemic and lockdowns may have a negative association with depressive symptoms in community-dwelling populations. Given the possibility of further surges in COVID-19 infections, GPs’ contact in the community should be enhanced.
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Since December 2019, a new infectious disease, " corona virus disease " (COVID-19), mainly lung lesion, has been emerging in China. The outbreak of covid-19 coincided with the Chinese New Year in 2020. The rapid spread of the disease triggered public panic and an overwhelming number of news reports on new media platforms. However, information does not always equate with the way of communication. The communication bias happened in the flow of information. This paper takes the information flow about covid-19 before 26th December, 2020 as a model, and compares the time of information flow in the early development of the epidemic with the approach of Edmund Carpenter's "explorations in media and anthropology" and Harold A. Innis' "the bias of communication ". The bias of time and of information delivered during the pandemic is examined. The study further focuses on the reflection and response of Chinese new media platforms and information platforms towards the public opinion management.
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Background:The coronavirus disease 2019 (COVID-19) outbreak is a global public health crisis that has affected the implementation of advance care planning (ACP) in Taiwan. The purpose of this study is to (1) confirm that COVID-19 significantly reduced public participation in ACP, (2) identify factors influencing the implementation of ACP during the COVID-19 pandemic and how they differ from those before the COVID-19 outbreak.Methods: An observational study from retrospective review of medical chart and clinical information.This is a hospital-based study to examine the characteristics of ACP implementation in Taiwan during COVID-19. A total of 1,253 participants were recruited, including 916 people who had completed ACP from September through December 2019, and 337 people from January through April 2020.Results:This study representing an approximately 65% decrease in ACP participation after COVID-19 outbreak. The cancellation rate of ACP during COVID-19 is higher before outbreak. After COVID-19 outbreak, Participation rate of disadvantaged populations increased from 16.92% to 21.66%. The percentage of participants with caregiver experiences decreased from 31.66%to to 23.44% . Participants who did not wish for their families to bear decision-making responsibilities increased from 44.00% to 52.52%. The percentage of offspring participation increased from 86.57% to 90.80%. The percentage of individuals completing ACP after the outbreak without signing an advance directive increased from 5.57% to 9.20%. The COVID-19 pandemic significantly reduced participation in ACP. Conclusions: This study directly compared the ACP implementation before and after COVID-19, which is a tremendous global health crisis influencing the conceptions of life and death.COVID-19 has threatened the public’s health and has changed ACP in the healthcare system by increasing public awareness of the topic of death. After COVID-19, both medical staff and the public should clearly express their opinions on terminal care.Policy supports and active participation of medical team can encourage disadvantages to complete ACP.Healthcare workers should provide palliative and terminal care services in which patient comfort and dignity are the primary focus of care.Trial registration:This study was approved on 3 June 2020 by the Taipei City Hospital Institutional Review Board (Case No.: TCHIRB-10808008-E).
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COVID-19 , DeathABSTRACT
Background With the spread of COVID-19 from Wuhan, Hubei Province to other areas of the country, medical staff in Fever Clinics faced the challenge of identifying suspected cases among patients with respiratory infections manifested with fever. We aimed to describe the prevalence and clinical features of COVID-19 as compared to pneumonias of other etiologies in a Fever Clinic in Beijing. Methods In this single-center, retrospective study, 342 cases of pneumonia were diagnosed in Fever Clinic in Peking University Third Hospital between January 21 to February 15, 2020. From these patients, 88 were reviewed by panel discussion as possible or probable cases of COVID-19, and received 2019-nCoV detection by RT-PCR. COVID-19 was confirmed by positive 2019-nCoV in 19 cases, and by epidemiological, clinical and CT features in 2 cases (the COVID-19 Group, n=21), while the remaining 67 cases served as the non-COVID-19 group. Demographic and epidemiological data, symptoms, laboratory and lung CT findings were collected, and compared between the two groups. Findings The prevalence of COVID-19 in all pneumonia patients during the study period was 6.14% (21/342). Compared with the non-COVID-19 group, more patients with COVID-19 had an identified epidemiological history (90.5% versus 32.8%, P<0.001). The COVID-19 group had lower WBC [5.19x10^9/L ({+/-}1.47) versus 7.21x10^9/L ({+/-}2.94), P<0.001] and neutrophil counts [3.39x10^9/L ({+/-}1.48) versus 5.38x10^9/L ({+/-}2.85), P<0.001] in peripheral blood. However, the percentage and count of lymphocytes were not different. On lung CT scans, involvement of 4 or more lobes was more common in the COVID-19 group (45% versus 16.4%, P=0.008). Interpretation In the period of COVID-19 epidemic outside Hubei Province, the prevalence of COVID-19 in patients with pneumonia visiting to our Fever Clinic in Beijing was 6.14%. Epidemiological evidence was important for prompt case finding, and lower blood WBC and neutrophil counts may be useful for differentiation from pneumonia of other etiologies.