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BACKGROUND: In the context of the Corona Virus Disease 2019 (COVID-19) pandemic, research on personal-job fit and physical and mental health was inadequate. We aimed to explore the relationship between personal-job fit and physical and mental health among medical staff during the two years after COVID-19 pandemic and verify emotional labor and burnout as mediators. METHODS: A total of 2868 medical staff from two general hospitals, were included from July 3 to July 27, 2022, in Wuhan, China. SPSS was used for statistical description, and AMOS was used for structural equation modeling (SEM) to analyze the mediating effect of emotional labor and burnout. RESULTS: In the SEM, the total effect of personal-job fit on physical and mental health was significant (ß = 0.855, 95 % CI: 0.748-0.972). The mediating effect of surface acting between personal-job fit and physical and mental health was significant (ß = 0.078, 95 % CI: 0.053-0.110). The mediating effect of burnout was significant (ß = 0.220, 95 % CI: 0.175-0.274), but the mediating effect of deep acting was not significant (ß = 0.006, 95 % CI: -0.013-0.025). The chain mediating effect of surface acting or deep acting and burnout between personal-job fit and physical and mental health was significant (ß = 0.082, 95 % CI: 0.059-0.108; ß = 0.049, 95 % CI: 0.038-0.063). LIMITATIONS: Owing to the cross-sectional study, causal relationship, and direction of effects among variables could not be determined. CONCLUSIONS: Personal-job fit has significant direct and indirect effects on physical and mental health. Monitoring and intervening in personal-job fit, emotional labor, and burnout might be effective ways to promoting physical and mental health among medical staff during the COVID-19 pandemic.
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Burnout, Professional , COVID-19 , Humans , Mental Health , Pandemics , Cross-Sectional Studies , Surveys and Questionnaires , Burnout, Professional/psychology , Burnout, Psychological , Medical Staff , Job SatisfactionABSTRACT
Using the non-parametric thermal optimal path method, we investigate the dynamic lead–lag relationship between carbon emission trading and stock markets in China, and further consider the impact of different types of exogenous shocks on the lead–lag relationship. The empirical results show that the stock market leads the carbon market on most trading days, and the relationship reverses when the mean values of carbon market return are significantly smaller than zero. In addition, the lead–lag relationships when the carbon market leads the high energy-consuming stock market sectors are more obvious. We also find that there exist significant heterogeneous effects of different types of exogenous shocks on the lead–lag relationship between the two markets, including government policy, the Sino-US trade war and the Covid-19 outbreak. These findings have the potential to help regulators understand the interrelationship between components of the financial market, and be of great value for investors to optimize portfolio allocation by incorporating carbon assets into the portfolio.
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Background Coronavirus disease 2019 (COVID-19) has progressively impacted our daily lives, resulting in unexpected physical and mental stress on medical staff. This study is designed to investigate the levels of and risk factors for burnout, depression, anxiety, and insomnia among medical staff during the COVID-19 epidemic breakout in Shanghai, China. Methods This cross-sectional survey was conducted from May 1 to May 31, 2022, among medical staff who were on the frontline during the epidemic breakout in Shanghai from different institutions. The MBI-HSS was used to assess burnout, PHQ-9, GAD-7 and ISI were used to evaluate mental status and insomnia. Results A total of 543 valid questionnaires were collected. The depersonalization, depression, anxiety, and insomnia scores of medical staff were significantly higher during the pandemic in Shanghai compared with norms, while lack of personal achievement scores were decreased. Working time, work unit, work environment and age are important influencers of burnout, depression and anxiety of medical staff. Long working hours are the most likely causes of burnout and emotional disorders. Medical staff in primary hospitals were most likely to suffer from burnout and emotional disorders, while medical staff in tertiary hospitals had a reduced sense of personal achievement. Young medical staff are prone to negative emotions such as depression and anxiety, while older medical staff have a lower sense of personal accomplishment. Medical staff who were not in the shelter hospitals or designated hospitals were more likely to have problems of emotional exhaustion, depersonalization and anxiety than those who were in the shelter hospitals or designated hospitals. Contracting COVID-19 had no effect on medical staff. Emotional exhaustion and depersonalization were positively correlated with anxiety, depression, and sleep disorders while personal achievement was negatively correlated with these factors. Conclusion Medical staff in Shanghai had high burnout, depression, anxiety and insomnia levels during the epidemic outbreak in Shanghai. During the COVID-19, medical staff may suffer different psychological problems which should be concerned. Care and supports about burnout, mental health and insomnia need to be taken to promote the mental health of medical staff according to different characteristics of medical staff.
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The repetitive applications of vaccine boosters have been brought up in face of continuous emergence of SARS-CoV-2 variants with neutralization escape mutations, but their protective efficacy and potential adverse effects remain largely unknown. Here, we compared the humoral and cellular immune responses of an extended course of recombinant receptor binding domain (RBD) vaccine boosters with those from conventional immunization strategy in a Balb/c mice model. Multiple vaccine boosters after the conventional vaccination course significantly decreased RBD-specific antibody titers and serum neutralizing efficacy against the Delta and Omicron variants, and profoundly impaired CD4+ and CD8+T cell activation and increased PD-1 and LAG-3 expressions in these T cells. Mechanistically, we confirmed that extended vaccination with RBD boosters overturned the protective immune memories by promoting adaptive immune tolerance. Our findings demonstrate potential risks with the continuous use of SARS-CoV-2 vaccine boosters, providing immediate implications for the global COVID-19 vaccination enhancement strategies.
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Recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has infected millions of individuals worldwide. While COVID-19 generally affects the lungs, it also damages other organs, including those of the cardiovascular system. Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disorder. Studies have shown that HCM patients with COVID-19 have a higher mortality rate;however, the reason for this phenomenon is not yet elucidated. Herein, we conducted transcriptomic analyses to identify shared biomarkers between HCM and COVID-19 to bridge this knowledge gap. Differentially expressed genes (DEGs) were obtained using the Gene Expression Omnibus ribonucleic acid (RNA) sequencing datasets, GSE147507 and GSE89714, to identify shared pathways and potential drug candidates. We discovered 30 DEGs that were common between these two datasets. Using a combination of statistical and biological tools, protein-protein interactions were constructed in response to these findings to support hub genes and modules. We discovered that HCM is linked to COVID-19 progression based on a functional analysis under ontology terms. Based on the DEGs identified from the datasets, a coregulatory network of transcription factors, genes, proteins, and microRNAs was also discovered. Lastly, our research suggests that the potential drugs we identified might be helpful for COVID-19 therapy.
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Hospitals generate large volumes of wastewater. Dissolved organic matter (DOM) in wastewater effluent can act as precursors of disinfection by-products, transporter of pollutants, and affect the performance of treatment plants. This study aims to characterize the composition of DOM in medical wastewater and investigate the selectivity of the hospital treatment plant in the removal of DOM. DOM was characterized by Fourier-transform ion-cyclotron resonance mass spectrometry (FT-ICR-MS) and excitation-emission matrix fluorescence spectroscopy (EEMs). DOM of medical wastewater was dominated by aliphatic and highly unsaturated compounds, a feature that is remarkably different from that of natural DOM. In the membrane bioreactor (MBR) unit, more CHNO compounds and highly unsaturated compounds were formed. After disinfection, the highly unsaturated and humic-like compounds were reduced, accompanying a decrease in aromaticity. After reverse osmosis, the highly unsaturated and CHO compounds were concentrated and removed. These steps were complementary in the removal of DOM, suggesting effective transformation and elimination of DOM. This study contributes to a better understanding of the features of DOM in medical wastewater and treatment plant performance in the removal of DOM, which is indispensable for the large-scale design and application of technologies for hospital wastewater treatment, especially in the context of the COVID-19 pandemic.
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Many medical issues have gradually emerged under the severe impact of the COVID-19 pandemic, which has not only changed the medical culture but also tested medical staffs' response abilities, emotional pressure, sense of identity, and belonging to the organization. The relationships among medical staffs' emotional labor, leisure coping strategies, workplace spirituality, and organizational commitment during the COVID-19 pandemic are explored in this study. With medical staffs as the research subjects, a questionnaire survey was conducted using convenience sampling;a total of 360 questionnaires were distributed and 330 were returned, for a recovery rate of 91%. There were 300 valid questionnaires after 30 invalid questionnaires were excluded, for an effective recovery rate of 90%. SPSS and AMOS software were used for statistical analysis. According to the research results: (1) emotional labor had a significant effect on workplace spirituality, (2) workplace spirituality had a significant impact on organizational commitment, (3) emotional labor had a negative and significant impact on organizational commitment, (4) emotional labor had a significant impact on leisure coping strategies, and (5) the mediating effect of workplace spirituality between emotional labor and organizational commitment was not significant. Finally, relevant practical suggestions are provided based on the results of this study.
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Background Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors. Objective Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors. Method A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7;53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients’ suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument. Results The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG. Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors. HIGHLIGHTS • Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.
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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Spike protein that mediates coronavirus entry into host cells is a major target for COVID-19 vaccines and antibody therapeutics. However, multiple variants of SARS-CoV-2 have emerged, which may potentially compromise vaccine effectiveness. Using a pseudovirus-based assay, we evaluated SARS-CoV-2 cell entry mediated by the viral Spike B.1.617 and B.1.1.7 variants. We also compared the neutralization ability of monoclonal antibodies from convalescent sera and neutralizing antibodies (NAbs) elicited by CoronaVac (inactivated vaccine) and ZF2001 (RBD-subunit vaccine) against B.1.617 and B.1.1.7 variants. Our results showed that, compared to D614G and B.1.1.7 variants, B.1.617 shows enhanced viral entry and membrane fusion, as well as more resistant to antibody neutralization. These findings have important implications for understanding viral infectivity and for immunization policy against SARS-CoV-2 variants.
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Loneliness and isolation are on the rise worldwide, threatening human well-being and the wellness of different age groups and backgrounds. Notably, global social distancing measures during the COVID-19 crisis have exacerbated this problem, resulting in various psychological and physiological ailments. Within both the categories of social and medical robots, companion robots are capable of engaging emotionally with users and providing continuous monitoring and assessment of their health. In this study, we propose a framework for modeling the emotion space of companion robots to facilitate their emotion generation and transition based on Plutchik’s wheel of emotions and reversible quantum circuit schemes. Superposition encodings allow fewer computing resources for the generation and storage of emotional states, and by using unitary operations, they facilitate easier emotion transition and recovery over different intervals. Further, an encryption strategy is designed based on the emotion communication architecture to secure the emotion-related data in human-robot interaction. It is hoped that such an integrative framework and research agenda exploring the role of companion robots will be useful to care for users’ social health by mitigating their negative emotions, especially during difficult times.
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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Spike protein that mediates coronavirus entry into host cells is a major target for COVID-19 vaccines and antibody therapeutics. However, multiple variants of SARS-CoV-2 have emerged, which may potentially compromise vaccine effectiveness. Using a pseudovirus-based assay, we evaluated SARS-CoV-2 cell entry mediated by the viral Spike B.1.617 and B.1.1.7 variants. We also compared the neutralization ability of monoclonal antibodies from convalescent sera and neutralizing antibodies (NAbs) elicited by CoronaVac (inactivated vaccine) and ZF2001 (RBD-subunit vaccine) against B.1.617 and B.1.1.7 variants. Our results showed that, compared to D614G and B.1.1.7 variants, B.1.617 shows enhanced viral entry and membrane fusion, as well as more resistant to antibody neutralization. These findings have important implications for understanding viral infectivity and for immunization policy against SARS-CoV-2 variants.
Subject(s)
Coronavirus Infections , COVID-19ABSTRACT
Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has spread to many countries around the world, developing into a global pandemic with increasing numbers of deaths reported worldwide. To data, although some vaccines have been developed, there are no ideal drugs to treat novel coronavirus pneumonia (coronavirus disease 2019 (COVID-19)). By examining the structure of the coronavirus and briefly describing its possible pathogenesis based on recent autopsy reports conducted by various teams worldwide, this review analyzes the possible structural and functional changes of the human body upon infection with SARS-CoV-2. We observed that the most prominent pathological changes in COVID-19 patients are diffuse alveolar damage (DAD) of the lungs and microthrombus formation, resulting in an imbalance of the ventilation/perfusion ratio and respiratory failure. Although direct evidence of viral infection can also be found in other organs and tissues, the viral load is relatively small. The conclusion that the injuries of the extra-pulmonary organs are directly caused by the virus needs further investigation.
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COVID-19/pathology , Lung/pathology , COVID-19/physiopathology , Human Body , Humans , Immune Evasion , Lung/virology , Viral LoadABSTRACT
Background. Insufficient information on SARS-CoV-2 testing results exists in clinical practice from the United States. Methods. We conducted an observational retrospective cohort study using Optum(R) de-identified COVID-19 electronic health records from the United States to characterize patients who received a SARS-CoV-2 viral or antibody test between February 20, 2020 and July 10, 2020. We assessed temporal trends in testing and positivity by demographic and clinical characteristics; evaluated concordance between viral and antibody tests; and identified factors associated with positivity via multivariable logistic regression. Results. Our study population included 891,754 patients. Overall positivity rate for SARS-CoV-2 was 9% and 12% for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Among patients who received a viral test followed by an antibody test, concordance ranged from 90%-93% depending on the duration between the two tests which is notable given uncertainties related to specific viral and antibody test characteristics. The following factors increased the odds of viral and antibody positivity in multivariable models: male, Hispanic or non-Hispanic Black and Asian, uninsured or Medicaid insurance, Northeast residence, dementia, diabetes, and obesity. Charlson Comorbidity Index was negatively associated with test positivity. We identified symptoms that were positively associated with test positivity, as well as, commonly co-occurring symptoms / conditions. Pediatric patients had reduced odds of a positive viral test, but conversely had increased odds of a positive antibody test. Conclusions. This study identified sociodemographic and clinical factors associated with SARS-CoV-2 testing and positivity within routine clinical practice from the United States.
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COVID-19 , Obesity , Dementia , Diabetes MellitusSubject(s)
Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Cell Line, Tumor , Convalescence , Humans , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/geneticsABSTRACT
Genome-wide association studies have identified 3p21.31 as the main risk locus for severe symptoms and hospitalization in COVID-19 patients. To elucidate the mechanistic basis of this genetic association, we performed a comprehensive epigenomic dissection of the 3p21.31 locus. Our analyses pinpoint activating variants in regulatory regions of the chemokine receptor-encoding CCR1 gene as potentially pathogenic by enhancing infiltration of monocytes and macrophages into the lungs of patients with severe COVID-19.
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COVID-19ABSTRACT
The lack of an identifiable intermediate host species for the proximal animal ancestor of SARS-CoV-2 and the distance (~1500 km) from Wuhan to Yunnan province, where the closest evolutionary related coronaviruses circulating in horseshoe bats have been identified, is fueling speculation on the natural origins of SARS-CoV-2. Here we analyse SARS-CoV-2's related horseshoe bat and pangolin Sarbecoviruses and confirm Rhinolophus affinis continues to be the likely reservoir species as its host range extends across Central and Southern China. This would explain the bat Sarbecovirus recombinants in the West and East China, trafficked pangolin infections and bat Sarbecovirus recombinants linked to Southern China. Recent ecological disturbances as a result of changes in meat consumption could then explain SARS-CoV-2 transmission to humans through direct or indirect contact with the reservoir wildlife, and subsequent emergence towards Hubei in Central China. The only way, however, of finding the animal progenitor of SARS-CoV-2 as well as the whereabouts of its close relatives, very likely capable of posing a similar threat of emergence in the human population and other animals, will be by increasing the intensity of our sampling.
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SARS-CoV-2 Spike-specific antibodies contribute the majority of the neutralizing activity in most convalescent human sera. Two SARS-CoV-2 variants, N501Y.V1 (also known as B.1.1.7 lineage or VOC-202012/01) and N501Y.V2 (B.1.351 lineage), reported from the United Kingdom and South Africa, contain several mutations in the receptor binding domain of Spike and are of particular concern. To address the infectivity and neutralization escape phenotypes potentially caused by these mutations, we used SARS-CoV-2 pseudovirus system to compare the viral infectivity, as well as the neutralization activities of convalescent sera and monoclonal antibodies (mAbs) against SARS-CoV-2 variants. Our results showed that N501Y Variant 1 and Variant 2 increase viral infectivity compared to the reference strain (wild-type, WT) in vitro. At 8 months after symptom onset, 17 serum samples of 20 participants (85%) retaining titers of ID50 >40 against WT pseudovirus, whereas the NAb titers of 8 samples (40%) and 18 samples (90%) decreased below the threshold against N501Y.V1 and N501Y.V2, respectively. In addition, both N501Y Variant 1 and Variant 2 reduced neutralization sensitivity to most (6/8) mAbs tested, while N501Y.V2 even abrogated neutralizing activity of two mAbs. Taken together the results suggest that N501Y.V1 and N501Y.V2 reduce neutralization sensitivity to some convalescent sera and mAbs.
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Coronavirus Infections/diagnosis , Leukocytes/cytology , Lymphocytes/cytology , Pneumonia, Viral/diagnosis , Adult , Aged , Area Under Curve , Betacoronavirus/pathogenicity , COVID-19 , China/epidemiology , Coronavirus Infections/blood , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Retrospective Studies , SARS-CoV-2 , Sensitivity and SpecificityABSTRACT
CONTEXT.: The coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coagulation dysfunction is a hallmark in patients with COVID-19. Fulminant thrombotic complications emerge as critical issues in patients with severe COVID-19. OBJECTIVE.: To present a review of the literature and discuss the mechanisms of COVID-19 underlying coagulation activation and the implications for anticoagulant and thrombolytic treatment in the management of COVID-19. DATA SOURCES.: We performed a systemic review of scientific papers on the topic of COVID-19, available online via the PubMed NCBI, medRxiv, and Preprints as of May 15, 2020. We also shared our experience on the management of thrombotic events in patients with COVID-19. CONCLUSIONS.: COVID-19-associated coagulopathy ranges from mild laboratory alterations to disseminated intravascular coagulation (DIC) with a predominant phenotype of thrombotic/multiple organ failure. Characteristically, high D-dimer levels on admission and/or continuously increasing concentrations of D-dimer are associated with disease progression and poor overall survival. SARS-CoV-2 infection triggers the immune-hemostatic response. Drastic inflammatory responses including, but not limited to, cytokine storm, vasculopathy, and NETosis may contribute to an overwhelming activation of coagulation. Hypercoagulability and systemic thrombotic complications necessitate anticoagulant and thrombolytic interventions, which provide opportunities to prevent or reduce "excessive" thrombin generation while preserving "adaptive" hemostasis and bring additional benefit via their anti-inflammatory effect in the setting of COVID-19.
Subject(s)
Blood Coagulation Disorders/virology , Coronavirus Infections/blood , Pneumonia, Viral/blood , Thrombosis/virology , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Humans , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2ABSTRACT
BACKGROUND: In the context of the COVID-19 outbreak of worldwide, we aim to analyze the laboratory risk factors of in-hospital death in patients with severe COVID-19. METHODS: All ≥18-year-old patients with confirmed severe COVID-19 admitted to Tongji Hospital (Wuhan, China) from February 3 to February 20, 2020, were retrospectively enrolled and followed up until March 20, 2020. Epidemiological, clinical, laboratory, and treatment data were collected and explored the risk factors associated with in-hospital death. RESULTS: A total of 73 severe patients were enrolled in the study, of whom 20 (27%) patients died in hospital during the average 28 days of follow-up period. The median age of non-survivors was significantly older than survivors (69 [64-76.5] years vs 64 [56-71.3] years, P = .033) and 15 (75%) patients were males. The laboratory abnormalities of non-survivors mainly presented in serious inflammation response and multiple organ failure, with high levels of cytokines and deranged coagulation parameters. Multivariable regression showed that neutrophil count greater than 4.47 × 109 /L (OR, 58.35; 95%CI: 2.16-1571.69; P = .016), hypersensitivity C-reactive protein greater than 86.7 mg/L (OR, 14.90; 95%CI: 1.29-171.10; P = .030), creatine kinase greater than 101 U/L (OR, 161.62; 95%CI: 6.45-4045.20; P = .002), and blood urea nitrogen greater than 6.7 mmol/L (OR, 11.18; 95%CI: 1.36-91.62; P = .024) were risk factors for in-hospital death. CONCLUSION: The risk factors of neutrophil count, hypersensitivity C-reactive protein, creatine kinase, and blood urea nitrogen could help clinicians to early identify COVID-19 severe patients with poor outcomes on admission. Virus direct attack and cytokine storm play a major role in the death of COVID-19.