Role of melatonin in respiratory diseases (Review).

Melatonin, primarily secreted by the pineal gland, is an anthracemal compound. Its chemical name is N-acetyl-5-methoxytryptamine. Great advances in melatonin-related research have been made, including the understanding of its roles in the rhythm of the sleep/wake cycle, retardation of aging processes, as well as antioxidant and/or anti-inflammatory effects. Melatonin exerts a wide range of physiological effects related to the high lipophilicity of melatonin itself. Melatonin has strong radical scavenging activity, which serves an important role in pulmonary disorders. Pulmonary disorders are among the diseases that threaten human health. Especially in developing countries, due to environmental factors such as smoke and dust, the incidences of pulmonary disorders are high. Melatonin has been reported to have great potential to treat patients with pulmonary disorders. The present review discusses the relationship between melatonin and pulmonary disorders, including coronavirus disease-2019, chronic obstructive pulmonary disease, non-small cell lung cancer and pulmonary fibrosis.

Secondary bloodstream infection in critically ill patients with COVID-19.

OBJECTIVE: Secondary infection, especially bloodstream infection, is an important cause of death in critically ill patients with COVID-19. We aimed to describe secondary bloodstream infection (SBI) in critically ill adults with COVID-19 in the intensive care unit (ICU) and to explore risk factors related to SBI. METHODS: We reviewed all SBI cases among critically ill patients with COVID-19 from 12 February 2020 to 24 March 2020 in the COVID-19 ICU of Jingmen First People's Hospital. We compared risk factors associated with bloodstream infection in this study. All SBIs were confirmed by blood culture. RESULTS: We identified five cases of SBI among the 32 patients: three with Enterococcus faecium, one mixed septicemia (E. faecium and Candida albicans), and one C. parapsilosis. There were no significant differences between the SBI group and non-SBI group. Significant risk factors for SBI were extracorporeal membrane oxygenation, central venous catheter, indwelling urethral catheter, and nasogastric tube. CONCLUSIONS: Our findings confirmed that the incidence of secondary infection, particularly SBI, and mortality are high among critically ill patients with COVID-19. We showed that long-term hospitalization and invasive procedures such as tracheotomy, central venous catheter, indwelling urethral catheter, and nasogastric tube are risk factors for SBI and other complications.

The mediating role of regulatory emotional self-efficacy on negative emotions during the COVID-19 pandemic: A cross-sectional study.

Nurses exposed to coronavirus disease 2019 (COVID-19) are psychologically stressed. This study examines the characteristics and distribution of negative emotions among Chinese nurses during the COVID-19 pandemic and explores regulatory emotional self-efficacy (RESE) as the underlying mechanism in the relationship between nurses' personalities and negative emotions. A cross-sectional design with convenience sampling was utilized. Three comprehensive tertiary hospitals located in China were selected. Nurses (n = 339) who cared for COVID-19 patients were enrolled. Recruitment was conducted between 14 February 2020 and 1 March 2020. Self-reported questionnaires about personality, RESE, and epidemic-related negative emotions were completed online. A correlation analysis, structural equation modelling, and the bootstrapping method were used to analyse the data. This study identified a 24.9% incidence of negative emotions in nurses. RESE was a significant mediator explaining the effect of personality on epidemic-related negative emotions. RESE mediated the effect of introversion-extroversion on depression (ß = -0.151, P = 0.015), neuroticism (ß = -0.182, P = 0.007), fear (ß = -0.142, P = 0.006), anxiety (ß = -0.189, P = 0.015), and hypochondria (ß = -0.118, P = 0.010); it also mediated the effect of neuroticism on depression (ß = 0.313, P = 0.002), neuroticism (ß = 0.394, P = 0.003), fear (ß = 0.345, P = 0.005), anxiety (ß = 0.384, P = 0.003), and hypochondria (ß = 0.259, P = 0.004). Nurses caring for COVID-19 patients displayed negative emotions, particularly emotionally unstable and introverted nurses with a low RESE level. RESE is often essential for interventions because it significantly influences the relationship between personality and negative emotions. In the event of a major outbreak, tailored psychological well-being education, which includes emotional self-efficacy strategies, should be provided by organizations to help nurses manage stress related to the outbreak.