Current status and correlates of screen time among children in Guangdong during the COVID-19 pandemic

Objective To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods Using the convenience sampling method, a total of 5 266 pupils aged 6-12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi-square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07+or-9.62) min, which totaled (110.41+or-51.98)min per day. Sex, grade, being the only child, and parents' education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR=1.27;weekends: OR=1.40;P < 0.05) or lower levels of physical activity (weekdays: OR=1.86;weekend: OR=1.84;P < 0.05) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P < 0.05) or lower level (weekdays: OR=1.32, P < 0.05) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents' recreational screen time 2 h/d had a higher risk of prolonged recreational screen time than the reference group;children who exhibited moderate to vigorous levels of physical activity < 1 h/d (weekdays: OR=1.31, P < 0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR=2.65;weekend: OR=2.65;P < 0.05) or for 2 h/d (weekdays: OR=4.05, weekend: OR=5.24, P < 0.05) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children's health.

Emotional and behavioral problems and determinants among primary and middle school students aged 6 to 17-year-old in Guangdong Province during the COVID-19 pandemic

Objective: To gain a better understanding of the emotional and behavioral problems associated determinants of primary and middle school students from Guangdong Province during the COVID-19 pandemic, so as to provide a basis for developing targeted intervention strategies.

Pathological changes in the lungs and lymphatic organs of 12 COVID-19 autopsy cases.

Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of 12 COVID-19 decedents-findings that evaluated histopathological changes, immune cell signature and inflammatory factor expression in the lungs, spleen and lymph nodes. Here we show that the major pulmonary alterations included diffuse alveolar damage, interstitial fibrosis and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration and abundant production of inflammatory factors (IL-6, IP-10, TNFα and IL-1ß). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.