Does COVID-19 Affect the Accessibility of Outdoor Sports Venues? A Case Study in Nanchang, China

The COVID-19 pandemic has been a great challenge to society, the economy, and population health. It has become a significant public health event and social problem. Exploring the impact of COVID-19 on the accessibility of outdoor sports venues is crucial for people's health. Based on spatial theory, the quantitative and qualitative analyses of outdoor sports venues' spatial distribution and accessibility were conducted, and the epidemic's impact on them was analyzed. The results show that: (1) The existing outdoor sports venues in Nanchang show a distribution pattern of 'sparse in the north and south, and strong aggregation in the middle';. (2) As a result of the epidemic, the center of the standard deviation ellipse in outdoor sports sites shifted to the southeast, while the number of open venues decreased by 68%. (3) Before COVID-19, the entire study area could achieve full coverage by driving for 17 min, riding for 70 min, or walking for 119 min. After COVID-19, the time increased to 29, 109, and 193 min, respectively. (4) Under the high-risk scenario of COVID-19, the average walking time for people to reach outdoor sports venues increased from 6.2 min to 14.0 min in the study area, with an increase of 126%. Finally, according to the findings of this study, recommendations were made on how government departments could build or re-open outdoor sports venues during and after this epidemic.

Identifying Contextual and Spatial Risk Factors for Post-Acute Sequelae of SARS-CoV-2 Infection: An EHR-based Cohort Study from the RECOVER Program (preprint)

Post-acute sequelae of SARS-CoV-2 infection (PASC) affects a wide range of organ systems among a large proportion of patients with SARS-CoV-2 infection. Although studies have identified a broad set of patient-level risk factors for PASC, little is known about the contextual and spatial risk factors for PASC. Using electronic health data of patients with COVID-19 from two large clinical research networks in New York City and Florida, we identified contextual and spatial risk factors from nearly 200 environmental characteristics for 23 PASC symptoms and conditions of eight organ systems. We conducted a two-phase environment-wide association study. In Phase 1, we ran a mixed effects logistic regression with 5-digit ZIP Code tabulation area (ZCTA5) random intercepts for each PASC outcome and each contextual and spatial factor, adjusting for a comprehensive set of patient-level confounders. In Phase 2, we ran a mixed effects logistic regression for each PASC outcome including all significant (false positive discovery adjusted p-value < 0.05) contextual and spatial characteristics identified from Phase I and adjusting for confounders. We identified air toxicants (e.g., methyl methacrylate), criteria air pollutants (e.g., sulfur dioxide), particulate matter (PM2.5) compositions (e.g., ammonium), neighborhood deprivation, and built environment (e.g., food access) that were associated with increased risk of PASC conditions related to nervous, respiratory, blood, circulatory, endocrine, and other organ systems. Specific contextual and spatial risk factors for each PASC condition and symptom were different across New York City area and Florida. Future research is warranted to extend the analyses to other regions and examine more granular contextual and spatial characteristics to inform public health efforts to help patients recover from SARS-CoV-2 infection.

Microbial and human transcriptional profiling of coronavirus disease 2019 patients: Potential predictors of disease severity

The high morbidity of patients with coronavirus disease 2019 (COVID-19) brings on a panic around the world. COVID-19 is associated with sex bias, immune system, and preexisting chronic diseases. We analyzed the gene expression in patients with COVID-19 and in their microbiota in order to identify potential biomarkers to aid in disease management. A total of 129 RNA samples from nasopharyngeal, oropharyngeal, and anal swabs were collected and sequenced in a high-throughput manner. Several microbial strains differed in abundance between patients with mild or severe COVID-19. Microbial genera were more abundant in oropharyngeal swabs than in nasopharyngeal or anal swabs. Oropharyngeal swabs allowed more sensitive detection of the causative SARS-CoV-2. Microbial and human transcriptomes in swabs from patients with mild disease showed enrichment of genes involved in amino acid metabolism, or protein modification via small protein removal, and antibacterial defense responses, respectively, whereas swabs from patients with severe disease showed enrichment of genes involved in drug metabolism, or negative regulation of apoptosis execution, spermatogenesis, and immune system, respectively. Microbial abundance and diversity did not differ significantly between males and females. The expression of several host genes on the X chromosome correlated negatively with disease severity. In this way, our analyses identify host genes whose differential expression could aid in the diagnosis of COVID-19 and prediction of its severity via non-invasive assay.

Analysis of epidemic characteristics of COVID-19 clusters in Chenzhou, Hunan Province

Objective: To analyze the epidemiological characteristics of 8 clusters of coronavirus disease 2019 (COVID-19) in Chenzhou City, and provide scientific basis for epidemic prevention and control.

Critical Influences on Responsible Tourism Behavior and the Mediating Role of Ambivalent Emotions

This research employed a behavioral model to confirm and elucidate the critical influence of place attachment, destination involvement, and ambivalent emotion on responsible tourism behaviors. A total of 415 questionnaires were collected from tourists visiting Penghu Island in Taiwan. Following data analysis using structural equation modeling, the results suggested that place attachment, destination involvement, and ambivalent emotion critically impact responsible tourism behaviors, and that place attachment is negatively related to ambivalent emotion. In addition, ambivalent emotion was found to mediate the relationship between place attachment and responsible tourism behaviors. Finally, implications for the promotion of sustainable tourism development were thoughtfully provided based on these findings.

Air quality characteristics in Wuhan (China) during the 2020 COVID-19 pandemic.

Understanding the relationship between air quality, pollution emission control measures, and meteorological conditions is important for developing effective air quality improvement policies. In this study, we used pollution monitoring and meteorological data from January to May 2020 to analyze the air quality characteristics during the COVID-19 lockdown in Wuhan, which lasted from January 23 to April 8, 2020. Compared with the same period in 2019, the air quality in 2020 was significantly better. The total excellent and good air quality rates increased by 17.58%-90.08% in 2020; concentrations of NO2, particulate matter with a diameter <10 µm (PM10) and <2.5 µm (PM2.5), and total volatile organic compounds (TVOCs) also decreased by 38.23%, 30.25%, 32.92%, and 39.80%, respectively. Moreover, the number of days with NO2, PM10, and PM2.5 as the primary pollutants decreased by approximately 10%, 9%, and 15%, respectively. We compared the wind direction, wind speed, temperature, and relative humidity in January-April 2020, 2019, 2018, and 2017 and found no obvious correlation between meteorological factors and improved air quality during the 2020 lockdown. The implementation of strict lockdown measures, such as home quarantining, traffic restrictions, and non-essential enterprise shutdowns, was the dominant cause for the substantial air quality improvement during the 2020 COVID-19 lockdown in Wuhan.

Effects of severe acute respiratory syndrome coronavirus 2 infection on pregnant women and their infants: a retrospective study in Wuhan, China

Context.- The pandemic of a novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global health burden. Objective.- To investigate the effect of the SARS-CoV-2 infection on maternal, fetal, and neonatal morbidity and other poor obstetrical outcomes. Design.- All suspected cases of pregnant women with coronavirus disease 2019 (COVID-19) admitted into one center in Wuhan from January 20 to March 19, 2020, were included. Detailed clinical data of those pregnancies with COVID-19 were retrospectively collected and analyzed. Results.- Twenty-seven pregnant women (4 early pregnancies included) with laboratory or clinically confirmed SARS-CoV-2 infection and 24 neonates born to the 23 women in late pregnancy were analyzed. On admission, 46.2% (13 of 27) of the patients had symptoms, including fever (11 of 27), cough (9 of 27), and vomiting (1 of 27). Decreased total lymphocytes count was observed in 81.5% (22 of 27) of patients. Twenty-six patients showed typical viral pneumonia by chest computed tomography scan, whereas 1 patient confirmed with COVID-19 infection showed no abnormality on chest computed tomography. One mother developed severe pneumonia 3 days after her delivery. No maternal or perinatal death occurred. Moreover, 1 early preterm newborn born to a mother with the complication of premature rupture of fetal membranes, highly suspected to have SARS-CoV-2 infection, was SARS-CoV-2 negative after repeated real-time reverse transcriptase polymerase chain reaction testing. Statistical differences were observed between the groups of women in early and late pregnancy with COVID-19 in the occurrence of lymphopenia and thrombocytopenia. Conclusions.- No major complications were reported among the studied cohort, though 1 serious case and 1 perinatal infection were observed. Much effort should be made to reduce the pathogenic effect of COVID-19 infection in pregnancies.

Physical Exercise and Economic Burden Associated With Anxiety Symptoms in Pregnant Women During the COVID-19 Pandemic (preprint)

Background: COVID-19 with high infectivity and high concealment has been widely spread around the world. This major public health event has caused anxiety among the public, including pregnant women. The aim of this study was to assess the incidence of anxiety symptoms in pregnant women during the COVID-19 pandemic and its influencing factors.Methods: Using an ongoing prospective pregnancy registry, we performed a single center cross-sectional analysis to investigate the overall prevalence of anxiety symptoms among pregnant women during the COVID-19 pandemic. Online questionnaires were used to collect information including sociodemographic data, physical activity and economic situations. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety symptoms. The univariate regression analysis was performed to detect factors potentially influencing anxiety symptoms among pregnant women. The multivariate regression analysis was also conducted to analyze the association of physical exercise and economic burden with anxiety symptoms by adjusting for other variables.Results: A total of 1,517 pregnant women entered the analysis. The study reported that 31.64% of the respondents had anxiety symptoms. Those with bank loans were at higher odds of suffering from anxiety symptoms compared to those without bank loans [(adjusted odds ratio (aOR) 1.494, 95% confidence interval (CI) 1.181~1.889]. Those who took 2,000~5,000 steps/day (aOR 0.825, 95% CI 0.603~0.875) and >5,000 steps/day (aOR 0.924, 95% CI 0.439~0.945) were at lower odds of suffering from anxiety symptoms compared to those who took <500 steps/day. Similarly, the adjusted odds ratios for anxiety symptoms was 0.750 (95% CI 0.663~0.790) and 0.800 (95% CI 0.226~0.889) lower in participants with exercise frequencies of 4-6, and ≥7 times/week, compared to those with a frequency of <2 times/week.Conclusions: Three in ten pregnant women experienced anxiety symptoms during the COVID-19 pandemic, and anxiety symptoms showed association with bank loans and physical exercise. To prevent anxiety of pregnant women, the promotion of healthy lifestyles, improvement of mental health services, and expansion of social support should be implemented during epidemics. In parallel, the integration of psycho-educational interventions with mental health services among public health centers is required to minimize anxiety symptoms in pregnancy women.