ABSTRACT
BACKGROUND: Asymptomatic transmission is a major concern for SARS-CoV-2 community spread; however, little information is available on demographic, virological characteristics and prognosis of asymptomatic cases. METHODS: All COVID-19 patients hospitalized in Guangdong Province from September 1, 2020 to February 28, 2021, were included and were divided into asymptomatic and symptomaticgroup. The source country of all patients, clinical laboratory test results, the genotype of virus and the time of SARS-CoV-2 RNA turning negative or hospitalization were confirmed. RESULTS: Total 233 patients from 57 different countries or regions were included, with 83 (35.6%) asymptomatic and 150 (64.4%) symptomatic patients. Asymptomatic cases were younger (P = 0.019), lower rate in comorbidities (P = 0.021) such as hypertension (P = 0.083) and chronic liver disease (P = 0.045), lower PCT (P = 0.021), DDI (P < 0.001) and ALT (P = 0.029), but higher WBC count (P = 0.002) and lymphocyte (P = 0.011) than symptomatic patients. As for SARS-CoV-2 subtypes, patients infected with B.1.1 (53.8%), B.1.351 (81.8%) and B.1.524 (60%) are mainly asymptomatic, while infected with B, B.1, B.1.1.63, B.1.1.7, B.1.36, B.1.36.1, B.1.36.16, B.1.5 and B.6 were inclined to be symptomatic. Patients infected with variant B.1.351 and B.1.524 spent longer time in SARS-CoV-2 RNA turn negative (26 days, P = 0.085; 41 days, P = 0.007) and hospitalization (28 days, P = 0.085; 43 days, P = 0.004). CONCLUSIONS: The asymptomatic cases are prone to develop in patients with younger age, less comorbidities andinfected with B.1.1 and B.1.524 variants. More attention should be paid for lineage B.1.524 because it can significantly prolong the SARS-CoV-2 RNA negative conversion time and hospitalization in infected cases.
ABSTRACT
Objective: The central issue of this research is to evaluate the extent of cognitive appraisal and coping processes within the pandemic encounter and determines their influence on frontline healthcare providers who had been dispatched to the coronavirus disease 2019 (COVID-19) epicenter (HPDE) distress symptoms. Materials and methods: An electronic survey of the HPDE and frontline healthcare providers who worked in their original medical facility (HPOF) was conducted from March 1 to 15, 2020. Two variables, appraisal (measured with an 18-item questionnaire) and coping (measured The Brief Cope questionnaire), were used in the analysis to explain distress symptoms (Impact of Event Scale-Revised). Results: A total of 723 eligible respondents completed the survey with a response rate of 57.3% (351 HPDE and 372 HPOF). The mean IES-R scores of HPDE respondents were 26.47 ± 11.7. Of HPDE respondents, 246 (70.09%) reported distress symptoms (score 9-88). The scores of intrusion, avoidance, and hyperarousal for HPDE were 10.28 ± 4.7, 8.97 ± 4.3, and 7.20 ± 3.2, respectively. The respondents had higher scores in overall distress and three subscales than HPOF. Appraisal and coping variables explained 77% of the distress variance. Five appraisal variables (health of self, health of family/others, virus spread, vulnerability or loss of control, and general health) were positively associated with distress symptoms. Four coping variables (active coping, positive reframing, self-distraction, and behavioral disengagement) were negatively associated with distress level, whereas self-blame was positively associated with distress symptoms. Regarding the appraisal, the scores of HPDE were significantly higher than HPOF (all p-values < 0.05), whereas being isolated was not significantly different between HDPE nurses and HPOF nurses. HPDE was significantly more likely to use humor, emotional support, instrumental support, self-distractions, venting, substance use, denial, behavioral disengagement, and self-blame (P < 0.05), whereas HPOF was significantly more likely to use active coping and acceptance (P < 0.05). HPDE doctors were significantly more likely than nurses to use active coping and acceptance (P < 0.05), whereas HPDE nurses were significantly more likely to use emotional support and use self-blame (P < 0.05). Conclusion: Frontline healthcare providers who had been dispatched to the COVID-19 epicenter respondents had a higher distress level. Therefore, we should provide proactive psychological support based on specific appraisal and coping variables.