Exploring tourism business model importance with the emergence of blockchain system: directions for tourism industry of China.

The study aims to explore the importance of the tourism business model with the emergence of the blockchain platform in China. The study focused on the importance of the tourism business model of china, studied the need to improve the tourism business infrastructure, and traced the value of the blockchain system in the tourism industry of china. For this, the researchers used a semi-structured interview approach to conduct a qualitative research design. About nine Chinese tourism and travel industry experts were interwar after initial screening using purposive sampling techniques. The respondents' responses were analyzed by applying a thematic analysis approach, and by this, the researchers extracted the main themes on study topicality to fill the gap in the literature. The study's novelty is in its topicality and context, for which it also provides viable, practical directions for stakeholders.

[Changes in Secondary Inorganic Ions in PM2.5 at Different Pollution Stages Before and After COVID-19 Control].

To investigate the change characteristics of secondary inorganic ions in PM2.5 at different pollution stages before and after COVID-19, the online monitoring of winter meteorological and atmospheric pollutant concentrations in Zhengzhou from December 15, 2019 to February 15, 2020 was conducted using a high-resolution (1 h) online instrument. This study analyzed the causes of the haze process of COVID-19, the diurnal variation characteristics of air pollutants, and the distribution characteristics of air pollutants at different stages of haze.The results showed that Zhengzhou was mainly controlled by the high-pressure ridge during the haze process, and the weather situation was stable, which was conducive to the accumulation of air pollutants. SNA was the main component of water-soluble ions, accounting for more than 90%. Home isolation measures during COVID-19 had different impacts on the distribution characteristics of air pollutants in different haze stages. After COVID-19, the concentration of PM2.5 in the clean, occurrence, and dissipation stages increased compared with that before COVID-19 but significantly decreased in the development stage. The home isolation policy significantly reduced the high value of PM2.5. The concentrations of NO2, SO2, NH3, and CO were the highest in the haze development stage, showing a trend of first increasing and then decreasing. The concentration of O3 was lowest in the pre-COVID-19 development stage but highest in the post-COVID-19 development stage. The linear correlation between[NH4+]/[SO42-] and[NO3-]/[SO42-] at different time periods before and after COVID-19 was strong, indicating that the home isolation policy of COVID-19 did not change the generation mode of NO3-, and the corresponding reaction was always the main generation mode of NO3-. The correlation between[excess-NH4+] and[NO3-] was high in different periods before COVID-19, and NO3- generation was related to the increase in NH3 or NH4+ in the process of PM2.5 pollution in Zhengzhou.

Effectiveness of inactivated COVID-19 vaccines against mild disease, pneumonia, and severe disease among persons infected with SARS-CoV-2 Omicron variant: Real-world study in Jilin Province, China.

BACKGROUND: : It is critical to determine the real-world performance of vaccines against coronavirus disease 2019 (COVID-19) so that appropriate treatments and policies can be implemented. There was a rapid wave of infections by the Omicron variant in Jilin Province (China) during spring 2022. We examined the effectiveness of inactivated vaccines against Omicron using real-world data from this epidemic. METHODS: . This retrospective case-case study of vaccine effectiveness (VE) examined infected patients who were quarantined and treated from April 16 to June 8, 2022 and responded to an electronic questionnaire. Data were analyzed by univariable and multivariable analyses. RESULTS: . A total of 2968 cases with SARS-CoV-2 infections (asymptomatic: 1029, mild disease: 1858, pneumonia: 108, severe disease: 21) were enrolled in the study. Multivariable regression indicated that the risk for pneumonia or severe disease was greater in those who were older or had underlying diseases, but was less in those who received COVID-19 vaccines. Relative to no vaccination, VE against the composite of pneumonia and severe disease was significant for those who received 2 doses (60.1%, 95%CI: 40.0%, 73.5%) or 3 doses (68.1%, 95%CI: 44.6%, 81.7%), and VE was similar in the subgroups of males and females. However, VE against the composite of all three classes of symptomatic diseases was not significant overall, nor after stratification by sex. There was no statistical difference in the VE of vaccines from different manufacturers. CONCLUSION: . The inactivated COVID-19 vaccines protected patients against pneumonia and severe disease from Omicron infection, and booster vaccination enhanced this effect.

How Community-Based Eldercare Services Adapt in Response to Covid-19 Restrictions: Evidence from Singapore.

This study investigated service adaptation strategies that community-based eldercare services (CES) in Singapore adopted in view of the COVID-19 pandemic restrictions. These strategies were also examined for their strengths and challenges. A qualitative study using semi-structured interviews was conducted individually with 11 social service staff from various CES in Singapore. Findings indicated that two main forms of service adaptation emerged: (1) increased engagement with clients and relevant stakeholders, and (2) increased use of telecommunication modalities. Resulting benefits included (1) perceived enhancement of social connectedness and social engagement for service users, and (2) new opportunities for CES to review operations and tap on increased visibility of service users. However, difficulties using telecommunications, resource constraints, and work stressors remain. It is recommended that CES providers implement supportive workplace practices, complement direct service provision with technology, and leverage on opportunities to improve the social environments of community-dwelling older adults.

Longitudinal trajectories of suicidal ideation among Chinese medical students: the role of childhood trauma (preprint)

Background: The aim of this study was to understand the longitudinal trajectory of suicidal ideation among Chinese medical students and the role of childhood trauma. Methods: Using a whole-group sampling method, we assessed suicidal ideation in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Self-rating Idea of Suicide Scale (SIOSS) and the Childhood Trauma Questionnaire-Short Form  (CTQ-SF) were used to assess suicidal ideation and childhood trauma. The regression of mixed models was used to analyze the developmental trajectory of suicidal ideation. Results: Chinese medical students scored higher on suicidal ideation than the general population, and the prevalence of suicidal ideation increased during the COVID-19 pandemic. The trajectory of suicidal ideation among Chinese medical students was divided into two groups: a low-level, slowly rising group and a high-level, continuous group. The low-level, slowly rising group had a significant time effect (B=1.57, p<0.001) and showed a slowly increasing trend. Emotional neglect, somatic neglect, emotional abuse and somatic abuse all had significant positive predictive effects for the low-risk, slowly rising group (B=0.18-0.65, P<0.01). Conclusion: The trajectory of suicidal ideation among medical students can be divided into a low-risk, slow-rising group and a high-risk, continuous group; the more emotional neglect, somatic neglect, emotional abuse and physical abuse experienced during childhood, the more likely medical students are to develop a high-risk, continuous state of suicidal ideation.

Development of a nomogram to assess the impact of the myocardial injury on the prognosis of COVID-19 patients.

Coronavirus disease 2019 (COVID-19) has been spreading worldwide. Many COVID-19 patients were accompanied by myocardial injury during the course of the disease. To evaluate the association of cardiac injury with clinical outcomes in COVID-19 patients, we recruited 261 COVID-19 cases admitted to Tongji Hospital of Huazhong University of Science and Technology in this study. Compared with patients without myocardial injury, those with myocardial injury were older, with shorter hospital stays and lower survival rates. They also had higher levels of inflammatory biomarkers (Interleukin-6,8,10 and C-reactive protein), coagulation biomarkers, liver and kidney function markers. Kaplan-Meier analysis demonstrated that patients with myocardial injury had a higher mortality rate. The multivariate Cox regression model and the nomogram revealed that myocardial injury, co-morbidity, and abnormal procalcitonin (PCT) levels were independent risk factors of the mortality of COVID-19 patients. The linear correlation analysis and the ROC curve suggested a predictive value of the neutrophil-lymphocyte ratio (NLR) in cardiac injury. Summarily, myocardial injury in COVID-19 patients is associated with a higher mortality risk. Attention should be paid to monitoring myocardial injury in patients with significantly elevated myocardial markers and NLR at admission.

Analysis of mortality surveillance of residents in Minhang district of Shanghai from January to April in 2016-2020

Objective: To characterize the mortality rate of residents in Minhang District of Shanghai from January to April in 2016-2020, and to determine the change in the epidemic Coronavirus Disease 2019 (COVID-19) in 2020.

The Impact of Scarcity on Consumers' Impulse Buying Based on the S-O-R Theory.

Purpose: The global COVID-19 pandemic impacted the healthcare systems of every nation. The scarcity of medical protective equipment led to impulse buying at the early stages of the COVID-19 outbreak in China which resulted in stockpiling and the increase of prices by retailers and insufficiencies among frontline workers. This situation impacted epidemic control work and market order and is the context from which this paper identifies how the scarcity of medical protective equipment affected Chinese consumers' impulse buying based on the theories of S-O-R model and bandwagon effect. The research provides insight into the mechanism of mediation (fear of missing out) and moderation (bandwagon) in the relationship between scarcity and impulse buying. Design/Methodology/Approach: This study uses convenience sampling, surveying 488 Chinese consumers through an online questionnaire. Smart-PLS was used to test the hypotheses. Findings: The empirical findings demonstrate that scarcity makes consumers fear missing the chance of getting protective medical equipment, leading ultimately to impulse buying. Besides, the scarcity effect on consumers' impulse buying was found to depend on other consumers' follow up behaviour in such emergency situations. Research Limitations/Implications: The findings provide managerial and theoretical insight and a point of reference for businesses in the implementation of a scarcity strategy. The findings will also prove useful to the Chinese Risk Response Department as it continuously improves its responses to the risk of consumers' impulse buying during a pandemic. Originality/Value: This study consolidates and takes research forward in the areas of impulse buying and consumer behaviour, confirming the mediating effect of fear of missing out and the moderating effect of the bandwagon in the relationship between scarcity and impulse buying.

Impact of the COVID-19 pandemic on patients with chronic kidney disease: A narrative review.

ABSTRACT: Severe acute respiratory disease coronavirus 2 is currently causing the coronavirus disease 2019 (COVID-19) pandemic, placing extreme strain on the global health system. Vaccination is the main measure for preventing the COVID-19 epidemic, especially for high-risk groups including patients with chronic kidney disease (CKD). However, CKD patients receiving dialysis or kidney transplant may be characterized by decreased renal function and immune disorders, which may have uncertainties in their health. This overview aims to introduce the possible impact of the COVID-19 vaccine on kidney disease and its application in patients with CKD to provide evidence for the COVID-19 vaccine in patients with CKD. The data for this study were collected from PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and the China Knowledge Resource Integrated Database (CNKI). The following keywords were used: "COVID-19", "COVID-19 vaccine," and "CKD". The publication time of the papers was set from the establishment of the databases to September 2021. A total of 47 studies were included, and patients with CKD are a high-risk group for COVID-19 infection and severe illness. Vaccination is a powerful tool for preventing CKD patients from COVID-19. Because of possible side effects, the recurrence or deterioration of kidney disease may occur in CKD patients after vaccination. Although vaccination for patients with CKD remains a problem, with the advantages outweighing the disadvantages, stable CKD patients should complete a vaccination plan, and doctors should be aware of the recurrence or deterioration of kidney disease and close monitoring. DATA ACCESS STATEMENT: Research data supporting this publication are available from the electronic databases of PubMed, Cochrane Library, Embase, ClinicalTrials.gov, and the China Knowledge Resource Integrated Database (CNKI).

Using big data to understand the online ecology of COVID-19 vaccination hesitancy

With a large population of people vaccinated, it is possible that at-risk people are shielded, and the coronavirus disease is contained. Given the low vaccine uptakes, achieving herd immunity via vaccination campaigns can be challenging. After a literature review, we found a paucity of research studies of vaccine hesitancy from social media settings. This study aims to categorise and create a typology of social media contents and assess the priority of concerns for future public health messaging. With a dataset of 43,203 YouTube comments, we applied text analytics and multiple regression analyses to examine the correlations between vaccine hesitancy factors and vaccination intention. Our major findings are (i) Polarized views on vaccines existed in the social media ecology of public discourse, with a majority of people unwilling to get vaccinated against COVID-19;(ii) Reasons behind vaccine hesitancy included concerns about vaccine safety, potential side-effects, lack of trust in government and pharmaceutical companies;(iii) Political partisan-preferences were exemplified in vaccine decision-making processes;(iv) Anti-vaccine movements with amplified misinformation fuelled vaccine hesitancy and undermined public confidence in COVID-19 vaccines. We suggest public health practitioners engage in social media and craft evidenced-based messages to online communities in a balanced and palatable way.

Effectiveness of Systemic Corticosteroids Therapy for Nonsevere Patients With COVID-19: A Multicenter, Retrospective, Longitudinal Cohort Study.

OBJECTIVES: Corticosteroids were clinically used in the treatment of nonsevere patients with COVID-19, but the efficacy of such treatment lacked sufficient clinical evidence, and the impact of dose had never been studied. This study aimed to evaluate the effect of systemic corticosteroid use (SCU) in nonsevere patients with COVID-19. METHODS: We conducted a multicenter retrospective cohort study in Hubei Province. A total of 1726 patients admitted with nonsevere type COVID-19 were included. Mixed-effect Cox model, mixed-effect Cox model with time-varying exposure, multiple linear regression, and propensity score analysis (inverse probability of treatment weight and propensity score matching) were used to explore the association between SCU and progression into severe type, all-cause mortality, and length of stay. RESULTS: During the follow-up of 30 days, 29.8% of nonsevere patients with COVID-19 received treatment with systemic corticosteroids. The use of systemic corticosteroids was associated with higher probability of developing severe type (adjusted hazard ratio 1.81; 95% confidence interval 1.47-2.21), all-cause mortality (adjusted hazard ratio 2.92; 95% confidence interval 1.39-6.15) in time-varying Cox analysis, and prolonged hospitalization (ß 4.14; P < .001) in multiple linear regression. Analysis with 2 propensity score cohorts displayed similar results. Besides, increased corticosteroid dose was significantly associated with elevated probability of developing severe type (P < .001) and prolonged hospitalization (P < .001). CONCLUSIONS: Corticosteroid treatment against nonsevere patients with COVID-19 was significantly associated with worse clinical outcomes. The higher dose was significantly associated with elevated risk of poor disease progression. We recommend that SCU should be avoided unless necessary among nonsevere patients with COVID-19.

Social trust and stress symptoms among older adults during the COVID-19 pandemic: evidence from Asia.

OBJECTIVES: To investigate whether social trust is associated with more stress symptoms among middle-aged and older adults in six East and Southeast Asia regions during the COVID-19 pandemic. METHODS: This multi-region study used cross-sectional survey data collected in May 2020. Participants were a probability-based internet sample of adults aged 55 or older. RESULTS: Government trust was negatively associated with stress in Singapore and South Korea. Higher levels of health care trust were significantly associated with less stress in Singapore and Taiwan. Trust in neighbors was associated with a higher likelihood of stress in Hong Kong and a lower likelihood in Singapore. Social trust was not associated with stress in Japan or Thailand. DISCUSSION: Findings suggest the level of social trust in relation to stress substantially varied by region. Interventions to strengthen trust during COVID-19 and other major health crises need to be tailored to fit regions' unique circumstances.

Comparison of Safety of Different Vaccine Boosters Following Two-Dose Inactivated Vaccines: A Parallel Controlled Prospective Study.

A vaccine booster to maintain high antibody levels and provide effective protection against COVID-19 has been recommended. However, little is known about the safety of a booster for different vaccines. We conducted a parallel controlled prospective study to compare the safety of a booster usingfour common vaccines in China. In total, 320 eligible participants who had received two doses of an inactivated vaccine were equally allocated to receive a booster of the same vaccine (Group A), a different inactivated vaccine (Group B), an adenovirus type-5 vectored vaccine (Group C), or a protein subunit vaccine (Group D). A higher risk of adverse reactions, observed up to 28 days after injection, was found in Groups C and D, compared to Group A, with odds ratios (OR) of 11.63 (95% confidence interval (CI): 4.22-32.05) and 4.38 (1.53-12.56), respectively. Recipients in Group C were more likely to report ≥two reactions (OR = 29.18, 95% CI: 3.70-229.82), and had a higher risk of injection site pain, dizziness, and fatigue. A gender and age disparity in the risk of adverse reactions was identified. Despite the majority of reactions being mild, heterologous booster strategies do increase the risk of adverse reactions, relative to homologous boosters, in subjects who have had two doses of inactive vaccine.

Prevalence of Visual Impairment Among Students Before and During the COVID-19 Pandemic, Findings From 1,057,061 Individuals in Guangzhou, Southern China.

BACKGROUND: Visual impairment (VI) is a growing public health concern among students as a result of the COVID-19 pandemic. OBJECTIVE: This study investigated the change in VI before and during the pandemic among students. METHODS: Data on 547,864 and 497,371 students were obtained from the Guangzhou Survey on Students' Constitution and Health (GSSCH) collected in October 2019 and October 2020, respectively. VI was defined as the unaided distance visual acuity lower than 20/25 Snellen equivalent (LogMAR 0.10) in the worse eye. Change in VI based on age and sociodemographic variables were evaluated by chi-square test for trend as appropriate. Comparisons of different categorical variables were tested by contingency tables-based chi-square test. We have further analysis of the students who went through both of the 2019 and 2020 examinations for evaluating the VI incidence during the COVID-19 pandemic. RESULTS: More than 1,045,235 students were involved in our study, among whom 271,790 (54.65%) out of 497,371 students in Guangzhou suffered from VI during the COVID-19 compared with 293,001(53.48%) visually impaired students (total tested participants = 547,864) before the COVID-19 pandemic. During the pandemic, the overall prevalence of VI actually showed an increased age tendency and reached the highest level in the 17 [80.04%, 95%Confidence interval (CI):79.53 to 80.54%] and the 18 (79.64, 95%CI: 79.06 to 80.23%) age groups. Rapid growth was detected among students aged between 9 and 16 years old (raised by 46.21) while older students were more likely to get moderate and severe VI than younger ones. Students involved in more screen-based activities [(64.83%, 2019); (66.59%, 2020)] appeared to have a higher prevalence of VI than those involved in less [(49.17%, 2019); (49.26%, 2020)]. CONCLUSION: A rising trend of VI among students was detected before and during the COVID-19 pandemic. Moreover, the pandemic appeared to be associated with a rapid VI shift in younger and boy populations. Potential danger may arise when public health emergencies occur in the school, and more effort should be made to improve students' vision.

Creating a Digital Toolkit to Reduce Fatigue and Promote Quality of Life in Multiple Sclerosis: Participatory Design and Usability Study.

BACKGROUND: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS), experienced by more than 80% of people with MS. FACETS (Fatigue: Applying Cognitive Behavioral and Energy Effectiveness Techniques to Lifestyle) is an evidence-based, face-to-face, 6-session group fatigue management program for people with MS. Homework tasks are an integral part of FACETS and are currently undertaken in a paper-based form. Feedback from a consultation undertaken with FACETS attendees and health care professionals with experience in delivering the FACETS program suggested that being able to complete the homework tasks digitally would be desirable, potentially enhancing engagement and adherence and enabling on-the-go access to fit into busy lifestyles. Relative to other long-term conditions, there are few apps specifically for MS and, of those available, many have been developed with little or no input from people with MS. OBJECTIVE: The purpose of this mixed methods study was to create a digital toolkit comprising the homework tasks (eg, activity diary, goal planner, thought diary) of the FACETS program for people with MS, considering end users' unique requirements throughout the design, build, prototyping, and testing stages. METHODS: Phase 1 involved the elicitation of detailed user requirements for the toolkit via 2 focus groups with previous attendees of FACETS (n=3 and n=6) and wireframing. Phase 2 involved supervised usability testing with people with MS (n=11) with iterative prototyping. The usability sessions involved going through test scenarios using the FACETS toolkit on an Android test phone with video capture and concurrent think-aloud followed by completion of the System Usability Scale (SUS) and a semistructured interview collecting feedback about design, content, and functionality. RESULTS: The mean SUS score for the digital toolkit was 74.3 (SD 16.8, 95% CI 63.2-85.6; range 37.5-95), which equates to an adjective rating of good and a B grade (70th-79th percentile range) on the Sauro-Lewis curved grading scale. A number of usability and design issues (such as simplifying overall screen flow to better meet users' needs) and suggestions for improvements (such as using location-based services and displaying personalized information and progress via a central dashboard) were addressed and implemented during the usability testing cycle. CONCLUSIONS: This work highlights the importance of the participation of people with MS across the entire development cycle, working to a human-centered design methodology to enable a considered and MS-centered solution to be developed. Continued horizon scanning for emergent technological enhancements will enable us to identify opportunities for further improvements to the FACETS toolkit prior to launch. The toolkit supports self-monitoring and management of fatigue and has potential applicability to other long-term conditions where fatigue is a significant issue.

Traceable surveillance and genetic diversity analysis of coronaviruses in poultry from China in 2019.

Coronavirus disease 2019 (COVID-19), caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China, and rapidly spread throughout the world. This newly emerging pathogen is highly transmittable and can cause fatal disease. More than 35 million cases have been confirmed, with a fatality rate of about 2.9% to October 9, 2020. However, the original and intermediate hosts of SARS-CoV-2 remain unknown. Here, 3160 poultry samples collected from 14 provinces of China between September and December 2019 were tested for SARS-CoV-2 infection. All the samples were SARS-CoV-2 negative, but 593 avian coronaviruses were detected, including 485 avian infectious bronchitis viruses, 72 duck coronaviruses, and 36 pigeon coronaviruses, with positivity rates of 15.35%, 2.28%, and 1.14%, respectively. Our surveillance demonstrates the diversity of avian coronaviruses in China, with higher prevalence rates in some regions. Furthermore, the possibility that SARS-CoV-2 originated from a known avian-origin coronavirus can be preliminarily ruled out. More surveillance of and research into avian coronaviruses are required to better understand the diversity, distribution, cross-species transmission, and clinical significance of these viruses.

Evaluation of early antibiotic use in patients with non-severe COVID-19 without bacterial infection.

OBJECTIVES: The use of antibiotics was common in some countries during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, but adequate evaluation remains lacking. This study aimed to evaluate the effect of early antibiotic use in patients with non-severe COVID-19 admitted without bacterial infection. METHODS: This multi-centre retrospective cohort study included 1,373 inpatients with non-severe COVID-19 admitted without bacterial infection. Patients were divided into two groups according to their exposure to antibiotics within 48 h of admission. The outcomes were progression to severe COVID-19, length of stay >15 days and mortality rate. A mixed-effect Cox model and random effect logistic regression were used to explore the association between early antibiotic use and outcomes. RESULTS: During the 30-day follow-up period, the proportion of patients who progressed to severe COVID-19 in the early antibiotic use group was almost 1.4 times that of the comparison group. In the mixed-effect model, the early use of antibiotics was associated with higher probability of developing severe COVID-19 and staying in hospital for >15 days. However, there was no significant association between early use of antibiotics and mortality. Analysis with propensity-score-matched cohorts displayed similar results. In subgroup analysis, patients receiving any class of antibiotic were at increased risk of adverse health outcomes. Azithromycin did not improve disease progression and length of stay in patients with COVID-19. CONCLUSIONS: It is suggested that antibiotic use should be avoided unless absolutely necessary in patients with non-severe COVID-19, particularly in the early stages.

The Impact of Scarcity of Medical Protective Products on Chinese Consumers’ Impulsive Purchasing during the COVID-19 Epidemic in China

In 2020, during the peak period of the COVID-19 outbreak in China, the scarcity of medical protective products significantly influenced consumers’ impulsive purchasing and affected the public order. It is important to identify the effect of scarcity on consumers’ impulsive purchasing during this difficult time. However, scant research has been conducted on the impact of scarcity of medical protective products on Chinese consumers’ impulsive purchasing. This paper investigates the impact of the scarcity of medical protective products on consumers’ impulsive purchasing during the pandemic in China based on the theories of scarcity, S-O-R and bandwagon effect. Simultaneously, this study identifies the different mediating mechanisms (fear of missing out and perception) and the moderation (bandwagon) in the relationship between scarcity and impulsive purchasing. Finally, 509 validity data were collected by using an online questionnaire, and SmartPLS was used for data analysis. The findings present that the fear of missing out, perception and bandwagon dominate the scarcity effect on impulsive purchasing. The findings provide more information on consumers’ impulsive purchasing in the context of scarcity of medical protective products. Marketers and the Chinese government can adopt measures to reduce their effect, which may help maintain the public order during the epidemic.

Ultrasound Imaging Findings of Acute Testicular Infection in Patients With Coronavirus Disease 2019: A Single-Center-Based Study in Wuhan, China.

OBJECTIVES: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, raising widespread public health concerns. Our team treated hospitalized patients with COVID-19 in Wuhan, where the outbreak first began, and we suspected that SARS-CoV-2 may cause testicular infection in male patients. We conducted this study to explore that observation. METHODS: We enrolled male patients with a confirmed diagnosis of COVID-19 and performed a bedside ultrasound (US) examination of the scrotum, focused on findings of acute inflammation such as tunica albuginea thickening, enlargement and heterogeneous echogenicity of the testis, epididymis, or both, an abscess, scrotal wall edema, and hydrocele. Then we compared the proportions of observed epididymo-orchitis in patients from different age groups and COVID-19 severity groups. RESULTS: A total of 142 patients with COVID-19 were enrolled in our study, and 32 (22.5%) patients had acute orchitis, epididymitis, or epididymo-orchitis on scrotal US imaging, according to the diagnosis criteria. The observed risk of acute scrotal infection increased with age, with the incidence reaching 53.3% in men older than 80 years. We also observed that men with severe COVID-19 had a significantly higher possibility of epididymo-orchitis compared to the nonsevere COVID-19 group (P = .037). CONCLUSIONS: This study shows US imaging evidence that SARS-CoV-2 may cause infection of the testis or epididymis, and the risk is worthy of the attention of clinicians.