The Efficacy of SARS-CoV-2 Vaccination in the Elderly: A Systemic Review and Meta-analysis.

BACKGROUND: Given the reduced immune response to vaccines in older populations, this study aimed to evaluate the efficacy of COVID-19 vaccinations and its impact on breakthrough infection, hospital admission, and mortality in the elderly. METHODS: We carried out a systemic review and meta-analysis where MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and Cochrane Central Register for Controlled Trials were queried to identify relevant literature. We included randomized controlled trials (RCTs), non-randomized trials, prospective, observational cohort, and case-control studies assessing breakthrough infection, hospital admission, and mortality after coronavirus 2 (SARS-CoV-2) vaccination in the elderly (≥ 60 years old). RESULTS: Overall, 26 studies were included in this meta-analysis. Compared with the unvaccinated group, the vaccinated group showed a decreased risk of SARS-CoV-2 infection after 28-34 (relative risk [RR] = 0.42, 95% confidence interval [CI] 0.37-0.49) and 35-60 days (RR = 0.49, 95% CI 0.37-0.62). There was a step-wise increase in efficacy with additional doses with the two-dose group experiencing decreased risk of breakthrough infection (RR = 0.37, 95% CI 0.32-0.42), hospital admissions (RR = 0.25, 95% CI 0.14-0.45), disease severity (RR = 0.38, 95% CI 0.20-0.70), and mortality (RR = 0.21, 95% CI 0.14-0.32) compared with those receiving one or no doses. Similarly three-dose and four-dose vaccine groups also showed a decreased risk of breakthrough infection (3-dose: RR = 0.14, 95% CI 0.10-0.20; 4-dose RR = 0.46, 95% CI 0.4-0.53), hospital admissions (3-dose: RR = 0.11, 95% CI 0.07-0.17; 4-dose: RR = 0.42, 95% CI 0.32-0.55), and all-cause mortality (3-dose: RR = 0.10, 95% CI 0.02-0.48; 4-dose: RR = 0.48, 95% CI 0.28-0.84) Subgroup analysis found that protection against mortality for vaccinated vs. unvaccinated groups was similar by age (60-79 years: RR = 0.59; 95% CI, 0.47-0.74; ≥ 80 years: RR = 0.76; 95% CI, 0.59-0.98) and gender (female: RR = 0.66; 95% CI, 0.50-0.87, male: (RR = 0.58; 95% CI, 0.44-0.76), and comorbid cardiovascular disease (CVD) (RR = 0.69; 95% CI, 0.52-0.92) or diabetes (DM) (RR = 0.59; 95% CI, 0.39-0.89. CONCLUSIONS: Our pooled results showed that SARS-CoV-2 vaccines administered to the elderly is effective in preventing prevent breakthrough infection, hospitalization, severity, and death. What's more, increasing number of vaccine doses is becoming increasingly effective.

The impact of anti-Asian racism on routine activities and mental health among Korean American older adults and their caregivers

Introduction Reported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. Nevertheless, limited research addresses the health impact of perceived anti-Asian racism on Asian Americans, especially among older adults, during COVID-19. To address the gap, we examined how the novel coronavirus pandemic affected Korean American older adults, one of the largest Asian subgroups. Specifically, this study addressed the magnitude of racism or discrimination related to the pandemic and impact of anti-Asian racism on negative mental health symptoms among Korean American older adults and their caregivers. Methods We used survey data collected from 175 Korean American older adults with probable dementia and their primary caregivers (female = 62%, mean age = 71 years) who went through eligibility screening for an ongoing randomized controlled trial involving dyads in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347). Results Nearly a quarter of the survey sample reported they were fearful for their safety due to anti-Asian racism related to the pandemic. Additionally, 47% of the respondents indicated changes to routine activities due to anti-Asian racism or discrimination related to COVID-19. The most common changes included avoiding walking alone or physical activities outside, followed by avoiding public transportation or leaving the house to go to any public places such as grocery stores, churches, or schools, not carrying out usual social activities, and avoiding going to health care appointments. Multinomial logistic regression revealed that people who reported changes to routine activities were at least five times more likely (adjusted odds ratio = 5.017, 95% confidence interval = 1.503, 16.748) to report negative mental health symptoms than those who did not. Being fearful for their own safety was not associated with experiencing negative mental health symptoms in the survey sample. Discussion Study findings indicate that the increased reporting of anti-Asian racism during the COVID-19 pandemic has substantially affected Korean American older adults and their caregivers. The mechanism by which changes to routine activities is related to negative mental health symptoms is unclear, future research is needed to elucidate this pathway. Furthermore, our findings highlight the importance of identifying multi-level strategies to raise awareness of and to mitigate the reported surge of racism.

Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support

Background During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations. Methods Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates. Results 56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (β = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms. Conclusion Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout. Contribution The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.

Can online interview efficiently recruit graduate students during COVID-19 pandemic?

China is facing its largest COVID-19 outbreaks since the early days of the pandemic. This makes on-site interview impossible for graduate student admission. How to do online interview efficiently in recruiting graduate students is a question. Here I sort out the experience and feelings.

Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support.

Background: During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations. Methods: Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates. Results: 56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (ß = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms. Conclusion: Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout. Contribution: The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.

Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China.

BACKGROUND: Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. METHODS: From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. RESULTS: Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LIMITATIONS: This report is limited by the convenience sampling method. CONCLUSIONS: The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.

The impact of anti-Asian racism on routine activities and mental health among Korean American older adults and their caregivers.

Introduction: Reported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. Nevertheless, limited research addresses the health impact of perceived anti-Asian racism on Asian Americans, especially among older adults, during COVID-19. To address the gap, we examined how the novel coronavirus pandemic affected Korean American older adults, one of the largest Asian subgroups. Specifically, this study addressed the magnitude of racism or discrimination related to the pandemic and impact of anti-Asian racism on negative mental health symptoms among Korean American older adults and their caregivers. Methods: We used survey data collected from 175 Korean American older adults with probable dementia and their primary caregivers (female = 62%, mean age = 71 years) who went through eligibility screening for an ongoing randomized controlled trial involving dyads in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347). Results: Nearly a quarter of the survey sample reported they were fearful for their safety due to anti-Asian racism related to the pandemic. Additionally, 47% of the respondents indicated changes to routine activities due to anti-Asian racism or discrimination related to COVID-19. The most common changes included avoiding walking alone or physical activities outside, followed by avoiding public transportation or leaving the house to go to any public places such as grocery stores, churches, or schools, not carrying out usual social activities, and avoiding going to health care appointments. Multinomial logistic regression revealed that people who reported changes to routine activities were at least five times more likely (adjusted odds ratio = 5.017, 95% confidence interval = 1.503, 16.748) to report negative mental health symptoms than those who did not. Being fearful for their own safety was not associated with experiencing negative mental health symptoms in the survey sample. Discussion: Study findings indicate that the increased reporting of anti-Asian racism during the COVID-19 pandemic has substantially affected Korean American older adults and their caregivers. The mechanism by which changes to routine activities is related to negative mental health symptoms is unclear, future research is needed to elucidate this pathway. Furthermore, our findings highlight the importance of identifying multi-level strategies to raise awareness of and to mitigate the reported surge of racism.

Increasing the Repertoire for Depression Care: Methods and Challenges of a Randomized Controlled Trial of Peer Support for Vulnerable Older Adults.

OBJECTIVE: Low-income White and older adults of color face barriers to depression care. Our purpose is to describe the methods and challenges encountered during the implementation of a randomized controlled trial to test the effectiveness of a peer support depression care intervention for low-income White and older adults of color during the COVID-19 pandemic. METHODS: Peer Enhanced Depression Care (Peers) is an 8-week community-based intervention that uses peer mentors who are trained and supervised to provide social support and self-care skills to depressed older adults. The effectiveness of the intervention in reducing depression will be evaluated by following a sample of older adults recruited in the community over a 12-month period. Target enrollment is 160 older adults. We hypothesize that participants randomized to the Peer Enhanced Depression Care intervention will experience greater decrease in depressive symptoms compared to participants randomized to the social interaction control. We provide lessons learned regarding the recruitment of BIPOC and White low-income older adults and peer mentors during the COVID-19 pandemic. RESULTS: Recruitment challenges occurred in primary care clinics that were unable to accommodate recruitment efforts during the pandemic. This led to focused outreach to community-based organizations serving older adults. Challenges to participant recruitment have included barriers related to stigma, distrust, as well as unfamiliarity with research. Peer mentor recruitment was facilitated by existing government-supported resources. CONCLUSIONS: This study will provide knowledge regarding the effectiveness, mechanism, and processes of delivering an informal psychosocial intervention such as peer support to a vulnerable older adult population.

Characteristics of Cognitive Function Changes and Related Factors in Individuals With Cognitive Impairment During the Pandemic of COVID-19: A Retrospective Chart Review Study.

OBJECTIVE: This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID-19 and tested regularly at least three times within the last 5 years were included (1st, the initial screening; 2nd, the test immediately before the COVID-19 pandemic; 3rd, the most recent test after the pandemic). Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID-19. RESULTS: When comparing CDR changes before and after COVID-19, there was no significant difference between the two groups (p=0.317). Alternatively, the main effect of the time when the test was conducted was significant (p<0.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/ improved group significantly decreased before COVID-19 (1st-2nd) (p=0.045). After COVID-19 (2nd-3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<0.001). Mini-Mental State Examination recall memory and changes in activity during COVID-19 were significantly associated with CDR deterioration. CONCLUSION: Memory dysfunction and decreased activity during the COVID-19 pandemic are strongly related to the deterioration of cognitive impairment.

A high-throughput fully automatic biosensing platform for efficient COVID-19 detection.

We propose a label-free biosensor based on a porous silicon resonant microcavity and localized surface plasmon resonance. The biosensor detects SARS-CoV-2 antigen based on engineered trimeric angiotensin converting enzyme-2 binding protein, which is conserved across different variants. Robotic arms run the detection process including sample loading, incubation, sensor surface rinsing, and optical measurements using a portable spectrometer. Both the biosensor and the optical measurement system are readily scalable to accommodate testing a wide range of sample numbers. The limit of detection is 100 TCID50/ml. The detection time is 5 min, and the throughput of one single robotic site is up to 384 specimens in 30 min. The measurement interface requires little training, has standard operation, and therefore is suitable for widespread use in rapid and onsite COVID-19 screening or surveillance.

Characterization and pathogenicity of the porcine epidemic diarrhea virus isolated in China.

Piglet diarrhea caused by the porcine epidemic diarrhea virus (PEDV) is a common problem on pig farms in China associated with high morbidity and mortality rates. In this study, three PEDV isolates were successfully detected after the fourth blind passage in Vero cells. The samples were obtained from infected piglet farms in Jilin (Changchun), and Shandong (Qingdao) Provinces of China and were designated as CH/CC-1/2018, CH/CC-2/2018, and CH/QD/2018. According to the analysis of the complete S protein gene sequence, the CH/CC-1/2018 and CH/CC-2/2018 were allocated to the G2b branch, while CH/QD/2018 was located in the G1a interval and was closer to the vaccine strain CV777. Successful detection and identification of the isolated strains were carried out using electron microscopy and indirect immunofluorescence. Meanwhile, animal challenge experiments and viral RNA copies determination were used to compare the pathogenicity. The results showed that CH/CC-1/2018 in Changchun was more pathogenic than CH/QD/2018 in Qingdao. In conclusion, the discovery of these new strains is conducive to the development of vaccines to prevent the pandemic of PEDV, especially that the CH/CC-1/2018, and CH/CC-2/2018 were not related to the classical vaccine strain CV777.

Impact of vaccination on kinetics of neutralizing antibodies against SARS-CoV-2 by Serum live neutralization test based on a prospective cohort.

How much the vaccine contributes to the induction and development of neutralizing antibodies (NAbs) of breakthrough cases relative to those unvaccinated-infected cases is not fully understood. We conducted a prospective cohort study and collected serum samples from 576 individuals who were diagnosed with SARS-CoV-2 Delta strain infection, including 245 breakthrough cases and 331 unvaccinated-infected cases. NAbs were analyzed by live virus microneutralization test and transformation of NAb titer. NAbs titers against SARS-CoV-2 ancestral and Delta variant in breakthrough cases were 7.8-fold and 4.0-fold higher than in unvaccinated-infected cases, respectively. NAbs titers in breakthrough cases peaked at the second week after onset/infection. However, the NAbs titers in the unvaccinated-infected cases reached their highest levels during the third week. Compared to those with higher levels of NAbs, those with lower levels of NAbs had no difference in viral clearance duration time (P>0.05), did exhibit higher viral load at the beginning of infection/maximum viral load of infection. NAb levels were statistically higher in the moderate cases than in the mild cases (P<0.0001). Notably, in breakthrough cases, NAb levels were highest longer than 4 months after vaccination (Delta strain: 53118.2 U/mL), and lowest in breakthrough cases shorter than 1 month (Delta strain: 7551.2 U/mL). Cross-neutralization against the ancestral strain and the current circulating isolate (Omicron BA.5) was significantly lower than against the Delta variant in both breakthrough cases and unvaccinated-infected cases. Our study demonstrated that vaccination could induce immune responses more rapidly and greater which could be effective in controlling SARS-CoV-2.

Kinetics of SARS-CoV-2 neutralizing antibodies in Omicron breakthrough cases with inactivated vaccination: Role in inferring the history and duration of infection.

Background: The quantitative level and kinetics of neutralizing antibodies (NAbs) in individuals with Omicron breakthrough infections may differ from those of vaccinated individuals without infection. Therefore, we aimed to evaluate the difference in NAb levels to distinguish the breakthrough cases from the post-immunized population to identify early infected person in an outbreak epidemic when nasal and/or pharyngeal swab nucleic acid real-time PCR results were negative. Methods: We collected 1077 serum samples from 877 individuals, including 189 with Omicron BA.2 breakthrough infection and 688 post-immunized participants. NAb titers were detected using the surrogate virus neutralization test, and were log(2)-transformed to normalize prior to analysis using Student's unpaired t-tests. Geometric mean titers (GMT) were calculated with 95% confidence intervals (CI). Linear regression models were used to identify factors associated with NAb levels. We further conducted ROC curve analysis to evaluate the NAbs' ability to identify breakthrough infected individuals in the vaccinated population. Results: The breakthrough infection group had a consistently higher NAb levels than the post-immunized group according to time since the last vaccination. NAb titers in the breakthrough infection group were 6.4-fold higher than those in the post-immunized group (GMT: 40.72 AU/mL and 6.38 AU/mL, respectively; p<0.0001). In the breakthrough infection group, the NAbs in the convalescent phase were 10.9-fold higher than in the acute phase (GMT: 200.48 AU/mL and 18.46 AU/mL, respectively; p<0.0001). In addition, the time since infection, booster vaccination, and the time since last vaccination were associated with log(2)-transformed NAb levels in the breakthrough infection group. ROC curve analysis showed that ROC area was largest (0.728) when the cut-off value of log(2)-transformed NAb was 6, which indicated that NAb levels could identify breakthrough infected individuals in the vaccinated population. Conclusion: Our study demonstrates that the NAb titers of Omicron BA.2 variant breakthrough cases are higher than in the post-immunized group. The difference in NAb levels could be used to identify cases of breakthrough infection from the post-immunized population in an outbreak epidemic.

Characteristics of Cognitive Function Changes and Related Factors in Individuals with Cognitive Impairment during the Pandemic of COVID‐19

Background This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment affected by the coronavirus disease 2019 (COVID‐19) pandemic. Method Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID‐19 and tested regularly at least three times within the last 5 years were included. Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID‐19. Result When comparing CDR changes before and after COVID‐19, there was no significant difference between the two groups (p = .317). Alternatively, the main effect of the time when the test was conducted was significant (p<.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/improved group significantly decreased before COVID‐19 (1st–2nd) (p = .045). After COVID‐19 (2nd–3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<.001). MMSE recall memory and changes in activity during COVID‐19 were significantly associated with CDR deterioration. Conclusion Memory dysfunction and decreased activity during the COVID‐19 pandemic are strongly related to the deterioration of cognitive impairment.

Understanding Drivers of Vaccine Hesitancy During the COVID-19 Pandemic Among Older Adults in Jiangsu Province, China: Cross-sectional Survey.

BACKGROUND: Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death. OBJECTIVE: This study aimed to explore the drivers of vaccine hesitancy among older adults based on the "3Cs" (confidence, complacency, and convenience) framework, where socioeconomic status and vaccination history played the role of moderators. METHODS: A cross-sectional questionnaire survey was conducted in Jiangsu Province, China, between June 1 and July 20, 2021. Older adults (aged ≥60 years) were recruited using a stratified sampling method. Vaccine hesitancy was influenced by the 3Cs in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate associations between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the 95% CI of the pathway's coefficients. RESULTS: A total of 1341 older adults participated. The mean age was 71.3 (SD 5.4) years, and 44.7% (599/1341) of participants were men. Confidence (b=0.967; 95% CI 0.759-1.201; P=.002), convenience (b=0.458; 95% CI 0.333-0.590; P=.002), and less complacency (b=0.301; 95% CI 0.187-0.408; P=.002) were positively associated with less vaccine hesitancy. Socioeconomic status weakened the positive effect of low complacency (b=-0.065; P=.03) on low vaccine hesitancy. COVID-19 vaccination history negatively moderated the positive association between confidence (b=-0.071; P=.02) and lower vaccine hesitancy. CONCLUSIONS: Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults. COVID-19 vaccination history, as well as confidence, had a positive association with less vaccine hesitancy and could weaken the role of confidence in vaccine hesitancy. Socioeconomic status had a substitution relationship with less complacency, which suggested a competitive positive association between them on less vaccine hesitancy.

Development of a multiplex RT-PCR method for the detection of four porcine enteric coronaviruses.

Porcine enteric coronaviruses are pathogens that cause viral diarrhea in pigs and are widely prevalent worldwide. Moreover, studies have shown that some porcine enteric coronaviruses can infect humans and poultry. In order to effectively monitor these viruses, it is necessary to establish a multiple detection method to understand their prevalence and conduct in-depth research. Common porcine enteric coronaviruses include Porcine epidemic diarrhea virus (PEDV), Porcine transmissible gastroenteritis virus (TGEV), Porcine delta coronavirus (PDCoV), and Swine acute diarrhea syndrome coronavirus (SADS-CoV). Pigs infected with these viruses have the common clinical symptoms that are difficult to distinguish. A quadruplex RT-PCR (reverse transcription-polymerase chain reaction) method for the simultaneous detection of PEDV, PDCoV, TGEV and SADS-CoV was developed. Four pairs of specific primers were designed for the PEDV M gene, PDCoV N gene, TGEV S gene and SADS-CoV RdRp gene. Multiplex RT-PCR results showed that the target fragments of PDCoV, SADS-CoV, PEDV and TGEV could be amplified by this method. and the specific fragments with sizes of 250 bp, 368 bp, 616 bp and 801 bp were amplified, respectively. This method cannot amplify any fragment of nucleic acids of Seneca Valley virus (SVV), Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) and Atypical Porcine Pestivirus (APPV), and has good specificity. The lowest detection limits of PDCoV, PEDV, TGEV and SADS-CoV were 5.66 × 105 copies/µL, 6.48 × 105 copies/µL, 8.54 × 105 copies/µL and 7.79 × 106 copies/µL, respectively. A total of 94 samples were collected from pig farms were analyzed using this method. There were 15 positive samples for PEDV, 3 positive samples for mixed infection of PEDV and PDCoV, 2 positive samples for mixed infection of PEDV and TGEV, and 1 positive sample for mixed infection of PEDV, TGEV, and PDCoV. Multiplex RT-PCR method could detect four intestinal coronaviruses (PEDV, PDCoV, TGEV, and SADS-CoV) in pigs efficiently, cheaply and accurately, which can be used for clinical large-scale epidemiological investigation and diagnosis.

Clinical characteristics and short-term mortality of 102 hospitalized hemodialysis patients infected with SARS-CoV-2 omicron BA.2.2.1 variant in Shanghai, China.

Background: The aim of this study was to analyze clinical features and short-term mortality in hemodialysis (HD) patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) omicron BA.2.2.1 variant. Methods: In a retrospective single-center case series, 102 consecutive hospitalized HD patients infected with the coronavirus omicron variant were assessed at Pudong Hospital in Shanghai, China, from April 6 to April 18, 2022; the final date of follow-up was May 16, 2022. Clinical, laboratory, chest CT, and treatment data were collected and analyzed. The association between these factors and all-cause mortality was studied using univariate and multivariate analyses. The relationship between lymphocyte count and short-term mortality was based on receiver operating characteristic (ROC) curve analysis. Kaplan-Meier analysis was used to assess overall survival. Results: In total, 102 patients were included in this study. The patients were divided into two groups: HD patients with pneumonia (N = 46) and without pneumonia (N = 56). Of the 102 patients, 12 (11.8%) died. Multivariate regression analysis revealed that all-cause mortality was correlated with lymphocyte counts and type B natriuretic peptide (BNP), C-reactive protein (CRP), and D-dimer levels (P < 0.05). The cut-off value of lymphocyte counts was 0.61 × 109/L for all-cause mortality. The overall survival rate was significantly different between HD patients with and without pneumonia (P < 0.05). Conclusions: Lymphocyte counts are important for the prediction of short-term mortality in HD patients with SARS-CoV-2 infection. HD patients with lung involvement have poorer survival rates than those without lung involvement.

Artificial intelligence model on chest imaging to diagnose COVID-19 and other pneumonias: A systematic review and meta-analysis.

Objectives: When diagnosing Coronavirus disease 2019(COVID-19), radiologists cannot make an accurate judgments because the image characteristics of COVID-19 and other pneumonia are similar. As machine learning advances, artificial intelligence(AI) models show promise in diagnosing COVID-19 and other pneumonias. We performed a systematic review and meta-analysis to assess the diagnostic accuracy and methodological quality of the models. Methods: We searched PubMed, Cochrane Library, Web of Science, and Embase, preprints from medRxiv and bioRxiv to locate studies published before December 2021, with no language restrictions. And a quality assessment (QUADAS-2), Radiomics Quality Score (RQS) tools and CLAIM checklist were used to assess the quality of each study. We used random-effects models to calculate pooled sensitivity and specificity, I2 values to assess heterogeneity, and Deeks' test to assess publication bias. Results: We screened 32 studies from the 2001 retrieved articles for inclusion in the meta-analysis. We included 6737 participants in the test or validation group. The meta-analysis revealed that AI models based on chest imaging distinguishes COVID-19 from other pneumonias: pooled area under the curve (AUC) 0.96 (95 % CI, 0.94-0.98), sensitivity 0.92 (95 % CI, 0.88-0.94), pooled specificity 0.91 (95 % CI, 0.87-0.93). The average RQS score of 13 studies using radiomics was 7.8, accounting for 22 % of the total score. The 19 studies using deep learning methods had an average CLAIM score of 20, slightly less than half (48.24 %) the ideal score of 42.00. Conclusions: The AI model for chest imaging could well diagnose COVID-19 and other pneumonias. However, it has not been implemented as a clinical decision-making tool. Future researchers should pay more attention to the quality of research methodology and further improve the generalizability of the developed predictive models.

Changes of factors associated with vaccine hesitancy in Chinese residents: A qualitative study

Introduction There is an urgent need to address vaccine hesitancy to achieve booster vaccination. This study aimed to reveal the factors associated with vaccine hesitancy (including COVID-19 vaccine) among Chinese residents, address modifications of the factors since the previous year, and propose vaccination rate improvement measures. Materials and methods This qualitative return visit study was performed between January and mid-February 2022, following the last interview conducted between February and March 2021. According to an outline designed in advance, 60 Chinese residents from 12 provinces participated in semi-structured interviews. Results Vaccine safety was the biggest concern raised by respondents, followed by self-immunity and vaccine effectiveness, eliciting concern since the interview last year. Notably, online media accounted for a more significant portion of suggestion sources than before, and fear of pain was a novel factor affecting vaccine hesitancy. Moreover, unlike other areas, those from provinces with a per capita gross domestic product of 3–5 (RMB 10,000) reported less concern about vaccine price and effectiveness. They tended to seek advice via online media less and were greatly influenced by vaccination policies. Conclusions Influential factors of vaccine hesitancy among Chinese residents are changing dynamically. Monitoring these trends is essential for public health measures and higher vaccination levels.

Research progress on the application of antiseptics after mucosal exposure of SARS-CoV-2

The transmission routes of SARS-CoV-2 include droplet, air and contact transmission, but regardless of the transmission route, the virus must eventually be exposed through the oral, nasal and ocular mucous membranes to invade the human body. Guaranteeing the respiratory protection of front-line medical staff in the prevention and control of COVID-19 is one of the primary tasks of nosocomial infection management. According to "Technical Guidelines for Prevention and Control of COVID-19 in Healthcare Settings (3rd Edition)", oral/nasal cavity can be disinfected with hydrogen peroxide, iodophor, in the event of occupational respiratory exposure. But, at the moment, In the field of nosocomial management, compared with hand hygiene, "mucosal hygiene" is rarely mentioned, especially the treatment of respiratory mucosa after exposure to acute infectious respiratory pathogens, which is still blank in the domestic research. After a rapid literature review, it is found that some antiseptics have been widely used in clinical practices, such as gargling with bactericidal solution before the diagnosis and treatment procedure for dental patients under COVID-19 epidemic, nasal decolonization for patients undergoing elective surgery to prevent surgical site infection, and use of eye drops of antiseptics to prevent neonatal conjunctivitis. In view of the current lack of effective antiviral drugs for treatment of SARS-CoV-2, and the constantly emerging mutant strains can break through the immune barrier of human body, this paper recommends that medical personnel use antiseptics for emergency mucosal disinfection as an supporting measure for respiratory tract protection after accidental exposure to SARS-CoV-2 of oral, nasal and ocular mucosa.