Analysis on traditional Chinese medicine syndrome characteristics of patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant in a shelter hospital in Shanghai

Objective: To analyze the characteristics of traditional Chinese medicine (TCM) syndromes of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in a shelter hospital in Shanghai. Methods: A total of 621 patients infected with SARS-CoV-2 omicron variant from Apr. 4 to May 24, 2022 in a shelter hospital in Shanghai were enrolled. The data of the patients, including the general information and common clinical syndromes (such as fever, headache, stuffy nose, runny nose, cough, and sputum), were collected on admission by TCM syndrome electronic scale, and core syndrome characteristics were analyzed base on the proportion of each symptom. The syndromes were divided according to the symptom score of patients, and the differences of disease course among the syndromes were compared. Results: The proportion of patients aged 30 to 49 years old was the highest among 621 patients infected with omicron variant (49.76%, 309/621). The most prominent symptoms were cough and expectoration, accounting for 62.32% (387/621) and 68.12% (423/621), respectively. The more common symptoms included sore throat, stuffy nose, runny nose, fatigue, muscle pain, and headache. White sputum was mostly seen in the expectoration and clear mucus was mostly seen in runny nose. According to the clinical symptoms, the core syndrome characteristic of patients infected with omicron variant was cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome was plague invading the defensive exterior, accounting for 40.10% (249/621). The second and third ones were heat toxin attacking the lung syndrome (29.95%, 186/621) and dampness obstructing (17.55%, 109/621), while the least common syndrome was deficiency of qi and yin (7.73%, 48/621). The course of qi and yin deficiency was longer than the other 3 syndromes (P < 0.05). Conclusion: The core TCM syndrome characteristic of patients infected with SARS-CoV-2 omicron variant is cold epidemic constraint in the lung featuring dampness and toxins. The main syndrome is plague invading the defensive exterior. The pattern tends to convert into qi and yin deficiency along the long course.

Effectiveness of Chinese medicine formula Huashibaidu granule on mild COVID-19 patients: A prospective, non-randomized, controlled trial

Background The effectiveness and safety of Huashibaidu granule (HSBD) in treating mild Corona Virus Disease 2019 (COVID-19) patients infected with SARS-CoV-2 remain to be identified. We aimed to evaluate the effectiveness of HSBD in mild COVID-19 patients. Methods A prospective, non-randomized, controlled study in mild COVID-19 patients was conducted in Shanghai, from April 8 to May 6, 2022. The enrolled patients were diagnosed as mild COVID-19. Finally, 360 patients received HSBD, and 368 patients received TCM placebo (administered orally 20g twice daily for 7 days). The primary endpoints were the negative conversion rate of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the negative conversion time. Secondary endpoints included the hospitalized days and the improvement in the clinical condition. Results The negative conversion rate of SARS-CoV-2 at 7 days posttreatment in the HSBD group was higher than that in the control group (95.28% vs. 82.61%, P < 0.001). The median negative conversion time in the HSBD group was markedly decreased by 2 days compared with the control group (3 [3-6] vs. 5 [4-7], P < 0.001). In addition, the median hospitalized day was shortened in the HSBD group by 1 day compared with the control group (6 [4-7] vs. 7 [5-9], P < 0.001). The clinical improvement rate (275/360 [76.39%]) in the HSBD group within 7 days was significantly higher than that (203/368 [55.16%]) in the control group (P < 0.001). The improvement of symptom scores in the HSBD group was higher than that in the control group (2 [1-4] vs. 1 [1-2], P < 0.001). No severe adverse events occurred. Conclusions Our study suggested that HSBD effectively increased the negative conversion rate of SARS-CoV-2 and shortened the negative conversion time and hospitalized days in mild COVID-19 patients. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR2200058668

A Bibliometric Analysis of Psychological Research on COVID-19

The coronavirus disease 2019(COVID-19) pandemic has had a profound impact on people's mental health, and psychological research on COVID-19 has been growing exponentially. Therefore, this study aims to understand the development trends, research collaboration, and knowledge exchange of psychological research on COVID-19, and focuses on scientific collaboration, hotspots, and the knowledge base. A total of 8,235 documents were collected from the Web of Science database. VOSviewer was used to conduct the descriptive and bibliometric analysis. The results show that the U.S.A. is the most productive country, with the most citations, the most links with other countries, and the strongest total link strength with other countries. Stanford University in the U.S.A. has the strongest total link strength with other research institutions. Mark Griffiths has the most co-author publications with other authors, and Handan Akkas has collaborated with the most authors. According to the analysis of keywords, research hotspots are categorized into five clusters as follows: "COVID-19 pandemic and public health", "anxiety and depression", "emotional regulation and coping", "sample characteristics and interventions", and "scale development and investigation". The knowledge base of COVID-19 psychological research covers four major domains as follows: "COVID-19 psychological research", "mental scales", "SARS related research", and "statistical applications. Accordingly, this study proposes enlightenment in psychological research on COVID-19 that international cooperation can develop short-term and long-term strategies for mental health, and make good use of mental scales to understand and respond to maintain mental health. Ultimately, sharing the research results will bring more opportunities to solve problems for COVID-19 psychological research.

Does a smart business environment promote corporate investment? a case study of Hangzhou.

As a result of business environment reforms in China's Hangzou, the cost of business has reduced, the confidence of Hangzhou enterprises has survived the COVID-19 outbreak, and foreign investment continues to increase. Nevertheless, Hangzhou's business environment has shortcomings, such as insufficient technology, talent, and intelligent infrastructure. Two unresolved questions persist: (i) Has the smart business environment stimulated corporate investment by reducing system costs and boosting corporate confidence? (ii) How do the commercial climate's shortcomings impact the relationship between the intelligent business environment and business costs/confidence? We examined the impact of a local smart business environment on the corporate investment scale in Hangzhou using factor analysis, cluster analysis, linear regression, and path analyses of data from 297 firm managers. Smart governance improved public administration, financing, and rule of law. The business environment promoted investment by increasing business confidence and decreasing institutional costs. Weak intelligent property protection and legal fairness hindered the positive influence of smart governance on business confidence and system costs. This is the first study combining business environment, smart city, and smart governance concepts to analyze the influence of local smart business environments on business confidence, institutional costs, and investment. Our conclusion on the limitation effect of intelligent business environment on enterprise investment attempts to inspire further research on the intersection of business environments and smart cities. The law of intelligent business environment attracting investment obtained in the context of China, the largest developing country with diversified economic development, is of great significance for other developing countries. Countries can attract investment and promote economic development through intelligent governance. Developing countries should construct smart service platforms, coordinate supervision of public credit, reduce financing constraint, construct a government under the rule of law, improve the quality of land management, and protect intellectual property rights.

Psychological distress and associated factors among kidney transplant recipients and living kidney donors during COVID-19.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has caused significant psychological distress globally. Our study assessed the prevalence of psychological distress and associated factors during COVID-19 pandemic among kidney transplant recipients and kidney donors. METHODS: A cross-sectional survey of 497 participants (325 recipients and 172 donors) was conducted from 1st May to 30th June 2020 in Singapore. The survey questionnaire assessed knowledge levels of COVID-19, socio-demographic data, health status, psychosocial impact of COVID-19, and precautionary behaviors during the pandemic. Psychological distress was defined as having anxiety, depression, or stress measured by the validated Depression, Anxiety and Stress Scale-21. Linear regression analyses were used to assess factors associated with higher psychological distress. RESULTS: The prevalence of psychological distress was 14.3% (95% confidence interval: 11.5-17.6%) in the overall population; it was 12.8% (9.79-16.6%) in recipients and 13.4% (9.08-19.6%) in donors with no significant difference (P = 0.67). Younger age (21-49 vs. ≥50 years), unmarried status, non-Singapore citizen, worse health conditions, and worrying about physical and mental health were associated with higher psychological distress. Malays (versus Chinese), taking precautionary measures (hand sanitization), and receiving enough information about COVID-19 were associated with lower psychological distress. No interactions were observed between recipients and donors. CONCLUSIONS: At least one in ten recipients and donors suffer from psychological distress during COVID-19 pandemic. Focused health education to younger adults, unmarried individuals, non-Singapore citizens, and those with poor health status could potentially prevent psychological distress in recipients and donors.

Home Nursing for Disabled Elderly Patients during Corona Virus Disease 2019 in Wuhan City

Abstract: Objective: To provide door-to-door nursing service for disabled elderly patients during Corona Virus Disease 2019, so as to ensure patient safety and improve service quality. Methods: Set up home visiting service commando team, reengineer the visiting process, do a good job in hierarchical management, strengthen the protection of medical staff, patients and their families, and provide online and offline health education guidance. Results: there were 178 cases of on-site service, including 44 emergency cases and 134 non emergency cases;69 times of dressing change, 85 times of catheter change, 19 times of gastric tube change, 71 times of bladder irrigation, 6 times of health assessment and 2 times of foot disease treatment. All the visiting officers Corona Virus Disease 2019 suspected or confirmed cases to do their own protection, no cross infection occurred in 1 cases. Conclusion: during the epidemic period of Corona Virus Disease 2019, the needs of elderly patients with disability were met, which provided practical experience for dealing with public health emergencies and preventing the risk of infectious diseases.

Actionable druggable genome-wide Mendelian randomization identifies repurposing opportunities for COVID-19.

Drug repurposing provides a rapid approach to meet the urgent need for therapeutics to address COVID-19. To identify therapeutic targets relevant to COVID-19, we conducted Mendelian randomization analyses, deriving genetic instruments based on transcriptomic and proteomic data for 1,263 actionable proteins that are targeted by approved drugs or in clinical phase of drug development. Using summary statistics from the Host Genetics Initiative and the Million Veteran Program, we studied 7,554 patients hospitalized with COVID-19 and >1 million controls. We found significant Mendelian randomization results for three proteins (ACE2, P = 1.6 × 10-6; IFNAR2, P = 9.8 × 10-11 and IL-10RB, P = 2.3 × 10-14) using cis-expression quantitative trait loci genetic instruments that also had strong evidence for colocalization with COVID-19 hospitalization. To disentangle the shared expression quantitative trait loci signal for IL10RB and IFNAR2, we conducted phenome-wide association scans and pathway enrichment analysis, which suggested that IFNAR2 is more likely to play a role in COVID-19 hospitalization. Our findings prioritize trials of drugs targeting IFNAR2 and ACE2 for early management of COVID-19.

Mendelian randomisation identifies alternative splicing of the FAS death receptor as a mediator of severe COVID-19 (preprint)

Severe COVID-19 is characterised by immunopathology and epithelial injury. Proteomic studies have identified circulating proteins that are biomarkers of severe COVID-19, but cannot distinguish correlation from causation. To address this, we performed Mendelian randomisation (MR) to identify proteins that mediate severe COVID-19. Using protein quantitative trait loci (pQTL) data from the SCALLOP consortium, involving meta-analysis of up to 26,494 individuals, and COVID-19 genome-wide association data from the Host Genetics Initiative, we performed MR for 157 COVID-19 severity protein biomarkers. We identified significant MR results for five proteins: FAS, TNFRSF10A, CCL2, EPHB4 and LGALS9. Further evaluation of these candidates using sensitivity analyses and colocalization testing provided strong evidence to implicate the apoptosis-associated cytokine receptor FAS as a causal mediator of severe COVID-19. This effect was specific to severe disease. Using RNA-seq data from 4,778 individuals, we demonstrate that the pQTL at the FAS locus results from genetically influenced alternate splicing causing skipping of exon 6. We show that the risk allele for very severe COVID-19 increases the proportion of transcripts lacking exon 6, and thereby increases soluble FAS. Soluble FAS acts as a decoy receptor for FAS-ligand, inhibiting apoptosis induced through membrane-bound FAS. In summary, we demonstrate a novel genetic mechanism that contributes to risk of severe of COVID-19, highlighting a pathway that may be a promising therapeutic target.

Actionable druggable genome-wide Mendelian randomization identifies repurposingopportunities for COVID-19 (preprint)

Drug repurposing provides a rapid approach to meet the urgent need for therapeutics to address COVID-19. To identify therapeutic targets relevant to COVID-19, we conducted Mendelian randomization (MR) analyses, deriving genetic instruments based on transcriptomic and proteomic data for 1,263 actionable proteins that are targeted by approved drugs or in clinical phase of drug development. Using summary statistics from the Host Genetics Initiative and the Million Veteran Program, we studied 7,554 patients hospitalized with COVID-19 and >1 million controls. We found significant Mendelian randomization results for three proteins (ACE2: P=1.6x10^-6, IFNAR2: P=9.8x10^-11, and IL-10RB: P=1.9x10^-14) using cis-eQTL genetic instruments that also had strong evidence for colocalization with COVID-19 hospitalization. To disentangle the shared eQTL signal for IL10RB and IFNAR2, we conducted phenome-wide association scans and pathway enrichment analysis, which suggested that IFNAR2 is more likely to play a role in COVID-19 hospitalization. Our findings prioritize trials of drugs targeting IFNAR2 and ACE2 for early management of COVID-19.

Clinical Features and Efficacy of Antiviral Drug, Arbidol in 220 Nonemergency COVID‐19 Patients from East-West-Lake Shelter Hospital in Wuhan: A Retrospective Case Series (preprint)

Objective. We aimed to describe the features of 220 nonemergency (mild or common type) COVID-19 patients from a shelter hospital, as well as evaluate the efficiency of antiviral drug, Arbidol in their disease progressions. Methods. Basic clinical characteristics were described and the efficacy of Arbidol was evaluated based on gender, age, maximum body temperature of the patients. Results. Basically, males had a higher risk of fever and more onset symptoms than females. Arbidol could accelerate fever recovery and viral clearance in respiratory specimens, particularly in males. Arbidol also contributed to shorter hospital stay without obvious adverse reactions.Conclusions. In the retrospective COVID-19 cohort, gender was one of the important factors affecting patient's conditions. Arbidol showed several beneficial effects in these patients, especially in males. This study brought more researches enlightenment in understanding the emerging infectious disease.