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Objective To explore the efforts of applying mindfulness stress reduction therapy in alleviating stress reactions and burnout among head nurses in the context of the Coronavirus disease 2019 (COVID-19). Methods This was a quasi experimental study. In June 2021, 109 head nurses with mild or above burnout measured by Maslach Burnout Inventory (MBI) from 12 hospitals in Zhangjiagang City were selected as the research objects to implement mindfulness-based stress reduction therapy for 8 weeks, and the scores of the Five Facet Mindfulness Question-naire (FFMQ), Stress Response Questionnaire (SRQ) and MBI of the head nurses were compared before and after the intervention. Results The five dimensions of observation, description, perceived action, non-judgment, and non-response and the total scores of the FFMQ were (26.28 ± 1.32), (26.94 ± 1.29), (25.49 ± 0.99), (25.45 ± 1.05), (23.48 ± 1.01), and (127.63 ± 3.78) of the post-intervention, which were higher than the pre-intervention scores of (25.04 ± 1.37), (25.04 ± 1.37), (25.37 ± 1.18), (24.15 ± 1.00), (24.09 ± 0.98), (22.26 ± 1.04), and (120.90 ± 4.06), with statistically significant differences (t values were -39.21- -15.36, all P＜0.01). The three dimensions of emotional, somatic, and behavioral responses and total scores of the post-intervention SRQ were (27.70 ± 6.12), (20.75 ± 4.20), (15.19 ± 3.11), and (65.99 ± 12.43), respectively, lower than the pre-intervention scores of (29.19 ± 6.91), (21.86 ± 5.20), (16.48 ± 4.16), and (70.12 ± 15.97), with statistically significant differences (t values were 5.70-9.33, all P＜0.01);the scores of dimensions of emotional exhaustion and depersonalization in post-intervention MBI were (26.24 ± 4.60) and (5.96 ± 1.25), lower than the pre-intervention scores of (29.66 ± 6.02) and (6.90 ± 1.59). The post-intervention scores of personal fulfillment (32.37 ± 5.02), higher than the pre-intervention scores of (28.60 ± 6.04), all with statistically significant differences (t=15.36, 13.50, - 9.65, all P＜0.01). Conclusions The implementation of mindfulness stress reduction therapy for the head nurses can relieve their work pressure due to the prevention and control of the COVID-19 epidemic, reshape their healthy psychology, and reduce job burnout. © The Author(s) 2023.
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Geographic information systems (GIS) and choropleth maps for COVID-19 cases as well as COVID-19 test and vaccination rates proved very valuable to informing decision-making on the local and regional levels of government in Shelby County, Tennessee, USA. The authors have all served on the City of Memphis and Shelby County COVID Joint Task Force and share here their observations about the challenges and promises related to these techniques in the context of a fast-changing environment. As the pandemic unfolded, new virus variants emerged and the population became increasingly vaccinated. Consequently, the use of GIS changed, and maps needed to be continually adapted to the shifting needs of decision makers. The authors describe their approaches to leveraging GIS techniques to monitor the spread of the disease, draw conclusions about the effect of policy measures, and address health disparities. They outline the strengths and weaknesses of choropleth maps, reflect on how best to facilitate interorganizational communication of the derived information, and suggest desirable aspects of educational courses for GIS as well as skill sets in personnel that they came to appreciate as essential. © 2023 Taylor and Francis Group, LLC.
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The pandemic of the COVID-19, has brought a great impact to the education and teaching, so the teaching can only be carried out online, in order to ensure the monitoring and management of teaching quality during teaching. This project import the latest information intelligent teaching system, multi-directional to ensure the monitoring and control of teaching quality, the deep integration of 'Rain Classroom' technology and teaching in this project, So that the interaction information between teachers and students can be recorded in real time during the online teaching, and organized, analyzed, stored also;Import the online teaching platform, collected the students records that finished homework during the epidemic;Import the online virtual experiment platform, online to finished the remote experimental operation of students. Thus, the trinity builds a three-dimensional teaching quality assurance system to escort high-quality big data course teaching during the epidemic. © 2023 IEEE.
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Aiming at the new coronavirus that appeared in 2019, which has caused a large number of infected patients worldwide due to its high contagiousness, in order to detect the source of infection in time and cut off the chain of transmission, we developed a new Chest X-ray (CXR) image classification algorithm with high accuracy, simple operation and fast processing for COVID-19. The algorithm is based on ConvNeXt pure convolutional neural network, we adjusted the network structure and loss function, added some new Data Augmentation methods and introduced attention mechanism. Compared with other classical convolutional neural network classification algorithms such as AlexNet, ResNet-34, ResNet-50, ResNet-101, ConvNeXt-tiny, ConvNeXt-small and ConvNeXt-base, the improved algorithm has better performance on COVID dataset.
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A 100 million ton crude oil purchases and sale contract signed between China and Russia, and the crude oil will pass through Kazakhstan and flow along the Alashankou-Dushanzi-Urumchi crude oil pipeline to western Region. As an important crude oil import channel, this paper analyzes the current situation of Alashankou-Dushanzi-Urumchi crude oil pipeline and puts forward some countermeasures. Both Russia and Kazakhstan are major crude oil exporters, with internal demand for exporting crude oil to China. There is a huge gap between domestic crude oil demand, and social and economic development depends on crude oil import. The geographical environment of the crude oil pipeline is conducive to pipeline protection. The security environment of Xinjiang has improved. The situation in Russia and Ukraine and the civil strife in Kazakhstan have limited impact on the pipeline which will have good development opportunities. Thus, this paper proposes the following management strategies. First of all, strengthen communication and coordination between upstream and downstream enterprises. Second, reduce cost and increase efficiency. Third, attach importance of the application of new technologies. Fourth, establish emergency plans and hold emergency drills for emergencies such as COVID-19 outbreak and pipeline leakage. Fifth, strengthen anti-terrorism and riot control. Sixth, strengthen corporate culture and talent team construction. © The Authors, published by EDP Sciences. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/).
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Objective: To analyze relevant literature on Lianhua Qingwen preparations and clarify the research advances and hot spots in this field,so as to provide references for clinical rational application and further research. Method(s): Literature related to Lianhua Qingwen preparations in the recent 10 years was retrieved from six databases,including China National Knowledge InfrastructureCNKI,VIP,Wanfang Data, PubMed,and Web of Science,followed by management and analysis by NoteExpress and CiteSpace. Result(s): Finally,344 and 76 Chinese and English research articles were included,and the number of publications increased in recent years. The research articles were published in 162 Chinese and 48 English journals. Shijiazhuang Yiling Pharmaceutical Co.,Ltd. and Guangzhou Medical University were institutions with the largest number of Chinese and English publications,respectively. LIU Minyan was the author who had published the most articles. Keywords with high frequency included clinical efficacy,Lianhua Qingwen,inflammatory factors,traditional Chinese medicine,and coronavirus disease-2019COVID-19. Nineteen clusters,including clinical efficacy,Chinese medicine,Lianhua Qingwen,COVID-19,and influenza A virus,and 47 emergent keywords,including herpes zoster,pneumonia,inflammatory factors,influenza,and gut microbiota,were generated. Conclusion(s):Cooperation and exchanges in this field are insufficient. Research focuses on the clinical efficacy of Lianhua Qingwen in the treatment of COVID-19 and other diseases,pharmacological action and mechanism of antiviral drugs,and micro-mechanism research focuses on related pathways and target proteins,as well as the combination of Chinese and western medicines.Copyright © 2023, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
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The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) Omicron variants BA.5.2 and BF.7 have become the main epidemic strains in China since the quarantine policy was lifted in 7th December 2022. Cough is one of the main symptoms induced by SARS-CoV-2 infection. SARS-CoV-2 infection-associated cough injuries the lung and upper respiratory tract, while the infected people cough out virus and liquid which forms virus-containing aerosols, a medium for quickly spreading. Furthermore, cough is one of primary sequelae of discharged patients in corona virus disease 2019 (COVID-19). By now, there are no efficacious drugs for treatment of upper respiratory tract infection associated cough induced by omicron. Traditional Chinese medicine (TCM) has a long history on treating cough. By reviewing the mechanisms of the occurrence of cough after SARS-CoV-2 infection, potential therapeutic targets and cough suppressant herbs with significant efficacy in clinical and basic research, we provide a reference for the treatment of cough after SARS-Cov-2 infection and a basis for the majority of infected patients to select appropriate herbs for cough relief under guidance of physicians.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Objectives: Various interventions were used to control the COVID-19 pandemic and protect population health, including vaccination, medication and nonpharmaceutical interventions (NPIs). This study aims to examine the cost-effectiveness of different combinations of NPIs (including social distancing, mask wearing, tracing-testing-isolation, mass testing, and lockdown), oral medicine (Paxlovid), and vaccination (including two-dose and three-dose vaccination) under the Delta and Omicron pandemic in China. Method(s): We constructed a Markov model using a SIRI structure with a one-week cycle length over one-year time horizon to estimate the cost-effectiveness of different combinations in China from societal perspective. Effectiveness of interventions, disease transition probabilities and costs were from published data, quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER) and net monetary benefits were calculated for one-year time horizon. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model. Scenario analysis was developed to examine different situations under the Omicron pandemic. Result(s): Under the Delta pandemic, implementing the combination of social distancing, mask wearing, mass testing and three-dose vaccination was the optimal strategy, with cost at $11165635.33 and utility of 94309.94 QALYs, and had 60% probability of being cost-effective compared with other strategies. Three-dose vaccination combinations were better than two-dose combinations. Under the Omicron pandemic, antigen testing was better than nucleic testing by avoiding cross infections;second, adding Paxlovid or lockdown to the combined intervention strategies could increase limited health outcomes at huge cost and thus were not cost-effective;last, encouraging patients to stay at home can save societal costs compared with concentrated quarantine at hospitals. Conclusion(s): Three-dose vaccination and self-quarantine of asymptomatic and mild cases can save total costs. Under the Omicron pandemic outbreak, antigen testing is a better way to control the pandemic, and adding Paxlovid or lockdown to intervention combinations is not cost-effective.Copyright © 2023
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Multiple comparisons are general term for hypothesis testing of whether there is a significant difference between the means of each sample after analysis of variance. ANOVA can only determine whether there is a difference between the population means, and multiple comparisons can further test the differences between the sample means. This study will select the LSD (Least significant difference) test method in the multiple comparison method to conduct a differential test on the physical fitness test data of four different grades from 2018 to 2021 since the COVID-19 epidemic, and analyze the physical fitness of Chinese students under the background of new coronavirus epidemic. Change characteristics of health level, and summarize relevant experience, urge relevant personnel to make targeted improvements to the future work of students' physical health training, and scientifically improve the physical health level of Chinese students. © 2023 SPIE.
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Objective To analyze the epidemiological characteristics of COVID-19 cluster epidemic in Huizhou from January to February in 2020, and we provide experience and reference for the prevention and control of cluster epidemic. Methods Descriptive epidemiology was used to analyze the clusters of COVID-19 in Huizhou city. Results From January to February in 2020, a total of 19 COVID-19 cluster outbreaks were reported in Huizhou. The most common cluster outbreaks were in Huidong county (8 cases), Boluo county (3 cases) and Huiyang district (3 cases). There were 59 cases involved in 19 outbreaks, among which 46 were confirmed cases, and 13 were asymptomatic infected. The sex ratio of male to female was 0.84: 1, the age was 1-85 years old. The 19 cases of outbreaks were all caused by imported cases, among which 13 cases were imported from Wuhan (68.4%), 3 cases were imported from Hubei province except Wuhan (15.8%), and 3 cases were imported from other provinces and cities (15.8%). There were 13 cases (68.4%) in the first generation, and 6 cases (31.6%) in the second generation. Events exposed place were variety, including 3 (15.8%) simple family exposure, 13 (68.4%) joint exposure, exposure family, 1 (5.26%) of the joint exposure, family exposure, family dinners, 1 (5.26%) of the joint exposure, family exposure, exposure (hotel) exposed in public places, 1 (5.26%) of the collective unit (workplace) exposure. Conclusion All the COVID - 19 cluster outbreaks in Huizhou city were caused by imported cases, most of which occurred in the family and were caused by families living together and eating together. As the number of people returning to work, production and school increases, various prevention and control measures should be implemented in key areas, key populations and key places to prevent the outbreak from rebounding.Copyright © China Tropical Medicine 2021.
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With the arrival of the Covid-19 pandemic, mandatory changes occurred in the way of educating students, initiating the global heyday of ICT with its virtual envi-ronments;achieving in a short time the virtualization of the teaching and learning process. The objective of carrying out a systematic review of articles on aca-demic performance in a virtual learning environment in higher educational institutions under the context of a pandemic. The method used is a systematic review, with a methodology based on the PRISMA 2020 Declaration, analyzing the articles found in the SciELO database, with a final sample of 12 articles in a period of time from 2020 to 2022;Obtaining the following results: a) the essence of learning in a vir-tual environment is based on self-management in the construction of learning, b) academic performance in a virtual environment is 90% subjective and 95% of students consider access as an obstacle. to tech-nological means, c) the teaching commitment was up to the 4th objective of sustainable development. Concluding that the student must self-manage the construction of their learning to obtain a positive educational performance in a virtual environment, the teacher's role is essential in the construction of learning.
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The timely assessment of mental health is difficult since we lack the objective measurements of symptoms, especially for the Covid-19 pandemic quarantined students. Fortunately, smart phones can capture the real-world data such as the GPS traces and the phone active time et.al that link the behavioral patterns to the mental health. However, recent studies are based on a very small size of participants and only collect fewer phone features, which means that the effective predicting models which require various features are hardly adopted. In this paper, we develop an android application to record multidimensional data of users as well as a PHQ-9 and a SAS questionary, and we distribute it to 176 college students to collect larger scale data when in quarantine period. To address the unprecise problem of handcrafted feature extraction, we design an autoencoder machine learning model to monitor the student mental health. Extensive experiments indicate that the performance of the proposed method improves its F-1 score for PHQ-9 and SAS by 5% and 6% to the state of the current studies, respectively. © 2023 IEEE.
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Background/Aims The COVID-19 pandemic posed unique challenges for people worldwide in self-caring for their rheumatoid arthritis (RA). COVID-19 also prompted global changes in public health (e.g., vaccination programs and mask wearing) and rheumatology services (e.g., integrating telehealth with in-person healthcare). To facilitate cross-country learning of how to support people with RA to self-care during and post-pandemic, better understanding of individuals' experiences of self-care in the context of changes in public health and 'integrated' healthcare is needed. Our study aimed to explore transferability in experiences of public health measures and telehealth during COVID- 19 among individuals with RA in Canada and the UK. Methods Between July and October 2022, online focus groups (90 mins) took place with participants living with RA in the UK. Participants were recruited via social media and professional networks (including Versus Arthritis). Each participant received a report >=7days before each focus group, with a request to review in advance. The report contained preliminary findings identified through reflexive thematic analysis of interviews (30-70 mins) with thirty-nine participants with RA in British Columbia, Canada (26-86 years;36 females) between December 2020 and 2021. Nine preliminary themes were identified across three topics: accessing telehealth and in-person healthcare;decision-making around COVID-19 vaccinations and public health measures;and renegotiating 'the self'. The themes guided the focus groups, wherein UK participants shared their perspectives on each theme arising in the Canadian context. Audio-visual recordings were transcribed verbatim, and transcripts were de-identified. Ongoing directed content analysis of focus group data involves a collaborative approach with patient partners. Results Four focus groups involving thirteen participants (44-81 years;11 females) living across the UK were conducted. Participants had lived with RA for between 3-36 years. Canadian experiences typically resonated with UK participants, with some feeling a sense of unity and sadness that challenges were also experienced by others living with RA beyond their national context. Many UK participants supported preferences expressed by Canadian participants for a 'hybrid' healthcare approach to maximise benefits and minimise downsides of telehealth, and in-person consultations post-pandemic. Benefits (e.g., avoiding risk of COVID-19 transmission with telehealth) and disadvantages (e.g., lacking sensitivity/accuracy of in-person assessments) described by Canadian participants also resonated with UKbased participants. Many described how their decision-making on adopting public health measures to maintain their self-care was supported and/or undermined in their local context/community. Conclusion Our findings offer novel insights into the challenges and opportunities experienced by people with RA in their decision-making around public health measures and telehealth during a global pandemic. They also demonstrate some transferability of experiences between the UK and Canada. Insights may serve to inform decision-making for policy and programmes to support self-care (e.g., by integrating telehealth into routine rheumatology practice) across countries during and postpandemic.
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[Background] Front-line medical staff are an important group in fighting against Coronavirus Disease 2019 (COVID-19), and their mental health should not be ignored. [Objective] This study investigates the current situation and influencing factors of post-traumatic stress disorder (PTSD) among front-line anti-epidemic medical staff during COVID-19 epidemic. [Methods] Medical staff who had participated in fighting against the COVID-19 epidemic wereselected from three grade III Class A hospitals and four grade II Class A hospitals in a city of Hubei Province by convenient sampling method in May 2020. The survey was conducted online using the Post-traumatic Stress Checklist-Civilian Version (PCL-C) as the main survey tool to investigate current situation and characteristics of PTSD among these participants. A total of 1120 questionnaires were collected, of which 1071 were valid, and the effective rate was 95.6%. [Results] Of the 1071 participants, the average age was (32.59+/-5.21) years;the ratio of male to female was 1: 5.02;the ratio of doctor to nurse was 1:5.8;nearly 70% participants came from grade III Class A hospitals;married participants accounted for 75.4%;most of them held a bachelor degree or above (86.5%);members of the Communist Party of China (CPC) accounted for 22.9%;50.9% had junior titles;the working years were mainly 5-10 years (42.8%);more than 80.0% participants volunteered to join the front-line fight;95.1% participants received family support;43.0% participated in rescue missions;78.1% participants fought the epidemic in their own hospitals;more than 60% participants considered the workload was greater than before;34.4% participants fought in the front-line for 2-4 weeks, and 23.5% participants did for more than 6 weeks. There were 111 cases of positive PTSD syndromes (PCL-C total score >=38) with an overall positive rate of 10.4%, and the scores of reexperience [1.40 (1.00, 1.80)] and hypervigilance [1.40 (1.00, 2.00)] were higher than the score of avoidance [1.14 (1.00, 2.57)]. The results of univariate analysis revealed that PTSD occurred differently among participants grouped by age, political affiliation, working years, anti-epidemic activities location, accumulated working hours in fighting against COVID-19, having child parenting duty, voluntariness, family support, whether family members participated in front-line activities, and rescue mission assignment (P<0.05). The results of logistic regression analysis showed that the incidence rates of reporting PTSD syndromes in medical personnel aged 31-40 years (OR=0.346, 95%CI: 0.164-0.730) and aged 41 years and above (OR=0.513, 95%CI: 0.319-0.823) were lower than that in those aged 20-30 years;the incidence rates of reporting PTSD syndromes in medical staff who were CPC members (OR=0.499, 95%CI: 0.274-0.909), volunteered to participate (OR=0.584, 95%CI: 0.360-0.945), and received family support (OR=0.453, 95%CI: 0.222-0.921) were lower than those did not (P<0.05);the incidence rates of reporting PTSD syndromes among medical workers who had child parenting duty (OR=2.372, 95%CI: 1.392-4.042), whose family members participated in front-line activities (OR=1.709, 95%CI: 1.135-2.575), and who participated in rescue missions (OR=1.705, 95%CI: 1.133-2.565) were higher than those who did not (P<0.05). [Conclusion] The positive PTSD syndrome rate is 10.4% in the front-line anti-epidemic medical staff. Age, political affiliation, voluntariness, family support, having child parenting duty, with a family members participating in the fight, and rescue mission assignment are the influencing factors of PTSD.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Mother-academics are disadvantaged by historical and systemic inequalities situated within academia which have been compounded by the pandemic. Through the analytical lens of the theory of practice architectures, we focus on work practices and women's emotional experiences while reconfiguring their identities as online academics and simultaneously their changing home worlds due to the close proximity of their children at the kitchen table. Findings indicate that pre-COVID-19, boundaries between mothering and academia were delineated by the physicality of settings. In contrast, when forced to work from home during the pandemic, skilful navigation was required to obtain a home/work balance. Empathy was required to realign and locate a form of equilibrium in the merging online and home environment at the kitchen table. We contribute to the growing body of literature that advocates for academia to become a less gendered environment in the future. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.
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During an emergency, timely and effective distribution of emergency supplies is critical in rescue. In the context of Covid-19, given the difficulties in distributing supplies to communities due to super infectious viruses, unmanned vehicle distribution is studied by taking into account the priority and satisfaction of communities to improve distribution safety and effectiveness of supplies. Furthermore, the influence of distribution time on the overall efficiency is also taken into account, thus ultimately establishing an unmanned distribution model with the shortest distribution time while meeting community satisfaction. The improved whale algorithm is used to solve the dual-objective model and compared with the basic whale optimization algorithm. The results show that the improved whale algorithm demonstrates better convergence, searchability, and stability. The constructed model can scientifically distribute daily necessities to communities while considering their priority and satisfaction. © 2022 IEEE.
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Objective: To explore the guidance value of "treatment of disease in accordance with three conditions" theory in the prevention and treatment of corona virus disease 2019 (COVID-19) based on the differences of syndromes and traditional Chinese medicine (TCM) treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. Method(s): Demographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system (HIS) of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. Result(s): A total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai, dominated by young and middle-aged males, had clinical symptoms of fever, abnormal sweating, and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat, with manifest cold, dampness, and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness, accompanied by draining depressed heat. The core Chinese medicines used are Poria, Armeniacae Semen Amarum, Gypsum Fibrosum, Citri Reticulatae Pericarpium, and Pogostemonis Herba. By contrast, the 105 patients in Ruili, dominated by young females, had atypical clinical symptoms, and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach, with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen, resolving dampness, and dispersing Qi with light drugs. The core Chinese medicines used are Poria, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Coicis Semen, Platycodonis Radix, Lonicerae Japonicae Flos, and Pogostemonis Herba. Conclusion(s): The differences in clinical characteristics, TCM syndromes, and medication of COVID-19 patients from the two places may result from different regions, population characteristics, and the time point of the COVID-19 outbreak. The "treatment of disease in accordance with three conditions" theory can help to understand the internal correlation and guide the treatments.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
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Introduction: Post-COVID-19 syndrome has emerged as we learn more about COVID-19 but its influence on patient well-being after discharge is not well researched. The study examined the impact of demography and symptom persistence on functional outcome post hospitalization. Method(s): A single-centre, cross-sectional study was conducted via retrospective review of medical records of patients who attended the post-COVID-19 clinic follow-up from September 2020 until August 2021. Associating factors with functional status was analysed using logistic regression. Result(s): The mean age of 201 patients was 55 (SD: 14.1) years old, with population match ethnic proportions and equal gender distribution. Most were diagnosed with COVID-19 Stage 3 or higher. Hypertension (57.1%) and diabetes (39.1%) were the common comorbidities. Cough (59.3%), dyspnoea (43.3%), and fever (42.5%) were the most prevalent hospitalization symptoms, while malaise (21.0%), dyspnoea (17.8%), and cough (17.4%) were the most common post-discharge symptoms. Slightly less than half (46.6%) had poor functional outcome. Patients with malaise [AOR: 4.76 (95% CI: 1.89, 12.02), p=0.001] and cough [AOR: 2.97 (95% CI: 1.17, 7.55), p=0.022] had higher odds of poor functional outcome. Twenty-three patients sought treatment for persistent symptoms, but only three contacted the COVID team for advice. Conclusion(s): Persistent symptoms like malaise and cough which was associated with poorer functional outcomes alongside low health-seeking behaviour implying a lack of knowledge about the impact of symptom persistence on their quality of life. This serves as a guide for patient's education on recovery and future follow-up plans in the post-COVID-19 clinic.
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Introduction: One of the common causes of COVID-19 related death is acute respiratory distress syndrome (C-ARDS). Dexamethasone is the cornerstone in the therapy of C-ARDS and reduces mortality probably by suppressing inflammatory levels in ICU patients. Its anti-inflammatory effects may be concentration-related. However, no pharmacokinetic studies of dexamethasone have been conducted in ICU patients. Therefore, we designed a population pharmacokinetic study to gain a deeper understanding of the pharmacokinetics of dexamethasone in critically ill patients in order to identify relevant covariates that can be used to personalize dosing regimens and improve clinical outcomes. Method(s): This was a retrospective pilot study at the ICU of the Erasmus Medical Center. Blood samples were collected in adults at the ICU with COVID who were treated with fixed dose intravenous dexamethasone (6 mg/day). The data were analyzed using Nonlinear Mixed Effects Modelling (NONMEM) software for population pharmacokinetic analysis and clinically relevant covariates were selected and evaluated. Result(s): A total of 51 dexamethasone samples were measured in 18 patients. A two-compartment model with first-order kinetics best fitted the data. The mean population estimates for drug clearance and inter-compartment clearance were 2.85 L/h (IIV 62.9%) and 2.11 L/h, respectively, and central and peripheral volumes of distribution were 15.4 L and 12.3 L, respectively. The covariate analysis showed a significant correlation between dexamethasone clearance and CRP. Dexamethasone clearance decreased significantly with increasing CRP in the range of 0-50 mg/L and a correlation was observed with CRP up to 100 mg/L. Conclusion(s): The dexamethasone PK parameters of ICU COVID patients were quite different from those come from healthy populations. Inflammation might play an important role in dexamethasone clearance and the dosing should be more individualized in order to achieve best therapeutic effect in ICU patients.
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Objective To understand the epidemiological characteristics of COVID-19 in Shaanxi Province from December 9, 2021 to January 20, 2022, and analyze the factors influencing the interval from isolation to diagnosis. Methods We collected the data of local COVID-19 cases from December 9, 2021 to January 20, 2022 published on the official website of Health Commission of Shaanxi Province. Descriptive statistical method was used to analyze the epidemiological characteristics of COVID-19 in Shaanxi Province. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences between groups. The unconditional Logistic regression model was applied to analyze the factors influencing the interval between isolation and diagnosis. Results The outbreak of COVID-19 in Shaanxi Province started on December 9, 2021 and ended on January 20, 2022. The overall change trend of the outbreak showed an "inverted V" shape. A total of 2,080 confirmed local cases were reported, and the main type of disease was mild, with an incidence rate of 5.26/100,000. Xi'an had the most cases, accounting for 98. 69% of the total. The reported cases were mainly concentrated in people aged 21 to 55 years old, with a male-to-female sex ratio of 1.19:1. The median interval from isolation to diagnosis was 3 days, the shortest interval being 0 day and the longest interval being 21 days. Unconditional Logistic regression model analysis showed that the way of finding cases was the factor influencing the interval from isolation to diagnosis. Compared with the way of isolation of the key population, the way of the nucleic acid screening could reduce the risk of late detection of confirmed cases by 89% (OR = 0.11, 95% CI: 0. 07 - 0.16). Conclusion The way of finding cases is the factor influencing the interval from isolation to diagnosis. In the face of the recent intensification of the spread of Omicron variant in mainland China, accurate and rapid identification and detection of confirmed cases can not only reduce the risk of the spread of the epidemic, but also endeavor more time and initiative for the treatment of patients, which is the key to curbing the spread of the epidemic.Copyright © 2023 Xi'an Medical University. All rights reserved.