ABSTRACT
The article introduces a mathematics education measure in response to the COVID-19 epidemic in China and explores students' degree of approval and perception of digital equity towards the response. After the outbreak of the COVID-19, the Chinese New Century Primary School Mathematics Textbook (NCPM) committee had developed a series of micro classes (abbreviated as NCPM micro classes), and more than 25 million teachers and students in China watched the NCPM micro classes during the 3 months social isolation. Then, students' degree of approval towards the NCPM micro classes and perception of digital equity were examined after social isolation. A total of 132,740 pieces of data were collected from Chinese primary school students. Quantitative analysis of student's degree of approval towards different parts of NCPM micro classes indicated that the introduction, interaction, summary and consolidation, curriculum characteristics, and goal achievement parts of the NCPM micro classes have received high approval from students, and students with higher former achievement perceived a higher degree of approval towards the NCPM micro classes. Furthermore, we found that gender, socioeconomic status, school location, and learning location had no significant impact on students' degree of approval, indicating a digital equity exists. This study helps researchers or educators understand the mathematics education response to the COVID-19 outbreak in China and extends our understanding of primary students' degree of approval and perception of digital equity with these online classes.
ABSTRACT
OBJECTIVE: Association of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) use with coronavirus disease 2019 (COVID-19) remains controversial. We aimed to investigate the impact of ACEI/ARB use on all-cause mortality in severe COVID-19 patients with hypertension. METHODS: We enrolled 650 COVID-19 patients from Changsha and Wuhan city between 17 January 2020 and 8 March 2020. Demographic, clinical characteristics, and outcomes were collected. Multivariable analysis and propensity-score matching were performed to assess the impact of ACEI/ARB therapy on mortality. RESULTS: Among the 650 patients, 126 who had severe COVID-19 concomitant with hypertension were analyzed. The average age was 66 years and 56 (44.4%) were men. There were 37 ACEI/ARB users and 21 in-hospital deaths (mortality rate, 16.7%). Male sex (odds ratio [OR], 5.13; 95% confidence interval [CI], 1.75 to 17.8), but not ACEI/ARB use (OR, 1.09; 95%CI, 0.31 to 3.43), was an independent risk factor for mortality in severe COVID-19 patients with hypertension. After propensity-score matching, 60 severe COVID-19 patients were included and no significant correlation between use of ACEI/ARB and mortality was observed. CONCLUSIONS: There was no significant association of ACEI/ARB use with mortality in severe COVID-19 patients with hypertension. These findings support the continuation of ACEI/ARB therapy for such patients.
Subject(s)
Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , COVID-19/mortality , Hypertension/drug therapy , Aged , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/complications , COVID-19/diagnosis , COVID-19/virology , Female , Gene Expression Regulation/drug effects , Hospital Mortality , Humans , Hypertension/complications , Male , Pandemics , Renin-Angiotensin System/drug effects , Retrospective Studies , Risk Factors , SARS-CoV-2/drug effects , SARS-CoV-2/pathogenicity , Severity of Illness Index , Spike Glycoprotein, Coronavirus/metabolism , Virus Internalization/drug effectsABSTRACT
In the recent outbreak of novel coronavirus infection worldwide, the risk of thrombosis and bleeding should be concerned. We aimed to observe the dynamic changes of D-dimer levels during disease progression to evaluate their value for thrombosis. In this study, we report the clinical and laboratory results of 57 patients with confirmed COVID-19 pneumonia and 46 patients with confirmed community-acquired bacterial pneumonia (CAP). And their concentrations of D-dimer, infection-related biomarkers, and conventional coagulation were retrospectively analyzed. The Padua prediction score is used to identify patients at high risk for venous thromboembolism (VTE). The results found that, on admission, both in COVID-19 patients and CAP patients, D-dimer levels were significantly increased, and compared with CAP patients, D-dimer levels were higher in COVID-19 patients (P < 0.05). Besides, we found that in COVID-19 patients, D-dimer were related with markers of inflammation, especially with hsCRP (R = 0.426, P < 0.05). However, there was low correlation between VTE score and D-dimer levels (Spearman's R = 0.264, P > 0.05) weakened the role of D-dimer in the prediction of thrombosis. After treatments, D-dimer levels decreased which was synchronous with hsCRP levels in patients with good clinical prognosis, but there were still some patients with anomalous increasing D-dimer levels after therapy. In conclusion, elevated baseline D-dimer levels are associated with inflammation but not with VTE score in COVID-19 patients, suggesting that it is unreasonable to judge whether anticoagulation is needed only according to D-dimer levels. However, the abnormal changes of D-dimer and inflammatory factors suggest that anticoagulant therapy might be needed.