The Impact of Vaccination Time on the Antibody Response to an Inactivated Vaccine against SARS-CoV-2 (IMPROVE-2): A Randomized Controlled Trial.

There is still controversy about whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination at different times of day will induce a stronger immune response. Therefore, a randomized controlled trial (ChiCTR2100045109) is conducted to investigate the impact of vaccination time on the antibody response to the inactivated vaccine against SARS-CoV-2 from April 15 to 28, 2021. Participants are randomly assigned in a 1:1 ratio to receive inactivated SARS-CoV-2 vaccine in the morning or afternoon. The primary endpoint is the change of neutralizing antibody between baseline and 28 days after the second dose. In total, 503 participants are randomized, and 469 participants (238 in the morning group and 231 in the afternoon group) complete the follow-up. There is no significant difference in the change of neutralizing antibody between baseline and 28 days after the second dose between the morning and afternoon groups (22.2 [13.2, 45.0] AU mL-1  vs 22.0 [14.4, 40.7] AU mL-1 , P = 0.873). In prespecified age and sex subgroup analyses, there is also no significant difference in the morning and afternoon group (all P > 0.05). This study demonstrates that the vaccination time does not affect the antibody response of two doses of inactivated SARS-CoV-2 vaccine.

Double challenges: How working from home affects dual-earner couples' work-family experiences

Against the backdrop of COVID-19 pandemic, we draw on family systems theory to elucidate how daily work-from-home status (WFH) affects both members in dual-earner couples. We propose that the WFH exerts intra-individual and inter-individual influences on employees' and their partners' work task and family task completion and their subsequent reactions to their work and family experiences. We examined the hypothesized relationships with two daily survey studies on dual-earner couples conducted during the pandemic (i.e., 1,559 daily responses of 165 dual-earner couples from China in Study 1, and 773 daily responses of 57 dual-earner couples from South Korea in Study 2). The two studies provide converging results that working from home (vs. office) increased employees' family task completion for both husbands and wives and that wives working from home (vs. office) decreased husbands' family task completion. Further, in both studies, daily work task completion increased felt guilt toward family (for wives only) through increased work-family conflict, and daily family task completion increased psychological withdrawal from work through increased family-work conflict for both husbands and wives. Moreover, we found in Study 2 that on days when husbands had flexible work schedule, wives completed more work tasks when working from home (vs. office) and that on days when wives had inflexible work arrangement, husbands completed more family tasks when working from home (vs. office). Across the two studies, there were no clear gender-difference patterns in husbands' and wives' work and family experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Double challenges: How working from home affects dual-earner couples' work-family experiences

Against the backdrop of COVID-19 pandemic, we draw on family systems theory to elucidate how daily work-from-home status (WFH) affects both members in dual-earner couples. We propose that the WFH exerts intra-individual and inter-individual influences on employees' and their partners' work task and family task completion and their subsequent reactions to their work and family experiences. We examined the hypothesized relationships with two daily survey studies on dual-earner couples conducted during the pandemic (i.e., 1,559 daily responses of 165 dual-earner couples from China in Study 1, and 773 daily responses of 57 dual-earner couples from South Korea in Study 2). The two studies provide converging results that working from home (vs. office) increased employees' family task completion for both husbands and wives and that wives working from home (vs. office) decreased husbands' family task completion. Further, in both studies, daily work task completion increased felt guilt toward family (for wives only) through increased work-family conflict, and daily family task completion increased psychological withdrawal from work through increased family-work conflict for both husbands and wives. Moreover, we found in Study 2 that on days when husbands had flexible work schedule, wives completed more work tasks when working from home (vs. office) and that on days when wives had inflexible work arrangement, husbands completed more family tasks when working from home (vs. office). Across the two studies, there were no clear gender-difference patterns in husbands' and wives' work and family experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Impacts of delta and omicron variants on inactivated SARS-CoV-2 vaccine-induced T cell responses in patients with autoimmune diseases and healthy controls.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (COVID-19), which is still devastating economies and communities globally. The increasing infections of variants of concern (VOCs) in vaccinated population have raised concerns about the effectiveness of current vaccines. Patients with autoimmune diseases (PAD) under immunosuppressant treatments are facing higher risk of infection and potentially lower immune responses to SARS-CoV-2 vaccination. METHODS: Blood samples were collected from PAD or healthy controls (HC) who finished two or three doses of inactivated vaccines. Spike peptides derived from wild-type strain, delta, omicron BA.1 were utilised to evaluate T cell responses and their cross-recognition of delta and omicron in HC and PAD by flow cytometry and ex vivo IFNγ-ELISpot. RESULTS: We found that inactivated vaccine-induced spike-specific memory T cells were long-lasting in both PAD and HC. These spike-specific T cells were highly conserved and cross-recognized delta and omicron. Moreover, a third inactivated vaccine expanded spike-specific T cells that responded to delta and omicron spike peptides substantially in both PAD and HC. Importantly, the polyfunctionality of spike-specific memory T cells was preserved in terms of cytokine and cytotoxic responses. Although the extent of T cell responses was lower in PAD after two-dose, T cell responses were boosted to a greater magnitude in PAD by the third dose, bringing comparable spike-specific T cell immunity after the third dose. CONCLUSION: Inactivated vaccine-induced spike-specific T cells remain largely intact against delta and omicron variants. This study expands our understanding of inactivated vaccine-induced T cell responses in PAD and HC, which could have important indications for vaccination strategy.

Double challenges: How working from home affects dual-earner couples' work-family experiences

Against the backdrop of COVID-19 pandemic, we draw on family systems theory to elucidate how daily work-from-home status (WFH) affects both members in dual-earner couples. We propose that the WFH exerts intra-individual and inter-individual influences on employees' and their partners' work task and family task completion and their subsequent reactions to their work and family experiences. We examined the hypothesized relationships with two daily survey studies on dual-earner couples conducted during the pandemic (i.e., 1,559 daily responses of 165 dual-earner couples from China in Study 1, and 773 daily responses of 57 dual-earner couples from South Korea in Study 2). The two studies provide converging results that working from home (vs. office) increased employees' family task completion for both husbands and wives and that wives working from home (vs. office) decreased husbands' family task completion. Further, in both studies, daily work task completion increased felt guilt toward family (for wives only) through increased work-family conflict, and daily family task completion increased psychological withdrawal from work through increased family-work conflict for both husbands and wives. Moreover, we found in Study 2 that on days when husbands had flexible work schedule, wives completed more work tasks when working from home (vs. office) and that on days when wives had inflexible work arrangement, husbands completed more family tasks when working from home (vs. office). Across the two studies, there were no clear gender-difference patterns in husbands' and wives' work and family experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A fourth dose of the inactivated SARS-CoV-2 vaccine redistributes humoral immunity to the N-terminal domain.

The effectiveness of a 3rd dose of SARS-CoV-2 vaccines waned quickly in the Omicron-predominant period. In response to fast-waning immunity and the threat of Omicron variant of concern (VOC) to healthcare workers (HCWs), we conduct a non-randomized trial (ChiCTR2200055564) in which 38 HCWs volunteer to receive a homologous booster of inactivated vaccines (BBIBP-CorV) 6 months after the 3rd dose. The primary and secondary outcomes are neutralizing antibodies (NAbs) and the receptor-binding domain (RBD)-directed antibodies, respectively. The 4th dose recalls waned immunity while having distinct effects on humoral responses to different antigens. The peak antibody response to the RBD induced by the 4th dose is inferior to that after the 3rd dose, whereas responses to the N-terminal domain (NTD) of spike protein are further strengthened significantly. Accordingly, the 4th dose further elevates the peak level of NAbs against ancestral SARS-CoV-2 and Omicron BA.2, but not BA.1 which has more NTD mutations. No severe adverse events related to vaccination are recorded during the trial. Here, we show that redistribution of immune focus after repeated vaccinations may modulate cross-protective immune responses against different VOCs.

Mental state, biological rhythm and social support among healthcare workers during the early stages of the COVID-19 epidemic in Wuhan.

Background: The COVID-19 pandemic has put the mental health of healthcare workers at risk. However, the potential psychosocial factors underlying mental health problems, such as depression and anxiety, require further investigation. The present study aimed to explore the factors that influence the mental state of healthcare workers. Methods: A total of 276 healthcare workers completed a set of online self-report questionnaires from February 4 to 7, 2020, in the following order: general information related to the COVID-19 outbreak, Biological Rhythms Interview of Assessment in Neuropsychiatry, Beck Depression Inventory-II, Beck Anxiety Inventory, and Social Support Rating Scale. Results: Our study revealed that both social support and age moderated the ability of biological rhythm disturbance to exacerbate depression (R2 = 0.47; effect size f2 = 0.85). Higher levels of social support buffered the amplification of depression associated with increased biological rhythm disturbance in all age groups, and especially in younger individuals (mean age = 26.57, se = 0.04). Depressive symptoms were predicted by both social and sleeping rhythms, whereas anxiety symptoms were predicted only by social rhythm. Married individuals had lower biological rhythm disturbance ratings and higher social support ratings. Females also reported higher ratings in social support. Conclusions: Our study suggests that biological rhythm intervention along with social support can reduce the negative effect of biological rhythm disturbance on mood disorders, especially in younger people. We also provide evidence for the ability of social support to buffer stress in a major health crisis and demonstrate the effects of marital status and sex, which provide a different perspective for studying mental crisis management.

Effect of Inactivated SARS-CoV-2 Vaccine on Thyroid Function and Autoimmunity Within 28 Days After the Second Dose.

Background: The safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines is widely appreciated. However, there is limited knowledge regarding the potential impact of SARS-CoV-2 vaccines on the thyroid. Methods: We performed two prospective clinical trials between April and June, 2021, enrolling recipients of the inactivated SARS-CoV-2 vaccine (BBIBP-CorV and CoronaVac). Thyroid function, antithyroid antibody levels, and SARS-CoV-2 neutralizing antibody levels were detected for each participant before receiving the first vaccine dose and 28 days after receiving the second vaccine dose. Results: A total of 657 recipients participated in the study. The overall median thyroid function and levels of antithyroid antibodies before and after SARS-CoV-2 vaccination were within the normal range. Among the 564 participants with normal thyroid function at baseline, 36 (6.38% [confidence interval; CI 4.51-8.73]) developed thyroid dysfunction. Of the 545 recipients with negative antithyroid antibodies at baseline, none developed abnormal antibodies after vaccination. Notably, 75.27% (70/93 [CI 65.24-83.63]) of the 93 recipients with thyroid dysfunction returned to normal function after vaccination. The levels of antithyroid peroxidase antibody (96.20% [CI 89.30-99.21]) and antithyroglobulin antibody (TgAb; 88.31% [CI 78.97-94.51]) remained positive after vaccination in most patients with abnormal values at baseline. However, the TgAb levels in more than half of the patients (48/77) decreased. All of 11 abnormal thyrotropin receptor antibody levels at baseline decreased postvaccination. Conclusions: Vaccination with an inactivated SARS-CoV-2 vaccine had no significant adverse impact on thyroid function or antithyroid antibodies within the first 28 days after the second dose. Clinical Trial Registration: ChiCTR2100045109 and ChiCTR2100042222.

Parallel profiling of antigenicity alteration and immune escape of SARS-CoV-2 Omicron and other variants.

SARS-CoV-2 variants have evolved a variety of critical mutations, leading to antigenicity changes and immune escape. The recent emerging SARS-CoV-2 Omicron variant attracted global attention due to its significant resistance to current antibody therapies and vaccines. Here, we profiled the mutations of Omicron and other various circulating SARS-CoV-2 variants in parallel by computational interface analysis and in vitro experimental assays. We identified critical mutations that lead to antigenicity changes and diminished neutralization efficiency of a panel of 14 antibodies due to diverse molecular mechanisms influencing the antigen-antibody interaction. Our study identified that Omicron exhibited extraordinary potency in immune escape compared to the other variants of concern, and explores the application of computational interface analysis in SARS-CoV-2 mutation surveillance and demonstrates its potential for the early identification of concerning variants, providing preliminary guidance for neutralizing antibody therapy.

Robust induction of B cell and T cell responses by a third dose of inactivated SARS-CoV-2 vaccine.

SARS-CoV-2 inactivated vaccines have shown remarkable efficacy in clinical trials, especially in reducing severe illness and casualty. However, the waning of humoral immunity over time has raised concern over the durability of immune memory following vaccination. Thus, we conducted a nonrandomized trial among the healthcare workers (HCWs) to investigate the long-term sustainability of SARS-CoV-2-specific B cells and T cells stimulated by inactivated vaccines and the potential need for a third booster dose. Although neutralizing antibodies elicited by the standard two-dose vaccination schedule dropped from a peak of 29.3 arbitrary units (AU)/mL to 8.8 AU/mL 5 months after the second vaccination, spike-specific memory B and T cells were still detectable, forming the basis for a quick recall response. As expected, the faded humoral immune response was vigorously elevated to 63.6 AU/mL by 7.2 folds 1 week after the third dose along with abundant spike-specific circulating follicular helper T cells in parallel. Meanwhile, spike-specific CD4+ and CD8+ T cells were also robustly elevated by 5.9 and 2.7 folds respectively. Robust expansion of memory pools by the third dose potentiated greater durability of protective immune responses. Another key finding in this trial was that HCWs with low serological response to two doses were not truly "non-responders" but fully equipped with immune memory that could be quickly recalled by a third dose even 5 months after the second vaccination. Collectively, these data provide insights into the generation of long-term immunological memory by the inactivated vaccine, which could be rapidly recalled and further boosted by a third dose.

Job search self-regulation during COVID-19: Linking search constraints, health concerns, and invulnerability to job search processes and outcomes.

The COVID-19 pandemic has caused tremendous job loss and made it difficult for unemployed individuals to search for new jobs. Specifically, the pandemic has created numerous job search obstacles, such as increased childcare and community responsibilities, that interfere with job seekers' ability to search for a job. Yet, the job search literature has scantily examined the implications of such job search constraints for job seekers even in normal times, and the limited studies that do exist have produced mostly null findings. Drawing from self-regulation theories, we position COVID-19 job search constraints as a catalyst for lower hopeful search cognitions but greater reflective metacognitive activities. To account for the distinct mechanism via which health concerns highlighted by the pandemic influence job search, we further contend that job search self-regulation is contingent upon job seekers' COVID-19 invulnerability, a novel resource-protective cognition that reflects an optimistic perception regarding how at risk job seekers feel to catching and falling ill due to COVID-19. In turn, we link such self-regulatory cognition and effort to seekers' job search distress, and job search behaviors and outcomes (i.e., number of job interviews), respectively. We also identify health-related resource loss risk factors (i.e., health status and share of family and friends' COVID-19 exposure) that impact COVID-19 invulnerability perceptions. Collecting three waves of data from 228 unemployed job seekers, we found general support for our model. Theoretical and practical implications of the current research for now and after the pandemic are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China.

BACKGROUND: Systemic corticosteroids are now recommended in many treatment guidelines, although supporting evidence is limited to 1 randomized controlled clinical trial (RECOVERY). OBJECTIVE: To identify whether corticosteroids were beneficial to COVID-19 patients. METHODS: A total of 1514 severe and 249 critical hospitalized COVID-19 patients from 2 medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting [IPTW] and propensity score matching [PSM]) were used to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases. RESULTS: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to the non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in either severe cases (HR = 1.77; 95% CI, 1.08-2.89; P = 0.023), or critical cases (HR = 2.07; 95% CI, 1.08-3.98; P = 0.028). Findings were similar in time-varying Cox analysis. For patients with severe COVID-19 at admission, corticosteroid use was not associated with improved or harmful outcome in either PSM or IPTW analysis. For critical COVID-19 patients at admission, results were consistent with multivariable Cox model analysis. CONCLUSION: Corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality for severe or critical cases in Wuhan. Absence of the beneficial effect in our study in contrast to that observed in the RECOVERY clinical trial may be due to biases in observational data, in particular prescription by indication bias, differences in clinical characteristics of patients, choice of corticosteroid used, timing of initiation of treatment, and duration of treatment.

Elevation of blood glucose level predicts worse outcomes in hospitalized patients with COVID-19: a retrospective cohort study.

INTRODUCTION: With intense deficiency of medical resources during COVID-19 pandemic, risk stratification is of strategic importance. Blood glucose level is an important risk factor for the prognosis of infection and critically ill patients. We aimed to investigate the prognostic value of blood glucose level in patients with COVID-19. RESEARCH DESIGN AND METHODS: We collected clinical and survival information of 2041 consecutive hospitalized patients with COVID-19 from two medical centers in Wuhan. Patients without available blood glucose level were excluded. We performed multivariable Cox regression to calculate HRs of blood glucose-associated indexes for the risk of progression to critical cases/mortality among non-critical cases, as well as in-hospital mortality in critical cases. Sensitivity analysis were conducted in patient without diabetes. RESULTS: Elevation of admission blood glucose level was an independent risk factor for progression to critical cases/death among non-critical cases (HR=1.30, 95% CI 1.03 to 1.63, p=0.026). Elevation of initial blood glucose level of critical diagnosis was an independent risk factor for in-hospital mortality in critical cases (HR=1.84, 95% CI 1.14 to 2.98, p=0.013). Higher median glucose level during hospital stay or after critical diagnosis (≥6.1 mmol/L) was independently associated with increased risks of progression to critical cases/death among non-critical cases, as well as in-hospital mortality in critical cases. Above results were consistent in the sensitivity analysis in patients without diabetes. CONCLUSIONS: Elevation of blood glucose level predicted worse outcomes in hospitalized patients with COVID-19. Our findings may provide a simple and practical way to risk stratify COVID-19 inpatients for hierarchical management, particularly where medical resources are in severe shortage during the pandemic.