Review of taste and taste disturbance in COVID-19 patients.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has become a significant global public health concern. The virus gains entry to cells via angiotensin-converting enzyme-2 (ACE2) receptors, which have been found to be the functional receptor for SARS-CoV-2 infection. High expression of ACE2 is found in type II alveolar cells, macrophages, bronchial and tracheal epithelial cells and in the oral cavity, particularly on the tongue. Taste disturbance is one of the early symptoms of COVID-19, suggesting that taste cells in taste buds are vulnerable to SARS-CoV-2 infection. Taste is modulated by hormones that are regulated in the renin-angiotensin-aldosterone system. Hypothetical causes of taste disturbance by SARS-CoV-2 may be due to direct cell and/or neuronal injuries, inflammatory responses and dysregulation of ACE2.

Medical teachers' experience of emergency remote teaching during the COVID-19 pandemic: a cross-institutional study.

BACKGROUND: The COVID-19 pandemic and the consequent social distancing measures caused unprecedented disruption for medical and healthcare education. This study examined medical teachers' experience with emergency remote teaching during the pandemic and their acceptance of online teaching after the pandemic. METHODS: In this sequential mixed methods study, online surveys were disseminated to teachers (n = 139) at two Asia-Pacific medical schools to evaluate their experience with emergency remote teaching during the pandemic. Subsequently, in-depth interviews were conducted with teachers from both institutions (n = 13). Each interviewee was classified into an adopter category based on Rogers' Diffusion of Innovations Theory. Interview transcripts were analyzed thematically, and the descriptive themes were mapped to broader themes partly based on the Technology Acceptance Model and these included: (i) perceived usefulness of online teaching, (ii) perceived ease of delivering online teaching, (iii) experience with institutional support and (iv) acceptance of online teaching after the pandemic. RESULTS: Our participants described accounts of successes with their emergency remote teaching and difficulties they experienced. In general, most participants found it difficult to deliver clinical skills teaching remotely and manage large groups of students in synchronous online classes. With regards to institutional support, teachers with lower technological literacy required just-in-time technical support, while teachers who were innovative in their online teaching practices found that IT support alone could not fully address their needs. It was also found that teachers' acceptance of online teaching after the pandemic was influenced by their belief about the usefulness of online teaching. CONCLUSIONS: This study demonstrated that our participants managed to adapt to emergency remote teaching during this pandemic, and it also identified a myriad of drivers and blockers to online teaching adoption for medical teachers. It highlights the need for institutes to better support their teaching staff with diverse needs in their online teaching.

Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support.

Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.

Using Technology for the Efficient and Precise Assessment of Cognitive Skills in Countries with Limited Standardized Assessment Instruments: A Report on the Case of Saudi Arabia

In Saudi Arabia, the country’s progress toward appropriate and inclusive education programs for children with disabilities is still evolving. A crucial aspect of this evolution has been the development of a comprehensive assessment battery that covers a broad range of cognitive factors for the diagnosis of neurodevelopment disorders and other types of intellectual atypicalities, including giftedness. The Alif–Ya Assessment Battery consists of 47 subtests based on various theories of intelligence. Alif–Ya capitalizes on advanced technologies to enable its delivery either in person or remotely. Moreover, over half of Alif–Ya’s subtests are adaptive;items are selected for the test takers based on their previous responses. In this paper, we provide an overview of the Alif–Ya Assessment Battery, describe how it was designed to make the best use of the latest and best features of technology for the appropriate and accurate assessment of children and adolescents in the Kingdom of Saudi Arabia via remote or in-person administration, and present initial data collected with the battery.

Rare disasters, exchange rates, and macroeconomic policy: Evidence from COVID-19☆

The rapid spread of the novel coronavirus (COVID-19) has had a dramatic effect on financial markets worldwide. This paper explores the association between rare disasters, macroeconomic policy, and the exchange rate, using COVID-19 as an example. Analysis of data from 27 advanced and emerging economies reveals a strong correlation between COVID-19 and time-varying risk premiums in the foreign exchange market. Moreover, the spread of COVID-19 significantly depreciates the domestic exchange rate in emerging markets, but not in advanced countries. During the COVID-19 crisis, expansionary fiscal policies and unconventional monetary policies led to an appreciation of local currencies. However, conventional expansionary monetary policies had the opposite effect, indicating that the traditional effect of monetary policy on the exchange rate takes precedence even in the event of a rare disaster.

Hesitancy Towards COVID-19 Vaccine Among Older People in Luzhou, China: A Cross-sectional Study (preprint)

Background: Vaccination is one of the most effective and low-cost health measures to prevent COVID-19. Vaccine hesitancy is an obstacle to COVID-19 vaccination. Objective: This study aims to inform the vaccine hesitancy and analyze related factors towards COVID-19 vaccination among elderly in Luzhou, so as to provide suggestions for increasing vaccines uptake. Methods: : A face-to-face questionnaire cross-sectional survey was conducted among the elderly people over 60 years old in Luzhou City in April 2021 by multi-stage sampling method. Results: : A total of 1047 valid questionnaires were received. 42.0%（440/1047）vaccine hesitancy was reported among elderly in total. Female (OR=1.282, 95%CI:1.003-1.649), live in the rural (OR=3.659, 95%CI:2.813-4.758), poor health (OR=2.318, 95%CI:1.473-3.649), individuals not having regular medical check-ups (OR=2.669, 95%CI:2.072-3.437) and no history of self-funded influenza vaccination ( OR=2.408, 95% CI:1.656-3.502) reported slightly higher vaccine hesitancy. Being in low-risk areas and no need to get vaccinated (OR=16.877, 95%CI:11.750-24.242), being considered that the current protective measures had been able to avoid infection (OR=5.539, 95%CI:3.596-8.532), being considered that the natural immunity get from the disease was better than getting COVID-19 vaccine (OR=5.297, 95%CI:3.666-7.653), being concerned about side effects (OR=5.155, 95%CI:3.655-7.270) and being concerned that the vaccine was ineffective (OR=10.244, 95%CI:6.831-15.362) had higher prevalence of vaccine hesitancy. Those who believing the COVID-19 vaccine was safe and reliable (OR=0.075, 95%CI:0.044-0.130), the vaccine was free (OR=0.466, 95%CI:0.312-0.697) and individuals with higher education (OR=0.189, 95%CI:0.126-0.284) were more willing to get vaccinated. Conclusion: Confidence in vaccines and perceptions of benefits and risk are associated with vaccine hesitancy. It’s very important to strengthen vaccine health literacy education for older people and enhance vaccine confidence. Countries need to supervise the public opinions in social media, television broadcasting and other media, so as to ensure the correct orientation of public opinion. Open and transparent evidence-based information is also needed which can help improve the vaccination coverage rate of the public.

Effect analysis of meteorological conditions on air quality during the winter COVID-19 lockdown in Beijing

The influence of meteorological conditions on the pollution processes was investigated in this study by analyzing the changes of air quality as well as the characteristics of two persistent heavy pollution episodes during the Coronavirus Disea se 2019（COVID-19） prevention（January 24 to February 29） of 2020 winter compared with the same period of 2015～2019. Cold air intensity in 2020 winter was weaker with the cold surges frequency decreased by 50%. Air temperature was 0.73℃ higher, and wind speed and mixed layer height were 17.8% and 32.5% lower, respectively. Relative humidity and dew point temperature increased by 60. 9% and 48.1%, respectively. Northerly wind frequency reduced 7.5% while both of southerly and easterly wind increased 6.0%. As shown above, all meteorological conditions in 2020 winter were significantly more favorable for air pollution than the same historical period. Moreover, two heavy pollution episodes（January 24～29 and February 8～14） lasted for 59 and 75 hours were analyzed. At the cumulative stage, regional transport that can be divided into east and south channel greatly affected PM2.5, with the contribution of 70% and 58% for two episodes. By contrast, the contribution of local pollution was 67% and 48%, respectively, indicating the increased proportion of hygroscopic growth and secondary generation in the maintenance and aggravation stages. Under the meteorological background of "high humidity and high atmospheric stability", the combined effects of atmospheric vertical dynamics and horizontal convergence accumulated PM2.5 and water vapor in Beijing plain and prevented them from spreading beyond the boundary layer. Further bidirectional feedback between increased pollutants and meteorological factor s in stable boundary layer resulting in aggravation of pollution. According to EMI index, meteorological conditions during the epi demic prevention in 2020 winter caused an increase of 70.1% in PM2.5 concentration compared to pre-COVID-19. Emissions reduction caused by emergency measures for COVID-19 lockdown offset 53% of the adverse impact induced by meteorological conditions. As for the two episodes in 2020 winter, EMI was 26.9% and 19.7% larger than the average of other nine episodes in the correspond ing period of 2015～2019, and PM2.5 concentration was basically unchanged or slightly reduced. Overall, if the current social emission level is not changed, emission reduction caused by city blockade under special circumstances can only partially reduce the pollution concentration, however, cannot completely offset the adverse impact of meteorological conditions.

Management of Breast Cancer Patients During the Coronavirus Disease 2019 Pandemic: The Experience From the Epicenter of China, Wuhan.

BACKGROUND: The coronavirus disease 2019 pandemic is a global public health event. Wuhan used to be the epicenter of China and finally controlled the outbreak through city lockdown and many other policies. However, the pandemic and the prevention strategies had a huge impact on the medical care procedures for patients with breast cancer, leading to the delay or interruption of anticancer therapies. PATIENTS AND METHODS: To better serve patients with breast cancer under the premise of epidemic control, many strategies have been proposed and optimized in our center. One of the most important parts of these strategies is the promotion of telemedicine, including online consultation, online prescription, and drug mailing services. RESULTS: In keeping with the city and hospital policies, we have also introduced stricter ward management policies and more precise care. CONCLUSION: Here, we collected the diagnosis and treatment process of patients with breast cancer in our center during the coronavirus disease 2019 pandemic, which was found to be correlated to a reduction in chemotherapy-related myelosuppression and hepatic dysfunction, hoping to provide a reference for other cancer centers that may suffer from the similar situation.

Prevalence and Factors Associated with Post-Traumatic Stress Disorder in Healthcare Workers Exposed to COVID-19 in Wuhan, China: A Cross-Sectional Survey (preprint)

Background: The COVID-19 pandemic has posed significant threats to both physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, evidence regarding the long-term impact of COVID-19 is limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 eight months after end of outbreak in Wuhan, China. Methods: A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units in Wuhan during the outbreak (from November 2019 to April 2020). The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5, the family care index questionnaire, and the quality of life scale. The prevalence, risk and protective factors, and impact of post-traumatic stress disorder healthcare workers were then analyzed with logistic regression.Results: Among the 659 participants, 90 healthcare workers were still suffering from PTSD eight months after the end of outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors of PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals surfaced as protective factors. The impact of PTSD on COVID-19-exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign.Conclusions: Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the common recognized risk factors, comorbid of chronic disease was identified as the new independent risk factors of developing PTSD. For countries where the pandemic is still ongoing or in the case of future outbreaks of new communicable diseases, this research may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.

Analysis of the disposal of medical waste management at home and abroad and suggestions on countermeasures

The widespread outbreak of COVID-19 in 2020 has aroused great concern of the government and the public on the environmental management and safe disposal of medical wastes. Developed countries have established a relatively comprehensive medical waste management system, while the China's medical waste management system and treatment methods still need to be improved. The current status of the production, management and disposal of medical wastes were analyzed systematically in this paper to summarize and analyze the problems of medical waste management and disposal in China. Learned from the foreign practices, effective methods such as strengthening the classified medical waste collection management system, the establishment of the producers responsible recycling system, the full implementation of the centralized processing system, the strengthening of the whole process of tracking management of each link, the deepening of the disposal technology research, and the building of the emergency disposal of medical wastes management system were put forward to provide references for further standardizing the development in this field.

Management of oral medicine emergencies during COVID-19: A study to develop practise guidelines.

Coronavirus disease (COVID-19) pandemic has become a significant global public health concern. Since the announcement of the Public Health Emergency of International Concern, many countries have implemented lockdown and restrictive quarantines; therefore, routine dentistry, as well as oral medicine practise, have been suspended in several countries. However, urgent oral cares and emergencies are still operated and delivered by on-call dental practitioners. The objective of this study was to investigate the management of oral medicine emergency during a viral pandemic such as COVID-19. During the lockdown period, digital technologies, such as video conferencing with Zoom, Google Meeting or WhatsApp, are useful and efficient tools that oral medicine practitioners could consider to use for patient triage, managing emergencies, reassure, and follow patients remotely. Oral medicine emergencies can be carefully evaluated and triaged via video conferencing and sometimes phone contact, to avoid life-threatening risks while realising the limitations by both patient and clinician.

An online coronavirus analysis platform from the National Genomics Data Center.

Since the first reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic, spreading to more than 200 countries and regions worldwide. With continued research progress and virus detection, SARS-CoV-2 genomes and sequencing data have been reported and accumulated at an unprecedented rate. To meet the need for fast analysis of these genome sequences, the National Genomics Data Center (NGDC) of the China National Center for Bioinformation (CNCB) has established an online coronavirus analysis platform, which includes de novoassembly, BLAST alignment, genome annotation, variant identification, and variant annotation modules. The online analysis platform can be freely accessed at the 2019 Novel Coronavirus Resource (2019nCoVR) (https://bigd.big.ac.cn/ncov/online/tools).

Discovery of rhodomyrtone as a broad-spectrum antiviral inhibitor with anti-SARS-CoV-2 activity (preprint)

The outbreak of new viruses, such as serve acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as the emerging of drug-resistance viruses highlight the urgent need for the development of broad-spectrum antiviral drugs. Herein, we report the discovery of a plant-derived small molecule, 6,8-dihydroxy-9-isobutyl-2,2,4,4-tetramethyl-7-(3-methylbutanoyl)-4,9-dihydro-1H- xanthene-1,3(2H)-dione (rhodomyrtone, RDT), which exhibited potent broad-spectrum antiviral activities against several RNA and DNA viruses, including SARS-CoV-2, respiratory syncytial virus (RSV), herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (HCMV), and Kaposi's sarcoma-associated herpesvirus (KSHV). RDT can significantly suppress viral gene expression and show the low possibility to elicit drug-resistant variants. Mechanistic study implied that RDT inhibited viral infection by disturbing the cellular factors that essential for viral gene expression. Our results suggested that RDT might be a promising lead compound for the development of broad-spectrum antiviral drugs.

Mechanism of Farfarae Flos in Qingfei Paidu Decoction against COVID-19 based on network pharmacology and molecular docking

Objective: To investigate the mechanism of Farfarae Flos (FF) in Qingfei Paidu Decoction against coronavirus disease 2019 (COVID-19) based on network pharmacology and molecular docking. Methods: Based on our previous study, the main compounds in FF were selected. The potential targets of FF were searched by Swiss Target Prediction and BATMAN-TCM database. GenCLiP 3 and GeneCard were used to predict and screen the therapeutic targets of COVID-19, and then Cytoscape 3.7.1 was used to build the compound-target-disease network. The String database was used to build the target PPI network. Gene ontology (GO) function enrichment analysis and KEGG pathway enrichment analysis were performed in the DAVID database. Molecular docking was performed based on the above compounds and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3CL hydrolase and angiotensin converting enzyme II (ACE2). Results: The compound-target-disease network contained 14 compounds, 104 targets and four diseases. GO function enrichment analysis revealed 444 GO items (P < 0.05), including 325 biological process (BP) items, 44 cell composition (CC) items and 75 molecular function (MF) items. A total of 94 signal pathways (P < 0.05) were screened out by KEGG pathway enrichment analysis. The results of molecular docking showed that the affinity of 3,4-dicaffeoylquinic acid and 4,5-dicaffeoylquinic acid with proteins were better than Remdesivir. Conclusion: The compounds in FF can bind with SARS-CoV-2 3CL hydrolase and ACE2, and then act on many targets to regulate multiple signaling pathways, thus exerting the therapeutic effect on COVID-19.

Adopting STING agonist cyclic dinucleotides as a potential adjuvant for SARS-CoV-2 vaccine (preprint)

A novel STING agonist CDGSF unilaterally modified with phosphorothioate and fluorine was synthesized. CDGSF displayed better STING activity over dithio CDG. Immunization of SARS-CoV-2 Spike protein with CDGSF as an adjuvant elicited an exceptional high antibody titer and a robust T cell response, which were better than the group using aluminium hydroxide as a adjuvant. These results highlighted the adjuvant potential of STING agonist in SARS-CoV-2 vaccine preparation for the first time.

Infectivity, susceptibility, and risk factors associated with SARS-CoV-2 transmission under intensive contact tracing in Hunan, China (preprint)

BackgroundSeveral parameters driving the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain unclear, including age-specific differences in infectivity and susceptibility, and the contribution of inapparent infections to transmission. Robust estimates of key time-to-event distributions remain scarce as well. MethodsWe collected individual records for 1,178 SARS-CoV-2 infected individuals and their 15,648 contacts identified by contact tracing and monitoring over the period from January 13 to April 02, 2020 in Hunan Province, China. We provide descriptive statistics of the characteristics of cases and their close contacts; we fitted distributions to time-to-key-events distributions and infectiousness profile over time; and we used generalized linear mixed model to estimate risk factors for susceptibility and transmissibility of SARS-CoV-2. ResultsWe estimated the mean serial interval at 5.5 days (95%CI -5.0, 19.9) and the mean generation time at 5.5 days (95%CI 1.7, 11.6). The infectiousness was estimated to peak 1.8 days before symptom onset, with 95% of transmission events occurring between 7.6 days before and 7.3 days after the date of symptom onset. The proportion of pre-symptomatic transmission was estimated to be 62.5%. We estimated that at least 3.5% of cases were generated asymptomatic individuals. SARS-CoV-2 transmissibility was not significantly different between working-age adults (15-59 years old) and other age groups (0-14 years old: p-value=0.16; 60 years and over: p-value=0.33), whilst susceptibility to SARS-CoV-2 infection was estimated to increase with age (p-value=0.03). In addition, transmission risk was higher for household contacts (p-value<0.001), decreased for higher generations within a cluster (second generation: odds ratio=0.13, p-value<0.001; generations 3-4: odds ratio=0.05, p-value<0.001, relative to generation 1), and decreased for infectors with a larger number of contacts (p-value=0.04). InterpretationOur findings warn of the possible relevant contribution of children to SARS-CoV-2 transmission. When lockdown interventions are in place, we found that odds of transmission are highest in the household setting but, with the relaxation of interventions, other settings (including schools) could bear a higher risk of transmission. Moreover, the estimated relevant fraction of pre-symptomatic and asymptomatic transmission highlight the importance of large-scale testing, contact tracing activities, and the use of personnel protective equipment during the COVID-19 pandemic.