Economic Policy Uncertainty and Conditional Dependence between China and U.S. Stock Markets

In this paper, we investigate the impact of economic policy uncertainty (EPU) on the conditional dependence between China and U.S. stock markets by employing the Copula-mixed-data sampling (Copula-MIDAS) framework. In the case of EPU, we consider the global EPU (GEPU), the American EPU (AEPU), and the China EPU (CEPU). The empirical analysis based on the Shanghai Stock Exchange Composite (SSEC) index in China and the S&P 500 index in the U.S. shows that the tail dependence between China and U.S. stock markets is symmetrical, and the t Copula outperforms alternative Copulas in terms of in-sample goodness of fit. In particular, we find that the t Copula-MIDAS model with EPU dominates the traditional time-varying t Copula in terms of in-sample fitting. Moreover, we observe that both the GEPU and AEPU have a significantly positive impact on the conditional dependence between China and U.S. stock markets, whereas CEPU has no significant impact. The tail dependence between China and U.S. stock markets exhibits an increasing trend, particularly in the recent years.

COVID-19 Vaccine Effectiveness by Product and Timing in New York State (preprint)

BackgroundUS population-based data on COVID-19 vaccine effectiveness (VE) for the 3 currently FDA-authorized products is limited. Whether declines in VE are due to waning immunity, the Delta variant, or other causes, is debated. MethodsWe conducted a prospective study of 8,834,604 New York adults, comparing vaccine cohorts defined by product, age, and month of full-vaccination to age-specific unvaccinated cohorts, by linking statewide testing, hospital, and vaccine registry databases. VE was estimated from May 1, 2021 for incident laboratory-confirmed COVID-19 cases (weekly life-table hazard rates through September 3) and hospitalizations (monthly incidence rates through August 31). Results155,092 COVID-19 cases and 14,862 hospitalizations occurred. Estimated VE for cases declined contemporaneously across age, products, and time-cohorts, from high levels beginning May 1 (1.8% Delta variant prevalence), to a nadir around July 10 (85.3% Delta), with limited changes thereafter (>95% Delta). Decreases were greatest for Pfizer-BioNTech (-24.6%, -19.1%, -14.1% for 18-49, 50-64 years, and [≥]65 years, respectively), and similar for Moderna (-18.0%, -11.6%, -9.0%, respectively) and Janssen (-19.2%, -10.8, -10.9%, respectively). VE for hospitalization for adults 18-64 years was >86% across cohorts, without time trend. Among persons [≥]65 years, VE declined from May to August for Pfizer-BioNTech (95.0% to 89.2%) and Moderna (97.2% to 94.1%). VE was lower for Janssen, without trend, ranging 85.5%-82.8%. ConclusionsDeclines in VE for cases may have been primarily driven by factors other than waning. VE for hospitalizations remained high, with modest declines limited to Pfizer-BioNTech and Moderna recipients [≥]65 years, supporting targeted booster dosing recommendations.

The Sex Difference and Potential Influence Factors In 96,237 Patients With Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis (preprint)

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease was first identified in December 2019 in Wuhan and has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic. Numerous studies of the clinical characteristics of patients with SARS-CoV-2 have been reported, yet yielded varying results given the sex difference of prevalence, severity and fatality rate. We conducted a review and meta-analysis of the sex differences of COVID-19, aiming to reveal the epidemiological characteristics and potential influencing factors of COVID-19 and provide reference for the prevention and treatment of patients.Results: By screening 1436 studies, 156 studies including 96237 COVID-19 patients from multiple countries were included. We found out that females account for 0.47 [95% CI (0.45-0.48)] of the diagnosed COVID-19 cases, while males for 0.53 of the cases [95% CI (0.52-0.55)]. Females admitted into intensive care unit (ICU) or with severe/critical illness were also analyzed, and the ratio was 0.14 [95% CI (0.11-0.17)] among all the severely/critically ill patients, which was almost twice lower than the ratio of males (0.24 [95% CI (0.19-0.29)]). The fatality rate of female patients was 0.10 [95%CI (0.05-0.17)], which was much lower than that of males (0.18[95%CI (0.11-0.29)]).Conclusions: There exists a significantly different clinical outcome between male and female COVID-19 patients. Females are less severely affected, which might be associated with the sex-based difference in immune response, female hormones and behaviors. However, more specific studies are needed to identify more relevant factors.

Elevated COVID-19 outcomes among persons living with diagnosed HIV infection in New York State: Results from a population-level match of HIV, COVID-19, and hospitalization databases (preprint)

Background: New York State (NYS) has been an epicenter for both COVID-19 and HIV/AIDS epidemics. Persons Living with diagnosed HIV (PLWDH) may be more prone to COVID-19 infection and severe outcomes, yet few population-based studies have assessed the extent to which PLWDH are diagnosed, hospitalized, and have died with COVID-19, relative to non-PLWDH. Methods: NYS HIV surveillance, COVID-19 laboratory confirmed diagnoses, and hospitalization databases were matched. COVID-19 diagnoses, hospitalization, and in-hospital death rates comparing PLWDH to non-PLWDH were computed, with unadjusted rate ratios (RR) and indirect standardized RR (sRR), adjusting for sex, age, and region. Adjusted RR (aRR) for outcomes among PLWDH were assessed by age/CD4-defined HIV disease stage, and viral load suppression, using Poisson regression models. Results: From March 1-June 7, 2020, PLWDH were more frequently diagnosed with COVID-19 than non-PLWDH in unadjusted (RR [95% confidence interval (CI)]: 1.43[1.38-1.48), 2,988 PLWDH], but not in adjusted comparisons (sRR [95% CI]: 0.94[0.91-0.97]). Per-population COVID-19 hospitalization was higher among PLWDH (RR [95% CI]: 2.61[2.45-2.79], sRR [95% CI]: 1.38[1.29-1.47], 896 PLWDH), as was in-hospital death (RR [95% CI]: 2.55[2.22-2.93], sRR [95%CI]: 1.23 [1.07-1.40], 207 PLWDH), albeit not among those hospitalized (sRR [95% CI]: 0.96[0.83-1.09]). Among PLWDH, hospitalization risk increased with disease progression from HIV Stage 1 to Stage 2 (aRR [95% CI]:1.27[1.09-1.47]) and Stage 3 (aRR [95% CI]: 1.54[1.24-1.91]), and for those virally unsuppressed (aRR [95% CI]: 1.54[1.24-1.91]). Conclusion: PLWDH experienced poorer COVID-related outcomes relative to non-PLWDH, with 1-in-522 PLWDH dying with COVID-19, seemingly driven by higher rates of severe disease requiring hospitalization.

Screening COVID-19 with Chest CT in Preference to RT-PCR: Based on Mortality Analysis (preprint)

Corona Virus Disease 2019 (COVID-19) became the outbreak of infectious diseases emergency worldwide. It remains unknown whether the RT-PCR test results was associated with the prognosis of COVID-19 patients or not. In this study, a total number of 495 patients with typical chest CT feature and symptom consistent with COVID-19 were retrospectively included from Jan 23, 2020 to Feb 26, 2020. 186 (37.58%), 32 (6.46%) and 277 (55.96%) COVID-19 patients had initial positive, suspected and negative RT-PCR results, respectively. The mean age was 58.55 years and 254(51.3%) were older than 60 years. 60.00% (297/495), 22.02% (109/495) and 17.98% (89/495) of COVID-19 patients were common, severe and critically type, respectively. There were no significant differences of age, gender, time from onset to hospitalization and severity classification in the patients with initial positive and negative RT-PCR result. The mortality rate of patients with positive and negative were 7.14% and 7.94%. Patients with initial negative or initial positive RT-PCR results had no significant difference of mortality rate (c2=4.079, p=0.130). The number of patients with lymphocyte ratios under the normal level was significantly larger in patients with initial negative RT-PCR results (59/92) compared with the patients with initial positive result (86/167), p=0.033. COVID-19 patients with positive or negative RT-PCR results had no significant difference in severity and mortality. Chest CT may be a more effective tool to screen COVID-19 in preference to RT-PCR.

Cytotoxicity evaluation of chloroquine and hydroxychloroquine in multiple cell lines and tissues by dynamic imaging system and PBPK model (preprint)

Chloroquine (CQ) and hydroxychloroquine (HCQ) have been used in treating COVID-19 patients recently. However, both drugs have some contradictions and rare but severe side effects, such as hypoglycemia, retina and cardiac toxicity. To further uncover the toxicity profile of CQ and HCQ in different tissues, we evaluated the cytotoxicity of them in 8 cell lines, and further adopted the physiologically-based pharmacokinetic models (PBPK) to predict the tissue risk respectively. Retina, myocardium, lung, liver, kidney, vascular endothelium and intestinal epithelium originated cells were included in the toxicity evaluation of CQ and HCQ respectively. The proliferation pattern was monitored in 0-72 hours by IncuCyte S3, which could perform long-term continuous image and video of cells upon CQ or HCQ treatment. CC50 and the ratio of tissue trough concentrations to CC50 (RTTCC) were brought into predicted toxicity profiles. The CC50 at 24 h, 48 h, 72 h of CQ and HCQ decreased in the time-dependent manner, which indicates the accumulative cytotoxic effect. HCQ was found to be less toxic in 7 cell types except cardiomyocytes H9C2 cells (CC50-48 h=29.55 M; CC50-72 h=15.26 M). In addition, RTTCC is significant higher in CQ treatment group compared to HCQ group, which indicates that relative safety of HCQ. Both CQ and HCQ have certain cytotoxicity in time dependent manner which indicates the necessity of short period administration clinically. HCQ has the less impact in 7 cell lines proliferation and less toxicity compared to CQ in heart, liver, kidney and lung.

A multi-centered, retrospective, descriptive study on 107 dead patients with COVID-19 (preprint)

Since the emergence of Corona Virus Disease 2019 (COVID-19) in Wuhan city, Hubei Province, China, it has caused thousands of deaths. As the ongoing outbreak of COVID-19 around the world, the number of deaths will definitely continue to increase. We aimed to further describe the clinical characteristics of dead cases with COVID-19 through a large sample and multi-centered study and to find some clinical predictors for the deterioration of COVID-19 during the process.   Methods One hundred and seven patients (16 patients from Lei Shen-Shan Hospital, 54 patients from Seventh Hospital of Wuhan and 37 patients from Zhongnan Hospital of Wuhan University) with COVID-19 were enrolled in our research from Jan 22 to Feb 29, 2020. The demographic, clinical, radiological, laboratory and treatment data of all cases were analysed.   Results Of the 107 dead patients with COVID-19, 71 (66.4%) were male and 36 (33.6%) were female. The mean age of the patients was 71.2 ± 12.1 years. 82 (76.6%) of patients had chronic diseases. The mean duration from admission to death was 9 (IQR,5-14) days. Respiratory functional damage was the most common one followed by heart and kidney. Hematuria was found in 36(33.6%) patients. 89(83.2%) patients’ albumin levels were decreased. 68(63.6%) patients had anemia. concerning laboratory results, 55 (69.6%) and 56 (70.1%) patients have the elevated white blood cells and elevated Neutrophils during the process; only 43 (54.4%) have the decreased Lymphocytes; The values of platelets and haemoglobin decreased in 64(81.0%) and 58 (73.4%) patients. Alanine aminotransferase and aspartate aminotransferase elevated in near half of patients, while almost 80% of patients have the decreased albumin. The elevated blood urea nitrogen and cystatin C were manifested in about 70% of patients. Procalcitonin was elevated in 38 (71.7%) patients.   Conclusions In conclusion, the older men with chronic diseases are more likely to die from COVID-19. Apart from that, more attention should be pay on timely treatment, coinfections, malnutrition, and dysfunction of kidney and coagulation. The rising values (white blood cell, blood urea nitrogen, cystatin C, PCT and PT) and the decreased values (PLT, Hb and albumin) maybe meaningful for predict the poor prognosis.