Depression among schoolchildren and adolescents aged 9-17 years during the outbreak of COVID­19 in Beijing: a cross-sectional online survey.

The COVID-19 outbreak and related confinement have highly impacted psychological health among children and adolescents. This study aimed to explore the potential risk factors for depression among primary and middle school students and provide advices for psychological interventions during the outbreaks. An online cross-sectional survey was conducted among 18 primary and middle school students via quota sampling in Beijing during March 2020. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess depression. Differences between characteristics and depression were examined by chi-square tests. Multivariate logistic regression was used to reveal the potential risk factors for depression. A total of 7377 participants were included. The proportion of depression was 29.7%. Students in rural areas, with higher school categories, in graduating grades, with poor or excessive sleep duration, and without daily exercise were associated with a higher proportion of depression. Furthermore, students with a higher knowledge performance of COVID-19 showed a lower proportion of depression (odds ratio [OR] = 0.900, 95% confidence intervals [95% CI]: 0.888-0.913). Students who worried about academic performance (OR = 1.919, 95% CI: 1.718-2.144) or COVID-19 infection (OR = 1.450, 95% CI: 1.268-1.658) exhibited a high proportion of depression. The proportion of depression among primary and middle school students was negatively associated with the knowledge score and positively associated with their worry. Our findings suggest that psychological intervention might be more necessary for students with specific characteristics.

Associations of Ambient Air Pollutants and Meteorological Factors With COVID-19 Transmission in 31 Chinese Provinces: A Time Series Study.

Evidence regarding the effects of environmental factors on COVID-19 transmission is mixed. We aimed to explore the associations of air pollutants and meteorological factors with COVID-19 confirmed cases during the outbreak period throughout China. The number of COVID-19 confirmed cases, air pollutant concentrations, and meteorological factors in China from January 25 to February 29, 2020, (36 days) were extracted from authoritative electronic databases. The associations were estimated for a single-day lag as well as moving averages lag using generalized additive mixed models. Region-specific analyses and meta-analysis were conducted in 5 selected regions from the north to south of China with diverse air pollution levels and weather conditions and sufficient sample size. Nonlinear concentration-response analyses were performed. An increase of each interquartile range in PM2.5, PM10, SO2, NO2, O3, and CO at lag4 corresponded to 1.40 (1.37-1.43), 1.35 (1.32-1.37), 1.01 (1.00-1.02), 1.08 (1.07-1.10), 1.28 (1.27-1.29), and 1.26 (1.24-1.28) ORs of daily new cases, respectively. For 1°C, 1%, and 1 m/s increase in temperature, relative humidity, and wind velocity, the ORs were 0.97 (0.97-0.98), 0.96 (0.96-0.97), and 0.94 (0.92-0.95), respectively. The estimates of PM2.5, PM10, NO2, and all meteorological factors remained significantly after meta-analysis for the five selected regions. The concentration-response relationships showed that higher concentrations of air pollutants and lower meteorological factors were associated with daily new cases increasing. Higher air pollutant concentrations and lower temperature, relative humidity and wind velocity may favor COVID-19 transmission. Controlling ambient air pollution, especially for PM2.5, PM10, NO2, may be an important component of reducing risk of COVID-19 infection. In addition, as winter months are arriving in China, the meteorological factors may play a negative role in prevention. Therefore, it is significant to implement the public health control measures persistently in case another possible pandemic.

Aggravation effect of regional transport on wintertime PM2.5 over the middle reaches of the Yangtze River under China's air pollutant emission reduction process

The contributions of emission reduction and meteorological changes to air quality improvement in Hubei Province (HB) have required assessment in recent years. In this study, the WRF-Chem scenario tests were conducted to evaluate the effect of both the emission and meteorological changes on the winter PM2.5 from 2015 to 2019, especially that of regional transport and local emissions on the PM2.5 variations in HB. The results showed that meteorological changes in January 2019 increased the PM2.5 by 24% relative to January 2015, whereas emissions reduced it by 36%, indicating that emission reduction was vital in improving the air quality in HB. However, the meteorological changes increased the concentration of air pollutants by 10–25% relative to January 2018. This led to a rebound of the observed pollutant concentrations in January 2019, highlighting the importance of meteorological conditions on air pollution. Regional transport of air pollutants contributed to the inter-annual increase of wintertime PM2.5 by 78%, driven purely by meteorology from 2015 to 2019. This indicated that regional PM2.5 transport could aggravate PM2.5 levels in winter over HB with the reduction of air pollutant emissions in China. Additionally, the regional transport of air pollutants contributed to the decrease in PM2.5 in HB by 42%, resulting from the non-local emission reduction during COVID-19 lockdown in winter. This indicates the importance of the regional transport of air pollutants in driving regional changes in the atmospheric environment over China.

Caring for anxiety among adults in the face of COVID-19: A cross-sectional online survey.

BACKGROUND: The outbreak of COVID-19 poses a challenge to psychological resilience. The aim of this study was to evaluate the prevalence of anxiety and identify risk and protective factors associated with the presence of anxiety symptoms in the face of COVID-19 among adults. METHODS: A cross-sectional online survey was conducted in adults from March 2nd to March 16th 2020. The self-rating anxiety scale (SAS) was used to measure the status of anxiety. Unconditional multivariate logistic regression was performed to identify the factors associated with anxiety. RESULTS: Among the 7144 respondents, 9.3% met the criteria for anxiety risk based on the SAS. Symptoms of anxiety were more prevalent among farmer (OR=1.43, 95%CI: 1.03-1.99), respondents lived in urban out of Beijing during the COVID-19 outbreak (OR=1.73, 95%CI: 1.14-2.63), and slept less than six hours per day (OR=2.64, 95%CI: 1.96-3.57). Compared to participants who didn't exercise, a lower risk of anxiety was observed in those exercised 30-60 minutes/day (OR=0.62, 95%CI: 0.41-0.94) and more than 60 minutes/day (OR=0.57, 95%CI: 0.37-0.88). And compared with participants whose knowledge and perceptions of COVID-9 scores in lower quartile, the OR (95%CI) for the second, third and upper quartile were 0.58 (0.46, 0.73), 0.48 (0.37, 0.61) and 0.42(0.33, 0.52), respectively. LIMITATIONS: No diagnostic interview for mental disorders was administered in the original studies limiting analysis of sensitivity and specificity of the Swahili PHQ-9. CONCLUSION: There was a high level of anxiety in the face of COVID-19 among adults. The results point to characteristics of adults in particular need for attention to anxiety and suggest possible targets for intervention such as strengthening of physical activity and knowledge and perceptions of COVID-19.

Clinical Characteristics and Prognosis of 244 Cardiovascular Patients Suffering From Coronavirus Disease in Wuhan, China.

Background The coronavirus disease 2019 (COVID-19) has developed into a global outbreak. Patients with cardiovascular disease (CVD) with COVID-19 have different clinical characteristics and prognostic outcomes. This study aimed to summarize the clinical characteristics and laboratory indicators of patients with COVID-19 with CVD, especially the critically ill patients. Methods and Results This study included 244 patients diagnosed with COVID-19 and CVD (hypertension, coronary heart disease, or heart failure). The patients were categorized into critical (n=36) and noncritical (n=208) groups according to the interim guidance of China's National Health Commission. Clinical, laboratory, and outcome data were collected from the patients' medical records and compared between the 2 groups. The average body mass index of patients was significantly higher in the critical group than in the noncritical group. Neutrophil/lymphocyte ratio, and C-reactive protein, procalcitonin, and fibrinogen, and d-dimer levels at admission were significantly increased in the critical group. The all-cause mortality rate among cases of COVID-19 combined with CVD was 19.26%; the proportion of coronary heart disease and heart failure was significantly higher in deceased patients than in recovered patients. High body mass index, previous history of coronary heart disease, lactic acid accumulation, and a decrease in the partial pressure of oxygen were associated with death. Conclusions All-cause mortality in patients with COVID-19 with CVD in hospitals is high. The high neutrophil/lymphocyte ratio may be a predictor of critical patients. Overweight/obesity combined with coronary heart disease, severe hypoxia, and lactic acid accumulation resulting from respiratory failure are related to poor outcomes. Registration URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2000029865.