Food Intake and Diet Quality of Pregnant Women in China During the COVID-19 Pandemic: A National Cross-Sectional Study.

Background: Between January and April 2020, China implemented differentiated prevention and control strategies across the country, based on the severity of the COVID-19 epidemic/pandemic in different regions. These strategies included lockdowns, social distancing, and the closure of public places. These measures may have affected dietary intake to varying degrees. This study aimed to assess variations in food intake and diet quality among pregnant women according to regional severity and related control measures during the most severe period of COVID-19 restrictions in 2020. Methods: A total of 3,678 pregnant women from 19 provinces/municipalities in mainland China were analyzed in this nationwide, multi-center study. Food intake data were obtained and assessed using a validated food frequency questionnaire (FFQ). Diet quality was quantified using the Diet Balance Index for Pregnancy (DBI-P), which included high bound score (HBS, excessive dietary intake), low bound score (LBS, insufficient dietary intake), and diet quality distance (DQD, dietary imbalance). Linear trend tests and multivariable regression analyses were performed to examine the association between food intake, DBI-P and the severity of pandemic. Results: The median daily intake of vegetables, fruit, livestock/poultry meat, dairy, and nuts decreased (p < 0.05) according to low, moderate, and high severity of the pandemic, while no significant differences in cereals/potatoes, eggs, and fish/shrimp intake. The median daily intake of cereals/potatoes exceeded the recommended ranges, and the daily intake of eggs and fish/shrimp was below recommended ranges regardless of the pandemic severity (p < 0.05). Regarding diet quality, HBS decreased (lower excessive consumption) (p = 0.047) and LBS increased (greater insufficient consumption) (p = 0.046) with increased severity of the pandemic. On multivariable analyses, moderate and high pandemic severity were related to lower HBS risk (OR = 0.687, OR = 0.537) and higher LBS risk (ß = 1.517, ß = 3.020) when compared to low pandemic severity. Conclusions: Under more severe COVID-19 pandemic conditions, pregnant women consumed less quality food, characterized by reduced consumption of vegetables, fruit, livestock/poultry meat, dairy and nuts, while the quality of the foods that pregnant women consumed in excess tended to improve, but the overconsumption of cereals/potatoes was a problem.

Effects of the COVID-19 pandemic on acute stress disorder and career planning among healthcare students.

This study aimed to investigate the effects of COVID-19 on the prevalence of acute stress disorder and subsequent effects on career planning among healthcare students. A cross-sectional survey was conducted among 1158 healthcare students across five medical universities in February 2020. Acute stress disorder was assessed using the Stanford Acute Stress Response Questionnaire. Further data regarding COVID-19 knowledge, individual behaviours, occupational choices, and career planning were collected. Based on the results of the Stanford Acute Stress Response Questionnaire, the students were divided into high-risk and low-risk groups for acute stress disorder. The correlation between acute stress disorder and the impact on career planning was analysed. The high-risk group comprised 143 (12.3%) participants, while 1015 (87.7%) participants were in the low-risk group. Two factors increased the risk of acute stress disorder in the students, including 'I think the pandemic is far away from me' (B: 1.27, 95%CI: 1.60-7.87) and 'Physical contact with confirmed or suspected cases' (B: 2.49, 95%CI: 3.42-42.44). Those who obtained pandemic information from official media sources indicated a lower risk of acute stress disorder (B: -0.24, 95%CI: 0.49-1.26). The high-risk group was more likely to quit the medical profession after graduation. The COVID-19 pandemic may cause acute stress disorder among healthcare students and affect their career planning. Universities and relevant departments should provide more information and moral support for these students.

Mesenchymal Stem Cell-Based Therapy for COVID-19: Possibility and Potential.

A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) has emerged in Wuhan, China since the end of December 2019 and has quickly spread all over the world in a matter of two months. To date, no specific treatment has been proven to be effective for coronavirus (COVID-19). With the rapid increase of infected patients and deaths, it is vital to explore an effective treatment for COVID-19. Current studies suggest that there exists cytokine storm in SARS-CoV-2-infected patients; some of the them will develop acute respiratory distress syndrome (ARDS) and multiple organ dysfunction, and even death. Mesenchymal stem cells (MSCs) possess the property of immunomodulation. Given the previous preclinical and clinical studies, MSCs therapy has shown safety and efficacy in the treatment of respiratory failure or ARDS. Based on similar principles, MSCs therapy may also be an effective therapy in the treatment of COVID-19. In this study, we summarized the clinical outcomes of MSCs for ARDS patients in some preclinical and clinical studies and discussed the application of MSCs for patients with COVID-19 in China and the related important issues with MSCs used during the outbreak.

Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: cross-sectional study.

OBJECTIVES: This study described the needs of pregnant women and the contents of online obstetric consultation in representative areas with various severity of the epidemic in China. DESIGN: This was a cross- sectional study. SETTING: Yue Yi Tong (YYT), a free online communication platform that allows pregnant women to consult professional obstetricians. PARTICIPANTS: All the pregnant women who used the YYT platform. INTERVENTION: From 10 to 23 February, we collected data on online obstetric consultations and participants' satisfaction through the YYT platform in the mild, moderate and severe epidemic areas which were defined according to the local confirmed cases. The primary outcomes were the reasons for online consultations by the severity of the epidemic. All the comparisons were performed using χ2 test. Statistical analysis was performed using SPSS V.24. RESULTS: A total of 2599 pregnant women participated in this study, of whom 448 (17.24%), 1332 (51.25%) and 819 (31.51%) were from the mild, moderate and severe epidemic areas, respectively. The distribution of the amount of online consultations was significantly different not only in different areas (p<0.001) but also in different trimesters (p<0.001). A total of 957 participants completed the satisfaction part of the survey. In this study, 77.95% of the participants used e-health for the first time, and 94.63% of the participants were completely or mostly satisfied with the online consultations. CONCLUSIONS: The distribution of the amount of online consultations was significantly different not only in different areas but also in different trimesters. In any trimester, the amount of consultations on the second category (obstetric care-seeking behaviour) was the highest in the severe epidemic areas. The needs for online consultations were substantial. In order to prevent irreversible obstetric adverse events, an appropriate antenatal care contingency plan with e-health services is highly recommended during the Public Health Emergency of International Concern.

Changes in physiology and immune system during pregnancy and coronavirus infection: A review.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the 3rd epidemic coronavirus after severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Since December 2019, the outbreak of the Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 has aroused great attention around the world. Pregnant women and their fetuses have been concerned as a high-risk population. We explained why pregnant women are susceptible to coronavirus in terms of their adaptive changes in physiology and immune system during pregnancy, and described the associations between maternal clinical symptoms, perinatal outcomes and coronavirus infections.

Management of a delivery suite during the COVID-19 epidemic.

BACKGROUND: Since the first report of the new coronavirus (COVID-19) infection in December of 2019, it has become rapidly prevalent and been declared as a Public Health Emergency of International Concern by the World Health Organization. There are quite a few cases reported involving delivery with COVID-19 infection, but little valuable suggestion was provided about what healthcare providers of obstetrics and neonatology should do in their clinic practice for unknown status or presumed negative women. Here, we summarized the current practice of delivery management in China that successfully prevented rapid increase in adverse pregnancy outcomes and nosocomial infection in departments of obstetrics and neonatology during the pandemic of COVID-19.

Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection.

OBJECTIVE: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy. METHODS: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed. RESULTS: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy. CONCLUSION: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.