Validation of an HPLC-CAD Method for Determination of Lipid Content in LNP-Encapsulated COVID-19 mRNA Vaccines.

Lipid nanoparticles (LNPs) are widely used as delivery systems for mRNA vaccines. The stability and bilayer fluidity of LNPs are determined by the properties and contents of the various lipids used in the formulation system, and the delivery efficiency of LNPs largely depends on the lipid composition. For the quality control of such vaccines, here we developed and validated an HPLC-CAD method to identify and determine the contents of four lipids in an LNP-encapsulated COVID-19 mRNA vaccine to support lipid analysis for the development of new drugs and vaccines.

Changing spatiotemporal patterns for hepatitis of unspecified aetiology in China, 2004-2021: a population-based surveillance study.

Objectives: As global efforts continue toward the target of eliminating viral hepatitis by 2030, the emergence of acute hepatitis of unspecified aetiology (HUA) remains a concern. This study assesses the overall trends and changes in spatiotemporal patterns in HUA in China from 2004 to 2021. Methods: We extracted the incidence and mortality rates of HUA from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2021. We used R software, ArcGIS, Moran's statistical analysis, and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the HUA across China. Results: From 2004 to 2021, a total of 707,559 cases of HUA have been diagnosed, including 636 deaths. The proportion of HUA in viral hepatitis gradually decreased from 7.55% in 2004 to 0.72% in 2021. The annual incidence of HUA decreased sharply from 6.6957 per 100,000 population in 2004 to 0.6302 per 100,000 population in 2021, with an average annual percentage change (APC) reduction of -13.1% (p < 0.001). The same result was seen in the mortality (APC, -22.14%, from 0.0089/100,000 in 2004 to 0.0002/100,000 in 2021, p < 0.001). All Chinese provinces saw a decline in incidence and mortality. Longitudinal analysis identified the age distribution in the incidence and mortality of HUA did not change and was highest in persons aged 15-59 years, accounting for 70% of all reported cases. During the COVID-19 pandemic, no significant increase was seen in pediatric HUA cases in China. Conclusion: China is experiencing an unprecedented decline in HUA, with the lowest incidence and mortality for 18 years. However, it is still important to sensitively monitor the overall trends of HUA and further improve HUA public health policy and practice in China.

Predictive value of fasting blood glucose and TG/HDL-C ratio in non-diabetic patients with COVID-19

Objective: To investigate the predictive values of fasting blood glucose and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) in non-diabetic patients with COVID-19. Methods: A total of 39 non-diabetic patients with COVID-19 admitted to the Fourth Hospital of Xi'an from December 2021 to January 2022 were included. And 34 health examination subjects from the Second Affiliated Hospital of Xi'an Jiaotong University were matched as health control according to their propensity score. The clinical characteristics and laboratory test results between groups were compared, and the predictive value of fasting glucose and TG/HDL-C in non-diabetic COVID-19 patients was analyzed by logistic regression and receiver operating curve (ROC). Results: COVID-19 patients were either mild (30 cases) or common type (9 cases) with mild symptoms and good clinical prognosis. The median age was 29.0 (20.0, 49.0) years, 24 (61.5%) were males. Fasting blood glucose (4.30+or-0.47 mmol/L) and HDL-C [1.07 (0.86, 1.30) mmol/L] levels in COVID-19 patients were significantly lower than healthy controls [5.15+or-0.70 mmol/L, 2.24 (1.77, 3.05) mmol/L], the differences were statistically significant (t=6.277, P < 0.001;Z=6.026, P < 0.001). However, low density lipoprotein cholesterol (LDL-C) [2.40 (1.81, 2.91) mmol/L] and TG/HDL-C [0.91 (0.54, 1.52)] in COVID-19 patients were significantly increased compared to healthy controls [1.11 (0.99, 1.30) mmol/L, 0.54 (0.33, 0.90)], and the differences were statistically significant (Z=-6.271, -2.801, all P < 0.005). Logistic regression analysis showed that fasting blood glucose on admission could be an independent protective factor (OR:0.020, 95% CI: 0.003 ~ 0.150) and elevated TG/HDL-C be a risk factor (OR:4.802, 95% CI: 1.249 ~ 18.460) for COVID-19 infection among non-diabetic populations. The ROC curve showed that fasting blood glucose and TG/HDL-C were good at predicting the risk of COVID-19, and the area under the curve (AUC) were 0.871 and 0.708, respectively, and was 0.895 when combined. Conclusion: Decreased fasting blood glucose and elevated TG/HDL-C would be risk factors for COVID-19 infection in the non-diabetic population, and both have good predictive value for the incidence of COVID-19.

Carbon trading and COVID-19: a hybrid machine learning approach for international carbon price forecasting.

Accurate carbon price forecasting can better allocate carbon emissions and thus ensure a balance between economic development and potential climate impacts. In this paper, we propose a new two-stage framework based on processes of decomposition and re-estimation to forecast prices across international carbon markets. We focus on the Emissions Trading System (ETS) in the EU, as well as the five main pilot schemes in China, spanning the period from May 2014 to January 2022. In this way, the raw carbon prices are first separated into multiple sub-factors and then reconstructed into factors of 'trend' and 'period' with the use of Singular Spectrum Analysis (SSA). Once the subsequences have been thus decomposed, we further apply six machine learning and deep learning methods, allowing the data to be assembled and thus facilitating the prediction of the final carbon price values. We find that from amongst these machine learning models, the Support vector regression (SSA-SVR) and Least squares support vector regression (SSA-LSSVR) stand out in terms of performance for the prediction of carbon prices in both the European ETS and equivalent models in China. Another interesting finding to come out of our experiments is that the sophisticated algorithms are far from being the best performing models in the prediction of carbon prices. Even after accounting for the impacts of the COVID-19 pandemic and other macro-economic variables, as well as the prices of other energy sources, our framework still works effectively.

Epidemiological features and trends in the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020: Based on national surveillance.

Objectives: The aim of this study is to describe, visualize, and compare the trends and epidemiological features of the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020. Setting: Data were obtained from the database of the National Infectious Disease Surveillance System (NIDSS) and reports released by the National and local Health Commissions from 2004 to 2020. Spearman correlations and Joinpoint regression models were used to quantify the temporal trends of RIDs by calculating annual percentage changes (APCs) in the rates of mortality. Results: The overall mortality rate of RIDs was stable across China from 2004 to 2020 (R = -0.38, P = 0.13), with an APC per year of -2.2% (95% CI: -4.6 to 0.3; P = 0.1000). However, the overall mortality rate of 10 RIDs in 2020 decreased by 31.80% (P = 0.006) compared to the previous 5 years before the COVID-19 pandemic. The highest mortality occurred in northwestern, western, and northern China. Tuberculosis was the leading cause of RID mortality, and mortality from tuberculosis was relatively stable throughout the 17 years (R = -0.36, P = 0.16), with an APC of -1.9% (95% CI -4.1 to 0.4, P = 0.1000). Seasonal influenza was the only disease for which mortality significantly increased (R = 0.73, P = 0.00089), with an APC of 29.70% (95% CI 16.60-44.40%; P = 0.0000). The highest yearly case fatality ratios (CFR) belong to avian influenza A H5N1 [687.5 per 1,000 (33/48)] and epidemic cerebrospinal meningitis [90.5748 per 1,000 (1,010/11,151)]. The age-specific CFR of 10 RIDs was highest among people over 85 years old [13.6551 per 1,000 (2,353/172,316)] and was lowest among children younger than 10 years, particularly in 5-year-old children [0.0552 per 1,000 (58/1,051,178)]. Conclusions: The mortality rates of 10 RIDs were relatively stable from 2004 to 2020 with significant differences among Chinese provinces and age groups. There was an increased mortality trend for seasonal influenza and concerted efforts are needed to reduce the mortality rate of seasonal influenza in the future.

Impact of the COVID-19 pandemic and the dynamic COVID-zero strategy on HIV incidence and mortality in China.

BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, the Chinese government implemented the dynamic COVID-zero strategy. We hypothesized that pandemic mitigation measures might have reduced the incidence, mortality rates, and case fatality ratios (CFRs) of the human immunodeficiency virus (HIV) in 2020-2022. METHOD: We collected HIV incidence and mortality data from the website of the National Health Commission of the People's Republic of China from January 2015 to December 2022. We compared the observed and predicted HIV values in 2020-2022 with those in 2015-2019 using a two-ratio Z-test. RESULTS: From January 1, 2015, to December 31, 2022, a total of 480,747 HIV incident cases were reported in mainland China, of which 60,906 (per year) and 58,739 (per year) were reported in 2015-2019 (pre-COVID-19 stage) and 2020-2022 (post-COVID-19 stage), respectively. The average yearly HIV incidence decreased by 5.2450% (from 4.4143 to 4.1827 per 100,000 people, p <  0.001) in 2020-2022 compared with that in 2015-2019. However, the average yearly HIV mortality rates and CFRs increased by 14.1076 and 20.4238%, respectively (all p <  0.001), in 2020-2022 compared with those in 2015-2019. During the emergency phase in January 2020 to April 2020, the monthly incidence was significantly lower (23.7158%) than that during the corresponding period in 2015-2019, while the incidence during the routine stage in May 2020-December 2022 increased by 27.4334%, (all p <  0.001). The observed incidence and mortality rates for HIV decreased by 16.55 and 18.1052% in 2020, by 25.1274 and 20.2136% in 2021, and by 39.7921 and 31.7535% in 2022, respectively, compared with the predicted values, (all p <  0.001). CONCLUSIONS: The findings suggest that China's dynamic COVID-zero strategy may have partly disrupted HIV transmission and further slowed down its growth. Without China's dynamic COVID-zero strategy, HIV incidence and deaths in the country would have likely remained high in 2020-2022. There is an urgent need to expand and improve HIV prevention, care, and treatment, as well as surveillance in the future.

Healthy cities initiative in China: Progress, challenges, and the way forward.

China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Along with related urban health governmental initiatives, the program has helped put health on the agenda of local governments while raising public awareness. Healthy City actions taken at the municipal scale also prepared cities to deal with the COVID-19 pandemic. However, after intermittent trials spanning the past two decades, the Healthy Cities initiative in China has reached a crucial juncture. It risks becoming inconsequential given its overlap with other health promotion efforts, changing public health priorities in response to the pandemic, and the partial adoption of the Healthy Cities approach advanced by the World Health Organization (WHO). We recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sustainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health. Achieving this alignment will require leveraging the full spectrum of best practices in Healthy Cities actions and expanding assessment efforts. Funding: Tsinghua-Toyota Joint Research Fund "Healthy city systems for smart cities" program.

Fingerprinting trimeric SARS-CoV-2 RBD by capillary isoelectric focusing with whole-column imaging detection.

Because the spike (S) protein of the severe acute respiratory syndrome coronavirus (SARS-CoV) is the immunodominant antigen, the S protein and its receptor-binding domain (RBD) are both targets currently to be genetically engineered for designing the broad-spectrum vaccine. In theory, the expressed protein exists as a set of variants that are roughly the same but slightly different, which depends on the protein expression system. The variants can be phenotypically manifested as charge heterogeneity. Here, we attempted to depict the charge heterogeneity of the trimeric SARS-CoV-2 RBD by using capillary isoelectric focusing with whole-column imaging detection (cIEF-WCID). In its nature form, the electropherogram fingerprints of the trimeric RBD were presented under optimized experimental conditions. The peaks of matrix buffers can be fully distinguishable from peaks of trimeric RBD. The isoelectric point (pI) was determined to be within a range of 6.67-9.54 covering the theoretical pI of 9.02. The fingerprints of three batches of trimeric RBDs are completely the same, with the intra-batch and batch-to-batch relative standard deviations (RSDs) of both pI values and area percentage of each peak no more than 1.0%, indicating that the production process is stable and this method can be used to surveillance the batch-to-batch consistency. The fingerprint remained unchanged after incubating at 37 °C for 7 d and oxidizing by 0.015% H2O2. In addition, the fingerprint was destroyed when adjusting the pH value to higher than 10.0 but still stable when the pH was lower than 4.0. In summary, the cIEF-WCID fingerprint can be used for the identification, batch-to-batch consistency evaluation, and stability study of the trimeric SARS-CoV-2 RBD, as part of a quality control strategy during the potential vaccine production.

The clinical and virological features of two children's coinfections with human adenovirus type 7 and human coronavirus-229E virus.

Objective: Human adenovirus (HAdV) coinfection with other respiratory viruses is common, but adenovirus infection combined with human coronavirus-229E (HCoV-229E) is very rare. Study design and setting: Clinical manifestations, laboratory examinations, and disease severity were compared between three groups: one coinfected with HAdV-Ad7 and HCoV-229E, one infected only with adenovirus (mono-adenovirus), and one infected only with HCoV-229E (mono-HCoV-229E). Results: From July to August 2019, there were 24 hospitalized children: two were coinfected with HAdV-Ad7 and HCoV-229E, and 21 were infected with a single adenovirus infection. Finally, one 14-year-old boy presented with a high fever, but tested negative for HAdV-Ad7 and HCoV-229E. Additionally, three adult asymptotic cases with HCoV-229E were screened. No significant difference in age was found in the coinfection and mono-adenovirus groups (11 vs. 8 years, p = 0.332). Both groups had the same incubation period (2.5 vs. 3 days, p = 0.8302), fever duration (2.5 vs. 2.9 days, p = 0.5062), and length of hospital stay (7 vs. 6.76 days, p = 0.640). No obvious differences were found in viral loads between the coinfection and mono-adenovirus groups (25.4 vs. 23.7, p = 0.570), or in the coinfection and mono-HCoV-229E groups (32.9 vs. 30.06, p = 0.067). All cases recovered and were discharged from the hospital. Conclusion: HAdV-Ad7 and HCoV-229E coinfection in healthy children may not increase the clinical severity or prolong the clinical course. The specific interaction mechanism between the viruses requires further study.

Biparatopic antibody BA7208/7125 effectively neutralizes SARS-CoV-2 variants including Omicron BA.1-BA.5.

SARS-CoV-2 Omicron subvariants have demonstrated extensive evasion from monoclonal antibodies (mAbs) developed for clinical use, which raises an urgent need to develop new broad-spectrum mAbs. Here, we report the isolation and analysis of two anti-RBD neutralizing antibodies BA7208 and BA7125 from mice engineered to produce human antibodies. While BA7125 showed broadly neutralizing activity against all variants except the Omicron sublineages, BA7208 was potently neutralizing against all tested SARS-CoV-2 variants (including Omicron BA.1-BA.5) except Mu. By combining BA7208 and BA7125 through the knobs-into-holes technology, we generated a biparatopic antibody BA7208/7125 that was able to neutralize all tested circulating SARS-CoV-2 variants. Cryo-electron microscopy structure of these broad-spectrum antibodies in complex with trimeric Delta and Omicron spike indicated that the contact residues are highly conserved and had minimal interactions with mutational residues in RBD of current variants. In addition, we showed that administration of BA7208/7125 via the intraperitoneal, intranasal, or aerosol inhalation route showed potent therapeutic efficacy against Omicron BA.1 and BA.2 in hACE2-transgenic and wild-type mice and, separately, effective prophylaxis. BA7208/7125 thus has the potential to be an effective candidate as an intervention against COVID-19.

The clinical and virological features of two children's coinfections with human adenovirus type 7 and human coronavirus-229E virus

Objective Human adenovirus (HAdV) coinfection with other respiratory viruses is common, but adenovirus infection combined with human coronavirus-229E (HCoV-229E) is very rare. Study design and setting Clinical manifestations, laboratory examinations, and disease severity were compared between three groups: one coinfected with HAdV-Ad7 and HCoV-229E, one infected only with adenovirus (mono-adenovirus), and one infected only with HCoV-229E (mono-HCoV-229E). Results From July to August 2019, there were 24 hospitalized children: two were coinfected with HAdV-Ad7 and HCoV-229E, and 21 were infected with a single adenovirus infection. Finally, one 14-year-old boy presented with a high fever, but tested negative for HAdV-Ad7 and HCoV-229E. Additionally, three adult asymptotic cases with HCoV-229E were screened. No significant difference in age was found in the coinfection and mono-adenovirus groups (11 vs. 8 years, p = 0.332). Both groups had the same incubation period (2.5 vs. 3 days, p = 0.8302), fever duration (2.5 vs. 2.9 days, p = 0.5062), and length of hospital stay (7 vs. 6.76 days, p = 0.640). No obvious differences were found in viral loads between the coinfection and mono-adenovirus groups (25.4 vs. 23.7, p = 0.570), or in the coinfection and mono-HCoV-229E groups (32.9 vs. 30.06, p = 0.067). All cases recovered and were discharged from the hospital. Conclusion HAdV-Ad7 and HCoV-229E coinfection in healthy children may not increase the clinical severity or prolong the clinical course. The specific interaction mechanism between the viruses requires further study.

Heterogeneous Venture Capital and Technological Innovation Network Evolution: Corporate Reputation as Mediating Variable

Amid the pandemic of COVID-19, the collaborative innovation network of enterprises is conducive to the sharing of innovation resources, knowledge transfer, and technology diffusion, which is closely related to the improvement of corporate technological innovation performance. From the perspective of corporate reputation in the field of venture capital investment, and based on transaction cost theory, basic resource theory and reputation effect theory, this paper discusses the evolution mechanism of corporate technological innovation network, constructs an integrated model for the relationships between heterogeneous venture capital investment, corporate reputation and technological innovation network evolution, and then examines the impact of different types of heterogeneous venture capital investment on the evolution mechanism of technological innovation network, as well as the mediating effects of corporate reputation. Through the empirical analysis of the data obtained from the survey of 500 enterprises, the research shows that that independent venture capital is more conducive to enhancing the internal corporate reputation and promoting the evolution of technological innovation networks towards being self-centered;corporate venture capital is more conducive to consolidating the external reputation of enterprises and promoting the evolution of technological innovation networks towards being holistic. Corporate reputation has some mediating effects on the relationship between heterogeneous venture capital and technological innovation network evolution.

Leading via virtual communication: a longitudinal field experiment on work team creativity in an extreme context

COVID-19 has prompted diverse responses from governments and created an extreme context for organizations to operate. In this context, company leaders face fluctuated macrolevel policies, endure physical separation from their members, and must rely on virtual communication to conduct teamwork. Yet little is known about what and how leader communication can be effective in inducing team creativity to survive the extreme context. Building on the affective events theory and the literature on media richness, we develop a theoretical model explicating how leaders’ rich (as opposed to lean) virtual communication can mitigate the negative impact of stringent government responses to COVID-19 on work team creativity via a sequential mediation process: first by inhibiting team anxiety and then by facilitating team information elaboration. Data from a three-stage eight-day longitudinal field experiment, in combination with an experience sampling method with 251 employees, on a chain preschool in eight Chinese cities, provide strong support for the hypothesized model.

Comprehensive profiling and characterization of cellular microRNAs in response to coxsackievirus A10 infection in bronchial epithelial cells.

Coxsackievirus A10 (CV-A10), the causative agent of hand, foot, and mouth disease (HFMD), caused a series of outbreaks in recent years and often leads to neurological impairment, but a clear understanding of the disease pathogenesis and host response remains elusive. Cellular microRNAs (miRNAs), a large family of non-coding RNA molecules, have been reported to be key regulators in viral pathogenesis and virus-host interactions. However, the role of host cellular miRNAs defensing against CV-A10 infection is still obscure. To address this issue, we systematically analyzed miRNA expression profiles in CV-A10-infected 16HBE cells by high-throughput sequencing methods in this study. It allowed us to successfully identify 312 and 278 miRNAs with differential expression at 12 h and 24 h post-CV-A10 infection, respectively. Among these, 4 miRNAs and their target genes were analyzed by RT-qPCR, which confirmed the sequencing data. Gene target prediction and enrichment analysis revealed that the predicted targets of these miRNAs were significantly enriched in numerous cellular processes, especially in regulation of basic physical process, host immune response and neurological impairment. And the integrated network was built to further indicate the regulatory roles of miRNAs in host-CV-A10 interactions. Consequently, our findings could provide a beneficial basis for further studies on the regulatory roles of miRNAs relevant to the host immune responses and neuropathogenesis caused by CV-A10 infection.

Asymptomatic and pre-symptomatic infection in Coronavirus Disease 2019 pandemic.

With the presence of Coronavirus Disease 2019 (COVID-19) asymptomatic infections detected, their proportion, transmission potential, and other aspects such as immunity and related emerging challenges have attracted people's attention. We have found that based on high-quality research, asymptomatic infections account for at least one-third of the total cases, whereas based on systematic review and meta-analysis, the proportion is about one-fifth. Evaluating the true transmission potential of asymptomatic cases is difficult but critical, since it may affect national policies in response to COVID-19. We have summarized the current evidence and found, compared with symptomatic cases, the transmission capacity of asymptomatic individuals is weaker, even though they have similar viral load and relatively short virus shedding duration. As the outbreak progresses, asymptomatic infections have also been found to develop long COVID-19. In addition, the role of asymptomatic infection in COVID-19 remains to be further revealed as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to emerge. Nevertheless, as asymptomatic infections transmit the SARS-CoV-2 virus silently, they still pose a substantial threat to public health. Therefore, it is essential to conduct screening to obtain more knowledge about the asymptomatic infections and to detect them as soon as possible; meanwhile, management of them is also a key point in the fight against COVID-19 community transmission. The different management of asymptomatic infections in various countries are compared and the experience in China is displayed in detail.

The impact of COVID-19 continuous containment and mitigation strategy on the epidemic of vector-borne diseases in China.

BACKGROUND: This study explored the effect of a continuous mitigation and containment strategy for coronavirus disease 2019 (COVID-19) on five vector-borne diseases (VBDs) in China from 2020 to 2021. METHODS: Data on VBDs from 2015 to 2021 were obtained from the National Health Commission of the People's Republic of China, and the actual trend in disease activity in 2020-2021 was compared with that in 2015-2019 using a two-ratio Z-test and two proportional tests. Similarly, the estimated trend in disease activity was compared with the actual trend in disease activity in 2020. RESULTS: There were 13,456 and 3684 average yearly cases of VBDs in 2015-2019 and 2020, respectively. This represents a decrease in the average yearly incidence of total VBDs of 72.95% in 2020, from 0.9753 per 100,000 population in 2015-2019 to 0.2638 per 100,000 population in 2020 (t = 75.17, P < 0.001). The observed morbidity rates of the overall VBDs were significantly lower than the predicted rates (47.04% reduction; t = 31.72, P < 0.001). The greatest decline was found in dengue, with a 77.13% reduction (observed rate vs predicted rate: 0.0574 vs. 0.2510 per 100,000; t = 41.42, P < 0.001). Similarly, the average yearly mortality rate of total VBDs decreased by 77.60%, from 0.0064 per 100,000 population in 2015-2019 to 0.0014 per 100,000 population in 2020 (t = 6.58, P < 0.001). A decreasing trend was also seen in the monthly incidence of total VBDs in 2021 compared to 2020 by 43.14% (t = 5.48, P < 0.001). CONCLUSIONS: The results of this study verify that the mobility and mortality rates of VBDs significantly decreased from 2015-2019 to 2020-2021, and that they are possibly associated to the continuous COVID-19 mitigation and contamination strategy implemented in China in 2020-2021.

Effects of the enhanced public health intervention during the COVID-19 epidemic on respiratory and gastrointestinal infectious diseases in China.

The public health interventions to mitigate coronavirus disease 2019 (COVID-19) could also potentially reduce the global activity of influenza. However, this strategy's impact on other common infectious diseases is unknown. We collected data of 10 respiratory infectious (RI) diseases, influenza-like illnesses (ILIs), and seven gastrointestinal infectious (GI) diseases during 2015-2020 in China and applied two proportional tests to check the differences in the yearly incidence and mortality, and case-fatality rates (CFRs) over the years 2015-2020. The results showed that the overall RI activity decreased by 7.47%, from 181.64 in 2015-2019 to 168.08 per 100 000 in 2020 (p < 0.001); however, the incidence of influenza was seen to have a 16.08% escalation (p < 0.001). In contrast, the average weekly ILI percentage and positive influenza virus rate decreased by 6.25% and 61.94%, respectively, in 2020 compared to the previous 5 years (all p < 0.001). The overall incidence of GI decreased by 45.28%, from 253.73 in 2015-2019 to 138.84 in 2020 per 100 000 (p < 0.001), and with the greatest decline seen in hand, foot, and mouth disease (HFMD) (64.66%; p < 0.001). The mortality and CFRs from RI increased by 128.49% and 146.95%, respectively, in 2020, compared to 2015-2019 (p < 0.001). However, the mortality rates and CFRs of seven GI decreased by 70.56% and 46.12%, respectively (p < 0.001). In conclusion, China's COVID-19 elimination/containment strategy is very effective in reducing the incidence rates of RI and GI, and ILI activity, as well as the mortality and CFRs of GI diseases.

The Effect of Coronavirus 2019 Disease Control Measures on the Incidence of Respiratory Infectious Disease and Air Pollutant Concentrations in the Yangtze River Delta Region, China.

The Yangtze River Delta is one of the top five Chinese regions affected by COVID-19, as it is adjacent to Hubei Province, where COVID-19 first emerged. We investigated the impact of COVID-19 non-pharmaceutical interventions (NPIs) on changes in respiratory infectious diseases (RIDs) incidence and air quality in the Yangtze River Delta by constructing two proportional tests and fitting ARIMA and linear regression models. Compared with the pre-COVID-19 period, the average monthly incidence of seven RIDs decreased by 37.80% (p < 0.001) and 37.11% (p < 0.001) during the COVID-19 period and the post-vaccination period, respectively, in Shanghai, and decreased by 20.39% (p < 0.001) and 22.86% (p < 0.001), respectively, in Zhejiang. Similarly, compared with the pre-COVID-19 period, the monthly overall concentrations of six air pollutants decreased by 12.7% (p = 0.003) and 18.79% (p < 0.001) during the COVID-19 period and the post-vaccination period, respectively, in Shanghai, and decreased by 12.85% (p = 0.008) and 15.26% (p = 0.001), respectively, in Zhejiang. Interestingly, no significant difference in overall incidence of RIDs and concentrations of air quality was shown between the COVID-19 period and the post-vaccination period in either Shanghai or Zhejiang. This study provides additional evidence that the NPIs measures taken to control COVID-19 were effective in improving air quality and reducing the spread of RIDs. However, a direct causal relationship has not been established.

Risk assessment of venous thromboembolism and bleeding in COVID-19 patients.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a newly recognized illness that has spread rapidly all over the world. More and more reports highlight the risk of venous thromboembolism (VTE) in COVID-19. Our study aims to identify in-hospital VTE risk and bleeding risk in COVID-19 patients. METHODS: We retrospectively studied 138 consecutively enrolled patients with COVID-19 and identified in-hospital VTE and bleeding risk by Padua Prediction Score and Improve bleed risk assessment model. The clinical data and features were analyzed in VTE patients. RESULTS: Our findings identified that 23 (16.7%) patients with COVID-19 were at high risk for VTE according to Padua prediction score and 9 (6.5%) patients were at high risk of bleeding for VTE prophylaxis according to Improve prediction score. Fifteen critically ill patients faced double high risk from thrombosis (Padua score more than 4 points in all 15 [100%] patients) and hemorrhage (Improve score more than 7 points in 9 [60.0%] patients). Thrombotic events were identified in four patients (2.9%) of all COVID-19 patients. All of them were diagnosed with deep vein thrombosis by ultrasound 3 to 18 days after admission. Three (75.0%) were critically ill patients, which means that the incidence of VTE among critically ill patients was 20%. One major hemorrhage happened in critically ill patients during VTE treatment. CONCLUSION: Critically ill patients with COVID-19 suffered both a high risk of thrombosis and bleeding risks. More effective VTE prevention strategies based on an individual assessment of bleeding risks were necessary for critically ill patients with COVID-19.

The impact of the COVID-19 pandemic on the incidence and mortality of zoonotic diseases in China.

BACKGROUND: It has been reported that strict non-pharmaceutical measures can significantly reduce the incidence and mortality of respiratory and intestinal infectious diseases during the COVID-19 pandemic, but there are limited reports on the impact in terms of the rates of zoonotic diseases. METHODS: We extracted the incidence and mortality data of eight notifiable infectious zoonotic diseases from the website of the National Health Commission of the People's Republic of China for the period of January 2015 to April 2021. RESULTS: First, the overall incidence of zoonotic diseases decreased from 0.3714 per 100 000 in 2015-2019 to 0.2756 in 2020 (25.79% reduction, p<0.001); however, a dramatic increase in activity was seen in 2021 compared with 2020 (0.4478 per 100 000 in 2021, 62.47% increase, p<0.001). Anthrax, brucellosis, leptospirosis and hydatid disease exhibited significant upward trends in 2021. Second, analysed further by stages, the monthly incidence in the routine stage (from May to December 2020) was much higher than that in the emergency stage of the COVID-19 (from January to April 2020) (55.33% increase, p<0.001). We also found that the monthly observed incidence was significantly lower than the predicted incidence of a 10.29% reduction in the emergency stage. Third, no differences were seen in mortality between 2021 and 2020, while a significant decline was found in 2020 compared with the previous 5 years (72.70%, p<0.001). CONCLUSIONS: Strict containment and feasible suppression strategies during the 2020 period of the COVID-19 pandemic had positive impacts on the overall incidence of zoonotic diseases in China. However, anthrax, brucellosis, leptospirosis and hydatid diseases might increase with the relaxation of non-pharmacological interventions in 2021.