Predictive values of procalcitonin for coinfections in patients with COVID-19: a systematic review and meta-analysis.

OBJECTIVES: To assess the ability of procalcitonin (PCT)-a promising marker for coinfections-to predict coinfections in patients with COVID-19. METHODS: In this systematic review and meta-analysis, PubMed, Embase, Web of Science, Cochrane, the China National Knowledge Infrastructure (CNKI), and Wanfang were searched to identify eligible studies (up to August 30, 2021). Articles that reported the predictive value of PCT for coinfections in patients with COVID-19 were included. Individual and pooled sensitivities and specificities were reported, and I2 was used to test heterogeneity. This study was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42021283344). RESULTS: Five studies involving a total of 2775 patients reported the predictive value of PCT for coinfections in patients with COVID-19. The sensitivity, specificity, and area under the curve of PCT in predicting coinfections in the pooled studies were 0.60 (95% CI 0.35-0.81, I2 = 88.85), 0.71 (95% CI 0.58-0.81, I2 = 87.82), and 0.72(95% CI 0.68-0.76) respectively. CONCLUSIONS: Although PCT has limited predictive value for coinfections in patients with COVID-19, lower PCT levels seem to indicate a decreased probability of having a coinfection.

Ruxolitinib as an Effective Treatment for Hemophagocytic Lymphohistiocytosis Secondary to SARS-Cov-2 Infection: A Case Report.

Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome. SARS-CoV-2 infection can induce secondary HLH, as described in previous case reports, but diagnosis and treatment are challenging. Case Study: We described an older male patient diagnosed with HLH related to previous SARS-CoV-2 infection. Fever was the only clinical manifestation initially but deterioration in clinical condition and laboratory parameters was observed during hospitalization. He responded poorly to classical therapy but was successfully treated with ruxolitinib. Conclusion: Clinicians should be aware of the possibility of HLH secondary to mild SARS-CoV-2 infection and take timely therapeutic measures to inhibit an inflammatory factor storm. Ruxolitinib is a potential choice for COVID-19 related HLH.

How do three-layer surgical masks prevent SARS-CoV-2 aerosol transmission?

The three-layer surgical mask was recognized by the World Health Organization as an effective-protection tool for reducing SARS-CoV-2 transmission during the COVID-19 pandemic; however, the contribution of each layer of this mask to the particle size-dependent filtration performance resistance remains unclear. Here, both experimental work and numerical simulation were conducted to study the role of each mask layer in particle size-dependent filtration and respiratory resistance. By using scanning electron microscopy images of a commercial three-layer mask, composed of two spun-bond and one melt-blown nonwoven polypropylene fabric layers, four representative models were constructed, in which the computational fluid dynamics of multiphase flow were performed. The pressure drop of all models under different flow conditions was measured next. Numerical simulation was then verified by comparing the experimental results in the present study and other theoretical works. The filtration efficiency of the spun-bond polypropylene nonwoven fabric layer was much lower than that of the melt-blown nonwoven polypropylene fabric layer for the particle diameter in the range of 0.1-2.0 µm. Both the spun-bond and melt-blown nonwoven polypropylene fabric layers demonstrated extremely low filtration efficiency for particles was<0.3 µm in diameter, with the maximum filtration efficiency being only 30%. The present results may facilitate rational design of mask products in terms of layer number and structural design.

Molecular characteristics of ambient organic aerosols in Shanghai winter before and after the COVID-19 outbreak.

During the global pandemic of COVID-19, the world adopted different strategies to avoid the human and economic loss, and so does China. The reduction of human activities during this time period caused reduction in PM emissions. This study adopted a HPLC-Q-TOF-MS to compare the chemical compositions of ambient aerosol samples collected in Shanghai winter before (2018, 2019) and after (2021) the COVID-19 outbreak. The identified compositions were classified into subgroups of CHO, CHN, CHON, CHONS, CHOS and CHN compounds. Results showed that CHO compounds and CHON compounds were dominating the organic compounds in ESI- and ESI+, respectively. The average percentages of CHO- compounds were 57.97 % in 2018, 58.98 % in 2019, and 43.93 % in 2021, respectively. The average percentages of CHON+ compounds were 52.74 % in 2018, 50.34 % in 2019, and 52.02 % in 2021, respectively. The proportion of aliphatic compounds increased gradually during the three years, especially in 2021, indicating that CHO compounds were less affected by aromatic precursors after the COVID-19 outbreak. The contribution of anthropogenic emissions in Shanghai was weakened compared with the previous years. In addition, there was an enhanced emission source containing hydroxyl for CHOS compound formation in 2021. The variations of atmospheric oxidation degree among the three years were not significant.

Research on the Relationship between Physical Literacy, Physical Activity and Sedentary Behavior.

During the COVID-19 pandemic, college students' health-related physical activity and physical literacy aroused widespread concern. This study evaluated the relationship among physical literacy (PL), sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA); we further explored whether LAP and SB mediated the association between PL and MVPA. METHODS: This study was based on a cross-sectional survey of Chinese college students. The Perceived Physical Literacy Instrument Scale (PPLI-SC) and International Physical Activity Questionnaire Short Form (IPAQ-SF) were used to investigate the PL, MVPA, LPA, and SB. RESULTS: There were 2996 valid questionnaires with 829 boys and 2167 girls. The MVPA, LPA, and PL of boys were significantly higher than girls, while the SB values were significantly lower in girls (p < 0.01). The correlation analysis showed that there was a significant correlation between the two indexes except for SB and LPA. Path analysis shows that PL directly, significantly, and positively affects MVPA. PL reduces SB (ß = -0.085, p < 0.001) and increases LPA (ß = 0.097, p < 0.001). The total mediation effect accounted for 14.014%, and the mediation effects of SB and LPA accounted for 4.417% and 9.597%, respectively. CONCLUSIONS: LPA and SB partially mediated the relation between PL and MVPA. SB and LPA partially explain the impact of PL on MVPA. The findings suggest that managing SB and improving LPA could play a significant indirect role in increasing the positive effect of PL on MVPA and that increasing the opportunities for LPA increased the MVPA for Chinese college students.

Psychiatric symptoms before and after COVID-19 vaccination: A cohort study of hospitalized schizophrenia patients.

This study aimed to examine the impact of COVID-19 vaccination on the psychiatric symptoms of hospitalized schizophrenia patients and to evaluate the association between the severity of psychiatric symptoms and the COVID-19 vaccination decision. We assessed the psychiatric symptoms of 330 hospitalized schizophrenia patients who accepted the vaccine and 114 patients who declined the vaccine option with PANSS before and after vaccination. We showed that the unwillingness to receive the vaccine is correlated with a higher level of psychiatric symptoms. COVID-19 vaccination is associated with slight deterioration of the schizophrenia symptoms of elderly hospitalized patients.

Higher benefit-risk ratio of COVID-19 vaccination in patients with schizophrenia and major depressive disorder versus patients with bipolar disorder when compared to controls.

Patients with major psychiatric disorders (MPD) that include schizophrenia (SCH), bipolar disorder (BP), and major depressive disorder (MDD) are at increased risk for coronavirus disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccines in MPD patients have not been fully evaluated. This study aimed to investigate adverse events (AEs)/side effects and efficacy of COVID-19 vaccines in MPD patients. This retrospective study included 2034 patients with SCH, BP, or MDD who voluntarily received either BBIBP-CorV or Sinovac COVID-19 vaccines, and 2034 matched healthy controls. The incidence of AEs/side effects and the efficacy of COIVD-19 vaccinations among the two groups were compared. The risk ratio (RR) of side effects in patients with MPD was 0.60 (95% confidence interval [CI]: 0.53-0.68) after the first dose and 0.80 (95% CI: 0.65-0.99) following the second dose, suggesting a significantly lower risk in the MPD group versus healthy controls. The RRs of AEs did not differ between patients and controls. Notably, fully vaccinated patients exhibited a decreased risk of influenza with or without fever compared with controls (RR=0.38, 95% CI: 0.31-0.46; RR=0.23, 95% CI: 0.17-0.30; respectively). Further subgroup comparisons revealed a significantly lower risk of influenza with fever in MDD (RR=0.13, 95% CI: 0.08-0.21) and SCH (RR=0.24, 95% CI: 0.17-0.34) than BP (RR=0.85, 95% CI: 0.69-1.06) compared to controls. We conclude that the benefit-risk ratio of COVID-19 vaccination was more favorable in SCH or MDD versus BP when compared with controls. These data indicate that COVID-19 vaccines are safe and protective in patients with MPD from COVID-19.

Effect of internet-delivered cognitive behavioral therapy on insomnia in convalescent patients with COVID-19: Protocol for a systematic review and meta-analysis.

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) has made a serious public health threat worldwide. Recent evidence has indicated that COVID-19 patients in convalescence frequently experience insomnia, which reduces their quality of life and causes unknown risks. The positive effect of cognitive behavior on insomnia has been well addressed in previous studies. Given the high infectivity and epidemicity of COVID-19, Internet-delivered intervention may be safer than face-to-face treatment. However, whether Internet-delivered cognitive behavioral therapy can effectively improve the insomnia of COVID-19 patients in convalescence has not been completely determined yet. Therefore, we conducted a meta-analysis and systematic review to evaluate the effects of Internet-delivered cognitive behavioral therapy on insomnia in COVID-19 patients in convalescence, with the aim to confer some guidance for its clinical application. METHODS AND ANALYSIS: This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Two researchers will retrieve the relevant literature on Internet-delivered cognitive behavioral therapy for insomnia in convalescent patients with COVID-19 in PubMed, Web of Science, Embase, MEDLINE, Cochrane Library, Clinical Trials gov, Chinese Biomedical Literature Database (CBM), and Chinese National Knowledge Infrastructure (CNKI) from inception to 11th of December. In addition, we will review the relevant trials and references of the included literature and manually searched the grey literature. The two researchers will independently extracted data and information and evaluated the quality of the included literature. The Review Manager software (version 5.3) and Stata software (version 14.0) will be used for data analysis. The mean difference or the standardized mean difference of 95% CI will be used to calculate continuous variables to synthesize the data. In addition, I2 and Cochrane will be used for heterogeneity assessment. TRIAL REGISTRATION: PROSPERO registration number CRD42021271278.

The Sleep Quality of the Frontline Healthcare Workers and the Improving Effect of Tai Chi.

Background: A number of studies have documented that coronavirus disease 2019 (COVID-19) brought more negative impact on the physical and psychological functioning of frontline healthcare workers. Especially, sleep quality was focused. This study aimed to investigate the sleep quality of frontline healthcare workers, risk factors for sleep quality, and the effect of Tai Chi training. Methods: A total of 98 frontline healthcare workers were recruited, coming from the infection department, fever clinic, laboratory, and medical imaging department in a COVID-19-designated hospital in Shanghai. Of them, 50 participated in a 2-week intervention and were randomized to receive a Tai Chi training or relaxation training. Participants were assessed at baseline, 7 and 14 days after participation. Demographic information, sleep quality, and anxiety were measured by using the demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Beck Anxiety Inventory (BAI). Results: 13.3% participants were above the cut-off score (>10) for the PSQI. Regression analysis showed gender, age, working years, and job category had effect on sleep quality. Compared to the control group, participants in the Tai Chi training group had lower scores on both PSQI (p < 0.05) and BAI (p < 0.01) after the 2-week intervention. Conclusion: It was demonstrated that poor sleep quality existed in the frontline healthcare workers, which was related to gender, age, working years, and job category. Tai Chi training can dramatically improve their sleep quality and reduce anxiety symptoms.

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.

Inhalation of MSC-EVs is a noninvasive strategy for ameliorating acute lung injury.

Mesenchymal stem cell-derived small extracellular vesicles (MSC-EVs) are promising nanotherapeutic agent for pneumonia (bacterial origin, COVID-19), but the optimal administration route and potential mechanisms of action remain poorly understood. This study compared the administration of MSC-EVs via inhalation and tail vein injection for the treatment of acute lung injury (ALI) and determined the host-derived mechanisms that may contribute to the therapeutic effects of MSC-EVs in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells (macrophage cell line) and animal models. Luminex liquid chip and hematoxylin and eosin (HE) staining revealed that, compared with the vehicle control, inhaled MSC-EVs outperformed those injected via the tail vein, by reducing the expression of pro-inflammatory cytokines, increasing the expression of anti-inflammatory cytokine, and decreasing pathological scores in ALI. MSC-EV administration promoted the polarization of macrophages towards a M2 phenotype in vitro and in vivo (via inhalation). RNA sequencing revealed that immune and redox mediators, including TLR4, Arg1, and HO-1, were associated with the activity MSC-EVs against ALI mice. Western blotting and immunofluorescence revealed that correlative inflammatory and oxidative mediators were involved in the therapeutic effects of MSC-EVs in LPS-stimulated cells and mice. Moreover, variable expression of Nrf2 was observed following treatment with MSC-EVs in cell and animal models, and knockdown of Nrf2 attenuated the anti-inflammatory and antioxidant activities of MSC-EVs in LPS-stimulated macrophages. Together, these data suggest that inhalation of MSC-EVs as a noninvasive strategy for attenuation of ALI, and the adaptive regulation of Nrf2 may contribute to their anti-inflammatory and anti-oxidant activity in mice.

Epidemiological characteristics and clinical manifestations of pediatric patients with COVID-19 in China: A multicenter retrospective study.

Importance: The Coronavirus disease 2019 (COVID-19) global pandemic poses a considerable challenge for pediatricians. Objective: This study aimed to identify the epidemiological characteristics and clinical features of pediatric patients with COVID-19 in China. Methods: This multicenter retrospective study included pediatric patients from 46 hospitals in China, covering 12 provinces and two municipalities. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: In total, 211 pediatric patients with COVID-19 were included in this study. The median age was 7.0 years (range: 22 days to 18 years). Approximately 16.3% of the patients exhibited asymptomatic infections, 23.0% had upper respiratory tract infections, and 60.7% had pneumonia, including two with severe pneumonia and one with critical illness. Approximately 78.7% of the pediatric patients occurred in familial clusters. The most three common symptoms or signs at onset in children with COVID-19 were fever (54.5%), cough (49.3%), and pharyngeal congestion (20.8%). Only 17.6% of the patients presented with decreased lymphocyte count, whereas 13.6% had increased lymphocyte count. Among the patients with pneumonia who exhibited abnormal chest computed tomography findings, 18.2% (23/127) of the patients had no other symptoms. Generally, the chest radiographs showed abnormalities that affected both lungs (49.6%); ground-glass opacity (47.2%) was the most common manifestation. The cure and improvement rates were 86.7% (183/211) and 13.3% (28/211), respectively. Only one patient with an underlying condition received invasive mechanical ventilation; none of the patients died. Interpretation: Similar to adults, children of all age groups are susceptible to COVID-19. Fortunately, most pediatric patients have mild symptoms or remain asymptomatic, despite the high incidence of pneumonia. Decreased proportions of white blood cells and lymphocytes are less frequent in children than in adults.

Comparison of Clinical Characteristics Among COVID-19 and Non-COVID-19 Pediatric Pneumonias: A Multicenter Cross-Sectional Study.

Background: The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias. Methods: We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test. Results: A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups. Conclusion: Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.

Research and Application of Virtual Reality Technology for Undergraduate Online Teaching

Under the strong influence of the COVID-19, online teaching has been carried out in Colleges and universities all over the world. There are essential differences between online teaching and offline teaching. Although the teaching method of live online teaching is novel, a series of problems arise, such as students can’t keep up with the steps of teachers, which is difficult to absorb teaching content and low teaching efficiency. Therefore, the objective of this paper is effectively solve the online teaching, poor understanding and analysis ability, low atmosphere and other problems. In this paper, VR technology e-learning which is new ideas, the design of new VR and online teaching integration way, the construction of online VR classroom and teacher control system, the use of modeling technology to create virtual classroom, cross space real-time teaching, improve the efficiency of online teaching in colleges and universities.

Smell disorders in COVID-19 patients: role of olfactory training: A protocol for systematic review and meta-analysis.

BACKGROUND: As the coronavirus disease 2019 (COVID-19) spread around the world, a surge of evidence suggests that smell disorders are common symptoms in COVID-19 infection. This dysfunction may cause loss of appetite, malnutrition, poisoning, and depression. Obviously, the impairment has a strong impact on the quality of life. Therefore, there is an urgent need to identify effective treatments. Various therapies have been studied to treat smell disorders after infection, and olfactory training (OT) is considered a promising treatment option. Assessing the effectiveness and safety of olfactory training for COVID-19 patients with smell disorders is the main purpose of this systematic review protocol. METHODS: PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, ClinicalTrials.gov trials registry, and Chinese Clinical Trial Registry will be searched from January 2019 to January 2021. A combination of subject words and free text words will be applied in the searches. The language is limited to Chinese and English. The complete process will include study selection, data extraction, risk of bias assessment, and meta-analyses. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by Review Manager V.5.3 (Cochrane Collaboration) or Stata V.16.0 software. RESULTS: This proposed study will assess the effectiveness and safety of OT for COVID-19 patients with smell disorders. CONCLUSION: The conclusion of this study will provide evidence to prove the effectiveness and safety of olfactory training for COVID-19 patients with smell disorders. ETHICS AND DISSEMINATION: This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval. REGISTRATION: PEROSPERO CRD42020218009.

Tai Chi for the elderly patients with COVID-19 in recovery period: A protocol for systematic review and meta-analysis.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has caused a great impact in many countries. Older people are more susceptible to the virus than other people. As a good health exercise suitable for the elderly, Tai Chi has a positive impact on heart function, blood pressure, lung function, immunity, etc. It can enhance cardiopulmonary function, increase the elasticity of blood vessels, and improve the body's self-regulation function. For the elder patients with COVID-19, Tai Chi has outstanding merits. METHODS: We will search PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database, Wanfang Database, Clinical Trials and Chinese Clinical Trial Registry. The complete process will include study selection, data extraction, risk of bias assessment and meta-analyses. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by Stata/SE 15.1 software. RESULTS: This proposed study will evaluate the effectiveness and safety of Tai Chi for the improvement of psychological pressure, cardiopulmonary function, and immunity in elderly COVID-19 patients during the recovery period. CONCLUSION: The conclusion of this study will provide evidence to prove the safety and effectiveness of Tai Chi on elderly COVID-19 patients during the recovery period. ETHICS AND DISSEMINATION: This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval. REGISTRATION: PEROSPERO CRD42020220128.

Environmental Indicator for COVID-19 Non-Pharmaceutical Interventions.

A novel coronavirus (COVID-19) has caused viral pneumonia worldwide, posing a major threat to international health. Our study reports that city lockdown is an effective way to reduce the number of new cases and the nitrogen dioxide (NO2) concentration can be used as an environmental lockdown indicator to evaluate the effectiveness of lockdown measures. The airborne NO2 concentration steeply decreased over the vast majority of COVID-19-hit areas since the lockdown. The total number of newly confirmed cases reached an inflection point about two weeks since the lockdown and could be reduced by about 50% within 30 days of the lockdown. The stricter lockdown will help newly confirmed cases to decline earlier and more rapidly, and at the same time, the reduction rate of NO2 concentration will increase. Our research results show that NO2 satellite observations can help decision makers effectively monitor and manage non-pharmaceutical interventions in the epidemic.

Acupuncture for COVID-19 patient after ventilator weaning: A protocol for systematic review and meta-analysis.

BACKGROUND: COVID-19 has spread globally since its outbreak in late 2019. It mainly attacks people's respiratory system. Many patients with severe COVID-19 require a ventilator to support breathing, and their lung function is often impaired to varying degrees after ventilator weaning. Acupuncture has been reported to improve respiratory function, but there is no evidence that it can improve respiratory function in ventilator users with COVID-19 after they are removed from the machine. The protocol of the systematic review and meta-analysis will clarify safety and effectiveness of acupuncture on respiratory rehabilitation after weaning from the ventilator during the treatment of COVID-19. METHODS: We will search PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database, Wanfang Database, Clinical Trials and Chinese Clinical Trial Registry. Relevant English language and Chinese language literature will be included. A combination of subject words and free text words will be applied in the searches. The complete process will include study selection, data extraction, risk of bias assessment, and meta-analyses. We will use subgroup analysis and sensitivity analysis to explore the sources of heterogeneity if there is heterogeneity. We will use funnel charts to assess the risk of bias. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by RevMan5.2 or Stata/SE 15.1 software. RESULTS: This study will assess safety and effectiveness of acupuncture for rehabilitation on respiratory function after weaning from the ventilator during the treatment of COVID-19. CONCLUSIONS: The conclusion of this study will give evidence to prove safety and effectiveness of acupuncture for rehabilitation on respiratory after weaning from the ventilator during the treatment of COVID-19. REGISTRATION: PROSPERO CRD42020206889.

The effect of Tai Chi on the quality of life in the elderly patients recovering from coronavirus disease 2019: A protocol for systematic review and meta-analysis.

BACKGROUND: coronavirus disease 2019 (COVID-19) is spreading fast starting late 2019. As their cardiopulmonary and immune functions gradually decline, elderly people are prone to COVID-19. Tai Chi has a positive impact on heart function, blood pressure, lung function, blood circulation, and so on, and it's suitable for the elderly. Quality of life (QoL)can reflect of individuals' physical and mental health, it can also reflects their ability to participate in society. This systematic review and meta-analysis will summarize the current evidence that Tai Chi improve the QoL in the elderly patients recovering from COVID-19. METHODS: We will search PubMed, EMBASE, MEDLINE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database, Wanfang Database, Clinical Trials and Chinese Clinical Trial Registry. The complete process will include study selection, data extraction, risk of bias assessment and meta-analyses. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by Stata/SE 15.1 software. RESULTS: This proposed study will evaluate the effectiveness and safety of Tai Chi for the improvement of QoL in elderly COVID-19 patients during the recovery period. CONCLUSION: The conclusion of this study will provide evidence to prove the safety and effectiveness of Tai Chi on elderly COVID-19 patients during the recovery period. ETHICS AND DISSEMINATION: This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval. REGISTRATION: PEROSPERO CRD42020206875.