Real-world effectiveness of primary series and booster doses of inactivated COVID-19 vaccine against Omicron BA.2 variant infection in China: a retrospective cohort study.

BACKGROUND: China has been using inactivated COVID-19 vaccines as primary series and booster doses to protect the population from severe to fatal COVID-19. We evaluated primary and booster vaccine effectiveness (VE) against Omicron BA.2 infection outcomes. METHODS: This was a 13-province retrospective cohort study of quarantined close contacts of BA.2-infected individuals. Outcomes were BA.2 infection, COVID-19 pneumonia or worse, and severe/critical COVID-19. Absolute VE was estimated by comparison with an unvaccinated group. RESULTS: There were 289,427 close-contacts ≥3 years old exposed to Omicron BA.2 cases; 31,831 turned nucleic-acid amplification test (NAAT)-positive during quarantine, 97.2% with mild or asymptomatic infection, 2.6% had COVID-19 pneumonia, and 0.15% had severe/critical COVID-19. None died. Adjusted VE against any infection was 17% for primary series and 22% when boosted. Primary series aVE in adults >18 years was 66% against pneumonia or worse infection and 91% against severe/critical COVID-19. Booster dose aVE was 74% against pneumonia or worse, and 93% against severe/critical COVID-19. CONCLUSIONS: Inactivated COVID-19 vaccines provided modest protection from infection, very good protection against pneumonia, and excellent protection against severe/critical COVID-19. Booster doses are necessary to provide strongest protection.

Analysis of the Government and Capital Market's Response to Normalized Epidemic Prevention and Control Based on the Development of Smart Health Care

With the continuous prominence of medical problems, the construction of a smart medical system has received more and more attention. With coronavirus disease 2019 in a state of regular prevention and control, the epidemic prevention and control in China had produced favorable effects. Therefore, a comprehensive evaluation of the emergency governance mechanism in China was crucial to epidemic prevention and control worldwide. This paper empirically analyzed the effects of epidemic prevention and control based on the dual perspective of epidemic governance and capital market, taking the daily outbreak data at the provincial level in China as the sample. The findings were as follows: (1) The accumulation of epidemic medical treatment experience in each province and city produced a positive emergency effect on preventing and controlling the dissemination of epidemic. The effective medical security mechanism was one of the most important mechanisms for the significant emergency effect, with the effective material security as a critical supplement. (2) Companies and corporations with stronger capabilities for emergency medical treatment received more positive responses from the capital market comparatively. Aiming at diversifying directions and measurements for the improvement of emergency governance, this paper provided theoretical bases for improving the emergency governance system against major public health emergencies by using the Chinese characteristics.

Factors associated with neutralizing antibody levels induced by two inactivated COVID-19 vaccines for 12 months after primary series vaccination.

Background: BBIBP-CorV and CoronaVac inactivated COVID-19 vaccines are widely-used, World Health Organization-emergency-listed vaccines. Understanding antibody level changes over time after vaccination is important for booster dose policies. We evaluated neutralizing antibody (nAb) titers and associated factors for the first 12 months after primary-series vaccination with BBIBP-CorV and CoronaVac. Methods: Our study consisted of a set of cross-sectional sero-surveys in Zhejiang and Shanxi provinces, China. In 2021, we enrolled 1,527 consenting 18-59-year-olds who received two doses of BBIBP-CorV or CoronaVac 1, 3, 6, 9, or 12 months earlier and obtained blood samples and demographic and medical data. We obtained 6-month convalescent sera from 62 individuals in Hebei province. Serum nAb titers were measured by standard micro-neutralization cytopathic effect assay in Vero cells with ancestral SARS-CoV-2 strain HB01. We used the first WHO International Standard (IS) for anti-SARS-CoV-2 immunoglobulin (NIBSC code 20/136) to standardized geometric mean concentrations (IU/mL) derived from the nAb geometric mean titers (GMT over 1:4 was considered seropositive). We analyzed nAb titer trends using Chi-square and factors related to nAb titers with logistic regression and linear models. Results: Numbers of subjects in each of the five month-groupings ranged from 100 to 200 for each vaccine and met group-specific target sample sizes. Seropositivity rates from BBIBP-CorV were 98.0% at 1 month and 53.5% at 12 months, and GMTs were 25.0 and 4.0. Respective seropositivity rates from CoronaVac were 90.0% and 62.5%, and GMTs were 20.2 and 4.1. One-, three-, six-, nine-, and twelve-month GMCs were 217.2, 84.1, 85.7, 44.6, and 10.9 IU/mL in BBIBP-CorV recipients and 195.7, 94.6, 51.7, 27.6, and 13.4 IU/mL in CoronaVac recipients. Six-month convalescent seropositivity was 95.2%; GMC was 108.9 IU/mL. Seropositivity and GMCs were associated with age, sex, and time since vaccination. Conclusions: Neutralizing Ab levels against ancestral SARS-CoV-2 from BBIBP-CorV or CoronaVac vaccination were similar and decreased with increasing time since vaccination; over half of 12-month post-vaccination subjects were seropositive. Seropositivity and GMCs from BBIBP-CorV and CoronaVac six and nine months after vaccination were similar to or slightly lower than in six-month convalescent sera. These real-world data suggest necessity of six-month booster doses.

Current status and prospects of hematopoietic stem cell transplantation in China.

ABSTRACT: Hematopoietic stem cell transplantation (HSCT) is a highly effective and unique medical procedure for the treatment of most hematological malignancies. The first allogeneic transplantation was performed by E. Donnall Thomas in 1957. Since then, the field has evolved and expanded worldwide. The first successful allogenic HSCT (allo-HSCT) in China was conducted in 1981. Although the development of allo-HSCT in China lagged, China has since made considerable contributions to the process of HSCT worldwide, with more than 10,000 HSCTs performed annually. In particular, haploid HSCT (haplo-HSCT) technology represented in the Beijing Protocol has demonstrated similar efficacy to human leukocyte antigen-matched HSCT and has gradually become the pre-dominant choice for allo-HSCT in China. Currently, the number of haplo-HSCT procedures exceeds 5000 per year, and the Beijing Protocol has been greatly improved by implementing updated individualized strategies for controlling complications, relapse, and infection management. In addition, innovative haplo-HSCT technologies developed by different medical transplantation centers, such as Soochow, Zhejiang, Fujian, Chongqing, and Anhui, have emerged, providing inspiration for the refinement of global practice. This review will focus on the current activity in this field and highlight important trends that are vital in China's allo-HSCT process, examining the current viewpoint and future directions.

Safety, immunogenicity, and immune persistence of two inactivated COVID-19 vaccines replacement vaccination in China: An observational cohort study.

BACKGROUND: To mitigate a national shortage of WIBP-CorV COVID-19 vaccine, China's regulator approved administering BBIBP-CorV after WIBP-CorV for completion of a primary series. In a pragmatic observational study, we compared immunogenicity and safety of a primary series of WIBP-CorV followed by BBIBP-CorV with a primary series of two doses of BBIBP-CorV. METHODS: We invited healthy 18-59-years-old adults who had already received either WIBP-CorV or BBIBP-CorV as their first dose in a primary series to participate in this observational cohort study. Subjects who had received WIBP-CorV as their first dose became the observation group; subjects who had received BBIBP-CorV as their first dose became the control group. All participants received BBIBP-CorV as their second dose. We obtained sera 1, 2, and 6 months after second doses for nAb titer measurement by micro-neutralization cytopathic effect assay with SARS-CoV-2 strain HB01, standardized with WHO International Standard for anti-SARS-CoV-2 immunoglobulin. Safety was assessed for the 7 days after administration of second doses. RESULTS: Between March and December 2021, 275 subjects were included in the observation group and 133 in the control group. Neutralizing seropositivity (≥1:4) rates were 98.91 % and 99.25 % at 1 month and 53.16 % and 70.69 % at 6 months. One-month geometric mean titers (GMTs) were 21.33 and 22.45; one-month geometric mean concentrations (GMCs) were 227.71 IU/mL and 273.27 IU/mL. One to two months after vaccination, observation group seropositivity rates and titers were not significantly different to the control group's. Adverse reaction rates were 11.27 % and 18.80 %, all mild or moderate in severity. CONCLUSIONS: Both primary series were immunogenic; immunogenicity of WIBP-CorV followed by BBIBP-CorV was not different than immunogenicity following two doses of BBIBP-CorV for two months after vaccination; safety profiles were acceptable for both regimens. BBIBP-CorV can be used to complete a primary series that started with WIBP-CorV.

National emissions inventory and future trends in greenhouse gases and other air pollutants from civil airports in China.

Civil aviation is an important source of air pollutants, but this field has received insufficient attention in China. Based on the standard emissions model of the International Civil Aviation Organization (ICAO) and actual flight information from 241 airports, this study estimated a comprehensive emissions inventory for 2010-2020 by considering the impacts of mixing layer height. The results showed that annual pollutant emissions rapidly trended upward along with population and economic growth; however, the emissions decreased owing to the impacts of the COVID-19 pandemic. In 2020, the emissions of carbon monoxide (CO), nitrogen oxides (NOX), particulate matter (PM), methane (CH4), nitrous oxide (N2O), carbon dioxide (CO2), and water vapor (H2O) were 34.34, 65.73, 0.10, 0.34, 0.40, 14,706.26, and 5733.11 Gg, respectively. The emissions of total volatile organic compounds (VOCs) from China's civil airports in 2020 were estimated at 17.20 Gg; the major components were formic acid (1.70 Gg), acetic acid (1.62 Gg), 1-butylene (1.03 Gg), acetone (0.96 Gg), and acetaldehyde (0.93 Gg). The distribution of pollutant emissions was consistent with the level of economic development, mainly in Beijing, Guangzhou, and Shanghai. In addition, we estimated future pollution trends for the aviation industry under four scenarios. Under the comprehensive scenario, which considered the impacts of economic growth, passenger turnover, cargo turnover, COVID-19, and technological efficiency, the levels of typical pollutants were expected to increase by nearly 1.51-fold from 2010 to 2035.

Association of COVID-19 Vaccination and Clinical Severity of Patients Infected with Delta or Omicron Variants - China, May 21, 2021-February 28, 2022.

What is already known about this topic?: Compared with the international mRNA and adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccines, there is less real-world research data about breakthrough cases in people vaccinated with China-made COVID-19 vaccines. Analyses of clinical outcomes of breakthrough cases will be an important supplement to the clinical trial efficacy and observational effectiveness data of China-made COVID-19 vaccines. What is added by this report?: COVID-19 vaccine age-eligible individuals (≥3 years old) who received full primary series and a booster dose of China-made COVID-19 vaccines had good protection from pneumonia caused by Delta variant infection. There was only one serious Delta case in children (unvaccinated), but among adults 18 years and older, there was good protection from serious illness with primary vaccination and booster vaccination. Among people ≥60 years, full vaccination and booster vaccination were associated with protection from pneumonia and risk of serious COVID-19 caused by Omicron variant infection. There were few serious Omicron cases. What are the implications for public health practice?: Everyone 3 years and older without contraindications should be fully vaccinated against COVID-19; schedule-eligible adults should receive booster doses. The pace of booster dose administration, especially among the elderly, should be accelerated.

Difference in Amyloid Load Between Single Memory Domain and Multidomain Subjective Cognitive Decline: A Study from the SILCODE.

BACKGROUND: Subjective cognitive decline (SCD), an at-risk condition of Alzheimer's disease (AD), can involve various cognitive domains, such as memory, language, planning, and attention. OBJECTIVE: We aim to explore the difference in amyloid load between the single memory domain SCD (sd-SCD) and the multidomain SCD (md-SCD) and assess the relationship of amyloid pathology with quantitative SCD scores and objective cognition. METHODS: A total of 63 SCD participants from the SILCODE study underwent the clinical evaluation, neuropsychological assessment, and 18F-florbetapir PET scan. Global amyloid standard uptake value ratio (SUVr) was calculated. Additionally, regional amyloid SUVr was quantified in 12 brain regions of interests. A nonparametric rank ANCOVA was used to compare the global and regional amyloid SUVr between the md-SCD (n = 34) and sd-SCD (n = 29) groups. A multiple linear regression analysis was conducted to test the relationship of amyloid SUVr with quantitative SCD scores and objective cognition. RESULTS: Compared with individuals with sd-SCD, individuals with md-SCD had increased global amyloid SUVr (F = 5.033, p = 0.029) and regional amyloid SUVr in the left middle temporal gyrus (F = 12.309, p = 0.001; Bonferroni corrected), after controlling for the effects of age, sex, and education. When pooling all SCD participants together, the increased global amyloid SUVr was related with higher SCD-plus sum scores and lower Auditory Verbal Learning Test-delayed recall scores. CONCLUSION: According to our findings, individuals with md-SCD showed higher amyloid accumulation than individuals with sd-SCD, suggesting that md-SCD may experience a more advanced stage of SCD. Additionally, increased global amyloid load was predictive of a poorer episodic memory function in SCD individuals.

Risk assessment of public health emergencies concerned in the mainland of China, October 2021

Objective: To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in October 2021.

Would Older Adults Perform Preventive Practices in the Post-COVID-19 Era? A Community-Based Cross-Sectional Survey in China.

During the post-COVID-19 era, preventive practices, such as washing hands and wearing a mask, remain key measures for controlling the spread of infection for older adults. This study investigated the status of preventive practices among older adults and identified the related influencing factors. Participants who were ≥60 years old were recruited nationwide. Data were collected through self-designed questionnaires, including demographic variables, knowledge, perceived vulnerability, response efficacy, anxiety and preventive practices. Descriptive statistics and chi-square tests were performed. Hierarchical logistic regression was conducted to determine the predictors. A total of 2996 participants completed this study. Of them, 2358 (78.7%) participants reported washing hands regularly in the last two weeks, and 1699 (56.7%) always wore masks outside this year. Knowledge (hand washing: OR = 1.09, p < 0.01; mask wearing: OR = 1.17, p < 0.01) and response efficacy (hand washing: OR = 1.61, p < 0.01; mask wearing: OR = 1.70, p < 0.01) were positively associated with preventive practices, whereas perceived vulnerability had a negative effect (hand washing: OR = 0.54, p < 0.01; mask wearing: OR = 0.72, p < 0.01). Knowledge, response efficacy and perceived vulnerability were found to be significant predictors of the preventive practice among older adults in the post-COVID-19 era. This study provides new insights into preventive suggestions after the peak of the pandemic and also has significant implications in improving the life quality of older adults.

DeepR2cov: deep representation learning on heterogeneous drug networks to discover anti-inflammatory agents for COVID-19.

Recent studies have demonstrated that the excessive inflammatory response is an important factor of death in coronavirus disease 2019 (COVID-19) patients. In this study, we propose a deep representation on heterogeneous drug networks, termed DeepR2cov, to discover potential agents for treating the excessive inflammatory response in COVID-19 patients. This work explores the multi-hub characteristic of a heterogeneous drug network integrating eight unique networks. Inspired by the multi-hub characteristic, we design 3 billion special meta paths to train a deep representation model for learning low-dimensional vectors that integrate long-range structure dependency and complex semantic relation among network nodes. Based on the representation vectors and transcriptomics data, we predict 22 drugs that bind to tumor necrosis factor-α or interleukin-6, whose therapeutic associations with the inflammation storm in COVID-19 patients, and molecular binding model are further validated via data from PubMed publications, ongoing clinical trials and a docking program. In addition, the results on five biomedical applications suggest that DeepR2cov significantly outperforms five existing representation approaches. In summary, DeepR2cov is a powerful network representation approach and holds the potential to accelerate treatment of the inflammatory responses in COVID-19 patients. The source code and data can be downloaded from https://github.com/pengsl-lab/DeepR2cov.git.

[Clinical efficacy and safety of different antiviral regimens in patients with coronavirus disease 2019].

OBJECTIVE: To investigate the clinical efficacy and short-term and long-term adverse reactions for different antiviral regiments for coronavirus disease 2019 (COVID-19) in Ningxia Hui Autonomous Region during hospitalization and follow-up in 3 months. METHODS: A single-center retrospective study was conducted to enroll the COVID-19 patients in isolation ward of the only designated hospital to receive COVID-19 patients (the Fourth People's Hospital of Ningxia Hui Autonomous Region) when the authors were assigned by the Ningxia Health Commission as experts from January 20, 2020 to March 15, 2020. According to the antiviral regimen, the patients were divided into conventional antiviral group and unconventional antiviral group. The conventional antiviral group received α-interferon combined with Lopinavir/Ritonavir (LPV/R). The unconventional antiviral group was given α-interferon combined with LPV/R and Abidor or Ribavirin or Chloroquine. The patients were divided into mild (13 cases), ordinary (45 cases), severe (14 cases) and critical (1 case) types. The clinical data, length of hospital stay, the first 2019 novel coronavirus (2019-nCoV) nucleic acid negative recovery time, cost of hospitalization, 2019-nCoV nucleic acid positive reversal after 14 days of discharge, and the combination of hormones and antibiotics were collected. The differences in blood routine, liver function, blood lipid level and adverse reactions of antiviral drugs during hospitalization were compared between the two groups at 1, 3 and 7 days after admission and 1 and 3 months after discharge. RESULTS: (1) General information: a total of 75 patients with confirmed COVID-19 were admitted, and 73 patients were eventually enrolled, including 47 cases in the conventional antiviral group and 26 cases in the unconventional antiviral group. Patients with different clinical classification were analyzed, the higher the clinical classification and the patients' age, the higher the proportion of primary diseases and the cost of treatment, and the longer the length of hospital stay. Compared with conventional antiviral group, in unconventional antiviral group the percentage of severe and critical patients were higher [34.6% (9/26) vs. 10.6% (5/47), 3.8% (1/26) vs. 0 (0/47)], the length of hospital stay (days: 16.1±5.6 vs. 11.6±3.3), first nucleic acid negative recovery time (days: 12.4±4.5 vs. 10.0±3.5) were longer, and hospitalization cost was higher [Yuan: 11 984.2 (9 000.6, 24 424.7) vs. 8 140.4 (6 715.7,9 707.7)], with statistically significant differences (all P < 0.05). There were no significant differences in gender, age, proportion of patients with primary diseases and nucleic acid positive reversal rate after 14 days of discharge between the unconventional and conventional antiviral groups (all P > 0.05). (2) Laboratory tests: during the hospitalization, white blood cell count (WBC), platelet count (PLT), total bilirubin (TBil) and three acyl glycerin (TG) levels were first increased and then reduced, lymphocyte count (LYM) was first decreased and then increased in two groups. In the unconventional antiviral group, WBC [(6.53±2.78)×109/L], PLT [(250.77±96.12)×109/L], and TG [(1.94±0.96) µmol/L] all reached their peak values at 7 days after admission. TBil peaked at 3 days after admission, which was (23.69±12.14) µmol/L, and LYM reached the peak 1 month after discharge, which was (1.82±0.50)×109/L; however, there was no statistical significance among the above indicators between two groups. There were no statistically significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total cholesterol (TC) between the two groups at each time point. (3) The ratio of combined use of hormones in the non-antiviral group was significantly higher than that in the conventional antiviral group [26.9% (7/26) vs. 4.3% (2/47), P < 0.05]. CONCLUSIONS: Age and associated primary diseases are related to the severity of COVID-19 patients. Unconventional antiviral treatment regimens are mostly used for severe COVID-19 patients whose ucleic acid did not turn negative for a long time. Individual antiviral therapy can be used based on the patients' response and tolerance to drugs.

One Hundred Days of Coronavirus Disease 2019 Prevention and Control in China.

The epidemic of novel coronavirus disease was first reported in China in late December 2019 and was brought under control after some 2 months in China. However, it has become a global pandemic, and the number of cases and deaths continues to increase outside of China. We describe the emergence of the pandemic, detail the first 100 days of China's response as a phase 1 containment strategy followed by phase 2 containment, and briefly highlight areas of focus for the future. Specific, simple, and pragmatic strategies used in China for risk assessment, prioritization, and deployment of resources are described. Details of implementation, at different risk levels, of the traditional public health interventions are shared. Involvement of society in mounting a whole country response and challenges experienced with logistics and supply chains are described. Finally, the methods China is employing to cautiously restart social life and economic activity are outlined.

Network Representation Learning-Based Drug Mechanism Discovery and Anti-Inflammatory Response Against COVID-19 (preprint)

Recent studies have been demonstrated that the excessive inflammatory response is an important factor of death in COVID-19 patients. In this study, we proposed a network representation learning-based methodology, termed AIdrug2cov, to discover drug mechanism and anti-inflammatory response for patients with COVID-19. This work explores the multi-hub characteristic of a heterogeneous drug network integrating 8 unique networks. Inspired by the multi-hub characteristic, we design three billion special meta paths to train a deep representation model for learning low-dimensional vectors that integrate long-range structure dependency and complex semantic relation among network nodes. Using the representation vectors, AIdrug2cov identifies 40 potential targets and 22 high-confidence drugs that bind to tumor necrosis factor(TNF)-α or interleukin(IL)-6 to prevent excessive inflammatory responses in COVID-19 patients. Finally, we analyze mechanisms of action based on PubMed publications and ongoing clinical trials, and explore the possible binding modes between the new predicted drugs and targets via docking program. In addition, the results in 5 pharmacological application suggested that AIdrug2cov significantly outperforms 5 other state-of-the-art network representation approaches, future demonstrating the availability of AIdrug2cov in drug development field. In summary, AIdrug2cov is practically useful for accelerating COVID-19 therapeutic development. The source code and data can be downloaded from https://github.com/pengsl-lab/AIdrug2cov.git.

Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan.

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 µg/mL (interquartile range [IQR] 1.90-14.31 µg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 µg/mL; IQR, 7.12-21.66 vs median, 2.44 µg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.