Fractional modeling and optimal control strategies for mutated COVID‐19 pandemic

As the COVID‐19 continues to mutate, the number of infected people is increasing dramatically, and the vaccine is not enough to fight the mutated strain. In this paper, a SEIR‐type fractional model with reinfection and vaccine inefficacy is proposed, which can successfully capture the mutated COVID‐19 pandemic. The existence, uniqueness, boundedness, and nonnegativeness of the fractional model are derived. Based on the basic reproduction number R0$$ {R}_0 $$, locally stability and globally stability are analyzed. The sensitivity analysis evaluate the influence of each parameter on the R0$$ {R}_0 $$ and rank key epidemiological parameters. Finally, the necessary conditions for implementing fractional optimal control are obtained by Pontryagin's maximum principle, and the corresponding optimal solutions are derived for mitigation COVID‐19 transmission. The numerical results show that humans will coexist with COVID‐19 for a long time under the current control strategy. Furthermore, it is particularly important to develop new vaccines with higher protection rates. [ FROM AUTHOR] Copyright of Mathematical Methods in the Applied Sciences is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Treating SARS-CoV-2 Omicron variant infection by molnupiravir for pandemic mitigation and living with the virus: a mathematical modeling study.

Treating severe COVID-19 patients and controlling the spread of SARS-CoV-2 are concurrently important in mitigating the pandemic. Classically, antiviral drugs are primarily developed for treating hospitalized COVID-19 patients with severe diseases to reduce morbidity and/or mortality, which have limited effects on limiting pandemic spread. In this study, we simulated the expanded applications of oral antiviral drugs such as molnupiravir to mitigate the pandemic by treating nonhospitalized COVID-19 cases. We developed a compartmental mathematical model to simulate the effects of molnupiravir treatment assuming various scenarios in the Omicron variant dominated settings in Denmark, the United Kingdom and Germany. We found that treating nonhospitalized cases can limit Omicron spread. This indirectly reduces the burden of hospitalization and patient death. The effectiveness of this approach depends on the intrinsic nature of the antiviral drug and the strategies of implementation. Hypothetically, if resuming pre-pandemic social contact pattern, extensive application of molnupiravir treatment would dramatically (but not completely) mitigate the COVID-19 burden, and thus there remains lifetime cost of living with the virus.

Factors Affecting Patient Adherence to Inhalation Therapy: An Application of SEIPS Model 2.0.

Purpose: This study aims to explore factors that affect patient adherence to inhalation therapy by applying a patient-centered approach. Patients and Methods: We conducted a qualitative study to identify the factors that influence adherent behaviors among asthma/COPD patients. 35 semi-structured interviews with patients, and 15 semi-structured interviews with healthcare providers (HCPs) who manage asthma/COPD patients were conducted. The SEIPS 2.0 model was applied as a conceptual framework for guiding the interview content and analysis of the interview data. Results: Based on the findings of this study, a conceptual framework of patient adherence in asthma/COPD during inhalation therapy was constructed including five themes: person, task, tool, physical environment, and culture and society. Person-related factors include patient ability and emotional experience. Task-related factors refer to task type and frequency and flexibility. Tool-related factors are the type of inhalers and usability of inhalers. Physical environment-related factors include home environment and COVID-19 situation. Culture and social related factors consist of two aspects: cultural beliefs and social stigma. Conclusion: The findings of the study identified 10 influential factors that impact on patient adherence to inhalation therapy. A SEIPS-based conceptual model was constructed based on the responses of patients and HCPs to explore the experiences of patients engaging in inhalation therapy and interacting with inhalation devices. In particular, new insight about factors of emotional experience, physical environment and traditional cultural beliefs were found crucial for patients with Asthma/COPD to conduct patients' adherent behaviors.

Acceptance of COVID-19 vaccination and influencing factors among people living with HIV in Guangxi, China: a cross-sectional survey.

BACKGROUND: Vaccination has been proven to be an effective approach against the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to determine the acceptance rate and factors influencing acceptance of COVID-19 vaccination among people living with HIV (PLWH) in Guangxi, China. METHODS: A cross-sectional survey was carried out in five cities in Guangxi, China from May 7 to June 1, 2021. Questionnaires on the acceptance of COVID-19 vaccination and the related factors were conducted among PLWH recruited by simple random sampling. Univariate and multivariate logistic regression analyses were performed to identify factors associated with acceptance of COVID-19 vaccination. RESULTS: Of all valid respondents (n = 903), 72.9% (n = 658) were willing to receive COVID-19 vaccination. Fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was the main reason for being willing to receive vaccination (76.0%), while the main reasons for not willing were the concerns about vaccine safety (54.7%) and the vaccination's effect on antiretroviral therapy (ART) (50.6%). The most important factors influencing acceptance were the perception that vaccination is unsafe for HIV-infected people (aOR = 0.082, 95% CI = 0.024-0.282) and the poor efficacy in preventing SARS-CoV-2 infection in HIV-infected people (aOR = 0.093, 95% CI = 0.030-0.287). Other factors associated with acceptance included Zhuang ethnicity (aOR = 1.653, 95% CI = 1.109-2.465), highest education level of middle school, high school or above (aOR = 1.747, 95% CI = 1.170-2.608; aOR = 2.492, 95% CI = 1.326-4.682), and the vaccination having little effect on ART efficacy (aOR = 2.889, 95% CI = 1.378-6.059). CONCLUSIONS: Acceptance rate of the COVID-19 vaccination is relatively low among PLWH compared to the general population in China, although some patients refused vaccination due to concerns about vaccine safety and vaccination affecting ART efficacy. More research is needed to investigate the impact of the COVID-19 vaccines on ART efficacy and the effectiveness in preventing SARS-CoV-2 infection among PLWH.

Comparison of liver biochemical abnormality between COVID-19 patients with liver cirrhosis versus COVID-19 alone and liver cirrhosis alone: A STROBE observational study.

ABSTRACT: Coronavirus disease (COVID-19) patients frequently develop liver biochemical abnormality. However, liver biochemical abnormality in COVID-19 patients with liver cirrhosis is under-recognized.Patients hospitalized during COVID-19 pandemic in China (ie, from February to April 2020) were screened. All of 17 COVID-19 patients with liver cirrhosis consecutively admitted to the Wuhan Huoshenshan Hospital were identified. Meanwhile, 17 age-, sex-, and severity-matched COVID-19 patients without liver cirrhosis admitted to this hospital were selected as a control group; all of 14 cirrhotic patients without COVID-19 consecutively admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command were selected as another control group. Incidence of liver biochemical abnormality and decompensated events were primarily compared.Among the COVID-19 patients with liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 76.50% and 84.60%, respectively; 7 (41.20%) had decompensated events at admission; 1 was transferred to intensive care unit due to gastrointestinal bleeding. Among the COVID-19 patients without liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 58.80% (P = .271) and 60.00% (P = .150), respectively. Among the cirrhotic patients without COVID-19, the incidence of liver biochemical abnormality at admission and during hospitalization were 69.20% (P = .657) and 81.80% (P = .855), respectively; 11 (78.60%) had decompensated events at admission (P = .036). None died during hospitalization among the three groups.Liver biochemical abnormality is common in COVID-19 patients with liver cirrhosis. Management of decompensated events in cirrhotic patients without COVID-19 should not be neglected during COVID-19 pandemic.

A multi-regional, hierarchical-tier mathematical model of the spread and control of COVID-19 epidemics from epicentre to adjacent regions.

Epicentres are the focus of COVID-19 research, whereas emerging regions with mainly imported cases due to population movement are often neglected. Classical compartmental models are useful, however, likely oversimplify the complexity when studying epidemics. This study aimed to develop a multi-regional, hierarchical-tier mathematical model for better understanding the complexity and heterogeneity of COVID-19 spread and control. By incorporating the epidemiological and population flow data, we have successfully constructed a multi-regional, hierarchical-tier SLIHR model. With this model, we revealed insight into how COVID-19 was spread from the epicentre Wuhan to other regions in Mainland China based on the large population flow network data. By comprehensive analysis of the effects of different control measures, we identified that Level 1 emergency response, community prevention and application of big data tools significantly correlate with the effectiveness of local epidemic containment across different provinces of China outside the epicentre. In conclusion, our multi-regional, hierarchical-tier SLIHR model revealed insight into how COVID-19 spread from the epicentre Wuhan to other regions of China, and the subsequent control of local epidemics. These findings bear important implications for many other countries and regions to better understand and respond to their local epidemics associated with the ongoing COVID-19 pandemic.

Mental Health During the Covid-19 Outbreak in China: a Meta-Analysis.

BACKGROUND: Covid-19 has started to spread within China since the end of December 2019. Despite government's immediate actions and strict control, more and more people were infected every day. As such a contagious virus can spread easily and rapidly between people, the whole country was put into lockdown and people were forced into isolation. In order to understand the impact of Covid-19 on mental health well-being, Chinese researchers have conducted several studies. However, no consistent results were obtained. Therefore, a meta-analysis was conducted. METHODS: We searched Embase, PubMed, and Web of Science databases to find literature from December 2019 to April 2020 related to Covid-19 and mental health, among which results such as comments, letters, reviews and case reports were excluded. The incidence of anxiety and depression in the population was synthesized and discussed. RESULTS: A total of 27,475 subjects were included in 12 studies. Random effect model is used to account for the data. The results showed that the incidence of anxiety was 25% (95% CI: 0.19-0.32), and the incidence of depression was 28% (95% CI: 0.17-0.38). Significant heterogeneity was detected across studies regarding these incidence estimates. Subgroup analysis included the study population and assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity. CONCLUSIONS: Owing to the significant heterogeneity detected in studies regarding this pooled prevalence of anxiety and depression, we must interpret the results with caution. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system, which integrating epidemiological monitoring, screening and psychological crisis prevention and interventions.