ABSTRACT
For much of 2020, countries around the world fought against the COVID-19 pandemic. Many countries went into lockdown to control the fast spread of the virus. The unusual restrictions and confinement of the lockdown brought about new challenges for people's everyday lives. With flexibility, adaptability, and problem-solving at the core of its nature, creativity has the potential to help people cope with harsh and uncertain circumstances. Were people more, the same, or less creative in their everyday life during the period of lockdown, and in which ways? What are the emotions and motivations underlying their creative or non-creative behaviors? The current study aims to explore these questions from a cross-cultural perspective. A total of 754 comparable employee samples from three Chinese and three German cities were asked about their moods during the lockdown period, their self-rated level of creativity in daily lives before and during the lockdown, and their motivations behind their creative activities. Significant increases in creativity were observed in all everyday activities in both countries with only two exceptions in the German sample. Despite minor differences, a common pattern was found across cultures: whereas the activating positive mood could directly lead to the increase in creativity in some everyday activities, such a direct Mood-Creativity link was limited in the activating negative mood circumstances. In such circumstances, motivation intervened to enable the link to creativity. It was also found that this indirect effect of motivation between mood and creativity was more pronounced with the German participants.
ABSTRACT
BACKGROUND: Coronavirus disease 19 (COVID-19)-associated coagulopathy is a hallmark of disease severity and poor prognosis. The key manifestations of this prothrombotic syndrome-microvascular thrombosis, stroke, and venous and pulmonary clots-are also observed in severe and catastrophic antiphospholipid syndrome. Antiphospholipid antibodies (aPL) are detectable in COVID-19 patients, but their association with the clinical course of COVID-19 remains unproven. OBJECTIVES: To analyze the presence and relevance of lipid-binding aPL in hospitalized COVID-19 patients. METHODS: Two cohorts of 53 and 121 patients from a single center hospitalized for PCR-proven severe acute respiratory syndrome-coronavirus 2 infection were analyzed for the presence of aPL and clinical severity of COVID-19. RESULTS: We here demonstrate that lipid-binding aPL are common in COVID-19. COVID-19 patients with lipid-binding aPL have higher median concentrations of C-reactive protein and D-dimer, and are more likely to have a critical clinical course and fatal outcome. Lipid-binding aPL isolated from COVID-19 patients target the recently described cell surface complex of lysobisphosphatidic acid (LBPA) with the protein C receptor (EPCR) to induce prothrombotic and inflammatory responses in monocytes and endothelial cells. We show that B1a cells producing lipid-reactive aPL of the IgG isotype circulate in the blood of COVID-19 patients. In vivo, COVID-19 aPL accelerate thrombus formation in an experimental mouse model dependent on the recently delineated signaling pathway involving EPCR-LBPA. CONCLUSIONS: COVID-19 patients rapidly expand B1a cells secreting pathogenic lipid-binding aPL with broad thrombotic and inflammatory effects. The association with markers of inflammation and coagulation, clinical severity, and mortality suggests a causal role of aPL in COVID-19-associated coagulopathy.