Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support.

BACKGROUND: COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. METHODS: The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. RESULTS: Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01). CONCLUSION: Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

Coronavac inactivated vaccine triggers durable, cross-reactive Fc-mediated phagocytosis activities.

Although humoral responses elicited by infection or vaccine lost the ability to prevent transmission against Omicron, vaccine-induced antibodies may still contribute to disease attenuation through Fc-mediated effector functions. However, Fc effector function elicited by CoronaVac, as the most widely supplied inactivated vaccine globally, has not been characterized. For the first time, our study depicted Fc-mediated phagocytosis activity induced by CoronaVac, including antibody-dependent cellular phagocytosis (ADCP) and antibody-dependent neutrophil phagocytosis (ADNP) activities, and further compared with that from convalescent individuals and CoronaVac recipients with subsequent breakthrough infections. We showed that 2-dose of CoronaVac effectively induced both ADCP and ADNP, but was substantially lower compared to infection, whereas the booster dose further augmented ADCP and ADNP responses, and remained detectable for 52 weeks. Among CoronaVac recipients, ADCP and ADNP responses also demonstrated cross-reactivity against Omicron subvariants, and breakthrough infection could enhance the phagocytic response. Meanwhile, serum samples from vaccinees, convalescent individuals with wildtype infection, BA.2 and BA.5 breakthrough infection demonstrated differential cross-reactive ADCP and ADNP responses against Omicron subvariants, suggesting the different subvariants of spike antigen exposure might alter the cross-reactivity of Fc effector function. Further, ADCP and ADNP responses were strongly correlated with Spike-specific IgG responses and neutralizing activities, indicating coordinated neutralization activity, ADCP and ADNP responses triggered by CoronaVac. Of note, the ADCP and ADNP responses were more durable and cross-reactive than corresponding Spike-specific IgG titers and neutralizing activities. Our study has important implications for optimal boosting vaccine strategies that may induce potent and broad Fc-mediated phagocytic activities.

The Revision Trend of Rules of Medical Diagnosis and Treatment by Telecommunications and the Practice of Physician's Duty of Diagnosing in Person

There is no doubt that telemedicine has successfully played a pivotal role in response to the COVID-19 pandemic in Taiwan and abroad. In the post-pandemic era, Taiwan has announced the revision of the rules of medical diagnosis and treatment by telecommunications, which is expected to be implemented in 2023. Expanding special circumstances, increasing communication diagnosis and treatment items, relaxing prescriptions, and increasing information security regulations are mentioned. This article will explore whether the physician's diagnosis by himself or herself under Article 11 of the Physicians Act can break through the traditional face-to-face method, or introduce one of the methods that the United States and Japan have matured to regard telemedicine as a customary medical practice. On the basis of considering the patient's autonomous rights and best interests, moderately amend the physicians law or medical care act, and make good use of telemedicine.

Immunodominant SARS-CoV-2-specific CD4+ and CD8+ T-cell responses elicited by inactivated vaccines in healthy adults.

Safety profiles and humoral responses to inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been previously assessed, but cellular immune responses to inactivated SARS-CoV-2 vaccines remain understudied. Here, we report the comprehensive characteristics of SARS-CoV-2-specific CD4+ and CD8+ T-cell responses elicited by the BBIBP-CorV vaccine. A total of 295 healthy adults were recruited, and SARS-CoV-2-specific T-cell responses were detected after stimulation with overlapping peptide pools spanning the entire length of the envelope (E), membrane (M), nucleocapsid (N), and spike (S) proteins. Robust and durable CD4+ (p < 0.0001) and CD8+ (p < 0.0001) T-cell responses specific to SARS-CoV-2 were detected following the third vaccination, with an increase in specific CD8+ T-cells, compared to CD4+ T-cells. Cytokine profiles showed that interferon gamma and tumor necrosis factor-α were predominantly expressed with the negligible expression of interleukin (IL)-4 and IL-10, indicating a Th1- or Tc1-biased response. Compared to E and M proteins, N and S activated a higher proportion of specific T-cells with broader functions. The predominant frequency of the N antigen (49/89) was highest for CD4+ T-cell immunity. Furthermore, N19-36 and N391-408 were identified to contain dominant CD8+ and CD4+ T-cell epitopes, respectively. In addition, N19-36 -specific CD8+ T-cells were mainly effector memory CD45RA cells, whereas N391-408 -specific CD4+ T-cells were mainly effector memory cells. Therefore, this study reports comprehensive features of T-cell immunity induced by the inactivated SARS-CoV-2 vaccine BBIBP-CorV and proposes highly conserved candidate peptides which may be beneficial in vaccine optimization.

The Environmental Stability of SARS-CoV-2 Variants Omicron BA.1 and BA.5 on the Surfaces of Widely Used Transport Packaging Materials.

The increased transmissibility of SARS-CoV-2 variants of concern (VOCs) has raised questions regarding the environmental stability of these viruses. Although a prolonged survival time has been reported for SARS-CoV-2, how long new variants can persist on contaminated surfaces and how environmental factors affect the persistence time are not fully characterized. The present study provides a comprehensive assessment of the stability of Omicron variants BA.1 and BA.5, which are currently circulating strains, on the surfaces of widely used transport packaging materials. By monitoring viable virus detection over a 7-day period under different environmental conditions, it was found that the environmental stability of SARS-CoV-2 Omicron variants depended heavily on the surface type, temperature, and virus concentration. In addition, virus nucleic acid exhibited high stability on the material surface independent of whether viable virus was detected. These findings provide useful information for logistics practitioners and the general public to appropriately deal with transport items under different conditions to minimize the risk of epidemic transmission. IMPORTANCE This study shows the environmental stability of SARS-CoV-2 Variants Omicron BA.1 and BA.5 on surfaces of widely used transport packaging materials. The findings demonstrate that the environmental stability of the SARS-CoV-2 Omicron variants varies based on material type. The viability of SARS-CoV-2 on material surfaces depends heavily on temperature and viral titer. Low temperatures and high viral titers promote virus survival. Moreover, in contrast to virus viability, virus nucleic acid exhibits high stability on the surfaces of widely used materials, making the detection of virus nucleic acid unsuitable for evaluating the risk of epidemic transmission.

Mechanism of an RBM-targeted rabbit monoclonal antibody 9H1 neutralizing SARS-CoV-2.

The COVID-19 pandemic, caused by SARS-CoV-2, has led to over 750 million infections and 6.8 million deaths worldwide since late 2019. Due to the continuous evolution of SARS-CoV-2, many significant variants have emerged, creating ongoing challenges to the prevention and treatment of the pandemic. Therefore, the study of antibody responses against SARS-CoV-2 is essential for the development of vaccines and therapeutics. Here we perform single particle cryo-electron microscopy (cryo-EM) structure determination of a rabbit monoclonal antibody (RmAb) 9H1 in complex with the SARS-CoV-2 wild-type (WT) spike trimer. Our structural analysis shows that 9H1 interacts with the receptor-binding motif (RBM) region of the receptor-binding domain (RBD) on the spike protein and by directly competing with angiotensin-converting enzyme 2 (ACE2), it blocks the binding of the virus to the receptor and achieves neutralization. Our findings suggest that utilizing rabbit-derived mAbs provides valuable insights into the molecular interactions between neutralizing antibodies and spike proteins and may also facilitate the development of therapeutic antibodies and expand the antibody library.

SARS-CoV-2 Infection Causes Hyperglycemia in Cats.

Isolated reports of new-onset diabetes in patients with coronavirus disease 2019 (COVID-19) have led researchers to hypothesize that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects human exocrine and endocrine pancreatic cells ex vivo and in vivo. However, existing research lacks experimental evidence indicating that SARS-CoV-2 can infect pancreatic tissue. Here, we found that cats infected with a high dose of SARS-CoV-2 exhibited hyperglycemia. We also detected SARS-CoV-2 RNA in pancreatic tissues of these cats, and immunohistochemical staining revealed the presence of SARS-CoV-2 nucleocapsid protein (NP) in islet cells. SARS-CoV-2 NP and spike proteins were primarily detected in glucagon-positive cells, and most glucagon-positive cells expressed ACE2. Additionally, immune protection experiments conducted on cats showed that blood glucose levels of immunized cats did not increase postchallenge. Our data indicate cat pancreas as a SARS-CoV-2 target and suggest that the infection of glucagon-positive cells could contribute to the metabolic dysregulation observed in SARS-CoV-2-infected cats.

Coronavirus accessory protein ORF3 biology and its contribution to viral behavior and pathogenesis

Coronavirus porcine epidemic diarrhea virus (PEDV) is classified in the genus Alphacoronavirus, family Coronaviridae that encodes the only accessory protein, ORF3 protein. However, how ORF3 contributes to viral pathogenicity, adaptability, and replication is obscure. In this review, we summarize current knowledge and identify gaps in many aspects of ORF3 protein in PEDV, with emphasis on its unique biological features, including membrane topology, Golgi retention mechanism, potential intrinsic disordered property, functional motifs, protein glycosylation, and codon usage phenotypes relate to genetic evolution and gene expression. In addition, we propose intriguing questions related to ORF3 protein that we hope to stimulate further studies and encourage collaboration among virologists worldwide to provide constructive knowledge about the unique characteristics and biological functions of ORF3 protein, by which their potential role in clarifying viral behavior and pathogenesis can be possible. Graphical abstract

Evolving deep convolutional neutral network by hybrid sine-cosine and extreme learning machine for real-time COVID19 diagnosis from X-ray images.

The COVID19 pandemic globally and significantly has affected the life and health of many communities. The early detection of infected patients is effective in fighting COVID19. Using radiology (X-Ray) images is, perhaps, the fastest way to diagnose the patients. Thereby, deep Convolutional Neural Networks (CNNs) can be considered as applicable tools to diagnose COVID19 positive cases. Due to the complicated architecture of a deep CNN, its real-time training and testing become a challenging problem. This paper proposes using the Extreme Learning Machine (ELM) instead of the last fully connected layer to address this deficiency. However, the parameters' stochastic tuning of ELM's supervised section causes the final model unreliability. Therefore, to cope with this problem and maintain network reliability, the sine-cosine algorithm was utilized to tune the ELM's parameters. The designed network is then benchmarked on the COVID-Xray-5k dataset, and the results are verified by a comparative study with canonical deep CNN, ELM optimized by cuckoo search, ELM optimized by genetic algorithm, and ELM optimized by whale optimization algorithm. The proposed approach outperforms comparative benchmarks with a final accuracy of 98.83% on the COVID-Xray-5k dataset, leading to a relative error reduction of 2.33% compared to a canonical deep CNN. Even more critical, the designed network's training time is only 0.9421 ms and the overall detection test time for 3100 images is 2.721 s.

Mechanism of a rabbit monoclonal antibody broadly neutralizing SARS-CoV-2 variants.

Due to the continuous evolution of SARS-CoV-2, the Omicron variant has emerged and exhibits severe immune evasion. The high number of mutations at key antigenic sites on the spike protein has made a large number of existing antibodies and vaccines ineffective against this variant. Therefore, it is urgent to develop efficient broad-spectrum neutralizing therapeutic drugs. Here we characterize a rabbit monoclonal antibody (RmAb) 1H1 with broad-spectrum neutralizing potency against Omicron sublineages including BA.1, BA.1.1, BA.2, BA.2.12.1, BA.2.75, BA.3 and BA.4/5. Cryo-electron microscopy (cryo-EM) structure determination of the BA.1 spike-1H1 Fab complexes shows that 1H1 targets a highly conserved region of RBD and avoids most of the circulating Omicron mutations, explaining its broad-spectrum neutralization potency. Our findings indicate 1H1 as a promising RmAb model for designing broad-spectrum neutralizing antibodies and shed light on the development of therapeutic agents as well as effective vaccines against newly emerging variants in the future.

Coronavirus accessory protein ORF3 biology and its contribution to viral behavior and pathogenesis.

Coronavirus porcine epidemic diarrhea virus (PEDV) is classified in the genus Alphacoronavirus, family Coronaviridae that encodes the only accessory protein, ORF3 protein. However, how ORF3 contributes to viral pathogenicity, adaptability, and replication is obscure. In this review, we summarize current knowledge and identify gaps in many aspects of ORF3 protein in PEDV, with emphasis on its unique biological features, including membrane topology, Golgi retention mechanism, potential intrinsic disordered property, functional motifs, protein glycosylation, and codon usage phenotypes related to genetic evolution and gene expression. In addition, we propose intriguing questions related to ORF3 protein that we hope to stimulate further studies and encourage collaboration among virologists worldwide to provide constructive knowledge about the unique characteristics and biological functions of ORF3 protein, by which their potential role in clarifying viral behavior and pathogenesis can be possible.

Potential core genes associated with COVID-19 identified via weighted gene co-expression network analysis.

AIMS: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus belonging to the Coronaviridae family that causes coronavirus disease (COVID-19). This disease rapidly reached pandemic status, presenting a serious threat to global health. However, the detailed molecular mechanism contributing to COVID-19 has not yet been elucidated. METHODS: The expression profiles, including the mRNA levels, of samples from patients infected with SARS-CoV-2 along with clinical data were obtained from the GSE152075 dataset in the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was used to identify co-expression modules, which were then implemented to evaluate the relationships between fundamental modules and clinical traits. The differentially expressed genes (DEGs), gene ontology (GO) functional enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were evaluated using R software packages. RESULTS: A total of 377 SARS-CoV-2-infected samples and 54 normal samples with available clinical and genetic data were obtained from the GEO database. There were 1444 DEGs identified between the sample types, which were used to screen out 11 co-expression modules in the WGCNA. Six co-expression modules were significantly associated with three clinical traits (SARS-CoV-2 positivity, age, and sex). Among the DEGs in two modules significantly correlated with SARS-CoV-2 positivity, enrichment was observed in the biological process of viral infection strategies (viral translation) in the GO analysis. The KEGG signalling pathway analysis demonstrated that the DEGs in the two modules were commonly enriched in oxidative phosphorylation, ribosome, and thermogenesis pathways. Moreover, a five-core gene set (RPL35A, RPL7A, RPS15, RPS20, and RPL17) with top connectivity with other genes was identified in the SARS-CoV-2 infection modules, suggesting that these genes may be indispensable in viral transcription after infection. CONCLUSION: The identified core genes and signalling pathways associated with SARS-CoV-2 infection can significantly supplement the current understanding of COVID-19. The five core genes encoding ribosomal proteins may be indispensable in viral protein biosynthesis after SARS-CoV-2 infection and serve as therapeutic targets for COVID-19 treatment. These findings can be used as a basis for creating a hypothetical model for future experimental studies regarding associations of SARS-CoV-2 infection with ribosomal protein function.

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital.

Aim: COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods: A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results: Three latent profiles were identified-low security (Class 1), moderate security (Class 2), and high security (Class 3)-accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3; Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions: Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.

Real-world COVID-19 vaccine effectiveness against the Omicron BA.2 variant in a SARS-CoV-2 infection-naive population.

The SARS-CoV-2 Omicron variant has demonstrated enhanced transmissibility and escape of vaccine-derived immunity. Although first-generation vaccines remain effective against severe disease and death, robust evidence on vaccine effectiveness (VE) against all Omicron infections, irrespective of symptoms, remains sparse. We used a community-wide serosurvey with 5,310 subjects to estimate how vaccination histories modulated risk of infection in infection-naive Hong Kong during a large wave of Omicron BA.2 epidemic in January-July 2022. We estimated that Omicron infected 45% (41-48%) of the local population. Three and four doses of BNT162b2 or CoronaVac were effective against Omicron infection 7 days after vaccination (VE of 48% (95% credible interval 34-64%) and 69% (46-98%) for three and four doses of BNT162b2, respectively; VE of 30% (1-66%) and 56% (6-97%) for three and four doses of CoronaVac, respectively). At 100 days after immunization, VE waned to 26% (7-41%) and 35% (10-71%) for three and four doses of BNT162b2, and to 6% (0-29%) and 11% (0-54%) for three and four doses of CoronaVac. The rapid waning of VE against infection conferred by first-generation vaccines and an increasingly complex viral evolutionary landscape highlight the necessity for rapidly deploying updated vaccines followed by vigilant monitoring of VE.

Repeated COVID-19 Relapse of an Imported Patient Infected with SARS-CoV-2 Delta Variant of Concern.

BACKGROUND: Repeated re-positive of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) B.1.617.2 (Delta) variants of concern (VOC) in recovered coronavirus disease 2019 (COVID-19) patients have not been reported yet. METHODS: We reported a rare case of repeated COVID-19 relapse during the post-discharge surveillance. RESULTS: This case had long-term viral shedding for 79 days. CONCLUSIONS: This case highlights that longer observation and isolation periods need be considered for patients with SARS-CoV-2 delta VOC infection.

The relationship between perceived organizational support and insomnia in Chinese nurses: The Serial multiple mediation analysis.

Background: Nurses are in high-pressure, high-load, and high-risk environment for a long time, and their insomnia cannot be ignored. Insomnia not only has a negative impact on the physical and mental health of nurses, but also on the efficiency and quality of nursing work. Objective: The purpose of this study was to investigate the multiple mediating effect of psychological capital, effort-reward ratio, and overcommitment in the relationship between perceived organizational support and insomnia among Chinese nurses. Methods: A cross-sectional study has been carried out in a tertiary grade A hospital in Shandong Province, China from March 2021 to May 2021. The demographic questionnaire, Perceived Organization Support Questionnaire, Psychological Capital Questionnaire, Chinese version Effort-Reward Imbalance, Questionnaire and Athens Insomnia Scale were used for data collection. SPSS PROCESS 3.4 macro program developed by Hayes was used to test the serial multiple mediation. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson's correlation analyses, ordinary least-squares regression, and the bootstrap method were used for data analysis. Results: 658 valid questionnaires were collected (81.2%). Nurses' perceived organizational support was positively correlated with psychological capital (r = 0.455, p < 0.001), and was significantly negatively correlated with effort-reward ratio (r = -0.318, p < 0.001), overcommitment (r = -0.328, p < 0.001), and insomnia (r = -0.358, p < 0.001); Psychological capital was negatively correlated with effort-reward ratio (r = -0.275, p < 0.001), overcommitment (r = -0.339, p < 0.001), and insomnia (r = -0.402, p < 0.001), respectively; effort-reward ratio and overcommitment were significantly positively correlated with insomnia (r = 0.379, p < 0.001; r = 0.466, p < 0.001), respectively. In the model of perceived organizational support-psychological capital-effort-reward ratio-insomnia, the overall mediating effect was -0.080 (95%CI: -0.109 ~ -0.058), and the mediating effect of psychological capital was -0.050, accounting for 34.30% of the total effect; the mediating effect of effort-reward ratio was -0.024, accounting for 16.49% of the total effect; the chain mediating effect of psychological capital and effort-reward ratio was -0.007, accounting for 4.49% of the total effect. In the model of perceived organizational support-psychological capital-overcommitment-insomnia, the overall mediating effect was -0.085 (95%CI: -0.109 ~ -0.064), and the mediating effect of psychological capital was -0.042, accounting for 28.64% of the total effect; the mediating effect of overcommitment was -0.029, accounting for 19.81% of the total effect; the chain mediating effect of psychological capital and overcommitment was -0.015, accounting for 10.14% of the total effect. Conclusion: Perceived organizational support had direct negative influence on insomnia. Psychological capital and effort-reward ratio/overcommitment acted as chained mediating factor could partially relieve insomnia symptoms related to perceived organizational support. It is suggested to improve the level of organizational support and psychological capital of nurses, and reduce the effort-reward imbalance and overcommitment of nurses, so as to effectively decline and deal with nurses' insomnia.

A qualitative exploration of progress, challenges, and opportunities in community nutrition services in Taiwan

Objectives: In 2018, Taiwan's Health Promotion Administration funded the establishment of community nutrition centers in various cities and counties to prevent frailty among community older adults. This study investigated the current suite of community nutrition services and the challenges and opportunities therein. Methods: In total, 17 community dietitians from 14 counties/cities and 5 professional community health workers were interviewed. These community dietitians and community health workers underwent design thinking training, and its effects were evaluated. Results: (1) Services: The community dietitians reported that the current services provided by the community nutrition centers include older adult nutrition screening and surveys, nutrition education, consultations aimed at helping community centers and restaurants to establish healthy food environments, nutrition promotion, and the recruitment of dietitians and other personnel. (2) Challenges: The community dietitians reported that the challenges included a lack of human resources, a lack of reliable and valid dietary questionnaires, overly large variations in older adult-related nutrition needs and resources across multiple areas, difficulties in implementing nutrition education at an intensive and large-scale level, difficulties in evaluating the effects of nutrition education, obstacles in collaborations with other sectors, low uptake in dietitian recruitment, and difficulties in coping with the COVID-19 pandemic. (3) Opportunities: The professional community health workers suggested strengthening community nutrition promotion, providing nutrition-related experiential learning opportunities, establishing collaborations among multiple sectors, presenting and promoting the community nutrition achievements of the centers, and applying design thinking to promote community nutrition services. The evaluation of the design thinking training intervention revealed its positive effects on increasing the knowledge, attitudes, and performance of community health workers and their intention to apply design thinking. Conclusions: Taiwan's community nutrition centers play a key role in reinforcing healthy eating habits among older adults. This study provided insights regarding the challenges and opportunities pertaining to the promotion of community nutrition services. (Taiwan J Public Health. 2022;41(5):524-537)

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital

Aim COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results Three latent profiles were identified—low security (Class 1), moderate security (Class 2), and high security (Class 3)—accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3;Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.

Clinical features and viral etiology of acute respiratory infection in an outpatient fever clinic during COVID-19 pandemic in a tertiary hospital in Nanjing, China.

BACKGROUND: Clinical feature and viral etiology for acute respiratory infection (ARI) in the community was unknown during coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: In a retrospective study, we aimed to characterize the clinical feature and etiology for the ARI patients admitted to the outpatient fever clinic in Nanjing Drum Tower Hospital between November 2020 and March 2021. METHODS: Fifteen common respiratory pathogens were tested using pharyngeal swabs by multiplex reverse transcriptase-polymerase chain reaction assays. RESULTS: Of the 242 patients, 56 (23%) were tested positive for at least one viral agent. The predominant viruses included human rhinovirus (HRV) (5.4%), parainfluenza virus type III (PIV-III) (5.0%), and human coronavirus-NL63 (HCoV-NL63) (3.7%). Cough, sputum, nasal obstruction, and rhinorrhea were the most prevalent symptoms in patients with viral infection. Elderly and the patients with underlying diseases were susceptible to pneumonia accompanied with sputum and chest oppression. Three (5.4%) patients in virus infection group, whereas 31 (16.7%) in non-viral infection group (p = 0.033), were empirically prescribed with antiviral agents. Among 149 patients who received antibiotic therapy, 30 (20.1%) patients were later identified with viral infection. CONCLUSION: Our study indicated the importance of accurate diagnosis of ARI, especially during the COVID-19 pandemic, which might facilitate appropriate clinical treatment.