Real-world effectiveness of Azvudine in hospitalized patients with COVID-19: a retrospective cohort study (preprint)

Current guidelines prioritize the use of the Azvudine in coronavirus disease 2019 (COVID-19) patients. However, the clinical effectiveness of Azvudine in real-world studies was lacking, despite the clinical trials showed shorter time of nucleic acid negative conversion. To evaluate the clinical effectiveness following Azvudine treatment in hospitalized COVID-19 patients, we identified 1505 hospitalized COVID-19 patients during the study period, with a follow-up of up to 29 days. After exclusions and propensity score matching, we included 226 Azvudine recipients and 226 matched controls. The lower crude incidence rate of composite disease progression outcome (4.21 vs. 10.39 per 1000 person-days, P=0.041) and all-cause mortality (1.57 vs. 6.00 per 1000 person-days, P=0.027) were observed among Azvudine recipients compared with matched controls. The incidence rates of initiation of invasive mechanical ventilation were also statistically different between the groups according to the log-rank tests (P=0.020). Azvudine treatment was associated with significantly lower risks of composite disease progression outcome (hazard ratio [HR]: 0.43; 95% confidence interval [CI]: 0.18 to 0.99) and all-cause death (HR: 0.26; 95% CI: 0.07 to 0.94) compared with matched controls. Subgroup analyses indicated robustness of the point estimates of HRs (ranged from 0.14 to 0.84). Notably, male Azvudine recipients had a stronger effectiveness than female recipients with respect to both composite outcome and all-cause death. These findings suggest that Azvudine treatment showed substantial clinical benefits in hospitalized COVID-19 patients, and should be considered for use in this population of patients.

Real-world effectiveness of Azvudine in hospitalized patients with COVID-19: a retrospective cohort study (preprint)

Current guidelines prioritize the use of the Azvudine in coronavirus disease 2019 (COVID-19) patients. However, the clinical effectiveness of Azvudine in real-world studies was lacking, despite the clinical trials showed shorter time of nucleic acid negative conversion. To evaluate the clinical effectiveness following Azvudine treatment in hospitalized COVID-19 patients, we identified 1505 hospitalized COVID-19 patients during the study period, with a follow-up of up to 29 days. After exclusions and propensity score matching, we included 226 Azvudine recipients and 226 matched controls. The lower crude incidence rate of composite disease progression outcome (4.21 vs. 10.39 per 1000 person-days, P=0.041) and all-cause mortality (1.57 vs. 6.00 per 1000 person-days, P=0.027) were observed among Azvudine recipients compared with matched controls. The incidence rates of initiation of invasive mechanical ventilation were also statistically different between the groups according to the log-rank tests (P=0.020). Azvudine treatment was associated with significantly lower risks of composite disease progression outcome (hazard ratio [HR]: 0.43; 95% confidence interval [CI]: 0.18 to 0.99) and all-cause death (HR: 0.26; 95% CI: 0.07 to 0.94) compared with matched controls. Subgroup analyses indicated robustness of the point estimates of HRs (ranged from 0.14 to 0.84). Notably, male Azvudine recipients had a stronger effectiveness than female recipients with respect to both composite outcome and all-cause death. These findings suggest that Azvudine treatment showed substantial clinical benefits in hospitalized COVID-19 patients, and should be considered for use in this population of patients.

Advances in the use of nanomaterials for nucleic acid detection in point-of-care testing devices: A review

The outbreak of the coronavirus (COVID-19) has heightened awareness of the importance of quick and easy testing. The convenience, speed, and timely results from point-of-care testing (POCT) in all vitro diagnostic devices has drawn the strong interest of researchers. However, there are still many challenges in the development of POCT devices, such as the pretreatment of samples, detection sensitivity, specificity, and so on. It is anticipated that the unique properties of nanomaterials, e.g., their magnetic, optical, thermal, and electrically conductive features, will address the deficiencies that currently exist in POCT devices. In this review, we mainly analyze the work processes of POCT devices, especially in nucleic acid detection, and summarize how novel nanomaterials used in various aspects of POCT products can improve performance, with the ultimate aims of offering new ideas for the application of nanomaterials and the overall development of POCT devices.

Determination of a reasonable threshold of total bilirubin for the diagnosis of hepatitis B virus- associated acute -on - chronic liver failure. (Theme Issue: New progress in the treatment of hepatobiliary tumors in the new era of immunotherapy.) [Chinese]

Objective: To investigate a reasonable threshold d total bilirubin for the diagnosis of hepatitis B virus - related acute - on -chronic liver failure (HBV - ACLF), and to realize accurate early diagnosis.

Successful combinatorial therapy of sirolimus and neuraminidase inhibitors in a patient with highly pathogenic avian influenza A (H5N6) virus: a case report

Background Highly pathogenic avian influenza A (H5N6) virus poses a continuous threat to human health since 2014. Although neuraminidase inhibitors (NAIs) are prescribed in most patients infected with the H5N6 virus, the fatality remains high, indicating the need for an improved treatment regimen. Sirolimus, an inhibitor of the mammalian target of rapamycin (mTOR), has been reported to reduce viral replication and improve clinical outcomes in severe H1N1 infections when combined with oseltamivir. Here, we report the first case of severe H5N6 pneumonia successfully treated by sirolimus and NAIs. Case Description A 22-year-old man developed high fever and chills on September 24, 2018 (Day-0) and was hospitalized on Day-3. Influenza A (H5N6) was identified on Day-6 from a throat swab specimen. Despite the administration of NAIs and other supportive measures, the patient’s clinical conditions and lung images showed continued deterioration, accompanied by persistently high viral titers. Consequently, sirolimus administration (rapamycin;2 mg per day for 14 days) was started on Day-12. His PaO2/FiO2 values and Sequential Organ Failure Assessment (SOFA) score gradually improved, and imaging outcomes revealed the resolution of bilateral lung infiltrations. The viral titer gradually decreased and turned negative on Day-25. Sirolimus and NAIs were stopped on the same day. The patient was discharged on Day-65. Based on observations from a 2-year follow-up, the patient was found to be in a good condition without complications. Conclusions In conclusion, sirolimus might be a novel and practical therapeutic approach to severe H5N6-associated pneumonia in humans.

Facile fabrication of phenylenediamine residue derived N, O co-doped hierarchical hyperporous carbon for high-efficient chloroxylenol removal

The chloroxylenol (PCMX) has shown well virucidal efficacy against COVID-19, but the large-scale utilization of which will undoubtedly pose extra environmental threaten. In the present study, the recycled industrial phenylenediamine residue was used and an integrated strategy of “carbonization-casting-activation” using super low-dose of activator and templates was established to achieve in-situ N/O co-doping and facile synthesis of a kind of hierarchical hyperporous carbons (HHPC). The sample of HHPC-1.25-0.5 obtained with activator and template to residue of 1.25 and 0.5 respectively shows super-high specific surface area of 3602 m2/g and volume of 2.81 cm3/g and demonstrates remarkable adsorption capacity of 1475 mg/g for PCMX in batch and of 1148 mg/g in dynamic column adsorption test. In addition, the HHPC-1.25-0.5 exhibits excellent reusability and tolerance for PCMX adsorption under various ionic backgrounds and real water matrix conditions. The combined physio-chemistry characterization, kinetic study and DFT calculation reveal that the enhanced high performances originate from the hierarchical pore structure and strong electrostatic interaction between PCMX and surface rich pyridinic-N and carbonyl groups.

Reopen Schools Safely: Simulating COVID-19 Transmission on Campus With a Contact Network Agent-based Model (preprint)

Background: As phases of COVID-19 vaccination are quickly rolling out, how to evaluate the vaccination effects and then make safe reopening plans has become a prime concern for local governments and school officials.Methods: We develop a contact network agent-based model (CN-ABM) to simulate on-campus disease transmission scenarios at the micro-scale. The CN-ABM establishes a contact network for each agent based on their daily activity pattern, evaluates the agent's health status change in different activity environments, and then simulates the epidemic curve on campus. Based on the developed model, we identify how different community risk levels, teaching modalities, and vaccination rates would shape the epidemic curve. Results: The results show that in scenarios where vaccination is not available, restricting on-campus students to under 50% can largely flatten the epi curve (peak value < 2%); and the best result (peak value < 1%) can be achieved by limiting on-campus students to less than 25%. In scenarios where vaccination is available, it is suggested to maintain a maximum of 75% on-campus students and a vaccination rate of at least 45% to suppress the curve (peak value < 2%); and the best result (peak value < 1%) can be achieved at a vaccination rate of 65%. The study also derives the transmission chain of infectious agents, which can be used to identify high-risk activity environments. Conclusions: The developed CN-ABM model can be employed to evaluate the health outcome of COVID-19 outbreaks on campus based on different disease transmission scenarios. It can assist local government and school officials with developing proactive intervention strategies to safely reopen schools. 

Reopening International Borders without Quarantine: Contact Tracing Integrated Policy against COVID-19 (preprint)

With the COVID-19 vaccination widely implemented in most countries, propelled by the need to revive the tourism economy, there is a growing prospect for relieving the social distancing regulation and reopening borders in tourism-oriented countries and regions. The need incentivizes stakeholders to develop border control strategies that fully evaluate health risks if mandatory quarantines are lifted. In this study, we have employed a computational approach to investigate the contact tracing integrated policy in different border reopening scenarios in Hong Kong, China. Built on a modified SEIR epidemic model with a 30% vaccination coverage, the results suggest that scenarios with digital contact tracing and quick isolation intervention can reduce the infectious population by 92.11% compared to those without contact tracing. By further restricting the inbound population with a 10,000 daily quota and applying moderate-to-strong community non-pharmacological interventions (NPIs), the average daily confirmed cases in the forecast period of 60 days can be well controlled at around 9 per day (95% CI: 7-12). Two main policy recommendations are drawn from the study. First, digital contact tracing would be an effective countermeasure for reducing local virus spread, especially when it is applied along with a moderate level of vaccination coverage. Second, implementing a daily quota on inbound travelers and restrictive community NPIs would further keep the local infection under control. This study offers scientific evidence and prospective guidance for developing and instituting plans to lift mandatory border control policies in preparing for the global economic recovery.

Evaluation of vertical transmission of SARS-CoV-2 in utero: nine pregnant women and their newborns (preprint)

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mainly transmitted by droplets and close contact, has caused a pandemic worldwide as of November 2020. According to the current case reports and cohort studies, the symptoms of pregnant women infected with SARS-CoV-2 were similar to normal adults and may cause a series of adverse consequences of pregnancy (placental abruption, fetal distress, epilepsy during pregnancy, etc.). However, whether SARS-CoV-2 can be transmitted to the fetus through the placental barrier is still a focus of debate. MethodsIn this study, in order to find out whether SARS-CoV-2 infect fetus through placental barrier, we performed qualitative detection of virus structural protein (spike protein and nucleoprotein) and targeted receptor protein (ACE2, CD147 and GRP78) expression on the placental tissue of seven pregnant women diagnosed with COVID-19 through immunohistochemistry. Amniotic fluid, neonatal throat, anal swab and breastmilk samples were collected immediately in the operating room for verification after delivery, which were all tested for SARS-CoV-2 by reverse transcriptionpolymerase chain reaction (RT-PCR). ResultsThe result showed that CD147 was expressed on the basal side of the chorionic trophoblast cell membrane and ACE2 was expressed on the maternal side, while GRP78 was strongly expressed in the cell membrane and cytoplasm. The RT-PCR results of Amniotic fluid, neonatal throat, anal swab and breastmilk samples were all negative. ConclusionsWe believed that despite the detection of viral structural proteins in the placenta, SARS-CoV-2 cannot be transmitted to infants due to the presence of the placental barrier. SummaryOur results showed that, excluding environmental pollution after birth and vaginal infection during childbirth, SARS-CoV-2 was less likely to be transmitted vertically in utero.

Maternal Outcomes and Risk Factors for Severity Among Pregnant Women With COVID-19: A Case Control Study From the COVI-Preg International Registry (preprint)

Background: Recent evidence suggests that pregnant women might be at higher risk of severe disease associated with the emerging pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while exposed fetuses/newborns could suffer from preterm birth, growth restriction and neonatal infections. The magnitude of this increased risk and specific risk factors for severity remains unclear.Methods: We performed a case control study comparing pregnant women with severe coronavirus disease 19 (case) to pregnant women with a milder form (controls) enrolled in COVI-Preg international registry cohort between from March 24 to July 26, 2020. Risk factors for severity, obstetrical, fetal and neonatal outcomes were assessed.Findings: A total of 926 pregnant women with a positive test for SARS-CoV-2 were included, among which 92 (9.9%) presented a severe COVID-19 disease. Risk factors for severe maternal outcomes were pulmonary comorbidities [aOR 4.3, 95% CI 1.9-9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0-7.0] and diabetes [aOR2.2, 95% CI 1.1-4.5]. Pregnant women with severe maternal outcomes were at higher risk of cesarean sections [70.7% (n=53/75)], preterm deliveries [62.7% (n= 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n=31/75)].Interpretation: Pregnant women, particularly those with associated comorbidities, seem to be at higher risk of severe complications of SARS-CoV-2 infection. Obstetrical and neonatal outcomes appear to be influenced by the severity of maternal disease; complications include cesarean sections, prematurity and neonatal admission to the intensive care unit.Funding Statement: None.Declaration of Interests: The authors declare that they have no conflicts of interest.Ethics Approval Statement: The study was approved by both the Swiss Ethical Board (CER-VD- 2020-00548) and the local ethics boards at each participating center.

Maternal and Obstetrical Outcomes in a Cohort of Pregnant Women Tested for SARS-CoV-2: Interim Results of the COVI-Preg International Registry (preprint)

Background: Pregnant women represent a vulnerable population at higher risk of complications of infectious diseases. Data regarding the consequences of the emerging pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy are scarce. Recent evidence suggests that pregnant women might be at higher risk of severe disease, while exposed fetuses and newborns could suffer from preterm birth, growth restriction and neonatal infections.Methods: We developed an international web registry to allow structured data collection. Pregnant women at any stage during gestation tested for SARS-CoV-2 infection were enrolled. Maternal, obstetrical and neonatal outcomes were recorded.Findings: 1033 pregnant women tested for SARS-CoV-2 were included, among which 926 tested positive and 107 tested negative. Positive pregnant women were at higher risk of severe maternal outcomes compared to negative women [aRR 5.6, 95% CI 1.4-22.7]. Risk factors for severe maternal outcomes among positive women were pulmonary comorbidities [aOR 4.3, 95% CI 1.9-9.5], hypertensive disorders [aOR 2.7, 95% CI 1.0-7.0] and diabetes [aOR2.2, 95% CI 1.1-4.5]. No difference in term of obstetrical and neonatal outcomes were observed between positive and negative women. Positive pregnant women with severe maternal outcomes were at higher risk of cesarean sections [70.7% (n=53/75)], preterm deliveries [62.7% (n= 32/51)] and newborns requiring admission to the neonatal intensive care unit [41.3% (n=31/75)]. A positive neonatal SARS-CoV-2 test was observed in 2.9% (n=11/384) of newborns with an available test at birth.Interpretation: Pregnant women, particularly those with associated comorbidities, seem to be at higher risk of severe complications of SARS-CoV-2 infection. Preliminary data regarding obstetrical and neonatal outcomes among women with a mild disease are reassuring.Funding Statement: None.Declaration of Interests: The authors declare that we have no conflicts of interest.Ethics Approval Statement: The study was approved by both the Swiss Ethical Board (CER-VD-2020-00548) and the local ethics boards at each participating center.

Number of Pre-Existing Comorbidities and Prognosis of COVID-19: A Retrospective Cohort Study (preprint)

Background: Though many studies have described the association of COVID-19 and different kinds of noncommunicable chronic diseases, information with the combine effects of comorbidities to COVID-19 patients have not been well characterized yet. The aim of this study was to examine the associations of numbers of comorbidities with critical type and death of COVID-19.Methods: This was a single-centered retrospective study among patients with COVID-19. All patients with COVID-19 enrolled in this study were diagnosed according to World Health Organization interim guidance. Six different kinds of noncommunicable chronic diseases were included in this study. The logistic regression model was used to estimate the fixed effect of numbers of comorbidities on critical type or death, adjusting for potential confounders.Results: In total, 475 COVID-19 patients were enrolled in our study, included 234 females and 241 males. Hypertension was the most frequent type (162 [34.1%] of 475 patients). Patients with two or more comorbidities have higher risk of critical type (OR 3.072, 95% CI [1.581, 5.970], p=0.001) and death (OR 5.538, 95% CI [1.577, 19.451], p=0.008) compared to patients without comorbidities. And the results were similar after adjusting for age and gender in critical type (OR 2.021, 95% CI [1.002–4.077], p=0.049) and death (OR 3.653, 95% CI [0.989, 13.494], p=0.052).Conclusions: The number of comorbidities was an independent risk factor for critical type and death in COVID-19 patients.

Risk Assessment of COVID-19 Based on Multisource Data from a Geographical Viewpoint

In June 4, 2020, Corona Virus Disease 2019(COVID-19) cases in Wuhan were cleared, and the epidemic situation was basically controlled. Such public safety infectious disease includes influences great pressure on the national economy. At present, some countries and regions in the world are still in epidemic situation, and there is an urgent need to judge the infection situation and travel risk in the region. In a relatively fine scale down to perceive the surrounding situation, and then rational zoning decisions to promote the resumption of production and work. In this study, indicators for the evaluation of COVID-19 epidemic were constructed using multi-sourced data. A computational evaluation of 736 fine-grained grids was performed using the GeoDetector model and the decision tree model. The study found that the risk level in older neighborhoods was much higher than in newer neighborhoods;the population density was the most important determinant of infection;the number of urban people slumped to 37% of that in usual times according to Tencent data after the 'city closure';The model this paper used portrays the major factor in defining low-risk areas and high-risk areas, and offers suggestions and assessment from a geographical perspective to fight COVID-19, thus presenting great practical value.

Coexisting illness and COVID-19 (preprint)

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread throughout worldwide. Hypertension, diabetes, cardiovascular disease, and cerebrovascular disease were the most common coexisting illness among patients with severe SARS-CoV-2 infection. We aim to analyze the effect of them on the result of laboratory finding in patients with severe or critical SARS-CoV-2 infection.Methods: The date of a total of 49 patients who met the inclusion criteria from January 12 to March 20, 2020, from the first affiliated hospital of Harbin medical university were analyzed in our study.Results: Compared with patients without any coexisting illness, we found that PT levels were decreased in patients with cerebrovascular disease, hypertension or cardiovascular disease, and D-Dimer levels were decreased in patients with cerebrovascular disease, hypertension or diabetes. Similarly, LDH and ALT levels were lower in patients with cerebrovascular disease than that without any coexisting illness.Conclusions: Hypertension, diabetes, cardiovascular disease, and cerebrovascular disease are associated with an increased disease severity and risk of death in patients with COVID-19. Recently study also reported that the levels of PT, D-dimer, and LDH were increased and predicted the deterioration of disease in severe patients with SARS-CoV-2 infection.  Interestingly, our results demonstrate that the levels of laboratory indicators such as PT, D-dimer, LDH and ALT were decreased in patients with coexisting illness than without any coexisting illness. It may give us the inaccurate result when we use those laboratory indicators to predict the deterioration of the patients and we need to pay more attention to it.

Adopting STING agonist cyclic dinucleotides as a potential adjuvant for SARS-CoV-2 vaccine (preprint)

A novel STING agonist CDGSF unilaterally modified with phosphorothioate and fluorine was synthesized. CDGSF displayed better STING activity over dithio CDG. Immunization of SARS-CoV-2 Spike protein with CDGSF as an adjuvant elicited an exceptional high antibody titer and a robust T cell response, which were better than the group using aluminium hydroxide as a adjuvant. These results highlighted the adjuvant potential of STING agonist in SARS-CoV-2 vaccine preparation for the first time.

Turning rural villages into the home front for social stability-Examination of coronavirus disease 2019 control experiences in rural areas in China.

Since the outbreak of COVID-19, the disease has continued to spread and countries around the world have been plagued by its causal agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the comprehensive fight against the SARS-CoV-2, China has taken a series of important measures, achieved major victories in safeguarding people's lives and health, and accumulated important experience. Rural epidemic prevention and control is a basic part of the entire prevention and control system, with certain particularities. This study summarizes China's experience in preventing and controlling COVID-19 and the local measures taken to effectively prevent the spread of the disease in rural areas. All countries worldwide can learn from China's experience and take measures according to their own national and local conditions to effectively achieve the rural prevention and control of COVID-19. Meanwhile, the crisis itself can be viewed as a new opportunity for rural development.

Changes in lipid metabolism in patients with severe COVID-19 (preprint)

Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

Number of Pre-Existing Comorbidities and Prognosis of COVID-19: A Retrospective Cohort Study (preprint)

Background: Though many studies have described the association of coronavirus disease 2019 (COVID-19) and different kinds of noncommunicable chronic diseases, information with the combine effects of comorbidities to COVID-19 patients have not been well characterized yet. The aim of this study was to examine the associations of numbers of comorbidities with critical type and death of COVID-19.Methods: This was a single-centered retrospective study among patients with COVID-19. All patients with COVID-19 enrolled in this study were diagnosed according to World Health Organization interim guidance. Six different kinds of noncommunicable chronic diseases were included in this study. The logistic regression model was used to estimate the fixed effect of numbers of comorbidities on critical type or death, adjusting for potential confounders.Results: In total, 475 COVID-19 patients were enrolled in our study, included 234 females and 241 males. Hypertension was the most frequent type (162 [34.1%] of 475 patients). Patients with two or more comorbidities have higher risk of critical type (OR 3.072, 95% CI [1.581, 5.970], p=0.001) and death (OR 5.538, 95% CI [1.577, 19.451], p=0.008) compared to patients without comorbidities. And the results were similar after adjusting for age and gender in critical type (OR 2.021, 95% CI [1.002–4.077], p=0.049) and death (OR 3.653, 95% CI [0.989, 13.494], p=0.052).Conclusions: The number of comorbidities was an independent risk factor for critical type and death in COVID-19 patients.

Unemployment and health-related quality of life in melanoma patients during the COVID-19 pandemic: A web-based cross-sectional study (preprint)

Background The outbreak of coronavirus disease-2019 (COVID-19) ineluctably caused social distancing and unemployment, which may bring additional health risks for patients with cancer. To investigate the association of the pandemic-related impacts with the health-related quality of life (HRQoL) among patients with melanoma during the COVID-19 pandemic, we conducted a cross-sectional study among Chinese patients with melanoma.Methods A self-administered online questionnaire was distributed to melanoma patients through social media. Demographic and clinical data, and pandemic-related impacts (unemployment and income loss) were collected. HRQoL was determined by the Functional Assessment of Cancer Therapy-General (FACT-G) and its disease-specific module (the melanoma subscale, MS).Results A total of 70 patients with melanoma completed the study. The mean age of the patients was 55.2 ± 14.8 years, 45.7% (32/70) were male, and 21.4% (15/70) were unemployed since the epidemic. Unemployment of the patients and their family members and income loss were significantly associated with a lower FACT-G score, while the MS score was associated with the unemployment of the patients’ family members.Conclusions Our findings suggested that unemployment is associated with impaired HRQoL in melanoma patients during the COVID-19 epidemic.

Compliance and containment in social distancing: mathematical modeling of COVID-19 across townships (preprint)

In the early development of COVID-19, large-scale preventive measures, such as border control and air travel restrictions, were implemented to slow international and domestic transmissions. When these measures were in full effect, new cases of infection would be primarily induced by community spread, such as the human interaction within and between neighboring cities and towns, which is generally known as the meso-scale. Existing studies of COVID-19 using mathematical models are unable to accommodate the need for meso-scale modeling, because of the unavailability of COVID-19 data at this scale and the different timings of local intervention policies. In this respect, we propose a meso-scale mathematical model of COVID-19 using town-level infection data in the state of Connecticut. We consider the spatial interaction in terms of the inter-town travel in the model. Based on the developed model, we evaluated how different strengths of social distancing policy enforcement may impact future epidemic curves based on two evaluative metrics: compliance and containment. The developed model and the simulation results will establish the foundation for community-level assessment and better preparation for COVID-19.