Assessment of the Risk and Symptoms of SARS-CoV-2 Infection Among Healthcare Workers During the Omicron Transmission Period: A Multicentric Study from Four Hospitals of Mainland China.

Purpose: The SARS-CoV-2 omicron variant emerged and spread rapidly among the population in the early stage of China's normalized prevention and control in December 2022. Healthcare workers (HCWs) are particularly exposed to SARS-CoV-2, it is important to evaluate the impact of the omicron pandemic on HCWs in China. Methods: A self-administered online survey was conducted on infected HCWs from four hospitals of Taizhou. A total of 748 HCWs received the survey via DingTalk, and 328 responded to the questionnaire. The risk factors were investigated using univariate and multivariate logistic regression analysis. Results: By December 20, 2022, 748 HCWs tested positive by PCR, and the infection rate was 11.4% (748/6581). Among 328 respondents, the most common symptoms were cough (88.4%), fever (83.5%), runny nose (77.1%), sore throat (73.2%), headache (70.1%), muscle aches (67.1%), and fatigue (53.4%). 69.8% (229/328) of the participants had five or more major onset symptoms, while no severe case was observed. The multivariate analysis indicated that the poor sleep quality (OR = 2.29, 95% CI: 1.31-4.02, P = 0.004) was an independent risk factor for more major onset symptoms, while wore gloves ≥95% times in working (OR = 0.49, 95% CI: 0.28-0.85, P = 0.011) was significantly related to fewer symptoms. In addition, 239 (72.9%) recipients reported high fever (temperature ≥38.5°C), less common cold (≤3 vs >3 times/year, OR = 2.20, 95% CI: 1.05-4.65, P = 0.038) was significantly associated with high fever. Conclusion: Our findings imply rapid transmissibility of omicron and multiple-onset symptoms among HCWs. Improved autoimmunity and self-protection measures for HCWs may be helpful in controlling infection and clinical symptoms. Our results provide empirical reference values for improved countermeasures and protective measures for major public health emergencies.

Global age-structured spatial modeling for emerging infectious diseases like COVID-19.

Modeling the global dynamics of emerging infectious diseases (EIDs) like COVID-19 can provide important guidance in the preparation and mitigation of pandemic threats. While age-structured transmission models are widely used to simulate the evolution of EIDs, most of these studies focus on the analysis of specific countries and fail to characterize the spatial spread of EIDs across the world. Here, we developed a global pandemic simulator that integrates age-structured disease transmission models across 3,157 cities and explored its usage under several scenarios. We found that without mitigations, EIDs like COVID-19 are highly likely to cause profound global impacts. For pandemics seeded in most cities, the impacts are equally severe by the end of the first year. The result highlights the urgent need for strengthening global infectious disease monitoring capacity to provide early warnings of future outbreaks. Additionally, we found that the global mitigation efforts could be easily hampered if developed countries or countries near the seed origin take no control. The result indicates that successful pandemic mitigations require collective efforts across countries. The role of developed countries is vitally important as their passive responses may significantly impact other countries.

How to avoid a local epidemic becoming a global pandemic.

Here, we combine international air travel passenger data with a standard epidemiological model of the initial 3 mo of the COVID-19 pandemic (January through March 2020; toward the end of which the entire world locked down). Using the information available during this initial phase of the pandemic, our model accurately describes the main features of the actual global development of the pandemic demonstrated by the high degree of coherence between the model and global data. The validated model allows for an exploration of alternative policy efficacies (reducing air travel and/or introducing different degrees of compulsory immigration quarantine upon arrival to a country) in delaying the global spread of SARS-CoV-2 and thus is suggestive of similar efficacy in anticipating the spread of future global disease outbreaks. We show that a lesson from the recent pandemic is that reducing air travel globally is more effective in reducing the global spread than adopting immigration quarantine. Reducing air travel out of a source country has the most important effect regarding the spreading of the disease to the rest of the world. Based upon our results, we propose a digital twin as a further developed tool to inform future pandemic decision-making to inform measures intended to control the spread of disease agents of potential future pandemics. We discuss the design criteria for such a digital twin model as well as the feasibility of obtaining access to the necessary online data on international air travel.

Healthy cities initiative in China: Progress, challenges, and the way forward.

China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Along with related urban health governmental initiatives, the program has helped put health on the agenda of local governments while raising public awareness. Healthy City actions taken at the municipal scale also prepared cities to deal with the COVID-19 pandemic. However, after intermittent trials spanning the past two decades, the Healthy Cities initiative in China has reached a crucial juncture. It risks becoming inconsequential given its overlap with other health promotion efforts, changing public health priorities in response to the pandemic, and the partial adoption of the Healthy Cities approach advanced by the World Health Organization (WHO). We recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sustainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health. Achieving this alignment will require leveraging the full spectrum of best practices in Healthy Cities actions and expanding assessment efforts. Funding: Tsinghua-Toyota Joint Research Fund "Healthy city systems for smart cities" program.

Mechanism of Huoxiang Zhengqi oral liquid in the treatment of COVID-19 based on biological information technology

Objective: To explore the network regulation mechanism of Huoxiang Zhengqi Oral Liquid(HXZQ) in the treatment of coronavirus disease 19 (COVID-19).

Investigation of the mechanism of fangfeng tongsheng pills in the treatment COVID-19 by network pharmacology and molecular docking

Objective: To explore the active components and potential mechanism of Fangfeng Tongsheng Pills by using network pharmacology and molecular docking in the treatment of coronavirus disease 19(COVID-19). Methods The main chemical constituents and action targets of various medicines in Fangfeng Tongsheng Pills were collected via traditional Chinese medicine system pharmacology database and online analysis platform(TCMSP). The related targets of COVID-19 were collected by using GeneCards database, and the repeating parts with Fangfeng Tongsheng Pills were taken as the research targets. Cytoscape software was used to create a drug-target-disease network. The common target was imported into STRING database, and the protein-protein interaction network diagram was constructed by Cytoscape software. The GO(gene ontology) function enrichment analysis and Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were performed by DAVID to predict their mechanism. The core components of Fangfeng Tongsheng Pills were docked with the therapeutic target of COVID-19 by AutoDock software. Results A total of 224 active compounds and 696 active targets were screened from Fangfeng Tongsheng Pills, including 79 targets coincided with COVID-19, and 10 active compounds, i.e. quercetin, luteolin, kaempferol,beta-sitosterol, naringenin, etc., 23 effective targets, i.e. PTGS2, PTGS1, NOS2, F10, DPP4, etc. A total of 65 GO function enrichment analysis results and 101 KEGG pathway enrichment results were obtained, including inflammatory response, tumor necrosis factor(TNF) signaling pathway, hypoxia inducible factor-1(HIF-1) signaling pathway, vascular endothelial growth factors(VEGF) signaling pathway, toll-like receptors(TLRs) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B(PI3K-Akt) signaling pathway, and mitogen-activated protein kinase(MAPK) signaling pathway. Conclusion The active components in Fangfeng Tongsheng Pills, such as beta-sitosterol, quercetin, luteolin, kaempferol and naringenin, can combine with SARS-Co V2-3CL hydrolase and ACE2, act on the key target [TNF, Caspase-3, mitogen-activated protein kinase(MAPK1), interleukin-6(IL-6), prostaglandin-endoperoxide synthase 2(PGTS2)] of TNF, HIF-1, VEGF, MAPK and toll-like receptor signaling pathway, and play the roles of anti-inflammation, immune regulation, anti-hypoxic stress and anti-virus infection, thus play a role in the treatment of COVID-19.

What Affects Perceived Health Risk Attitude During the Pandemic: Evidence From Migration and Dining Behavior in China

The COVID-19 pandemic changed behaviors, at least temporarily, and possibly more permanently, with implications for both work and leisure activities. Some of those behavioral changes, such as dining in restaurants, have significant ripple effects on businesses and employment. We investigate the response to health risks in China with a study of decisions about eating out during the pandemic. We find that compared to a traditional measure of financial risk attitude, dining out behavior better captures individuals? attitude toward the health risk posed by the pandemic and is more significant in predicting their expected total consumption during the recovery phase of the pandemic. In addition, we find that the effect of domestic in-migration is positive with respect to dining out, a signifier of confidence in the government response to the safety of internal flows. In contrast, international migration and port city of entry status are strongly negative with respect to dining out. The risk from the virus is perceived to be much stronger in such contexts. From a policy perspective establishing border controls was critical in re-creating a robust economy. Additional city and household level characteristics that affect dining-out behavior are also identified.

Economic uncertainty spillover and social networks

This research investigates the impact of social networks on developing economic uncertainty spillover networks. The study constructs an inter-provincial Chinese economic uncertainty spillover network using a high dimesion dataset and assembles the provincial social network using microblog data. Furthermore, the exponential random graph model is used to analyze the impact of social networks. The findings indicate that the social network significantly hinders the formation of an economic uncertainty spillover network, particularly during the COVID-19 pandemic. Notably, the impact of social networks is found to be more statistically significant than that of population and other attributes. While most existing research has focused on the influence of social networks from a microeconomic perspective, this study contributes to the literature by uncovering a robust negative relationship between social networks and economic uncertainty spillover networks, particularly curbing the uncertainty caused by the COVID-19 pandemic.

Exploring chemical changes of the haze pollution during a recent round of COVID-19 lockdown in a megacity in Northeast China.

COVID-19 rebounded in China in January 2021, with Heilongjiang as one of the worst-affected provinces. This resulted in a new round of lockdown in Harbin, the capital city of Heilongjiang, from 20 January to 22 February of 2021. A field campaign was conducted to explore the responses of haze pollution in Harbin to the lockdown. Levoglucosan was used to reflect biomass burning emissions, while the molar ratio of sulfur (the sum of sulfur dioxide and sulfate) to nitrogen (the sum of nitrogen dioxide and nitrate), i.e., RS/N, was used as an indicator for the relative importance of coal combustion and vehicle emissions. Based on a synthesis of the levoglucosan and RS/N results, reference period was selected with minimal influences of non-lockdown-related emission variations. As indicated by the almost unchanged sulfur dioxide concentrations, coal combustion emissions were relatively stable throughout the lockdown and reference periods, presumably because the associated activities, e.g., heating supply, power generation, etc., were usually uninterruptible. On the other hand, as suggested by the increase of RS/N, vehicle emissions were considerably reduced during lockdown, likely due to the stay-at-home orders. Compared to results from the reference samples, the lockdown period exhibited higher levels of ozone and various indicators for secondary aerosol formation, pointing to an enhancement of secondary pollution. In addition, photochemistry-related reactions in aqueous phase appeared to be present during the lockdown period, which have not been reported in the frigid atmosphere over Northeast China.

CDS spreads and COVID-19 pandemic

US corporate credit default swap (CDS) spreads have significantly increased since the beginning of the COVID-19 global pandemic. This paper shows that the magnitude of the pandemic measured by the number of COVID-19 cases and deaths both in the US and globally are positively linked to the CDS spreads, an effect both economically and statistically significant. However, there is a significant heterogenous effects across sectors, in which banking, travel & leisure, transportation, airlines, and restaurants are the hardest hit sectors. The analysis also documents that the COVID-19 pandemic increases corporate CDS spreads via increased firms’ distress levels transmission channels.

Critical Role of Simultaneous Reduction of Atmospheric Odd Oxygen for Winter Haze Mitigation.

The lockdown due to COVID-19 created a rare opportunity to examine the nonlinear responses of secondary aerosols, which are formed through atmospheric oxidation of gaseous precursors, to intensive precursor emission reductions. Based on unique observational data sets from six supersites in eastern China during 2019-2021, we found that the lockdown caused considerable decreases (32-61%) in different secondary aerosol components in the study region because of similar-degree precursor reductions. However, due to insufficient combustion-related volatile organic compound (VOC) reduction, odd oxygen (Ox = O3 + NO2) concentration, an indicator of the extent of photochemical processing, showed little change and did not promote more decreases in secondary aerosols. We also found that the Chinese provinces and international cities that experienced reduced Ox during the lockdown usually gained a greater simultaneous PM2.5 decrease than other provinces and cities with an increased Ox. Therefore, we argue that strict VOC control in winter, which has been largely ignored so far, is critical in future policies to mitigate winter haze more efficiently by reducing Ox simultaneously.

Screening of anti-SARS-CoV-2 leading compounds based on molecular docking technology

Objective To screen the novel small-molecule inhibitors against novel coronavirus(SARS-CoV-2), the binding protein combined spike protein of coronavirus(S protein) with angiotensin converting enzyme 2(ACE2) receptor was selected as the targets, based on compatibility-combination-TCM-compound database constructed by our group. Methods According to the virological and infection mechanisms of SARS-CoV-2, Q-Site Finder was used to identify the active sites on structural model of the binding protein combined S protein with ACE2 receptor, and molecular docking technology was employed to conduct the potential drug screening research from 4 kinds of 120 compounds such as betulinic acids, diosgenins, sterols, and podophyllotoxins by comparing the score value between the components of the same structure parent nucleusy. Results The active sites predicted by Q-site Finder were used as the key receptor residues for this molecular docking, and the structure parent nucleus of betulinic acid and diosgenin showed preferable binding ability, with 3beta-O-acetylated cholesterol(-13.1 kcal.mol-1), BH-11(-12.9 kcal.mol-1) and BH-12(-12.9 kcal.mol-1) as the top 3% compounds. Meanwhile, the structural parent nucleus of podophyllotoxin was not suitable for relevant research. Above results were verified by docking compounds with the higher absolute value of binding ability with 3 CLpro. Conclusion The structure parent nucleus of betulinic acid, diosgenin, as well as 3beta-O-acetylated cholesterol, BH-11 and BH-12 have the potential anti-SARS-CoV-2 effect, which can provide references for the subsequent new drug research and development against SARS-CoV-2.

50-gene risk profiles in peripheral blood predict COVID-19 outcomes: A retrospective, multicenter cohort study.

BACKGROUND: COVID-19 has been associated with Interstitial Lung Disease features. The immune transcriptomic overlap between Idiopathic Pulmonary Fibrosis (IPF) and COVID-19 has not been investigated. METHODS: we analyzed blood transcript levels of 50 genes known to predict IPF mortality in three COVID-19 and two IPF cohorts. The Scoring Algorithm of Molecular Subphenotypes (SAMS) was applied to distinguish high versus low-risk profiles in all cohorts. SAMS cutoffs derived from the COVID-19 Discovery cohort were used to predict intensive care unit (ICU) status, need for mechanical ventilation, and in-hospital mortality in the COVID-19 Validation cohort. A COVID-19 Single-cell RNA-sequencing cohort was used to identify the cellular sources of the 50-gene risk profiles. The same COVID-19 SAMS cutoffs were used to predict mortality in the IPF cohorts. FINDINGS: 50-gene risk profiles discriminated severe from mild COVID-19 in the Discovery cohort (P = 0·015) and predicted ICU admission, need for mechanical ventilation, and in-hospital mortality (AUC: 0·77, 0·75, and 0·74, respectively, P < 0·001) in the COVID-19 Validation cohort. In COVID-19, 50-gene expressing cells with a high-risk profile included monocytes, dendritic cells, and neutrophils, while low-risk profile-expressing cells included CD4+, CD8+ T lymphocytes, IgG producing plasmablasts, B cells, NK, and gamma/delta T cells. Same COVID-19 SAMS cutoffs were also predictive of mortality in the University of Chicago (HR:5·26, 95%CI:1·81-15·27, P = 0·0013) and Imperial College of London (HR:4·31, 95%CI:1·81-10·23, P = 0·0016) IPF cohorts. INTERPRETATION: 50-gene risk profiles in peripheral blood predict COVID-19 and IPF outcomes. The cellular sources of these gene expression changes suggest common innate and adaptive immune responses in both diseases. FUNDING: This work was supported in part by National Institute for Health Research Clinician Scientist Fellowship NIHR: CS-2013-13-017 (TMM); Action for Pulmonary Fibrosis Mike Bray fellowship (PLM); The National Heart, Lung, and Blood Institute (NHLBI) through award K01-HL-130704 (AJ); The University of South Florida (USF) Academic Support Fund and the USF Foundation, Ubben Fibrosis Fund (JHM).

Dynamic Continuum of Nanoscale Peptide Assemblies Facilitates Endocytosis and Endosomal Escape.

Alkaline phosphatase (ALP) enables intracellular targeting by peptide assemblies, but how the ALP substrates enter cells remains elusive. Here we show that nanoscale phosphopeptide assemblies cluster ALP to enable caveolae-mediated endocytosis (CME) and endosomal escape. Specifically, fluorescent phosphopeptides undergo enzyme-catalyzed self-assembly to form nanofibers. Live cell imaging unveils that phosphopeptides nanoparticles, coincubated with HEK293 cells overexpressing red fluorescent protein-tagged tissue-nonspecific ALP (TNAP-RFP), cluster TNAP-RFP in lipid rafts to enable CME. Further dephosphorylation of the phosphopeptides produces peptidic nanofibers for endosomal escape. Inhibiting TNAP, cleaving the membrane anchored TNAP, or disrupting lipid rafts abolishes the endocytosis. Decreasing the transformation to nanofibers prevents the endosomal escape. As the first study establishing a dynamic continuum of nanoscale assemblies for cellular uptake, this work illustrates an effective design for enzyme-responsive supramolecular therapeutics and provides mechanism insights for understanding the dynamics of cellular uptake of proteins or exogenous peptide aggregates.

Increased quality of life in patients with stroke during the COVID-19 pandemic: a matched-pair study.

Patients with stroke are likely to experience impaired health-related quality of life (QOL), especially during the COVID-19 pandemic. This study aimed to evaluate the QOL of Chinese patients with stroke during the pandemic and explore the associated variables. A matched-pair, multicenter survey was conducted before and during the COVID-19 pandemic. Questionnaires including the 36-item Short-Form Health Survey (SF-36), the Activities of Daily Living (ADL) scale, and the Questionnaire about the Process of Recovery (QPR) were used. A total of 172 matched pairs (344 patients) were recruited in this study. Hierarchical multiple regression analysis was performed to analyze variables associated with QOL. Physical and mental component scores (PCS and MCS) were higher among the stroke patients during the pandemic (44.20 ± 18.92 and 54.24 ± 19.08) than before the pandemic (37.98 ± 14.52 and 43.50 ± 20.94). Pandemic stress, demographic and clinical characteristics were negative variables associated with PCS and MCS. QPR was positively associated with PCS and MCS. The QOL of Chinese stroke patients was higher during than before the COVID-19 pandemic. Pandemic stress aggravated stroke patients' QOL, while personal recovery could alleviate the detrimental effect of pandemic stress on QOL for stroke patients.

Reduction of Human Mobility Matters during Early COVID-19 Outbreaks: Evidence from India, Japan and China.

Mobility restrictions have been a heated topic during the global pandemic of coronavirus disease 2019 (COVID-19). However, multiple recent findings have verified its importance in blocking virus spread. Evidence on the association between mobility, cases imported from abroad and local medical resource supplies is limited. To reveal the association, this study quantified the importance of inter- and intra-country mobility in containing virus spread and avoiding hospitalizations during early stages of COVID-19 outbreaks in India, Japan, and China. We calculated the time-varying reproductive number (Rt) and duration from illness onset to diagnosis confirmation (Doc), to represent conditions of virus spread and hospital bed shortages, respectively. Results showed that inter-country mobility fluctuation could explain 80%, 35%, and 12% of the variance in imported cases and could prevent 20 million, 5 million, and 40 million imported cases in India, Japan and China, respectively. The critical time for screening and monitoring of imported cases is 2 weeks at minimum and 4 weeks at maximum, according to the time when the Pearson's Rs between Rt and imported cases reaches a peak (>0.8). We also found that if local transmission is initiated, a 1% increase in intra-country mobility would result in 1430 (±501), 109 (±181), and 10 (±1) additional bed shortages, as estimated using the Doc in India, Japan, and China, respectively. Our findings provide vital reference for governments to tailor their pre-vaccination policies regarding mobility, especially during future epidemic waves of COVID-19 or similar severe epidemic outbreaks.

Effects of sources of social support and resilience on the mental health of different age groups during the COVID-19 pandemic.

BACKGROUND: A pandemic is a very stressful event, especially for highly vulnerable people (e.g., older adults). The purpose of the current study was to investigate the main and interactive relationships of social support and resilience on individual mental health during the COVID-19 pandemic across three age groups: emerging adults, adults, and older adults. METHODS: A survey was conducted with 23,192 participants aged 18-85. Respondents completed a questionnaire, including items on the COVID-19-related support they perceived from different sources, the abbreviated version of the Connor-Davidson Resilience Scale, and the Mental Health Inventory. RESULTS: Latent profile analysis identified five profiles of social support, and the patterns of potential profiles were similar in all groups. However, category distribution in the five profiles was significantly different among the age groups. Furthermore, analysis using the BCH command showed significant differences in mental health among these profiles. Lastly, interactive analyses indicated resilience had a positive relationship with mental health, and social support served as a buffer against the negative impact of low resilience on mental health. CONCLUSIONS: This study provides quantitative evidence for socioemotional selectivity theory (SST) and enables several practical implications for helping different age groups protecting mental health during pandemic.

Global COVID-19 pandemic demands joint interventions for the suppression of future waves.

Emerging evidence suggests a resurgence of COVID-19 in the coming years. It is thus critical to optimize emergency response planning from a broad, integrated perspective. We developed a mathematical model incorporating climate-driven variation in community transmissions and movement-modulated spatial diffusions of COVID-19 into various intervention scenarios. We find that an intensive 8-wk intervention targeting the reduction of local transmissibility and international travel is efficient and effective. Practically, we suggest a tiered implementation of this strategy where interventions are first implemented at locations in what we call the Global Intervention Hub, followed by timely interventions in secondary high-risk locations. We argue that thinking globally, categorizing locations in a hub-and-spoke intervention network, and acting locally, applying interventions at high-risk areas, is a functional strategy to avert the tremendous burden that would otherwise be placed on public health and society.