[Epidemiological investigation on the local epidemic situation in Zhengzhou High-Tech Zone caused by SARS-CoV-2 Delta variant].

This study collected epidemic data of COVID-19 in Zhengzhou from January 1 to January 20 in 2022. The epidemiological characteristics of the local epidemic in Zhengzhou High-tech Zone caused by the SARS-CoV-2 Delta variant were analyzed through epidemiological survey and big data analysis, which could provide a scientific basis for the prevention and control of the Delta variant. In detail, a total of 276 close contacts and 599 secondary close contacts were found in this study. The attack rate of close contacts and secondary close contacts was 5.43% (15/276) and 0.17% (1/599), respectively. There were 10 confirmed cases associated with the chain of transmission. Among them, the attack rates in close contacts of the first, second, third, fourth and fifth generation cases were 20.00% (5/25), 17.86% (5/28), 0.72% (1/139) and 14.81% (4/27), 0 (0/57), respectively. The attack rates in close contacts after sharing rooms/beds, having meals, having neighbor contacts, sharing vehicles with the patients, having same space contacts, and having work contacts were 26.67%, 9.10%, 8.33%, 4.55%, 1.43%, and 0 respectively. Collectively, the local epidemic situation in Zhengzhou High-tech Zone has an obvious family cluster. Prevention and control work should focus on decreasing family clusters of cases and community transmission.

Suppress the aerosol generation from the air turbine handpiece in dental clinics

The COVID-19 pandemic imposes a severe challenge to the health care providers and patients in dental clinics as the dental procedures produce abundant airborne materials. Although dental practices use a multi-layered protective procedure to reduce the potential danger from dental aerosols, it is still beneficial to suppress the aerosol generation from the origin as much as possible. Reducing the aerosol generation (especially the droplets of smaller diameters) from the very beginning will ease the burden on all subsequent layers of protection. In this work, we first provide a relatively complete picture of the structure of the spray produced by the air turbine handpiece. We found that the spray consists of two domains: one is the canopy shaped centrifugal zone and the other is a dense ballistic spray core. The droplets from the centrifugal zone are much smaller than those of the spray core and, hence, are more prone to stay in the air. The location of the centrifugal zone also makes it more challenging to be contained by the mouth or rubber dam. To suppress the atomization of the centrifugal zone, we used the food-additive carboxymethylcellulose sodium (CMC-Na) water solutions of different concentrations. The data show that the viscoelastic property of the 0.5 wt. % CMC-Na water solution can effectively suppress the aerosol generation of the centrifugal zone. (C) 2022 Author(s).

Risk perception, anxiety, and depression among hospital pharmacists during the COVID-19 pandemic: The mediating effect of positive and negative affect

This study investigated the impacts of risk perception of COVID-19 on anxiety and depression symptoms among hospital pharmacists in China. We conducted a cross-sectional study with hospital pharmacists during the COVID-19 pandemic in China. Some 4,219 hospital pharmacists completed an online survey including demographic questions, risk perception of COVID-19, General Anxiety Disorder-7, Patient Health Questionnaire-9, and Positive and Negative Affect Schedule. Multivariate regression and mediation analyses were conducted. The results indicated that 41.9% and 29.4% of hospital pharmacists experienced mild to severe levels of anxiety and depression symptoms, respectively. In older age, a higher level of risk perception of COVID-19, and negative affect experience were risk factors, whereas positive affect experience was a protective factor for anxiety and depression symptoms among pharmacists. Experience of positive and negative affect mediated the relationship between risk perception of COVID-19 and anxiety and depression among hospital pharmacists in China. Timely mental health services need to be provided for hospital pharmacists during the COVID-19 pandemic.

Enhanced personal protective equipment can cause acute kidney injury in health care workers during COVID-19 pandemics

Introduction: Enhanced personal protective equipment (PPE) can expose health care workers (HCWs) to high heat stress and dehydration. The objective of this study was to assess the risk of acute kidney injury (AKI) among HCWs during the pandemic. Material and Methods: We recruited 52 HCWs worked on the mobile COVID-19 screening bus in the summer of 2021. We measured the body water content, pulse, core body temperature, blood pressure, creatinine, and urinary analysis before and after the work shift. We obtained the amount of water intake, environmental and personal measurements of temperature, humidity, and heat stress index during the work shift. Physicians interviewed the study subjects to confirm their medical history. Paired sample t-tests were used to test the pre and post-measurements. Results and Conclusions: After excluding 18 subjects who did not wear PPE in the pilot study, 34 HCWs were used in the analyses (male: 11.8%;female: 88.2 %). Most of them were nurses, with a mean age of 30.53 years old (SD 6.82). After a work shift, 14.7% of the subjects had incident AKI (1.5 times reference value or increase≧0.3 mg/dl). Core body temperature increased 0.27 degree (95% confidence interval [CI]: 0.16 to 0.38), creatinine level increased 0.161 mg/dl (95% CI: 0.11 to 0.22, p<0.001). The estimated glomerular filtration rate (eGFR) showed a significant decline in renal function (-16.82 ml/min/1.73m2, 95% CI: -22.47 to -11.17, p<0.001). There was a protective effect of hydration (p= 0.09). In conclusion, wearing enhanced PPE can cause kidney injuries. There is an urgent need to develop regulations to prevent AKI among HCWs.

The Impact of Temperature on the Risk of COVID-19: A Multinational Study

The current understanding of ambient temperature and its link to the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. The objective of this study was to explore the environmental and climatic risk factors for SARS-CoV-2. For this study, we analyzed the data at the beginning of the outbreak (from 20 January to 31 March 2020) to avoid the influence of preventive or control measures. We obtained the number of cases and deaths due to SARS-CoV-2, international tourism, population age, universal health coverage, regional factors, the SARS-CoV-2 testing rate, and population density of a country. A total of 154 countries were included in this study. There were high incidence rates and mortality risks in the countries that had an average ambient temperature between 0 and 10 degreeC. The adjusted incidence rate for temperatures between 0 and 10 degreeC was 2.91 (95% CI 2.87-2.95). We randomly divided the data into a training set (80% of data) for model derivation and a test set (20% of data) for validation. Using a random forest statistical model, the model had high accuracy for predicting the high epidemic status of a country (ROC = 95.5%, 95% CI 87.9-100.0%) in the test set. Population age, temperature, and international tourism were the most important factors affecting the risk of SARS-CoV-2 in a country. An understanding the determinants of the SARS-CoV-2 outbreak can help to design better strategies for disease control. This study highlights the need to consider thermal effect in the prevention of emerging infectious diseases.

[Preliminary analysis on COVID-19 case spectrum and spread intensity in different provinces in China except Hubei province].

Objective: To analyze the characteristics of COVID-19 case spectrum and spread intensity in different provinces in China except Hubei province. Methods: The daily incidence data and case information of COVID-19 were collected from the official websites of provincial and municipal health commissions. The morbidity rate, severity rate, case-fatality rate, and spread ratio of COVID-19 were calculated. Results: As of 20 March, 2020, a total of 12 941 cases of COVID-19 had been conformed, including 116 deaths, and the average morbidity rate, severity rate and case-fatality rate were 0.97/100 000, 13.5% and 0.90%, respectively. The morbidity rates in Zhejiang (2.12/100 000), Jiangxi (2.01/100 000) and Beijing (1.93/100 000) ranked top three. The characteristics of COVID-19 case spectrum varied from province to province. The first three provinces (autonomous region, municipality) with high severity rates were Tianjin (45.6%), Xinjiang (35.5%) and Heilongjiang (29.5%). The case-fatality rate was highest in Xinjiang (3.95%), followed by Hainan (3.57%) and Heilongjiang (2.70%). The average spread ratio was 0.98 and the spread intensity varied from province to province. Tibet had the lowest spread ratio (0), followed by Qinghai (0.20) and Guangdong (0.23). Conclusion: The intervention measures were effective in preventing the spread of COVID-19 and improved treatment effect in China. However, there were significant differences among different regions in severity, case-fatality rate and spread ratio.

Is chronic obstructive pulmonary disease an independent predictor for adverse outcomes in coronavirus disease 2019 patients?

OBJECTIVE: This study aimed to investigate whether pre-existing chronic obstructive pulmonary disease (COPD) was an independent predictor for adverse outcomes in coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS: We searched electronic databases, including PubMed, Web of Science, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) to screen for eligible articles. A quantitative meta-analysis was performed on the basis of adjusted effect estimates. RESULTS: We observed that COPD was significantly associated with an increased risk of adverse outcomes in COVID-19 patients, which is based on 18 studies with 26,075 cases reporting adjusted effect estimates (pooled effect = 1.53, 95% confidence interval (CI): 1.29-1.8; I2 = 35.4%, random-effects model). CONCLUSIONS: We found that pre-existing COPD was an independent risk factor for predicting the adverse outcomes in COVID-19 patients.

Application of "Universal Formula" in the prevention and treatment of COVID-19 and its innovative development

In the history of fighting the plague, traditional Chinese medicine (TCM) has the tradition of using "Universal Formula" with "cauldron boiling medicine". The practice of prevention and treatment of plague with "Universal Formula" is not only one of the important characteristics of TCM, but also deeply embodies the scientific connotation of the plague prevention and control model of "disease differentiation and treatment" combined with "syndrome differentiation and treatment". In the battle against COVID-19, a batch of contemporary anti-epidemic "Universal Formula" represented by "Hanshiyi Formula (Wuhan anti-epidemic prescription)" and "Qingfei Paidu Decoction" were used for both treatment and prevention. It covered a large number of people and had significant clinical effects. It has become a sharp weapon for TCM to intervene in anti-epidemic work. The "Universal Formula" used in the prevention and treatment of COVID-19 not only retains the essence of the traditional "Universal Formula" for anti-epidemic, but also has innovations in legislative prescriptions, drug formulations, drug distribution forms, medication guidance, and drug efficacy research, which reflects the development of the anti-epidemic with "Universal Formula". This article discussed the overview and diagnosis of the plague and treatment model of "disease differentiation and treatment" combined with "syndrome differentiation and treatment", the theoretical basis of anti-epidemic theory of "Universal Formula", and the innovation and development of the application of "Universal Formula". Under the background of science and technology, the important value and strategic path of "Universal Formula" will be used to help the in-depth development of anti-epidemic work of TCM in the face of new and sudden large-scale plagues in the future. © 2020, Chinese Journal of New Drugs Co. Ltd. All right reserved.

D-dimer is associated with the risk of mortality in Coronavirus Disease 2019 patients.

This study aims to investigate the association between D-dimer and the risk of mortality in coronavirus disease 2019 (COVID-19) patients using a meta-analysis. We found that the D-dimer levels in non-survival patients were significantly higher than those in survival patients (SMD = 0.91, 95% CI = 0.79 to 1.03). In conclusion, the elevated D-dimer levels were associated with an increased risk of mortality in COVID-19 patients.

[Analysis on the epidemic factors for COVID-19].

As a new infectious disease, the epidemic process of COVID-19 has a series of special influencing factors and conditions. In this paper, some obvious characteristics of this widespread epidemic are discussed, including the new pathogen making people feel confused, the slow onset bringing confusion to the clinic, the miscellaneous source of infection also causing confusion to prevention and control work, the easy route of transmissions leading to a sharp increase of confirmed cases, the high susceptibility of the population leading to a high incidence, and the natural epidemic process coupled with the complexity of natural factors and the superposition of social factors. The positive and effective prevention and control strategies and measures adopted by China have greatly changed the natural epidemic process and trajectory of this epidemic, which has been highly affirmed by the expert group of the World Health Organization and praised by many countries and international organizations. However, to sum up carefully and think deeply, it will be a long-term and arduous work to plan and realize public health security in China and even the world in the future.

Detection and Analysis of Safety Signals of Chloroquine Based Upon FDA Adverse Event Database

OBJECTIVE: To analyze and evaluate the safety signals of chloroquine in the patients, and to provide a valuable reference for rational use in clinic. METHODS: Both the reporting odds ratio (ROR) method and Bayesian confidence propagation neural network (BCPNN) were applied to analyze safety signals of chloroquine based upon the adverse drug events (ADEs) data ranging from 2004 to 2020 as reported in the Adverse Event Reporting System (FAERS) database of the Food and Drug Administration (FDA), and to systematically assesse the safety signals of chloroquine phosphate on various organs systems. RESULTS: Among the 2 063 reports of ADEs studied, 557 reports were considered to be mainly caused by chloroquine. The results demonstrated that the high-risk ADEs signals of chloroquine involved various systems, such as atrioventricular block complete (ROR=2.90, IC-2SD=1.64), ventricular fibrillation (ROR=3.40, IC-2SD=1.27), blindness (ROR=27.51, IC-2SD=0.55), cardiogenic shock (ROR=6.86, IC-2SD=0.54), vomiting (ROR=1.70, IC-2SD=1.83). Moreover, some rare ADEs with high-risk signals showed a correlation with chloroquine, including hypokalaemia (ROR=4.18,IC-2SD=1.51), renal failure acute (ROR=3.08, IC-2SD=0.30), methaemoglobinaemia (ROR=4.37, IC-2SD=0.03), and pyrexia (ROR=1.80, IC-2SD=1.84), which were consistent with literature reports. However, these ADEs were not listed in instruction and worth much attention in clinic. Moreover, basic diseases of patients and drug incompatibility need much attention to prevent the occurrence and exacerbation of chloroquine-related adverse reactions. CONCLUSION: A comprehensive analysis of the ADEs signals of chloroquine could shed some light on understanding of its safety characteristics and would provide valuable information for rational use of chloroquine in clinic, especially in treatment of COVID-19.

[The preliminary analysis on the characteristics of the cluster for the COVID-19].

Since December 2019, COVID-19, a new emerging infection disease, has spread in 27 countries and regions. The clusters of many cases were reported with the epidemic progresses. We collected currently available information for 377 COVID-19 clusters (1 719 cases), excluded the hospital clusters and Hubei cases, during the period from January 1 to February 20, 2020. There were 297 family clusters (79%), case median was 4; 39 clusters of dining (10%), case median was 5; 23 clusters of shopping malls or supermarkets (6%), case median was 13; 12 clusters of work units (3%), case median was 6, and 6 clusters of transportation. We selected 325 cases to estimate the incubation period and its range was 1 to 20 days, median was 7 days, and mode was 4 days. The analysis of the epidemic situation in a department store in China indicated that there was a possibility of patients as the source of infection during the incubation period of the epidemic. From February 5 to 21, 2020, 634 persons were infected on the Diamond Princess Liner. All persons are susceptible to the 2019 coronavirus. Age, patients during the incubation period and the worse environment might be the cause of the cases rising. The progress of the two typical outbreaks clearly demonstrated the spread of the early cases in Wuhan. In conclusion, screening and isolating close contacts remained essential other than clinical treatment during the epidemic. Especially for the healthy people in the epidemic area, isolation was the key.