ABSTRACT
Background: Home isolation is a generally effective strategy for coronavirus disease control during lockdown periods. This study is to determine the potential adverse consequences of home isolation to mental health among school-aged youth after lifting of major lockdown measures in central China. Methods: This cohort study assessed the mental health of school-aged children and adolescents enrolled in Wuhan city and nearby areas in Hubei province, China, from July 1 to August 31, 2020. Post-lockdown responses to anxiety, depression, sleep disturbances and post-traumatic stress symptoms were assessed in online questionnaire-based surveys. Participants’ scores for the Zung self-rated anxiety scale, the Patient Health Questionnaire-9, the self-rating scale of sleep and the post-traumatic stress disorder self-rating scale (PTSS) were analyzed. Results: Questionnaire responses of 730 school children were collected. Among the participants, 6.25% of them had scores above thresholds for PTSS, 5.81% had anxiety, and 48.84% had depression. All subjects reported that they experienced sleep disturbances. Subjects who had anxiety might have a high risk for developing depression [OR: 16.07, p =0.008, 95%CI (2.08-123.94)] and PTSS [OR: 12.97, p <0.001, 95%CI (5.41-31.11)]. Both depression [OR: 17.35, p =0.006, 95%CI (2.28-131.87)] and PTSS [OR: 14.18, p <0.001, 95%CI (6.00-33.47)] were risk factors for developing anxiety among participants. Interestingly, higher educational levels of primary caregivers were a risk factor for developing depression [OR: 1.62, p =0.005, 95%CI (1.16-2.28)] in the participants, but a protective factor against PTSS [OR: 0.47, p =0.048, 95%CI (0.23-0.99)].Conclusions: The local youth had less than expected degree of increases in their self-reported PTSS and anxiety, after exiting lockdown-related isolation. As a result of a combination of compensatory mechanisms including internet-based home-schooling and increased intra-familial interactions, home isolation did not affect the mental health of local school-aged youth to an extent as great as expected.Trial registration: The Registration number of this trial is ChiCTR2000033054.
ABSTRACT
Background: The majority of COVID-19 patients presented persisting symptoms after discharge. We aimed to determine the long-term enteric consequences of SARS-CoV-2 infection, and to identify the risk and the protective factors for gastrointestinal sequelae.Methods: A retrospective cohort of 117 SARS-CoV-2 nucleic acid positive patients hospitalized in 12 hospitals from January 16 to March 7, 2020 were included in this study. Clinical data collected during hospitalization, from return visits and from telephone interviews in 3 months after discharge were reviewed. Multivariable logistic regression was performed to identify the risk and the protective factors for any and individual gastrointestinal sequelae.Findings: In three months after discharge, 53 patients (45%) presented at least one gastrointestinal sequelae. Common gastrointestinal sequelae included loss of appetite (28 patients, 24%), nausea (21 patients, 18%), acid reflux (21 patients, 18%), and diarrhea (17 patients, 15%). Decreased blood oxygen saturation and PPI treatment were risk factors, while enteral nutrition was a protective factor for gastrointestinal sequelae in general. For individual gastrointestinal sequelae, the decreased blood oxygen saturation was a risk factor, while male sex was a protective factor for loss of appetite after discharge. For nausea after discharge, PPI treatment was a risk factor while parenteral nutrition was a protective factor. Decreased blood oxygen saturation, BMI >25, and PPI treatment were risk factors for acid reflux after discharge. And finally, male sex was a risk factor for diarrhea after discharge.Interpretation: At three months after discharge, gastrointestinal sequelae were still common in recovering COVID-19 patients. Decreased blood oxygen saturation, PPI treatment, BMI >25, and male sex are risk factors, while nutritional support and male sex are protective factors, for gastrointestinal sequelae. Our data highlight the importance of gastrointestinal care and nutritional support for discharged COVID-19 patients.Funding: Guangdong Province “Pearl River Talent Plan” Innovation and Entrepreneurship Team Project, National Natural Science Foundation of China, and the National Key Clinical Discipline of China.Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: This study was approved by the Institutional Review Boards of Sun Yat-sen University and the participating hospitals.
Subject(s)
COVID-19 , DiarrheaABSTRACT
BackgroundCurrently no satisfactory pharmaceutical intervention is available for COVID-19. This retrospective study aimed to determine the therapeutic effect of thymosin alpha1 in critical COVID-19. ResultsWe enrolled 109 critically ill severe acute respiratory syndrome-related coronavirus-2 RNA positive patients from 15 hospitals. The mortality rate in critical patients treated with thymosin alpha1 was 11%, compared to 56% in critical patients not treated with thymosin alpha1. With confounding factors adjusted in multivariate logistic regression, thymosin alpha1 treatment was identified as a protective factor for critical COVID-19. ConclusionOur observation advocates the treatment of critical COVID-19 with thymosin alpha1.
Subject(s)
COVID-19 , Respiratory InsufficiencyABSTRACT
Background: Prior studies reported that 5~32% COVID-19 patients were critically ill, a situation that poses great challenge for the management of the patients and ICU resources. We aim to identify independent risk factors to serve as prediction markers for critical illness of SARS-CoV-2 infection. Methods Fifty-two critical and 200 non-critical SARS-CoV-2 nucleic acid positive patients hospitalized in 15 hospitals outside Wuhan from January 19 to March 6, 2020 were enrolled in this study. Multivariable logistic regression and LASSO logistic regression were performed to identify independent risk factors for critical illness. Results Age older than 60 years, dyspnea, respiratory rate > 24 breaths per min, leukocytosis >9.5 X10 9 /L, neutrophilia >6.3 X10 9 /L, lymphopenia <1.1 X10 9 /L, neutrophil-to-lymphocyte ratio >3.53, fibrinogen >4g/L, d-dimer >0.55 µg/mL, blood urea nitrogen >7.1 mM, elevated aspartate transaminase, elevated alanine aminotransferase, total bilirubin >21 µM, and Sequential Organ Failure Assessment (SOFA) score ≥2 were identified as risk factors for critical illness. LASSO logistic regression identified the best combination of risk factors as SOFA score, age, dyspnea, and leukocytosis. The Area Under the Receiver-Operator Curve values for the risk factors in predicting critical illness were 0.921 for SOFA score, 0.776 for age, 0.764 for dyspnea, 0.658 for leukocytosis, and 0.960 for the combination of the four risk factors. Conclusions Our findings advocate the use of risk factors SOFA score ≥2, age >60, dyspnea and leukocytosis >9.5 X10 9 /L on admission, alone or in combination, to determine the optimal management of the patients and health care resources.