Predictive value of fasting blood glucose and TG/HDL-C ratio in non-diabetic patients with COVID-19

Objective: To investigate the predictive values of fasting blood glucose and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) in non-diabetic patients with COVID-19. Methods: A total of 39 non-diabetic patients with COVID-19 admitted to the Fourth Hospital of Xi'an from December 2021 to January 2022 were included. And 34 health examination subjects from the Second Affiliated Hospital of Xi'an Jiaotong University were matched as health control according to their propensity score. The clinical characteristics and laboratory test results between groups were compared, and the predictive value of fasting glucose and TG/HDL-C in non-diabetic COVID-19 patients was analyzed by logistic regression and receiver operating curve (ROC). Results: COVID-19 patients were either mild (30 cases) or common type (9 cases) with mild symptoms and good clinical prognosis. The median age was 29.0 (20.0, 49.0) years, 24 (61.5%) were males. Fasting blood glucose (4.30+or-0.47 mmol/L) and HDL-C [1.07 (0.86, 1.30) mmol/L] levels in COVID-19 patients were significantly lower than healthy controls [5.15+or-0.70 mmol/L, 2.24 (1.77, 3.05) mmol/L], the differences were statistically significant (t=6.277, P < 0.001;Z=6.026, P < 0.001). However, low density lipoprotein cholesterol (LDL-C) [2.40 (1.81, 2.91) mmol/L] and TG/HDL-C [0.91 (0.54, 1.52)] in COVID-19 patients were significantly increased compared to healthy controls [1.11 (0.99, 1.30) mmol/L, 0.54 (0.33, 0.90)], and the differences were statistically significant (Z=-6.271, -2.801, all P < 0.005). Logistic regression analysis showed that fasting blood glucose on admission could be an independent protective factor (OR:0.020, 95% CI: 0.003 ~ 0.150) and elevated TG/HDL-C be a risk factor (OR:4.802, 95% CI: 1.249 ~ 18.460) for COVID-19 infection among non-diabetic populations. The ROC curve showed that fasting blood glucose and TG/HDL-C were good at predicting the risk of COVID-19, and the area under the curve (AUC) were 0.871 and 0.708, respectively, and was 0.895 when combined. Conclusion: Decreased fasting blood glucose and elevated TG/HDL-C would be risk factors for COVID-19 infection in the non-diabetic population, and both have good predictive value for the incidence of COVID-19.

Auricular acupressure for adverse events following immunization after COVID-19 vaccine injection: A multicentre, blinded, randomized controlled trial.

BACKGROUND: Some adverse events following immunization (AEFI) were observed in potential corelation with COVID-19 vaccination but without prevention or ongoing trial for it. We aimed to investigate efficacy of auricular acupressure (AuriAc) therapy in preventing AEFI after first dosage of the vaccine. METHODS: We performed a multicentre randomized controlled trial with three arms, including AuriAc, SAuriAc (sham auricular acupressure), and TrAsU (treatment as usual) group, carried out in four medical institutions in Chengdu, China, from March 17th to April 23rd, 2021. We enrolled participants based on eligibility criteria and randomized them into three groups: AuriAc (AEFI-specific auricular points applied, n = 52), SAuriAc (n = 51) or TrAsU (n = 44) group. Primary outcomes were percentages of any AEFI and local pain, and secondary outcomes were percentages who reported other AEFI. They were followed at 1, 3, 5, 7, and 14 days, by phone or online, with severity evaluated. RESULTS: 147 participants (73.47% females) were included with median age as 31 years (25-45, IQR). One day after the injection, participants in AuriAc group reported significant reduction on percentages of any AEFI [intention-to-treat, difference of percentage (DP) = -20.13, 95%CI: - 0.39, - 0.02, p = 0.01; per-protocol, DP = -22.21, 95%CI: - 0.40, - 0.03, P = 0.02] and local pain (per-protocol, DP = -18.40, 95%CI: -0.36, -0.01, P = 0.04), compared with TrAsU group. The effects were slight at other follow-up days and for other outcomes, and with a low percentage of mild local allergic reactions. CONCLUSIONS: We firstly explored potential of AuriAc for preventing AEFI related to COVID-19 vaccine injection, which is beneficial for the vaccine recipients, but evidence is limited. TRIAL REGISTRATION: chictr.org.cn no. ChiCTR2100043210 (http://www.chictr.org.cn/showproj.aspx?proj=121519).

Qualitative Research on the Training Experiences and Needs of Intensive Care Unit General Nurses Against the Background of Regular Coronavirus Disease 2019 Prevention and Control.

Objective: This study aimed to investigate the training experiences and needs of intensive care unit (ICU) general nurses against a background of regular Coronavirus disease (COVID-19) prevention and control. Methods: Using the phenomenological method of qualitative research, semi-structured interviews were conducted with 10 ICU nurses. The interview data were analyzed, sorted, summarized, and refined using the content analysis method. Results: The following five themes were extracted from the interviews, based on the training experiences of the nurses: 1) broadening their thinking; 2) discovering their personal shortcomings; 3) gaining self-confidence; 4) calmly facing frontline work; 5) experiencing high assessment pressure. The training needs of the nurses could be summarized into the following four themes: 1) increased training time; 2) improving the assessment mechanism; 3) establishing a normal rotating-shift training system; 4) balancing the teaching levels. Conclusion: Against a background of regular epidemic prevention and control, ICU training for general nurses is of high practical significance and value. Thus, active exploration and research should be conducted to establish perfect training and assessment mechanisms for these nurses. Additionally, training methods that are suitable for clinical needs should be formulated and training systematization and standardization must be promoted.

Perceived Stress Positively Relates to Insomnia Symptoms: The Moderation of Resilience in Chinese Pregnant Women During COVID-19.

Background: The government's COVID-19 pandemic response lockdown strategy had a negative psychological and physical impact on individuals, which necessitated special care to pregnant women's mental health. There has been no large-scale research on the underlying relationship between perceived stress and insomnia symptoms in pregnant Chinese women up to this point. During the COVID-19 pandemic, we wanted to see if there was an association between perceived stress and insomnia symptoms, as well as the moderating impact of resilience for Chinese pregnant women. Methods: This cross-sectional study examined 2115 pregnant women from central and western China using multi-stage sampling methodologies. A systematic questionnaire was used to collect information on sleep quality, perceived stress, and resilience using the Insomnia Severity Index, Perceptual Stress Scale, and Connor and Davidson Resilience Scale. To assess the moderating influence of resilience, hierarchical regressions were used. Results: During the COVID-19 pandemic, 18.53% of respondents (N = 2115) reported experiencing sleeplessness. In pregnant women, perceived stress was positively linked with insomnia symptoms (p < 0.001). Furthermore, resilience significantly attenuated the influence of perceived stress on insomnia symptoms in Chinese expectant mother (ßinteraction = -0.0126, p < 0.001). Conclusion: Pregnant women with strong resilience were less influenced by perceived stress than those with poor resilience. The findings of this study might give empirical proof that health care professionals should identify the relevance of reducing perceived stress in pregnant women with poor resilience and provide better treatment and support when necessary.

Current care practices for patients with Duchenne muscular dystrophy in China.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has presented challenges in the care of patients with chronic diseases. We identified the challenges faced by Chinese patients with Duchenne muscular dystrophy (DMD) during the pandemic. METHODS: An online cross-sectional survey was conducted between March 27 and June 30, 2021. RESULTS: Of the 2105 valid questionnaire responses, 2,056 patients were from non-lockdown areas. In these areas, 42.8% reduced outside daily activities, 49.4% reduced rehabilitation service use, 39.7% postponed regular follow-ups, and 40.8% reported accelerated motor function decline. These figures generally increased for patients from lockdown areas-67.3% reduced outside daily activities, 44.9% reduced rehabilitation service use, 79.6% postponed regular follow-ups, and 55.1% reported accelerated motor function decline. Ambulation loss was most commonly reported in September and March before 2020; however, this trend was absent in 2020. Regarding the informed prices of disease-modifying drugs in Europe and the United States, 86.7% could afford a maximum of one-twentieth of the prices, 8.0% could afford one-tenth of the prices, and only 0.6% of the patients could afford the full prices. CONCLUSIONS: Implementation of standardized care for DMD in China is consistent with global practices, and the COVID-19 pandemic has affected the care of patients with chronic diseases worldwide, particularly in lockdown areas. Telemedicine is an effective model for providing healthcare to such patients. Healthcare workers should assist patients and establish more robust chronic disease management systems. Collaboration between governmental and non-governmental entities could address the cost of disease-modifying drugs in China and other developing countries.

The Evolution and Disparities of Online Attitudes Toward COVID-19 Vaccines: Year-long Longitudinal and Cross-sectional Study.

BACKGROUND: Due to the urgency caused by the COVID-19 pandemic worldwide, vaccine manufacturers have to shorten and parallel the development steps to accelerate COVID-19 vaccine production. Although all usual safety and efficacy monitoring mechanisms remain in place, varied attitudes toward the new vaccines have arisen among different population groups. OBJECTIVE: This study aimed to discern the evolution and disparities of attitudes toward COVID-19 vaccines among various population groups through the study of large-scale tweets spanning over a whole year. METHODS: We collected over 1.4 billion tweets from June 2020 to July 2021, which cover some critical phases concerning the development and inoculation of COVID-19 vaccines worldwide. We first developed a data mining model that incorporates a series of deep learning algorithms for inferring a range of individual characteristics, both in reality and in cyberspace, as well as sentiments and emotions expressed in tweets. We further conducted an observational study, including an overall analysis, a longitudinal study, and a cross-sectional study, to collectively explore the attitudes of major population groups. RESULTS: Our study derived 3 main findings. First, the whole population's attentiveness toward vaccines was strongly correlated (Pearson r=0.9512) with official COVID-19 statistics, including confirmed cases and deaths. Such attentiveness was also noticeably influenced by major vaccine-related events. Second, after the beginning of large-scale vaccine inoculation, the sentiments of all population groups stabilized, followed by a considerably pessimistic trend after June 2021. Third, attitude disparities toward vaccines existed among population groups defined by 8 different demographic characteristics. By crossing the 2 dimensions of attitude, we found that among population groups carrying low sentiments, some had high attentiveness ratios, such as males and individuals aged ≥40 years, while some had low attentiveness ratios, such as individuals aged ≤18 years, those with occupations of the 3rd category, those with account age <5 years, and those with follower number <500. These findings can be used as a guide in deciding who should be given more attention and what kinds of help to give to alleviate the concerns about vaccines. CONCLUSIONS: This study tracked the year-long evolution of attitudes toward COVID-19 vaccines among various population groups defined by 8 demographic characteristics, through which significant disparities in attitudes along multiple dimensions were revealed. According to these findings, it is suggested that governments and public health organizations should provide targeted interventions to address different concerns, especially among males, older people, and other individuals with low levels of education, low awareness of news, low income, and light use of social media. Moreover, public health authorities may consider cooperating with Twitter users having high levels of social influence to promote the acceptance of COVID-19 vaccines among all population groups.

Two newly isolated GVI lineage infectious bronchitis viruses in China show unique molecular and pathogenicity characteristics.

During 2016 to 2020, GVI-1 type infectious bronchitis virus (IBV) strains were sporadically reported across China, indicating a new epidemic trend of the virus. Here we investigated the molecular characteristics and pathogenicity of two newly isolated GVI-1 type IBV virus strains (CK/CH/TJ1904 and CK/CH/NP2011) from infected chicken farms in China. Genetic evolution analysis of the S1 gene showed the highest homology with the GVI-1 representative strain, TC07-2. Phylogenetic analysis and recombination analysis of the virus genomes indicated that newly isolated strains in China may be independently derived from recombination events that occurred between GI-19 and GI-22 strains and early GVI-1 viruses. Interestingly, unlike the deduced parental GI-19 or GI-22 strains, CK/CH/TJ1904 and CK/CH/NP2011 showed affinity for the trachea rather than the kidney and were less pathogenic. This difference may be because of recombination events that occurred during the long co-existence of the GVI-1 viruses with prevalent GI-19 and GI-22 strains. Considering the new trend, it is very important to permanently monitor circulating strains and to develop new vaccines to counteract emerging new-type IBVs.

A three-arm, multicenter, open-label randomized controlled trial of hydroxychloroquine and low-dose prednisone to treat recurrent pregnancy loss in women with undifferentiated connective tissue diseases: protocol for the Immunosuppressant regimens for LIving FEtuses (ILIFE) trial.

BACKGROUND: Undifferentiated connective tissue disease (UCTD) is known to induce adverse pregnancy outcomes and even recurrent spontaneous abortion (RSA) by placental vascular damage and inflammation activation. Anticoagulation can prevent pregnancy morbidities. However, it is unknown whether the addition of immune suppressants to anticoagulation can prevent spontaneous pregnancy loss in UCTD patients. The purpose of this study is to evaluate the efficacy of hydroxychloroquine (HCQ) and low-dose prednisone on recurrent pregnancy loss for women with UCTD. METHODS: The Immunosuppressant for Living Fetuses (ILIFE) Trial is a three-arm, multicenter, open-label randomized controlled trial with the primary objective of comparing hydroxychloroquine combined with low-dose prednisone and anticoagulation with anticoagulation alone in treating UCTD women with recurrent spontaneous abortion. The third arm of using hydroxychloroquine combined with anticoagulant for secondary comparison. A total of 426 eligible patients will be randomly assigned to each of the three arms with a 1:1:1 allocation ratio. The primary outcome is the rate of live births. Secondary outcomes include adverse pregnancy outcomes and progression of UCTD. DISCUSSION: This is the first multi-center, open-label, randomized controlled trial which evaluates the efficacy of immunosuppressant regimens on pregnancy outcomes and UCTD progression. It will provide evidence on whether the immunosuppressant ameliorates the pregnancy prognosis in UCTD patients with RSA and the progression into defined connective tissue disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT03671174 . Registered on 14 September 2018.

Understanding Concerns, Sentiments, and Disparities Among Population Groups During the COVID-19 Pandemic Via Twitter Data Mining: Large-scale Cross-sectional Study.

BACKGROUND: Since the beginning of the COVID-19 pandemic in late 2019, its far-reaching impacts have been witnessed globally across all aspects of human life, such as health, economy, politics, and education. Such widely penetrating impacts cast significant and profound burdens on all population groups, incurring varied concerns and sentiments among them. OBJECTIVE: This study aims to identify the concerns, sentiments, and disparities of various population groups during the COVID-19 pandemic through a cross-sectional study conducted via large-scale Twitter data mining infoveillance. METHODS: This study consisted of three steps: first, tweets posted during the pandemic were collected and preprocessed on a large scale; second, the key population attributes, concerns, sentiments, and emotions were extracted via a collection of natural language processing procedures; third, multiple analyses were conducted to reveal concerns, sentiments, and disparities among population groups during the pandemic. Overall, this study implemented a quick, effective, and economical approach for analyzing population-level disparities during a public health event. The source code developed in this study was released for free public use at GitHub. RESULTS: A total of 1,015,655 original English tweets posted from August 7 to 12, 2020, were acquired and analyzed to obtain the following results. Organizations were significantly more concerned about COVID-19 (odds ratio [OR] 3.48, 95% CI 3.39-3.58) and expressed more fear and depression emotions than individuals. Females were less concerned about COVID-19 (OR 0.73, 95% CI 0.71-0.75) and expressed less fear and depression emotions than males. Among all age groups (ie, ≤18, 19-29, 30-39, and ≥40 years of age), the attention ORs of COVID-19 fear and depression increased significantly with age. It is worth noting that not all females paid less attention to COVID-19 than males. In the age group of 40 years or older, females were more concerned than males, especially regarding the economic and education topics. In addition, males 40 years or older and 18 years or younger were the least positive. Lastly, in all sentiment analyses, the sentiment polarities regarding political topics were always the lowest among the five topics of concern across all population groups. CONCLUSIONS: Through large-scale Twitter data mining, this study revealed that meaningful differences regarding concerns and sentiments about COVID-19-related topics existed among population groups during the study period. Therefore, specialized and varied attention and support are needed for different population groups. In addition, the efficient analysis method implemented by our publicly released code can be utilized to dynamically track the evolution of each population group during the pandemic or any other major event for better informed public health research and interventions.

Foundation and Clinical Evaluation of a New Method for Detecting SARS-CoV-2 Antigen by Fluorescent Microsphere Immunochromatography.

Purpose: To develop a rapid detection reagent for SARS-CoV-2 antigen for the auxiliary diagnosis of new coronary pneumonia (COVID-19), and perform the methodological evaluation and clinical evaluation of the reagent. Method: SARS-CoV-2 N-protein test strip was created by combining fluorescent microsphere labeling technology and immunochromatographic technology, based on the principle of double antibody sandwich. Then we evaluated the analytical capability and clinical application of the strips. Result: The limit of detection of the strips for recombinant N protein was 100 ng/ml and for activated SARS -CoV-2 virus was 1 × 103 TCID50/ml. The strips also have high analytical specificity and anti-interference capability. According to the predetermined cut-off value, the specificity of the test strip in healthy controls and patients with other respiratory disease was 100.00 and 97.29%, the sensitivity in COVID-19 cases at progress stage and cured stage was 67.15 and 7.02%. The positive percentage agreement and negative percentage agreement of antigen strip to RNA test were 83.16 and 94.45%. Conclusion: SARS-CoV-2 fluorescence immunochromatographic test strip can achieve fast, sensitive and accurate detection, which can meet the clinical requirements for rapid detection of viruses on the spot.

Establishing a high sensitivity detection method for SARS-CoV-2 IgM/IgG and developing a clinical application of this method.

COVID-19 is caused by SARS-CoV-2 infection and was initially discovered in Wuhan. This outbreak quickly spread all over China and then to more than 20 other countries. SARS-CoV-2 fluorescent microsphere immunochromatographic test strips were prepared by the combination of time-resolved fluorescence immunoassay with a lateral flow assay. The analytical performance and clinical evaluation of this testing method was done and the clinical significance of the testing method was verified. The LLOD of SARS-CoV-2 antibody IgG and IgM was 0.121U/L and 0.366U/L. The specificity of IgM and IgG strips in healthy people and in patients with non-COVID-19 disease was 94%, 96.72% and 95.50%, 99.49%, respectively; and sensitivity of IgM and IgG strips for patients during treatment and follow-up was 63.02%, 37.61% and 87.28%, 90.17%, respectively. The SARS-CoV-2 antibody test strip can provide rapid, flexible and accurate testing, and is able to meet the clinical requirement for rapid on-site testing of virus. The ability to detect IgM and IgG provided a significant benefit for the detection and prediction of clinical course with COVID-19 patients.

Two cases of corona virus disease 2019 (COVID-19) treated with the combination of acupuncture and medication in bedridden patients2.

The paper reports the experiences in treatment of two cases of corona virus disease 2019 (COVID-19) with the combination of acupuncture and medication in bedridden patients confirmed in C7 Inpatient Ward, Wuhan Leishenshan Hospital, China. The combined treatment of acupuncture with the oral administration of "Shanghai leishen No.1 formula" was given every day. The prescription was modified weekly according the symptoms of the patients. Besides, the antivirus, anti-infectious and symptomatic treatment of western medicine was combined. Both of the two cases were improved and discharged. It is anticipated that the treatment experiences in these two cases may provide the instruction and enlightenment for the prevention and treatment of COVID-19.