Results of the Adult COVID-19 Lifestyle Matching Study.

Objective: The aim of our case-control study was to find the influence of lifestyle and comorbidities on COVID-19 susceptibility, identify risk factors and protective factors, and identify ways to encourage people to adopt a healthy lifestyle. Methods: Patients with COVID-19 were matched with non-COVID-19 participants in a ratio of 1:2. Univariate analysis was performed using the chi-square test, and multivariate analysis was performed using conditional logistic regression. Results: Multivariate analysis using conditional logistic regression found that alcohol consumption (AC) and a bland diet increased the risk of COVID-19, while college degrees and above, smoking, drinking tea, and exercise, especially walking, significantly reduced the risk of COVID-19. Conclusion: After removing the effects of demographic factors, the study demonstrated that AC significantly reduced the ability of the body to resist COVID-19 infection. Moreover, following a bland diet increased the susceptibility to COVID-19. Notably, people who drank tea and performed regular exercises, especially walking, were significantly less likely to be infected with COVID-19. College degree or above relative illiteracy is COVID-19 protective factors of infection.

Perceptions towards online learning among medical students during the COVID-19 pandemic.

Social distancing has been essential during the COVID-19 pandemic to slow the spread of the disease. Online learning ensures students can participate in learning activities while also maintaining a physical distance from other students. Although online learning was used to prevent the spread of COVID-19, the development of online learning has also been promoted. Here, we sought to explore the perceptions and responses of students to online learning during the pandemic using a cross-sectional study. Electronic questionnaire was used for data collection. Statistical analyses were performed for 1614 valid questionnaires and P < 0.05 was considered statistically significant. Overall, COVID-19 had more effect on female students, such as fear of COVID-19 (2.4 times higher than the number of male students) and length of time spent learning (H = 42.449, P < 0.05). However, the higher the students' grades were, the less the impact of COVID-19. For the style of lessons, all students would prefer shorter lessons (P < 0.05). Female and fifth-grade students were more prefer combined online and face-to-face learning, and male and freshmen students were more likely to prefer face-to-face learning after the pandemic. More than 50% of students thought the main advantage of online learning was convenience, with low efficiency being a disadvantage. The main factors negatively influencing online learning were eyestrain, poor network connections, and poor learning environments at home. In conclusion, synchronous online and face-to-face learning may become more common in future curricula, however the efficiency of online learning and the female students more attentions.

Hepatitis of unknown etiology in children: Current evidence and association.

Two years after the coronavirus disease 2019 (COVID-19) pandemic, acute hepatitis of unknown etiology in children (AHUCD) began to be reported worldwide. The novel coronavirus and adenovirus were found in pathogen and antibody tests in AHUCD cases reported by the World Health Organization. Children are not exposed to the viruses that children are generally exposed to owing to COVID-19 infection preventive measures such as isolation and wearing masks; therefore, some researchers have speculated that this disease is related to reduced exposure to pathogens. Some scientists have also speculated that the disease is related to liver injury and adenoviral hepatitis, which are the sequelae of COVID-19. Some evidence also suggests a weak association between the disease and COVID-19 vaccination. Therefore, further research and investigation of the pathogenesis, preventive measures, and early treatment of hepatitis of unknown etiology are required. This study aimed to synthesize available evidence to further elucidate this disease in order to treat and prevent it effectively.

Meta-analysis of prevalence and associated factors of depressive symptoms in Chinese college students before and after the COVID-19 epidemic

Objective: To explore the prevalence and related factors of depressive symptoms in Chinese college students before and after the COVID-19 epidemic and to provide a reference for mental health education and management.

Comparative Analysis of Long Non-Coding RNA Expression and Immune Response in Mild and Severe COVID-19.

Background: Coronavirus disease 2019 (COVID-19) is a worldwide emergency, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Long non-coding RNAs (lncRNAs) do not encode proteins but could participate in immune response. Methods: In our study, 39 COVID-19 patients were enrolled. The microarray of peripheral blood mononuclear cells from healthy and COVID-19 patients was applied to identify the expression profiles of lncRNAs and mRNAs. Identified differentially expressed (DE) lncRNAs were validated by qRT-PCR. Then, the lncRNA-mRNA network was constructed and visualized using Cytoscape (3.6.1) based on the Pearson correlation coefficient. The enrichment of DE mRNAs was analyzed using Metascape. The difference in frequencies of immune cells and cytokines was detected using CIBERSORT and ImmPort based on DE mRNAs. Results: All patients with COVID-19 displayed lymphopenia, especially in T cells, and hyper-inflammatory responses, including IL-6 and TNF-α. Four immune-related lncRNAs in COVID-19 were found and further validated, including AC136475.9, CATG00000032642.1, G004246, and XLOC_013290. Functional analysis enriched in downregulation of the T-cell receptor and the antigen processing and presentation as well as increased apoptotic proteins, which could lead to T-cell cytopenia. In addition, they participated in monocyte remodeling, which contributed to releasing cytokines and chemokines and then recruiting more monocytes and aggravating the clinical severity of COVID-19 patients. Conclusion: Taken together, four lncRNAs were in part of immune response in COVID-19, which was involved in the T-cell cytopenia by downregulating the antigen processing and presentation, the T-cell receptor, and an increased proportion of monocytes, with a distinct change in cytokines and chemokines.

Progressive destruction of jaws caused by the delayed treatment of Langerhans cell histiocytosis in a 2-year-old boy: A case report.

Langerhans cell histiocytosis (LCH) is a disease with varied clinic manifestations. The oral symptoms and signs of LCH localized to the jaws are nonspecific, which may lead to misdiagnosis of this disease. The purpose of this paper was to present the case of a 2-year, 4-month-old LCH patient with progressive destruction of jaws caused by the delayed treatment due to the global outbreak of COVID-19. The cone beam CT analysis after an interval of 6 months reminded us the great significance of early diagnosis and treatment of LCH.

Structural Genomic Analysis of SARS-CoV-2 and Other Coronaviruses.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we conducted a comparative analysis of the structural genes of SARS-CoV-2 and other CoVs. We found that the sequence of the E gene was the most evolutionarily conserved across 200 SARS-CoV-2 isolates. The E gene and M gene sequences of SARS-CoV-2 and NC014470 CoV were closely related and fell within the same branch of a phylogenetic tree. The absolute diversity of E gene and M gene sequences of SARS-CoV-2 isolates was similar to that of common CoVs (C-CoVs) infecting other organisms. The absolute diversity of the M gene sequence of the KJ481931 CoV that can infect humans was similar to that of SARS-CoV-2 and C-CoVs infecting other organisms. The M gene sequence of KJ481931 CoV (infecting humans), SARS-CoV-2 and NC014470 CoV (infecting other organisms) were closely related, falling within the same branch of a phylogenetic tree. Patterns of variation and evolutionary characteristics of the N gene and S gene were very similar. These data may be of value for understanding the origins and intermediate hosts of SARS-CoV-2.

The influence mechanism of household waste separation behavior among college students in the post COVID-19 pandemic period.

College students are one of the most important groups of participants and promoters of household waste separation. Taking Ningbo as a case study, an online + offline questionnaire survey among more than 1700 students in 10 colleges is conducted to identify the main factors and pathways influencing waste separation behavior in the post COVID-19 pandemic period. The results show that the KMO statistic is 0.926, Bartlet test is p < 0.001, indicating that questionnaire sample data is suitable for factor analysis. The modified Structural Equation Model test indicates that waste separation behavior of college students mainly results from the combined effect of eight subjective intrinsic factors and seven external situational factors. Among them, the convenience of recycling facilities, the convenience of sorting facilities and the publicity and education of sorting knowledge are the top three factors with the most significant influence. The mean value of epidemic impact factors is 0.277, which is slightly lower than conventional influence factors (0.289). Environmental Norms and Constraints are an essential component in the analysis framework of college students' waste separation behavior. In the future, society and colleges should give full play to the positive influence of the epidemic factor on college students' waste separation behavior. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10163-022-01363-3.

Research on sleep status, body mass index, anxiety and depression of college students during the post-pandemic era in Wuhan, China.

OBJECTIVE: Wuhan was the first Chinese city to be lockdown for the coronavirus disease 2019 (COVID-19) outbreak in springtime of 2020. The purpose of this study was to investigate the relationship between sleep status, body mass index, anxiety and depression in college students during the post-pandemic era in the universities of Wuhan, China. METHODS: A total of 1457 college students completed the online surveys from December 25, 2020 to January 16, 2021. Collected data included gender, age, school name, native place, grade, major, body mass index (BMI), the scores of self-assessment lists of sleep (SRSS), Zung self-rating anxiety scale (SAS) and Zung depression self-rating scale (SDS). RESULTS: 1445 valid questionnaires (99.18%) were received. Of all the respondents, the prevalence of insomnia, overweight and obesity, anxiety and depression were 32.73%, 19.45%, 15.43% and 62.91%, respectively. Female students were more likely to have insomnia and anxiety than male students. The rate of insomnia, overweight and obesity in postgraduates were higher than undergraduates. Non-medical students were more likely to be overweight and obese than medical students. In addition, insomnia severity was positively correlated to anxiety severity, and BMI was positively correlated to anxiety or depression severity. There was also a positive correlation between the severity of anxiety and depression. CONCLUSION: During the post-pandemic era, insomnia and depression are common problems among college students in Wuhan, suggesting that we should strengthen the sleep education of college students to improve sleeping disorders and psychosomatic health.

Knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle students in Hangzhou

Objective: To analyze knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle school students in Hangzhou and to provide a scientific basis for schools to carry out targeted prevention and control measures.

COVID-19 and financial market response in China: Micro evidence and possible mechanisms.

This paper uses event study based on the Generalized Autoregressive Conditional Heteroscedasticity (GARCH) model to study the impact of the COVID-19 outbreak on China's financial market. It finds that the pandemic had an overall significant and negative impact on the stock prices of firms listed on SSE, SZSE and ChiNext. However, such impact appeared to be heterogeneous across industries, affecting listed firms in industries such as pharmaceutical and telecommunications positively, but those in services industries such as accommodation, catering, and commercial services negatively. Apparently, a crisis for some had been an opportunity for others. In addition, this paper seeks to understand the micro mechanism behind the heterogeneity of pandemic shock from the perspective of firms' financial position. It finds that listed firms with higher debt level were hit harder, whereas those with more net cash flow had displayed higher resilience against the blow of the pandemic. However, the opposite pattern is found among those listed on ChiNext and in industries severely devastated by the pandemic. These findings have policy implications in terms of preventing systemic financial risks and facilitating recovery during pandemic-induced economic downturns. It also helps investor adjust investment strategies, hedge against risks, and secure gains when the market conditions in general are unfavorable.

RBM15-mediated N6-methyladenosine modification affects COVID-19 severity by regulating the expression of multitarget genes.

Severe coronavirus disease 2019 (COVID-19) is characterized by symptoms of lymphopenia and multiorgan damage, but the underlying mechanisms remain unclear. To explore the function of N6-methyladenosine (m6A) modifications in COVID-19, we performed microarray analyses to comprehensively characterize the m6A epitranscriptome. The results revealed distinct global m6A profiles in severe and mild COVID-19 patients. Programmed cell death and inflammatory response were the major biological processes modulated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Further, RBM15, a major m6A methyltransferase, was significantly elevated and positively correlated with disease severity. Silencing RBM15 drastically reduced lymphocyte death in vitro. Knockdown of RBM15 remarkably suppressed the expression levels of multitarget genes related to programmed cell death and inflammatory response. This study shows that SARS-CoV-2 infection alters the m6A epitranscriptome of lymphocytes, particularly in the case of severe patients. RBM15 regulated host immune response to SARS-CoV-2 by elevating m6A modifications of multitarget genes. These findings indicate that RBM15 can serve as a target for the treatment of COVID-19.

Comparative study of hospitalized children with acute respiratory distress syndrome caused by SARS-CoV-2 and influenza virus.

BACKGROUND: Since the outbreak of coronavirus disease 2019 in December 2019, more than 8 million cases have occurred worldwide as of June 16, 2020. However, it is important to distinguish COVID-19 from other respiratory infectious diseases, such as influenza. Here, we comparatively described the clinical characteristics of children with COVID-19 and paediatric patients with influenza. METHODS: In this retrospective, single-centre study, we reviewed the electronic medical records of 585 paediatric patients with COVID-19 or influenza in Wuhan Children's Hospital, China. Clinical and epidemiological characteristics, laboratory findings, and clinical outcomes were comparatively analysed. RESULTS: The median ages were 6.96 years (IQR, 2-10.81) for children with confirmed COVID-19, 2.67 years (IQR, 1.03-15.25) for those with influenza A and 3.67 years (IQR, 1.62-5.54) for those with influenza B. Fever was a symptom in 84 (34.7%) COVID-19 cases, 132 (70.21%) influenza A cases and 111 (74.50%) influenza B cases. The median length of stay (LOS) was 11 (8-15) days for paediatric COVID-19 patients, 4 (3-6) days for influenza A patients and 5 (3-6) days for influenza B patients. Twenty-six (13.98%) influenza A patients and 18 (12.59%) influenza B patients presented with decreased white blood cell counts, while 13 (5.33%) COVID-19 patients presented with decreased white blood cell counts. Eight (3.28%) COVID-19 patients, 23 (12.71%) influenza A patients and 21 (14.79%) influenza B patients experienced lymphocytopenia. Acute cardiac injury occurred in 18 (7.29%) COVID-19 patients, while 37 (19.68%) influenza A and 27 (18.12%) influenza B patients had acute cardiac injury. CONCLUSION: In this study, the illnesses of children with COVID-19 were demonstrated to be less severe than those of paediatric patients with influenza, and COVID-19 patients had milder illness and fewer complications.

Inflammation and Antiviral Immune Response Associated With Severe Progression of COVID-19.

Coronavirus disease-2019 (COVID-19) is a novel respiratory disease induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It remains poorly understood how the host immune system responds to the infection during disease progression. We applied microarray analysis of the whole genome transcriptome to peripheral blood mononuclear cells (PBMCs) taken from severe and mild COVID-19 patients as well as healthy controls. Functional enrichment analysis of genes associated with COVID-19 severity indicated that disease progression is featured by overactivation of myeloid cells and deficient T cell function. The upregulation of TLR6 and MMP9, which promote the neutrophils-mediated inflammatory response, and the downregulation of SKAP1 and LAG3, which regulate T cells function, were associated with disease severity. Importantly, the regulation of these four genes was absent in patients with influenza A (H1N1). And compared with stimulation with hemagglutinin (HA) of H1N1 virus, the regulation pattern of these genes was unique in PBMCs response to Spike protein of SARS-CoV-2 ex vivo. Our data also suggested that severe SARS-CoV-2 infection largely silenced the response of type I interferons (IFNs) and altered the proportion of immune cells, providing a potential mechanism for the hypercytokinemia. This study indicates that SARS-CoV-2 infection impairs inflammatory and immune signatures in patients, especially those at severe stage. The potential mechanisms underpinning severe COVID-19 progression include overactive myeloid cells, impaired function of T cells, and inadequate induction of type I IFNs signaling.

Negative-Pressure Isolation Mask for Endoscopic Examination During the Coronavirus Disease 2019 Pandemic: A Randomized Controlled Trial.

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, endoscopists have high risks of exposure to exhaled air from patients during gastroscopy. To minimize this risk, we transformed the oxygen mask into a fully closed negative-pressure gastroscope isolation mask. This study aimed to evaluate the effectiveness, safety, and feasibility of use of this mask during gastroscopy. METHODS: From February 28, 2020, to March 10, 2020, 320 patients undergoing gastroscopy were randomly assigned into the mask group (n = 160) or conventional group (n = 160). Patients in the mask group wore the isolation mask during gastroscopy, whereas patients in the conventional group did not wear the mask. The adenosine triphosphate fluorescence and carbon dioxide (CO2) concentration in patients' exhaled air were measured to reflect the degree of environmental pollution by exhaled air. Patients' vital signs, operation time, and adverse events during endoscopy were also evaluated. RESULTS: Four patients were excluded because of noncooperation or incomplete data. A total of 316 patients were included in the final analysis. The difference between the highest CO2 concentration around patients' mouth and CO2 concentration in the environment was significantly decreased in the mask group compared with the conventional group. There was no significant difference in the adenosine triphosphate fluorescence, vital signs, and operation time between the 2 groups. No severe adverse events related to the isolation mask, endoscopy failure, or new coronavirus infection during follow-up were recorded. DISCUSSION: This new isolation mask showed excellent feasibility of use and safety compared with routine gastroscopy during the COVID-19 pandemic.

Which Factors, Smoking, Drinking Alcohol, Betel Quid Chewing, or Underlying Diseases, Are More Likely to Influence the Severity of COVID-19?

The global outbreak of the coronavirus disease 2019 (COVID-19) pandemic occurred in late 2019 and early 2020. The factors that influence disease severity should be of clinical concern. Existing findings on the effects of smoking on COVID-19 are also controversial and need to be confirmed by further research. In addition, the effects of alcohol consumption and betel quid (BQ) chewing on COVID-19 are unclear. The aim of this study was to examine the demographic characteristics of COVID-19 patients and the effects of smoking, drinking, BQ chewing, and underlying diseases on the severity of COVID-19. A retrospective study was conducted on 91 patients with confirmed cases of COVID-19 hospitalized in Yueyang, Hunan Province, China from 21 January to 8 March, 2020. Patient demographic data, and information on smoking, drinking and BQ chewing, and underlying diseases were extracted from the patient electronic medical records (EMR) and telephone interviews. The chi-square test was used to conduct a univariate analysis of the factors influencing the severity of COVID-19, and ordinal logistic regression analysis was used to identify the factors related to the severity of COVID-19. The results showed that the rates of smoking, drinking and BQ chewing were 15.4, 26.4, and 7.1%, respectively, there was no significant relationship between these lifestyle factors and the severity of COVID-19 (P > 0.05). However, underlying diseases such as diabetes [odds ratio (OR) = 7.740, 95% confidence interval (CI):1.000-60.740, P = 0.050], source of infection (OR = 0.180, 95% CI: 0.030-0.980, P = 0.049), and employment status (retired/unemployed vs. employed: OR = 29.430, 95% CI, 1.050 - 822.330, P = 0.047) were significant independent predictors of severe COVID-19 infection. These individuals should be informed of methods to increase personal protection, and doctors should prevent these individuals from developing serious diseases. It is important to pay attention to the source of infection and timely medical treatment. This study showed that the clinical classification of COVID-19 was associated with patients with diabetes, source of infection, and retired/unemployed. Therefore in the clinical practice of COVID-19 should be more concern these factors. Although no statistical significance was found in smoking, drinking alcohol, BQ chewing, and severity of COVID-19 patients, more studies have confirmed that are harmful and risk factors for underlying diseases in the population. Health authorities should formulate policies to publicize the harmful effects of smoking, drinking, and betel nut chewing and promote a healthy lifestyle.

1.6 Million transactions replicate distributed PV market slowdown by COVID-19 lockdown.

Solar PV has seen a spectacular market development in recent years and has become a cost competitive source of electricity in many parts of the world. Yet, prospective observations show that the coronavirus pandemic could impact renewable energy projects, especially in the distributed market. Tracking and attributing the economic footprint of COVID-19 lockdowns in the photovoltaic sector poses a significant research challenge. Based on millions of financial transaction records and 44 thousand photovoltaic installation records, we tracked the spatio-temporal sale network of the distributed photovoltaic market and explored the extent of market slowdown. We found that a two-month lockdown duration can be assessed as a high-risk threshold value. When the lockdown duration exceeds the threshold value, the monthly value-added loss reaches 67.7%, and emission reduction capacity is cut by 64.2% over the whole year. We show that risks of a slowdown in PV deployment due to COVID-19 lockdowns can be mitigated by comprehensive incentive strategies for the distributed PV market amid market uncertainties.

Comparative analysis of SARS-CoV-2 and its receptor ACE2 with evolutionarily related coronaviruses.

The pandemic COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is spreading very rapidly worldwide. To date, the origin and intermediate hosts of SARS-CoV-2 remain unclear. In this study, we conducted comparative analysis among SARS-CoV-2 and non-SARS-CoV-2 coronavirus strains to elucidate their phylogenetic relationships. We found: 1, the SARS-CoV-2 strains analyzed could be divided into 3 clades with regional aggregation; 2, the non-SARS-CoV-2 common coronaviruses that infect humans or other organisms to cause respiratory syndrome and epizootic catarrhal gastroenteritis could also be divided into 3 clades; 3, the hosts of the common coronaviruses closest to SARS-CoV-2 were Apodemus chevrieri (a rodent), Delphinapterus leucas (beluga whale), Hypsugo savii (bat) , Camelus bactrianus (camel) and Mustela vison (mink); and 4, the gene sequences of the receptor ACE2 from different hosts could also be divided into 3 clades. The ACE2 gene sequences closest to that of humans in evolution include those from Nannospalax galili (Upper Galilee mountains blind mole rat), Phyllostomus discolor (pale spear-nosed bat), Mus musculus (house mouse), Delphinapterus leucas (beluga whale), and Catharus ustulatus (Swainson's thrush). We conclude that SARS-CoV-2 may have evolved from a distant common ancestor with the common coronaviruses but not a branch of any of them, implying that the prevalent pandemic COVID-19 agent SARS-CoV-2 may have existed in a yet to be identified primary host for a long time.

Management of an endoscopy center during the outbreak of COVID-19: Experience from West China Hospital.

Since the outbreak of the coronavirus disease 2019 (COVID-19), various measures have been taken to protect against the infection. As droplet and contact transmission are the main routes of COVID-19 infection, endoscopy centers are considered to be high-risk areas for exposure to COVID-19. We have undertaken several countermeasures in our endoscopic center during the pandemic, and have gained significant experience in terms of prevention and control of COVID-19. We here present our experience and strategies adopted for preventing hospital infection in our endoscopy center during the COVID-19 pandemic. We describe our management of the environment, endoscope, patients, and medical staff, and our self-made masks.