COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Methods: An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Results: A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine's safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusions: Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

A POSSIBLE WAY FOR PREVENTING THE NOVEL CORONAVIRUS

All living cells are affected deadly by their environmental temperature, a rela-tively higher temperature results in a higher metabolic rate, but when it reaches a threshold, its death acceleration occurs. The same principle is also valid for the Covid-19 virus. This paper suggests a sample way to its prevention by a hot cup of water under the noise. The vapor with a high temperature can make the virus greatly inactive. An optimal height from a boiling water surface is recommended. © 2022. Society of Thermal Engineers of Serbia.

Infectious Disease Dynamics Model Considering Suspected Population

The outbreak of COVID-19 calls for the improvement of infectious disease dynamics model to meet the requirements of future infectious disease's prediction and risk assessment. On the basis of SEIR model, a new transmission dynamics model named as SSEIR is proposed. In order to describe the dynamics evolution of the SSEIR model, a new set of ordinary differential equations (ODE) is constructed. The SSEIR dynamics model is used to simulate and predict the progress of pandemic situation inWuhan, China. Because that the suspected people have different dynamics characteristics from the susceptible people and the exposed people, this paper put them in a new independent category. To describe the dynamics evolution of SSEIR model, a new set of ordinary differential equations (ODE) is constructed. The SSEIR model can be used to simulate and predict the progress of infectious diseases.

[A randomized controlled trial study of immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in different immunization schedules].

Objective: To compare the immunogenicity and safety of an inactivated SARS-CoV-2 vaccine used for the vaccination in public security officers with different immunization schedules. Methods: From January to February, 2021, 405 public security officers in Taiyuan were randomly divided into 3 groups. Two doses of SARS-CoV-2 inactivated vaccine were injected according to the immunization schedule of 0-14 days, 0-21 days or 0-28 days, respectively. The nucleic acid of SARS-CoV-2 was detected by reverse transcription polymerase chain reaction. The neutralizing antibodies to SARS-CoV-2 were tested by microdose cytopathogenic efficiency assay of live virus. The GMT, seroconversion rate of SARS-CoV-2 neutralizing antibody and safety of the vaccine were analyzed for the 3 groups. Results: The seroconversion rate of SARS-CoV-2 neutralizing antibody was 100% in all the 3 groups. The SARS-CoV-2 neutralizing antibody level of 0-21 day group [166.70 (95%CI: 148.30-185.10)] was similar to that of 0-28 day group [179.50 (95%CI: 156.50-202.60)] (P>0.05), significantly higher than that of 0-14 day group [86.08 (95%CI: 72.36-99.80)] (P<0.001). The incidence rates of adverse reaction in the 3 groups were 1.48% (2/135), 0.74% (1/136) and 1.49% (2/134) respectively (P=0.750), all the adverse reactions were mild. Conclusions: The vaccination of inactivated SARS-CoV-2 vaccine with different immunization schedules in public security officers showed good safety and high seroconversion rate, and the GMTs of SARS-CoV-2 neutralizing antibody in 0-21 day group and 0-28 day group were higher than that in 0-14 day group.

Spatiotemporal evolution and influencing factors of Coronavirus disease 2019 in Jiangxi province

Objective To analyze the epidemiological characteristics, spatiotemporal evolution and influencing factors of coronavirus disease 2019 (COVID-19) in Jiangxi Province. Methods  Text analysis was used to extract epidemiological information, ArcGIS 10.3 was performed to capture the evolution, spatial analysis method was applied to explore the spatiotemporal characteristics, and Partial Least Square (PLS) estimation was used to analyze the influencing factors of the epidemic distribution.  Results  In Jiangxi Province, 930 cases have been confirmed in total, with young and middle-aged people accounting for the most (60.40%), and the service industry, migrant workers and labors accounted for the largest proportion. According to the activity track and contact history, the cases can be divided into three types: Imported, mixed and diffuse. The diffuse cases account for 85.48% of the total. The development of the epidemic can be divided into three stages: Import period, diffusion period and control period. The spatial distribution of the epidemic showed the pattern of “southwest-northeast” and “the northern part of Jiangxi was more heavily affected than the southern and middle part of Jiangxi, with high primary ratio in Nanchang-Xinyu”. Population concentration, the intensity of communication and the distance from the worst-hit area were the main factors affecting the distribution of the epidemic.  Conclusions  The gender distribution of confirmed cases was balanced, with young and middle-aged people as the main group. The epidemic had great influence on service industry. The epidemic developed with the pattern of “rapid increase followed by slow decrease”, and with significant spatial heterogeneity. Population concentration and mobility as well as the overall epidemic pattern were the key factors affecting the epidemic distribution. © 2021, Publication Centre of Anhui Medical University. All rights reserved.

Eltrombopag plus rhtpo versus eltrombopag for itp during the covid-19 pandemic (elaborate-19)

Background: Immune thrombocytopenia (ITP) is an acquired thrombocytopenia caused by immune-mediated platelet destruction and impaired platelet production. Recombinant human thrombopoietin (rhTPO) and Eltrombopag, a small molecule agonist of thrombopoietin receptor (TPO-RA), are both recommended as the subsequent treatment for ITP patients, which also already showed robust efficacy. They increase the number of platelets through different mechanisms, and previous studies demonstrated that they might exert synergic effect. During the COVID- 19 pandemic, the classical subsequent treatment regimen for ITP of immunosuppressants and/or steroids might increase patients' susceptibility of virus infections. The investigators hypothesized that the combination of these two agents could be a promising option for ITP treatment during the COVID-19 pandemic. To minimize ITP patients' risk during the COVID-19 global crisis and to improve treatment efficacy, this treatment regimen of Eltrombopag plus rhTPO should be investigated. This trial is registered with ClinicalTrials.gov, number NCT01667263. Aims: This study aimed to evaluate the sustained responses at 6 months and safety of Eltrombopag plus rhTPO as treatment for corticosteroid- resistant or relapsed ITP patients during the COVID-19 pandemic. Methods: In this open-label, randomized, phase 2 trial, we enrolled confirmed corticosteroid-resistant or relapsed adult ITP patients from 5 different tertiary medical centers in China. They were randomly assigned 1:1 with an interactive web-based response system to receive either Eltrombopag 25-75 mg oral daily according to platelet response plus rh-TPO 300U/kg subcutaneous injection once daily for 7 consecutive days, followed by a tapering dose in maintenance therapy or Eltrombopag monotherapy for 12 weeks (Figure 1). The primary endpoint was 6-month sustained response (SR) defined as platelet counts maintained > 30×109/L and at least a doubling of baseline platelet count. Key secondary endpoints were initial response by day 14, duration of response (DOR), TTR, bleeding scores, and adverse events (AEs). Results: Between August 2020, and March 2021, 60 patients were randomly allocated into either rh-TPO plus Eltrombopag (n=30) or Eltrombopag monotherapy (n=30). At the 6-month follow-up, the proportion of patients with SR was significantly higher in the rh-TPO plus Eltrombopag group than in the Eltrombopag monotherapy group (66.7% vs 36.7%, p= 0.020). The combination of rh-TPO and Eltrombopag resulted in a higher incidence of initial response by day 14 compared with Eltrombopag monotherapy (76.7% vs 60%, p= 0.165). Throughout the follow-up period, overall DOR was greater in the combination group, estimated by the Kaplan-Meier analysis. Bleeding was more effectively controlled in the rh-TPO plus Eltrombopag arm, with fewer bleeding events and lower bleeding scores. There was no difference between the 2 groups in terms of rescue treatments. All subjects tolerated the treatment well, and no grade 4 adverse events or treatment- related death were reported. No statistically significant differences were observed in the incidence of treatment-related AEs between the two groups. Summary/Conclusion: Rh-TPO plus Eltrombopag is an effective and safe treatment for corticosteroid-resistant or relapsed ITP patients during the COVID-19 pandemic. (NCT04516837).

A cross-sectional survey on information access through hospital's official account on new media and its association with antenatal care knowledge and health behaviors of pregnant women under COVID-19 epidemic

Objective To explore the association between accessing antenatal care information through hospitals' official new media accounts and antenatal care knowledge and individual prevention behavior under COVID-19 epidemic, and to provide evidence for improving the emergency plan for maternity health care services in China under public health emergencies. Methods The online survey was conducted from Feb 5th to Mar 1st, 2020, at the peak of the COVID-19 epidemic in China. Approaches of accessing antenatal care information, COVID-19 related antenatal care knowledge and individual prevention behavior was collected via cross-sectional design. Results A total of 1 936 valid questionnaires were obtained from 21 provinces, autonomous regions and municipalities. Under the COVID-19 epidemic, 75.4% of the pregnant women reported they got institutional service and health education information from hospitals' official new media accounts such as WeChat and Weibo. Multivariate Logistic analysis showed that pregnant women who received information from official accounts of new media had higher scores of COVID-19 relevant antenatal care knowledge (aOR=1.36, 95%CI:1.08-1.71, P<0.01)and individual prevention behaviors(aOR=1.46, 95%CI:1.18-1.82, P<0.01) than those who obtained information from other sources. Conclusion The access to antenatal care knowledge via hospitals' official social media accounts was associated with better antenatal care knowledge and individual prevention behaviors among pregnant women. Under major public health emergency, it is suggested for health institutions to disseminate antenatal health care information via hospitals' official accounts in new media like Wechat and Weibo. Appropriate training should be developed to ensure the quality of health education and service provision in official new media accounts. © 2021, Editorial Department of Fudan University Journal of Medical Sciences. All right reserved.

The value of PCT, IL-6, and CRP in the early diagnosis and evaluation of COVID-19.

OBJECTIVE: The aim of the present study was to assess the value of inflammatory factors procalcitonin (PCT), interleukin 6 (IL-6), and C-reactive protein (CRP) in the early diagnosis and evaluation of novel coronavirus pneumonia (COVID-19). MATERIALS AND METHODS: The data of 140 patients with pneumonia in our hospital, including 70 who had COVID-19 and 70 who had community-acquired pneumonia (CAP), were statistically analyzed. The levels of PCT, IL-6, and CRP were measured and statistically analyzed to determine the differences between the two groups. The differences in the COVID-19 group were analyzed after subgrouping into the ordinary type, severe type, and critical type. RESULTS: The PCT and CRP levels in the COVID-19 group were statistically lower than those in the CAP group (p < 0.05), but IL-6 was not statistically different between the two groups (p > 0.05). Statistically significant differences existed in IL-6 and CRP when comparing the COVID-19 subgroups of the critical type, severe type, and ordinary type (p < 0.05). However, there was no clinical meaning in the evaluation of the difference in PCT levels among the three subgroups with COVID-19. CONCLUSIONS: PCT and CRP could be used as indicators in the differentiation between COVID-19 and CAP, but IL-6 was of little significance in the differentiation. The higher the IL-6 and CRP, the more severe the condition of COVID-19 might be.

Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study.

OBJECTIVES: Since December 2019, the novel coronavirus disease 2019 (COVID-19) that emerged in Wuhan city has spread rapidly around the world. The risk for poor outcome dramatically increases once a patient progresses to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in individuals with mild to moderate COVID-19. METHODS: We conducted a cohort study that included 1007 individuals with mild to moderate COVID-19 from three hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients were followed up for 28 days for observation of disease progression. The end point was the progression to a more severe disease stage. RESULTS: During a follow up of 28 days, 720 patients (71.50%) had recovered or were symptomatically stable, 222 patients (22.05%) had progressed to severe disease, 22 patients (2.18%) had progressed to the critically ill stage and 43 patients (4.27%) had died. Multivariate Cox proportional hazards models identified that increased age (hazard ratio (HR) 2.56, 95% CI 1.97-3.33), male sex (HR 1.79, 95% CI 1.41-2.28), presence of hypertension (HR 1.44, 95% CI 1.11-1.88), diabetes (HR 1.82, 95% CI 1.35-2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38-2.93) and coronary artery disease (HR 1.83, 95% CI 1.26-2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34-0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02-2.90), urea nitrogen (HR 1.72, 95% CI 1.21-2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26-7.21) and D-dimer (HR 2.01, 95% CI 1.12-3.58) at baseline were also associated with risk for disease progression. CONCLUSIONS: This study identified a panel of risk factors for disease progression in individuals with mild to moderate COVID-19.