Disparities in opioid use disorder-related hospital use among postpartum Virginia Medicaid members.

INTRODUCTION: The overdose crisis is increasingly revealing disparities in opioid use disorder (OUD) outcomes by race and ethnicity. Virginia, like other states, has witnessed drastic increases in overdose deaths. However, research has not described how the overdose crisis has impacted pregnant and postpartum Virginians. We report the prevalence of OUD-related hospital use during the first year postpartum among Virginia Medicaid members in the years preceding the COVID-19 pandemic. We secondarily assess how prenatal OUD treatment is associated with postpartum OUD-related hospital use. METHODS: This population-level retrospective cohort study used Virginia Medicaid claims data for live infant deliveries between July 2016 and June 2019. The primary outcome of OUD-related hospital use included overdose events, emergency department visits, and acute inpatient stays. Independent variables of interest were prenatal receipt of medication for OUD (MOUD) and receipt of non-MOUD treatment components in line with a comprehensive care approach (e.g., case management, behavioral health). Both descriptive and multivariate analyses were performed for all deliveries and stratified by White and Black non-Hispanic individuals to bring attention to the devastating impacts of the overdose crisis within communities of color. RESULTS: The study sample included 96,649 deliveries. Over a third were by Black birthing individuals (n = 34,283). Prenatally, 2.5 % had evidence of OUD, which occurred more often among White (4 %) than Black (0.8 %) non-Hispanic birthing individuals. Postpartum OUD-related hospital use occurred in 10.7 % of deliveries with OUD, more commonly after deliveries by Black, non-Hispanic birthing individuals with OUD (16.5 %) than their White, non-Hispanic counterparts (9.7 %), and this disparity persisted in the multivariable analysis (Black AOR 1.64, 95 % CI 1.14-2.36). Postpartum OUD-related hospital events were less frequent for individuals receiving versus not receiving postpartum MOUD within 30 days prior to the event. Prenatal OUD treatment, including MOUD, was not associated with decreased odds of postpartum OUD-related hospital use in the race-stratified models. CONCLUSION: Postpartum individuals with OUD are at high risk for mortality and morbidity, especially Black individuals not receiving MOUD after delivery. An urgent need remains to effectively address the systemic and structural drivers of racial disparities in transitions of OUD care through the one-year postpartum period.

Repeat-Dose Toxicity of Candidate Omicron COVID-19 Vaccine in Sprague-Dawley Rats

Due to a large number of mutations in the spike protein and immune escape, the Omicron variant (B.1.1.529) has become a predominant variant of concern (VOC) strain. To prevent the disease, we developed a candidate inactivated vaccine (Omicron COVID-19 Vaccine (Vero Cell), Inactivated). To evaluate the safety of the vaccine, we tested the repeat-dose toxicity in Sprague-Dawley (SD) rats. The doses were administered randomly to three groups: physiological saline solution (control), aluminum adjuvant in PBS solution adjuvant (adjuvant group), and low-dose and high-dose omicron vaccines (vaccine group) for 6 weeks. The SD rats were allowed to recover for 4 weeks after withdrawal. We evaluated the physiological condition of the rats, including their ophthalmological condition, body weight, food intake, body temperature, blood biochemistry, urine, neutralizing antibody, inflammation at the injection site, and organs weight. In summary, no dose-dependent adverse toxicological changes were observed, and a recovery trend was obvious, which proved the preclinical safety of the candidate omicron vaccine and provided evidence for clinical trials in humans. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Repeat-Dose Toxicity of Candidate Omicron COVID-19 Vaccine in Sprague-Dawley Rats

Due to a large number of mutations in the spike protein and immune escape, the Omicron variant (B.1.1.529) has become a predominant variant of concern (VOC) strain. To prevent the disease, we developed a candidate inactivated vaccine (Omicron COVID-19 Vaccine (Vero Cell), Inactivated). To evaluate the safety of the vaccine, we tested the repeat-dose toxicity in Sprague-Dawley (SD) rats. The doses were administered randomly to three groups: physiological saline solution (control), aluminum adjuvant in PBS solution adjuvant (adjuvant group), and low-dose and high-dose omicron vaccines (vaccine group) for 6 weeks. The SD rats were allowed to recover for 4 weeks after withdrawal. We evaluated the physiological condition of the rats, including their ophthalmological condition, body weight, food intake, body temperature, blood biochemistry, urine, neutralizing antibody, inflammation at the injection site, and organs weight. In summary, no dose-dependent adverse toxicological changes were observed, and a recovery trend was obvious, which proved the preclinical safety of the candidate omicron vaccine and provided evidence for clinical trials in humans.

The Expression Levels of SARS-CoV-2 Infection-Mediating Molecules Promoted by Interferon-γ and Tumor Necrosis Factor-α Are Downregulated by Hydrogen Sulfide.

Autoimmune thyroid diseases (AITDs), which include Hashimoto's thyroiditis (HT) and Graves' disease (GD), have a higher prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the literature. The effects of AITD-associated cytokines on SARS-CoV-2 infection-mediating molecule levels might be involved in the pathogenesis of susceptibility. We speculated that hydrogen sulfide (H2S) might attenuate this process since H2S has antiviral effects. Using immunohistochemistry, we found that angiotensin-converting enzyme-II (ACE2) expression was higher in the HT group and neuropilin 1 (NRP1) expression was higher in HT and GD groups than in the normal group, while transmembrane protease serine type 2 (TMPRSS2) expression was lower in HT and GD groups. When culturing primary thyrocytes with cytokines or sodium hydrosulfide (NaHS) plus cytokines, we found that ACE2 and NRP1 mRNA levels were upregulated while TMPRSS2 levels were downregulated by interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α). After pretreatment with NaHS in thyrocytes, ACE2 and NRP1 expression were downregulated compared to IFN-γ or TNF-α treatment, and NaHS had no effect on TMPRSS2 expression. Our findings suggested that IFN-γ and TNF-α, which are elevated in AITDs, promoted ACE2 and NRP1 expression and inhibited TMPRSS2 expression. H2S might protect against SARS-CoV-2 infection by downregulating ACE2 and NRP1 levels.

Immunogenicity and safety of an egg culture-based quadrivalent inactivated non-adjuvanted subunit influenza vaccine in subjects ≥3 years: A randomized, multicenter, double-blind, active-controlled phase III, non-inferiority trial.

Subunit influenza vaccine only formulated with surface antigen proteins has better safety profiles relative to split-virion influenza vaccine. Compared to the traditional quadrivalent split-virion influenza vaccine, a novel quadrivalent subunit influenza vaccine is urgently needed in China. We completed a phase 3, randomized, double-blind, active-controlled, non-inferiority clinical study at two sites in Henan Province, China. Eligible volunteers were split into four age cohorts (3-8 years, 9-17 years, 18-64 years, and ≥ 65 years, based on their dates of birth) and randomly assigned (1:1) to the subunit and the split-virion ecNAIIV4 groups. All volunteers were intramuscularly administered a single vaccine dose at baseline, and children aged 3-8 years received a boosting dose at day 28. And the immune response was evaluated by measuring hemagglutinin-inhibition antibody titers against the four vaccine strains in blood samples. Safety profiles had nonsignificant differences between the study groups in ≥ 3 years cohort. Most adverse reactions post-vaccination, both local and systemic, were mild to moderate and resolved within 3 days. And no serious adverse events occurred. The immunogenicity of the trial vaccine was non-inferior to the comparator. Further, a two-dose vaccine series can provide better seroprotection than that of a one-dose series in children aged 3-8 years, with clinically acceptable safety profiles. Clinical Trials Registration. ChiCTR2100049934.

Virginia Medicaid Expansion: New Members Report Reduced Financial Concerns During The COVID-19 Pandemic.

Medicaid is a critical antipoverty program. Since the Affordable Care Act expanded Medicaid eligibility, millions of newly eligible people have enrolled, creating positive financial improvements for low-income families. We examined the association of Virginia's 2019 Medicaid expansion and changes in health care-related and non-health-care-related financial needs among newly eligible Medicaid enrollees. Our unique survey collected responses between December 2018 and April 2019 from newly enrolled members reporting on experiences in the year before enrollment and between July 2020 and May 2021 from members reporting on experiences one year after enrollment. The follow-up period coincided with the COVID-19 pandemic. Medicaid enrollment was associated with decreases in concern about all financial needs assessed: housing, food, monthly bills, credit card and loan payments, and health care costs. These reductions were broadly similar across demographic subgroups and across the months of the pandemic that overlapped with the follow-up period. We add to the evidence that Medicaid expansion is a social safety-net policy that could improve equity among low-income families, potentially encouraging states that have yet to expand to do so.

Vaccination with Omicron Inactivated Vaccine in Pre-vaccinated Mice Protects against SARS-CoV-2 Prototype and Omicron Variants.

In response to the fast-waning immune response and the great threat of the Omicron variant of concern (VOC) to the public, we report the pilot-scale production of an inactivated Omicron vaccine candidate that induces high levels of neutralizing antibody titers to protect against the Omicron virus. Here, we demonstrate that the inactivated Omicron vaccine is safe and effective in recalling immune responses to the HB02, Omicron, and Delta viruses after one or two doses of BBIBP-CorV. In addition, the efficient productivity and good genetic stability of the manufactured inactivated vaccine is proved. These results support the further evaluation of the Omicron vaccine in a clinical trial.

Immunogenicity Evaluating of the Multivalent COVID-19 Inactivated Vaccine against the SARS-CoV-2 Variants.

It has been reported that the novel coronavirus (COVID-19) has caused more than 286 million cases and 5.4 million deaths to date. Several strategies have been implemented globally, such as social distancing and the development of the vaccines. Several severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have appeared, such as Alpha, Beta, Gamma, Delta, and Omicron. With the rapid spread of the novel coronavirus and the rapidly changing mutants, the development of a broad-spectrum multivalent vaccine is considered to be the most effective way to defend against the constantly mutating virus. Here, we evaluated the immunogenicity of the multivalent COVID-19 inactivated vaccine. Mice were immunized by multivalent COVID-19 inactivated vaccine, and the neutralizing antibodies in serum were analyzed. The results show that HB02 + Delta + Omicron trivalent vaccine could provide broad spectrum protection against HB02, Beta, Delta, and Omicron virus. Additionally, the different multivalent COVID-19 inactivated vaccines could enhance cellular immunity. Together, our findings suggest that the multivalent COVID-19 inactivated vaccine can provide broad spectrum protection against HB02 and other virus variants in humoral and cellular immunity, providing new ideas for the development of a broad-spectrum COVID-19 vaccine.

Supervised learning-based assessment of office layout satisfaction in academic buildings

Employee satisfaction significantly affects health, well-being and productivity, and office layout plays a dominant role in office psychological satisfaction. However, existing studies have not yet proposed a quantitative evaluation method for office layout satisfaction to assist design decisions. This study conducts a post-occupancy evaluation (POE) process of office layout satisfaction from 1,317 staff members at 3 universities in the Yangtze River Delta, China. The proposed office layout feature network supports the questionnaire design and environmental measurement. Based on the survey data, multiple resampling methods are considered to face the imbalanced dataset problem, and feature selection integrates statistical analysis methods and machine learning algorithms. Nine supervised learning algorithms are tested for office layout satisfaction prediction, and the final predictive model is established based on the random forest algorithm. The predictive model explanation is further integrated with original data analysis to extract the quantified impacts of various building characteristics. The workstation adjustment under the background of COVID-19 in an actual staff office is chosen to be an application scenario of the predictive model. The results show that the workstation distance, room depth and room width-depth ratio are dominant in the evaluation of office layout satisfaction. The proposed predictive model achieves 64.5% accuracy, and the prediction results are interpretable, which promotes its application in office design practice. The data processing methods in this study respond to the common data problems in the POE based opinion collection process. The extracted influence mechanisms of building characteristics can directly support user-centered office design.

Long-term immune responses in patients with confirmed novel coronavirus disease-2019: a 9-month prospective cohort study in Shanghai, China.

BACKGROUND: The duration of antibodies against SARS-CoV-2 in Covid-19 patients remains uncertain. Longitudinal serological studies are needed to prevent disease and transmission of the virus. METHODS: In 2020, 414 blood samples were tested, obtained from 157 confirmed Covid-19 patients, in a prospective cohort study in Shanghai. RESULTS: The seropositive rate of IgM peaked at 40.5% (17/42) within 1 month after illness onset and then declined. The seropositive rate of IgG was 90.6% (58/64) after 2 months, remained above 85% from 2 to 9 months and was 90.9% (40/44) after 9 months. Generalized estimating equations models suggested that IgM (P < 0.001) but not IgG significantly decreased over time. Age ≥ 40 years (adjusted odds ratio [aOR] 4.531; 95% confidence interval [CI] 1.879-10.932), and cigarette smoking (aOR 0.344; 95% CI 0.124-0.951) were associated with IgG, and age ≥ 40 years (aOR 2.820; 95% CI 1.579-5.036) was associated with IgM. After seroconversion, over 90% and 75.1% of subjects were estimated to remain IgG-positive 220 and 254 days, respectively. Of 1420 self-reported symptoms questionnaires, only 5% reported symptoms 9 months after onset. CONCLUSIONS: In patients with a history of natural infection, anti-SARS-CoV-2 IgG is long-lived, being present for at least 9 months after illness onset. The long duration of natural immunity can mitigate and eliminate Covid-19 and the ongoing pandemic.

Preparation and characterization of immobilized 5-HT1A receptor stationary phase for high throughput screening of the receptor-binding ligands from complex systems like Curcuma wenyujin Y. H. Chen et C. Ling extract.

The incidence of depression has increased significantly during the COVID-19 pandemic. This disease is closely associated with serotonin 1A (5-HT1A) receptor and often treated by complex prescription containing Curcuma wenyujin Y. H. Chen et C. Ling. Therefore, we hypothesized that this herb contains bioactive compounds specially binding to the receptor. However, the rapid discovery of new ligands of 5-HT1A receptor is still challenging due to the lack of efficient screening methods. To address this problem, we developed and characterized a novel approach for the rapid screening of ligands by using immobilized 5-HT1A receptor as the chromatographic stationary phase. Briefly, haloalkane dehalogenase was fused at the C-terminal of 5-HT1A receptor, and the modified 5-HT1A receptor was immobilized on amino-microspheres by the reaction between haloalkane dehalogenase and 6-chlorohexanoic acid linker. Scanning electron microscope and X-ray photo-electron were used to characterize the morphology and element of the immobilized receptor. The binding of three specific ligands to 5-HT1A receptor was investigated by two different methods. Moreover, we examined the feasibility of 5-HT1A receptor colume in high throughput screening of new ligands from complex systems as exemplified by Curcuma wenyujin Y. H. Chen et C. Ling. Gweicurculactone, 2-hydroxy-1-(3,4-dihydroxybenzene)-7-(4'-hydroxybezene)-heptane and curcuminol F were identified as the ligands of 5-HT1A receptor with the binding energies of -7.06 kcal/mol, -7.77 kcal/mol and -5.26 kcal/mol, respectively. Collectively, these results indicated that the immobilized 5-HT1A receptor was capable of screening bioactive compound from complex system, providing an effective methodology for high throughput screening.

Recognition efficiency of atypical cardiovascular readings on ECG devices through fogged goggles.

In their continuing battle against the COVID-19 pandemic, medical workers in hospitals worldwide need to wear safety glasses and goggles to protect their eyes from the possible transmission of the virus. However, they work for long hours and need to wear a mask and other personal protective equipment, which causes their protective eye wear to fog up. This fogging up of eye wear, in turn, has a substantial impact in the speed and accuracy of reading information on the interface of electrocardiogram (ECG) machines. To gain a better understanding of the extent of the impact, this study experimentally simulates the fogging of protective goggles when viewing the interface with three variables: the degree of fogging of the goggles, brightness of the screen, and color of the font of the cardiovascular readings. This experimental study on the target recognition of digital font is carried out by simulating the interface of an ECG machine and readability of the ECG machine with fogged eye wear. The experimental results indicate that the fogging of the lenses has a significant impact on the recognition speed and the degree of fogging has a significant correlation with the font color and brightness of the screen. With a reduction in screen brightness, its influence on recognition speed shows a v-shaped trend, and the response time is the shortest when the screen brightness is 150 cd/m2. When eyewear is fogged, yellow and green font colors allow a quicker response with a higher accuracy. On the whole, the subjects show a better performance with the use of green font, but there are inconsistencies. In terms of the interaction among the three variables, the same results are also found and the same conclusion can be made accordingly. This research study can act as a reference for the interface design of medical equipment in events where medical staff wear protective eyewear for a long period of time.

Cope with the COVID-19 pandemic: Dynamic bed allocation and patient subsidization in a public healthcare system.

In many countries and territories, public hospitals play a major role in coping with the COVID-19 pandemic. For public hospital managers, on the one hand, they must best utilize their hospital beds to serve the COVID-19 patients immediately. On the other hand, they need to consider the need of bed resources from non-COVID-19 patients, including emergency and elective patients. In this work, we consider two control mechanisms for public hospital managers to maximize the overall utility of patients. One is the dynamic allocation of bed resources according to the evolution process of the COVID-19 pandemic. The other is the usage of a subsidy scheme to move elective patients from the public to private hospitals. We develop a dynamic programming model to study the allocation of isolation and ordinary beds and the effect of the subsidy policy in serving three types of patients, COVID-19, emergency, and elective-care. We first show that the dynamic allocation between isolation and ordinary beds can provide a better utilization of bed resources, by cutting down at least 33.5% of the total cost compared with the static policy (i.e., keeping a fixed number of isolation beds) when facing a medium pandemic alert. Our results further show that subsidizing elective patients and referring them to private hospitals is an efficient way to ease the overcrowded situation in public hospitals. Our results demonstrate that, by dynamically conducting bed allocation and subsidy scheme in different phases of the COVID-19 pandemic, patient overall utility can be greatly improved.

Characteristics of human coronavirus infection in acute respiratory infection cases in Shanghai, 2015-2019

Objective To understand the infection status of human coronavirus (HCoV) in acute respiratory infection cases in Shanghai, and provide scientific basis for prevention and control of human infection with coronavirus. Methods A total of 3 531 samples were collected through acute respiratory infection surveillance in Shanghai from 2015 to 2019, and multiplex PCR technology was used to detect common respiratory viruses. Results In the 3 531 samples, the virus detection rate was 39.73% (1 403/3 531). The detection rate of HCoV was 3.14% (111/3 531), ranking 3rd after the detection rates of influenza virus and rhinovirus/enteric virus. The spread subtypes were mainly HCoV-OC43 and HCoV-NL63. Different subtypes of HCoV spread alternately in the population every year. The incidence of co-infection was as high as 36.93% (41/111), and the proportion of co-infection in severe cases was high. Conclusion HCoV is an important pathogen of acute respiratory tract infection in Shanghai. It is necessary to strengthen the etiological surveillance in acute respiratory tract infection cases, especially the co-infection of HCoV and other pathogens.

The Impact of the SARS-COV-2 Pandemic on the Mental Health and Employment Decisions of Medical Students in North China.

Background: The outbreak of severe respiratory syndrome coronavirus 2 (SARS-COV-2) has led to long periods of social isolation for individuals across the world. Although medical students generally have a high prevalence of mental health problems, they have received less attention than other groups concerning the impact of SARS-COV-2. Therefore, the present study investigated the mental health status, risk factors, and protective factors for mental health problems in medical students in North China during the SARS-COV-2 pandemic. Methods: A WeChat-based survey, which included the Depression Anxiety Stress Scale-21 and measures of social demographics, was performed twice. Risk and protective factors were identified by binary logistic regression analysis. Results: A total of 702 effective questionnaires were collected in two separate surveys. In total, 24.55% of medical students were suffering anxiety to different degrees of severity, 13.18% were suffering depression in the first survey, and 3.71% wanted to give up working in primary medical care during the SARS-COV-2 pandemic in the second survey. In contrast, during the SARS-COV-2 pandemic, a risk factor for anxiety and depression was gender which is male, while being knowledgeable about the SARS-COV-2 pandemic and having a lower academic burden were both protective factors. Conclusions: Measures are required to prevent increases in mental health problems in medical students. Our findings suggest that increasing knowledge about the SARS-COV-2 pandemic and reducing academic burden in medical students is extremely important during the SARS-COV-2 pandemic.

Spatial and temporal variation characteristics of atmospheric NO2 and SO2 in the Beijing-Tianjin-Hebei region before and after the COVID-19 outbreak.

Emergency response mechanisms were activated throughout China during the COVID-19 outbreak. It is different from the temporary, partial, and limited pollution control measures taken to ensure the regional environmental quality during several important events such as the 2008 Beijing Olympic Games and the 2014 Asia-Pacific Economic Cooperation (APEC). During the COVID-19 epidemic period, extensive movement of people and almost all unnecessary industrial production (necessary industrial production refers to the production of food, epidemic prevention materials, etc.) have been severely restricted, so transportation and industrial production have been greatly reduced. This is a rare extreme emission reduction scenario that presents a unique opportunity for atmospheric research. In this study, based on hourly mass concentration data of NO2 and SO2 from atmospheric monitoring sites in the Beijing-Tianjin-Hebei (BTH) region during the COVID-19 epidemic period, the changes in transportation and industrial production in the region, data statistics, and spatial analysis were used to analyze the pollution changes and their causes. The results indicate that the NO2 and SO2 concentrations in the BTH region decreased significantly during the epidemic period. The spatial distribution pattern of NO2 pollution in the BTH region was "high in the southeast and low in the northwest," and SO2 pollution in the BTH region was high in the southern and eastern parts of Hebei. The initiation of emergency response level 1 had an obvious effect on reducing NO2 and SO2 pollution in the region, while the impact of emergency response level 2 and below was limited. Compared with the single traffic control, the comprehensive control, similar to the emergency response, had a better effect on reducing NO2 pollution in the region. The control of major large cities in the region also had a certain effect on alleviating NO2 and SO2 pollution in the entire region. Moreover, for activities under short-term control, it is particularly important to guard against the "retaliatory growth" after the control is lifted. By reducing and controlling some polluting industries in industrial production, the degree of NO2 and SO2 pollution in the region can be effectively reduced. The manufacturing industry of chemical raw materials and the chemical products and non-metallic mineral products industry made a great contribution to the change in industrial source pollution emissions in the BTH region during the COVID-19 epidemic. Road traffic emissions remained an important source of NO2 emissions in the BTH region during this period. NO2 emission reduction can be effectively achieved by controlling road traffic and transportation.

[Analysis of Changes and Factors Influencing Air Pollutants in the Beijing-Tianjin-Hebei Region During the COVID-19 Pandemic].

A series of strict control measures were imposed in the Beijing-Tianjin-Hebei region in early 2020 to control the spread of COVID-19. These measures have led to a reduction of anthropogenic air pollutants, providing an opportunity to observe the contribution of human activities to local air pollution. In this study, the control period was divided into four stages:the before, early, middle, and later stages. Based on a variety of data including meteorological, traffic, and industrial manufacturing datasets, statistical methods were combined with spatial analysis to evaluate changes in air pollution and associated human impacts during each stage. In addition, suggestions are made for further regional air pollution control in the Beijing-Tianjin-Hebei area. Key results are as follows:① Overall, the AQI and the concentrations of six air pollutants, especially SO2, PM10, and NO2, were lower during control period than during the equivalent period in 2019 (reductions of 26.5%, 24.3%, and 16.9%, respectively). From the before to later stages, pollutants (except O3) showed a downward trend while O3 increased significantly during the before stage (by 76.2%) and the growth rate slowed during the middle and later stages; ②During the prior stage, Beijing experienced two periods with heavy air pollution days as a result of the local accumulation of pollutants, secondary transformation, and regional transport. The concentration of PM2.5 in February was nearly 60% lower than in February 2014 under similar meteorological conditions in Beijing; ③ Following an increase in traffic volume and industrial activity, changes in air pollutants tended to be stable or slightly increase during the middle and later stages of the control period. The grey relation coefficients between thermal radiation intensity anomalies and the main pollutants in heavy industrial cities were greater than 0.6, which means that the control of industrial emissions remains key to controlling air pollution.

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis.

Since December 2019, COVID-19 has aroused global attention. Studies show the link between obesity and severe outcome of influenza and COVID-19. Thus, we aimed to compare the impacts of obesity on the severity and mortality of influenza and COVID-19 by performing a meta-analysis. A systematic search was performed in MEDLINE, EMASE, ClinicalTrials.gov, and Web of Science from January 2009 to July 2020. The protocol was registered onto PROSPERO (CRD42020201461). After selection, 46 studies were included in this meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed. We found obesity was a risk factor for the severity and mortality of influenza (ORsevere outcome = 1.56, CI: 1.28-1.90; ORmortality = 1.99, CI: 1.15-3.46). For COVID-19, obesity was a significant risk factor only for severe outcome (OR = 2.07, CI: 1.53-2.81) but not for mortality (OR = 1.57, CI: 0.85-2.90). Compared with obesity, morbid obesity was linked with a higher risk for the severity and mortality of both influenza (OR = 1.40, CI: 1.10-1.79) and COVID-19 (OR = 3.76, CI: 2.67-5.28). Thus, obesity should be recommended as a risk factor for the prognosis assessment of COVID-19. Special monitoring and earlier treatment should be implemented in patients with obesity and COVID-19.

Relationship of Physical Activity With Anxiety and Depression Symptoms in Chinese College Students During the COVID-19 Outbreak.

INTRODUCTION: During the COVID-19 outbreak, many citizens were asked to stay at home in self-quarantine, which can pose a significant challenge with respect to remaining physically active and maintaining mental health. This study aimed to evaluate the prevalence of inadequate physical activity, anxiety, and depression and to explore the relationship of physical activity with anxiety and depression symptoms among Chinese college students during quarantine. METHOD: Using a web-based cross-sectional survey, we collected data from 1,396 Chinese college students. Anxiety and depression were assessed with the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), respectively. The data on physical activity were collected by types of physical activity and the International Physical Activity Questionnaire (IPAQ-SF). RESULTS: During the COVID-19 outbreak, about 52.3% of Chinese college students had inadequate physical activity. The rates of anxiety and depression symptoms were 31.0 and 41.8%, respectively. A high level of physical activity (ß = -0.121, P < 0.001) was significantly closely associated with low anxiety, while a moderate (ß = -0.095, P = 0.001), or high (ß = -0.179, P < 0.001) level of physical activity was significantly closely associated with reduced depression after adjusting confounding demographic factors. Moreover, specific types of physical activity, such as stretching and resistance training, were negatively correlated with both anxiety and depression; doing household chores was negatively correlated with depression. CONCLUSION: Our findings highlight specific levels and types of home-based physical activities that need to be taken into consideration to protect the mental health of college students during the COVID-19 epidemic.