The Comprehensive Analyses of Mental Status in COVID-19 Patients, Health Care Workers and General Population During the COVID-19 Pandemic (preprint)

Background: The mental status of patients with Corona Virus Disease 2019 (COVID-19) (PCs), health care workers (HCWs) exposed to the COVID-19, and general population (GP) has be reported. However, no studies comprehensively investigated their mental status. Thus, this study investigated the prevalence, comparisons and risk factors of mental problems among three groups during the COVID-19 pandemic. Methods: 1300 participants including 137 PCs, 159 HCWs and 1003 GP were enrolled. The anxiety, depression and post-traumatic stress symptom (PTSS) were assessed by the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Findings: During the COVID-19 pandemic, the prevalence of anxiety, depression and PTSS were 21.7%, 76.1% and 19.5% in PCs, 9.3%, 25.3% and 9.5% in HCWs, and 12.7%, 25.8% and 6.9% in GP, respectively. The SAS, SDS and PCL-C total scores differed among three groups after controlling for covariates (all, p<0.01). The SAS, SDS and PCL-C total scores were significantly higher in PCs than HCWs and GP (all, p<0.01). Moreover, the distribution of age grouped differed between HCWs with and without depression (p<0.05). The frequency of having friend or relative infected was higher in PCs with than without PTSS as well as the higher married frequency in GP with than without PTSS (both, p<0.01). Further analyses showed the correlation of having friend or relative infected with PCL-C total score in PCs (p=0.004, OR=4.36, 95%CI: 1.60-11.91), the association of age 30-40 years with SDS total score in HCWs (p=0.014, OR=0.35, 95%CI: 0.16-0.81) and the relationship between married and PCL-C total score in GP (p=0.004, OR=3.89, 95%CI: 1.59-9.52). Interpretation: Our data revealed the high prevalence of mental problems among PCs, HCWs and GP, and more serious mental problems in PCs than HCWs and GP as well as the significant effects of having friend or relative infected, married and age 30-40 years on mental problems in the different population during the COVID-19 pandemic. Thus, these findings further suggested that mental problems in the different population should adopt the different psychological interventions to reduce their mental distress caused by the COVID-19.Funding Statement: This work was supported by the National Natural Science Foundation of China (81771439), Jiangsu Provincial Key Research and Development Program (BE2018662), Jiangsu Provincial Health Commission Science Research Program (QNRC2016228, H2019056 and LGY2018010), Jiangsu Provincial Six Talent Peaks Project (WSN-165), Suzhou Municipal Sci-Tech Bureau Program (SS2019009), and CAS Key Laboratory of Mental Health, Institute of Psychology (KLMH2019K03).Declaration of Interests: The authors declared no conflict of interest.Ethics Approval Statement: The protocol, questionnaire and informed consent of this study were approved by the Institutional Review Board at the Affiliated Guangji Hospital of Soochow University.

Comparison of acute pneumonia caused by SARS-COV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak (preprint)

Background: Until July 14, 2020, coronavirus disease-2019 (COVID-19) has infected more than 130 million individuals and has caused a certain degree of panic. Viral pneumonia caused by common viruses such as respiratory syncytial virus, rhinovirus, human metapneumovirus, human bocavirus, and parainfluenza viruses have been more common in children. However, the incidence of COVID-19 in children was significantly lower than that in adults. The purpose of this study was to describe the clinical manifestations, treatment and outcomes of COVID-19 in children compared to those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak. Methods: Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study. A total of 64 children with COVID-19 were defined as the COVID-19 cohort, of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort. Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort. Results: Compared to the viral pneumonia cohort, children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19 (53/64 vs. 23/284), were of older median age (6.3 vs. 3.2 years), and had a higher proportion of ground-glass opacity (GGO) on computed tomography (18/40 vs. 0/38) (all P ＜0.001). Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases (1/40 vs. 38/284, P =0.048), and lower cases with high fever (3/40 vs 167/284, P ＜0.001), requiring intensive care (1/40 vs 32/284, P ＜0.047) and with shorter symptomatic duration (median 5 vs 8 days, P ＜0.001). The proportion of cases with evaluated inflammatory indicators, biochemical indicators related to organ or tissue damage, D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than in the viral pneumonia cohort (all P ＜0.05). No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs (lopinavir-ritonavir, ribavirin, and arbidol) as compared to duration in 39 children without antiviral therapy [median 10 vs. 9 days, P =0.885]. Conclusion: The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonias. Lopinavir-ritonavir, ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19. During the COVID-19 outbreak, attention also must be given to children with infection by other pathogens infection.