The COVID-19 pandemic and physical activity.

The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health, economy, and lifestyle. Although the virus usually first invades and infects the lung and respiratory track tissue, in extreme cases, almost all major organs in the body are now known to be negatively impacted often leading to severe systemic failure in some people. Unfortunately, there is currently no effective treatment for this disease. Pre-existing pathological conditions or comorbidities such as age are a major reason for premature death and increased morbidity and mortality. The immobilization due to hospitalization and bed rest and the physical inactivity due to sustained quarantine and social distancing can downregulate the ability of organs systems to resist to viral infection and increase the risk of damage to the immune, respiratory, cardiovascular, musculoskeletal systems and the brain. The cellular mechanisms and danger of this "second wave" effect of COVID-19 to the human body, along with the effects of aging, proper nutrition, and regular physical activity, are reviewed in this article.

Religiosity and the Naturalness Bias in Drug and Vaccine Choices.

Research reveals a bias for natural versus synthetic drugs. We sought to determine if this bias is associated with religiosity. Three cross-sectional studies (N = 1399 U.S. participants) were conducted to examine the impact of religiosity on the naturalness bias in the drug and vaccine domains. We assessed measures of religiosity, preferences for natural versus synthetic drugs and vaccines in hypothetical scenarios, and a health-related behavior (COVID-19 vaccination status). The results revealed that participants high versus low in religiosity had stronger preferences for natural versus synthetic drugs and vaccines. Furthermore, participants high versus low in religiosity were less likely to have taken the COVID-19 vaccine, and the natural drug bias was a mediator of this effect. Overall, participants higher in religiosity had a stronger preference for natural versus synthetic drugs and vaccines, and this preference had implications for health behavior.

Comparison of Systemic Financial Risks in the US before and after the COVID-19 Outbreak-A Copula-GARCH with CES Approach

The analysis and prediction of systemic financial risks in the US during the COVID-19 pandemic is of great significance to the stability of financial markets in the US and even the world. This paper aims to predict the systemic financial risk in the US before and during the COVID-19 pandemic by using copula-GJR-GARCH models with component expected shortfall (CES), and also identify systemically important financial institutions (SIFIs) for the two comparative periods. The empirical results show that the overall systemic financial risk increased after the outbreak of the COVID-19 pandemic, especially in the first half of the year. We predicted four extreme risks that were basically successful in capturing the high risks in the US financial markets. Second, we identified the SIFIs, and depository banks made the greatest contribution to systemic risk from four financial groups. Third, after the outbreak of the epidemic, the share of Broker-Dealer and Other Institutions in the overall systemic risk has apparently increased. Finally, we recommend that the US financial regulators should consider macro-prudential guidance for major financial institutions, and we should pay more attention to Broker-Dealers, thereby improving the financial stability of the US and the global financial markets.

An immunodominant NP105-113-B*07:02 cytotoxic T cell response controls viral replication and is associated with less severe COVID-19 disease.

NP105-113-B*07:02-specific CD8+ T cell responses are considered among the most dominant in SARS-CoV-2-infected individuals. We found strong association of this response with mild disease. Analysis of NP105-113-B*07:02-specific T cell clones and single-cell sequencing were performed concurrently, with functional avidity and antiviral efficacy assessed using an in vitro SARS-CoV-2 infection system, and were correlated with T cell receptor usage, transcriptome signature and disease severity (acute n = 77, convalescent n = 52). We demonstrated a beneficial association of NP105-113-B*07:02-specific T cells in COVID-19 disease progression, linked with expansion of T cell precursors, high functional avidity and antiviral effector function. Broad immune memory pools were narrowed postinfection but NP105-113-B*07:02-specific T cells were maintained 6 months after infection with preserved antiviral efficacy to the SARS-CoV-2 Victoria strain, as well as Alpha, Beta, Gamma and Delta variants. Our data show that NP105-113-B*07:02-specific T cell responses associate with mild disease and high antiviral efficacy, pointing to inclusion for future vaccine design.

Cultural Differences in People's Psychological Response to COVID-19.

The present research studied Chinese and Euro-Canadian students during the COVID-19 pandemic, focusing on their affect, optimism, well-being, and meaning in life. The results revealed both differences and similarities across cultures. As predicted, Chinese participants reported more positive affect and less negative affect, higher optimism, higher state psychological well-being, and higher meaning presence, compared to Euro-Canadian participants. The findings were replicated after a week's delay. Analyses on longitudinal data showed that state optimism, state well-being, and meaning presence influenced one another over time. These variables also mediated the cultural differences in one another. These results are consistent with cultural work on naïve dialecticism and non-linear lay theory of change. Results also demonstrate underlying relationships among the constructs that are common to both cultural groups. Broadly, the present research highlights the impact of culture on people's response to challenging life situations and the mechanisms underlying these cultural differences.

Immunodominant NP105-113-B*0702 cytotoxic T cell response controls viral replication and is associated with less severe COVID-19 disease (preprint)

NP 105-113 -B*07:02 specific CD8 + T-cell responses are considered among the most dominant in SARS-CoV-2-infected individuals. We found strong association of this response with mild disease. Analysis of NP 105-113 -B*07:02 specific T-cell clones and single cell sequencing were performed concurrently, with functional avidity and anti-viral efficacy assessed using an in vitro SARS-CoV-2 infection system, and were correlated with TCR usage, transcriptome signature, and disease severity (acute N=77, convalescent N=52). We demonstrated a beneficial association of NP 105-113 -B*07:02 specific T-cells in COVID-19 disease progression, linked with expansion of T-cell precursors, high functional avidity and anti-viral effector function. Broad immune memory pools were narrowed post-infection but NP 105-113 -B*07:02 specific T-cells were maintained 6 months after infection with preserved anti-viral efficacy to the SARS-CoV-2 Victoria strain, as well as new Alpha, Beta and Gamma variants. Our data shows that NP 105-113 -B*07:02 specific T-cell responses associate with mild disease and high anti-viral efficacy, pointing to inclusion for future vaccine design.

Lung Ultrasound Score as a Predictor of Mortality in Patients With COVID-19.

Background: Lung injury is a common condition among hospitalized patients with coronavirus disease 2019 (COVID-19). However, whether lung ultrasound (LUS) score predicts all-cause mortality in patients with COVID-19 is unknown. The aim of the present study was to explore the predictive value of lung ultrasound score for mortality in patients with COVID-19. Methods: Patients with COVID-19 who underwent lung ultrasound were prospectively enrolled from three hospitals in Wuhan, China between February 2020 and March 2020. Demographic, clinical, and laboratory data were collected from digital patient records. Lung ultrasound scores were analyzed offline by two observers. Primary outcome was in-hospital mortality. Results: Of the 402 patients, 318 (79.1%) had abnormal lung ultrasound. Compared with survivors (n = 360), non-survivors (n = 42) presented with more B2 lines, pleural line abnormalities, pulmonary consolidation, and pleural effusion (all p < 0.05). Moreover, non-survivors had higher global and anterolateral lung ultrasound score than survivors. In the receiver operating characteristic analysis, areas under the curve were 0.936 and 0.913 for global and anterolateral lung ultrasound score, respectively. A cutoff value of 15 for global lung ultrasound score had a sensitivity of 92.9% and specificity of 85.3%, and 9 for anterolateral score had a sensitivity of 88.1% and specificity of 83.3% for prediction of death. Kaplan-Meier analysis showed that both global and anterolateral scores were strong predictors of death (both p < 0.001). Multivariate Cox regression analysis showed that global lung ultrasound score was an independent predictor (hazard ratio, 1.08; 95% confidence interval, 1.01-1.16; p = 0.03) of death together with age, male sex, C-reactive protein, and creatine kinase-myocardial band. Conclusion: Lung ultrasound score as a semiquantitative tool can be easily measured by bedside lung ultrasound. It is a powerful predictor of in-hospital mortality and may play a crucial role in risk stratification of patients with COVID-19.

Prognostic Accuracy of Early Warning Scores for Clinical Deterioration in Patients With COVID-19.

Background: Early Warning Scores (EWS), including the National Early Warning Score 2 (NEWS2) and Modified NEWS (NEWS-C), have been recommended for triage decision in patients with COVID-19. However, the effectiveness of these EWS in COVID-19 has not been fully validated. The study aimed to investigate the predictive value of EWS to detect clinical deterioration in patients with COVID-19. Methods: Between February 7, 2020 and February 17, 2020, patients confirmed with COVID-19 were screened for this study. The outcomes were early deterioration of respiratory function (EDRF) and need for intensive respiratory support (IRS) during the treatment process. The EDRF was defined as changes in the respiratory component of the sequential organ failure assessment (SOFA) score at day 3 (ΔSOFAresp = SOFA resp at day 3-SOFAresp on admission), in which the positive value reflects clinical deterioration. The IRS was defined as the use of high flow nasal cannula oxygen therapy, noninvasive or invasive mechanical ventilation. The performances of EWS including NEWS, NEWS 2, NEWS-C, Modified Early Warning Scores (MEWS), Hamilton Early Warning Scores (HEWS), and quick sepsis-related organ failure assessment (qSOFA) for predicting EDRF and IRS were compared using the area under the receiver operating characteristic curve (AUROC). Results: A total of 116 patients were included in this study. Of them, 27 patients (23.3%) developed EDRF and 24 patients (20.7%) required IRS. Among these EWS, NEWS-C was the most accurate scoring system for predicting EDRF [AUROC 0.79 (95% CI, 0.69-0.89)] and IRS [AUROC 0.89 (95% CI, 0.82-0.96)], while NEWS 2 had the lowest accuracy in predicting EDRF [AUROC 0.59 (95% CI, 0.46-0.720)] and IRS [AUROC 0.69 (95% CI, 0.57-0.81)]. A NEWS-C ≥ 9 had a sensitivity of 59.3% and a specificity of 85.4% for predicting EDRF. For predicting IRS, a NEWS-C ≥ 9 had a sensitivity of 75% and a specificity of 88%. Conclusions: The NEWS-C was the most accurate scoring system among common EWS to identify patients with COVID-19 at risk for EDRF and need for IRS. The NEWS-C could be recommended as an early triage tool for patients with COVID-19.

Meaning making helps cope with COVID-19: A longitudinal study.

Meaning making is a useful coping strategy in negative situations. We investigated whether making meaning in negative experiences (MINE) would help people cope with COVID-19. We conducted a three-wave longitudinal study (N = 2364) three months before, during, and after the COVID-19 outbreak in China. Results showed that participants reported increased tendency of MINE during the COVID-19 outbreak than three months before the outbreak. Moreover, both initial MINE and the increased MINE predicted less psychological distress including depression, anxiety and stress, during and three months after the outbreak. Perceived benefits and costs of the COVID-19 mediated the long-term effect of MINE. These findings not only provide novel evidence for meaning making model but also shed light on the underlying mechanism, suggesting an effective strategy to cope with stressful events such as the ongoing COVID-19 pandemic.

Prognostic value of bedside lung ultrasound score in patients with COVID-19.

BACKGROUND: Bedside lung ultrasound (LUS) has emerged as a useful and non-invasive tool to detect lung involvement and monitor changes in patients with coronavirus disease 2019 (COVID-19). However, the clinical significance of the LUS score in patients with COVID-19 remains unknown. We aimed to investigate the prognostic value of the LUS score in patients with COVID-19. METHOD: The LUS protocol consisted of 12 scanning zones and was performed in 280 consecutive patients with COVID-19. The LUS score based on B-lines, lung consolidation and pleural line abnormalities was evaluated. RESULTS: The median time from admission to LUS examinations was 7 days (interquartile range [IQR] 3-10). Patients in the highest LUS score group were more likely to have a lower lymphocyte percentage (LYM%); higher levels of D-dimer, C-reactive protein, hypersensitive troponin I and creatine kinase muscle-brain; more invasive mechanical ventilation therapy; higher incidence of ARDS; and higher mortality than patients in the lowest LUS score group. After a median follow-up of 14 days [IQR, 10-20 days], 37 patients developed ARDS, and 13 died. Patients with adverse outcomes presented a higher rate of bilateral involvement; more involved zones and B-lines, pleural line abnormalities and consolidation; and a higher LUS score than event-free survivors. The Cox models adding the LUS score as a continuous variable (hazard ratio [HR]: 1.05, 95% confidence intervals [CI] 1.02 ~ 1.08; P < 0.001; Akaike information criterion [AIC] = 272; C-index = 0.903) or as a categorical variable (HR 10.76, 95% CI 2.75 ~ 42.05; P = 0.001; AIC = 272; C-index = 0.902) were found to predict poor outcomes more accurately than the basic model (AIC = 286; C-index = 0.866). An LUS score cut-off > 12 predicted adverse outcomes with a specificity and sensitivity of 90.5% and 91.9%, respectively. CONCLUSIONS: The LUS score devised by our group performs well at predicting adverse outcomes in patients with COVID-19 and is important for risk stratification in COVID-19 patients.

Quantified CT Evaluation in coronavirus disease (COVID-19): A study of 30 Patients in Chongqing, China (preprint)

Background Chest computed tomography (CT) provides insight into the progression and prognosis of COVID-19 pneumonia. Purpose To quantify the chest CT scans of patients with CODIV-19 pneumonia using the pulmonary inflammation index (PII)and associate it with the severity of pneumonia. Methods A total of thirty inpatients admitted between January 30 and February 29, 2020 with confirmed COVID-19 infection were enrolled in this retrospective review. Patients were classified as “severe”(those who met the severe pneumonia criteria) or “mild”. Chest CT scans and clinical statistics data were obtained at four milestones (the date of admission, 3 days after treatment, 1 week after treatment and the time the last CT scan was obtained before discharge orthe completionof our research). Results Thirty patients (18 males and 12 females, age 20–74 years) with confirmed COVID-19pneumonia were evaluated. Increased neutrophilswere noted in 11 (36.7%) patients and decreased in 3 (10%) patients. Elevation of C-reactive protein (CRP) in 22 (73.3%) patients and erythrocyte sedimentation rate in 27 (90%) patient were observed, but elevation of procalcitonin was not obvious. Seven (53.8%) patients had elevation of lactate dehydrogenase (LDH).The presentation of CT opacities was mainly in the form of distribution in both the severe andmild groups. The mean PII score in the severe group was 58% and 13.7% in the mild group. The score in the severe group was more than 50%and less than 20%in the mild group at every milestone. The score in the severe group was always higher than the mild group, therefore, the severity of the disease may be positively correlated with PII score. Conclusion The pulmonary inflammation index (PII) score of chest CT scans correlated with coronavirus disease (COVID-19) progression and could be used to indicate severity in patients.