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1.
BMJ Open ; 12(4), 2022.
Article in English | ProQuest Central | ID: covidwho-1794501

ABSTRACT

IntroductionThere is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions.Methods and analysisWe will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (TP), initiation of implementation (T0) and 1-year postinitiation (T1). We will extract project-related data from secondary documents at TP and conduct multistakeholder qualitative interviews to gather data at T0 and T1. We will undertake descriptive statistical analysis of TP data and analyse T0 and T1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks.Ethics and disseminationThe current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network.

2.
Front Public Health ; 10: 744881, 2022.
Article in English | MEDLINE | ID: covidwho-1775969

ABSTRACT

Background: Salt reduction is a cost-effective, and rather challenging public health strategy for controlling chronic diseases. The AppSalt program is a school-based multi-component mobile health (mhealth) salt reduction program designed to tackle the high salt intake in China. This mixed-methods process evaluation was conducted to investigate the implementation of this program across sites, identify factors associated with the implementation, and collect evidence to optimize the intervention design for future scale-up. Methods: Mixed methods were used sequentially to collect data regarding five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data were collected during the intervention process. Participation rate of intervention activities was calculated and compared across cities. The quantitative data was used for the selection of representative intervention participants for the qualitative interviews. Qualitative data were collected in face-to-face semi-structured interviews with purposively selected students (n = 33), adult family members (n = 33), teachers (n = 9), heads of schools (n = 9), key informants from local health, and education departments (n = 8). Thematic analysis technique was applied to analyze the interview transcripts using NVivo. The qualitative data were triangulated with the quantitative data during the interpretation phase. Results: The total number of families recruited for the intervention was 1,124. The overall retention rate of the AppSalt program was 97%. The intervention was implemented to a high level of fidelity against the protocol. About 80% of intervention participants completed all the app-based salt reduction courses, with a significant difference across the three cities (Shijiazhuang: 95%; Luzhou: 73%; Yueyang: 64%). The smartphone app in this program was perceived as a feasible and engaging health education tool by most intervention participants and key stakeholders. Through the interviews with participants and key stakeholders, we identified some barriers to implementing this program at primary schools, including the left-behind children who usually live with their grandparents and have limited access of smartphones; perceived adverse effects of smartphones on children (e.g., eyesight damage); and overlooked health education curriculum at Chinese primary schools. Conclusion: This process evaluation demonstrated the feasibility and acceptability of using smartphone applications delivered through the education system to engage families in China to reduce excessive salt intake. Clinical Trial Registration: The AppSalt study was registered at www.chictr.org.cn, identifier: ChiCTR1800017553. The date of registration is August 3, 2018.


Subject(s)
Sodium Chloride, Dietary , Adult , Child , China , Health Education , Health Promotion/methods , Humans
3.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-331858

ABSTRACT

Background: Waning of neutralizing titers and decline of protection shorter after the second dose of COVID-19 vaccines was observed, including China-made inactivated vaccines. Efficacy of a heterologous boosting using one dose recombinant SARS-CoV-2 fusion protein vaccine (V-01) in inactivated vaccine-primed population was studied, aimed to restore the immunity. Methods: A randomized, double-blind and placebo-controlled phase Ⅲ trial was conducted in healthy people aged 18 years or older in Pakistan and Malaysia. Each eligible participant received one dose of V-01 vaccine developed by Livzon Mabpharm Inc . or placebo 3-6 months after the 2-dose primary regimen, and was monitored for safety and efficacy. The primary endpoint was protection against confirmed symptomatic SARS-CoV-2 infection. Results: A total of 10,218 participants were randomly assigned to receive vaccine or placebo. Virus-neutralizing antibodies were assessed in 419 participants. A dramatical increase (11.3-fold;128.3 to 1452.8) of neutralizing titers was measured in V-01 group at 14 days after the booster. Over the two months surveillance, vaccine efficacy was 47.8% (95%CI: 22.6 to 64.7) according to the intention-to-treat principle. The most common adverse events were transient, mild-to-moderate pain at the injection site, fever, headache, and fatigue. Serious adverse events occurred almost equally in V-01 (0.12%) and placebo (0.16%) groups. Conclusion: The heterologous boosting with V-01 vaccine was safe, efficacious, and could elicit robust humoral immunity under the epidemic of the Omicron variant.

4.
The Journal of Product and Brand Management ; 31(3):394-414, 2022.
Article in English | ProQuest Central | ID: covidwho-1752302

ABSTRACT

Purpose>This study aims to focus on understanding the consumer-luxury brand relationships among Generation Z. Generation Z is an up-and-coming generational cohort that has received limited research attention in the domains of both consumer-brand relationships and luxury branding, despite its growing size and purchasing power. Therefore, this study highlights the distinctive patterns of Generation Z’s relationship with luxury by identifying their choice of a luxury brand, the nature of the brand relationships, what characterizes these relationships and the internal and external influences that shape these relationships.Design/methodology/approach>This study used brand collage construction. A total of 56 Generation Z respondents created brand collages that covered 38 different luxury brands. The data from the collages and their accompanying descriptions were evaluated using content analysis.Findings>This study identifies Generation Z’s unique yet expansive view of luxury that encompasses not only traditional luxury but also masstige and non-traditional luxury brands. Moreover, the findings generally support that Generation Z’s relationships with luxury brands are characterized by “like” rather than “love”;while Generation Z may feel a high level of loyalty toward luxury brands in terms of attitudes and behaviors, they do not necessarily have strong, passionate feelings for them.Originality/value>The findings of this study offer a comprehensive understanding of Generation Z’s brand relationship with luxury. Luxury marketers need to recognize that for Generation Z consumers, luxury is an integral part of their everyday lifestyle more than a display of success, which is clearly different from previous generations.

5.
JMIR Serious Games ; 10(1): e35040, 2022 Mar 22.
Article in English | MEDLINE | ID: covidwho-1753293

ABSTRACT

BACKGROUND: The COVID-19 outbreak has not only changed the lifestyles of people globally but has also resulted in other challenges, such as the requirement of self-isolation and distance learning. Moreover, people are unable to venture out to exercise, leading to reduced movement, and therefore, the demand for exercise at home has increased. OBJECTIVE: We intended to investigate the relationships between a Nintendo Ring Fit Adventure (RFA) intervention and improvements in running time, cardiac force index (CFI), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index score), and mood disorders (5-item Brief Symptom Rating Scale score). METHODS: This was a randomized prospective study and included 80 students who were required to complete a 1600-meter outdoor run before and after the intervention, the completion times of which were recorded in seconds. They were also required to fill out a lifestyle questionnaire. During the study, 40 participants (16 males and 24 females, with an average age of 23.75 years) were assigned to the RFA group and were required to exercise for 30 minutes 3 times per week (in the adventure mode) over 4 weeks. The exercise intensity was set according to the instructions given by the virtual coach during the first game. The remaining 40 participants (30 males and 10 females, with an average age of 22.65 years) were assigned to the control group and maintained their regular habits during the study period. RESULTS: The study was completed by 80 participants aged 20 to 36 years (mean 23.20, SD 2.96 years). The results showed that the running time in the RFA group was significantly reduced. After 4 weeks of physical training, it took females in the RFA group 19.79 seconds (P=.03) and males 22.56 seconds (P=.03) less than the baseline to complete the 1600-meter run. In contrast, there were no significant differences in the performance of the control group in the run before and after the fourth week of intervention. In terms of mood disorders, the average score of the RFA group increased from 1.81 to 3.31 for males (difference=1.50, P=.04) and from 3.17 to 4.54 for females (difference=1.38, P=.06). In addition, no significant differences between the RFA and control groups were observed for the CFI peak acceleration (CFIPA)_walk, CFIPA_run, or sleep quality. CONCLUSIONS: RFA could either maintain or improve an individual's physical fitness, thereby providing a good solution for people involved in distance learning or those who have not exercised for an extended period. TRIAL REGISTRATION: ClinicalTrials.gov NCT05227040; https://clinicaltrials.gov/ct2/show/NCT05227040.

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324964

ABSTRACT

Background: COVID-19 had caused more than 2.8 million deaths globally, and the epidemic will persist for an extended period of time. We analyzed clinical features of patients in the early stage of the epidemic, so as to deepen the understanding of the disease. Methods: : In this retrospective study, we included 84 confirmed cases of COVID-19 during February 1, 2020 and March 31, 2020. Baseline data were used to classify patients as moderate (57%) or severe/critical based on Chinese protocol. We focused on analyzing the differences in chest computed tomography (CT) between the two groups. Results: Of the 84 cases, 50 were male and the median age was 69 years. 55 (65%) patients had comorbidities at admission, more in the severe/critical group (P=0.040). 94% patients had bilateral lesions on CT, up to 68% had lesions involving all lobes. Ground glass opacification (GGO) (96%), consolidation (44%), Linear opacities (50%) and Air bronchogram (23%) were the mainly lesions. The lesion was gradually absorbed over time, but imaging abnormalities can persist for a long time. Compared with moderate cases, the severe/critical group had more pulmonary consolidation changes (P=0.044) and significantly higher CT severity Score (CTSS) (P=0.040). Lymphocyte counts were significantly lower (P=0.011) and NLR were higher (P=0.029) in severe/critical cases. Conclusions: : Chest CT showed bilateral and multiple GGO and consolidation mainly. After treatment, pulmonary lesions were gradually absorbed over time, and imaging abnormalities can be persistent for a long time. Lung consolidation, CTSS, comorbidity, lymphocyte counts, and NLR may be predictors of severe COVID-19.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324133

ABSTRACT

Prolonged school closure has been adopted worldwide to control COVID-19. Such preemptive implementation was predicated on the premise that school children are a core group for COVID-19 transmission. Using surveillance data from the Chinese cities of Shenzhen and Anqing, we inferred that children aged 18 or below are only around half as susceptible to COVID-19 infection as adults. Using transmission models parameterized with synthetic contact matrices for 152 jurisdictions around the world, we showed that the lower susceptibility of school children substantially limited the effectiveness of school closure in reducing COVID-19 transmissibility. Our results, together with recent findings that clinical severity of COVID-19 in children is lower, suggest that school closure may not be ideal as a sustained, primary intervention for controlling COVID-19.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-310727

ABSTRACT

It is still nontrivial to develop a new fast COVID-19 screening method with the easier access and lower cost, due to the technical and cost limitations of the current testing methods in the medical resource-poor districts. On the other hand, there are more and more ocular manifestations that have been reported in the COVID-19 patients as growing clinical evidence[1]. This inspired this project. We have conducted the joint clinical research since January 2021 at the ShiJiaZhuang City, Heibei province, China, which approved by the ethics committee of The fifth hospital of ShiJiaZhuang of Hebei Medical University. We undertake several blind tests of COVID-19 patients by Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Meantime as an important part of the ongoing globally COVID-19 eye test program by AIMOMICS since February 2020, we propose a new fast screening method of analyzing the eye-region images, captured by common CCD and CMOS cameras. This could reliably make a rapid risk screening of COVID-19 with the sustainable stable high performance in different countries and races. Our model for COVID-19 rapid prescreening have the merits of the lower cost, fully self-performed, non-invasive, importantly real-time, and thus enables the continuous health surveillance. We further implement it as the open accessible APIs, and provide public service to the world. Our pilot experiments show that our model is ready to be usable to all kinds of surveillance scenarios, such as infrared temperature measurement device at airports and stations, or directly pushing to the target people groups smartphones as a packaged application.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-309465

ABSTRACT

Background: Chest CT is working as a first-line imaging modality for diagnosing Corona Virus Disease 2019 (COVID-19). Whether the CT findings could differentiate between the COVID-19 admitted out of Wuhan and common pneumonia has not been investigated. This study aimed to compare the chest CT features of patients with COVID-19 admitted out of Wuhan, as against the patients with common pneumonia. Methods: : This retrospective study enrolled 37 individuals with COVID-19 from six medical centers out of Wuhan from January 17 th to February 26 th . Another group of 41 patients with acute pneumonia collected from the same timeframe in 2019 were enrolled as the control group. All the patients had high-resolution chest CT (HRCT) scans. Clinical variables were recorded including exposure history, clinical symptoms and laboratory findings. For each HRCT, pulmonary lesions including ground-glass opacification (GGO), consolidation, and evidence of fibrosis were recorded. The Student’s t test or Wilcoxon’s test was used for comparison between COVID-19 and common pneumonia. Spearman correlation was used to evaluate correlations between the pneumonia findings on CT and clinical variables. Results: : A total of 37 patients (M/F:19/18;43.73±16.71 years) in COVID-19 group and 41(M/F:13/28;49.77±15.00 years) in common pneumonia group were evaluated. Patients with COVID-19 demonstrated a typical pattern of bilateral, multi-lobal GGO, sometimes with consolidation and fibrosis, but a mild degree of pneumonia findings than the control group ( P = 0.0024). 23/37 (62.16%) patients with COVID-19 had a preferable subpleural distribution, while the patients with common pneumonia had higher frequency of peribronchovascular pattern (16/41, 39.02%, P =0.0046). The duration between the illness onset and CT were significantly correlated with the severity scores in both groups. Conclusion: Patients with COVID-19 admitted out of Wuhan demonstrated a milder pulmonary change and a preferable subpleural pattern on HRCT when comparing with the patients with common pneumonia.

12.
Sustainability ; 14(3):1856, 2022.
Article in English | ProQuest Central | ID: covidwho-1687025

ABSTRACT

Overwhelming remote communication episodes have become critical daily work demands for employees. On the basis of affective event theory, this study explores the effect of daily remote communication autonomy on positive affect and proactive work behaviors. We conducted a multilevel path analysis using a general survey, followed by experience sampling methodology, with a sample of 80 employees in China who completed surveys thrice daily over a two-week period. The results showed that daily remote communication autonomy increased positive affective reactions, which, in turn, enhanced proactive work behaviors on the same workday. Furthermore, positive day-level relationships leading to employee proactivity were only significant when the employees’ person-level general techno-workload was not high. The findings provide a new perspective for managing employees working under continuous techno-workload and demands for remote interactions.

13.
Int J Disaster Risk Reduct ; 70: 102793, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1683179

ABSTRACT

The aim of the study is to determine the trajectories of physical activity and depressive symptoms and their reciprocal relationship among community-dwelling older adults in the COVID-19 pandemic era. The study population consisted of a cohort of 511 participants aged 60 years and over, who were recruited from eight community health centers in Ya'an, China. The Physical Activity Scale for the Elderly and the Patient Health Questionnaire were respectively used to measure physical activity and depressive symptoms at three time points: before the COVID-19 outbreak (T0), during the outbreak period (T1), and after the subsidence of COVID-19 (T2). The results revealed that physical activity and depressive symptoms fluctuated substantially across T0, T1, and T2. In addition, more severe depressive symptoms at T0 and T1 were significantly associated with lower levels of physical activity at T1 and T2, but the obverse direction of physical activity being associated with subsequent depressive symptoms was not observed in the current study. These findings highlight the importance of supporting old people to remain physically active and combat mental distress early in a pandemic, and prevention and management of depressive symptoms may also be beneficial to promote physical activity.

14.
International journal of disaster risk reduction : IJDRR ; 2022.
Article in English | EuropePMC | ID: covidwho-1615232

ABSTRACT

The aim of the study is to determine the trajectories of physical activity and depressive symptoms and their reciprocal relationship among community-dwelling older adults in the COVID-19 pandemic era. The study population consisted of a cohort of 511 participants aged 60 years and over, who were recruited from eight community health centers in Ya'an, China. The Physical Activity Scale for the Elderly and the Patient Health Questionnaire were respectively used to measure physical activity and depressive symptoms at three time points: before the COVID-19 outbreak (T0), during the outbreak period (T1), and after the subsidence of COVID-19 (T2). The results revealed that physical activity and depressive symptoms fluctuated substantially across T0, T1, and T2. In addition, more severe depressive symptoms at T0 and T1 were significantly associated with lower levels of physical activity at T1 and T2, but the obverse direction of physical activity being associated with subsequent depressive symptoms was not observed in the current study. These findings highlight the importance of supporting old people to remain physically active and combat mental distress early in a pandemic, and prevention and management of depressive symptoms may also be beneficial to promote physical activity.

15.
Computers in Human Behavior ; 130:107177, 2022.
Article in English | ScienceDirect | ID: covidwho-1588120

ABSTRACT

Digital outcome divide, the inequality of the outcomes of exploiting and benefitting from the ICT access and usage, has been raised as a severe concern of the e-learning practices during the COVID-19 pandemic. This study drew on capital theory and related literature and conducted a survey of 492 Chinese middle school students to explore: (1) whether a digital outcome divide exists between rural and urban students under the e-learning condition during the COVID-19 pandemic;(2) if it does, how does students’ every form of capital impact the digital outcome divide. Our results revealed several important findings. First, we confirmed the existence of the digital outcome divide between rural and urban students, as rural students reported lower levels of behavioral engagement in e-learning courses compared to their urban peers. Second, we found that differences exist between rural and urban students in habitus (i.e., intrinsic motivation) and forms of capital, including cultural (i.e., e-learning self-efficacy) and social capital (i.e., parental support and teacher support), which are the main causes of the digital outcome divide. Third, a Blinder-Oaxaca decomposition analysis further confirmed that those factors could explain the major parts of the digital outcome divide between urban and rural students and that e-learning self-efficacy, intrinsic motivation, and parental support were the most dominant factors contributing to the rural-urban digital outcome divide in the e-learning context. Our study provides several important theoretical and managerial implications for researchers and educators.

16.
Signal Transduct Target Ther ; 6(1): 438, 2021 12 24.
Article in English | MEDLINE | ID: covidwho-1585880

ABSTRACT

Messenger RNA (mRNA) vaccine technology has shown its power in preventing the ongoing COVID-19 pandemic. Two mRNA vaccines targeting the full-length S protein of SARS-CoV-2 have been authorized for emergency use. Recently, we have developed a lipid nanoparticle-encapsulated mRNA (mRNA-LNP) encoding the receptor-binding domain (RBD) of SARS-CoV-2 (termed ARCoV), which confers complete protection in mouse model. Herein, we further characterized the protection efficacy of ARCoV in nonhuman primates and the long-term stability under normal refrigerator temperature. Intramuscular immunization of two doses of ARCoV elicited robust neutralizing antibodies as well as cellular response against SARS-CoV-2 in cynomolgus macaques. More importantly, ARCoV vaccination in macaques significantly protected animals from acute lung lesions caused by SARS-CoV-2, and viral replication in lungs and secretion in nasal swabs were completely cleared in all animals immunized with low or high doses of ARCoV. No evidence of antibody-dependent enhancement of infection was observed throughout the study. Finally, extensive stability assays showed that ARCoV can be stored at 2-8 °C for at least 6 months without decrease of immunogenicity. All these promising results strongly support the ongoing clinical trial.


Subject(s)
COVID-19 Vaccines/pharmacology , COVID-19/immunology , Immunogenicity, Vaccine , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , /pharmacology , Animals , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Chlorocebus aethiops , Humans , Macaca fascicularis , Vero Cells , /immunology
17.
MAbs ; 14(1): 2005507, 2022.
Article in English | MEDLINE | ID: covidwho-1585297

ABSTRACT

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a serious public health crisis worldwide, and considering the novelty of the disease, preventative and therapeutic measures alike are urgently needed. To accelerate such efforts, the development of JS016, a neutralizing monoclonal antibody directed against the SARS-CoV-2 spike protein, was expedited from a typical 12- to 18-month period to a 4-month period. During this process, transient Chinese hamster ovary cell lines are used to support preclinical, investigational new drug-enabling toxicology research, and early Chemistry, Manufacturing and Controls development; mini-pool materials to supply Phase 1 clinical trials; and a single-clone working cell bank for late-stage and pivotal clinical trials were successively adopted. Moreover, key process performance and product quality investigations using a series of orthogonal and state-of-the-art techniques were conducted to demonstrate the comparability of products manufactured using these three processes, and the results indicated that, despite observed variations in process performance, the primary and high-order structures, purity and impurity profiles, biological and immunological functions, and degradation behaviors under stress conditions were largely comparable. The study suggests that, in particular situations, this strategy can be adopted to accelerate the development of therapeutic biopharmaceuticals and their access to patients.


Subject(s)
Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/therapeutic use , Antibody Affinity/immunology , Antibody Specificity/immunology , CHO Cells , COVID-19/prevention & control , COVID-19/virology , Chromatography, High Pressure Liquid/methods , Circular Dichroism , Clone Cells , Cricetinae , Cricetulus , Humans , Immunoglobulin G/chemistry , Immunoglobulin G/immunology , Immunoglobulin G/therapeutic use , Isoelectric Point , SARS-CoV-2/metabolism , SARS-CoV-2/physiology , Spike Glycoprotein, Coronavirus/metabolism
19.
Philos Trans A Math Phys Eng Sci ; 380(2214): 20210124, 2022 Jan 10.
Article in English | MEDLINE | ID: covidwho-1528261

ABSTRACT

Prolonged school closure has been adopted worldwide to control COVID-19. Indeed, UN Educational, Scientific and Cultural Organization figures show that two-thirds of an academic year was lost on average worldwide due to COVID-19 school closures. Such pre-emptive implementation was predicated on the premise that school children are a core group for COVID-19 transmission. Using surveillance data from the Chinese cities of Shenzhen and Anqing together, we inferred that compared with the elderly aged 60 and over, children aged 18 and under and adults aged 19-59 were 75% and 32% less susceptible to infection, respectively. Using transmission models parametrized with synthetic contact matrices for 177 jurisdictions around the world, we showed that the lower susceptibility of school children substantially limited the effectiveness of school closure in reducing COVID-19 transmissibility. Our results, together with recent findings that clinical severity of COVID-19 in children is lower, suggest that school closure may not be ideal as a sustained, primary intervention for controlling COVID-19. This article is part of the theme issue 'Data science approach to infectious disease surveillance'.


Subject(s)
COVID-19 , Aged , Child , Humans , Middle Aged , SARS-CoV-2 , Schools
20.
Mil Med Res ; 8(1): 57, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1496239

ABSTRACT

BACKGROUND: Mitochondria have been shown to play vital roles during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) development. Currently, it is unclear whether mitochondrial DNA (mtDNA) variants, which define mtDNA haplogroups and determine oxidative phosphorylation performance and reactive oxygen species production, are associated with COVID-19 risk. METHODS: A population-based case-control study was conducted to compare the distribution of mtDNA variations defining mtDNA haplogroups between healthy controls (n = 615) and COVID-19 patients (n = 536). COVID-19 patients were diagnosed based on molecular diagnostics of the viral genome by qPCR and chest X-ray or computed tomography scanning. The exclusion criteria for the healthy controls were any history of disease in the month preceding the study assessment. MtDNA variants defining mtDNA haplogroups were identified by PCR-RFLPs and HVS-I sequencing and determined based on mtDNA phylogenetic analysis using Mitomap Phylogeny. Student's t-test was used for continuous variables, and Pearson's chi-squared test or Fisher's exact test was used for categorical variables. To assess the independent effect of each mtDNA variant defining mtDNA haplogroups, multivariate logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) with adjustments for possible confounding factors of age, sex, smoking and diseases (including cardiopulmonary diseases, diabetes, obesity and hypertension) as determined through clinical and radiographic examinations. RESULTS: Multivariate logistic regression analyses revealed that the most common investigated mtDNA variations (> 10% in the control population) at C5178a (in NADH dehydrogenase subunit 2 gene, ND2) and A249d (in the displacement loop region, D-loop)/T6392C (in cytochrome c oxidase I gene, CO1)/G10310A (in ND3) were associated with a reduced risk of severe COVID-19 (OR = 0.590, 95% CI 0.428-0.814, P = 0.001; and OR = 0.654, 95% CI 0.457-0.936, P = 0.020, respectively), while A4833G (ND2), A4715G (ND2), T3394C (ND1) and G5417A (ND2)/C16257a (D-loop)/C16261T (D-loop) were related to an increased risk of severe COVID-19 (OR = 2.336, 95% CI 1.179-4.608, P = 0.015; OR = 2.033, 95% CI 1.242-3.322, P = 0.005; OR = 3.040, 95% CI 1.522-6.061, P = 0.002; and OR = 2.890, 95% CI 1.199-6.993, P = 0.018, respectively). CONCLUSIONS: This is the first study to explore the association of mtDNA variants with individual's risk of developing severe COVID-19. Based on the case-control study, we concluded that the common mtDNA variants at C5178a and A249d/T6392C/G10310A might contribute to an individual's resistance to developing severe COVID-19, whereas A4833G, A4715G, T3394C and G5417A/C16257a/C16261T might increase an individual's risk of developing severe COVID-19.


Subject(s)
COVID-19 , DNA, Mitochondrial , COVID-19/genetics , Case-Control Studies , China , DNA, Mitochondrial/genetics , Humans , Mitochondria/genetics , Phylogeny , Risk Factors
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