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1.
PLoS Med ; 19(3): e1003930, 2022 03.
Article in English | MEDLINE | ID: covidwho-1793652

ABSTRACT

BACKGROUND: Low syphilis testing uptake is a major public health issue among men who have sex with men (MSM) in many low- and middle-income countries. Syphilis self-testing (SST) may complement and extend facility-based testing. We aimed to evaluate the effectiveness and costs of providing SST on increasing syphilis testing uptake among MSM in China. METHODS AND FINDINGS: An open-label, parallel 3-arm randomized controlled trial (RCT) was conducted between January 7, 2020 and July 17, 2020. Men who were at least 18 years of age, had condomless anal sex with men in the past year, reported not testing for syphilis in the last 6 months, and had a stable residence with mailing addresses were recruited from 124 cities in 26 Chinese provinces. Using block randomization with blocks of size 12, enrolled participants were randomly assigned (1:1:1) into 3 arms: standard of care arm, standard SST arm, and lottery incentivized SST arm (1 in 10 chance to win US$15 if they had a syphilis test). The primary outcome was the proportion of participants who tested for syphilis during the trial period and confirmed with photo verification and between arm comparisons were estimated with risk differences (RDs). Analyses were performed on a modified intention-to-treat basis: Participants were included in the complete case analysis if they had initiated at least 1 follow-up survey. The Syphilis/HIV Duo rapid test kit was used. A total of 451 men were enrolled. In total, 136 (90·7%, 136/150) in the standard of care arm, 142 (94·0%, 142/151) in the standard of SST arm, and 137 (91·3%, 137/150) in the lottery incentivized SST arm were included in the final analysis. The proportion of men who had at least 1 syphilis test during the trial period was 63.4% (95% confidence interval [CI]: 55.5% to 71.3%, p = 0.001) in the standard SST arm, 65.7% (95% CI: 57.7% to 73.6%, p = 0.0002) in the lottery incentivized SST arm, and 14.7% (95% CI: 8.8% to 20.7%, p < 0.001) in the standard of care arm. The estimated RD between the standard SST and standard of care arm was 48.7% (95% CI: 37.8% to 58.4%, p < 0.001). The majority (78.5%, 95% CI: 72.7% to 84.4%, p < 0.001) of syphilis self-testers reported never testing for syphilis. The cost per person tested was US$26.55 for standard SST, US$28.09 for the lottery incentivized SST, and US$66.19 for the standard of care. No study-related adverse events were reported during the study duration. Limitation was that the impact of the Coronavirus Disease 2019 (COVID-19) restrictions may have accentuated demand for decentralized testing. CONCLUSIONS: Compared to standard of care, providing SST significantly increased the proportion of MSM testing for syphilis in China and was cheaper (per person tested). TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1900022409.


Subject(s)
HIV Infections/diagnosis , Homosexuality, Male , Patient Participation/methods , Self-Testing , Syphilis/diagnosis , Adolescent , Adult , COVID-19/epidemiology , China/epidemiology , Follow-Up Studies , HIV Infections/prevention & control , Health Services Accessibility/organization & administration , Homosexuality, Male/statistics & numerical data , Humans , Immunoassay/methods , Male , Mass Screening/economics , Mass Screening/methods , Mass Screening/organization & administration , Middle Aged , Motivation , Pandemics , Reagent Kits, Diagnostic/economics , Reagent Kits, Diagnostic/supply & distribution , SARS-CoV-2 , Sexual and Gender Minorities/statistics & numerical data , Syphilis/epidemiology , Syphilis/prevention & control , Young Adult
2.
J Med Virol ; 94(5): 2222-2229, 2022 May.
Article in English | MEDLINE | ID: covidwho-1777590

ABSTRACT

To assess the clinical efficacy and safety of neutralizing monoclonal antibodies (mABs) for outpatients with coronavirus disease 2019 (COVID-19). PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (ICTRP) databases were searched from inception to July 19, 2021. Only randomized controlled trials (RCTs) that assessed the clinical efficacy and safety of neutralizing mABs in the treatment of COVID-19 outpatients were included. The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs. The primary outcome was the risk of COVID-19-related hospitalization or emergency department (ED) visits. The secondary outcomes were the risk of death and adverse events (AEs). Five articles were included, in which 3309 patients received neutralizing mAB and 2397 patients received a placebo. A significantly lower rate of hospitalization or ED visits was observed among patients who received neutralizing mABs than those who received a placebo (1.7% vs. 6.5%, odds ratios (OR): 0.26; 95% confidence interval (CI): 0.19-0.36; I2 = 0%). In addition, the rate of hospitalization was significantly lower in the patients who received neutralizing mABs than in the control group (OR: 0.24; 95% CI: 0.17-0.34; I2 = 0%). The mortality rate was also significantly lower in the patients who received neutralizing mABs than in the control group (OR: 0.16; 95% CI: 0.05-0.58; I2 = 3%). Neutralizing mABs were associated with a similar risk of any AE (OR: 0.81; 95% CI: 0.64-1.01; I2 = 52%) and a lower risk of serious AEs (OR: 0.37; 97% CI: 0.19-0.72; I2 = 45%) compared with a placebo. Neutralizing mABs can help reduce the risk of hospitalization or ED visits in COVID-19 outpatients. For these patients, neutralizing mABs are safe and not associated with a higher risk of AEs than a placebo.


Subject(s)
COVID-19 , Antibodies, Monoclonal/adverse effects , Antibodies, Neutralizing/therapeutic use , COVID-19/drug therapy , Humans , Outpatients , Randomized Controlled Trials as Topic
4.
Front Biosci (Landmark Ed) ; 27(2): 48, 2022 02 11.
Article in English | MEDLINE | ID: covidwho-1772157

ABSTRACT

BACKGROUND: Thymosin-α1 has been implicated into the treatment of novel respiratory virus Coronavirus Disease 2019 (COVID-19), but the underlying mechanisms are still disputable. AIM: Herein we aimed to reveal a previously unrecognized mechanism that thymosin-α1 prevents COVID-19 by binding with angiotensin-converting enzyme (ACE), which was inspired from the tool of network pharmacology. METHODS: KEGG pathway enrichment of thymosin-α1 treating COVID-19 was analyzed by Database of Functional Annotation Bioinformatics Microarray Analysis, then core targets were validated by ligand binding kinetics assay and fluorometric detection of ACE and ACE2 enzymatic activity. The production of angiotensin I, angiotensin II, angiotensin (1-7) and angiotensin (1-9) were detected by enzyme linked immunosorbent assay. RESULTS: We found that thymosin-α1 impaired the expressions of angiotensin-converting enzyme 2 and angiotensin (1-7) of human lung epithelial cells in a dose-dependent way (p < 0.001). In contrast, thymosin-α1 had no impact on their ACE and angiotensin (1-9) expressions but significantly inhibited the enzymatic activity of ACE (p > 0.05). CONCLUSION: The bioinformatic findings of network pharmacology and the corresponding pharmacological validations have revealed that thymosin-α1 treatment could decrease ACE2 expression in human lung epithelial cells, which strengthens the potential clinical applications of thymosin-α1 to prevent severe acute respiratory syndrome coronavirus 2 infection.


Subject(s)
Angiotensin-Converting Enzyme 2 , COVID-19 , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , COVID-19/drug therapy , Humans , SARS-CoV-2 , Thymalfasin/pharmacology
6.
MAbs ; 14(1): 2040350, 2022.
Article in English | MEDLINE | ID: covidwho-1740684

ABSTRACT

The emergence of escape variants of SARS-CoV-2 carrying mutations in the spike protein poses a challenge for therapeutic antibodies. Here, we show that through the comprehensive engineering of the variable region of the neutralizing monoclonal antibody 5A6, the engineered antibody, 5A6CCS1, is able to neutralize SARS-CoV-2 variants that escaped neutralization by the original 5A6 antibody. In addition to the improved affinity against variants, 5A6CCS1 was also optimized to achieve high solubility and low viscosity, enabling a high concentration formulation for subcutaneous injection. In cynomolgus monkeys, 5A6CCS1 showed a long plasma half-life and good subcutaneous bioavailability through engineering of the variable and constant region. These data demonstrate that 5A6CCS1 is a promising antibody for development against SARS-CoV-2 and highlight the importance of antibody engineering as a potential method to counteract escape variants.


Subject(s)
COVID-19 , Spike Glycoprotein, Coronavirus , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/therapy , Humans , Membrane Glycoproteins , Neutralization Tests , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Viral Envelope Proteins
7.
Forests ; 13(2):264, 2022.
Article in English | ProQuest Central | ID: covidwho-1715216

ABSTRACT

In the context of rapid urbanization, urban foresters are actively seeking management monitoring programs that address the challenges of urban biodiversity loss. Passive acoustic monitoring (PAM) has attracted attention because it allows for the collection of data passively, objectively, and continuously across large areas and for extended periods. However, it continues to be a difficult subject due to the massive amount of information that audio recordings contain. Most existing automated analysis methods have limitations in their application in urban areas, with unclear ecological relevance and efficacy. To better support urban forest biodiversity monitoring, we present a novel methodology for automatically extracting bird vocalizations from spectrograms of field audio recordings, integrating object-based classification. We applied this approach to acoustic data from an urban forest in Beijing and achieved an accuracy of 93.55% (±4.78%) in vocalization recognition while requiring less than ⅛ of the time needed for traditional inspection. The difference in efficiency would become more significant as the data size increases because object-based classification allows for batch processing of spectrograms. Using the extracted vocalizations, a series of acoustic and morphological features of bird-vocalization syllables (syllable feature metrics, SFMs) could be calculated to better quantify acoustic events and describe the soundscape. A significant correlation between the SFMs and biodiversity indices was found, with 57% of the variance in species richness, 41% in Shannon’s diversity index and 38% in Simpson’s diversity index being explained by SFMs. Therefore, our proposed method provides an effective complementary tool to existing automated methods for long-term urban forest biodiversity monitoring and conservation.

8.
Vaccines (Basel) ; 10(2)2022 Feb 17.
Article in English | MEDLINE | ID: covidwho-1708024

ABSTRACT

BACKGROUND: The ChAdOx1 nCoV-19 vaccine has been widely administered against SARS-CoV-2 infection; however, data regarding its immunogenicity, reactogenicity, and potential differences in responses among Asian populations remain scarce. METHODS: 270 participants without prior COVID-19 were enrolled to receive ChAdOx1 nCoV-19 vaccination with a prime-boost interval of 8-9 weeks. Their specific SARS-CoV-2 antibodies, neutralizing antibody titers (NT50), platelet counts, and D-dimer levels were analyzed before and after vaccination. RESULTS: The seroconversion rates of anti-RBD and anti-spike IgG at day 28 after a boost vaccination (BD28) were 100% and 95.19%, respectively. Anti-RBD and anti-spike IgG levels were highly correlated (r = 0.7891), which were 172.9 ± 170.4 and 179.3 ± 76.88 BAU/mL at BD28, respectively. The geometric mean concentrations (GMCs) of NT50 for all participants increased to 132.9 IU/mL (95% CI 120.0-147.1) at BD28 and were highly correlated with anti-RBD and anti-spike IgG levels (r = 0.8248 and 0.7474, respectively). Body weight index was statistically significantly associated with anti-RBD IgG levels (p = 0.035), while female recipients had higher anti-spike IgG levels (p = 0.038). The GMCs of NT50 declined with age (p = 0.0163) and were significantly different across age groups (159.7 IU/mL for 20-29 years, 99.4 IU/mL for ≥50 years, p = 0.0026). Injection-site pain, fever, and fatigue were the major reactogenicity, which were more pronounced after prime vaccination and in younger participants (<50 years). Platelet counts decreased and D-dimer levels increased after vaccination but were not clinically relevant. No serious adverse events or deaths were observed. CONCLUSION: The vaccine is well-tolerated and elicited robust humoral immunity against SARS-CoV-2 after standard prime-boost vaccination in Taiwanese recipients.

9.
Eur Radiol ; 2022 Feb 19.
Article in English | MEDLINE | ID: covidwho-1699891

ABSTRACT

OBJECTIVES: To visualize and quantitatively assess regional lung function of survivors of COVID-19 who were hospitalized using pulmonary free-breathing 1H MRI. METHODS: A total of 12 healthy volunteers and 27 COVID-19 survivors (62.4 ± 8.1 days between infection and image acquisition) were recruited in this prospective study and performed chest 1H MRI acquisitions with free tidal breathing. Then, conventional Fourier decomposition ventilation (FD-V) and global fractional ventilation (FVGlobal) were analyzed. Besides, a modified PREFUL (mPREFUL) method was developed to adapt to COVID-19 survivors and generate dynamic ventilation maps and parameters. All the ventilation maps and parameters were analyzed using Student's t-test. Pearson's correlation and a Bland-Altman plot between FVGlobal and mPREFUL were analyzed. RESULTS: There was no significant difference between COVID-19 and healthy groups regarding a static FD-V map (0.47 ± 0.12 vs 0.42 ± 0.08; p = .233). However, mPREFUL demonstrated lots of regional high ventilation areas (high ventilation percentage (HVP): 23.7% ± 10.6%) existed in survivors. This regional heterogeneity (i.e., HVP) in survivors was significantly higher than in healthy volunteers (p = .003). The survivors breathed deeper (flow-volume loop: 5375 ± 3978 vs 1688 ± 789; p = .005), and breathed more air in respiratory cycle (total amount: 62.6 ± 19.3 vs 37.3 ± 9.9; p < .001). Besides, mPREFUL showed both good Pearson's correlation (r = 0.74; p < .001) and Bland-Altman consistency (mean bias = -0.01) with FVGlobal. CONCLUSIONS: Dynamic ventilation imaging using pulmonary free-breathing 1H MRI found regional abnormity of dynamic ventilation function in COVID-19 survivors. KEY POINTS: • Pulmonary free-breathing1H MRI was used to visualize and quantitatively assess regional lung ventilation function of COVID-19 survivors. • Dynamic ventilation maps generated from 1H MRI were more sensitive to distinguish the COVID-19 and healthy groups (total air amount: 62.6 ± 19.3 vs 37.3 ± 9.9; p < .001), compared with static ventilation maps (FD-V value: 0.47 ± 0.12 vs 0.42 ± 0.08; p = .233). • COVID-19 survivors had larger regional heterogeneity (high ventilation percentage: 23.7% ± 10.6% vs 13.1% ± 7.9%; p = .003), and breathed deeper (flow-volume loop: 5375 ± 3978 vs 1688 ± 789; p = .005) than healthy volunteers.

10.
Stem Cell Reports ; 17(3): 522-537, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1692862

ABSTRACT

Patients with coronavirus disease 2019 (COVID-19) commonly have manifestations of heart disease. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome encodes 27 proteins. Currently, SARS-CoV-2 gene-induced abnormalities of human heart muscle cells remain elusive. Here, we comprehensively characterized the detrimental effects of a SARS-CoV-2 gene, Orf9c, on human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) by preforming multi-omic analyses. Transcriptomic analyses of hPSC-CMs infected by SARS-CoV-2 with Orf9c overexpression (Orf9cOE) identified concordantly up-regulated genes enriched into stress-related apoptosis and inflammation signaling pathways, and down-regulated CM functional genes. Proteomic analysis revealed enhanced expressions of apoptotic factors, whereas reduced protein factors for ATP synthesis by Orf9cOE. Orf9cOE significantly reduced cellular ATP level, induced apoptosis, and caused electrical dysfunctions of hPSC-CMs. Finally, drugs approved by the U.S. Food and Drug Administration, namely, ivermectin and meclizine, restored ATP levels and ameliorated CM death and functional abnormalities of Orf9cOE hPSC-CMs. Overall, we defined the molecular mechanisms underlying the detrimental impacts of Orf9c on hPSC-CMs and explored potentially therapeutic approaches to ameliorate Orf9c-induced cardiac injury and abnormalities.


Subject(s)
COVID-19/pathology , Coronavirus Nucleocapsid Proteins/genetics , Genome-Wide Association Study/methods , SARS-CoV-2/genetics , Action Potentials/drug effects , Adenosine Triphosphate/metabolism , Apoptosis/drug effects , Apoptosis/genetics , COVID-19/virology , Down-Regulation , Humans , Ivermectin/pharmacology , Meclizine/pharmacology , Myocytes, Cardiac/cytology , Myocytes, Cardiac/metabolism , Phosphoproteins/genetics , Pluripotent Stem Cells/cytology , Pluripotent Stem Cells/metabolism , Protein Interaction Maps/genetics , RNA, Messenger/chemistry , RNA, Messenger/metabolism , SARS-CoV-2/isolation & purification , Signal Transduction/genetics , Transcriptome/drug effects , Up-Regulation
11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-325138

ABSTRACT

Background: International flights have accelerated the global spread of Coronavirus Disease 2019 (COVID-19). Determination of the optimal quarantine period for international travelers is crucial to prevent the local spread caused by imported COVID-19 cases. Methods: We performed a retrospective epidemiological study using 491 imported COVID-19 cases in Chengdu, China, to describe the characteristic of the cases and estimate the time from arrival to confirmation for international travelers using nonparametric survival methods. Results: Among the 491 imported COVID-19 cases, 194 (39.5%) were asymptomatic infections. The mean age was 35.6 years (SD=12.1 years) and 83.3% were men. The majority (74.1%) were screened positive for SARS-CoV-2, conducted by Chengdu Customs District, the People’s Republic of China. Asymptomatic cases were younger than presymptomatic or symptomatic cases ( P <0.01). The daily number of imported COVID-19 cases displayed jagged changes. 95% of COVID-19 cases were confirmed by PT-PCR within 14 days (95% CI : 13-15) after arriving in Chengdu. Conclusions: A 14-day quarantine measure can ensure non-infection among international travelers with a 95% probability. Policymakers may consider an extension of the quarantine period to minimize the negative consequences of the COVID-19 confinement and prevent the international spread of COVID-19.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324806

ABSTRACT

Recently, the recurrence of positive SARS-CoV-2 viral RNA in recovered COVID-19 patients get more attention. Here we report a cohort study on the follow up of 182 recovered patients under medical isolation observation. There are 20 (10.99 %) patients out of the 182 were detected SARS-CoV-2 RNA turned positive, but none of them shows any clinical symptomatic recurrence indicating that COVID-19 has a good prognosis. Females and young patients aged under 15 have higher re-positive rate than the average, and none of the severe patients turned re-positive. Notably, most of the re-positive cases turn negative in the followed tests, suggesting that the importance of dynamic surveillance of SARS-CoV-2 RNA for infectivity assessment.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324805

ABSTRACT

The outbreak of Coronavirus Disease 2019 (COVID-19) is getting worse every day all over the world. The present study aimed to review the epidemiological characteristics of patients infected with COVID-19 in Shenzhen city, a super megacity of China, to provide some references for fighting to the coronavirus. We collected data of 417 patients with laboratory-confirmed COVID-19 of Shenzhen through March 7 th , 2020. The epidemiological characteristics of the patients were analyzed. Besides, we collected the governmental measures of Shenzhen city, and the the dynamic changes of the epidemic outbreak. Governmental strategies such as early detection, early hospitalization and popular science etc. are effective for the prevention and control of the epidemic. Nearly 80% confirmed patients with COVID-19 in Shenzhen were in normal or mild conditions, and the mortality was less than 1%. Age, gender, exposure to source of transmission within 14 days and basic diseases are major risk factors for severe patients. Patients in characters of elder, male, with exposure of Wuhan and carried basic diseases had higher risk to be in severe condition (P<0.01;P<0.001). There were 368 patients discharged from hospital by the end of March 7 th , 2020. Patients in severe conditions took more time from onset to discharge (P<0.001), so as those elder one (P<0.001) or who carried basic diseases (P<0.01). The differences of epidemiological characteristics between children and the elderly are still not clear. The nucleic acid test of some discharged patients returned to positive again, and the potential mechanisms need to be further explored. In conclusion, timely administrative intervention is necessary for prevention and control of the COVID-19 outbreak. Patients in characters of elder, male and carried basic diseases worthy more attention. The management of discharged patients, especially the investigation of the recurrence of positive SARS-CoV-2 RNA will be the focus on for the next step. Authors Bo Yuan and Ya-Wen An contributed equally to this work.

14.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-324075

ABSTRACT

BACKGROUND With the evolving growth of the COVID-19 epidemic, travel restriction policies would need to be adjusted accordingly. Prohibition of mass event may be relaxed for social and economic benefits when virus transmission stops but could bear the risk of epidemic rebound. Against the background of the varied SARS-CoV-2 prevalence internationally, we modelled the potential impacts of pre-event interventions on epidemic risk of holding a mass event when COVID-19 is under control. METHODS We developed a mathematical model of SARS-CoV-2 transmission in Guangdong Province, China, where local virus transmission ceased to occur. A large-scale international trade fair was assumed to be held, with influx of people from overseas and rest of China over a short period of time, who participated for 2-week. Scenarios of pre-event intervention (none, quarantine arrangement and polymerase chain reaction (PCR) testing for participants) were compared. The influence of contact pattern, SARS-CoV-2 prevalence outside the province and China, and testing coverage were examined in sensitivity analyses. RESULTS In basecase scenario (no event), the epidemic has been under control since March 2020. The event would lead to the detection of 1% more confirmed cases by 31 July when community contact rate increased to pre-epidemic level. In event scenario without additional interventions, there would be 599 (93%) more new infections comparing with basecase scenario. To avert new infections, quarantining all participants before the event would be the most effective strategy, followed by quarantining all overseas participants and testing all other participants, and testing all participants before the event and on day 7. However, testing strategy is likely to be affected by the SARS-CoV-2 prevalence outside the event province. CONCLUSIONS Pre-event interventions are effective for reducing the risk of epidemic rebound caused by an international large-scale event. Universal testing for participants is likely to be an effective and feasible intervention.

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311275

ABSTRACT

Early detection of infections is crucial to limit the spread of coronavirus 2019 disease (COVID-19). Here, we developed a flow cytometry-based assay to detect SARS-CoV-2 Spike protein (S protein) antibodies in COVID-19 patients. The assay detected specific IgM and IgG in COVID-19 patients and also the acquisition of all IgG subclasses, with IgG1 being the most dominant. The antibody response was significantly higher at a later stage of the infection. Furthermore, asymptomatic COVID-19 patients also developed specific IgM and IgG, with IgG1 as the most dominant subclass. Although the antibody levels were lower in asymptomatic infections, the assay was highly sensitive and detected 97% of asymptomatic infections. These findings demonstrated that the assay could be used for serological analysis of symptomatic patients, and also as a sensitive tool to detect asymptomatic infections, which may go undetected.Funding: Biomedical Research Council (BMRC), the A*ccelerate GAP-funded project (ACCL/19-GAP064-R20H-H) from Agency of Science, Technology and Research (A*STAR), and National Medical Research Council (NMRC) COVID-19 Research fund (COVID19RF-001, COVID-19RF-007, COVID-19RF-60).Conflict of Interest: The authors declare no competing interests.Ethical Approval: The study design and protocols for COVID-19, recovered SARS and seasonal human CoV patient cohorts were approved by National Healthcare Group (NHG) Domain Specific Review Board (DSRB) and performed, following ethical guidelines in the approved studies 2012/00917, 2020/00091 and 2020/00076 respectively. Healthy donor samples were collected in accordance with approved studies 2017/2806 and NUS IRB 04-140. Written informed consent was obtained from participants in accordance with the Declaration of Helsinki for Human Research.

16.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308401

ABSTRACT

Background: Facing the COVID-19 epidemic, Taiwan has demonstrated resilience at the initial stage of epidemic prevention and effectively slowed down its spread. This study aims to capture public epidemic awareness toward the COVID-19 through collecting social media- and Internet-based data and elaborate on how the public epidemic awareness rose and played a role in the epidemic prevention in Taiwan during the initial course of COVID-19 spread. Methods: Using the Google search query volume of COVID-19 and face mask as indicators of public epidemic awareness, we collected the volume of news reports and the mentions on social media about COVID-19 and face masks between December 31, 2019, and February 29, 2020, through big data analysis and sorted the daily total confirmed cases of COVID-19 worldwide and in Taiwan as well as critical mask-related measures implemented by the Taiwanese government to plot the trends in this information and conduct correlation analysis. Additionally, the content analysis was adopted to analyze the transmission of different types of fear information of COVID-19 between December 31, 2019, and March 29, 2020, and their effects on the public. Results: The Google search query volume of COVID-19 and face mask was significantly correlated with the number of confirmed cases in Taiwan, the number of news reports on COVID-19 (correlation coefficient: .74–.90). Since the first confirmed cases of COVID-19, public epidemic awareness has increased rapidly, prompting the government to formulate relevant emergency measures. Additionally, the findings from content analysis suggested that the fear of the loss of control best explains why panic behavior occurs in public. Conclusions: Confronting the highly infectious COVID-19, public epidemic awareness is vital. While fear is an inevitable product when an emerging infectious disease occurs, the government can convert resistance into assistance by understanding why fear arises and which fear factors cause excessive panic in public. Moreover, online social media promptly reflect public epidemic awareness, which can be used as a reference for epidemic prevention;this urges the government to deal with the crisis in the form of public opinion.

17.
PLoS Med ; 19(2): e1003928, 2022 02.
Article in English | MEDLINE | ID: covidwho-1686091

ABSTRACT

BACKGROUND: Digital network-based methods may enhance peer distribution of HIV self-testing (HIVST) kits, but interventions that can optimize this approach are needed. We aimed to assess whether monetary incentives and peer referral could improve a secondary distribution program for HIVST among men who have sex with men (MSM) in China. METHODS AND FINDINGS: Between October 21, 2019 and September 14, 2020, a 3-arm randomized controlled, single-blinded trial was conducted online among 309 individuals (defined as index participants) who were assigned male at birth, aged 18 years or older, ever had male-to-male sex, willing to order HIVST kits online, and consented to take surveys online. We randomly assigned index participants into one of the 3 arms: (1) standard secondary distribution (control) group (n = 102); (2) secondary distribution with monetary incentives (SD-M) group (n = 103); and (3) secondary distribution with monetary incentives plus peer referral (SD-M-PR) group (n = 104). Index participants in 3 groups were encouraged to order HIVST kits online and distribute to members within their social networks. Members who received kits directly from index participants or through peer referral links from index MSM were defined as alters. Index participants in the 2 intervention groups could receive a fixed incentive ($3 USD) online for the verified test result uploaded to the digital platform by each unique alter. Index participants in the SD-M-PR group could additionally have a personalized peer referral link for alters to order kits online. Both index participants and alters needed to pay a refundable deposit ($15 USD) for ordering a kit. All index participants were assigned an online 3-month follow-up survey after ordering kits. The primary outcomes were the mean number of alters motivated by index participants in each arm and the mean number of newly tested alters motivated by index participants in each arm. These were assessed using zero-inflated negative binomial regression to determine the group differences in the mean number of alters and the mean number of newly tested alters motivated by index participants. Analyses were performed on an intention-to-treat basis. We also conducted an economic evaluation using microcosting from a health provider perspective with a 3-month time horizon. The mean number of unique tested alters motivated by index participants was 0.57 ± 0.96 (mean ± standard deviation [SD]) in the control group, compared with 0.98 ± 1.38 in the SD-M group (mean difference [MD] = 0.41),and 1.78 ± 2.05 in the SD-M-PR group (MD = 1.21). The mean number of newly tested alters motivated by index participants was 0.16 ± 0.39 (mean ± SD) in the control group, compared with 0.41 ± 0.73 in the SD-M group (MD = 0.25) and 0.57 ± 0.91 in the SD-M-PR group (MD = 0.41), respectively. Results indicated that index participants in intervention arms were more likely to motivate unique tested alters (control versus SD-M: incidence rate ratio [IRR = 2.98, 95% CI = 1.82 to 4.89, p-value < 0.001; control versus SD-M-PR: IRR = 3.26, 95% CI = 2.29 to 4.63, p-value < 0.001) and newly tested alters (control versus SD-M: IRR = 4.22, 95% CI = 1.93 to 9.23, p-value < 0.001; control versus SD-M-PR: IRR = 3.49, 95% CI = 1.92 to 6.37, p-value < 0.001) to conduct HIVST. The proportion of newly tested testers among alters was 28% in the control group, 42% in the SD-M group, and 32% in the SD-M-PR group. A total of 18 testers (3 index participants and 15 alters) tested as HIV positive, and the HIV reactive rates for alters were similar between the 3 groups. The total costs were $19,485.97 for 794 testers, including 450 index participants and 344 alter testers. Overall, the average cost per tester was $24.54, and the average cost per alter tester was $56.65. Monetary incentives alone (SD-M group) were more cost-effective than monetary incentives with peer referral (SD-M-PR group) on average in terms of alters tested and newly tested alters, despite SD-M-PR having larger effects. Compared to the control group, the cost for one more alter tester in the SD-M group was $14.90 and $16.61 in the SD-M-PR group. For newly tested alters, the cost of one more alter in the SD-M group was $24.65 and $49.07 in the SD-M-PR group. No study-related adverse events were reported during the study. Limitations include the digital network approach might neglect individuals who lack internet access. CONCLUSIONS: Monetary incentives alone and the combined intervention of monetary incentives and peer referral can promote the secondary distribution of HIVST among MSM. Monetary incentives can also expand HIV testing by encouraging first-time testing through secondary distribution by MSM. This social network-based digital approach can be expanded to other public health research, especially in the era of the Coronavirus Disease 2019 (COVID-19). TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR) ChiCTR1900025433.


Subject(s)
HIV Infections/diagnosis , HIV Testing/instrumentation , Homosexuality, Male , Reimbursement, Incentive , Self-Testing , Sexual and Gender Minorities , Adult , China , Costs and Cost Analysis , HIV Testing/economics , HIV Testing/methods , Humans , Male
18.
Am J Infect Control ; 2022 Feb 02.
Article in English | MEDLINE | ID: covidwho-1664605

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has not only placed an unprecedented strain on healthcare systems worldwide, but has also caused irreparable physical and psychological damage to those infected. It is essential to understand the disease process and psychological experience of patients with COVID-19, to provide them with efficacious psychological guidance and interventions. This qualitative systematic review sought to explore the experience of COVID-19 patients. METHODS: The meta-analysis methodology developed by the Joanna Briggs Institute guided this systematic review and qualitative meta-analysis. Seven databases were searched, with no language restrictions. This study was registered with PROSPERO under accession number CRD42021279266. RESULTS: A total of 3107 potentially eligible articles were identified through database and reference list searches, among which 23 studies (from 10 countries) were ultimately included in our analysis. Five interrelated themes emerged: the complex psychological course of COVID-19 patients; the impact of the disease on the body; the expectation of support and guidance from multiple sources; coping strategies; and post-traumatic growth. CONCLUSIONS: Psychological distress among patients with COVID-19 was found to be widespread. Healthcare providers should pay attention to the psychological changes in patients, ensure continuity of care and provide professional support from hospital to home, and build patients' confidence so that they can return to their families and society. Long-term follow-up studies may provide deeper insight into the psychological needs of survivors.

19.
BMC Infect Dis ; 22(1): 83, 2022 Jan 24.
Article in English | MEDLINE | ID: covidwho-1649569

ABSTRACT

BACKGROUND: With the evolving growth of the COVID-19 epidemic, travel restriction policies would need to be adjusted accordingly. Prohibition of mass event may be relaxed for social and economic benefits when virus transmission stops but could bear the risk of epidemic rebound. Against the background of the varied SARS-CoV-2 prevalence internationally, we modelled the potential impacts of pre-event interventions on epidemic risk of holding a mass event when COVID-19 is under control. METHODS: We developed a mathematical model of SARS-CoV-2 transmission in Guangdong Province, China, where local virus transmission ceased to occur. A large-scale international trade fair was assumed to be held, with influx of people from overseas and rest of China over a short period of time, who participated for 2-week. Scenarios of pre-event intervention (none, quarantine arrangement and polymerase chain reaction (PCR) testing for participants) were compared. The influence of contact pattern, SARS-CoV-2 prevalence outside the province and China, and testing coverage were examined in sensitivity analyses. RESULTS: In basecase scenario (no event), the epidemic has been under control since March 2020. The event would lead to the detection of 1% more confirmed cases by 31 July when community contact rate increases to pre-epidemic level. In event scenario without additional interventions, there would be 599 (93%) more new infections comparing with basecase scenario. To avert new infections, quarantining all participants before the event would be the most effective strategy, followed by quarantining all overseas participants and testing all other participants, and testing all participants before the event and on day 7. However, testing strategy is likely to be affected by the SARS-CoV-2 prevalence outside the event province. CONCLUSIONS: Pre-event interventions are effective for reducing the risk of epidemic rebound caused by an international large-scale event. Universal testing for participants is likely to be an effective and feasible intervention.


Subject(s)
COVID-19 , Quarantine , Commerce , Humans , Internationality , SARS-CoV-2
20.
EMBO Mol Med ; 14(3): e15227, 2022 03 07.
Article in English | MEDLINE | ID: covidwho-1643965

ABSTRACT

The SARS-CoV-2 Delta (B.1.617.2) variant is capable of infecting vaccinated persons. An open question remains as to whether deficiencies in specific vaccine-elicited immune responses result in susceptibility to vaccine breakthrough infection. We investigated 55 vaccine breakthrough infection cases (mostly Delta) in Singapore, comparing them against 86 vaccinated close contacts who did not contract infection. Vaccine breakthrough cases showed lower memory B cell frequencies against SARS-CoV-2 receptor-binding domain (RBD). Compared to plasma antibodies, antibodies secreted by memory B cells retained a higher fraction of neutralizing properties against the Delta variant. Inflammatory cytokines including IL-1ß and TNF were lower in vaccine breakthrough infections than primary infection of similar disease severity, underscoring the usefulness of vaccination in preventing inflammation. This report highlights the importance of memory B cells against vaccine breakthrough and suggests that lower memory B cell levels may be a correlate of risk for Delta vaccine breakthrough infection.


Subject(s)
COVID-19 , COVID-19/prevention & control , COVID-19 Vaccines , Humans , SARS-CoV-2
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