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1.
Journal of Water Process Engineering ; 48:102834, 2022.
Article in English | ScienceDirect | ID: covidwho-1867447

ABSTRACT

Hospitals generate large volumes of wastewater. Dissolved organic matter (DOM) in wastewater effluent can act as precursors of disinfection by-products, transporter of pollutants, and affect the performance of treatment plants. This study aims to characterize the composition of DOM in medical wastewater and investigate the selectivity of the hospital treatment plant in the removal of DOM. DOM was characterized by Fourier-transform ion-cyclotron resonance mass spectrometry (FT-ICR-MS) and excitation-emission matrix fluorescence spectroscopy (EEMs). DOM of medical wastewater was dominated by aliphatic and highly unsaturated compounds, a feature that is remarkably different from that of natural DOM. In the membrane bioreactor (MBR) unit, more CHNO compounds and highly unsaturated compounds were formed. After disinfection, the highly unsaturated and humic-like compounds were reduced, accompanying a decrease in aromaticity. After reverse osmosis, the highly unsaturated and CHO compounds were concentrated and removed. These steps were complementary in the removal of DOM, suggesting effective transformation and elimination of DOM. This study contributes to a better understanding of the features of DOM in medical wastewater and treatment plant performance in the removal of DOM, which is indispensable for the large-scale design and application of technologies for hospital wastewater treatment, especially in the context of the COVID-19 pandemic.

2.
Sustainability ; 14(10):6198, 2022.
Article in English | MDPI | ID: covidwho-1857878

ABSTRACT

This study used a push–pull–mooring model (PPM model) to build an integrated model to explain the influencing factors of tourists' switching intention to wetland ecotourism after the COVID-19 pandemic. The push effect is crowding perception, the pull effect is nature-based destination attractiveness, and the mooring effect is the risk perception of COVID-19. The study collected 551 valid research samples by questionnaire survey in two world-class wetlands in Taiwan. The results of the regression analysis showed that push, pull, and mooring influenced tourists' switching intention to wetland ecotourism. Among them, the mooring effect regulated the relationship between the push effect and switching intention to wetland ecotourism, but did not regulate the relationship between the pull effect and switching intention to wetland ecotourism. Finally, the switching intention to wetland ecotourism further influenced wetland ecotourism behaviors. It is expected that people can go outdoors after the COVID-19 pandemic and bring substantial economic benefits of tourism to wetland ecological attractions in Taiwan.

3.
Front Public Health ; 9: 740800, 2021.
Article in English | MEDLINE | ID: covidwho-1775894

ABSTRACT

Background: Exposure to ambient particulate matter pollution (APMP) is a global health issue that directly affects the human respiratory system. Thus, we estimated the spatiotemporal trends in the burden of APMP-related respiratory diseases from 1990 to 2019. Methods: Based on the Global Burden of Disease Study 2019, data on the burden of APMP-related respiratory diseases were analyzed by age, sex, cause, and location. Joinpoint regression analysis was used to analyze the temporal trends in the burden of different respiratory diseases over the 30 years. Results: Globally, in 2019, APMP contributed the most to chronic obstructive pulmonary disease (COPD), with 695.1 thousand deaths and 15.4 million disability-adjusted life years (DALYs); however, the corresponding age-standardized death and DALY rates declined from 1990 to 2019. Similarly, although age-standardized death and DALY rates since 1990 decreased by 24% and 40%, respectively, lower respiratory infections (LRIs) still had the second highest number of deaths and DALYs attributable to APMP. This was followed by tracheal, bronchus, and lung (TBL) cancer, which showed increased age-standardized death and DALY rates during the past 30 years and reached 3.78 deaths per 100,000 persons and 84.22 DALYs per 100,000 persons in 2019. Among children aged < 5 years, LRIs had a huge burden attributable to APMP, whereas for older people, COPD was the leading cause of death and DALYs attributable to APMP. The APMP-related burdens of LRIs and COPD were relatively higher among countries with low and low-middle socio-demographic index (SDI), while countries with high-middle SDI showed the highest burden of TBL cancer attributable to APMP. Conclusions: APMP contributed substantially to the global burden of respiratory diseases, posing a significant threat to human health. Effective actions aimed at air pollution can potentially avoid an increase in the PM2.5-associated disease burden, especially in highly polluted areas.


Subject(s)
Air Pollution , Respiratory Tract Diseases , Adult , Aged , Air Pollution/adverse effects , Child , Child, Preschool , Global Burden of Disease , Humans , Particulate Matter/adverse effects , Quality-Adjusted Life Years , Respiratory Tract Diseases/epidemiology
6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323570

ABSTRACT

Background: The aim of the present study was to describe the clinical characteristics of patients with different levels of high-density lipoproteins (HDLs) and analyze the correlation between HDL levels and prognosis of coronavirus disease 2019 (COVID-19) patients. Methods In the clinical retrospective analysis, a total of 228 adult COVID-19 patients admitted to Public Health Treatment Center of Changsha, China from January 17 to March 14, 2020 were enrolled. Median with interquartile range and Mann-Whitney test were used to depict and analyze the clinical characteristics of patients. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between HDLs and severe events of COVID-19 patients. Results Median levels of high-density lipoprotein cholesterol (HDL-C) in adult COVID-19 patients were below normal range. Compared with patients with high HDL-C, patients with low HDL-C showed higher proportion of male (69.6% vs 45.6%, P  = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P  = 0.000) and alanine aminotransferase (ALT) (median, 21.49 vs 18.81 U/L, P  = 0.044), as well as higher proportion of severe events (37.0% vs 14.8%, P  = 0.001). Moreover, they presented a higher risk of developing severe events compared with those with high HDL-C (Log Rank P  < 0.001, Fig. 1). After adjusting for age, gender and underlying diseases, patients with low HDL-C still had elevated possibility of developing to severe cases than those with high HDL-C (HR 2.852, 95% CI 1.505–5.407, P  = 0.001). Conclusions HDL-C level decreased in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.

7.
MedComm (2020) ; 3(1): e112, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1626830

ABSTRACT

Specific roles of gut microbes in COVID-19 progression are critical. However, the circumstantial mechanism remains elusive. In this study, shotgun metagenomic or metatranscriptomic sequencing was performed on fecal samples collected from 13 COVID-19 patients and controls. We analyzed the structure of gut microbiota, identified the characteristic bacteria, and selected biomarkers. Further, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations were employed to correlate the taxon alterations and corresponding functions. The gut microbiota of COVID-19 patients was characterized by the enrichment of opportunistic pathogens and depletion of commensals. The abundance of Bacteroides spp. displayed an inverse relationship with COVID-19 severity, whereas Actinomyces oris, Escherichia coli, and Streptococcus parasanguini were positively correlated with disease severity. The genes encoding oxidoreductase were significantly enriched in gut microbiome of COVID-19 group. KEGG annotation indicated that the expression of ABC transporter was upregulated, while the synthesis pathway of butyrate was aberrantly reduced. Furthermore, increased metabolism of lipopolysaccharide, polyketide sugar, sphingolipids, and neutral amino acids were found. These results suggested the gut microbiome of COVID-19 patients was in a state of oxidative stress. Healthy gut microbiota may enhance antiviral defenses via butyrate metabolism, whereas the accumulation of opportunistic and inflammatory bacteria may exacerbate COVID-19 progression.

8.
Int J Environ Res Public Health ; 18(23)2021 11 27.
Article in English | MEDLINE | ID: covidwho-1551593

ABSTRACT

This study aimed to explore cross-country differences in the characteristics and determinations of self-other risk perceptions of the COVID-19 pandemic. We distinguished perceived risk to self from perceived risk to others and subdivided risk perceptions into three levels: personal, group, and societal. We focused on the differential impact of multiple communication channels (i.e., interpersonal communication, traditional media exposure, and new media exposure) on risk perceptions at the three levels. A sample of 790 college students completed self-report online questionnaires from May to June 2020, including 498 in China and 292 in the United States. The results showed an "ascending pattern," revealing that participants perceived higher levels of risk to others than to themselves. In addition, U.S. college students perceived higher risks of COVID-19 than Chinese college students at all levels. As for the relations between communication and risk perceptions, the results revealed that interpersonal communication and traditional media exposure were more effective with Chinese participants, whereas new media exposure was more effective with U.S. participants. Specifically, interpersonal communication was positively associated with risk perceptions at three levels, and the magnitude of the effect was higher in the Chinese group than in the U.S. group. Traditional media exposure increased societal risk perception only for Chinese college students, and new media exposure increased societal risk perception only for U.S. college students. Our findings provide theoretical implications for the characteristics and forming mechanisms of risk perceptions and also provide practical implications for policymakers in the two countries to implement effective measures to foster individuals' risk perceptions in relation to preventive behaviors.


Subject(s)
COVID-19 , China , Communication , Humans , Pandemics , SARS-CoV-2 , Students , Surveys and Questionnaires , United States
9.
Ann Palliat Med ; 10(10): 10591-10599, 2021 10.
Article in English | MEDLINE | ID: covidwho-1515698

ABSTRACT

BACKGROUND: During the epidemic, the mental health of college students was generally poor, especially anxiety and depression, which should be treated using counseling and intervention. This study aimed to observe the influence of dialectical behavior therapy on the anxiety and depression of medical students during the normalization of the prevention and control of the COVID-19 epidemic. METHODS: A total of 26 medical students (experimental group) were treated with dialectical behavior therapy intervention for 4 weeks. Changes in depression, anxiety, and stress levels were assessed by the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7) scale, the Somatic Self-rating Scale (SSS), and the Perceived Stress Scale (PSS-10). This group was compared with 26 medical students (control group) without intervention. RESULTS: The value-added scores of the PHQ-9 (t=2.543, P=0.014) and GAD-7 scales (t=3.790, P=0.000) in the experimental group were significantly higher than those in the control group, while in the SSS scale, the value-added score of the depressive symptoms subscale (t=2.234, P=0.030) in the experimental group was significantly higher than that of the control group. For the total score of the PSS-10 scale (t=2.435, P=0.018), the value-added score of the experimental group was significantly higher than that of the control group. CONCLUSIONS: The intervention of dialectical behavior therapy can effectively alleviate the depression and anxiety of medical students during the normalization of epidemic prevention and control. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100048784.


Subject(s)
COVID-19 , Dialectical Behavior Therapy , Epidemics , Psychotherapy, Group , Students, Medical , Anxiety/prevention & control , Anxiety Disorders/prevention & control , Humans , SARS-CoV-2
10.
Front Pharmacol ; 12: 655063, 2021.
Article in English | MEDLINE | ID: covidwho-1430715

ABSTRACT

Background: The outbreak of new coronavirus has tremendously threatened the public health system worldwide, including China. Chinese patent medicines (CPMs) have greatly contributed to the prevention and treatment of this viral infection, as well as the recovery of patients with COVID-19 infection. Therefore, numerous experts and guidelines recommend to take CPMs to treat pneumonia due to COVID-19. Aim of the Study: The present study reviewed CPMs recommended by the < Guidelines for diagnosis and management of COVID-19 (8th edition)> regarding evidence of their efficacy from clinical studies and the underlying mechanisms, which will lay the foundation for clinical use of these CPMs for COVID-19. Methods: The composition, efficacy, indications, history of use, and relevant clinical research on 14 recommended CPMs, including Huoxiangzhengqi capsules (pills, liquid, oral solution), Jinhuaqinggan granules, Lianhuaqingwen capsules (granules), Shufengjiedu capsules, Xiyanping injections, Xuebijing injections, Reduning injections, Tanreqing injections, Xingnaojing injections, Shenfu injections, Shengmai injections, Angongniuhuang pills, Suhexiang pills, were searched in both Chinese and English databases based on differences in stages of the disease and manifestations of such patients. Advantages of these CPMs over conventional treatments and their underlying mechanisms were explored by analyzing results from published articles and undergoing clinical trials. Results: Findings from clinical studies and Chinese experience in using these CPMs showed that CPMs, when used in combination with conventional treatments, were effective in managing COVID-19 with few side effects. Conclusion: CPMs have excellent efficacy in managing COVID-19 with a great potential for clinical use.

11.
Int J Nurs Sci ; 8(4): 367-369, 2021 Oct 10.
Article in English | MEDLINE | ID: covidwho-1415458
12.
Transbound Emerg Dis ; 2021 May 09.
Article in English | MEDLINE | ID: covidwho-1388406

ABSTRACT

Highly pathogenic coronaviruses, including SARS-CoV-2, SARS-CoV and MERS-CoV, are thought to be transmitted from bats to humans, but the viral genetic signatures that contribute to bat-to-human transmission remain largely obscure. In this study, we identified an identical ribosomal frameshift motif among the three bat-human pairs of viruses and strong purifying selection after jumping from bats to humans. This represents genetic signatures of coronaviruses that are related to bat-to-human transmission. To further trace the early human-to-human transmission of SARS-CoV-2 in North America, a geographically stratified genome-wide association study (North American isolates and the remaining isolates) and a retrospective study were conducted. We determined that the single nucleotide polymorphisms (SNPs) 1,059.C > T and 25,563.G > T were significantly associated with approximately half of the North American SARS-CoV-2 isolates that accumulated largely during March 2020. Retrospectively tracing isolates with these two SNPs was used to reconstruct the early, reliable transmission history of North American SARS-CoV-2, and European isolates (February 26, 2020) showed transmission 3 days earlier than North American isolates and 17 days earlier than Asian isolates. Collectively, we identified the genetic signatures of the three pairs of coronaviruses and reconstructed an early transmission history of North American SARS-CoV-2. We envision that these genetic signatures are possibly diagnosable and predic markers for public health surveillance.

13.
Front Med (Lausanne) ; 8: 663145, 2021.
Article in English | MEDLINE | ID: covidwho-1266666

ABSTRACT

Background: Predicting the risk of progression to severe coronavirus disease 2019 (COVID-19) could facilitate personalized diagnosis and treatment options, thus optimizing the use of medical resources. Methods: In this prospective study, 206 patients with COVID-19 were enrolled from regional medical institutions between December 20, 2019, and April 10, 2020. We collated a range of data to derive and validate a predictive model for COVID-19 progression, including demographics, clinical characteristics, laboratory findings, and cytokine levels. Variation analysis, along with the least absolute shrinkage and selection operator (LASSO) and Boruta algorithms, was used for modeling. The performance of the derived models was evaluated by specificity, sensitivity, area under the receiver operating characteristic (ROC) curve (AUC), Akaike information criterion (AIC), calibration plots, decision curve analysis (DCA), and Hosmer-Lemeshow test. Results: We used the LASSO algorithm and logistic regression to develop a model that can accurately predict the risk of progression to severe COVID-19. The model incorporated alanine aminotransferase (ALT), interleukin (IL)-6, expectoration, fatigue, lymphocyte ratio (LYMR), aspartate transaminase (AST), and creatinine (CREA). The model yielded a satisfactory predictive performance with an AUC of 0.9104 and 0.8792 in the derivation and validation cohorts, respectively. The final model was then used to create a nomogram that was packaged into an open-source and predictive calculator for clinical use. The model is freely available online at https://severeconid-19predction.shinyapps.io/SHINY/. Conclusion: In this study, we developed an open-source and free predictive calculator for COVID-19 progression based on ALT, IL-6, expectoration, fatigue, LYMR, AST, and CREA. The validated model can effectively predict progression to severe COVID-19, thus providing an efficient option for early and personalized management and the allocation of appropriate medical resources.

14.
Rev Environ Health ; 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1247692

ABSTRACT

Previous studies have confirmed that poor living conditions can lead to a wide range of health problems. However, in the context of the COVID-19 pandemic, vulnerable groups in unstable housing are more susceptible to disease. This study aims to systematically examine the housing and health problems of vulnerable groups using a bibliometric approach to explore how housing causes health problems, types of health illnesses, and coping strategies. It is found that the poor housing mechanism, persistent inequalities, and poor housing environments have a significant impact on the health of vulnerable groups. Therefore, the government must make concerted efforts across all sectors to ensure that the housing and health care needs of vulnerable groups are improved, and that housing security standards and related policies are improved; targeted safety plans are formulated with community as the carrier, taking into account the characteristics of vulnerable groups; and new information technology is widely used to provide medical convenience for vulnerable groups. It is hoped that the research in this paper can arouse social attention to the health of vulnerable groups and improve their health from the perspective of housing, so as to point out the direction for solving the housing health problems of vulnerable groups in the future.

15.
Signal Transduct Target Ther ; 6(1): 181, 2021 05 10.
Article in English | MEDLINE | ID: covidwho-1223081

ABSTRACT

Over 40% of the coronavirus disease 2019 (COVID-19) COVID-19 patients were asymptomatically infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the immune responses of these asymptomatic individuals is a critical factor for developing the strategy to contain the COVID-19 pandemic. Here, we determined the viral dynamics and antibody responses among 143 asymptomatic individuals identified in a massive screening of more than 5 million people in eight districts of Wuhan in May 2020. Asymptomatic individuals were admitted to the government-designated centralized sites in accordance with policy. The incidence rate of asymptomatic infection is ~2.92/100,000. These individuals had low viral copy numbers (peaked at 315 copies/mL) and short-lived antibody responses with the estimated diminish time of 69 days. The antibody responses in individuals with persistent SARS-CoV-2 infection is much longer with the estimated diminish time of 257 days. These results imply that the immune responses in the asymptomatic individuals are not potent enough for preventing SARS-CoV-2 re-infection, which has recently been reported in recovered COVID-19 patients. This casts doubt on the efficacy of forming "herd-immunity" through natural SARS-CoV-2 infection and urges for the development of safe and effective vaccines.


Subject(s)
Antibodies, Viral/immunology , Asymptomatic Infections/epidemiology , COVID-19/immunology , Immunity/immunology , Aged , Antibodies, Viral/blood , Antibodies, Viral/genetics , COVID-19/blood , COVID-19/physiopathology , COVID-19/virology , China/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity
16.
Virol Sin ; 35(6): 713-724, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1217485

ABSTRACT

Coronavirus disease 2019 (COVID-19), reminiscent of the severe acute respiratory syndrome (SARS) outbreak in 2003, has been a tragic disaster to people all over the world. As there is no specific drug for COVID-19, neutralizing antibodies are attracting more and more attention as one of the most effective means to combat the pandemic. Here, we introduced the etiological and serological characteristics of COVID-19, discussed the current stage of development of human monoclonal antibodies against SARS-CoV-2 and summarized the antigenic epitopes in the S glycoprotein, which may deepen the understanding of the profile of immune recognition and response against SARS-CoV-2 and provide insight for the design of effective vaccines and antibody-based therapies.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Antibodies, Neutralizing/therapeutic use , COVID-19/drug therapy , COVID-19/immunology , SARS-CoV-2/immunology , Animals , Antibodies, Monoclonal/immunology , Antibodies, Neutralizing/immunology , Antibodies, Viral/immunology , Antigens, Viral/chemistry , Antigens, Viral/immunology , Epitopes/immunology , Humans , Neutralization Tests , Pandemics , Spike Glycoprotein, Coronavirus/immunology
17.
Ann Work Expo Health ; 65(8): 1004-1008, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-1205525

ABSTRACT

OBJECTIVES: The aim of the present study was to investigate changes in the psychological state of medical personnel in the Department of Radiotherapy during the COVID-19 epidemic. METHODS: Psychological state was evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). All three questionnaires were first completed by medical personnel on 17-18 February 2020 and were repeated every 3 months thereafter until 17-18 August. The number and intentions of patients receiving radiotherapy (RT) in our department were also collected. RESULTS: Twenty medical personnel participated in the present study. The global PSQI score recorded in August was significantly lower than that recorded in February (P = 0.045). Among the seven components of the PSQI, sleep quality (P = 0.048) and daytime dysfunction (P = 0.006) in August were significantly improved compared with February, whereas SDS and SAS did not significantly differ among the three different time points. The proportion of patients who received palliative radiotherapy was significantly higher on 18 May than on 17 February (P = 0.005). CONCLUSIONS: Medical personnel in the Department of Radiotherapy experienced a significantly elevated incidence of sleeping problems during the early COVID-19 outbreak period. Multiple combinations of protective measures to avoid infection could improve sleep quality and ensure the safe delivery of RT to cancer patients.


Subject(s)
COVID-19 , Epidemics , Occupational Exposure , China/epidemiology , Cross-Sectional Studies , Hospitals, Teaching , Humans , SARS-CoV-2 , Tertiary Healthcare
18.
J Thorac Dis ; 13(3): 1380-1395, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1175846

ABSTRACT

BACKGROUND: Most evidence regarding the risk factors for early in-hospital mortality in patients with severe COVID-19 focused on laboratory data at the time of hospital admission without adequate adjustment for confounding variables. A multicenter, age-matched, case-control study was therefore designed to explore the dynamic changes in laboratory parameters during the first 10 days after admission and identify early risk indicators for in-hospital mortality in this patient cohort. METHODS: Demographics and clinical data were extracted from the medical records of 93 pairs of patients who had been admitted to hospital with severe COVID-19. These patients had either been discharged or were deceased by March 3, 2020. Data from days 1, 4, 7, and 10 of hospital admission were compared between survivors and non-survivors. Univariate and multivariate conditional logistic regression analyses were employed to identify early risk indicators of in-hospital death in this cohort. RESULTS: On admission, in-hospital mortality was associated with five risk indicators (ORs in descending order): aspartate aminotransferase (AST, >32 U/L) 43.20 (95% CI: 2.63, 710.04); C-reactive protein (CRP) greater than 100 mg/L 13.61 (1.78, 103.941); lymphocyte count lower than 0.6×109/L 9.95 (1.30, 76.42); oxygen index (OI) less than 200 8.23 (1.04, 65.15); and D-dimer over 1 mg/L 8.16 (1.23, 54.34). Sharp increases in D-dimer at day 4, accompanied by decreasing lymphocyte counts, deteriorating OI, and persistent remarkably high CRP concentration were observed among non-survivors during the early stages of hospital admission. CONCLUSIONS: The potential risk factors of high D-dimer, CRP, AST, low lymphocyte count and OI could help clinicians identify patients at high risk of death early in the hospital admission. This might assist with rationalization of health care resources.

19.
Infect Dis Poverty ; 10(1): 37, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1150428

ABSTRACT

BACKGROUND: The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China. METHODS: A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health. RESULTS: The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety (OR = 0.42-0.67) and higher frequency of washing hands (OR = 1.57-3.40). Higher level of education level was associated with probable depression (OR = 1.31-1.45) and higher frequency of wearing face mask (OR = 1.50-1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (aOR = 1.10-1.11), being quarantined (aOR = 1.42-1.57), personally knowing someone being infected with COVID-19 (aOR = 1.80-1.92), perception that COVID-19 would pose long term physical harm to human (aOR = 1.25-1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (aOR = 0.59-0.63) and lower tendency of always wearing face mask (aOR = 0.85). Social support was associated with lower levels of depression and anxiety (aOR = 0.86-0,87) and higher frequency of washing hands (aOR = 1.06). CONCLUSIONS: The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.


Subject(s)
COVID-19/prevention & control , COVID-19/psychology , Health Behavior , Mental Health , Pregnancy Complications, Infectious/prevention & control , SARS-CoV-2 , Adult , Age Factors , China , Depression/epidemiology , Educational Status , Female , Hand Disinfection/trends , Humans , Logistic Models , Maternal Health Services/statistics & numerical data , Odds Ratio , Personal Protective Equipment , Pregnancy , Pregnancy Complications, Infectious/psychology , Prenatal Care , Prevalence , Risk Factors , Social Support , Surveys and Questionnaires , Young Adult
20.
Med Sci Monit ; 27: e929986, 2021 Apr 17.
Article in English | MEDLINE | ID: covidwho-1148369

ABSTRACT

BACKGROUND This retrospective study aimed to investigate the factors associated with disease severity and patient outcomes in 631 patients with COVID-19 who were reported to the Jiangsu Commission of Health between January 1 and March 20, 2020. MATERIAL AND METHODS We conducted an epidemiological investigation enrolling 631 patients with laboratory-confirmed COVID-19 from our clinic from January to March 2020. Patients' information was collected through a standard questionnaire. Then, we described the patients' epidemiological characteristics, analyzed risk factors associated with disease severity, and assessed causes of zero mortality. Additionally, some key technologies for epidemic prevention and control were identified. RESULTS Of the 631 patients, 8.46% (n=53) were severe cases, and no deaths were recorded (n=0). The epidemic of COVID-19 has gone through 4 stages: a sporadic phase, an exponential growth phase, a peak plateau phase, and a declining phase. The proportion of severe cases was significantly different among the 4 stages and 13 municipal prefectures (P<0.001). Factors including age >65 years old, underlying medical conditions, highest fever >39.0°C, dyspnea, and lymphocytopenia (<1.0×109/L) were early warning signs of disease severity (P<0.05). In contrast, earlier clinic visits were associated with better patient outcomes (P=0.029). Further, the viral load was a potentially useful marker associated with COVID-19 infection severity. CONCLUSIONS The study findings from the beginning of the COVID-19 epidemic in Jiangsu Province, China showed that patients who were more than 65 years of age and with comorbidities and presented with a fever of more than 39.0°C developed more severe disease. However, mortality was prevented in this initial patient population by early supportive clinical management.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Adult , Aged , COVID-19/diagnosis , COVID-19/history , COVID-19/virology , China/epidemiology , Comorbidity , Female , Geography, Medical , History, 21st Century , Humans , Male , Middle Aged , Mortality , Open Reading Frames , Population Surveillance , RNA, Viral , Real-Time Polymerase Chain Reaction , Risk Factors , SARS-CoV-2/classification , SARS-CoV-2/genetics , Seasons , Severity of Illness Index , Viral Load
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