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1.
eBioMedicine ; 80:104048, 2022.
Article in English | ScienceDirect | ID: covidwho-1821212

ABSTRACT

Summary Background COVID-19 mRNA vaccines elicit strong T and B cell responses to the SARS-CoV-2 spike glycoprotein in both SARS-CoV-2 naïve and experienced patients. However, it is unknown whether the post-vaccine CD4+ T cell responses seen in patients with a history of COVID-19 are due to restimulation of T cell clonotypes that were first activated during natural infection or if they are the result of new clones activated by the vaccine. Methods To address this question, we analyzed the SARS-CoV-2 spike glycoprotein-specific CD4+ T cell receptor repertoire before and after vaccination in 10 COVID-19 convalescent patients and 4 SARS-CoV-2 naïve healthy donor vaccine recipients. We used the viral Functional Expansion of Specific T cells (ViraFEST) assay to quantitatively identify specific SARS-CoV-2 and common cold coronavirus CD4+ T cell clonotypes post COVID-19 disease resolution and post mRNA SARS-CoV-2 vaccination. Findings We found that while some preexisting T cell receptor clonotypes persisted, the post-vaccine repertoire consisted mainly of vaccine-induced clones and was largely distinct from the repertoire induced by natural infection. Vaccination-induced clones led to an overall maintenance of the total number of SARS-CoV-2 reactive clonotypes over time through expansion of novel clonotypes only stimulated through vaccination. Additionally, we demonstrated that the vaccine preferentially induces T cells that are only specific for SARS-CoV-2 antigens, rather than T cells that cross-recognize SARS-CoV-2/common cold coronaviruses. Interpretation These data demonstrate that SARS-CoV-2 vaccination in patients with prior SARS-CoV-2 infection induces a new antigen-specific repertoire and sheds light on the differential immune responses induced by vaccination versus natural infection. Funding Bloomberg∼Kimmel Institute for Cancer Immunotherapy, The Johns Hopkins University, The Bill and Melinda Gates Foundation, NCI U54CA260492, NIH.

2.
Vaccines ; 10(4):625, 2022.
Article in English | MDPI | ID: covidwho-1792367

ABSTRACT

Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rates when adjusting for demographic and social determinants of health (SDOH) variables, and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and a hierarchical multivariable quasi-binomial regression analysis were conducted, where the regression analysis was stratified by urban–rural status. The current study suggests that social capital contributes significantly to the disparities of vaccination uptake in the US. The results of the stratification analysis show common predictors of vaccine uptake but also suggest various patterns based on urbanization level regarding the associations of COVID-19 vaccination uptake with SDOH and social capital factors. The study provides a new perspective to address disparities in vaccination uptake through fostering social capital within communities;which may inform tailored public health intervention efforts to enhance social capital and promote vaccination uptake.

3.
Risk management and healthcare policy ; 15:447-456, 2022.
Article in English | EuropePMC | ID: covidwho-1743744

ABSTRACT

Purpose Fever is one of the most typical clinical symptoms of coronavirus disease 2019 (COVID-19), and non-contact infrared thermometers (NCITs) are commonly used to screen for fever. However, there is a lack of authoritative data to define a “fever” when an NCIT is used and previous studies have shown that NCIT readings fluctuate widely depending on ambient temperatures and the body surface site screened. The aim of this study was to establish cut-off points for normal temperatures of different body sites (neck, forehead, temples, and wrist) and investigate the accuracy of NCITs at various ambient temperatures to improve the standardization and accuracy of fever screening. Patients and Methods A prospective investigation was conducted among 904 participants in the outpatient and emergency departments of Chengdu Women’s and Children’s Central Hospital. Body temperature was measured using NCITs and mercury axillary thermometers. A receiver operating characteristic curve was used to determine the accuracy of body temperature detection at the four body surface sites. Data on participant characteristics were also collected. Results Among the four surface sites, the neck temperature detection group had the highest accuracy. When the neck temperature was 37.35°C as the optimum fever diagnostic threshold, the sensitivity was 0.866. The optimum fever diagnostic thresholds for forehead, temporal, and wrist temperature were 36.65°C, 36.65°C, and 36.75°C, respectively. Moreover, triple neck temperature detection had the highest sensitivity, up to 0.998, whereas the sensitivity of triple wrist temperature detections was 0.949. Notably, the accuracy of NCITs significantly reduced when the temperature was lower than 18°C. Conclusion Neck temperature had the highest accuracy among the four NCIT temperature measurement sites, with an optimum fever diagnostic threshold of 37.35°C. Considering the findings reported in our study, we recommend triple neck temperature detection with NCITs as the fever screening standard for COVID-19.

4.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329825

ABSTRACT

Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rate adjusting for demographic and social determinants of health (SDOH) variables;and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and hierarchical multivariable quasi-binomial regression analysis were conducted, then the regression analysis was stratified by urban-rural status. The current study suggests that social capital contributes significantly to the disparities of vaccination uptake in the US. The results of stratification analysis show common predictors of vaccine uptake but also suggest various patterns based on urbanization level regarding the associations of COVID-19 vaccination uptake with SDOH and social capital factors. The study provides a new perspective to address disparities in vaccination uptake through fostering social capital within communities, which may inform tailored public health intervention efforts in enhancing social capital and promoting vaccination uptake.

5.
BMJ Glob Health ; 7(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1642863

ABSTRACT

INTRODUCTION: Widespread problems of psychological distress have been observed in many countries following the outbreak of COVID-19, including Australia. What is lacking from current scholarship is a national-scale assessment that tracks the shifts in mental health during the pandemic timeline and across geographic contexts. METHODS: Drawing on 244 406 geotagged tweets in Australia from 1 January 2020 to 31 May 2021, we employed machine learning and spatial mapping techniques to classify, measure and map changes in the Australian public's mental health signals, and track their change across the different phases of the pandemic in eight Australian capital cities. RESULTS: Australians' mental health signals, quantified by sentiment scores, have a shift from pessimistic (early pandemic) to optimistic (middle pandemic), reflected by a 174.1% (95% CI 154.8 to 194.5) increase in sentiment scores. However, the signals progressively recessed towards a more pessimistic outlook (later pandemic) with a decrease in sentiment scores by 48.8% (95% CI 34.7 to 64.9). Such changes in mental health signals vary across capital cities. CONCLUSION: We set out a novel empirical framework using social media to systematically classify, measure, map and track the mental health of a nation. Our approach is designed in a manner that can readily be augmented into an ongoing monitoring capacity and extended to other nations. Tracking locales where people are displaying elevated levels of pessimistic mental health signals provide important information for the smart deployment of finite mental health services. This is especially critical in a time of crisis during which resources are stretched beyond normal bounds.


Subject(s)
COVID-19 , Pandemics , Australia/epidemiology , Humans , Mental Health , SARS-CoV-2
6.
Lancet HIV ; 8(11): e690-e700, 2021 11.
Article in English | MEDLINE | ID: covidwho-1541050

ABSTRACT

BACKGROUND: Evidence of whether people living with HIV are at elevated risk of adverse COVID-19 outcomes is inconclusive. We aimed to investigate this association using the population-based National COVID Cohort Collaborative (N3C) data in the USA. METHODS: We included all adult (aged ≥18 years) COVID-19 cases with any health-care encounter from 54 clinical sites in the USA, with data being deposited into the N3C. The outcomes were COVID-19 disease severity, hospitalisation, and mortality. Encounters in the same health-care system beginning on or after January 1, 2018, were also included to provide information about pre-existing health conditions (eg, comorbidities). Logistic regression models were employed to estimate the association of HIV infection and HIV markers (CD4 cell count, viral load) with hospitalisation, mortality, and clinical severity of COVID-19 (multinomial). The models were initially adjusted for demographic characteristics, then subsequently adjusted for smoking, obesity, and a broad range of comorbidities. Interaction terms were added to assess moderation effects by demographic characteristics. FINDINGS: In the harmonised N3C data release set from Jan 1, 2020, to May 8, 2021, there were 1 436 622 adult COVID-19 cases, of these, 13 170 individuals had HIV infection. A total of 26 130 COVID-19 related deaths occurred, with 445 among people with HIV. After adjusting for all the covariates, people with HIV had higher odds of COVID-19 death (adjusted odds ratio 1·29, 95% CI 1·16-1·44) and hospitalisation (1·20, 1·15-1·26), but lower odds of mild or moderate COVID-19 (0·61, 0·59-0·64) than people without HIV. Interaction terms revealed that the elevated odds were higher among older age groups, male, Black, African American, Hispanic, or Latinx adults. A lower CD4 cell count (<200 cells per µL) was associated with all the adverse COVID-19 outcomes, while viral suppression was only associated with reduced hospitalisation. INTERPRETATION: Given the COVID-19 pandemic's exacerbating effects on health inequities, public health and clinical communities must strengthen services and support to prevent aggravated COVID-19 outcomes among people with HIV, particularly for those with pronounced immunodeficiency. FUNDING: National Center for Advancing Translational Sciences, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , Pandemics , Adolescent , Adult , Aged , Cohort Studies , Humans , Male , SARS-CoV-2 , United States/epidemiology
7.
Journal for Immunotherapy of Cancer ; 9(Suppl 2):A310, 2021.
Article in English | ProQuest Central | ID: covidwho-1511494

ABSTRACT

BackgroundMucosal Associated Invariant T Cells (MAIT cells) are unconventional T cells that recognize vitamin B metabolites derived from bacteria and are mainly present in mucosal tissues and peripheral blood.1 Their activation by T Cell Receptor (TCR)-dependent and -independent pathways can result in effector function that can either promote or inhibit cytotoxic effects.2 MAIT cells are known to be involved in the pathogenesis of multiple diseases that involve mucosal tissues, such as non-small cell lung cancer (NSCLC).2 Recently, studies have shown that disparate outcomes to SARS-CoV-2-infection between males and females may involve a differential activation of MAIT cells in the lung mucosa.3 It is therefore conceivable to hypothesize that sex differences of MAIT cells in NSCLC may also impact outcome, however their involvement in progression and subsequent treatment response of NSCLC has never been explored.MethodsTo study the transcriptional program of MAIT cells in NSCLC as a function of sex, peripheral blood and tissue biospecimens were obtained from the first-in-human clinical trial of neoadjuvant anti-PD-1 (nivolumab) in resectable non-small cell lung cancer;NCT02259621.4 Coupled single-cell RNAseq/TCRseq was performed on tumor infiltrating lymphocytes (TIL), paired adjacent normal lung, and tumor-draining lymph nodes (TDLN). MAIT cells were identified by expression of SLC4A10 and the invariant TRAV1-2 and TRAJ33/12/20 TCR. Computational analysis revealed 4 distinct MAIT cell clusters and differentially expressed genes in the tumors and healthy normal lung of males as compared to females.ResultsIn MAIT cells from females, we found upregulation of CD8A, GNLY, and NKG7 genes. These genes are involved with T cell activation and cytolytic function, suggesting that the activation of these genes in MAIT cells could be contributing towards their cytolytic activity in females. In MAIT cells from males, we found upregulation of PDE3B and PCBP2 genes, which are known to be involved with immunosuppression and downregulation of cytotoxic T lymphocyte (CTL) responses. These findings were consistent in the healthy normal lung, suggesting these transcriptional programs may be due to the normal lung biology and not necessarily a byproduct of carcinogenesis.ConclusionsThese results highlight the potential for dual characteristics of MAIT cells in neoadjuvant anti-PD-1-treated NSCLCs and provide an important foundation in our study of the often dichotomous responses between males and females to immunotherapy. Future analyses will focus on the interplay of MAIT cells with other cells in the tumor microenvironment (TME) as a function of immunotherapy treatment and clinical response.ReferencesChen Z, Wang H, D’Souza C, et al. Mucosal-associated invariant T-cell activation and accumulation after in vivo infection depends on microbial riboflavin synthesis and co-stimulatory signals. Mucosal Immunol 2017;10:58–68.Wen X, Zhang X, et al. Title of article: mucosal-associated invariant T cells in lung cancers. Elsevier 2021;94.Yu C, Littleton S, et al. Mucosal-associated invariant T cell responses differ by sex in COVID-19. CellPress 2021;2:755–772.Caushi JX, Zhang J, Ji Z, et al. Transcriptional programs of neoantigen-specific TIL in anti-PD-1-treated lung cancers. Nature 2021.Ethics ApprovalThis study was approved by the Institutional Review Boards (IRB) at Johns Hopkins University (JHU) and Memorial Sloan Kettering Cancer Center and was conducted in accordance with the Declaration of Helsinki and the International Conference on Harmonization Good Clinical Practice guidelines. The patients described in this study provided written informed consent.

8.
Open Forum Infect Dis ; 8(9): ofab428, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1434434

ABSTRACT

BACKGROUND: Current literature examining the clinical characteristics of coronavirus disease 2019 (COVID-19) patients under-represent COVID-19 cases who were either asymptomatic or had mild symptoms. METHODS: We analyzed statewide data from 280 177 COVID-19 cases from various health care facilities during March 4-December 31, 2020. Each COVID-19 case was reported using the standardized Case Report Form (CRF), which collected information on demographic characteristics, symptoms, hospitalization, and death. We used multivariable logistic regression to analyze the associations between sociodemographics and disease severity, hospitalization, and mortality. RESULTS: Among a total of 280 177 COVID-19 cases, 5.2% (14 451) were hospitalized and 1.9% (5308) died. Older adults, males, and Black individuals had higher odds of hospitalization and death from COVID-19 (all P < 0.0001). In particular, individuals residing in rural areas experienced a high risk of death (odds ratio [OR], 1.16; 95% CI, 1.08-1.25). Regarding disease severity, older adults (OR, 1.06; 95% CI, 1.03-1.10) and Hispanic or Latino patients (OR, 2.06; 95% CI, 1.95-2.18) had higher odds of experiencing moderate/severe symptoms, while male and Asian patients, compared with White patients, had lower odds of experiencing moderate/severe symptoms. CONCLUSIONS: As the first statewide population-based study using data from multiple health care systems with a long follow-up period in the United States, we provide a more generalizable picture of COVID-19 symptoms and clinical outcomes. The findings from this study reinforce the fact that rural residence and racial/ethnic social determinants of health, unfortunately, remain predictors of adverse health outcomes for COVID-19 patients.

9.
Front Public Health ; 9: 675380, 2021.
Article in English | MEDLINE | ID: covidwho-1295725

ABSTRACT

Background: As the coronavirus disease 2019 (COVID-19) pandemic progressed globally, school closures and home quarantine may cause an increase in problematic Internet use among students in universities. Such a traumatic stress event may also contribute to the development of posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms. This study aimed to evaluate the prevalence of PTSD, depressive, and anxiety symptoms as well as the predictive role of problematic Internet use in the above-mentioned psychological problems in university students. Methods: A cross-sectional study was conducted through an online survey of 8,879 students in China between April 20 and April 26, 2020. The presence of PTSD, depressive, and anxiety symptoms and problematic Internet use were evaluated using PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression 9-item scale, the generalized anxiety disorder 7-item scale, and the Young diagnostic questionnaire, respectively. Sociodemographic information and the knowledge, attitude, and practice (KAP) toward COVID-19 data were also collected. Results: A total of 4,834 (54.4%) participants were female, and 7,564 (85.2%) were undergraduate students. A total of 615 students (6.9%) reported PTSD symptoms; 5.2% (465) and 10.1% (896) reported moderate to severe depressive and anxiety symptoms, respectively. The problematic Internet use was significantly associated with higher risk of PTSD, depressive, and anxiety symptoms (odds ratio 2.662 [95% CI, 2.239-3.165], odds ratio 4.582 [95% CI, 3.753-5.611], odds ratio 3.251 [95% CI, 2.814-3.757], respectively; all P < 0.001). Lower attitude and practice scores also contributed to the risk of depressive, anxiety, and PTSD symptoms (P < 0.05). Conclusions: Psychological problems should be paid more attention, and problematic Internet use may be a predictor when screening high-risk students for psychological problems. Our results will aid in timely psychological screening, which is meaningful in the prevention and intervention of psychological problems.


Subject(s)
COVID-19 , Universities , China/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Disease Outbreaks , Female , Humans , Internet Use , SARS-CoV-2 , Students
10.
J Clin Invest ; 131(10)2021 05 17.
Article in English | MEDLINE | ID: covidwho-1255762

ABSTRACT

BACKGROUNDRecent studies have reported T cell immunity to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in unexposed donors, possibly due to crossrecognition by T cells specific for common cold coronaviruses (CCCs). True T cell crossreactivity, defined as the recognition by a single TCR of more than one distinct peptide-MHC ligand, has never been shown in the context of SARS-CoV-2.METHODSWe used the viral functional expansion of specific T cells (ViraFEST) platform to identify T cell responses crossreactive for the spike (S) glycoproteins of SARS-CoV-2 and CCCs at the T cell receptor (TCR) clonotype level in convalescent COVID-19 patients (CCPs) and SARS-CoV-2-unexposed donors. Confirmation of SARS-CoV-2/CCC crossreactivity and assessments of functional avidity were performed using a TCR cloning and transfection system.RESULTSMemory CD4+ T cell clonotypes that crossrecognized the S proteins of SARS-CoV-2 and at least one other CCC were detected in 65% of CCPs and unexposed donors. Several of these TCRs were shared among multiple donors. Crossreactive T cells demonstrated significantly impaired SARS-CoV-2-specific proliferation in vitro relative to monospecific CD4+ T cells, which was consistent with lower functional avidity of their TCRs for SARS-CoV-2 relative to CCC.CONCLUSIONSOur data confirm, for what we believe is the first time, the existence of unique memory CD4+ T cell clonotypes crossrecognizing SARS-CoV-2 and CCCs. The lower avidity of crossreactive TCRs for SARS-CoV-2 may be the result of antigenic imprinting, such that preexisting CCC-specific memory T cells have reduced expansive capacity upon SARS-CoV-2 infection. Further studies are needed to determine how these crossreactive T cell responses affect clinical outcomes in COVID-19 patients.FUNDINGNIH funding (U54CA260492, P30CA006973, P41EB028239, R01AI153349, R01AI145435-A1, R21AI149760, and U19A1088791) was provided by the National Institute of Allergy and Infectious Diseases, the National Cancer Institute, and the National Institute of Biomedical Imaging and Bioengineering. The Bloomberg~Kimmel Institute for Cancer Immunotherapy, The Johns Hopkins University Provost, and The Bill and Melinda Gates Foundation provided funding for this study.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , COVID-19/immunology , Epitopes, T-Lymphocyte/immunology , Immunologic Memory , Receptors, Antigen, T-Cell/immunology , SARS-CoV-2/immunology , Adult , Aged , Cross Reactions , Female , Humans , Jurkat Cells , Male , Middle Aged
11.
J Clin Invest ; 131(10)2021 05 17.
Article in English | MEDLINE | ID: covidwho-1238630

ABSTRACT

BACKGROUNDRecent studies have reported T cell immunity to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in unexposed donors, possibly due to crossrecognition by T cells specific for common cold coronaviruses (CCCs). True T cell crossreactivity, defined as the recognition by a single TCR of more than one distinct peptide-MHC ligand, has never been shown in the context of SARS-CoV-2.METHODSWe used the viral functional expansion of specific T cells (ViraFEST) platform to identify T cell responses crossreactive for the spike (S) glycoproteins of SARS-CoV-2 and CCCs at the T cell receptor (TCR) clonotype level in convalescent COVID-19 patients (CCPs) and SARS-CoV-2-unexposed donors. Confirmation of SARS-CoV-2/CCC crossreactivity and assessments of functional avidity were performed using a TCR cloning and transfection system.RESULTSMemory CD4+ T cell clonotypes that crossrecognized the S proteins of SARS-CoV-2 and at least one other CCC were detected in 65% of CCPs and unexposed donors. Several of these TCRs were shared among multiple donors. Crossreactive T cells demonstrated significantly impaired SARS-CoV-2-specific proliferation in vitro relative to monospecific CD4+ T cells, which was consistent with lower functional avidity of their TCRs for SARS-CoV-2 relative to CCC.CONCLUSIONSOur data confirm, for what we believe is the first time, the existence of unique memory CD4+ T cell clonotypes crossrecognizing SARS-CoV-2 and CCCs. The lower avidity of crossreactive TCRs for SARS-CoV-2 may be the result of antigenic imprinting, such that preexisting CCC-specific memory T cells have reduced expansive capacity upon SARS-CoV-2 infection. Further studies are needed to determine how these crossreactive T cell responses affect clinical outcomes in COVID-19 patients.FUNDINGNIH funding (U54CA260492, P30CA006973, P41EB028239, R01AI153349, R01AI145435-A1, R21AI149760, and U19A1088791) was provided by the National Institute of Allergy and Infectious Diseases, the National Cancer Institute, and the National Institute of Biomedical Imaging and Bioengineering. The Bloomberg~Kimmel Institute for Cancer Immunotherapy, The Johns Hopkins University Provost, and The Bill and Melinda Gates Foundation provided funding for this study.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , COVID-19/immunology , Epitopes, T-Lymphocyte/immunology , Immunologic Memory , Receptors, Antigen, T-Cell/immunology , SARS-CoV-2/immunology , Adult , Aged , Cross Reactions , Female , Humans , Jurkat Cells , Male , Middle Aged
12.
Psychoneuroendocrinology ; 128: 105210, 2021 06.
Article in English | MEDLINE | ID: covidwho-1164354

ABSTRACT

BACKGROUND: The outbreak of COVID-19 epidemic has induced entire cities in China placed under 'mass quarantine'. The majority of pregnant women have to be confined at home may be more vulnerable to stressors. In our study, we aimed to explore the effects of the epidemic on maternal thyroid function, so as to provide evidence for prevention and intervention of sustained maternal and offspring's health impairment produced by thyroid dysfunction. METHODS: The subjects were selected from an ongoing prospective cohort study. we included the pregnant women who receive a thyroid function test during the COVID-19 epidemic and those receiving the test during the corresponding lunar period of 2019. A total of 7148 pregnant women with complete information were included in the final analysis. Multivariate linear and logistic regression models were used for analyzing the association of COVID-19 pandemic with FT4 levels and isolated hypothyroxinemia. RESULTS: We found a decreased maternal FT4 level during the period of the COVID-19 pandemic in first and second trimesters (ß = -0. 131, 95%CI = -0.257,-0.006,p = 0.040) and in first trimester (ß = -0. 0.176, 95%CI = -0.326,-0.026,p = 0.022) when adjusting for 25 (OH) vitamin D, vitamin B12, folate and ferritin and gestational days, maternal socio-demographic characteristics and health conditions. The status of pandemic increased the risks of isolated hypothyroxinemia in first and second trimesters (OR = 1.547, 95%CI = 1.251,1.913, p < 0.001) and first trimester (OR = 1.651, 95%CI = 1.289,2.114, p < 0.001) when adjusting for the covariates. However, these associations disappeared in the women with positive TPOAb (p > 0.05). Additionally, we found associations between daily reported new case of COVID-19 and maternal FT4 for single-day lag1, lag3 and multi-day lag01 and lag04 when adjusting for the covariates (each p < 0.05). CONCLUSIONS: Mass confinement as a primary community control strategy may have a significant cost to public health resources. Access to health service systems and adequate medical resources should be improved for pregnant women during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Pregnancy Complications/blood , Quarantine , Thyroid Diseases/blood , Thyroxine/blood , Adult , China/epidemiology , Female , Humans , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Trimester, First/blood , Pregnancy Trimester, Second/blood , Prospective Studies , Quarantine/statistics & numerical data , Thyroid Diseases/epidemiology
13.
J Med Internet Res ; 23(4): e27045, 2021 04 13.
Article in English | MEDLINE | ID: covidwho-1158317

ABSTRACT

BACKGROUND: Population mobility is closely associated with COVID-19 transmission, and it could be used as a proximal indicator to predict future outbreaks, which could inform proactive nonpharmaceutical interventions for disease control. South Carolina is one of the US states that reopened early, following which it experienced a sharp increase in COVID-19 cases. OBJECTIVE: The aims of this study are to examine the spatial-temporal relationship between population mobility and COVID-19 outbreaks and use population mobility data to predict daily new cases at both the state and county level in South Carolina. METHODS: This longitudinal study used disease surveillance data and Twitter-based population mobility data from March 6 to November 11, 2020, in South Carolina and its five counties with the largest number of cumulative confirmed COVID-19 cases. Population mobility was assessed based on the number of Twitter users with a travel distance greater than 0.5 miles. A Poisson count time series model was employed for COVID-19 forecasting. RESULTS: Population mobility was positively associated with state-level daily COVID-19 incidence as well as incidence in the top five counties (ie, Charleston, Greenville, Horry, Spartanburg, and Richland). At the state level, the final model with a time window within the last 7 days had the smallest prediction error, and the prediction accuracy was as high as 98.7%, 90.9%, and 81.6% for the next 3, 7, and 14 days, respectively. Among Charleston, Greenville, Horry, Spartanburg, and Richland counties, the best predictive models were established based on their observations in the last 9, 14, 28, 20, and 9 days, respectively. The 14-day prediction accuracy ranged from 60.3%-74.5%. CONCLUSIONS: Using Twitter-based population mobility data could provide acceptable predictions of COVID-19 daily new cases at both the state and county level in South Carolina. Population mobility measured via social media data could inform proactive measures and resource relocations to curb disease outbreaks and their negative influences.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks/statistics & numerical data , Forecasting/methods , Population Dynamics/statistics & numerical data , Social Media/statistics & numerical data , Spatio-Temporal Analysis , Travel/statistics & numerical data , Databases, Factual , Humans , Longitudinal Studies , South Carolina/epidemiology
15.
Medicine (Baltimore) ; 99(51): e23797, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-1087850

ABSTRACT

ABSTRACT: The coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 had resulted in a global pandemic. A comprehensive analysis of pediatric COVID-19 cases is essential to decipher the natural features of children under the risk of this disease.In the epidemic period, all the children infected with SARS-CoV-2 in Wuxi, a city with a stable medical system during the COVID-19 outbreak in China, were enrolled for comprehensive data documenting their clinical, prognosis, follow-up, treatment and various tests results. Combing their family cluster characteristics, the epidemiological, hospitalization, and transmission features of children with SARS-CoV-2 were analyzed and discussed.A total of 7 children were enrolled, including 4 mild cases, 1 moderate case, and 2 asymptomatic cases. The common symptoms were fever and dry cough. The length of viral nucleic acid duration in nasopharynx varied and was irrelevant to the severity of the symptom, whether symptomatic or asymptomatic. Two cases showed viral nucleic acid positive recurrence after discharge from the hospital. A child with type 1 diabetes was also focused, for the elevated blood sugar during hospitalization. All these children had close contacts with their family members, some of those were confirmed COVID-19 cases.We provided a holistic and detailed portrayal of the pediatric COVID-19 cases in a typical city of timely response to the epidemic. While the family cluster exhibits the major transmission mode, attention should be paid for the potential risk since the expanded social space of children in future.


Subject(s)
COVID-19/blood , SARS-CoV-2/isolation & purification , Adolescent , Antiviral Agents/therapeutic use , Asymptomatic Infections , COVID-19/diagnostic imaging , COVID-19/drug therapy , COVID-19/virology , Child , Child, Preschool , Female , Humans , Male , Radiography, Thoracic , Retrospective Studies , Tomography, X-Ray Computed
16.
JMIR Res Protoc ; 9(12): e24432, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-1013301

ABSTRACT

BACKGROUND: Human movement is one of the forces that drive the spatial spread of infectious diseases. To date, reducing and tracking human movement during the COVID-19 pandemic has proven effective in limiting the spread of the virus. Existing methods for monitoring and modeling the spatial spread of infectious diseases rely on various data sources as proxies of human movement, such as airline travel data, mobile phone data, and banknote tracking. However, intrinsic limitations of these data sources prevent us from systematic monitoring and analyses of human movement on different spatial scales (from local to global). OBJECTIVE: Big data from social media such as geotagged tweets have been widely used in human mobility studies, yet more research is needed to validate the capabilities and limitations of using such data for studying human movement at different geographic scales (eg, from local to global) in the context of global infectious disease transmission. This study aims to develop a novel data-driven public health approach using big data from Twitter coupled with other human mobility data sources and artificial intelligence to monitor and analyze human movement at different spatial scales (from global to regional to local). METHODS: We will first develop a database with optimized spatiotemporal indexing to store and manage the multisource data sets collected in this project. This database will be connected to our in-house Hadoop computing cluster for efficient big data computing and analytics. We will then develop innovative data models, predictive models, and computing algorithms to effectively extract and analyze human movement patterns using geotagged big data from Twitter and other human mobility data sources, with the goal of enhancing situational awareness and risk prediction in public health emergency response and disease surveillance systems. RESULTS: This project was funded as of May 2020. We have started the data collection, processing, and analysis for the project. CONCLUSIONS: Research findings can help government officials, public health managers, emergency responders, and researchers answer critical questions during the pandemic regarding the current and future infectious risk of a state, county, or community and the effectiveness of social/physical distancing practices in curtailing the spread of the virus. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/24432.

17.
18.
Child Youth Serv Rev ; 120: 105735, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-932968

ABSTRACT

This study was aimed to investigate the knowledge, attitudes, and practices (KAP) towards coronavirus disease 2019 (COVID-19) among school-aged children in the Hubei province when children were being confined to their homes. The questionnaire included questions of KAP about COVID-19, depressive and anxiety symptoms scales. Multivariable generalized linear regressions models were applied to estimate the unstandardized regression coefficients (ß) of KAP. The awareness rates about COVID-19 were 70.1%-99.5% for all 1650 valid questionnaires. 37.2% of the participants quite worried about being infected with COVID-19. Approximately 96% of them washed hands in certain situations, while 85.6% of them washed hands after coughing or sneezing. Compared to the students without depressive symptoms, those who had depressive symptoms scored lower of total KAP, knowledge, attitudes, and practice. The findings suggest that primary students had a relatively good awareness of COVID-19 during the epidemic, as well as optimistic attitudes and appropriate practices. However, some items of appropriate practices still needed to be enhanced.

19.
J Affect Disord ; 279: 412-416, 2021 01 15.
Article in English | MEDLINE | ID: covidwho-838368

ABSTRACT

BACKGROUND: To prevent spreading of the COVID-19 infection, many countries have implemented a nationwide school closure. We aimed to assess the prevalence of behavioral problems in school-aged children during home confinement. METHODS: We conducted an internet-based survey involving 1264 children (grades 2-6) and their parents from two primary schools between February 25 and March 8, 2020, in Hubei province, China. Behavioral problems were evaluated using the Strengths and Difficulties Questionnaire (SDQ). RESULTS: The prevalence of prosocial behaviors among children was 10.3%, followed by total difficulty (8.2%), conduct problems (7.0%), peer problems (6.6%), hyperactivity-inattention (6.3%) and emotional problems (4.7%). Compared with children who did not exercise, children with psychical activity had a lower hyperactivity-inattention risk (Odds Ratio (OR): 0.44 for 1-2 days/week; OR: 0.56 for more than 2 days/week) and less prosocial behaviors problems (OR: 0.65 for 1-2 days/week; OR: 0.55 for more than 2 days/week). Children of parents with anxious symptoms were associated with increased risks of emotional symptoms and total difficulty (OR: 5.64 and 3.78, respectively). LIMITATIONS: We adopted self-report questionnaires and did not collect baseline information before COVID-19 outbreak. The potential self-selection bias inherent in the study should be noted. CONCLUSION: The prevalence of behavioral problems among school-aged children varied from 4.7% to 10.3% in home quarantine during the COVID-19 outbreak. Taking physical exercise may be an efficient measure to reduce behavioral problems for school-aged children in home confinement.


Subject(s)
COVID-19/psychology , Mental Disorders/epidemiology , Problem Behavior/psychology , Quarantine/psychology , Adolescent , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/virology , Child , China/epidemiology , Emotions , Female , Humans , Male , Mental Disorders/psychology , Pandemics , Parents , Prevalence , SARS-CoV-2/isolation & purification , Schools , Self Report , Surveys and Questionnaires
20.
Aerosol Air Qual. Res. ; 7(20): 1552-1568, 20200701.
Article in English | WHO COVID, ELSEVIER | ID: covidwho-710494

ABSTRACT

This study investigated the AQI (air quality index) and atmospheric pollutants including PM 2.5, PM 10, CO, SO 2, NO 2and O 3in Chongqing, Luzhou and Chengdu from 2017 to 2019. In addition, the impacts of the COVID-19 event on the air quality in the three cities in 2020 were compared and discussed. For the combined AQIs for the three cities, in spring, the daily AQIs ranged between 25 and 182 and averaged 72.1. In summer, the daily AQIs ranged between 24 and 206 and averaged 77.5. In autumn, the daily AQIs ranged between 22 and 170 and averaged 61.1, and in winter, the daily AQIs ranged between 28 and 375 and averaged 99.6. The distributions of the six AQI classes in spring were 3%, 94%, 3%, 0%, 0%, and 0%; in summer, they were 11%, 74%, 15%, 0%, 0% and 0%; in autumn, they were 29%, 70%, 1%, 0%, 0%, and 0%, and in winter, they were 1%, 52%, 44%, 3%, 0%, and 0%, respectively. The average AQIs, in order, were Chengdu (85.4) > Chongqing (73.8) > Luzhou (73.2). Both the highest AQIs and PM 2.5(as the major indicatory air pollutant) occurred mainly in the low temperature season (January, December, and February), while O 3was the main air pollutant in June and August when the weather was hot. In February 2020, during the epidemic prevention and control actions taken in response to COVID-19 for the three cities, the combined AQIs for the top five days with the highest AQIs in February 2020 was 79.4, which was 23.6% lower than that from 2017–2019 (AQI = 100.7), and the average concentrations of PM 2.5, PM 10, SO 2, CO, and NO 2were 89.4 µg m –3, 106 µg m –3, 2.31 ppb, 0.72 ppm, and 12.3 ppb, respectively, and were 17.9%, 30.8%, 83.8%, 19.8%, and 62.1%, lower than those in February 2017–2019. However, the average O 3concentration (31.8 ppb) in February 2020 rather than decreasing, increased by 6.2%. This is because a lower NO 2concentration hindered the NO + O 3reaction and led to increase O 3concentration in the ambient air.

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