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The number of coronavirus disease 2019 (COVID-19) cases continues to surge, overwhelming healthcare systems and causing excess mortality in many countries. Testing of infectious populations remains a key strategy to contain the COVID-19 outbreak, delay the exponential spread of the disease, and flatten the epidemic curve. Using the Omicron variant outbreak as a background, this study aimed to evaluate the effectiveness of testing strategies with different test combinations and frequencies, analyze the factors associated with testing effectiveness, and optimize testing strategies based on these influencing factors. We developed a stochastic, agent-based, discrete-time susceptible–latent–infectious–recovered model simulating a community to estimate the association between three levels of testing strategies and COVID-19 transmission. Antigen testing and its combination strategies were more efficient than polymerase chain reaction (PCR)-related strategies. Antigen testing also showed better performance in reducing the demand for hospital beds and intensive care unit beds. The delay in the turnaround time of test results had a more significant impact on the efficiency of the testing strategy compared to the detection limit of viral load and detection-related contacts. The main advantage of antigen testing strategies is the short turnaround time, which is also a critical factor to be optimized to improve PCR strategies. After modifying the turnaround time, the strategies with less frequent testing were comparable to daily testing. The choice of testing strategy requires consideration of containment goals, test efficacy, community prevalence, and economic factors. This study provides evidence for the selection and optimization of testing strategies in the post-pandemic era and provides guidance for optimizing healthcare resources.
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Background: The management of LT patients during COVID-19 pandemic is important. Immunosuppressants (IS) are key therapy agents after liver transplant. Different ISs have different side effects. Calcineurin inhibitor (CNI) may lead to metabolic acidosis while mycophenolate mofetil (MMF) showed rare nephrotoxicity. We report a post-liver transplant girl who was infected with SARS-CoV-2, developing a severe mixed acidosis 3 months after the transplantation. Her acidosis was improved after withdrawing of MMF, leading the suspicion that acidosis maybe a rare side effect of MMF. Case presentation: A girl was admitted to our hospital due to SARS-CoV-2 infection, 3 months before admission the patient received LT due to Niemann-Pick disease (NPD). During hospitalization, blood gas analysis showed severe mixed acidosis. To relieve mixed acidosis, the patient was given oral rehydration salt and liquid replacement therapy. Considering that immunosuppressants may cause metabolic acidosis, dose of CsA was decreased and MMF was discontinued. Results: However, liquid replacement therapy and decreased CsA dose cannot improve the condition. As an attempt, MMF was discontinued, and 3 days later, the girl's acidosis was relieved, the latest blood gas analysis was normal with the original dose of CsA and no use of MMF or other IS. In addition, we used Naranjo Scale to see if adverse drug reactions (ADRs) existed. The final score was 6 which means MMF contributes to acidosis probably. Conclusion: The girl's mixed acidosis cannot be explained by Niemann-Pick disease and SARS-CoV-2 infection. CNIs could cause metabolic acidosis but declining the dose of CsA didn't improve her acidosis while withdrawing MMF showed a good effect. Together with the Naranjo Scale result, we suspect that acidosis maybe a rare side effect of MMF.
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BACKGROUND: The COVID-19 vaccination booster can effectively protect the elderly from infection while also lowering the risk of serious illness and death. However, barriers remain in willingness of the elderly to boost vaccination. OBJECTIVE: Using the protection motivation theory (PMT) and the theory of planned behavior (TPB), to study the factors that influence willingness of the elderly to get the COVID-19 vaccine booster. METHODS: The elderly who visited three randomly selected medical institutions in Nanjing's core urban region between March and April 2022 were chosen as study participants. A face-to-face survey was conducted using purposeful sampling and a self-designed questionnaire. The questionnaire contained sociodemographic characteristics, the elderly's willingness to obtain a COVID-19 vaccine booster, and psychosocial cognitive components based on the PMT and TPB. SmartPLS 3.0 was used to conduct structural equation modeling. RESULTS: 214 participants were included in the analysis. The combined model of the two behavioral theories explained the willingness to accept COVID-19 vaccine booster well with R2 of 0.490. Self-efficacy (ß = 0.315) was the strongest predictor of vaccine booster willingness. Subjective norms (ß = 0.160), perceived severity (ß = 0.157), and perceived vulnerability (ß = 0.159) also showed positive effects on vaccine booster willingness, while response cost (ß = -0.143) had a negative effect on the willingness. No significant association between attitudes, response efficacy and the willingness was discovered. CONCLUSION: The willingness of the elderly to receive the COVID-19 vaccine booster was affected by psychosocial cognitive factors. This study supports the applicability of the PMT and TPB models to interpret the willingness of the elderly in such areas.
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The continuously emerging of severe acute respiratory syndrome coronavirus-2 variants of concern (VOCs) led to a decline in effectiveness of the first-generation vaccines. Therefore, optimized vaccines and vaccination strategies, which show advantages in protecting against VOCs, are urgently needed. Here we constructed an optimized DNA vaccine plasmid containing built-in CpG adjuvant, and designed vaccine candidates encoding five forms of antigens derived from Wuhan-Hu-1. The results showed that plasmid with receptor binding domain (RBD) dimer-Fc fusing antigen (2RBD-Fc) induced the highest level of RBD-specific IgG and neutralizing antibodies in mice. Then 2dRBD-Fc and 2omRBD-Fc vaccines, respectively derived from delta and omicron VOCs, were constructed. The 2dRBD-Fc induced potent humoral and cellular immune responses, while the immunogenicity of 2omRBD-Fc was low. We also observed that sequential immunization with 2RBD-Fc, 2dRBD-Fc and 2omRBD-Fc effectively elicited neutralizing antibodies against each immunized strain, and RBD-specific T cell responses. To be noted, the Wuhan-Hu-1, delta and omicron neutralizing antibody titers induced by sequential immunization were comparable to that induced by repetitive immunization with 2RBD-Fc, 2dRBD-Fc or 2omRBD-Fc respectively. The results suggest that sequential immunization with DNA vaccines encoding potent antigens derived from different VOCs, may be a promising strategy to elicit immune responses against multiple variants.
Subject(s)
COVID-19 Vaccines , COVID-19 , Vaccines, DNA , Animals , Humans , Mice , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/geneticsABSTRACT
The number of coronavirus disease 2019 (COVID-19) cases continues to surge, overwhelming healthcare systems and causing excess mortality in many countries. Testing of infectious populations remains a key strategy to contain the COVID-19 outbreak, delay the exponential spread of the disease, and flatten the epidemic curve. Using the Omicron variant outbreak as a background, this study aimed to evaluate the effectiveness of testing strategies with different test combinations and frequencies, analyze the factors associated with testing effectiveness, and optimize testing strategies based on these influencing factors. We developed a stochastic, agent-based, discrete-time susceptible-latent-infectious-recovered model simulating a community to estimate the association between three levels of testing strategies and COVID-19 transmission. Antigen testing and its combination strategies were more efficient than polymerase chain reaction (PCR)-related strategies. Antigen testing also showed better performance in reducing the demand for hospital beds and intensive care unit beds. The delay in the turnaround time of test results had a more significant impact on the efficiency of the testing strategy compared to the detection limit of viral load and detection-related contacts. The main advantage of antigen testing strategies is the short turnaround time, which is also a critical factor to be optimized to improve PCR strategies. After modifying the turnaround time, the strategies with less frequent testing were comparable to daily testing. The choice of testing strategy requires consideration of containment goals, test efficacy, community prevalence, and economic factors. This study provides evidence for the selection and optimization of testing strategies in the post-pandemic era and provides guidance for optimizing healthcare resources.
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This study examined the relationship between perceived social support and subjective well-being among college students in the context of online learning during the COVID-19 pandemic. 515 college students in China that participated in an online questionnaire investigation were selected as the research sample. The results showed that perceived social support was significantly and positively associated with life satisfaction and positive affect and was significantly and negatively related to negative affect among college students learning online during the COVID-19 pandemic. Psychological capital (PsyCap) significantly mediated the relationships between perceived social support and three subjective well-being variables. The present study provides some implications to protect college students' subjective well-being in the context of online learning during the COVID-19 pandemic.
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Triclosan (TCS) has been widely used in daily life because of its broad-spectrum antibacterial activities. The residue of TCS and related compounds in the environment is one of the critical environmental safety problems, and the pandemic of COVID-19 aggravates the accumulation of TCS and related compounds in the environment. Therefore, detecting TCS and related compound residues in the environment is of great significance to human health and environmental safety. The distribution of TCS and related compounds are slightly different worldwide, and the removal methods also have advantages and disadvantages. This paper summarized the research progress on the source, distribution, degradation, analytical extraction, detection, and removal techniques of TCS and related compounds in different environmental samples. The commonly used analytical extraction methods for TCS and related compounds include solid-phase extraction, liquid-liquid extraction, solid-phase microextraction, liquid-phase microextraction, and so on. The determination methods include liquid chromatography coupled with different detectors, gas chromatography and related methods, sensors, electrochemical method, capillary electrophoresis. The removal techniques in various environmental samples mainly include biodegradation, advanced oxidation, and adsorption methods. Besides, both the pros and cons of different techniques have been compared and summarized, and the development and prospect of each technique have been given.
Subject(s)
COVID-19 , Triclosan , Humans , Triclosan/analysis , Chromatography, Liquid , Anti-Bacterial Agents , Solid Phase ExtractionABSTRACT
BACKGROUND: Gut microbiota alterations have been implicated in the pathogenesis of coronavirus disease 2019 (COVID-19). This study aimed to explore gut microbiota changes in a prospective cohort of COVID-19 children and their asymptomatic caregivers infected with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) Omicron variant. METHODS: A total of 186 participants, including 59 COVID-19 children, 50 asymptomatic adult caregivers, 52 healthy children (HC), and 25 healthy adults (HA), were recruited between 15 April and 31 May 2022. The gut microbiota composition was determined by 16S rRNA gene sequencing in fecal samples collected from the participants. Gut microbiota functional profiling was performed by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) software. RESULTS: The gut microbiota analysis of beta diversity revealed that the fecal microbial community of COVID-19 children remained far distantly related to HC. The relative abundances of the phyla Actinobacteria and Firmicutes were decreased, whereas Bacteroidetes, Proteobacteria, and Verrucomicrobiota were increased in COVID-19 children. Feces from COVID-19 children exhibited notably lower abundances of the genera Blautia, Bifidobacterium, Fusicatenibacter, Streptococcus, and Romboutsia and higher abundances of the genera Prevotella, Lachnoclostridium, Escherichia-Shigella, and Bacteroides than those from HC. The enterotype distributions of COVID-19 children were characterized by a high prevalence of enterotype Bacteroides. Similar changes in gut microbiota compositions were observed in asymptomatic caregivers. Furthermore, the microbial metabolic activities of KEGG (Kyoto Encyclopedia of Genes and Genomes) and COG (cluster of orthologous groups of proteins) pathways were perturbed in feces from subjects infected with the SARS-CoV-2 Omicron variant. CONCLUSION: Our data reveal altered gut microbiota compositions in both COVID-19 children and their asymptomatic caregivers infected with the SARS-CoV-2 Omicron variant, which further implicates the critical role of gut microbiota in COVID-19 pathogenesis.
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The receptor-binding domain of the SARS-CoV-2 spike mediates the key to binding the virus to the host receptor, but capturing the molecular signal of this spike RBD remains a formidable challenge. Here, we report a new surface-enhanced Raman spectroscopy (SERS) approach, which used gold nanoparticles prepared by low-speed constant-temperature centrifugation by bromine and calcium ions in two cleaning steps as the enhanced substrate to rapidly and accurately detect spike RBD large protein molecules in body fluids. The detection signal was extremely stable, and the orientation of the spike RBD on the enhanced substrate surface was also determined. This approach was specific in distinguishing different SARS-CoV-2 variants of spike RBD, including Delta, Beta, Gamma, and Omicron. Additionally, the enhanced substrate can identify biologically active or inactive spike RBD. This two-step cleaning enhanced substrate opens up opportunities not only for early diagnostics of SARS-CoV-2 virus but also for developing targeted drugs against viruses.
Subject(s)
Body Fluids , COVID-19 , Metal Nanoparticles , Humans , Bromides , COVID-19/diagnosis , Calcium , Gold , SARS-CoV-2 , IonsABSTRACT
During the COVID-19 pandemic, college students' health-related physical activity and physical literacy aroused widespread concern. This study evaluated the relationship among physical literacy (PL), sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA); we further explored whether LAP and SB mediated the association between PL and MVPA. METHODS: This study was based on a cross-sectional survey of Chinese college students. The Perceived Physical Literacy Instrument Scale (PPLI-SC) and International Physical Activity Questionnaire Short Form (IPAQ-SF) were used to investigate the PL, MVPA, LPA, and SB. RESULTS: There were 2996 valid questionnaires with 829 boys and 2167 girls. The MVPA, LPA, and PL of boys were significantly higher than girls, while the SB values were significantly lower in girls (p < 0.01). The correlation analysis showed that there was a significant correlation between the two indexes except for SB and LPA. Path analysis shows that PL directly, significantly, and positively affects MVPA. PL reduces SB (ß = -0.085, p < 0.001) and increases LPA (ß = 0.097, p < 0.001). The total mediation effect accounted for 14.014%, and the mediation effects of SB and LPA accounted for 4.417% and 9.597%, respectively. CONCLUSIONS: LPA and SB partially mediated the relation between PL and MVPA. SB and LPA partially explain the impact of PL on MVPA. The findings suggest that managing SB and improving LPA could play a significant indirect role in increasing the positive effect of PL on MVPA and that increasing the opportunities for LPA increased the MVPA for Chinese college students.
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COVID-19 , Sedentary Behavior , Male , Female , Humans , Cross-Sectional Studies , Literacy , Pandemics , COVID-19/epidemiology , Exercise , AccelerometryABSTRACT
To investigate COVID-19 vaccine coverage in immunosuppressed children, assess guardians' intention to vaccinate children, and determine reasons and associated factors. In addition, we attempted to capture the characteristics of them with Omicron. We obtained the vaccination coverage and guardian vaccine acceptance among pediatric transplant recipients through a web-based questionnaire conducted from April 12 to 28, 2022, and performed the statistical analysis. Seven organ transplant recipient children with Omicron were also clinically analyzed. The three-dose vaccine coverage for liver transplant (n = 563) and hematopoietic stem cell transplantation (n = 122) recipient children was 0.9% and 4.9%, and guardian vaccine acceptance was 63.8%. Independent risk factors for vaccine acceptance were the child's age, geographic location, type of transplant, guardian's vaccination status, guardian's level of distress about epidemic events, guardian's risk perception ability, anxiety, and knowledge of epidemic control. The main reasons for vaccine hesitancy were fear of vaccine-induced adverse events and doubts about efficacy. Ultimately, most children infected with Omicron have mild or no symptoms and are infected by intra-family. Since vaccine coverage and guardian acceptance are lowest among liver transplant children, and the infected are mainly intra-family, we should devise more targeted education and vaccination instructions for their guardians.
Subject(s)
COVID-19 , Epidemics , Child , Humans , COVID-19 Vaccines , Transplant Recipients , COVID-19/prevention & control , Anxiety , VaccinationABSTRACT
Vaccination is one of the most vigorous ways to intervene in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Cases of autoimmune hepatitis (AIH) after coronavirus disease (COVID-19) vaccination have been increasingly reported. Twenty-seven cases of AIH are summarized in this study, providing emerging evidence of autoimmune reactions in response to various COVID-19 vaccines, including in patients with special disease backgrounds such as primary sclerosing cholangitis (PSC), liver transplantation, and previous hepatitis C virus (HCV) treatment. Molecular mimicry, adjuvants, epitope spreading, bystander activation, X chromosome, and sceptical hepatotropism of SARS-CoV-2 may account for, to some extent, such autoimmune phenomena. Immunosuppressive corticosteroids perform well with or without azathioprine in such post-COVID-19-vaccination AIH. However, determination of the exact mechanism and establishment of causality require further confirmation.
Subject(s)
COVID-19 , Hepatitis, Autoimmune , Humans , Hepatitis, Autoimmune/etiology , COVID-19 Vaccines/adverse effects , SARS-CoV-2 , COVID-19/prevention & control , Vaccination/adverse effectsABSTRACT
A single particle aerosol mass spectrometer was deployed in a heavily polluted area of China during a coronavirus lockdown to explore the impact of reduced anthropogenic emissions on the chemical composition, size distributions, mixing state, and secondary formation of urban aerosols. Ten particle groups were identified using an adaptive resonance network algorithm. Increased atmospheric oxidation during the lockdown period (LP) resulted in a 42.2%–54% increase in the major NaK-SN particle fraction relative to the normal period (NP). In contrast, EC-aged particles decreased from 31.5% (NP) to 23.7% (LP), possibly due to lower emissions from motor vehicles and coal combustion. The peak particle size diameter increased from 440 nm during the NP to 500 nm during LP due to secondary particle formation. High proportions of mixed 62NO3− indicate extensive particle aging. Correlations between secondary organic (43C2H3O+, oxalate) and secondary inorganic species (62NO3−, 97HSO4− and 18NH4+) versus oxidants (Ox = O3 + NO2) and relative humidity (RH) indicate that increased atmospheric oxidation promoted the generation of secondary species, while the effects of RH were more complex. Differences between the NP and LP show that reductions in primary emissions had a remarkable impact on the aerosol particles. This study provides new insights into the effects of pollution emissions on atmospheric reactions and the specific aerosol types in urban regions. Graphical Image 1
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The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.
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This study examines consumer fraud at the onset of the COVID-19 pandemic and provides novel evidence for the opportunity model of predatory victimization. Scammers have taken advantage of the COVID-19 pandemic shock to exploit victims who are already vulnerable and suffering. The number of fraud cases has greatly increased as COVID-19 spread across the U.S., consistent with the vulnerable-to-become-victimization hypothesis based on the opportunity model of predatory victimization. A Google Trends analysis shows that the increase in fraud and scams is attributable to victims' increased vulnerability rather than to their awareness of fraud and increased motivation to report scams. An improvement in financial literacy is associated with the reduction of finance-related fraud and scams. Finally, we provide important policy implications to protect people from fraud victimization.
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To determine the vaccine hesitancy of pneumococcal conjugate vaccines (PCVs) in a low-resource setting in China and to identify associated factors, a face-to-face questionnaire survey was conducted in the city of Guilin, China, from December 2021 to March 2022, which comprised sociodemographic information, attitudes toward vaccines and pneumonia, and PCV13 vaccination willingness and willingness to pay (WTP). Stepwise logistic regression and Tobit regression models were fitted to identify factors associated with PCV13 vaccination willingness and WTP, respectively. In total, 1254 questionnaires were included, of which 899, 254, and 101 participants showed acceptance, hesitancy, and refusal to vaccinate their children with PCV13, respectively. Only 39.07% of participants knew about PCV13 before this survey. A total of 558 (48.40%) participants accepted the full payment of vaccination, and 477 (41.37%) other participants accepted the partial payment, with a median cost of CNY 920.00. Demographics, social and psychological context, and attitudes toward vaccines were all associated with PCV13 vaccination but varied for hesitators and refusers. There is a substantial local demand for vaccinating children with PCV13 and partial payment is widely accepted. More publicity and educational efforts and a socially supportive environment are required to alleviate vaccine hesitancy.
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Human coronaviruses (HCoVs) HCoV-NL63, HCoV-229E, HCoV-HKU1 and HCoV-OC43 have been circulated in the human population worldwide, and they are associated with a broad range of respiratory diseases with varying severity. However, there are neither effective therapeutic drugs nor licensed vaccines available for the treatment and prevention of infections by the four HCoVs. In this study, we collected nasopharyngeal aspirates of children hospitalized for respiratory tract infection in China during 2014-2018 and conducted next-generation sequencing. Sequences of four HCoVs were then selected for an in-depth analysis. Genome sequences of 2 HCoV-NL63, 8 HCoV-229E, 2 HCoV-HKU1, and 6 HCoV-OC43 were obtained. Based on the full-length S gene, a strong temporal signal was found in HCoV-229E and the molecular evolutionary rate was 6 × 10-4 substitutions/site/year. Based on the maximum-likelihood (ML) phylogenetic tree of complete S gene, we designated H78 as a new sub-genotype C2 of HCoV-HKU1, and the obtained P43 sequence was grouped into the reported novel genotype K of HCoV-OC43 circulating in Guangzhou, China. Based on the complete genome, potential recombination events were found to occur as two phenomena, namely intraspecies and interspecies. Moreover, we observed two amino acid substitutions in the S1 subunit of obtained HCoV-NL63 (G534V) and HCoV-HKU1 (H512R), while residues 534 and 512 are important for the binding of angiotensin-converting enzyme 2 and neutralizing antibodies, respectively. Our findings might provide a clue for the molecular evolution of the four HCoVs and help in the early diagnosis, treatment and prevention of broad-spectrum HCoV infection.
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BACKGROUND: There is growing evidence that patients recovering after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may have a variety of acute sequelae including newly diagnosed diabetes. However, the risk of diabetes in the post-acute phase is unclear. To solve this question, we aimed to determine if there was any association between status post-coronavirus disease (COVID-19) infection and a new diagnosis of diabetes. METHODS: We performed a systematic review and meta-analysis of cohort studies assessing new-onset diabetes after COVID-19. PubMed, Embase, Web of Science, and Cochrane databases were all searched from inception to June 10, 2022. Three evaluators independently extracted individual study data and assessed the risk of bias. Random-effects models estimated the pooled incidence and relative risk (RR) of diabetes compared to non-COVID-19 after COVID-19. RESULTS: Nine studies with nearly 40 million participants were included. Overall, the incidence of diabetes after COVID-19 was 15.53 (7.91-25.64) per 1000 person-years, and the relative risk of diabetes after COVID-19 infection was elevated (RR 1.62 [1.45-1.80]). The relative risk of type 1 diabetes was RR=1.48 (1.26-1.75) and type 2 diabetes was RR=1.70 (1.32-2.19), compared to non-COVID-19 patients. At all ages, there was a statistically significant positive association between infection with COVID-19 and the risk of diabetes: <18 years: RR=1.72 (1.19-2.49), ≥18 years: RR=1.63 (1.26-2.11), and >65 years: RR=1.68 (1.22-2.30). The relative risk of diabetes in different gender groups was about 2 (males: RR=2.08 [1.27-3.40]; females: RR=1.99 [1.47-2.80]). The risk of diabetes increased 1.17-fold (1.02-1.34) after COVID-19 infection compared to patients with general upper respiratory tract infections. Patients with severe COVID-19 were at higher risk (RR=1.67 [1.25-2.23]) of diabetes after COVID-19. The risk (RR=1.95 [1.85-2.06]) of diabetes was highest in the first 3 months after COVID-19. These results remained after taking confounding factors into account. CONCLUSIONS: After COVID-19, patients of all ages and genders had an elevated incidence and relative risk for a new diagnosis of diabetes. Particular attention should be paid during the first 3 months of follow-up after COVID-19 for new-onset diabetes.