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1.
J Virol ; : e0003822, 2022 Apr 14.
Article in English | MEDLINE | ID: covidwho-1788914

ABSTRACT

Due to the limitation of human studies with respect to individual difference or the accessibility of fresh tissue samples, how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in pathological complications in lung, the main site of infection, is still incompletely understood. Therefore, physiologically relevant animal models under realistic SARS-CoV-2 infection conditions would be helpful to our understanding of dysregulated inflammation response in lung in the context of targeted therapeutics. Here, we characterized the single-cell landscape in lung and spleen upon SARS-CoV-2 infection in an acute severe disease mouse model that replicates human symptoms, including severe lung pathology and lymphopenia. We showed a reduction of lymphocyte populations and an increase of neutrophils in lung and then demonstrated the key role of neutrophil-mediated lung immunopathology in both mice and humans. Under severe conditions, neutrophils recruited by a chemokine-driven positive feedback produced elevated "fatal signature" proinflammatory genes and pathways related to neutrophil activation or releasing of granular content. In addition, we identified a new Cd177high cluster that is undergoing respiratory burst and Stfahigh cluster cells that may dampen antigen presentation upon infection. We also revealed the devastating effect of overactivated neutrophil by showing the highly enriched neutrophil extracellular traps in lung and a dampened B-cell function in either lung or spleen that may be attributed to arginine consumption by neutrophil. The current study helped our understanding of SARS-CoV-2-induced pneumonia and warranted the concept of neutrophil-targeting therapeutics in COVID-19 treatment. IMPORTANCE We demonstrated the single-cell landscape in lung and spleen upon SARS-CoV-2 infection in an acute severe disease mouse model that replicated human symptoms, including severe lung pathology and lymphopenia. Our comprehensive study revealed the key role of neutrophil-mediated lung immunopathology in SARS-CoV-2-induced severe pneumonia, which not only helped our understanding of COVID-19 but also warranted the concept of neutrophil targeting therapeutics in COVID-19 treatment.

2.
Signal Transduct Target Ther ; 7(1): 83, 2022 03 11.
Article in English | MEDLINE | ID: covidwho-1740428

ABSTRACT

SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19. However, whether lymphocytes are targets of viral infection is yet to be determined, although SARS-CoV-2 RNA or antigen has been identified in T cells from patients. Here, we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells (PBCs) or postmortem lung T cells, and the infectious virus could also be detected from viral antigen-positive PBCs. We next prove that SARS-CoV-2 infects T lymphocytes, preferably activated CD4 + T cells in vitro. Upon infection, viral RNA, subgenomic RNA, viral protein or viral particle can be detected in the T cells. Furthermore, we show that the infection is spike-ACE2/TMPRSS2-independent through using ACE2 knockdown or receptor blocking experiments. Next, we demonstrate that viral antigen-positive T cells from patient undergone pronounced apoptosis. In vitro infection of T cells induced cell death that is likely in mitochondria ROS-HIF-1a-dependent pathways. Finally, we demonstrated that LFA-1, the protein exclusively expresses in multiple leukocytes, is more likely the entry molecule that mediated SARS-CoV-2 infection in T cells, compared to a list of other known receptors. Collectively, this work confirmed a SARS-CoV-2 infection of T cells, in a spike-ACE2-independent manner, which shed novel insights into the underlying mechanisms of SARS-CoV-2-induced lymphopenia in COVID-19 patients.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/metabolism , SARS-CoV-2/metabolism , T-Lymphocytes/metabolism , Animals , Caco-2 Cells , Chlorocebus aethiops , Humans , Vero Cells
3.
Emerg Microbes Infect ; 11(1): 902-913, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1730557

ABSTRACT

The immune memory of over 400 million COVID-19 convalescents is not completely understood. In this integrated study, we recorded the post-acute sequelae symptoms and tested the immune memories, including circulating antibodies, memory B cell, and memory CD4 or CD8 T cell responses of a cohort of 65 COVID-19 patients over 1-year after infection. Our data show that 48% of them still have one or more sequelae symptoms and all of them maintain at least one of the immune components. The chances of having sequelae symptoms or having better immune memory are associated with peak disease severity. We did four-time points sampling per subject to precisely understand the kinetics of durability of SARS-CoV-2 circulating antibodies. We found that the RBD IgG levels likely reach a stable plateau at around 6 months, albeit it is waning at the first 6 months after infection. At 1-year after infection, more than 90% of the convalescents generated memory CD4 or CD8 T memory responses, preferably against the SARS-CoV-2 M peptide pool. The convalescents also have polyfunctional and central memory T cells that could provide rapid and efficient response to SARS-CoV-2 re-infection. Based on this information, we assessed the immune protection against the Omicron variant and concluded that convalescents should still induce effective T cell immunity against the Omicron. By studying the circulating antibodies and memory B or T cell responses to SARS-CoV-2 in an integrated manner, our study provides insight into the understanding of protective immunity against diseases caused by secondary SARS-CoV-2 infection.


Subject(s)
COVID-19 , Antibodies, Viral , Humans , Immunity, Cellular , Longitudinal Studies , SARS-CoV-2
4.
Nat Rev Microbiol ; 20(5): 315, 2022 May.
Article in English | MEDLINE | ID: covidwho-1705646
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-308913

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Alongside investigations into the virology of SARS-CoV-2, understanding the host–virus dependencies are vital for the identification and rational design of effective antiviral therapy. Here, we report the dominant SARS-CoV-2 entry receptor, ACE2, conjugates with small ubiquitin-like modifier 3 (SUMO3) through a proteome-wide protein interaction analysis. We further demonstrate that E3 SUMO ligase PIAS4 prompts the SUMOylation and stabilization of ACE2, whereas deSUMOylation enzyme SENP3 reverses this process. Conjugation of SUMO3 with ACE2 at lysine (K) 187 hampers the K48-linked ubiquitination of ACE2, thus suppressing its subsequent cargo receptor TOLLIP-dependent autophagic degradation. Pharmacological intervention of ACE2 SUMOylation blocks the entry of SARS-CoV-2 and viral infection-triggered immune responses. Collectively, our findings suggest selective autophagic degradation of ACE2 orchestrated by SUMOylation and ubiquitination can be targeted to future antiviral therapy of SARS-CoV-2.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307596

ABSTRACT

Background: There is no consensus as to when and how to reopen schools during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate the safety of reopening universities and colleges using a combined strategy in China. Methods: This cross-sectional study included 13,116 staffs and postgraduate students who have returned to the four campuses of the University of Science and Technology of China from 17 February (students returned from 12 May) to 2 July 2020. The returning to school was guided by a combined strategy including use of personal protective equipment, management of transportation, serological and nucleic acid tests for COVID-19, quarantine, and restrictions in and out of campus. Epidemiology history and COVID-19 related symptoms (fever, cough, and dyspnoea) were recorded in a subset of participants using an online questionnaire. Results: Among 13,116 participants, 4067 tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and no positive results were identified. Of 9049 participants who chose to conduct antibody tests, 28 (0.3%) tested positive but no one was confirmed by the additional viral nucleic acid tests. Online questionnaires were collected from 5741 participants (mean 25.1 years, 35% female). High-risk exposures and COVID-19 related symptoms were reported in 8.3% and 7.4% of participants, respectively. Comorbidities (hypertension, diabetes, chronic pulmonary disease, and chronic kidney disease) were rare (0.2%-1.5%). Conclusions: Using a combined strategy for COVID-19 prevention and control, safely reopening of universities and colleges in low-risk regions is possible and laboratory screening for SARS-CoV-2 infection may not be necessary. Further studies need to cautiously evaluate the safety of reopening schools, if any, in the middle- and high-risk regions.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325359

ABSTRACT

Background: The objective of this study is to understand the psychological health status and analyze the related factors of healthcare workers for aid in Hubei during the epidemic. 220 subjects were investigated by Self-Rating Scale of Sleep(SRSS), Generalized Anxiety Scale (GAD-7), and 9-item patient health questionnaire (PHQ-9). Results The average SRSS score of all subjects was significantly higher than the national norm (p < 0.001)and the influencing factors were gender, whether the patients died under the charge of nursing/treatment, the history of psychosis and whether their family members were infected with the COVID-19. The average GAD-7 score of all subjects was in a moderate anxiety level, and the main influencing factors were gender, years of work, history of psychosis, self-perceived health statues and whether their family members were infected with the COVID-19. The average PHQ-9 score of all subjects was in mild depression level. The primary influencing factors were whether they nursed/treated severely ill patients during aid in Hubei and whether they had a history of psychosis. Conclusions During the outbreak of COVID-19, the symptoms of insomnia and anxiety of the healthcare workers for aid in Hubei were prominent. Moreover, male workers, those whose patients have died during their treatment, with previous anxiety disorders and whose family members infected with COVID-19 were facing more serious problems. Therefore, this special group needs to be strengthened follow-up psychological support individually.

9.
Virol Sin ; 2022 Jan 25.
Article in English | MEDLINE | ID: covidwho-1648554

ABSTRACT

The nationwide COVID-19 epidemic ended in 2020, a few months after its outbreak in Wuhan, China at the end of 2019. Most COVID-19 cases occurred in Hubei Province, with a few local outbreaks in other provinces of China. A few studies have reported the early SARS-CoV-2 epidemics in several large cities or provinces of China. However, information regarding the early epidemics in small and medium-sized cities, where there are still traditionally large families and community culture is more strongly maintained and thus, transmission profiles may differ, is limited. In this study, we characterized 60 newly sequenced SARS-CoV-2 genomes from Anyang as a representative of small and medium-sized Chinese cities, compared them with more than 400 reference genomes from the early outbreak, and studied the SARS-CoV-2 transmission profiles. Genomic epidemiology revealed multiple SARS-CoV-2 introductions in Anyang and a large-scale expansion of the epidemic because of the large family size. Moreover, our study revealed two transmission patterns in a single outbreak, which were attributed to different social activities. We observed the complete dynamic process of single-nucleotide polymorphism development during community transmission and found that intrahost variant analysis was an effective approach to studying cluster infections. In summary, our study provided new SARS-CoV-2 transmission profiles representative of small and medium-sized Chinese cities as well as information on the evolution of SARS-CoV-2 strains during the early COVID-19 epidemic in China.

10.
Viruses ; 13(12)2021 12 11.
Article in English | MEDLINE | ID: covidwho-1572660

ABSTRACT

Patients with COVID-19 generally raise antibodies against SARS-CoV-2 following infection, and the antibody level is positively correlated to the severity of disease. Whether the viral antibodies exacerbate COVID-19 through antibody-dependent enhancement (ADE) is still not fully understood. Here, we conducted in vitro assessment of whether convalescent serum enhanced SARS-CoV-2 infection or induced excessive immune responses in immune cells. Our data revealed that SARS-CoV-2 infection of primary B cells, macrophages and monocytes, which express variable levels of FcγR, could be enhanced by convalescent serum from COVID-19 patients. We also determined the factors associated with ADE, and found which showed a time-dependent but not viral-dose dependent manner. Furthermore, the ADE effect is not associated with the neutralizing titer or RBD antibody level when testing serum samples collected from different patients. However, it is higher in a medium level than low or high dilutions in a given sample that showed ADE effect, which is similar to dengue. Finally, we demonstrated more viral genes or dysregulated host immune gene expression under ADE conditions compared to the no-serum infection group. Collectively, our study provides insight into the understanding of an association of high viral antibody titer and severe lung pathology in severe patients with COVID-19.


Subject(s)
Antibody-Dependent Enhancement/immunology , Leukocytes/virology , SARS-CoV-2/pathogenicity , COVID-19/immunology , Cells, Cultured , Gene Expression Profiling , Humans , Immune Sera/immunology , Leukocytes/metabolism , Receptors, IgG/metabolism , Virus Replication/immunology
11.
Optom Vis Sci ; 98(11): 1299-1303, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1559084

ABSTRACT

SIGNIFICANCE: Previously, people had only recognized the discomfort of masks, and no one had ever realized the risk of ocular trauma associated with masks. We classify the causes of injuries into two categories and emphasize the importance of using masks properly. PURPOSE: This study aimed to characterize and classify ocular injuries caused by masks. CASE REPORTS: With the increase in the number of masks used during the coronavirus disease 2019 pandemic, we have seen a rise in mask-related ocular injuries. This is a single-center retrospective case series of patients presenting to the Peking University Third Hospital Ophthalmology Department emergency department with ocular injuries secondary to masks from February to August 2020. Nine patients (six males, three females) were reviewed. All patients had a unilateral injury (four right eyes, five left eyes). The most frequently injured site was the cornea, which was seen in five patients. Some patients were injured in more than one area. Seven patients were injured by metal nose wires or other rigid, sharp parts of masks. The other two patients were injured by elastic mask straps. CONCLUSIONS: Masks can cause two types of ocular injuries that may require surgical intervention. One kind is metal nose wires or other rigid, sharp parts of masks causing lacerations or abrasions. The other is recoiling elastic mask straps snapping into the eyes and causing contusions. Our report emphasizes the importance of using masks properly.


Subject(s)
COVID-19 , Pandemics , Cornea , Female , Humans , Male , Masks , Retrospective Studies , SARS-CoV-2
12.
Energy Economics ; : 105696, 2021.
Article in English | ScienceDirect | ID: covidwho-1509770

ABSTRACT

The COVID pandemic reveals the fragility of the global financial market during rare disasters. Conventional safe-haven assets like gold can be used to hedge against ordinary risks, but tail dependence can substantially reduce the hedging effectiveness. In contrast, green bonds focus on long-term, sustainable investments, so they become an important hedging tool against climate risks, financial risks, as well as rare disasters like COVID. The copula approach based on the TGARCH model is applied to estimate the joint distributions between green bonds and selected financial assets in both US and China. The quantile-based approach is also performed to offer a robustness check on tail dependence. The results show that all assets in the two countries have thick tails and tail dependence with time-varying features. The hedging effectiveness does decline during the COVID pandemic, but it is the hedging effectiveness against tail risks rather than against normal risks. It is argued that green bonds play a significant role in hedging against rare disasters especially in forex markets. It is also found that green bonds in the US and China converge in many aspects, suggesting a smaller cross-country difference than cross-asset difference.

13.
Signal Transduct Target Ther ; 6(1): 345, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1434094

ABSTRACT

The SARS-CoV-2 infection causes severe immune disruption. However, it is unclear if disrupted immune regulation still exists and pertains in recovered COVID-19 patients. In our study, we have characterized the immune phenotype of B cells from 15 recovered COVID-19 patients, and found that healthy controls and recovered patients had similar B-cell populations before and after BCR stimulation, but the frequencies of PBC in patients were significantly increased when compared to healthy controls before stimulation. However, the percentage of unswitched memory B cells was decreased in recovered patients but not changed in healthy controls upon BCR stimulation. Interestingly, we found that CD19 expression was significantly reduced in almost all the B-cell subsets in recovered patients. Moreover, the BCR signaling and early B-cell response were disrupted upon BCR stimulation. Mechanistically, we found that the reduced CD19 expression was caused by the dysregulation of cell metabolism. In conclusion, we found that SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism, which may provide a new intervention target to cure COVID-19.


Subject(s)
Antigens, CD19/immunology , B-Lymphocytes/immunology , COVID-19/immunology , Down-Regulation/immunology , Immunologic Deficiency Syndromes/immunology , SARS-CoV-2/immunology , Animals , COVID-19/complications , Chlorocebus aethiops , Female , Humans , Immunologic Deficiency Syndromes/etiology , Immunologic Deficiency Syndromes/virology , Immunologic Memory , Male , Mice , Mice, Transgenic , Receptors, Antigen, B-Cell/immunology , Vero Cells
14.
mSphere ; 5(1)2020 01 29.
Article in English | MEDLINE | ID: covidwho-1383493

ABSTRACT

Coronaviruses (CoVs) of bat origin have caused two pandemics in this century. Severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV both originated from bats, and it is highly likely that bat coronaviruses will cause future outbreaks. Active surveillance is both urgent and essential to predict and mitigate the emergence of these viruses in humans. Next-generation sequencing (NGS) is currently the preferred methodology for virus discovery to ensure unbiased sequencing of bat CoVs, considering their high genetic diversity. However, unbiased NGS is an expensive methodology and is prone to missing low-abundance CoV sequences due to the high background level of nonviral sequences present in surveillance field samples. Here, we employ a capture-based NGS approach using baits targeting most of the CoV species. Using this technology, we effectively reduced sequencing costs by increasing the sensitivity of detection. We discovered nine full genomes of bat CoVs in this study and revealed great genetic diversity for eight of them.IMPORTANCE Active surveillance is both urgent and essential to predict and mitigate the emergence of bat-origin CoV in humans and livestock. However, great genetic diversity increases the chance of homologous recombination among CoVs. Performing targeted PCR, a common practice for many surveillance studies, would not reflect this diversity. NGS, on the other hand, is an expensive methodology and is prone to missing low-abundance CoV sequences. Here, we employ a capture-based NGS approach using baits targeting all CoVs. Our work demonstrates that targeted, cost-effective, large-scale, genome-level surveillance of bat CoVs is now highly feasible.


Subject(s)
Chiroptera/virology , Coronavirus/classification , Coronavirus/isolation & purification , High-Throughput Nucleotide Sequencing/methods , Animals , Genetic Variation , Genome, Viral
16.
Methods Mol Biol ; 2327: 119-137, 2021.
Article in English | MEDLINE | ID: covidwho-1363726

ABSTRACT

Outbreak analysis and transmission surveillance of viruses can be performed via whole-genome sequencing after viral isolation. Such techniques have recently been applied to characterize and monitor SARS-CoV-2 , the etiological agent of the COVID-19 pandemic. However, the isolation and culture of SARS-CoV-2 is time consuming and requires biosafety level 3 containment, which is not ideal for many resource-constrained settings. An alternate method, bait capture allows target enrichment and sequencing of the entire SARS-CoV-2 genome eliminating the need for viral culture. This method uses a set of hybridization probes known as "baits" that span the genome and provide sensitive, accurate, and minimal off-target hybridization. Baits can be designed to detect any known virus or bacteria in a wide variety of specimen types, including oral secretions. The bait capture method presented herein allows the whole genome of SARS-CoV-2 in saliva to be sequenced without the need to culture and provides an outline of bait design and bioinformatic analysis to guide a bioinformatician.


Subject(s)
Genome, Viral , SARS-CoV-2/genetics , Saliva/virology , Whole Genome Sequencing/methods , Computational Biology , DNA, Complementary/genetics , Humans , Molecular Probes/genetics , Polymerase Chain Reaction/methods , SARS-CoV-2/isolation & purification , Specimen Handling/methods , Streptavidin , Whole Genome Sequencing/instrumentation
18.
Emerg Microbes Infect ; 10(1): 1507-1514, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1310873

ABSTRACT

Severe respiratory disease coronavirus-2 (SARS-CoV-2) has been the most devastating disease COVID-19 in the century. One of the unsolved scientific questions of SARS-CoV-2 is the animal origin of this virus. Bats and pangolins are recognized as the most probable reservoir hosts that harbour highly similar SARS-CoV-2 related viruses (SARSr-CoV-2). This study identified a novel lineage of SARSr-CoVs, including RaTG15 and seven other viruses, from bats at the same location where we found RaTG13 in 2015. Although RaTG15 and the related viruses share 97.2% amino acid sequence identities with SARS-CoV-2 in the conserved ORF1b region, it only shows less than 77.6% nucleotide identity to all known SARSr-CoVs at the genome level, thus forming a distinct lineage in the Sarbecovirus phylogenetic tree. We found that the RaTG15 receptor-binding domain (RBD) can bind to ACE2 from Rhinolophus affinis, Malayan pangolin, and use it as an entry receptor, except for ACE2 from humans. However, it contains a short deletion and has different key residues responsible for ACE2 binding. In addition, we showed that none of the known viruses in bat SARSr-CoV-2 lineage discovered uses human ACE2 as efficiently as the pangolin-derived SARSr-CoV-2 or some viruses in the SARSr-CoV-1 lineage. Therefore, further systematic and longitudinal studies in bats are needed to prevent future spillover events caused by SARSr-CoVs or to understand the origin of SARS-CoV-2 better.


Subject(s)
Angiotensin-Converting Enzyme 2/physiology , Cell Lineage , Chiroptera/virology , SARS Virus/isolation & purification , SARS-CoV-2/classification , Animals , Host Specificity , Phylogeny , SARS Virus/classification
19.
Virol Sin ; 35(6): 744-751, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1217476

ABSTRACT

The coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has spread around the world with high mortality. To diagnose promptly and accurately is the vital step to effectively control its pandemic. Dynamic characteristics of SARS-CoV-2-specific antibodies which are important for diagnosis of infection have not been fully demonstrated. In this retrospective, single-center, observational study, we enrolled the initial 131 confirmed cases of COVID-19 at Jin-Yin-Tan Hospital who had at least one-time antibody tested during their hospitalization. The dynamic changes of IgM and IgG antibodies to SARS-CoV-2 nucleocapsid protein in 226 serum samples were detected by ELISA. The sensitivities of IgM and IgG ELISA detection were analyzed. Result showed that the sensitivity of the IgG ELISA detection (92.5%) was significantly higher than that of the IgM (70.8%) (P < 0.001). The meantimes of seroconversion for IgM and IgG were 6 days and 3 days, respectively. The IgM and IgG antibody levels peaked at around 18 days and 23 days, and then IgM fell to below the baseline level at about day 36, whereas IgG maintained at a relatively high level. In conclusion, antibodies should be detected to aid in diagnosis of COVID-19 infection. IgG could be a sensitive indicator for retrospective diagnosis and contact tracing, while IgM could be an indicator of early infection.


Subject(s)
Antibodies, Viral/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Adult , Aged , Aged, 80 and over , Antibodies, Viral/blood , COVID-19/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Serological Testing/methods , China/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Immunoglobulin M/blood , Immunoglobulin M/immunology , Male , Middle Aged , Nucleocapsid Proteins/immunology , Pandemics , Retrospective Studies , Young Adult
20.
Ann Work Expo Health ; 65(7): 833-842, 2021 08 05.
Article in English | MEDLINE | ID: covidwho-1207255

ABSTRACT

BACKGROUND: This study aimed to determine the factors that were related to the psychological health status of healthcare workers aid for Hubei after the COVID-19 outbreak. METHODS: A total of 1260 participants completed the Self-Rating Scale of Sleep (SRSS), the Generalized Anxiety Scale (GAD-7), and the 9-item patient health questionnaire (PHQ-9) via the online questionnaires, and their related experiences with COVID-19 were collected. RESULTS: The average SRSS score of all participants (25.13 ± 6.41) indicated a mild sleep problem, and the factors that influenced their sleep were the respondent's gender, whether they had patients who died under their care, their history of psychosis and whether their family members were infected with COVID-19. The average GAD-7 score of all participants (12.37 ± 4.89) indicated a moderate anxiety level. The main factors that influenced anxiety were the respondent's gender, years of work, history of psychosis, self-perceived health status, and whether their family members were infected with COVID-19. The average PHQ-9 score of all participants (8.90 ± 5.42) indicated a mild depression level. The primary factors that influenced depression were whether the respondent had nursed/treated severely ill patients in Hubei and whether they had a history of psychosis. CONCLUSIONS: During the outbreak of COVID-19, the symptoms of anxiety were prominent among healthcare workers in Hubei. Moreover, male workers, those whose patients died during treatment, those with a history of anxiety disorders and those whose family members were infected with COVID-19 reported more serious problems. Therefore, this particular group of healthcare workers needs to be monitored and provided with tailored psychological support.


Subject(s)
COVID-19 , Occupational Exposure , Cross-Sectional Studies , Depression , Disease Outbreaks , Health Personnel , Humans , Male , Mental Health , SARS-CoV-2
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