Difference of Omicron variant infection and influence factors between people with and without HIV infection (preprint)

Background There are mixed findings in the literature regarding the association between HIV status and the risk of COVID-19 infection. Thus, we aimed to estimate the association between characteristics of HIV infection and the risk of COVID-19 Infection in a Chinese sample.Methods We conducted a cross-sectional survey of 1995 people living with HIV (PLWH) and 3503 HIV-negative adults in Ningbo, China. We compared the prevalence rates of the SARS-CoV-2 infection and the long nucleic acid conversion time (more than 2 weeks) among PLWH and HIV-negative participants, respectively. In addition, we explored the risk factors associated with SARS-CoV-2 infection and the long nucleic acid conversion time among the two groups.Results Overall, 1485/1995 (74.4%) PLWH and 2864/3503 (81.8%) HIV-negative people were infected with SARS-CoV-2. Among the SARS-CoV-2-infected participants, 437/1485 (29.4%) PLWH and 649/2864 (22.7%) HIV-negative people had the long nucleic acid conversion time. After controlling for the potential confounders, the rate of the SARS-CoV-2 infection was lower among the PLWH than the HIV-negative group (adjusted OR = 0.836, 95% CI = 0.706–0.990). However, PLWH had a significantly higher risk of the long nucleic acid conversion time after the SARS-CoV-2 infection (adjusted OR = 1.417, 95% CI = 1.176–1.707) than the HIV negative participants. Compared with those who did not receive ART, PLWH adults who received ART significantly had the increased risk of SARS-CoV-2 infection. Furthermore, HIV-negative participants receiving COVID-19 vaccines significantly displayed the decreased likelihood of the long nucleic acid conversion time after the SARS-CoV-2 infection.Conclusions Our study indicates that different HIV Infection status was significantly and differently associated with the SARS-CoV-2 infection and the long nucleic acid conversion time. However, the further studies are needed to confirm the effect of ART and COVID-19 vaccines on SARS-CoV-2 infection in PLWH.

Comparative analysis of epidemic characteristics and prevention and control measures of corona virus disease 2019 in Russian Federation

Objective: This article analyzes the epidemic situation and characteristics of Corona virus disease 2019 (COVID-19) in Russian Federation (referred to as Russia). summarizes the effective measures and problems exposed by Russia to deal with COVID-19, so as to provide reference for our country's epidemic prevention and control, and seek the direction of cooperation under the background of Sino Russia scientific and technological innovation in view of public health emergency.

Rational development of a combined mRNA vaccine against COVID-19 and influenza (preprint)

As the world continues to experience the COVID-19 pandemic, seasonal influenza remain a cause of severe morbidity and mortality globally. Worse yet, coinfection with SARS-CoV-2 and influenza A virus (IAV) leads to more severe clinical outcomes. The development of a combined vaccine against both COVID-19 and influenza is thus of high priority. Based on our established lipid nanoparticle (LNP)-encapsulated mRNA vaccine platform, we developed and characterized a novel mRNA vaccine encoding the HA antigen of influenza A (H1N1) virus, termed ARIAV. Then, ARIAV was combined with our COVID-19 mRNA vaccine ARCoV, which encodes the receptor binding domain (RBD) of the SARS-CoV-2 S protein, to formulate the final combined vaccine, AR-CoV/IAV. Further characterization demonstrated that immunization with two doses of AR-CoV/IAV elicited robust protective antibodies as well as antigen-specific cellular immune responses against SARS-CoV-2 and IAV. More importantly, AR-CoV/IAV immunization protected mice from coinfection with IAV and the SARS-CoV-2 Alpha and Delta variants. Our results highlight the potential of the LNP-mRNA vaccine platform in preventing COVID-19 and influenza, as well as other respiratory diseases.

Practices of poverty alleviation by open and distance education: a case report from the Open University of China

PurposeThe purpose of this report is to demonstrate open and distance education (ODE) can support poverty alleviation. Taking the practices of the Open University of China (the OUC) as an example, this paper aims to reveal how open universities make contributions to local residents in rural and remote areas.Design/methodology/approachFocusing on 25 poverty-stricken counties, the OUC had invested 58 million RMB to its learning centers in these counties from 2017 to 2020. The first one is to improve ICT and educational facilities in these learning centers. The second approach is to cultivate local residents with degree programs through ODE so as to promote local economic development. The third one is to design and develop training programs according to local context to meet the specific needs of local villagers.FindingsAfter 3 years working, cloud-based classrooms and computer rooms have been set up. Bookstores have been founded and printed books have been donated. Hundreds of thousands of digital micro lectures have been supplied to these learning centers which have been improved and fully played their functions. Nearly 50,000 local residents have been directly benefited. Village leaders have helped lift local residents out of poverty. Poverty-stricken villagers have been financed to study on either undergraduate or diploma programs. Local residents have improved their skills by learning with the training programs offered by the OUC.Originality/valueODE is proved to be an effective way to eradicate poverty. Open universities are proved to be able to make contributions to social justice. By fulfilling its commitments to eliminate poverty within the national strategy framework, the OUC has built its brand nationwide.

Characteristics and relationship between self-efficacy and physical activity of college students during COVID-19 epidemic

Objective: To explore the characteristics and relationship between physical activity and self-efficacy of college students during the COVID-19 epidemic, so as to provide evidence for the orderly development of physical education and curriculum reform of college students after their return to school.

Do Lockdowns Bring about Additional Mortality Benefits or Costs? Evidence based on Death Records from 300 Million Chinese People (preprint)

After the COVID-19 outbreak, China immediately adopted stringent lockdown policies to contain the virus. Using comprehensive death records covering around 300 million Chinese people, we estimate the impacts of city and community lockdowns on non-COVID-19 mortality outside of Wuhan. Employing a difference-in-differences method, we find that lockdowns reduced the number of non-COVID-19 deaths by 4.9% (cardiovascular deaths by 6.2%, injuries by 9.2%, and non-COVID-19 pneumonia deaths by 14.3%). The health benefits are likely driven by significant reductions in air pollution, traffic, and human interactions. A back-of-the-envelope calculation shows that more than 32,000 lives could have been saved from non-COVID-19 diseases/causes during the 40 days of the lockdown on which we focus. The results suggest that the rapid and strict virus countermeasures not only effectively controlled the spread of COVID-19 but also brought about massive unintended public health benefits. These findings can help better inform policymakers around the world about the benefits and costs of city and community lockdowns policies in dealing with the COVID-19 pandemic.

Neutrophil surged for mortality of COVID-19: a correlational study (preprint)

Background: Multiorgan damage by SARS-CoV-2 results in alterations of many clinical measures associated with mortality of COVID-19. This research discussed the pioneering pathogenicity factors that lead to the extensive damage elusive. Objectives: A cohort of COVID-19 patients. Methods: : We conducted a correlational analysis of hospital outcomes with an independent cohort of COVID-19 patients and we also presented a death case to illustrate for time course of immune cell density. Results: : The results showed that dysregulated immune cell densities were correlated with hospitalization duration before death, not before discharge. High neutrophil densities allowed sorting out one third of total death cases while a density of less than 70% of the white blood cells allowed sorting out 70% of surviving cases. Conclusion: Collectively surged neutrophil was a top trigger for mortality in patients with COVID-19.

Epidemic Dynamics of COVID-19 Based on SEAIUHR Model Considering Asymptomatic Cases in Henan Province, China (preprint)

Background New coronavirus disease (COVID-19), an infectious disease caused by a type of novel coronavirus, has emerged in various countries since the end of 2019 and caused a global pandemic. Many infected people went undetected because their symptoms were mild or asymptomatic, but the proportion and infectivity of asymptomatic infections remained unknown. Therefore, in this paper, we analyzed the proportion and infectivity of asymptomatic cases, as we as the prevalence of COVID-19 in Henan province.Methods We constructed SEAIUHR model based on COVID-19 cases reported from 21 January to 26 February 2020 in Henan province to estimate the proportion and infectivity of asymptomatic cases, as we as the change of effective reproductive number, \({R}_{t}\). At the same time, we simulated the changes of cases in different scenarios by changing the time and intensity of the implementation of prevention and control measures.Results The proportion of asymptomatic cases among COVID-19 infected individuals was 42% and infectivity of asymptomatic cases was 10% of that symptomatic ones. The basic reproductive number\({R}_{0}\)=2.73, and \({R}_{t}\) dropped below 1 on 1 February under a series of measures. If measures were taken five days earlier, the number of cases would be reduced by 2/3, and after 5 days the number would more than triple.Conclusions In Henan Province, the COVID-19 epidemic spread rapidly in the early stage, and there were a large number of asymptomatic infected individuals with relatively low infectivity. However, the epidemic was quickly brought under control with national measures, and the earlier measures were implemented, the better.

Radiologic evaluation of discharge quality in patients with COVID-19 (preprint)

Background   Worldwide spread of the novel coronavirus disease 2019 (COVID-19) has made hundreds of thousands people sick and fortunately many of them have been treated and discharged. However, it remains unclear how well the discharged patients were recovering. Chest CT scan, with demonstrated high sensitivity to COVID-19, was used here to examine clinical manifestations in patients at discharge.Methods This study registered retrospectively single-center case series of 180 discharged patients, all confirmed with COVID-19 at Wuhan Red Cross Hospital in Wuhan, China. Epidemiological, demographic, clinical, laboratory and treatment data were collected. CT imaging features of absorption vs progressive stage were compared and analyzed.Results Five pulmonary lobes were affected in 54 (30%) of the 180 patients at the absorption stage, comparing to 66% of them at the progressive stage (P=1.45×10-11). Forty five (25%) patients had pleural effusion on admission and 13 of them still carried hydrothorax when discharged as per standard discharge criteria(P=4.48×10-6). Besides, compared with those at progressive stage, 97 (54%) discharged patients had interlobular thickening (P=6.95×10-3) and 43% of them still presented adjacent pleura thickening (P=5.58×10-5). The median total CT score of discharged patients at absorption stage was lower than progressive stage (3 vs 12.5 ). The median total CT score recovery rate was 67% (range, 0-100%) and 139 (77%) patients showed less than 90% improvement at discharge.Conclusions A majority (77%) of the discharged patients had not recovered completely. The current discharge criteria may need to include 90% or higher CT score-based recovery rate.Authors Jingwen Li, Xi Long, Fang Fang, and Xuefei Lv contributed equally to this work.Authors Zhicheng Lin and Nian Xiong are joint last coauthors.

Clinical and CT features of mild-to-moderate COVID-19 cases after two sequential negative nucleic acid testing results: a retrospective analysis (preprint)

Background Numerous studies have been focused on the clinical and imaging features among COVID-19 patients positive for SARS-CoV-2, but the data after negative is limited. We aims to describe these features after negative respiratory nucleic acid testing results.Methods From January 31 to February 28, 2020, 51 mild-to-moderate COVID-19 cases (median: 34.0 years and 47.1% male) were retrospectively enrolled. Demographic, clinical, laboratory, and CT imaging data were collected before and after two sequential negative results for respiratory SARS-CoV-2 .Results After negative for respiratory SARS-CoV-2, the clinical symptoms continued to recover and the abnormal imaging were observed for all of the moderate cases. 77.4% of the moderate patients had multi-lobar involvement and lesions were more frequent in the lower lobes. The most common CT imaging manifestations were ground glass opacity (51.6%) and fibrous stripes (54.8%%). Among 12 out of 31 moderate patients with repeated chest CT scan after negative for SARS-CoV-2, 7 patients (58.3%) with ground-glass absorption reduced over 60% within one week, but there were still 4 cases (13.8%) with absorption less than 5%.Conclusions The clinical symptoms and abnormal imaging persisted but continued to recover after negative for respiratory SARS-CoV-2.

Clinical analysis of risk factors for severe patients with novel coronavirus pneumonia / 中华传染病杂志

Objective To analyze the clinical features of patients with coronavirus disease 2019 (COVID-19) in Shanghai and to investigate the risk factors for disease progression to severe cases. Methods The clinical data of 292 adult patients with COVID-19 hospitalized in Shanghai Public Health Clinical Center from January 20, 2020 to February 10, 2020 were retrospectively analyzed, including 21 severe patients and 271 mild patients. The demographic characteristics, epidemiological history, history of underlying diseases and laboratory examinations were compared between the two groups. Measurement data were compared using t test or Mann-Whitney U test. The count data were compared using hi-square test. The binary logistic regression equation was used to analyze the risk factors for the progression of patients to severe cases. Results Among the 292 patients, 21 were severe cases with the rate of 7.2% (21/292). One patient died, and the mortality rate was 4.8% in severe patients. The severe patients aged (65.0±15.7) years old, 19 (90.5%) were male, 11 (52.4%) had underlying diseases, 7 (33.3%) had close relatives diagnosed with COVID-19. The mild patients aged (48.7±15.7) years old, 135 (49.8%) were male, 74 (27.3%) had underlying diseases, 36 (13.3%) had close relatives diagnosed with COVID-19. The differences between two groups were all significant statistically ( t =-4.730, χ 2 =12.930, 5.938 and 4.744, respectively, all P <0.05). Compared with the mild patients, the levels of absolute numbers of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine, serum cystatin C, C reactive protein (CRP), procalcitonin , D -dimer, pro-B-type natriuretic peptide (proBNP), serum myoglobin, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), serum troponin I (cTnI) in severe patients were all significantly higher ( U =2 091.5, 1 928.0, 1 215.5, 729.0, 1 580.5, 1 375.5, 917.5, 789.5, 1 209.0, 1 434.0, 638.0, 964.5, 1 258.0 and 1 747.5, respectively, all P <0.05), while the levels of lymphocyte count, albumin, transferrin, CD3 + T lymphocyte count, CD8 + T lymphocyte count and CD4 + T lymphocyte count in severe patients were all significantly lower ( U =1 263.5, t =4.716, U =1 214.0, 962.0, 1 167.5 and 988.0, respectively, all P <0.05). Further logistic regression analysis showed that the albumin (odds ratio ( OR )=0.806, 95% CI 0.675-0.961), CRP ( OR =1.016, 95% CI 1.000-1.032), serum myoglobin ( OR =1.010, 95% CI 1.004-1.016), CD3 + T lymphocyte count ( OR =0.996, 95% CI 0.991-1.000) and CD8 + T lymphocyte count ( OR =1.006, 95% CI 1.001-1.010) at admission were independent risk factors for the progression of COVID-19 patients to severe illness (all P <0.05). Conclusions Severe cases of patients with COVID-19 in Shanghai are predominantly elderly men with underlying diseases. Albumin, CRP, serum myoglobin, CD3 + T lymphocyte count and CD8 + T lymphocyte count could be used as early warning indicators for severe cases, which deserve more clinical attention.

Clinical Features of Patients Infected with the 2019 Novel Coronavirus (COVID-19) in Shanghai, China (preprint)

Background: Since mid-December 2019, a cluster of pneumonia-like diseases caused by a novel coronavirus, now designated COVID-19 by the WHO, emerged in Wuhan city and rapidly spread throughout China. Here we identify the clinical characteristics of COVID-19 in a cohort of patients in Shanghai. Methods: Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, laboratory and radiological features. Results: Of 198 patients, the median duration from disease onset to hospital admission was 4 days. The mean age of the patients was 50.1 years, and 51.0% patients were male. The most common symptom was fever. Less than half of the patients presented with respiratory systems including cough, sputum production, itchy or sore throat, shortness of breath, and chest congestion. 5.6% patients had diarrhoea. On admission, T lymphocytes were decreased in 45.8% patients. Ground glass opacity was the most common radiological finding on chest computed tomography. 9.6% were admitted to the ICU because of the development of organ dysfunction. Compared with patients not treated in ICU, patients treated in the ICU were older, had longer waiting time to admission, fever over 38.5o C, dyspnoea, reduced T lymphocytes, elevated neutrophils and organ failure. Conclusions: In this single centre cohort of COVID-19 patients, the most common symptom was fever, and the most common laboratory abnormality was decreased blood T cell counts. Older age, male, fever over 38.5oC, symptoms of dyspnoea, and underlying comorbidity, were the risk factors most associated with severity of disease. Key words: 2019 novel coronavirus; acute respiratory infection; risk factors for disease severity