Life changes and mental health among Chinese children and adolescents during the pandemic: a combination of cross-sectional, longitudinal and clustering studies (preprint)

The measures to prevent COVID-19 pandemic had caused significant life changes, which could be distressing for mental health among children and adolescents. We aimed to evaluate the short- and long-term effects of life changes on children’s mental health in a large Chinese cohort. Survey-based life changes during COVID-19 lockdown were measured among 7,829 Chinese students at Grade 1–9, including social contacts, lifestyles and family financial status. Clustering analysis was applied to identify potential patterns of these changes. Depressive and anxiety symptoms were measured using the Center for Epidemiologic Studies Depression Scale and Screen for Child Anxiety Related Emotional Disorders. Logistic regression models were used to investigate the associations between these changes, their patterns and the presence of depression/anxiety symptoms using both cross-sectional and longitudinal designs. We found that the prevalence of depression and anxiety symptoms decreased during pandemic (34.6–32.6%). However, during and shortly after lockdown, students who reported negative impacts on their study, social and outside activities and diet, and decreased electronic time and sugar-sweetened consumption, as well as family income decline and unemployment had increased risks of depressive/anxiety symptoms, and students with changed sleep time had increased depressive symptoms. These associations attenuated or disappeared one year later. Similar patterns were observed in clustering analysis, while only the group with severe impact on family financial status showed a sustained increase in depression symptoms. In summary, restrictive measures that changed children and adolescents’ daily life during COVID-19 lockdown showed negative effects on their mental health, with some commonalities and distinctions patterns in the manifestation of depression and anxiety symptoms.

Severity and Mortality in Maintenance Hemodialysis Patients Infected with COVID-19 Omicron Strain: a Single-Centered, Retrospective Study in China (preprint)

Purpose The aim of this study was to observe the characteristics of COVID-19 infected maintenance hemodialysis (MHD) patients, identify the risk factors for severe illness and mortality in this population, and establish a preliminary risk prediction model for severe COVID-19 infection of MHD patients.Methods We included patients who underwent long-term maintenance hemodialysis and were hospitalized for COVID-19 infection at our hospital from December 2022 to March 2023. We retrospectively analyzed their demographic characteristics, clinical manifestations, laboratory tests, hemodialysis-related information, treatment strategies and complications. The patients were divided into severe (heavy and critical) and non-severe (mild and moderate) groups. Logistic regression and Cox proportional hazards analysis were used to identify the risk factors for severe COVID-19 progression.Results The presence of cerebrovascular disease, elevated NLR, fibrinogen, and D-dimer are independent risk indicators for severe COVID-19 infection in MHD patients in early stage. The presence of diabetes, cerebrovascular disease, and elevated D-dimer and NLR were associated with mortality.Conclusion MHD patients have a high probability of developing into severe and critical COVID-19 infection, and NLR, fibrinogen, and D-dimer can serve as early warning indicators for severe and critical progression of COVID-19 infection. The presence of diabetes, cerebrovascular disease, elevated NLR and D-dimer levels attribute to worse clinical outcomes and increased mortality.

Analysis of the SARS-CoV-2 spike protein revealed that blocked receptor-binding domain antigenicity decreases the production of neutralizing antibodies in vivo (preprint)

The identification of SARS-CoV-2 spike protein distribution and function in target cells has raised concerns about its possible impacts on vaccine efficacy and pathogenic effect in host cells. Thus, a better understanding of such consequences is necessary. In this study, we studied the biological characteristics of six variants of SARS-CoV-2 in A549 and HEK293 cells using four different technologies. The results showed that compared to the other fragments, the full-length spike protein exhibited the highest expression on the cell surface and was detectable in the cell supernatant, cytoplasm, and nucleus. Except for the cell surface, the S1 subunit generally expressed higher than the full-length spike protein. RBD and S2 subunits were expressed in the cytoskeleton. The SS-RBD peptide, which consists of a 19-amino acid signal peptide sequence (SS)-linked RBD, exhibited the highest expression in the cell supernatant among all other studied peptides. The SS positively enhanced the expression, migration, and secretion of SS-RBD from the cytoskeleton to the supernatant. Importantly, the FACS assay results showed that neutralizing antibodies (NAbs) could recognize SS-RBD but not RBD in the transfected cells, suggesting that RBD was tightly bound by ACE2 in HEK293 cells. In contrast, the antigenicity of the RBD in the spike protein was revealed and efficiently monitored only by 6-His-tag mAbs. Thus, our findings demonstrated that ACE2 blocks crucial immunogenic epitopes of the RBD, and the full-length spike protein mainly induces non-neutralizing antibodies in vivo. Therefore, we suggest that reducing ACE2 binding affinity and exposing the immunogenicity of the RBD on the spike protein is imperative for improving vaccine efficacy and generating new SARS-CoV-2 mRNA vaccines.

COVID-19 Pandemic and Household Liquidity Constraints: Evidence from Micro Data

This article provides an analysis of the impact of the pandemic on household liquidity constraints using the China Household Finance Survey (CHFS) data. We find that households’ liquidity constraints become serious after the outbreak of COVID-19. Households’ likelihood of liquidity constraints increases with the severity of the pandemic, mainly due to the COVID-19 pandemic shock to employment and household income. Meanwhile, the deterioration of households’ liquidity significantly increases their saving willingness and decreases their consumption.