Heterologous prime-boost immunisation with mRNA- and AdC68-based 2019-nCoV variant vaccines induces broad-spectrum immune responses in mice.

The ongoing evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) variants has been associated with the transmission and pathogenicity of COVID-19. Therefore, exploring the optimal immunisation strategy to improve the broad-spectrum cross-protection ability of COVID-19 vaccines is of great significance. Herein, we assessed different heterologous prime-boost strategies with chimpanzee adenovirus vector-based COVID-19 vaccines plus Wuhan-Hu-1 (WH-1) strain (AdW) and Beta variant (AdB) and mRNA-based COVID-19 vaccines plus WH-1 strain (ARW) and Omicron (B.1.1.529) variant (ARO) in 6-week-old female BALB/c mice. AdW and AdB were administered intramuscularly or intranasally, while ARW and ARO were administered intramuscularly. Intranasal or intramuscular vaccination with AdB followed by ARO booster exhibited the highest levels of cross-reactive IgG, pseudovirus-neutralising antibody (PNAb) responses, and angiotensin-converting enzyme-2 (ACE2)-binding inhibition rates against different 2019-nCoV variants among all vaccination groups. Moreover, intranasal AdB vaccination followed by ARO induced higher levels of IgA and neutralising antibody responses against live 2019-nCoV than intramuscular AdB vaccination followed by ARO. A single dose of AdB administered intranasally or intramuscularly induced broader cross-NAb responses than AdW. Th1-biased cellular immune response was induced in all vaccination groups. Intramuscular vaccination-only groups exhibited higher levels of Th1 cytokines than intranasal vaccination-only and intranasal vaccination-containing groups. However, no obvious differences were found in the levels of Th2 cytokines between the control and all vaccination groups. Our findings provide a basis for exploring vaccination strategies against different 2019-nCoV variants to achieve high broad-spectrum immune efficacy.

Race-Ethnicity and Depressive Symptoms Among U.S. Older Adults in the COVID-19 Pandemic: Uncovering the Counterbalancing Mechanisms.

Background and Objectives: Drawing on the counterbalancing framework, this study examined the counteracting roles of coronavirus disease (COVID)-related stressors (i.e., infection threat, family activity disruption, economic impact) and psychological resilience in explaining racial-ethnic disparities in depressive symptoms during the COVID-19 pandemic. Research Design and Methods: A competitive mediation model was fitted using nationally representative data from the Health and Retirement Study COVID-19 Project, which were collected in June 2020 (N = 1,717). A competitive mediation model was specified within which the associations between race-ethnicity categories and depressive symptoms were mediated by infection threat, family activity disruption, economic impact, and psychological resilience. A list of pre-COVID covariates and pre-COVID depressive symptoms were adjusted for in this model. Results: Infection threat, family activity disruption, economic impact, and psychological resilience were all higher among non-Hispanic Blacks and Hispanics than among non-Hispanic Whites. Economic impact had a positive whereas psychological resilience had a negative direct effect on depressive symptoms net of pre-COVID covariates and pre-COVID depressive symptoms. Mediation analyses revealed that, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics had higher depressive symptoms due to their higher family activity disruption and higher economic impact, but their higher levels of psychological resilience also reduced depressive symptoms. The counteracting indirect effects offset each other, resulting in a null total effect of race-ethnicity on depressive symptoms. Discussion and Implications: These findings suggest that interventions addressing the mental health impact of COVID should consider race/ethnicity-specific vulnerabilities and resilience. Future studies need to consider the complex and potentially counterbalancing mechanisms linking race-ethnicity and mental health.

Physical Disability, Psychological Resilience, and COVID-Related Changes in Depressive Symptoms Among U.S. Older Adults.

OBJECTIVES: This study pursued 3 goals: (1) to determine how depressive symptoms among U.S. older adults changed in 2018-2020, a period transitioning to the first wave of coronavirus disease (COVID) pandemic, compared to in prepandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018-2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018-2020. METHODS: Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before-after design and latent change score model to examine whether depressive symptoms change in 2018-2020 represents a continuation or departure from the overall trend of between-wave changes in 2010-2018. We also used physical disability in 2018 and psychological resilience in 2016-2018 to predict depressive symptoms change score in 2018-2020. RESULTS: In contrast to the relatively stable between-wave change trend in 2010-2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018-2020, which was primarily driven by increased affective symptoms (e.g., depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018-2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant. DISCUSSION: Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms.

Impact of Home Literacy Environment on Literacy Development of Children with Intellectual Disabilities: A Moderated Mediation Model

Research on the effects of the home literacy environment (HLE) on the literacy development of children with intellectual disabilities (ID) is limited, and relevant results are inconsistent. This study aimed to explore the influence of the HLE on the literacy development of children with ID, and the role of the reading interest and parent-child relationship in this process. The subjects of this study were 381 children with ID from special needs schools in 7 regions of China, including 234 boys and 147 girls aged 6-15 years. This study adopted the network survey method, and parents of these children completed the surveys of the HLE, literacy development, reading interest, and parent-child relationship. The results revealed that the HLE significantly influenced the literacy development of children with ID, and the reading interest partially mediated this effect. In this mediating process, the regression relationship between the HLE and the reading interest was positively regulated by the parent-child relationship. This study suggests that improving the HLE and parent-child relationship is beneficial for the reading interest and literacy development of children with ID.

Consumer perception of clean food labels

Purpose>This study puts forth a consumer-oriented concept of clean labels and attempts to empirically investigate consumer perceptions of these labels.Design/methodology/approach>A self-administered survey (n = 346) was used as the research instrument for data collection in the current study.Findings>Results from an online survey indicate that consumers perceived less processed, elimination of undesired ingredients and ethical concerns as salient attributes associated with clean labels. Consumer-perceived benefits of these attributes include healthiness, social responsibility, sensory appeal, reliable product and low calorie. Additionally, canonical correlation analysis yields two significant associations between clean label attributes and the corresponding benefits. Attributes of elimination of undesired ingredients and utilization of familiar elements drive the benefits of healthiness, low calorie and social responsibility. Attributes of being less processed and with simple ingredients are associated with the benefit of sensory appeal.Originality/value>This study systematically investigates the discrete clean halo effect by empirically examining the associations between the clean label attributes and the dimensionalities of benefits as perceived by consumers.

[Clinical features of children and their family members with family clusters of SARS-CoV-2 Omicron variant infection in Shanghai, China: an analysis of 380 cases]. / 上海380例家庭聚集性感染Omicronå˜å¼‚æ ªçš„å„¿ç«¥åŠå ¶å®¶å±žä¸´åºŠç‰¹å¾åˆ†æž.

OBJECTIVES: To study the clinical features and prognosis of children and their family members with family clusters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection under the admission mode of parent-child ward. METHODS: A retrospective analysis was performed on the medical data of 190 children and 190 family members with SARS-CoV-2 Omicron variant infection who were admitted to Shanghai Sixth People's Hospital, the designated hospital for coronavirus disease 2019 (COVID-19), April 8 to May 10, 2022. RESULTS: Both the child and adult groups were mainly mild COVID-19, and the proportion of mild cases in the child group was higher than that in the adult group (P<0.05). Respiratory symptoms were the main clinical manifestations in both groups. Compared with the adult group, the child group had higher incidence rates of fever, abdominal pain, diarrhea, and wheezing (P<0.05) and lower incidence rates of nasal obstruction, runny nose, cough, dry throat, throat itching, and throat pain (P<0.05). Compared with the child group, the adult group had higher rates of use of Chinese patent drugs, traditional Chinese medicine decoction, recombinant interferon spray, cough-relieving and phlegm-eliminating drugs, and nirmatrelvir/ritonavir tablets (P<0.05). Compared with the adult group, the child group had a lower vaccination rate of SARS-CoV-2 vaccine (30.5% vs 71.1%, P<0.001) and a shorter duration of positive SARS-CoV-2 nucleic acid (P<0.05). The patients with mild COVID-19 had a shorter duration of positive SARS-CoV-2 nucleic acid than those with common COVID-19 in both groups (P<0.05). The patients with underlying diseases had a longer duration of positive SARS-CoV-2 nucleic acid than those without such diseases in both groups (P<0.05). CONCLUSIONS: Both children and adults with family clusters of SARS-CoV-2 Omicron variant infection manifest mainly mild COVID-19. Despite lower vaccination rate of SARS-CoV-2 vaccine in children, they have rapid disease recovery, with a shorter duration of positive SARS-CoV-2 nucleic acid than adults, under the admission mode of parent-child ward.

Predictors of Influenza Vaccination among Chinese Middle School Students Based on the Health Belief Model: A Mixed-Methods Study.

Influenza vaccination rates among Chinese middle school students are low. This study aims to explore the influencing factors of vaccination among middle school students and promote vaccination. We conducted a mixed-methods study, integrating a questionnaire survey among 9145 middle school students in four cities in China and semi-structured interviews with 35 middle school students to understand their attitudes and perceptions toward vaccination based on the Health Belief Model. We found the overall vaccination rate was 38.2% (3493/9145), with students in Beijing, boarding at school, or senior high school showing higher values than their counterparts (p < 0.05). Multiple logistic regression results showed that non-boarding (OR = 0.46, 95%CI: 0.42-0.51) and perceived barriers (OR = 0.97, 95%CI: 0.96-0.98) were unfavorable factors for influenza vaccination, whereas perceived susceptibility (OR = 1.07, 95%CI: 1.05-1.08), perceived benefits (OR = 1.02, 95%CI: 1.01-1.04), cues to action (OR = 1.08, 95%CI: 1.05-1.11), and self-efficacy (OR = 1.04, 95%CI: 1.02-1.07) were facilitators. Qualitative results indicated that positive health beliefs, school, and the home environment contribute to vaccination. In conclusion, the influenza vaccination rate among middle school students remains low. The concerns about the safety and potential side effects of vaccines are the main barriers to vaccination, underscoring the need for strengthening communication, education, and information among students and their teachers/parents.

Combining intramuscular and intranasal homologous prime-boost with a chimpanzee adenovirus-based COVID-19 vaccine elicits potent humoral and cellular immune responses in mice.

The efficacy of many coronavirus disease 2019 (COVID-19) vaccines has been shown to decrease to varying extents against new severe acute respiratory syndrome coronavirus 2 variants, which are responsible for the continuing COVID-19 pandemic. Combining intramuscular and intranasal vaccination routes is a promising approach for achieving more potent immune responses. We evaluated the immunogenicity of prime-boost protocols with a chimpanzee adenovirus serotype 68 vector-based vaccine, ChAdTS-S, administered via both intranasal and intramuscular routes in BALB/c mice. Intramuscular priming followed by an intranasal booster elicited the highest levels of IgG, IgA, and pseudovirus neutralizing antibody titres among all the protocols tested at day 42 after prime immunization compared with the intranasal priming/intramuscular booster and prime-boost protocols using only one route. In addition, intramuscular priming followed by an intranasal booster induced high T-cell responses, measured using the IFN-γ ELISpot assay, that were similar to those observed upon intramuscular vaccination. All ChAdTS-S vaccination groups induced Th1-skewing of the T-cell response according to intracellular cytokine staining and Meso Scale Discovery cytokine profiling assays on day 56 after priming. This study provides reference data for assessing vaccination schemes of adenovirus-based COVID-19 vaccines with high immune efficacy.

Online self‐regulated learning and academic procrastination: A moderated mediation model

Online learning has recently replaced traditional offline learning as the mainstream learning model for Chinese college students owing to the COVID‐19 pandemic. This study examined the relationship between online self‐regulated learning and academic procrastination among 1149 Chinese undergraduates who participated in online learning. The effects of online self‐regulated learning on academic procrastination and whether it was mediated by attention control and moderated by peer support were investigated. Mediation analyses revealed that attention control partially mediates online self‐regulated learning and academic procrastination. Peer support moderated the direct effect of online self‐regulated learning and the mediating effect of attention control on academic procrastination. Our findings provide important ways to reduce academic procrastination and mitigate the adverse impacts of online learning. [ FROM AUTHOR] Copyright of Psychology in the Schools is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Advances in COVID-19 mRNA vaccine development.

To date, the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has determined 399,600,607 cases and 5,757,562 deaths worldwide. COVID-19 is a serious threat to human health globally. The World Health Organization (WHO) has declared COVID-19 pandemic a major public health emergency. Vaccination is the most effective and economical intervention for controlling the spread of epidemics, and consequently saving lives and protecting the health of the population. Various techniques have been employed in the development of COVID-19 vaccines. Among these, the COVID-19 messenger RNA (mRNA) vaccine has been drawing increasing attention owing to its great application prospects and advantages, which include short development cycle, easy industrialization, simple production process, flexibility to respond to new variants, and the capacity to induce better immune response. This review summarizes current knowledge on the structural characteristics, antigen design strategies, delivery systems, industrialization potential, quality control, latest clinical trials and real-world data of COVID-19 mRNA vaccines as well as mRNA technology. Current challenges and future directions in the development of preventive mRNA vaccines for major infectious diseases are also discussed.

Specific Interleukin-1 Inhibitors, Specific Interleukin-6 Inhibitors, and GM-CSF Blockades for COVID-19 (at the Edge of Sepsis): A Systematic Review.

Sepsis is a syndrome with high mortality, which seriously threatens human health. During the pandemic of coronavirus disease 2019 (COVID-19), some severe and critically ill COVID-19 patients with multiple organ dysfunction developed characteristics typical of sepsis and met the diagnostic criteria for sepsis. Timely detection of cytokine storm and appropriate regulation of inflammatory response may be significant in the prevention and treatment of sepsis. This study evaluated the efficacy and safety of specific interleukin (IL)-1 inhibitors, specific IL-6 inhibitors, and GM-CSF blockades in the treatment of COVID-19 (at the edge of sepsis) patients through systematic review and meta-analysis. METHODOLOGY: A literature search was conducted on PubMed, EMBASE, Clinical Key, Cochrane Library, CNKI, and Wanfang Database using proper keywords such as "SARS-CoV-2," "Corona Virus Disease 2019," "COVID-19," "anakinra," "tocilizumab," "siltuximab," "sarilumab," "mavrilimumab," "lenzilumab," and related words for publications released until August 22, 2021. Other available resources were also used to identify relevant articles. The present systematic review was performed based on PRISMA protocol. RESULTS: Based on the inclusion and exclusion criteria, 43 articles were included in the final review. The meta-analysis results showed that tocilizumab could reduce the mortality of patients with COVID-19 (at the edge of sepsis) [randomized controlled trials, RCTs: odds ratio (OR) 0.71, 95%CI: 0.52-0.97, low-certainty evidence; non-RCTs: risk ratio (RR) 0.68, 95%CI: 0.55-0.84, very low-certainty evidence) as was anakinra (non-RCTs: RR 0.47, 95%CI: 0.34-0.66, very low-certainty evidence). Sarilumab might reduce the mortality of patients with COVID-19 (at the edge of sepsis), but there was no statistical significance (OR 0.65, 95%CI: 0.36-1.2, low-certainty evidence). For safety outcomes, whether tocilizumab had an impact on serious adverse events (SAEs) was very uncertain (RCTs: OR 0.87, 95%CI: 0.38-2.0, low-certainty evidence; non-RCTs 1.18, 95%CI: 0.83-1.68, very low-certainty evidence) as was on secondary infections (RCTs: OR 0.71, 95%CI: 0.06-8.75, low-certainty evidence; non-RCTs: RR 1.15, 95%CI: 0.89-1.49, very low-certainty evidence). CONCLUSIONS: This systematic review showed that tocilizumab, sarilumab, and anakinra could reduce the mortality of people with COVID-19 (at the edge of sepsis), and tocilizumab did not significantly affect SAEs and secondary infections. The current evidence of the studies on patients treated with siltuximab, mavrilimumab, and lenzilumab is insufficient. In order to establish evidence with stronger quality, high-quality studies are needed. Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/prospero/), identifier CRD42020226545.

Effect of wearing masks on postoperative radiotherapy in cervical cancer patients during the COVID-19 pandemic: a retrospective study on acute toxicity (preprint)

Background: The COVID-19 pandemic has created great challenges and requirements for radiotherapy. Mask wearing is an effective physical intervention against disease transmission and has been part of daily prevention strategies. The aim of the study was to evaluate the effect of mask wearing on the toxicity of postoperative radiotherapy in patients with cervical cancer.Methods: Between December 2018 and June 2021, a retrospective review was conducted among patients with FIGO stage IB-IIA cervical cancer who were treated with postoperative concurrent chemoradiotherapy. Acute toxicities were graded according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 3.0.Results: A total of 85 patients were eligible for the study; 33 patients (38.9%) wore masks, whereas another 52 patients (61.1%) did not wear masks. There was a statistically significant difference in the incidence of grade 1-2 enteritis (57.6% vs. 21.1%, P = 0.005) and grade 3-4 enteritis (21.2% vs. 3.8%, P = 0.033) between the two groups. Other acute toxicity reactions were not significantly different.Conclusions: On the basis of clinical findings, we think that mask wearing for cervical cancer patients undergoing daily postoperative radiotherapy seems debatable. More attention should be focused on the impact of mask wearing on acute toxicity.

Asymptomatic COVID-19 Individuals Tend to Establish Relatively Balanced Innate and Adaptive Immune Responses.

The sharp increase in the proportion of asymptomatic cases and the potential risk of virus transmission have greatly increased the difficulty of controlling the COVID-19 pandemic. The individual immune response is closely associated with clinical outcomes and pathogenic mechanisms of COVID-19. However, the clinical characteristics and immunophenotyping features of immune cells of asymptomatic individuals remain somewhat mysterious. To better understand and predict the disease state and progress, we performed a comprehensive analysis of clinical data, laboratory indexes and immunophenotyping features in 41 patients with SARS-CoV-2 (including 24 asymptomatic cases and 17 symptomatic individuals). Firstly, from the perspective of demographic characteristics, the rate of asymptomatic infection was significantly higher in those with younger age. Secondly, the laboratory test results showed that some indexes, such as CRP (acute phase reaction protein), D-Dimer and fibrinogen (the marker for coagulation) were lower in the asymptomatic group. Finally, symptomatic individuals were prone to establishing a non-protective immune phenotype by abnormally decreasing the lymphocyte count and percentage, abnormally increasing the Th17 percentage and decreasing Treg percentage, which therefore cause an increase in the neutrophil/lymphocyte ratio (NLR), monocytes/lymphocytes ratio (MLR) and Th17/Treg ratio. On the other hand, asymptomatic individuals tended to establish a more effective and protective immune phenotype by maintaining a normal level of lymphocyte count and percentage and a high level of NK cells. At the same time, asymptomatic individuals can establish a relatively balanced immune response through maintaining a low level of monocytes, a relatively low level of Th17 and high level of Treg, which therefore lead to a decrease in MNKR and Th17/Treg ratio and finally the avoidance of excessive inflammatory responses. This may be one of the reasons for their asymptomatic states. This study is helpful to reveal the immunological characteristics of asymptomatic individuals, understand immune pathogenesis of COVID-19 and predict clinical outcomes more precisely. However, owing to small sample sizes, a future study with larger sample size is still warranted.

SARS-CoV-2 spike promotes inflammation and apoptosis through autophagy by ROS-suppressed PI3K/AKT/mTOR signaling.

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection-induced inflammatory responses are largely responsible for the death of novel coronavirus disease 2019 (COVID-19) patients. However, the mechanism by which SARS-CoV-2 triggers inflammatory responses remains unclear. Here, we aimed to explore the regulatory role of SARS-CoV-2 spike protein in infected cells and attempted to elucidate the molecular mechanism of SARS-CoV-2-induced inflammation. METHODS: SARS-CoV-2 spike pseudovirions (SCV-2-S) were generated using the spike-expressing virus packaging system. Western blot, mCherry-GFP-LC3 labeling, immunofluorescence, and RNA-seq were performed to examine the regulatory mechanism of SCV-2-S in autophagic response. The effects of SCV-2-S on apoptosis were evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), Western blot, and flow cytometry analysis. Enzyme-linked immunosorbent assay (ELISA) was carried out to examine the mechanism of SCV-2-S in inflammatory responses. RESULTS: Angiotensin-converting enzyme 2 (ACE2)-mediated SCV-2-S infection induced autophagy and apoptosis in human bronchial epithelial and microvascular endothelial cells. Mechanistically, SCV-2-S inhibited the PI3K/AKT/mTOR pathway by upregulating intracellular reactive oxygen species (ROS) levels, thus promoting the autophagic response. Ultimately, SCV-2-S-induced autophagy triggered inflammatory responses and apoptosis in infected cells. These findings not only improve our understanding of the mechanism underlying SARS-CoV-2 infection-induced pathogenic inflammation but also have important implications for developing anti-inflammatory therapies, such as ROS and autophagy inhibitors, for COVID-19 patients.

Parents' and adolescents' perceptions of parental involvement and their relationships with depression among Chinese middle school students during the COVID-19 pandemic.

Although psychological stress that adolescents may encounter during the COVID-19 pandemic has been of increasing interest to scholars, few studies have examined the profound impact that parents give to adolescents when staying indoors. This study surveyed 1,550 students and their parents from eight middle schools in eastern China. We employed multiple linear regressions with school fixed effects to examine the different perceptions of parental involvement between parents and children, and the relationships between these different types of parental involvement and depression in middle school students. Results indicated that discrepancies existed in their perceptions of behavioral aspects of parental involvement, including parental academic involvement, parent-teacher communication, and parent-child communication. Most saliently, higher levels of parental academic involvement (B = 0.051, p < 0.05) and lower levels of parent-child communication (B = -0.084, p < 0.05) perceived by students were associated with higher levels of depression. These findings contribute to the understanding of the association between parental involvement and students' mental health during the COVID-19 pandemic.

Adjuvant Therapy System of COVID-19 Patient: Integrating Warning, Therapy, Post-Therapy Psychological Intervention.

The 2019 novel coronavirus(COVID-19) spreads rapidly, and the large-scale infection leads to the lack of medical resources. For the purpose of providing more reasonable medical service to COVID-19 patients, we designed an novel adjuvant therapy system integrating warning, therapy, and post-therapy psychological intervention. The system combines data analysis, communication networks and artificial intelligence(AI) to design a guidance framework for the treatment of COVID-19 patients. Specifically, in this system, we first can use blood characteristic data to help make a definite diagnosis and classify the patients. Then, the classification results, together with the blood characteristics and underlying diseases disease characteristics of the patient, can be used to assist the doctor in treat treating the patient according to AI algorithms. Moreover, after the patient is discharged from the hospital, the system can monitor the psychological and physiological state at the data collection layer. And in the data feedback layer, this system can analyze the data and report the abnormalities of the patient to the doctor through communication network. Experiments show the effectiveness of our proposed system.

SARS-CoV-2 spillover into hospital outdoor environments.

Facing the ongoing coronavirus infectious disease-2019 (COVID-19) pandemic, many studies focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in indoor environment, on solid surface or in wastewater. It remains unclear whether SARS-CoV-2 can spill over into outdoor environments and impose transmission risks to surrounding people and communities. In this study, we investigated the presence of SARS-CoV-2 by measuring viral RNA in 118 samples from outdoor environment of three hospitals in Wuhan. We detected SARS-CoV-2 in soils (205-550 copies/g), aerosols (285-1,130 copies/m3) and wastewaters (255-18,744 copies/L) in locations close to hospital departments receiving COVID-19 patients or in wastewater treatment sectors. These findings revealed a significant viral spillover in hospital outdoor environments that was possibly caused by respiratory droplets from patients or aerosolized particles from wastewater containing SARS-CoV-2. In contrast, SARS-CoV-2 was not detected in other areas or on surfaces with regular implemented disinfection. Soils may behave as viral warehouse through deposition and serve as a secondary source spreading SARS-CoV-2 for a prolonged time. For the first time, our findings demonstrate that there are high-risk areas out of expectation in hospital outdoor environments to spread SARS-CoV-2, calling for sealing of wastewater treatment unit and complete sanitation to prevent COVID-19 transmission risks.

Spatial variation of dissolved organic nitrogen in Wuhan surface waters: Correlation with the occurrence of disinfection byproducts during the COVID-19 pandemic.

Intensified sanitization practices during the recent coronavirus disease-2019 (COVID-19) led to the release of chlorine-based disinfectants in surface water, potentially triggering the formation of disinfection byproducts (DBPs) in the presence of dissolved organic nitrogen (DON). Thus, a comprehensive investigation of DON's spatial distribution and its association with DBP occurrence in the surface water is urgently needed. In this study, a total of 51 water samples were collected from two rivers and four lakes in May 2020 in Wuhan to explore the regional variation of nitrogen (N) species, DON's compositional characteristics, and the three classes of DBP occurrence. In lakes, 53.0% to 86.3% of N existed as DON, with its concentration varying between 0.3-4.0 mg N/L. In contrast, NO3--N was the dominant N species in rivers. Spectral analysis revealed that DON in the lakes contained higher humic and fulvic materials with higher A254, A253/A203, SUVA254, and PIII+IV/PI+II+V ratios, while rivers had higher levels of hydrophilic compounds. Trihalomethanes (THMs) were the most prevalent DBPs in the surface waters, followed by N-nitrosamines and haloacetonitriles (HANs). The levels of N-nitrosamines (23.1-97.4 ng/L) increased significantly after the outbreak of the COVID-19 pandemic. Excessive DON in the surface waters was responsible for the formation of N-nitrosamines. This study confirmed that the presence of DON in surface water could result in DBP formation, especially N-nitrosamines, when disinfectants were discharged into surface water during the COVID-19 pandemic.