How Course Support and Academic Support Impact on Chinese Graduate Students during the COVID-19: The Multiple Mediating Roles of Thesis Writing and Anxiety.

Because of the impact of the COVID-19 pandemic, the learning style of graduate students has changed considerably, making them more susceptible to psychological problems. This study aimed to explore the mediating roles of thesis writing and anxiety between course support (including course-arrangement, course-assessment, and course-learning), academic support (including academic exchange with colleges, tutors and schoolmates) and depression. There were 3137 graduate students investigated by self-developed Graduate Students' Academic Affected Questionnaire, Self-Rating Anxiety Scale and Self-Rating Depression Scale. The results showed that (1) 82% of graduate students reported their course support, academic support and thesis writing were affected to varying degrees; (2) course support and academic support correlated with thesis writing, anxiety and depression (p < 0.001); (3) the mediation model fitted well, the mediating effect of anxiety between academic support and depression was significant (ß = 0.086, SE = 0.02, p < 0.001), the serial multiple mediating effects of thesis writing and anxiety between academic support and depression were significant (ß = 0.02, SE = 0.008, p = 0.013) and the serial multiple mediating effects of thesis writing and anxiety between course support and depression were also found to be significant (ß = 0.014, SE = 0.006, p = 0.014).

Associations of medications used during hospitalization and immunological changes in patients with COVID-19 during 3-month follow-up.

BACKGROUND: Understanding the immunological responses in COVID-19 patients during their recovery period is essential to the development of a vaccine and herd immunity. METHODS: This retrospective cohort study screened 233 patients admitted to the First Hospital of Changsha, China with COVID-19 from January 17th to February 29th, 2020. After completion of SARS-CoV2-specific immunoglobulins, and T cells tests at 2-week and 3-month follow-up points after discharge, 87 were enrolled. Wilcoxon signed-rank test was performed to assess changes in the values of IgG and IgM, the number of CD3+, CD4+ and CD8+ T cells, and CD4+/CD8+ ratio during the 3-month follow-up. Linear regressions were used to evaluate the associations of immunological changes and medications during hospitalization. RESULTS: The positive rate of IgG decreased from 98.6% (40/41) to 85.4% (35/41) in men and 100% (43/43) to 76.7% (33/43) in women, whereas IgM declined from 34.1% (14/41) to 12.2% (5/41) in men and 37.2% (16/43) to 27.9% (12/43) in women during the follow-up. CD4+ T cells increased from (median (IQR), 484 (384-635)) cells/ul to 543 (414-657) cells/ul (P = 0.01). Antibiotic use was negatively associated with IgG change (mean change [95%CI], 8.08 [0.80-15.37] U, P = 0.03), and glucocorticoid use was positively related to increased CD4+ T cells (100.85 [16.56-185.15] cells/ul, P = 0.02). CONCLUSION: This study demonstrated that the positive rates and values of IgG and IgM decreased in COVID-19 patients over a 3-month follow-up, while CD4+ T cells significantly increased. Moreover, we found that antibiotic use during hospitalization was associated with IgG decrease, and glucocorticoid use was associated with increases in CD4+ T cells.