A retrospective clinical study in Graves disease with COVID-19 infection in China (preprint)

Background Corona Virus Disease 2019 (COVID-19) is the most prevalent global pandemic in recent times. Graves disease (GD), an autoimmune thyroid disease, is a clinical syndrome caused by excessive thyroid hormones. Our study is to understand the current epidemiological situation of COVID-19 infection in GD patients, and to analyze whether COVID-19 will affect the thyroid function, thyroid autoantibody and metabolism of GD patients.Methods 109 GD patients were followed by Shanghai General Hospital Thyroid Disease Center (TDC) from November 2022 to June 2023. There were three groups defined, i.e., pre, one-month after and three months after infection with COVID-19. SPSS was used to analyze the recruited data.Results 109 GD patients are infected with COVID-19 (72.48%), uncontrolled GD patients with high FT3 had a higher COVID-19 infection rate (79.31%). As for thyroid function in 35 GD patients with antithyroid drug (ATD) maintenance stage, there were significant differences in FT3, FT4, TT3 and TT4 before and after being infected with COVID-19. What’s more, there’s a significant difference between GD patients in one month and three months after COVID-19 infection of high TSAb group (p = 0.048) but no significant difference between pre and one month. What’s more, there were significant differences in TT3, TT4 of GD patients after infected COVID-19 in non. And Phosphorus (P), 25-hydroxyvitamin D (25-OH-D3), Procollagen type 1 N-terminal propeptide (P1NP) in GD patients were be affected by COVID-19 infection.Conclusion GD patients with uncontrolled thyroid function group are susceptible to COVID-19. COVID-19 may affect the thyroid function of GD in TT3, TT4, TSAb high level group infection. COVID-19 vaccine is conducive to the stability of GD patients' condition. And COVID-19 may affect the bone metabolism in GD patients before and after COVID-19 infection. But there is no effect on glucose metabolism or lipid metabolism.

The impact of COVID-19 prevention and control policy adjustment on anxiety, depression and coping behavior in China: a Cross-sectional Online Survey, 21-28 December, 2022 (preprint)

Background Following external situation reports, individuals perceive risks, experience different emotional reactions, and further change their behaviors. Therefor people's psychological state will also be affected by the change after the adjustment of COVID-19 epidemic prevention and control policy, and it remains unknown what kind of coping behaviors will be produced due to emotional reactions. This study focuses on assessing the prevalence of negative emotions in the Chinese population after policy adjustments and explores how negative emotions affect people's coping behaviors.Methods A cross-sectional online survey was conducted during 21–28 December 2022, included sociodemographic characteristics, COVID-19 infection and irrational purchase behavior, psychological assessment, and opinion polling. Depression and anxiety status are assessed by PHQ-9 and GAD-7, Coping behavior is defined as " medical behavior and irrational consumption behavior after the adjustment of COVID-19 epidemic prevention and control policy in China". The relationship between anxiety, depression and coping behavior was analyzed by Pearson χ2 test, Fisher's exact test and logistic regression.Results A total of 3995 participants who reported infection with COVID-19 were included in this study, of which 2363 (59.1%) and 1194 (29.9%) had symptoms of depression and anxiety, respectively. According to the results of the Pearson χ2 test, there was a significant difference in clinical treatment (such as self- medication, seeking professional treatment, using online services of medical institutions) and irrational purchase behavior (such as large-scale purchases of medicines, masks) between different level of depression and anxiety. Logistic regression results show that depression was a risk factor for self- medication (OR = 1.254, 95%CI: 1.124 ~ 1.399), seeking professional treatment (OR = 1.215, 95%CI: 1.017 ~ 1.451), using online services of medical institutions (OR = 1.320, 95%CI: 1.159 ~ 1.503), large-scale purchases of medicines (OR = 1.154, 95%CI: 1.083 ~ 1.230) and masks (OR = 1.096, 95%CI: 1.005 ~ 1.196). Anxiety was a risk factor for seeking professional treatment(OR = 1.285, 95%CI: 1.009 ~ 1.636) and large-scale purchases of masks (OR = 1.168, 95%CI: 1.028 ~ 1.327).Conclusion Affected by depression, COVID-19 patients are more likely to have medical behaviors such as self- medication, seeking professional treatment, and using online services of medical institutions, which may also trigger their storage behaviors of medicines and masks; on the other hand, anxiety will trigger the coping behavior of patients to seek professional treatment and store masks in large quantities. Attention should be paid to expand mental health screening and guidance in community health institutions, and to carry out COVID-19 health education for depressed or anxious people, in order to reduce adverse drug reactions, avoid panic seeking professional treatment and irrational purchase behavior, and protect the mental health of the public.Trial registration: This study has been approved by the Medical Ethics Committee of Capital Medical University (2023SY086), and informed consent was obtained from the study subjects before the investigation.