Lessons on the COVID-19 pandemic: who are the most affected.

The COVID-19 pandemic has led to significant changes in work and lifestyle, impacting occupational mental health. This study examines the time and individual heterogeneity in the pandemic's effects on occupational mental health using panel data from job stress checks spanning 2018 to 2021. On average, there was an initial alleviation of high-stress risk in 2020, followed by a deterioration in 2021. Based on the job demand-resource theory, we identify the group of employees most affected by the pandemic. The findings highlight that employees in unfavorable workplace conditions are more likely to experience substantial adverse impacts. Adequate workplace support, including factors like interpersonal relationships, managerial support, job meaning, control, and work-life balance, is crucial for mitigating high-stress risk. Additionally, during the early phase of the pandemic, engaged employees experienced a slight decline in occupational mental health, while those lacking job resources at their worksite faced higher levels of occupational stress in the subsequent year. These findings offer practical suggestions for person-centered coping strategies to mitigate the pandemic's adverse impact.

Effectiveness of online expressive writing in reducing psychological distress among the asymptomatic COVID-19 patients in Fangcang Hospitals: A quasi-experiment study.

Objective: This study aimed to assess the applicability and effectiveness of an online format of expressive writing (EW) in reducing psychological distress among the asymptomatic COVID-19 patients in Fangcang Hospitals with a quasi-experiment. Method: Altogether 244 patients were assigned to the EW group(n=122) and the control group(n=122). Besides the routine psychological intervention (broadcast relaxation training at a fixed time) in Fangcang hospitals, The EW group was engaged in 8-day theme-based adaption EW intervention, whereas the control group received no interventions. All the participants were tested with the Brief Profile of Mood States (BPOMS) and Inpatient Mental Health Preliminary Screening Scale(IMHPS) before and after the intervention. After the intervention, the writing quality and intervention satisfaction of the EW group were evaluated by a self-designed writing quality questionnaire and EW satisfaction questionnaire. Results: The results indicated that the EW significantly improved in the BPOMS test, whereas the control group showed no significant change. The IMHPS score in the control group was statistically deteriorated than that before intervention, whereas the EW group showed no significant change. The writing quality was highly correlated with the score change of BPMOS. The overall satisfaction of patients with EW was 81.13%. Conclusion: EW can reduce psychological distress among the asymptomatic COVID-19 patients in Fangcang Hospitals. The higher the quality of writing, the greater the improvement of mood states. As a new form of psychological intervention in Fangcang hospitals with high patient satisfaction, EW has a value of popularization and application.

Seeing the big picture during the COVID-19 pandemic: the spillover effects of visionary leadership on employees' work-to-family conflict.

While an expanding body of research has revealed the beneficial impacts of visionary leadership on employees' work-related outcomes, little is known about its spillover effects on nonwork domains. Drawing upon work-home resources theory, we investigated the impacts of visionary leadership on employees' work-to-family conflict (WFC). Utilizing three-wave data from 268 employees, the results indicate that visionary leadership promotes follower relational energy, which in turn reduces WFC. Furthermore, perceived COVID-19 crisis disruption was found to strengthen the negative indirect link between visionary leadership and employees' WFC. Our research broadens our understanding of the potential positive spillover effects of visionary leadership in the nonwork domain through relational energy, and the accentuating effect of perceived crisis disruption on the work-family interface. The theoretical and managerial implications of these findings are discussed.

The relationship between the sources of confidence in overcoming COVID-19 and the improvement of medical students' professional identity: mediation by medical students' attention to COVID-19.

BACKGROUND: The prevalence of COVID-19 highlights the shortage of human medical resources, and improving medical students' professional identity is crucial to improving this situation. The sources of confidence in overcoming COVID-19 and medical students' attention to COVID-19 were significant factors affecting their professional identity. However, no study has investigated the mediating role of medical students' attention to COVID-19 in their relationship. This study investigates the relationship between these three factors in three medical university students in Hunan Province. METHODS: A cross-sectional survey study that used convenience sampling method was conducted on 2775 medical students from three universities in the Hunan Province of China from March 15 to April 19, 2020. An intermediary model was established to evaluate the role of medical students' attention to COVID-19 in the sources of confidence in overcoming COVID-19 and the improvement of medical students' professional identity. RESULTS: The sources of confidence in overcoming COVID-19, medical students' attention to national crisis events, and the improvement of medical students' professional identity was positively associated with each other (ß = 0.328 ~ 0.464, P < 0.001). The mediating effect accounted for 23.3% of the total effect and 30.4% of the direct effect. Medical students' attention to COVID-19 partially mediates the relationship between the sources of confidence to overcome COVID-19 and the improvement of medical students' professional identity. CONCLUSIONS: This study found that the sources of confidence in overcoming COVID-19 and medical students' attention to national crisis events have a significant predictive effect on the improvement of medical students' professional identity. Medical students' attention to COVID-19 mediated the relationship between the sources of confidence to overcome COVID-19 and the improvement of medical students' professional identity. The findings have emphasized the theoretical and practical significance of professional identity education for medical students.

Seeing the big picture during the COVID-19 pandemic: the spillover effects of visionary leadership on employees’ work-to-family conflict

While an expanding body of research has revealed the beneficial impacts of visionary leadership on employees’ work-related outcomes, little is known about its spillover effects on nonwork domains. Drawing upon work–home resources theory, we investigated the impacts of visionary leadership on employees’ work-to-family conflict (WFC). Utilizing three-wave data from 268 employees, the results indicate that visionary leadership promotes follower relational energy, which in turn reduces WFC. Furthermore, perceived COVID-19 crisis disruption was found to strengthen the negative indirect link between visionary leadership and employees’ WFC. Our research broadens our understanding of the potential positive spillover effects of visionary leadership in the nonwork domain through relational energy, and the accentuating effect of perceived crisis disruption on the work–family interface. The theoretical and managerial implications of these findings are discussed.

Occupational stress: evidence from industries affected by COVID-19 in Japan.

BACKGROUND: This study provides objective evidence on the impact of COVID-19 based on employee occupational stress reported from 13 different industries, and examines the determinants of employee psychological well-being. As the economic and social impacts of the COVID-19 pandemic continue, governments should consider industry-level differences when making support decisions concerning public resource allocation to corporations. However, little evidence exists regarding the differences in occupational stress across industries. METHODS: Employee occupational stress data (N = 673,071) was derived from workers in Japan from 2018 to 2020. The sample comprises workers from 13 industries, including civil services, service industry (other), real estate, medical/welfare, wholesale/retail, academic research, and accommodation/restaurant business. A logit model is employed to investigate the differences in employees' psychological well-being before and during the pandemic. RESULTS: In 2020, 11 out of 12 industries had significantly worse occupational stress compared to employees engaged in civil services. Over 23% of employees from the wholesale/retail and accommodation/restaurant industries were observed as high-stress employees. Improved compensation policies supporting these industries are suggested. In contrast, reduced occupational stress was found among employees in the transportation/postal and information/communication industries. Among the 13 industries, aside from high job demands, tough inter-person relationships in the workplace became the most significant stressors during the pandemic. CONCLUSIONS: The results confirm that the pandemic has had a heterogeneous effect on employee occupational stress across industries, thus suggesting that the level of compensation given to different industries during the COVID-19 pandemic should be discussed and approved by the Japanese government. Additionally, support for the wholesale/retail and accommodation/restaurant industries during the pandemic should be improved.

Coronavirus disease 2019 epidemic prediction in Shanghai under the "dynamic zero-COVID policy" using time-dependent SEAIQR model.

It's urgently needed to assess the COVID-19 epidemic under the "dynamic zero-COVID policy" in China, which provides a scientific basis for evaluating the effectiveness of this strategy in COVID-19 control. Here, we developed a time-dependent susceptible-exposed-asymptomatic-infected-quarantined-removed (SEAIQR) model with stage-specific interventions based on recent Shanghai epidemic data, considering a large number of asymptomatic infectious, the changing parameters, and control procedures. The data collected from March 1st, 2022 to April 15th, 2022 were used to fit the model, and the data of subsequent 7 days and 14 days were used to evaluate the model performance of forecasting. We then calculated the effective regeneration number (R t) and analyzed the sensitivity of different measures scenarios. Asymptomatic infectious accounts for the vast majority of the outbreaks in Shanghai, and Pudong is the district with the most positive cases. The peak of newly confirmed cases and newly asymptomatic infectious predicted by the SEAIQR model would appear on April 13th, 2022, with 1963 and 28,502 cases, respectively, and zero community transmission may be achieved in early to mid-May. The prediction errors for newly confirmed cases were considered to be reasonable, and newly asymptomatic infectious were considered to be good between April 16th to 22nd and reasonable between April 16th to 29th. The final ranges of cumulative confirmed cases and cumulative asymptomatic infectious predicted in this round of the epidemic were 26,477 âˆ¼ 47,749 and 402,254 âˆ¼ 730,176, respectively. At the beginning of the outbreak, R t was 6.69. Since the implementation of comprehensive control, R t showed a gradual downward trend, dropping to below 1.0 on April 15th, 2022. With the early implementation of control measures and the improvement of quarantine rate, recovery rate, and immunity threshold, the peak number of infections will continue to decrease, whereas the earlier the control is implemented, the earlier the turning point of the epidemic will arrive. The proposed time-dependent SEAIQR dynamic model fits and forecasts the epidemic well, which can provide a reference for decision making of the "dynamic zero-COVID policy".

SARS-CoV-2 variant B.1.1.7 caused HLA-A2+ CD8+ T cell epitope mutations for impaired cellular immune response.

Here, we evaluated the immune properties of the HLA-A2 restricted CD8+ T cell epitopes containing mutations from B.1.1.7, and furthermore performed a comprehensive analysis of the SARS-CoV-2 specific CD8+ T cell responses from COVID-19 convalescent patients and SARS-CoV-2 vaccinees recognizing the ancestral Wuhan strain compared to B.1.1.7. First, most of the predicted CD8+ T cell epitopes showed proper binding with HLA-A2, whereas epitopes from B.1.1.7 had lower binding capability than those from the ancestral strain. In addition, these peptides could effectively induce the activation and cytotoxicity of CD8+ T cells. Our results further showed that at least two site mutations in B.1.1.7 resulted in a decrease in CD8+ T cell activation and a possible immune evasion, namely A1708D mutation in ORF1ab1707-1716 and I2230T mutation in ORF1ab2230-2238. Our current analysis provides information that contributes to the understanding of SARS-CoV-2-specific CD8+ T cell responses elicited by infection of mutated strains or vaccination.

Research progress on potential drug interactions of anti-Coronavirus disease 2019 drugs

From the December 2019, coronavirus disease 2019 (COVID-19) was outbreak at home and abroad. Besides antiviral therapy, patients should be treated for complications, therefore a combination of drugs for treatment in Clinic need to be taken. Although recently published guidelines have repeatedly highlighted the drug interactions between the anti-COVID-l 9 medicines, it has not been detailed. The potential drug - drug interactions were reviewed 0f the anti-COVID-19 drugs, and in order to provide references for the clinical safety and rational use of the anti-COVID-19 drugs.

Development and Validation of a Nomogram for Predicting the Disease Progression of Nonsevere Coronavirus Disease 2019.

BACKGROUND AND OBJECTIVES: The majority of coronavirus disease 2019 (COVID-19) cases are nonsevere, but severe cases have high mortality and need early detection and treatment. We aimed to develop a nomogram to predict the disease progression of nonsevere COVID-19 based on simple data that can be easily obtained even in primary medical institutions. METHODS: In this retrospective, multicenter cohort study, we extracted data from initial simple medical evaluations of 495 COVID-19 patients randomized (2:1) into a development cohort and a validation cohort. The progression of nonsevere COVID-19 was recorded as the primary outcome. We built a nomogram with the development cohort and tested its performance in the validation cohort. RESULTS: The nomogram was developed with the nine factors included in the final model. The area under the curve (AUC) of the nomogram scoring system for predicting the progression of nonsevere COVID-19 into severe COVID-19 was 0.875 and 0.821 in the development cohort and validation cohort, respectively. The nomogram achieved a good concordance index for predicting the progression of nonsevere COVID-19 cases in the development and validation cohorts (concordance index of 0.875 in the development cohort and 0.821 in the validation cohort) and had well-fitted calibration curves showing good agreement between the estimates and the actual endpoint events. CONCLUSIONS: The proposed nomogram built with a simplified index might help to predict the progression of nonsevere COVID-19; thus, COVID-19 with a high risk of disease progression could be identified in time, allowing an appropriate therapeutic choice according to the potential disease severity.

Treatment strategies of hospitalized patients with coronavirus disease-19.

With the outbreak of coronavirus disease-19 (COVID-19), Changsha faced an increasing burden of treating the Wuhan migrants and their infected patients. This study is a retrospective, single-center case series of the 238 consecutive hospitalized patients with confirmed COVID-19 at the First Hospital of Changsha city, China, from 01/21 to 02/14, 2020; the final date of follow-up was 02/27, 2020. Of 238 patients 43.7% visited Wuhan, 58.4% got in touch with Wuhan people, and 47.5% had contacted with diagnosed patients. 37.8% patients had family members infected. 190 cases had mild / general disease, and 48 cases had severe / critical disease. Compared to mild or general patients, more severe or critical patients visited Wuhan (59.6% vs 40.2%; P=0.02) and contacted with Wuhan people (74.5% vs 55.0%; P=0.02). All patients received antiviral treatment, including Lopinavir / Ritonavir (29.3%), Interferon (14.6%) and their combination (40.6%), Arbidol (6.7%), Xuebijing (7.1%) and Chloroquine phosphate (1.3%). Severe and critical patients received glucocorticoid, Gamma-globulin and oxygen inhalation. Some received mechanic ventilation support. As of 02/27, 161 patients discharged. The median length of hospital stay was 13 days. The 10-, 14-, 20- and 28-day discharge rate was 19.1%, 42.8%, 65.0% and 76.4%, respectively. No hospital-related transmission was observed.

Psychological Health Issues of Medical Staff During the COVID-19 Outbreak.

Background: The outbreak of novel coronavirus disease 2019 (COVID-19) has caused public panic and psychological health problems, especially in medical staff. We aimed to investigate the psychological effect of the COVID-19 outbreak on medical staff. Methods: A cross-sectional study was conducted to examine the psychological impact of medical staff working in COVID-19 designated hospitals from February to March 2020 in China. We assessed psychological health problems using the Symptom Check List 90 (SCL-90). Results: Among 656 medical staff, 244 were frontline medical staff and 412 general medical staff. The prevalence of psychological health problems was 19.7%. The SCL-90 scores in frontline medical staff were significantly higher than that in general medical staff (mean: 141.22 vs. 129.54, P < 0.05). Furthermore, gender [odds ratio (OR) = 1.53, 95% CI = (1.02, 2.30), P = 0.042 for female vs. male] and the burden of current work [OR = 7.55, 95% CI = (3.75, 15.21), P < 0.001 for high burden; OR = 2.76, 95% CI = (1.80, 4.24), P < 0.001 for moderate burden vs. low burden] were associated with increased risk of poor psychological status. Conclusions: Medical staff experienced a high risk of psychological health problems during the outbreak of COVID-19, especially for frontline medical staff. Psychological health services are expected to arrange for medical staff in future unexpected infectious disease outbreaks.

Diverse immunoglobulin gene usage and convergent epitope targeting in neutralizing antibody responses to SARS-CoV-2.

It is unclear whether individuals with enormous diversity in B cell receptor repertoires are consistently able to mount effective antibody responses against SARS-CoV-2. We analyzed antibody responses in a cohort of 55 convalescent patients and isolated 54 potent neutralizing monoclonal antibodies (mAbs). While most of the mAbs target the angiotensin-converting enzyme 2 (ACE2) binding surface on the receptor binding domain (RBD) of SARS-CoV-2 spike protein, mAb 47D1 binds only to one side of the receptor binding surface on the RBD. Neutralization by 47D1 is achieved independent of interfering RBD-ACE2 binding. A crystal structure of the mAb-RBD complex shows that the IF motif at the tip of 47D1 CDR H2 interacts with a hydrophobic pocket in the RBD. Diverse immunoglobulin gene usage and convergent epitope targeting characterize neutralizing antibody responses to SARS-CoV-2, suggesting that vaccines that effectively present the receptor binding site on the RBD will likely elicit neutralizing antibody responses in a large fraction of the population.

Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID-19.

BACKGROUND: The impacts of chronic airway diseases on coronavirus disease 2019 (COVID-19) are far from understood. OBJECTIVE: To explore the influence of asthma and chronic obstructive pulmonary disease (COPD) comorbidity on disease expression and outcomes, and the potential underlying mechanisms in COVID-19 patients. METHODS: A total of 961 hospitalized COVID-19 patients with a definite clinical outcome (death or discharge) were retrospectively enrolled. Demographic and clinical information were extracted from the medical records. Lung tissue sections from patients suffering from lung cancer were used for immunohistochemistry study of angiotensin-converting enzyme II (ACE2) expression. BEAS-2B cell line was stimulated with various cytokines. RESULTS: In this cohort, 21 subjects (2.2%) had COPD and 22 (2.3%) had asthma. After adjusting for confounding factors, COPD patients had higher risk of developing severe illness (OR: 23.433; 95% CI 1.525-360.135; P < .01) and acute respiratory distress syndrome (OR: 19.762; 95% CI 1.461-267.369; P = .025) than asthmatics. COPD patients, particularly those with severe COVID-19, had lower counts of CD4+ T and CD8+ T cells and B cells and higher levels of TNF-α, IL-2 receptor, IL-10, IL-8, and IL-6 than asthmatics. COPD patients had increased, whereas asthmatics had decreased ACE2 protein expression in lower airways, compared with that in control subjects without asthma and COPD. IL-4 and IL-13 downregulated, but TNF-α, IL-12, and IL-17A upregulated ACE2 expression in BEAS-2B cells. CONCLUSION: Patients with asthma and COPD likely have different risk of severe COVID-19, which may be associated with different ACE2 expression.

Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019.

Health professions preventing and controlling Coronavirus Disease 2019 are prone to skin and mucous membrane injury, which may cause acute and chronic dermatitis, secondary infection and aggravation of underlying skin diseases. This is a consensus of Chinese experts on protective measures and advice on hand-cleaning- and medical-glove-related hand protection, mask- and goggles-related face protection, UV-related protection, eye protection, nasal and oral mucosa protection, outer ear, and hair protection. It is necessary to strictly follow standards of wearing protective equipment and specification of sterilizing and cleaning. Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection.

Follow-up Study of Long-time Positive RT-PCR in Stool Specimens From Asymptomatic Children Infected With SARS-CoV-2.

In the current study, we report on 4 children with confirmed SARS-CoV-2 infection, of which 3 of them were asymptomatic. These patients had both pharyngeal swabs and anal swabs testing during hospital or after discharge. All the 4 children showed long-time positive viral RNA in the stool specimens after pharyngeal swabs turned negative during the follow-up stage, especially in the asymptomatic children. The positive RNA in stool specimens of asymptomatic children last for more than 54 days after admission or 30 days after discharge.