Characterization of severe and critical COVID-19 infected individuals outside of Wuhan, China (preprint)

BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly transmissible among people，and the critical cases are still tough to treat, even leading to death. METHODS We retrospectively collected the clinical data of all the critical patients admitted to the Three Gorges Hospital(Chongqing, China) from Jan 20, 2020 to Feb 16, 2020 , whom were divided into improved group and worsen group. At last, we analyzed and compared the differences in laboratory indexes and length of hospital stay of the two groups. RESULT 46 cases were enrolled in the study. Comorbid conditions were present in 25 cases (54.3%). Most cases had symptoms, such as fever, cough, sputum, shortness of breath and dyspnea. The worsen group had a higher APACHE II score of 14(range from 5 to 23) than improved group(5, range from 3 to 7)(p<0.05). 32(69.6%) cases had low level lymphocyte counts (<1.0×109/L), including 8(66.7%) worsen group patients and 24(70.6%) improved group patients. The worsen group was 14.3(range from 8.21 to 18) with the ratio of neutrophil counts to lymphocyte counts, higher than that in improved group((7.33, range from 4.71 to 14.35)(p<0.05). There were faster respiratory frequencies in worsen group(23, range from 20 to 24.75) (p<0.05). And the worsen group had a lower OI(156.5, range from 74.25 to 233) than the other group(206, range from 177.5 to 242.75)(p<0.05). CONCLUSIONS Initial lower lymphocytes and higher APACHE II scores might be relative to the poor prognosis. And most of severe or critical patients had underlying diseases.

Keep it real: Assessing destination image congruence and its impact on tourist experience evaluations

Inaccurate promotional information about tourist destinations may result in tourists' negative evaluations. This study proposes a new approach to measure the congruence between projected and received images of a destination's attractions. Based on online textual data, this study investigates how image congruence influences tourists' evaluations of their destination experiences. Using promotional messages and reviews of attractions in Hainan, China obtained from a leading Chinese online travel agency (Ctrip) and a three-way fixed-effects regression model, this study demonstrates that image congruence positively affects tourists' appraisal of their destination experiences. External crises (e.g., the COVID-19 pandemic), the readability of promotional messages, and tourists' expertise moderate this relationship, reducing the positive impact of image congruence on tourist experience evaluation. This study bridges theoretical and empirical gaps in destination image (in)congruence research, informing tourism marketing agencies of effective promotional strategies in different contexts.

Matrix Kendall's tau in High-dimensions: A Robust Statistic for Matrix Factor Model (preprint)

In this article, we first propose generalized row/column matrix Kendall's tau for matrix-variate observations that are ubiquitous in areas such as finance and medical imaging. For a random matrix following a matrix-variate elliptically contoured distribution, we show that the eigenspaces of the proposed row/column matrix Kendall's tau coincide with those of the row/column scatter matrix respectively, with the same descending order of the eigenvalues. We perform eigenvalue decomposition to the generalized row/column matrix Kendall's tau for recovering the loading spaces of the matrix factor model. We also propose to estimate the pair of the factor numbers by exploiting the eigenvalue-ratios of the row/column matrix Kendall's tau. Theoretically, we derive the convergence rates of the estimators for loading spaces, factor scores and common components, and prove the consistency of the estimators for the factor numbers without any moment constraints on the idiosyncratic errors. Thorough simulation studies are conducted to show the higher degree of robustness of the proposed estimators over the existing ones. Analysis of a financial dataset of asset returns and a medical imaging dataset associated with COVID-19 illustrate the empirical usefulness of the proposed method.

Construction and strategies of disease prevention and control system in the new era in Shanghai

After the epidemic of novel Coronavirus Disease 2019(COVID-19), construction of disease prevention and control has become a top priority. As a pioneer in the recovery of global economy and society, Shanghai should play a fundamental role in building a comprehensive system of public health and advanced disease prevention and control in the new era. In this article, we systematically categorize the requirements for the construction of disease prevention and control system in the new era, identify the weakness and challenges during and after the epidemic, and then make suggestions. It is proposed that we should utilize the important window period of the"14th Five-Year Plan", with the"Healthy China"strategy and municipal"20 Tasks for Public Health Construction"as the starting point, to make substantial contribution to the functional orientation, investment of resources, capacity building, operational mechanism and team building, which may provide scientific evidence for the reform and development of disease prevention and control system.

Clinical Features of Hemodialysis (HD) patients confirmed with Coronavirus Disease 2019 (COVID-19): a Retrospective Case-Control Study (preprint)

Background: Since December 2019, Coronavirus Disease 2019(COVID-19) occurred in wuhan, China, and outbreaked rapidly into a global pandemic. This current poses great challenges to hemodialysis (HD) patients. Objective: To make a comprehensive evaluation and comparison between HD patients confirmed with COVID-19 and the general HD patients. Methods: HD patients confirmed with COVID-19 in Wuhan No.5 Hospital were admitted as confirmed group from Jan 10 to Mar 15, 2020. And HD patients not infected in our dialysis center were chosen as control group. General characteristics, laboratory indicators were retrospectively collected, analyzed and compared. Results: A total of 142 cases were admitted, including 43 cases in confirmed group and 99 in control group. Body mass index (BMI) was slightly lower in confirmed group than that in control group (P=0.011). The proportion of one or less underlying disease in confirmed group(51.16%) was higher than that in control group(14.14%)(P< 0.001), and the proportion of three or more underlying diseases in confirmed group(11.63%) was lower than that in control group(52.53%)(P< 0.001). Patients in confirmed group exhibited significantly lower hemoglobin, lymphocyte count, and lymphocyte percentage, but higher neutrophil percentage, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, aspartate transaminase, and alkaline phosphatase. There was no significant difference in age, gender, dialysis age, primary disease, the using of ACEI/ARB, platelet-to-lymphocyte ratio (PLR) , and other indicators between the two groups. Conclusions: Faced with Severe Acute Respiratory Syndrome-CoV-2 (SARS-CoV-2), HD patients with lower BMI and hemoglobin were more susceptible to be infected, which might be related to malnutrition. Once confirmed with COVID-19, HD patients expressed obviously disregulated in inflammation and immune.

Opinions on the corona virus disease 2019 / 重庆医学

The corona virus disease 2019 (COVID-19) has drawn much attention lately. It has the characteristics of hidden infection sources, diverse transmission channels, great differences in clinical characteristics and limited diagnostic methods. Additionally, the population is generally susceptible, and no specific medicines are available now, therefore, the prevention and control of the disease faces greater challenges. Mastering the characteristics of it for comprehensive prevention and control is the main strategy against the disease. This article systematically expounded the latest understanding of the disease.